WEST COAST EMT FINAL EXAM

D. ask the father to hold the child so you can assess him while your partner tries to calm the mother.

A 4-year-old boy had an apparent seizure. He is conscious and calm and is sitting on his mother's lap. His father is sitting in a nearby chair. The child's mother suddenly begins crying uncontrollably, which causes the child to start crying. You should:

A. reassure the child's mother that seizures in children are very common and that there is nothing to worry about.

B. attempt to calm the child's mother, but avoid separating her from her child because this will increase her anxiety.

C. give the child a favorite toy or blanket to hold onto and perform your assessment to the best of your ability.

D. ask the father to hold the child so you can assess him while your partner tries to calm the mother.

D. It is a constantly open line of communication that cannot be accessed by outside users.

Which of the following statements regarding a "dedicated line" is correct?

A. It is a designated frequency on a portable radio that provides direct access to medical control.

B. It is a frequency that is used exclusively by EMTs to communicate with one another in the field.

C. It is a constantly open line of communication that is under exclusive control of a single user.

D. It is a constantly open line of communication that cannot be accessed by outside users.

B. A mentally competent adult has the legal right to refuse EMS care and transport.

Which of the following statements regarding a patient refusal is correct?

A. A patient who consumed a few beers will likely be able to refuse EMS treatment.

B. A mentally competent adult has the legal right to refuse EMS care and transport.

C. Documentation of proposed care is unnecessary if the patient refuses treatment.

D. Advice given to a patient who refuses EMS treatment should not be documented.

B. direct your partner to apply manual in-line support of the patient's head.

Upon arriving at the scene of a motor vehicle crash, you find a single patient still seated in his car. There are no scene hazards. As you approach the vehicle, you note that the patient is semiconscious and has a large laceration to his forehead. You should:

A. slide a long backboard under his buttocks and lay him sideways on the board.

B. direct your partner to apply manual in-line support of the patient's head.

C. apply a cervical collar and quickly remove the patient with a clothes drag.

D. apply a vest-style extrication device before attempting to move the patient.

B. Long backboard

Which of the following is the MOST appropriate device to use when immobilizing a patient with a suspected spinal injury?

A. Portable stretcher

B. Long backboard

C. Scoop stretcher

D. Wheeled stretcher

C. secured to a fracture board with the strongest provider at the head end.

You are attending to a 22-year-old female patient who has overdosed. The patient is unresponsive in an upstairs bedroom. The most appropriate way to bring the patient downstairs is:

A. secured to a stair chair with the strongest provider at the foot end.

B. secured to a fracture board with the strongest provider at the foot end.

C. secured to a fracture board with the strongest provider at the head end.

D. secured to a stair chair with the strongest provider at the head end.

B. in the driver's compartment.

The LEAST practical place to store a portable oxygen cylinder is:

A. inside the jump kit.

B. in the driver's compartment.

C. near the side or rear door.

D. on the ambulance stretcher.

D. never duck under the body or the tail boom because the pilot cannot see you in these areas.

When approaching a helicopter, whether the rotor blades are moving or not, you should:

Select one:

A. approach the aircraft from the side because this will make it easier for you to access the aircraft doors.

B. remember that the main rotor blade is flexible and can dip as low as 5¢ to 6¢ from the ground.

C. carefully approach the aircraft from the rear unless a crew member instructs you to do otherwise.

D. never duck under the body or the tail boom because the pilot cannot see you in these areas.

D. DuoDote Auto-Injector

Which of the following is an example of regional equipment or supplies?

Select one:

A. Oral glucose

B. Inhaled bronchodilator

C. Vacuum splint

D. DuoDote Auto-Injector

A. advise the dispatcher that you are out of service and to send another unit.

You have just delivered a major trauma patient to the hospital. Shortly after departing the hospital, dispatch advises you of another call. The back of the ambulance is contaminated with bloody dressings and is in disarray, and you are in need of airway equipment and numerous other supplies. You should:

Select one:

A. advise the dispatcher that you are out of service and to send another unit.

B. quickly proceed to the call and clean and restock the ambulance afterwards.

C. have your partner quickly clean the ambulance as you proceed to the call.

D. proceed to the call, functioning only as an emergency medical responder.

A. direct your partner to begin ventilatory assistance.

A 19-year-old female has just been extricated from her severely damaged car. She is on a long backboard and has been moved to a place of safety. As your partner maintains manual stabilization of her head, you perform a rapid assessment. The patient is unresponsive, has slow and shallow respirations, and has bilaterally closed femur deformities. You should:

Select one:

