Shared Flashcard Set

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EMT
NREMT prep questions
112
Medical
Beginner
12/11/2016

Additional Medical Flashcards

 


 

Cards

Term
You are called to an unknown injury that occurred during a domestic dispute. You arrive to find a woman severely wounded by a blunt object. The police are talking to the man who assaulted the patient. As you are about to leave, you turn and punch the man in the face. What type of legal charges could you face from your actions?
Battery
Assault
Negligence
Abuse
Definition
Battery is the actual, intentional striking of someone, with intent to harm. Assault is carried out by a threat of bodily harm.
Term
You are responding as a part of a strike team to a bombing at a college stadium. You are driving a type III ambulance with lights and sirens on. What type of apparatus would be responding with you in your strike team?
Fire engines
Police cars
Special rescue teams
Ambulances
Definition
Ambulances
A strike team is organized to include the same kind and type of resource. Each strike team should have a designated leader and have the ability to communicate between all single resources in the team. A strike team may be a part of a task force.
Term
Which of the following will occur to a pregnant female's blood pressure in the second trimester?
It will drop significantly
It will raise significantly
Nothing will change
It will drop roughly 10-15 mmHg both systolically and diastolically
Definition
It will drop roughly 10-15 mmHg both systolically and diastolically
Term
When helping a patient deliver her baby in the field, you should coach her to push for ____ seconds and rest for ____ seconds.
5, 30
10, 10
30, 30
30, 60
Definition
Encourage the patient to push when she feels the urge to. Coach her to push for 10 seconds and then rest for 10 seconds. Pushing longer can cause tearing or blood vessel damage.
Term
When obtaining a history from a patient with a psychiatric illness, what kind of questions should you ask?
Non-specific, open-ended questions
Specific, open-ended questions
Non-specific, close-ended questions
Specific, close-ended questions
Definition
You should ask questions that pertain to the current situation but that cannot be answered with a simple "yes" or "no." This will allow the patient to explain what they are doing or feeling while still being pertinent to the current situation.
Term
A 1-year-old girl has swallowed an unknown amount of bleach. She is now crying and has vomited once. Which of the following is correct about Activated Charcoal?
Should be given if the girl can swallow without endangering her airway
Should be given if approved by medical direction
Should be given only if the girl vomits a second time
Should not be given in this case
Definition
Activated charcoal should not be given since the child swallowed bleach, because it is an alkaline base, and is therefore contraindicated.
Term
You have been dispatched for a 5-year-old male in respiratory distress in late January. The patient's mother states that she originally thought he just had a head cold but his condition has worsened and he is having trouble breathing now. Assessment of the patient reveals: BP 114/70, HR 90, RR 36 and labored, SpO2 93%. Bilateral wheezing is heard upon auscultation of lung sounds. What do you think is wrong with your patient?
Mononucleosis
Respiratory syncytial virus
Croup
Epiglottis
Definition
Respiratory syncytial virus is a common pediatric illness that occurs during winter and early spring. It is characterized by cold-like symptoms early on that progress to moderate-to-severe respiratory symptoms including increased respiratory rate, wheezing, and respiratory distress.
Term
Your ALS partner suspects the patient you are treating is experiencing cardiogenic shock. Which of the following presentations would your patient most likely not have?
Chest pain
Slow heart rate
Pulmonary edema with wheezes or rhales
Hives
Definition
Hives
Term
Which of the following reasons could be the cause of a falsely low pulse oximetry reading?
Hyperthermia
Anemia
Carbon Monoxide Poisoning
Cold extremities
Definition
Cold extremities often mean poor circulation. That can be the underlying cause of a falsely low pulse oximetry readings.
Term
You have been dispatched for "chest pain" at a local park. Your patient is a 52-year-old male who was playing in his recreational basketball league when he experienced sudden-onset, crushing chest pain. Your patient laid down on the court after becoming dizzy and vomiting. Vitals: P 81, BP 140/70, SpO2 99%, RR 18. The patient denies all other complaints other than chest pain. The patient also denies use of ED drugs. Which of the following is not indicated for this patient?
High-flow oxygen
Nitroglycerin
Aspirin
Cardiac monitoring
Definition
The patient is having chest pain and denies ED drug use - ASA, NTG, and cardiac monitoring are all indicated for this patient. The patient is not having difficulty breathing and his SpO2 is at 99% - oxygen is not indicated, especially high-flow oxygen.
Term
All of the following would be considered things to avoid when doing CPR, except for?
Compress the chest at a rate of 150/min
Compress the chest at a depth of 1 - 1.5 inches
Lean on the chest between compressions
Minimize pauses in compressions
Definition
Minimize pauses in compressions
Term
You arrive on the scene of a bicycle accident, where the cyclist was not wearing a helmet. His airway is obstructed by blood. He is unresponsive and making gurgling sounds. Your next course of action should be to?
Suction using a flexible suction catheter.
Suction using a rigid-tip catheter.
Open the airway with a head-tilt chin-lift and see if gurgling sounds continue
Reposition the airway with a modified jaw-thrust maneuver and see if gurgling sounds continue
Definition
The patient's airway must immediately be suctioned. There is no reason to use a flexible suction catheter, so a rigid-tip catheter should be used.
Term
Which of the following statements regarding the head tilt-chin lift maneuver is most accurate?
It can only be used in conjunction with an OPA
It should be used on all unresponsive patients
It is the best choice for patients with spinal injuries
It can only be used temporarily and must be replaced by an airway adjunct.
Definition
It can only be used temporarily and must be replaced by an airway adjunct.