A. direct your partner to begin ventilatory assistance.

B. obtain baseline vital signs and transport at once.

C. apply oxygen via a nonrebreathing mask.

D. stabilize her legs with long board splints.

C. immobilize him with a vest-style device.

A 33-year-old restrained driver of a motor vehicle crash is awake and alert, complaining only of neck pain and left leg pain. The vehicle is stable and no hazards are present. When removing this patient from his vehicle, you should:

Select one:

A. apply a full leg splint prior to extrication.

B. use the rapid extrication technique.

C. immobilize him with a vest-style device.

D. maintain slight traction to his neck area.

B. ensure that she is in a safe area, away from the scene.

The rescue team is in the process of extricating a 40-year-old male from his truck. The patient's wife, who was uninjured in the crash, is calmly observing the extrication and asks you if her husband will be all right. You should:

Select one:

A. allow her to talk to her husband during the extrication.

B. ensure that she is in a safe area, away from the scene.

C. allow her to observe the extrication and keep her calm.

D. ask her follow-up questions about the details of the crash.

C. immediately request additional resources.

Upon arriving at the scene of a motor vehicle crash, you can see three patients, one who is entrapped in his car and two who have been ejected from their vehicle. You should:

Select one:

A. begin triage to determine injury severity.

B. call medical control for further direction.

C. immediately request additional resources.

D. request law enforcement for traffic control.

A. after receiving approval from the incident commander.

When functioning at the scene of a motor vehicle crash in which a patient will require complex extrication, you should enter the vehicle and provide care to the patient:

Select one:

A. after receiving approval from the incident commander.

B. only if the patient has experienced a major injury.

C. after rescue personnel have cut the battery cables.

D. only after you believe the vehicle has been stabilized.

Immobilize the patient with neck and back pain on a long backboard and place him on the wheeled stretcher; place the patient with the deformed femur on a folding stretcher secured to the squad bench

*You have two patients who were involved in a motor vehicle crash when their SUV struck a tree—one with neck and back pain, and the other with a deformed left femur. The patient with the deformed femur states that he does not want to be placed on a hard board, nor does he want a collar around his neck. What is the MOST appropriate and practical method of securing these patients and placing them into the ambulance?

B. ask the patient if he can unlock the door.

You are attempting to gain access to a patient who was injured when his truck struck another vehicle from behind. The patient is conscious and alert, but is screaming in pain. You try to open the door, but it is locked. You should:

Select one:

A. request the rescue team to extricate him.

B. ask the patient if he can unlock the door.

C. break the window and unlock the door.

D. use a pry bar to attempt to open the door.

D. grab him by the clothes and immediately move him to safety.

You are standing by at the scene of a hostage situation when the incident commander advises you that one of his personnel has been shot. The patient is lying supine in an open area and is not moving. As the SWAT team escorts you to the patient, you should:

Select one:

A. limit your primary assessment to airway and breathing only.

B. treat only critical injuries before moving him to a safe place.

C. perform a rapid assessment and move him to a place of safety.

D. grab him by the clothes and immediately move him to safety.

C. call for additional resources and keep bystanders away from the vehicle

You arrive at an accident scene to find an alternative-fuel vehicle leaking an unknown substance. You should immediately _________.

Select one:

A. search the vehicle for occupants

B. disconnect the car battery

C. call for additional resources and keep bystanders away from the vehicle

D. apply retardant to the leaking fuel

C. has exceeded an effective span of control and should divide tasks and delegate the supervision of some tasks to another person.

*A supervisor who has more than seven people reporting to him or her:

Select one:

A. should regularly report to the incident commander (IC) to inform him or her of the functions that his or her team is performing.

B. is more beneficial to the overall effort than a supervisor with fewer personnel because his or her team can accomplish more tasks.

C. has exceeded an effective span of control and should divide tasks and delegate the supervision of some tasks to another person.

D. should assign a specific task to each person reporting to him or her and regularly follow up to ensure that the tasks were carried out.

C. Assess for bilateral radial pulses.

According to the START triage system, what should you do if a patient is found to have a respiratory rate of 24 breaths/min?