The head tilt-chin lift maneuver is never used when you suspect a spinal injury. It is a helpful method of opening a patient's airway, but its important to use an OPA or NPA for a more reliable method.
Term
Which of the following is not a type of airway obstruction?
Partial with good air exchange
Partial with poor air exchange
Complete
Incomplete
Definition
Incomplete
All of the above are accepted terms except incomplete for the types of airway obstructions.
Term
You arrive at the local elementary school where a 10-year-old male fell from a piece of play equipment, approximately ten feet to the ground. His respirations are shallow at 44 breaths/min, his right leg is deformed, and he isn't responding appropriately to commands. Your first priority is to?
Splint the injured leg
Spinal immobilization and rapid transport
Obtain parental consent prior to treatment
Apply a c-collar and ventilate with a BVM and supplemental oxygen
Definition
Apply a c-collar and ventilate with a BVM and supplemental oxygen
With this patient, you have implied consent to treat him. This patient needs spinal precautions and ventilations immediately.
Term
Which of the following early signs of shock is easily missed?
Decrease in respiratory rate and volume
Narrowing pulse pressures
Tachycardia
Decrease in Blood Pressure
Definition
It is common for EMS providers to overlook tachycardia as an early sign of shock as other signs/symptoms appear normal.
Term
You are treating a 4-year-old male with burns to his head, neck, both arms, and anterior/posterior torso. What percentage of body surface area is burned?
40
63
72
80.5
Definition
Remember, there are slight differences between adults and children. Using the rule of nines, we give the following percentages: head - 18, anterior torso - 18, posterior torso - 18, each arm - 9. 18+18+18+9+9 = 72. Using this method, the neck does not get any additional surface area added.
Term
You are assessing a 72-year-old female's GCS score. She's looking at you when answering questions, but appears confused by what you're asking. She is able to follow simple commands when you ask her to adjust her body when taking vital signs. What is this patient's GCS score?
10
12
14
15
Definition
14. There are 15 total points. For eyes - she received a 4/4. For verbal - she receives a 4/5 because of the confusion. For motor - she receives a 6/6.
Term
You are dispatched for a 65-year-old woman who had a ground level fall. She is lying on the kitchen floor and tracks you as you walk into the house. When you ask the patient what happened today, she responds with clear, but confused speech. The chief complaint is right foot pain. As you lean down and palpate her foot, she attempts to pull her leg away from you. With all of this information in mind, what is the patient's Glasgow Coma Scale (GCS) score?
9
12
5
10
Definition
12. The woman has spontaneous eye movement (4), has confused speech (4), and withdraws from painful stimuli (4).
Term
When you arrive to the report of a nosebleed, your 26-year-old female patient is acting very anxious and neurotic, screaming, My nose won't stop bleeding! What is this patient's GCS score?
10
12
13
15
Definition
15. Eyes: 4. Verbal: 5. Motor: 6
Term
You are assessing a 23-year-old female who was involved in a motor vehicle collision. She is unconscious and has no eye or verbal response to painful stimuli. However, when you place her on a backboard, you notice that she is flexing her arms. What is this patient's GCS score?
3
5
8
10
Definition
Flexion of the arms is also known as decorticate posturing and will be given a 3 on the GCS scale. No verbal response gets a 1. No eye movement gets a 1. A score this low is indicative of a very serious patient.
Term
You are on scene at the local skate park for a 10-year-old male that crashed while not wearing a helmet. The patient fell off his bike while going off a jump. He landed directly on his head and has been unconscious since the accident. He does not open his eyes to verbal or painful stimuli, is making incomprehensible sounds, and has abnormal flexion to a sternal rub. What is this patient's GCS?
3
15
6
9
Definition
No eye movement is a score of 1 for eye response. Incomprehensible sounds is a score of 2 for verbal response. Decorticate posturing (abnormal flexion) is a score of 3 for motor response. 1+2+3 = 6.
Term
What is the pneumonic AEIOU TIPS used for?
Soft tissue injuries
Common symptoms associated with a head injury
Components of the Cincinnati Stroke Assessment
Reasons for why a patient is unconscious
Definition
AEIOU TIPS is commonly used to help determine the cause for potential reasons for why a patient is unconscious, Alcohol, Epilepsy, Insulin, Oxygen, Uremia, Toxins, Infections, Psych, and Stroke.
Term
You get dispatched to a 3-year-old male who was found pulseless and apneic. Based on this information, what is this child's GCS score?
3
4
5
6
Definition
Eyes: 1. Verbal: 1. Motor: 1. Total = 3
Term
You arrive on scene to find an elderly male, who after your assessment, appears to be having an extrapyramidal reaction. His eyes are fixed to the right, and moans when you ask him a question. His arms, legs, hands, and feet, are fixed inward. What is his GCS score?
3
4
5
6
Definition
Eye: 1, Verbal: 2, Motor: 3
Term
The V in AVPU stands for what?
Definition
AVPU stands for Alert, Verbal, Pain, and Unconscious. It is used to measure a patient's mental status.
Term
our partner is attempting to stimulate an 8-month-old baby boy who was found in respiratory distress. 15 minutes before you got to him. The baby opens his eyes when you call out its name, however, it's only in between inconsolable crying. The baby appears to be moving normally. What is the baby's GCS score?

10
12
13
14
Definition
12
Term
Your patient is a term neonate that is experiencing a sinus infection. You know that a term neonate is a baby that is 0 to how many days old?
7
14
21
28
Definition
A term neonate is any child who is 0 to 28 days old.
Term
APGAR scores are first measured how many minutes after birth?
1 minute
2 minutes
3 minutes
5 minutes
Definition
1 minute
Term
APGAR scores are measured for a second time how many minutes after birth?

3 minutes
5 minutes
10 minutes
20 minutes
Definition
5 minutes
Term
You are assessing a newborn male patient. You find the patient to have a pulse of 88, weak breathing, flexed arms, strong cry upon stimulation and pink extremities. You would determine the APGAR score to be?
6
7
8
9
Definition
8. Appearance - 2, Pulse - 1 (because its <100), Grimace - 2, Activity - 2, Respirations - 1 (weak)
Term
You are dispatched to the scene of an erratic Midwife who runs towards you and puts a baby in your arms. During your quick examination you notice the following: the baby has cyanosis over its entire body, HR is 40, apneic, is completely flaccid, and gives you no response to your stimulation attempts. What is the APGAR of this newborn?

1
2
3
4
Definition
1
Term
Calculate the APGAR score for the following newborn:
- Appearance: cyanotic
- Pulse: 60
- Grimace: cries
- Activity: flexion of extremities
- Respiratory: slow
2
3
4
5
Definition
4. A: 0
P: 1
G: 1
A: 1
R: 1
Term
Calculate the APGAR score for the following newborn:
- Appearance: acrocyanosis
- Pulse: 140
- Grimace: crying
- Activity: active
- Respiratory: vigorous cry
8
10
7
6
Definition
8.
A: 1
P: 2
G: 1
A: 2
R: 2
Term
What is the best an APGAR score could be?
6
8
10
12
Definition
10
Term
Calculate the APGAR score for the following newborn:
- Appearance: pink
- Pulse: 120
- Grimace: sneeze
- Activity: active
- Respiratory: vigorous cry
10
9
8
7
Definition
10
A: 2
P: 2
G: 2
A: 2
R: 2
Term
You are on scene with a diabetic patient with a CBG of 30. A paramedic administers D50% and the patient's GCS increases to 15. As you begin obtaining a medical history from the patient, which of the following questions is least appropriate when asking about the patient's diabetic history?
Have you been sick recently?
Have you taken your insulin today?
Have you eaten today?
Have you gone to the bathroom today?
Definition
Recent illness, too much insulin, or not enough food are all possible reasons that could cause a person with diabetes to have a low blood sugar. Although asking a patient about their bowel movements may become pertinent at some point, it is the least appropriate question to ask when inquiring specifically about diabetes.
Term
Which of the following cardiac monitor cables is correctly matched to the limb it is associated with?
Left Leg - Green
Right Arm - White
Left Arm - Red
Right Leg - Black
Definition
Right Arm - White
Each cable should be labeled correctly for the limb it is supposed to be attached to.
Green: right leg
White: right arm
Red: left leg
Black: left arm
Term
Which of the following is not one of three general approaches used in patient assessment?
Contemplative
Informational
Resuscitative
Evacuation
Definition
Informational
Contemplative approach indicates that you have time to gather history and perform a physical exam.
Resuscitative approach is used when a patient require immediate interventions, such as cardiac arrest.
Evacuation approach is used for situations where you do not have control of your scene.
Term
You are called to an urban apartment where a woman has burns, bruises, and cuts on most of her torso, arms, and face. The carpet is black with ash and soot. She is lying supine, grasping a baseball bat. The house is completely quiet, except for the woman's moaning. She is responsive to pain only. You must first?
Perform a rapid trauma assessment
Assess pulse
Assess airway
Assess the respiratory rate
Definition
Assess pulse
This patient is unconscious based on the information you were given. Remember that during the initial assessment of an unconscious patient, you use C-A-B, assessing for circulation first... not ABC.
Term
Based on your assessment of a patient's respiratory status only, which of these patients should have the most serious initial impression?
A screaming 10-month-old female who fell off of a second story balcony onto grass
A 19-year-old female breathing 24/minute after being involved in a minor motor vehicle crash
A 22-year-old male who took PCP and is breathing fast (30/minute) and hard as he struggles to break out of hand cuffs
A 2-year-old male breathing 80/minute who has been sick for the past week and has a fever
Definition
The 2-year-old is the only patient with a respiratory status that is unexplainable and serious. A normal respiratory rate for toddlers should be 24-40 respirations/minute.
Although the 10-month-old had a significant fall, she is screaming and therefore has an open, patent airway that is adequate. The patient on PCP would have an elevated respiratory rate due to the effects of the drug. The patient involved in the MVC would have a slightly elevated respiratory rate due to stress and anxiety caused by the MVC.
Term
Oral mucosa, conjunctiva, and nail beds are all great areas to examine...
Definition
a patient's skin color.
Term
You arrive to find a patient who fell five feet off a porch and landed on his head. He is unresponsive, has gurgling respirations, and is bleeding from a head wound. What is the patient's most immediate life threat?
Severe external bleeding
Airway compromise
Hypovolemic shock
Head injury
Definition
Airway compromise is this patient's immediate life threat due to the gurgling, which indicates there is probable airway obstruction.
Term
What is the goal of your primary assessment?
Establish rapport with your patient
Explain your differential diagnosis to the patient
Identify and correct any apparent life-threats
Obtain a patient's medical history in chronological order
Definition
The primary assessment is conducted to identify and treat any life-threats. Airway-Breathing-Circulation in a conscious patient. Circulation-Airway-Breathing in an unconscious patient.
Term
Which of the following is NOT a proper action right after administering an Epi-pen to the victim of a severe allergic reaction?
Note the time of the injection
Rub the injection site for 10 seconds
Give another dose
Dispose of the Epi-pen properly
Definition
Term
You have just administered your first 0.4mg NTG sublingually to a 44-year-old female experiencing acute chest pain. How long should you wait before checking a BP to see the effects of your drug intervention?