Select one:

A. Administer high-flow oxygen.

B. Assess his or her neurologic status.

C. Assess for bilateral radial pulses.

D. Triage the patient as delayed.

A. the recommended transport destination for each patient.

*After primary triage, the triage supervisor should communicate all of the following information to the medical branch officer, EXCEPT:

Select one:

A. the recommended transport destination for each patient.

B. recommendations for movement to the treatment area.

C. the total number of patients that have been triaged.

D. the number of patients in each triage category.

A. must not begin treatment until all patients have been triaged.

*As a triage supervisor, you:

Select one:

A. must not begin treatment until all patients have been triaged.

B. must prepare patients for transport before they leave the triage area.

C. are responsible for providing initial treatment to all patients.

D. should communicate with area hospitals regarding their capabilities.

D. begin some form of positive-pressure ventilation.

Following proper decontamination, a 30-year-old male is brought to you. He is semiconscious and has rapid, shallow respirations. A quick visual assessment reveals no obvious bleeding. You should:

Select one:

A. ask a firefighter what the patient was exposed to.

B. perform a rapid assessment to locate critical injuries.

C. administer high-flow oxygen via a nonrebreathing mask.

D. begin some form of positive-pressure ventilation.

apply a CPAP device, monitor his BP, and observe him for signs of improvement or deterioration

*A 62-year-old man with a history of congestive heart failure presents with severe respiratory distres and with an oxygen saturation of 82%. When you auscultate his lungs, you hear widespread rales. He is conscious and alert, is able to follow simple comands, and can only speak in two-to three-word sentences at a time. You should:

C. freelancing.

The term used when individual units or different organizations make independent, and often inefficient, decisions regarding an incident is called:

Select one:

A. single command.

B. undermining.

C. freelancing.

D. logistical chaos.

B. assign him a delayed (yellow) category and continue triaging the other patients.

While triaging patients at the scene of a building collapse, you encounter a young child who is conscious, alert, and breathing; has bilateral radial pulses; and has a severely angulated leg, which is not bleeding. According to the JumpSTART triage system, you should:

Select one:

A. evacuate him to a designated area and assign him a minimal (green) category.

B. assign him a delayed (yellow) category and continue triaging the other patients.

C. apply high-flow oxygen, obtain baseline vital signs, and continue triaging.

D. quickly bind his legs together to stabilize the fracture, and continue triaging.

D. Exit the area immediately and gather information for the HazMat team.

You are approaching an overturned tanker truck to assess the driver, who appears to be unresponsive. As you get closer to the vehicle, you note the smell of noxious fumes and find that you are in the midst of a vapor cloud. What should you do?

Select one:

A. Cover your face with your shirt and quickly extricate the injured driver.

B. Realize that you are in the danger zone and prevent others from entering.

C. Remain where you are and perform a visual assessment of the patient.

D. Exit the area immediately and gather information for the HazMat team.

A. A 49-year-old female with diabetes and difficulty breathing

You are triaging four patients who were involved in a head-on motor vehicle crash. Which of the following patients should be assigned the highest (red) triage category?

Select one:

A. A 49-year-old female with diabetes and difficulty breathing

B. A 29-year-old male with bilaterally closed femur deformities

C. A 36-year-old female with back pain and numb extremities

D. A 50-year-old male with an open head injury and no pulse

C. assist his ventilations with high-flow oxygen.

After eating at a local restaurant, a 20-year-old male complains of blurred vision, difficulty speaking, and difficulty breathing. He is conscious; however, his respirations are profoundly labored and producing minimal tidal volume. You should:

Select one:

A. apply oxygen via a nonrebreathing mask.

B. position him supine and elevate his legs.

C. assist his ventilations with high-flow oxygen.

D. request a paramedic to administer atropine.

D. sarin.

*All of the following are vesicant agents, EXCEPT:

Select one:

A. lewisite.

B. sulfur mustard.

C. phosgene oxime.

D. sarin

B. a normal pulse oximetry reading.

The EMT should expect that a patient who was exposed to cyanide will have:

Select one:

A. an abnormally slow respiratory rate.

B. a normal pulse oximetry reading.

C. an abnormally slow pulse rate.

D. skin that is cherry red and hot.

C. Solid organs are relatively protected from shock wave injury but may be injured during the secondary or tertiary blast phase.

Which of the following statements regarding blast injuries is correct?

Select one:

A. Solid organs such as the middle ear, lungs, and gastrointestinal tract are the most susceptible to pressure changes.

B. Tertiary blast injuries are penetrating or nonpenetrating injuries that result from flying debris, such as ordnance projectiles.

C. Solid organs are relatively protected from shock wave injury but may be injured during the secondary or tertiary blast phase.

D. The gastrointestinal tract is the organ system most sensitive to blast injuries and is the leading cause of death following an explosion.

B. communicate effectively with other members of the health care team.

EMTs should have a strong working knowledge of medical terminology in order to:

Select one:

A. more clearly explain to patients the nature of their condition.

B. communicate effectively with other members of the health care team.

C. perform and document more accurate patient assessments.

D. determine and document more accurate patient diagnoses.

B. the problem is with the patient's liver.

You are transporting to a 66-year-old patient with a history of heart problems. The patient chart indicates that he has hepatomegaly. The root of the term indicates that:

Select one:

A. the problem is unrelated to the patient's heart condition.

B. the problem is with the patient's liver.

C. the problem is a direct consequence of the patient's heart disease.

D. the organ involved is enlarged.

C. minute volume is decreased.

If a patient's chest barely moves during inhalation, even if the patient's respiratory rate is normal, you should suspect that:

Select one:

A. expiratory reserve volume is decreased.

B. inspiratory reserve is increased.

C. minute volume is decreased.

D. overall tidal volume is increased.

D. brain and spinal cord.

*The central nervous system is composed of the:

Select one:

A. brain and sensory nerves.

B. spinal cord and sensory nerves.

C. motor and sensory nerves.

D. brain and spinal cord.

C. The arteries contract to increase the blood pressure.

*What happens when blood volume is lost from the body?

Select one:

A. Arterial blood is diverted to the skin and muscles.

B. Widespread vasodilation causes blood pressure to decrease.

C. The arteries contract to increase the blood pressure.

D. The veins dilate to increase systemic perfusion.

B. 70 beats/min.

The average pulse rate of persons between 19 and 60 years of age is typically:

Select one:

A. 90 beats/min.

B. 70 beats/min.

C. 80 beats/min.

D. 60 beats/min.

D. normal

The respiratory rate of 30 breaths per minute in an infant is ________.

Select one:

A. too shallow

B. too fast

C. too slow

D. normal

A. small infants are nose breathers and require clear nasal passages at all times.

You are dispatched to a call for a 4-month-old infant with respiratory distress. While you prepare to take care of this child, you must remember that:

Select one:

A. small infants are nose breathers and require clear nasal passages at all times.

B. the infant's proportionately small tongue often causes an airway obstruction.

C. an infant's head should be placed in a flexed position to prevent obstruction.

D. assisted ventilations in infants often need to be forceful to inflate their lungs.

C. airway, breathing, and circulation.

An elderly patient has fallen and hit her head. Your initial care should focus on:

Select one:

A. obtaining baseline vital signs.

B. gathering medical history data.

C. airway, breathing, and circulation.

D. providing immediate transport.

B. lips or oral mucosa.

In patients with deeply pigmented skin, changes in color may be apparent only in certain areas, such as the:

Select one:

A. dorsum of the hand.

B. lips or oral mucosa.

C. forehead and face.

D. back of the neck.

D. Jaw-thrust maneuver

What maneuver should be used to open the airway of an unresponsive patient with suspected trauma?

Select one:

A. Head tilt-neck lift

B. Tongue-jaw lift

C. Head tilt-chin lift

D. Jaw-thrust maneuver

A. Rapidly assessing a patient's respiratory status

Which of the following actions would NOT be performed during the scene size-up?

Select one:

A. Rapidly assessing a patient's respiratory status

B. Notifying the dispatcher to send fire personnel

C. Noting the position of a crashed motor vehicle

D. Asking a neighbor to secure the patient's dog

D. remove the airway and be prepared to suction her oropharynx.

A 19-year-old female is found unconscious by her roommate. Your primary assessment reveals that her breathing is inadequate. As you insert an oropharyngeal airway, she begins to gag violently. You should:

Select one:

A. insert the airway no further but leave it in place as a bite block.

B. continue to insert the airway as you suction her oropharynx.

C. select a smaller oropharyngeal airway and attempt to insert it.

D. remove the airway and be prepared to suction her oropharynx.

D. Carbon monoxide poisoning

A man was found unresponsive in his bed at home. There is no evidence of injury and the patient's medical history is not known. The patient's face is cyanotic, yet the pulse oximeter reads 98%. Which of the following would MOST likely explain this?

Select one:

A. Severe pulmonary edema

B. Increased body temperature

C. His extremities are cold

D. Carbon monoxide poisoning

C. nonrebreathing mask.

A patient who is suspected of being hypoxic and is breathing adequately should be given supplemental oxygen with a:

Select one:

A. nasal cannula.

B. mouth-to-mask device.

C. nonrebreathing mask.

D. bag-valve mask.

C. a lower airway obstruction.

During your assessment of a patient with respiratory distress, you hear wheezing when listening to breath sounds. This indicates:

Select one:

A. fluid in the alveoli.

B. swelling of the upper airway.

C. a lower airway obstruction.

D. secretions in the airway.

A. It forces the alveoli open and pushes oxygen across the alveolar membrane.

How does CPAP improve oxygenation and ventilation in patients with certain respiratory problems?