10-30 seconds
5-10 min
1-2 min
15-30 min
Definition
The onset of action for NTG is roughly 1-2 min so checking a BP during or shortly after that time would most likely be the best time to recheck.
Term
The corpus luteum works to produce which of the following hormones?
Prolactin
Progesterone
Luteinizing hormone
Follicle-stimulating hormone
Definition
The corpus luteum produces progesterone and secretes estrogen.
Term
At the scene of an MVC, you are conducting your rapid trauma assessment of a 76-year-old male. Upon examination of the chest, you see a raised section of ribs. There is an absence of paradoxical motion. What type of injury does this man most likely have?
Flail Segment
Broken ribs
Tension pneumothorax
Hematoma
Definition
The absence of paradoxical chest motion indicates that this is not a flail segment and most likely broken ribs.
Term
After directing the walking wounded to a safe location, what should you do next when utilizing the JumpSTART triage system?
Immediately begin triage
Begin treatment of the walking wounded in the treatment area
Move infants and young children (who cannot understand verbal commands) to the treatment area
Begin transport of the walking wounded so the patient's parents can pick them up at the designated hospital
Definition
Although triage is important, it is necessary to quickly move the infants and young children to the treatment area for secondary triage. These patients cannot provide basic needs for themselves so they need to be moved to a place that can provide basic needs for them.
Term
You are treating a patient who was rescued from a house fire and sustained multiple burns. Following assessment, you note burns to the anterior torso, back, right leg, and left forearm. By rule of nines, what percentage of the patient's body surface area is burned?
48.5%
54%
58.5%
63%
Definition
Anterior torso: 18%, right leg: 18%, back: 18%, left forearm: 4.5%. Expect to see questions concerning the rule of nines for both adults and pediatrics!
PREVIOUS
Term
Your patient is injured during a construction accident. You suspect a significant spine injury. You should begin your assessment by:
Assessing the airway.
Establishing manual cervical in-line immobilization.
Assessing perfusion.
Locating the types of visible wounds.
Definition
Immobilization is the first step of the assessment process when a significant head or spine injury is suspected. The other choices should all be performed after you immobilize the patient.
Term
A sedative medication can be prescribed for multiple purposes. Which of the following correctly gives TWO reasons why a sedative medication would be prescribed?
To decrease anxiety and inhibitions
To decrease jitters and fear
To increase heart rate and breathing rate
To induce sleep
Definition
The MOST correct response is to decrease anxiety and inhibitions. While other answers contain partially correct answers, you must look for the most correct answer that satisfies the best response to the question.
Term
The BLS survey stresses two components: early CPR and early what?
Compressions
Breaths
Defibrillation
Precordial Thump
Definition
The BLS survey by the AHA stresses both early CPR and early defibrillation. In these early minutes, advanced airway and drug administration is not a priority.
Term
What is the most common area injured in domestic assaults towards a pregnant female?
Face
Breasts
Head
Abdomen
Definition
Abdomen
It is important to think that there are two patients that will require assessment and further medical attention.
Term
When forming a differential diagnosis, which of the following is usually the most helpful?
Medical history
Medications
Chief complaint
Vital signs
Definition
While the patient's chief complaint and vital signs are helpful in directing your treatment, medical history is often what a differential diagnosis is based off of.
PREVIOUS
Term
You are called to the scene of a man down. The report said the man has no pulse and that a bystander is performing CPR. Upon arriving at the scene, what is your best course of action?
BSI - have bystander stop CPR - ventilate patient
BSI - have bystander stop CPR - check for pulse
Hook up the AED - BSI - open patient's airway
Attach AED - shock patient - BSI
Definition
BSI is necessary on all emergency calls. You should have the bystander stop CPR so you can check for a pulse.
Term
Age and gender are important considerations when assessing a patient. If a patient is unconscious, it may be necessary to go through their wallet to ascertain the information. In doing so, it is important that?
Another EMT or law enforcement is on the scene
You do not move the patient to access the information
You only look for the information pertaining to their age and gender
You document the contents of the wallet including the amount of cash found
Definition
An individual's wallet can prove to be an essential tool for gathering information about the individual that could be pertinent to their health care. It may be necessary to move the patient, gently and with great consideration for their safety in order to access it. When searching through a wallet it is important to look for hospital identification, or medical alert cards as well as contact information, age and gender. When this happens it is essential that another healthcare or law enforcement professional be on the scene to observe your conduct.
Term
You are on scene with a 22-year-old female who has just given birth to a healthy baby girl. Which of the following would you do first for completing an initial assessment of the newborn?
Clamp the cord 6" and 8" from infant's body
Obtain a 1 minute APGAR
Obtain a 5 minute APGAR
Stimulate the infant
Definition
Stimulating the infant is done immediately following delivery. Clamping of the cord and obtaining an APGAR are steps that should follow stimulation. This is a tricky question, just like you'll see on the NREMT. Just slow down and read the entire question. Remember this NREMT tip - time is rarely an issue for test takers.
Term
In a patient suffering from COPD, their respiratory drive is dependent on?
Oxygen
Carbon dioxide
PH level
Hemoglobin saturation
Definition
Oxygen. Those with COPD consistently have high C02 levels, which is a normal person's drive to continue breathing. With COPD, a patient's respiratory drive is dependant on low levels of oxygen to simulate a response of breathing.
Term
You are conducting your primary assessment of a patient complaining of difficulty breathing. Using your knowledge of anatomy and physiology, you know that inspiration is __________ and _________ compared to expiration which is __________ and _________.
Passive and shorter; active and longer
Passive and longer; active and shorter
Active and shorter; passive and longer
Active and longer; passive and shorter
Definition
Inspiration is shorter than expiration (approximately a ratio of 1:3). Inspiration is an active process, requiring contraction of the diaphragm in order to take place. Expiration occurs passively as the diaphragm relaxes.
Term
Which of the following is not one of the three accepted ways to clear an airway?
Finger Sweep
Suctioning
Recovery Position
Head tilt/chin lift maneuver
Definition
Make sure you read the question carefully and think this one through! The recovery position is an accepted way of attempting to clear an airway through the use of gravity. Finger sweeps are the manual way to clear an airway and suctioning is the mechanical way to do so. The head tilt chin lift maneuver is a means to open the airway, not clear it.
Term
An upper airway obstruction occurs outside of which anatomical structure?
Oropharynx
Hypopharynx
Abdomen
Thorax
Definition
The upper airway includes oropharynx and hypopharynx. Any airway obstruction that is located inside the thorax is considered a lower airway obstruction.
Term
An End-Tidal CO2 reading of 50mmHg signifies which of the following conditions?
Hypoventilation
Normal ventilation
Hyperventilation
Hypoxemia
Definition
Hypoventilation
Term
Pursed (or puckered) lip breathing is a sign of respiratory distress that patients will exhibit in an attempt to do which of the following?
Increase their lung capacity
Decrease their tidal volume
Keep the bronchioles from collapsing during exhalation
Allow the diaphragm to contract with more force
Definition
Keep the bronchioles from collapsing during exhalation. Pursed lip breathing is a true sign of respiratory distress. It should be noted while you are placing oxygen on them!
Term
Which breathing pattern is characterized as having an irregular pattern, rate, and depth with intermittent patterns of apnea?
Biot
Cheyne-Stokes
Agonal
Ataxic
Definition
Biot respirations may indicate severe brain injury or brain stem herniation.
Term
You arrive to find a 40-year-old female complaining of palpitations and dizziness. Your assessment reveals SpO2 reading of 86%, BP 102/78, pulse 128/irregular and respirations of 26 per minute. The patient tells you she has no past medical problems. What do you suspect based on the information?
Hypoxemia
Pneumonia
Pending respiratory arrest
Anxiety Attack
Definition
This patient should be considered hypoxic due to a pulse oximeter reading of 86% with no significant pulmonary medical history. This patient's vital signs are elevated due to the hypoxemia.
Term
Initial management of an unconscious adult patient who fell 15 feet from a tree include?
Performing a jaw-thrust maneuver
Performing a head tilt-chin-lift maneuver
Providing ventilations by BVM with 100% oxygen
Assessing the rate and quality of breathing
Definition
A-B-C. Ensuring an open and patent airway must come before assessing the rate and quality of breathing. You should suspect possible spinal trauma in this patient and, therefore, perform a modified jaw-thrust on this patient in order to maintain C-spine stabilization.
Term
An elderly man is found lying unresponsive next to his bed. His wife is unsure what happened or why he is lying unconscious. The patient has a strong carotid pulse. What is your next priority?
Jaw-thrust maneuver
Apply 100% supplemental oxygen
Assess respirations
Activate a modified-trauma
Definition
Apply 100% supplemental oxygen
Term
All of the following would be considered things to avoid when doing CPR, except for?
Compress the chest at a rate of 150/min
Compress the chest at a depth of 1 - 1.5 inches
Lean on the chest between compressions
Minimize pauses in compressions
Definition
Minimize pauses in compressions
Term
You have been dispatched for "chest pain" at a local park. Your patient is a 52-year-old male who was playing in his recreational basketball league when he experienced sudden-onset, crushing chest pain. Your patient laid down on the court after becoming dizzy and vomiting. Vitals: P 81, BP 140/70, SpO2 99%, RR 18. The patient denies all other complaints other than chest pain. The patient also denies use of ED drugs. Which of the following is not indicated for this patient?
High-flow oxygen
Nitroglycerin
Aspirin
Cardiac monitoring
Definition
High-flow oxygen. The patient is having chest pain and denies ED drug use - ASA, NTG, and cardiac monitoring are all indicated for this patient. The patient is not having difficulty breathing and his SpO2 is at 99% - oxygen is not indicated, especially high-flow oxygen.
Term
You have responded to a college campus for the report of a person who is unconscious and unresponsive. Your patient is a 19-year-old female student who is unconscious and unresponsive. The patient has snoring respirations with a respiratory rate of four breaths/minute and is becoming cyanotic around the lips. Her friends tell you that she just tried heroine for the first time. Your partner opens the patient's airway with a head tilt/chin lift and begins ventilating the patient with high-flow oxygen at a rate of 12 breaths/minute. Based on the information given to you by the patient's friend, you suspect a possible heroin overdose. You get a pen light out of your kit and assess the patient's pupils. Which cranial nerve is responsible for pupil size, shape, and reactivity?
Olfactory (I)
Optic (II)
Oculomotor (III)
Trochlear (IV)
Definition
Cranial nerves II, III, and IV are all associated with the eyes. The Optic nerve (II) is responsible for our ability to see. The Oculomotor nerve (III) is responsible for pupil size, shape, and reactivity. The Trochlear nerve is responsible for gaze.
Term
Your patient is a 9-year-old female who is unusually quiet according to her mother. She looks distant and is responding to verbal commands. When you take her vitals, you notice a slowed pulse. You suspect she is experiencing?
Hypotension
Hypoglycemia
Stroke
Hypoxia
Definition
In children, hypoxia often presents as altered mental status and bradycardia. Hypoxia occurs when there is a deprivation of oxygen to the body.