Select one:

A. It forces the alveoli open and pushes oxygen across the alveolar membrane.

B. It pushes thick, infected pulmonary secretions into isolated areas of the lung.

C. It decreases intrathoracic pressure, which allows more room for lung expansion.

D. It prevents alveolar collapse by pushing air into the lungs during inhalation.

D. can maintain a patent airway in a semiconscious patient with a gag reflex.

*The nasopharyngeal airway is MOST beneficial because it:

Select one:

A. effectively maintains the airway of a patient in cardiopulmonary arrest.

B. can effectively stabilize fractured nasal bones if it is inserted properly.

C. is generally well tolerated in conscious patients with an intact gag reflex.

D. can maintain a patent airway in a semiconscious patient with a gag reflex.

C. ventilation.

The physical act of moving air into and out of the lungs is called:

Select one:

A. respiration.

B. diffusion.

C. ventilation.

D. oxygenation.

C. Air moves primarily in the anatomic dead space and does not participate in pulmonary gas exchange.

What occurs when a patient is breathing very rapidly and shallowly?

Select one:

A. The majority of tidal volume reaches the lungs and diffuses across the alveolar-capillary membrane.

B. Minute volume increases because of a marked increase in both tidal volume and respiratory rate.

C. Air moves primarily in the anatomic dead space and does not participate in pulmonary gas exchange.

D. Air is forcefully drawn into the lungs due to the negative pressure created by the rapid respirations.

B. A 31-year-old semiconscious male with low blood sugar and adequate breathing

Which of the following patients should you place in the recovery position?

Select one:

A. A 40-year-old conscious female with a possible neck injury and regular respirations

B. A 31-year-old semiconscious male with low blood sugar and adequate breathing

C. A 19-year-old conscious male with a closed head injury and normal respirations

D. A 24-year-old unconscious female who overdosed and has a reduced tidal volume

B. 55%

You are performing mouth-to-mask ventilations with oxygen connected and set at a flow rate of 15 L/min. What percentage of oxygen is your patient receiving?

Select one:

A. 65%

B. 55%

C. 45%

D. 75%

B. reassess the patient and document her response to the medication.

A 31-year-old female is experiencing an acute asthma attack. She is conscious and alert, but in obvious respiratory distress. After assisting her with her prescribed MDI, you should:

Select one:

A. contact medical control and apprise him or her of what you did.

B. reassess the patient and document her response to the medication.

C. administer another treatment in 30 seconds if she is still in distress.

D. check the drug's expiration date to ensure that it is still current.

D. assist him with his nitroglycerin unless his systolic blood pressure is less than 100 mm Hg.

A 62-year-old male is seen with crushing chest pain, which he describes as being the same kind of pain that he had with a previous heart attack. He has prescribed nitroglycerin but states that he has not taken any. After administering supplemental oxygen if needed and contacting medical control, you should:

Select one:

A. begin immediate transport and request a rendezvous with a paramedic unit.

B. administer up to three doses of nitroglycerin before assessing his blood pressure.

C. administer the nitroglycerin unless he has taken Viagra within the past 72 hours.

D. assist him with his nitroglycerin unless his systolic blood pressure is less than 100 mm Hg.

C. Slow respirations

Which of the following clinical signs would necessitate the administration of naloxone (Narcan)?

Select one:

A. Extreme agitation

B. Tachycardia

C. Slow respirations

D. Hypertension

B. administer drugs via the IV route to achieve the fastest effect.

While assisting a paramedic in the attempted resuscitation of a 55-year-old male in cardiac arrest, you should expect the paramedic to:

Select one:

A. give the patient nitroglycerin to increase his blood pressure.

B. administer drugs via the IV route to achieve the fastest effect.

C. withhold drug therapy until an intraosseous catheter is in place.

D. give the patient activated charcoal to rule out a drug overdose.

B. Rapid transport to a trauma center

A 25-year-old unrestrained female struck the steering wheel with her chest when her car hit a tree while traveling at a high rate of speed. She has signs and symptoms of shock, which you suspect are the result of intrathoracic bleeding. Which of the following interventions will provide this patient with the greatest chance for survival?

Select one:

A. High-flow oxygen administration

B. Rapid transport to a trauma center

C. Intravenous fluid administration

D. Full immobilization of her spine

B. Control the bleeding.

As you approach a patient lying at the side of the roadway, you observe severe bleeding from the leg. What should your first action be?