Term
What percent of blood from digestion passes through the liver before returning to the heart?
100%
50%
25%
0%
Definition
The hepatic portal system filters 100% of the blood that passes through the digestive tract.
Term
Adequate ventilation needs to be present for how long before stopping to check for a pulse during neonatal ventilation?
10 seconds
30 seconds
60 seconds
2 minutes
Definition
30 seconds. Provide ventilations to maintain a respiratory rate of 40-60 breaths/minute and a heart rate of at least 100 bpm.
Term
Your patient is a 5-year-old male who hit his head on a rock after falling from a tree. Compared to an adult with head trauma, he is more likely to exhibit which of the following signs or symptoms?
Altered mental state
Vomiting
Bradycardia
Tachycardia
Definition
Vomiting. It is relatively common for children to experience nausea and vomiting after head trauma. In adults it usually only occurs in cases of severe trauma.
Term
Your newborn patient is going to be receiving blow-by oxygen. The proper rate and delivery of this should be?
10 L through NRB mask
12 L through NRB mask
5 L through NRB mask
4 L nasal cannula
Definition
5 L through NRB mask. Any higher concentration is likely to dry out the oral and nasal mucosa in infants.
PREVIOUS
Term
A normal systolic blood pressure is considered to be which of the following ranges?
90-140
100-160
80-130
70-110
Definition
Normal systolic blood pressures should be between 90 and 140mmHg.
Term
Which sensory pathways carry information from the brain and spinal cord to the rest of the body?
Motor Neurons
Sensory Neurons
Central Nervous System
Purkinje Fibers
Definition
Motor Neurons. Motor and sensory neurons are part of the peripheral nervous system. Sensory neurons take the information from the body to the brain and the motor neurons, just the opposite. Purkinje fibers are part of the heart's conduction system.
Term
During a technical rescue, whose safety is the last priority?
Rescue patient
Yours
Bystander
Rescue team
Definition
Although it may seem counterintuitive, the safety of the rescue patient comes "last" during a technical rescue incident. Patient safety is still very important but the safety of yourself, the rescue team, and any bystanders or involved personnel is more important.
Term
As you are performing triage in a multiple casualty incident, a patient gets up, and limps towards you screaming in pain from the burns on his arms. His arm is also broken and deformed. You tag him?
Black
Red
Yellow
Green
Definition
Although the patient is critical, he can walk on his own, which qualifies him as a part of the green "walking wounded." You instruct him to walk over to the triage or treatment area.
Term
Which of the following is not one of the main components of a mass casualty incident?
Triage
Command
Transportation
Communication
Definition
Communication. Command, triage, and transportation are the core of what all activities during a mass casualty incident are based on. Maintaining these three components creates a basic framework to help organize the mass casualty incident.
Term
What pediatric age group is most at risk for being injured after falling?
Infant to 12-months-old
1-year-old to 5-years-old
6-years-old to 12-years-old
13-years-old to 18-years-old
Definition
You should have a high index of suspicion when treating children ages 1 to 5 that have fallen. They are at an increased risk of injury after falling than other age groups.
Term
You are dispatched to a football field where a 19-year-old male has a reported arm injury. Your scene is secure and you take BSI precautions. You have made patient contact, checked vital signs, and are now performing a physical exam. While splinting an arm that has sustained a broken humerus, the highest priority is to?
Splint and transport as quickly as possible
Immobilize the arm completely
Ensure that the limb keeps as much CMS function as possible
Ensure that the splinting does not cover potential IV sites
Definition
CMS is the highest priority, and a higher priority than complete immobilization.
Term
A fractured pelvis can retain up to how much blood in an adult?
1,000 mL
1,500 mL
2,000 mL
2,500 mL
Definition
2,000 mL = 2 L
Term
What type of shock would a patient most likely have if they were suffering from cardiac tamponade?
Hypovolemic
Obstructive
Distributive
Irreversible
Definition
Obstructive shock is a physical obstruction of blood returning to the heart. With cardiac tamponade, there is compression on the heart with a build-up of a fluid or gas in the pericardium (sac around the heart).
Term
Which of the following clinical findings would not warrant the use of an AED?
Unresponsive patient
A patient with absent or abnormal breathing
A pulseless patient
A patient with a history of cardiac arrest
Definition
A patient with a history of cardiac arrest. Just because a patient has a history of cardiac arrest does not necessarily warrant the use of an AED as much as the other conditions listed do. Be careful and read the question, then choose the MOST correct answer.
Term
When administering Nitroglycerine to your 79-year-old female chest pain patient, it is important to ask her about recent history of taking erectile dysfunction medications. Women are prescribed these medications as well as men for ailments other than ED. These drugs were initially developed for the treatment of what condition?
Parkinson’s
Diabetes
Angina Pectoris
Neuropathy
Definition
The generic (sildenafil) was originally developed for the treatment of angina pectoris and hypertension because it is a vasodilator. This has a clinical significance for paramedics because women can be prescribed this medication as well as men. Paramedics must ask all patients if they have taken any erectile dysfunction medications before administering nitrates.
Term
When performing adult CPR, how far should you compress the chest?
At least one inch
1.5 - 2 inches
At least two inches
1/3 the depth of the torso
Definition
The depth on an adult is at least 2" and the compression rate is at least 100/min. The key to good compressions is to ensure that you have proper recoil, which is when you allow the chest to come back up completely before giving another compression.
Term
When you enter the home, you find a 56-year-old male sitting on a chair, leaning forward. He is holding his chest and breathing rapidly. He says that he feels like an elephant is sitting on his chest. He is also feeling dizzy and nauseated. The pain has occurred suddenly, within the last 30 minutes. His symptoms suggest that he is experiencing which of the following?
Heart attack
Angina Pectoris
Pulmonary Arrest
Lung Cancer
Definition
Angina Pectoris - In cases of chest pain, it is easy to assume a heart attack, and rightfully so. In this case, the patient is experiencing Angina Pectoris, which is considered a precursor to a heart attack. The pain was sudden for the patient, and he is slowly starting to show symptoms of a heart attack. The heart is responding to decreased oxygen flow to the heart muscles. If the heart continues to receive less and less oxygen, the muscles can die, leading to a heart attack (or myocardial infarction). In this case as well as full-blown heart attacks, it is important to work quickly and get the patient to the hospital as soon as possible.
NEXT
Term
You are called to an unknown 'patient down" at a private residence. As you get inside and into the back bedroom, you can see that there is a woman face down and motionless. She does not appear to be conscious and there is a pool of saliva next to her head. The two of you maintain spinal precautions as you get her onto your back. The husband states that she has a history of heart problems, takes a lot of medications, and has no allergies. What would you do next?
Have your partner begin CPR
Verify the absence of a carotid pulse and begin CPR
Verify a palpable pulse, attach the AED, and prepare to analyze
Open the airway with a jaw-thrust maneuver and deliver two rescue breaths
Definition
Verify the absence of a carotid pulse and begin CPR - Remember C-A- B... Verify a carotid pulse, or the absence of one, and begin CPR immediately if the patient is pulseless. Having your partner begin CPR could almost be a correct answer, but you must check a pulse first, making the other answer the best answer.
Term
Dementia results in impairment of cognitive function. This often includes memory-associated problems and all of the following except?
Agnosia
Apraxia
Ataxia
Aphasia
Definition
Ataxia - Agnosia, apraxia, and aphasia are all cognitive dysfunctions that are seen in demented patients. Ataxia is related to movement.
Term
Your 22-year-old female patient was ejected from the back of a motorcycle going approximately 45 mph. Firefighters have packaged her for transport and brought her to the back of your ambulance. You notice the patient has an irregular respiratory pattern and palpate a pulse rate of 48 BPM. You expect she is showing the three components of Cushing's Triad. Which of the following answers would be the third component?
Hypertension
Hypothermia
Lefort fracture
Incontinence
Definition
Hypertension - First off, what is Cushing's Triad? It's an indication of increased cranial pressure (ICP). Cushing's Triad is hypertension, low heart rate, and an irregular respiratory pattern. Think of Cushing's Triad as the opposite signs of shock. A LeFort Fracture is a fracture of the midface and although it could be associated with ICP, it is not one of the three components.
Term
You are dispatched emergent to a possible carbon monoxide poisoning in a family residence. As you are questioning your patient, your partner is about to apply the pulse oximetry. You quickly remember in school you learned that CO's affinity for hemoglobin compared to oxygen is ________ times greater?
200
100
400
800
Definition
200 - All that an oxygen saturation monitor is going to tell you is the percentage of hemoglobin that have a bound iron molecule within them. Since CO binds to those iron molecules much stronger than just plain oxygen, your oxygen saturation readings will not be accurate.
Term
ou arrive to find a 65-year-old male complaining of weakness. During your assessment, the patient continues to ask you the same questions over and over again and begins to lapse in and out of consciousness. You also notice the patient has become diaphoretic and tachycardiac. You believe this patient is suffering from?
Head Injury
Hypoglycemia
Myocaridal Infraction
Stroke
Definition
Hypoglycemia - This patient is presenting with altered mental status, sweating and increased heart rate, which are classic for hypoglycemia. You should immediately check the patient's blood sugar. Had this patient's blood sugar be normal, you should than suspect stroke, but this patient doesn't present with any stroke like symptoms.
Term
Which of the following hormones are paired correctly with the location where it originates in the body?
Insulin, alpha cells
Glucagon, beta cells
Aldosterone, adrenal cortex
Epinephrine, thymus
Definition
Aldosterone is produced by the adrenal cortex.
Glucagon is secreted by alpha cells and insulin is secreted by beta cells. Epinephrine is produced in the adrenal medulla.
Term
Which vertebrae supports the weight of the skull?
Atlas
Axis
C3
C4
Definition
Atlas
Term
Which of the following is not considered an universal precaution for health care workers?
Wearing disposable gloves during patient contact
Wearing safety glasses during venipuncture
Wiping sweat off your forehead with your forearm
Washing hands with soap and warm water
Definition
Wiping sweat off your forehead with your forearm - If you need to wipe your forehead or something else off, use a clean towel. Your forearm or sleeves may have been exposed to infectious body fluids without you knowing.
Term
Which of the following is not one of the three phases of the uterine menstrual cycle?
Proliferative
Secretory
Menstruation
Ovular
Definition
Ovular - The three phases of an uterine menstrual cycle are: proliferative, secretory, and menstruation.
Term
You respond to a 33-year-old pregnant female with vaginal bleeding. She is 28 weeks pregnant, denies pain, and states that bleeding of bright red blood came on suddenly a few hours ago. Vitals: BP 98/68, P 110, R 18, SpO2 97%. What is most likely causing this patient's condition?
Preeclampsia
Nuchal cord
Abruptio placenta
Placenta previa
Definition
Placenta previa - Preeclampsia is classified as hypertension with protein in the urine. No indications of either. Nuchal cord is a condition of the umbilical cord being wrapped around the fetal neck. Classic symptoms of placenta previa include: no pain, bright red bleeding, sudden onset. Abruptio placenta generally has abdominal, back or uterine pain associated with it. Definitely a tough question and if you struggled, go to the Obstetrics chapter and review the different pregnancy complications.