Select one:

A. Open the airway.

B. Control the bleeding.

C. Check for a pulse.

D. Administer oxygen.

A. widespread dilation of the blood vessels causes blood to pool in the vascular beds.

Distributive shock occurs when:

Select one:

A. widespread dilation of the blood vessels causes blood to pool in the vascular beds.

B. an injury causes restriction of the heart muscle and impairs its pumping function.

C. temporary but severe vasodilation causes a decrease in blood supply to the brain.

D. severe bleeding causes tachycardia in order to distribute blood to the organs faster.

B. septic shock

Shock due to severe infection is called ________.

Select one:

A. anaphylactic shock

B. septic shock

C. neurogenic shock

D. hypovolemic shock

D. Heart, blood vessels, blood

What are the three components of the "perfusion triangle"?

Select one:

A. Plasma, red blood cells, platelets

B. Arteries, veins, capillaries

C. Heart, brain, lungs

D. Heart, blood vessels, blood

D. changes in gastric motility may delay gastric emptying, which increases the risk for vomiting.

When treating an 80-year-old patient who is in shock, it is important to remember that:

Select one:

A. compensation from the respiratory system usually manifests with increased tidal volume.

B. the older patient's central nervous system usually reacts more briskly to compensate for shock.

C. medications older patients take for hypertension often cause an unusually fast heart rate.

D. changes in gastric motility may delay gastric emptying, which increases the risk for vomiting.

B. compensated shock

Your patient is in shock, but the body's defense mechanisms are currently able to maintain adequate circulation. This is called ___________.

Select one:

A. irreversible shock

B. compensated shock

C. decompensated shock

D. late shock

C. begin CPR until an AED is available.

A 60-year-old man is found to be unresponsive, pulseless, and apneic. You should:

Select one:

A. withhold CPR until he is defibrillated.

B. start CPR and transport immediately.

C. begin CPR until an AED is available.

D. determine if he has a valid living will.

e. if you ventilate a patient too quickly.

Gastric distention will MOST likely occur:

Select one:

a. in patients who are intubated.

c. when the airway is completely obstructed.

d. when you deliver minimal tidal volume.

e. if you ventilate a patient too quickly.

C. remove it

If an object is visible in the unconscious patient's airway, you should __________.

Select one:

A. leave it in place

B. place the patient on his or her side

C. remove it

D. continue chest compressions

A. respiratory arrest.

In most cases, cardiopulmonary arrest in infants and children is caused by:

Select one:

A. respiratory arrest.

B. a cardiac dysrhythmia.

C. a drug overdose.

D. severe chest trauma.

C. 30:2

What is the correct compression-to-ventilation ratio for adult CPR?

Select one:

A. 5:1

B. 30:1

C. 30:2

D. 3:2

B. remove the medication patch, wipe away any medication residue, and apply the AED pads.

Your partner is performing one-rescuer CPR on a middle-aged woman in cardiac arrest. When you apply the AED pads, you note that she has a medication patch over the same area where one of the AED pads will be placed. You should:

Select one:

A. move the patch to another area of the patient's chest and then properly apply the AED pads.

B. remove the medication patch, wipe away any medication residue, and apply the AED pads.

C. apply the AED pad at least 1 inch away from the medication patch to avoid skin burns.

D. continue CPR until you can determine the name of the medication contained in the patch.

C. a fever

Most patients with an infectious disease will have _________.

Select one:

A. abdominal pain

B. a low blood glucose level

C. a fever

D. seizures

A. Substance abuse

Which of the following conditions is NOT categorized as a psychiatric condition?

Select one:

A. Substance abuse

B. Alzheimer disease

C. Depression

D. Schizophrenia

C. schizophrenia

*Which of the following is an example of a functional behavioral disorder?

A. head trauma

B. drug addiction

C. schizophrenia

D. Alzheimer's disease

D. combination of a medical and trauma emergency.

You are attending to a 27-year-old male driver of a car. According to his passenger, the patient had been acting strangely while driving, then slumped forward against the steering wheel, apparently unconscious. The car drove off the road and struck a telephone pole. The patient remains unconscious, and physical assessment reveals only a large hematoma on his right forehead with no other physical signs. Your patient is a diabetic who had been under a lot of stress lately and may have missed meals. This is an example of a:

Select one:

A. trauma emergency.

B. medical emergency.

C. combination of a psychiatric and trauma emergency.

D. combination of a medical and trauma emergency.

A. epinephrine.

A 30-year-old male presents with acute shortness of breath, widespread hives, and facial swelling. He denies any past medical history and takes no medications. During your assessment, you hear wheezing over all the lung fields. His blood pressure is 90/50 mm Hg and his heart rate is 110 beats/min. In addition to giving him high-flow oxygen, the MOST important treatment for this patient is:

Select one:

A. epinephrine.

B. a beta-antagonist.

C. albuterol.

D. an antihistamine.

D. Spontaneous pneumothorax

A 59-year-old male with a history of emphysema complains of an acute worsening of his dyspnea and pleuritic chest pain following a forceful cough. Your assessment reveals that he has a barrel-shaped chest, unilaterally diminished breath sounds, and tachycardia. What is the MOST likely cause of this patient's condition?