Term
Adequate ventilation needs to be present for how long before stopping to check for a pulse during neonatal ventilation?
10 seconds
30 seconds
60 seconds
2 minutes
Definition
30 seconds - Provide ventilations to maintain a respiratory rate of 40-60 breaths/minute and a heart rate of at least 100 bpm.
Term
You arrive to a full-term home birth where a midwife tells you she assisted in the delivery of a newborn without complications, but the baby isn't acting normally. You note that the newborn is apneic with a pulse of 70 bpm and cyanotic. What is your next intervention?
Provide positive pressure ventilations
Begin chest compressions and positive pressure ventilations
Begin actively warming the newborn
Apply a non-rebreather with 100% oxygen
Definition
Provide positive pressure ventilations - If the newborn's heart rate is between 60-100 bpm, provide positive pressure ventilations and if it's less than 60 bpm, begin CPR immediately. Warming is important, but remember this question is asking for the next (most imminent) intervention. With ventilations, the newborn's heart rate and skin color should improve.
Term
When giving chest compressions to a newborn, the proper depth of chest compressions is approximately what anteroposterior diameter of the chest?
1/5 to 1/4
1/4 to 1/3
1/3 to 1/2
1/2 to 3/4
Definition
1/3 to 1/2 of the anteroposterior diameter of the chest is the proper depth when giving chest compressions to a newborn.
Term
You are assisting in the field delivery of a newborn. The head has just been delivered and you notice that the umbilical cord is wrapped tightly, several times around the newborn's neck. Which of the following would be the most appropriate primary action while attempting to free the cord from around the newborn's neck?
Clamp and cut the cord
Pull on the cord to get some slack in the cord
Attempt to unloop the cord from around the newborn's neck
Push the newborn's head back into the vagina and initiate rapid transport
Definition
Attempt to unloop the cord from around the newborn's neck - You should immediately try to unloop the cord from around the newborn's neck. If you are unable to free the cord, you will need to clamp and cut the cord. Never pull on the umbilical cord. In this situation, it is not appropriate to push the newborn back into the vagina.
Term
Which of the following events occurs during the luteal phase of the menstrual cycle?
Menstruation
Implantation of the egg into the uterine wall
Release of egg from the ovary
New egg growth
Definition
Menstruation
Term
Common signs and symptoms of endometritis include all of the following except?
Lower abdominal pain
Bloody and foul smelling discharge
Fever
Pinpoint tenderness in the umbilicus
Definition
Pinpoint tenderness in the umbilicus
Term
_________ marks the beginning of the first menstrual cycle. __________ marks the end of the menstrual cycle and also signals the end of ovarian function.
Puberty; menopause
Menopause; menstruation
Menarche; menopause
Puberty; menarche
Definition
Menarche; menopause - Menarche signals the beginning of the menstrual cycle during puberty and usually occurs around the age of 12 (can occur earlier or later). Menopause marks the end of the menstrual cycle and usually occurs around the age of 52 (can occur earlier or later). The ovaries stop functioning with the onset of menopause.
Term
The fetus' umbilical cord is made up of how many arteries and how many veins?
1 artery and 2 veins
2 arteries and 1 vein
3 arteries and 1 vein
3 arteries and 2 veins
Definition
2 arteries and 1 vein
Term
As you perform triage at a multiple-vehicle collision, you find a 34-year-old female patient sitting in her car unable to remember the events of the collision. She appears to not know what happened and is attempting to get out of the vehicle, even though you clearly directed her to stay in her seat. HR: 90, R 20, Capillary refill is less than 2 seconds. How would you classify this patient?
Green
Yellow
Red
Black
Definition
Red - First off, throw out black because the patient is breathing with a pulse. Using START triage, we're assessing respirations, perfusion (capillary refill), and mental status (ability to follow commands). The main thing that should alert you in this question is that she's unable to follow commands. When doing triage, you're quickly evaluating a patient and a decreased mental status would make this an immediate (red) classification.
Term
As you perform triage at a multiple-vehicle collision, you find a 34-year-old female patient sitting in her car unable to remember the events of the collision. She appears to not know what happened and is attempting to get out of the vehicle, even though you clearly directed her to stay in her seat. HR: 90, R 20, Capillary refill is less than 2 seconds. How would you classify this patient?
Green
Yellow
Red
Black
Definition
Red - First off, throw out black because the patient is breathing with a pulse. Using START triage, we're assessing respirations, perfusion (capillary refill), and mental status (ability to follow commands). The main thing that should alert you in this question is that she's unable to follow commands. When doing triage, you're quickly evaluating a patient and a decreased mental status would make this an immediate (red) classification.
Term
_____________ is used to stabilize cars involved in motor vehicle crash while extrication is occurring.
A rope system
Cribbing
A chock
A winch
Definition
Cribbing
Term
Which of the following is not one of the types of medical oversight?
Direct Medical Control
Indirect Medical Control
On-line Medical Control
Concurrent Medical Control
Definition
Concurrent Medical Control - The two main types of medical oversight are Direct and Indirect. On-line Medical Control is the most commonly referred to type of Direct Medical Control.
Term
What effect would you expect when the chest is not fully recoiled when administering chest compressions?
Reduced venous return
Increased blood flow
Negative intrathoracic pressure
Increased coronary perfusion pressure
Definition
Reduced venous return - hen you momentarily remove pressure from the chest (as you should do by allowing the chest to completely recoil), you are creating a negative intrathoracic pressure. This allows blood to enter the heart (increased venous return) and then travel out to the body when you compress down.
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