Select one:

A. Exacerbation of his COPD

B. Rupture of the diaphragm

C. Acute pulmonary embolism

D. Spontaneous pneumothorax

D. bronchiolitis

His parents tell you that their son has had a chest infection for the past two days and when they took him to their family doctor, they were told it was likely due to the respiratory syncytial virus (RSV). They have kept him well hydrated, but the infection seems to have gotten worse. On auscultation, you hear decreased air entry bilaterally with fine expiratory wheezes and the occasional coarse wet crackle. Based on this information, your patient is most likely suffering from:

Select one:

A. croup.

B. pertussis.

C. epiglottitis.

D. bronchiolitis.

D. oxygen and carbon dioxide must be able to freely diffuse across the alveolar-capillary membrane.

In order for efficient pulmonary gas exchange to occur:

Select one:

A. the percentage of inhaled carbon dioxide must exceed the percentage of inhaled oxygen.

B. the pulmonary capillaries must be completely constricted and the alveoli must be collapsed.

C. there must be low quantities of pulmonary surfactant to allow for full alveolar expansion.

D. oxygen and carbon dioxide must be able to freely diffuse across the alveolar-capillary membrane.

C. Alveoli

In what area of the lungs does respiration occur?

Select one:

A. Bronchi

B. Capillaries

C. Alveoli

D. Trachea

C. Shortness of breath and a blood pressure of 76/56 mm Hg

Treatment with continuous positive airway pressure (CPAP) would MOST likely be contraindicated in which of the following situations?

Select one:

A. Difficulty breathing, two-word dyspnea, and tachycardia

B. Conscious and alert patient with an oxygen saturation of 85%

C. Shortness of breath and a blood pressure of 76/56 mm Hg

D. Pulmonary edema, history of hypertension, and anxiety

C. abnormal breath sounds.

When auscultating the lungs of a patient with respiratory distress, you hear adventitious sounds. This means that the patient has:

Select one:

A. an absence of breath sounds.

B. diminished breath sounds.

C. abnormal breath sounds.

D. normal breath sounds.

D. Aspiration pneumonia

While auscultating an elderly woman's breath sounds, you hear low-pitched "rattling" sounds at the bases of both of her lungs. This finding is MOST consistent with which of the following conditions?

Select one:

A. Acute asthma attack

B. Widespread atelectasis

C. Early pulmonary edema

D. Aspiration pneumonia

D. instruct him to hold his breath for as long as he comfortably can.

You are assisting an asthma patient with his prescribed metered-dose inhaler. After the patient takes a deep breath and depresses the inhaler, you should:

Select one:

A. immediately reapply the oxygen mask and reassess his condition.

B. advise him to exhale forcefully to ensure medication absorption.

C. allow him to breathe room air and assess his oxygen saturation.

D. instruct him to hold his breath for as long as he comfortably can.

B. viral infection of the upper respiratory tract.

You are attending to a 3-year-old male patient who is presenting with severe shortness of breath. His parents report that he has had a cough and cold with a low grade fever for the past two days. They became worried today, as his level of distress has increased dramatically. On assessment, the patient is sitting upright and making high-pitched noises with each breath. Based on this information, the patient is most likely suffering from:

Select one:

A. inflammation of the lower respiratory tract and bronchospasm.

B. viral infection of the upper respiratory tract.

C. bacterial infection of the epiglottis.

D. inflammation of the bronchioles.

C. tuberculosis.

You are attending to a 54-year-old female patient in a homeless shelter. The patient tells you that she had the flu a couple of weeks ago, and she has not gotten over it. She has been tired and keeps waking up at night, sweating. She has been coughing up green sputum occasionally and has been experiencing episodes of chest pain that get worse when she breathes. Based on this information, your patient is most likely suffering from:

Select one:

A. influenza Type A.

B. pneumonia.

C. tuberculosis.

D. chronic obstructive pulmonary disease (COPD).

C. hypoxic drive

Your patient has a chronic respiratory condition. His stimulus to breathe is triggered by low oxygen levels in the blood. This is known as the ___________.

Select one:

A. COPD drive

B. CO2 drive

C. hypoxic drive

D. alternate drive

B. assess the adequacy of his respirations.

A 49-year-old male presents with an acute onset of crushing chest pain and diaphoresis. You should:

Select one:

A. administer up to 324 mg of baby aspirin.

B. assess the adequacy of his respirations.

C. administer up to three doses of nitroglycerin.

D. obtain vital signs and a SAMPLE history.

A. administer oxygen, give her 324 mg of aspirin, and assess her further.

*A 66-year-old female with a history of hypertension and diabetes presents with substernal chest pressure of 2 hours' duration. Her blood pressure is 140/90 mm Hg, her pulse is 100 beats/min and irregular, her respirations are 22 breaths/min, and her oxygen saturation is 92%. The patient does not have prescribed nitroglycerin, but her husband does. You should:

Select one:

A. administer oxygen, give her 324 mg of aspirin, and assess her further.

B. give her one nitroglycerin and reassess her systolic blood pressure.

C. obtain a SAMPLE history and contact medical control for advice.

D. give her high-flow oxygen, attach the AED, and transport at once.

C. the lumen of the coronary artery is narrowed and cannot accommodate increased blood flow.

A patient with atherosclerotic heart disease experiences chest pain during exertion because:

Select one:

A. the coronary arteries suddenly spasm and cause a marked reduction in myocardial blood flow.

B. the ragged edge of a tear in the coronary artery lumen causes local blood clotting and arterial narrowing.

C. the lumen of the coronary artery is narrowed and cannot accommodate increased blood flow.

D. tissues of the myocardium undergo necrosis secondary to a prolonged absence of oxygen.

C. who have experienced a head injury.

Nitroglycerin is contraindicated in patients:

Select one:

A. with a history of an ischemic stroke.

B. who have taken up to two doses.

C. who have experienced a head injury.

D. with a systolic blood pressure less than 120 mm Hg.

A. have chronic hypertension.

Signs and symptoms of a hypertensive emergency would MOST likely be delayed in patients who:

Select one:

A. have chronic hypertension.

B. regularly take illegal drugs.

C. are older than 40 years of age.

D. have had a stroke in the past.

C. Dependent edema

Which of the following signs is commonly observed in patients with right-sided heart failure?

Select one:

A. Labored breathing

B. Flat jugular veins

C. Dependent edema

D. Pulmonary edema

C. begin high-quality CPR and apply the AED as soon as possible.

You and your partner arrive at the scene of a middle-aged man who collapsed about 5 minutes ago. He is unresponsive, apneic, and pulseless. Bystanders are present, but have not provided any care. You should:

Select one:

A. perform two-rescuer CPR for 5 minutes and request ALS backup.

B. have your partner perform CPR while you question the bystanders.

C. begin high-quality CPR and apply the AED as soon as possible.

D. immediately apply the AED pads and analyze his cardiac rhythm.

D. He is currently not prescribed any medications

A 30-year-old male experienced a generalized (tonic-clonic) seizure, which stopped before you arrived at the scene. The patient is conscious, is answering your questions appropriately, and refuses EMS transport. Which of the following would be the MOST compelling reason to disagree with his refusal of transport?

Select one:

A. He has experienced seizures since he was 20

B. His Glasgow Coma Scale (GCS) score is 15

C. His wife states that this was his "usual" seizure

D. He is currently not prescribed any medications

A. Hypovolemia

Which of the following conditions would be the LEAST likely to mimic the signs and symptoms of a stroke?

Select one:

A. Hypovolemia

B. Intracranial bleeding

C. Hypoglycemia

D. A postictal state

D. recovery position and transport.

You are caring for a 68-year-old man with sudden onset of left-sided paralysis and slurred speech. His airway is patent, his respirations are 14 breaths/min with adequate depth, and his oxygen saturation is 98%. Treatment for this patient should include:

Select one:

A. oral glucose gel and transport.

B. ventilatory assistance and transport.

C. high-flow oxygen and transport.

D. recovery position and transport.

B. protect her airway from aspiration.

A 30-year-old woman with a history of alcoholism presents with severe upper abdominal pain and is vomiting large amounts of bright red blood. Her skin is cool, pale, and clammy; her heart rate is 120 beats/min and weak; and her blood pressure is 70/50 mm Hg. Your MOST immediate action should be to:

Select one:

A. keep her supine and keep her warm.

B. protect her airway from aspiration.

C. rapidly transport her to the hospital.

D. give her high-flow supplemental oxygen.

D. be alert for signs and symptoms of shock.

A 47-year-old male presents with severe abdominal pain of 3 hours' duration. His abdomen is distended and guarded. Your MOST important consideration for this patient should be to:

Select one:

A. determine the exact location and cause of his pain.

B. transport him in a supine position.

C. assess his blood pressure to determine perfusion adequacy.

D. be alert for signs and symptoms of shock.