emt 212 26-41

A productive cough, fever, and chills in an 80-year-old patient with a compromised immune system should make you most suspicious for:

Select one:

A. heart failure.

B. emphysema.

C. pneumonia.

D. bronchitis

C. pneumonia.

D.

is often the result of hypertension and atherosclerosis.

An abdominal aortic aneurysm:

Select one:

A. can sometimes be palpated as a mass in the groin area.

B.

causes dull pain that often radiates to the shoulders.

C.

is usually not repairable, even if discovered early.

D.

is often the result of hypertension and atherosclerosis.

C.

he or she fears hospitalization.

An elderly patient might understate or minimize the symptoms of his or her illness because:

Select one:

A.

the nervous system has deteriorated.

B.

of conditions such as dementia.

C.

he or she fears hospitalization.

D.

of decreased perception of pain.

Common causes of depression in the elderly include all of the following, except:

Select one:

A. an acute onset of dementia.

B. alcohol abuse and dependence.

C. prescription medication use.

D. chronic medical conditions.

A. an acute onset of dementia.

C.

osteoporosis and low-energy trauma.

Fractures of the pelvis in older patients often occur as the result of a combination of:

Select one:

A.

arthritic joints and high-energy trauma.

B.

increased bone density and car crashes.

C.

osteoporosis and low-energy trauma.

D.

acetabular separation and severe falls.

C.

frequently asking the patient if he or she understands.

Good general communication techniques with the elderly include:

Select one:

A.

using medical terms to ensure patient understanding.

B.

having at least two EMTs talk to the patient at a time.

C.

frequently asking the patient if he or she understands.

D.

explaining procedures while you are performing them.

B.

they fear retribution from the abuser.

Many older victims of physical abuse might make false statements or lie about the origin of their injuries because:

Select one:

A.

most elderly patients have dementia.

B.

they fear retribution from the abuser.

C.

they are protective of the abuser.

D.

they do not want to be bothersome.

C.

a decrease in bone mass and density.

Osteoporosis is defined as:

Select one:

A.

increased flexibility of bone mass.

B.

an abnormality near the growth plate.

C.

a decrease in bone mass and density.

D.

decreased bone marrow production.

Patients who have experienced even minor-appearing head injuries should be suspected of having a brain injury, especially if they:

Select one:

A. are taking blood-thinning medications.

B. have minor abrasions to the head area.

C. do not have deformities to the skull.

D. have a history of Alzheimer disease.

A. are taking blood-thinning medications.

A.

physical

Poor maintenance of home, poor personal care, and dietary neglect are all possible indicators of ____________ elder abuse.

Select one:

A.

physical

B.

financial

C.

psychological

D.

emotional

Syncope in the older patient is:

Select one:

A. generally of no concern unless the patient was injured.

B. most commonly caused by a silent myocardial infarction.

C. caused by an interruption of blood flow to the brain.

D. rarely life threatening but should be evaluated by a physician.

C. caused by an interruption of blood flow to the brain.

B.

tachypnea and paroxysmal nocturnal dyspnea.

The EMT should suspect left-sided heart failure in the geriatric patient who presents with:

Select one:

A.

jugular venous distention and peripheral edema.

B.

tachypnea and paroxysmal nocturnal dyspnea.

C.

fever and a cough that produces green sputum.

D.

swelling of the lower extremities and weakness.

C.

help EMS personnel remember what is different about elderly patients.

The purpose of the GEMS diamond is to:

Select one:

A.

provide clues about an elderly patient's problem by observing his or her home.

B.

replace the typical ABC approach to patient care when caring for the elderly.

C.

help EMS personnel remember what is different about elderly patients.

D.

provide the EMT with a standard format for assessing elderly patients.

B.

head trauma.

The reduction in brain weight and volume increases an older person's risk for:

Select one:

A.

delirium.

B.

head trauma.

C.

stroke.

D.

dementia.

The use of multiple prescription drugs by a single patient, causing the potential for negative effects such as overdosing or drug interaction, is called:

Select one:

A. polypharmacy.

B. drug tolerance.

C. potentiation.

D. drug dependency.

A. polypharmacy.

D.

have only one EMT speak to the patient at a time.

To minimize distractions and confusion when assessing an older patient, you should:

Select one:

A.

dismiss the family members from the room or area.

B.

perform a physical exam and then talk to the patient.

C.

elevate your voice and speak directly to the patient.

D.

have only one EMT speak to the patient at a time.

When faced with a situation in which an older patient with a terminal illness is in cardiac arrest, but written documentation regarding the patient's wishes cannot be located, the EMT should:

Select one:

A. try to locate the documentation.

B. attempt to resuscitate the patient.

C. contact medical control for advice.

D. allow the patient to die in peace.

B. attempt to resuscitate the patient.

B.

transport him or her to a hospital that he or she is familiar with.

When transporting a stable older patient to the hospital, the most effective way to reduce his or her anxiety is to:

Select one:

A.

allow at least two family members to accompany the patient.

B.

transport him or her to a hospital that he or she is familiar with.

C.

avoid the use of a long backboard, even if trauma is suspected.

D.

perform frequent detailed assessments to gain the patient's trust.

Which of the following is the most common mechanism of injury in older patients?

Select one:

A. Burns

B. Abuse

C. Suicide

D. Falls

D. Falls

Which of the following observations or statements represents the "E" in the GEMS diamond?

Select one:

A. A patient is assisted with his or her activities of daily living.

B. The patient's residence is cold due to a malfunctioning heater.

C. The patient's medications have not been filled in 2 months.

D. Elderly patients present atypically and deserve your respect.

B. The patient's residence is cold due to a malfunctioning heater.

Bruising to the _________ is LEAST suggestive of child abuse.

shins

child with N. meningitis would most likely present with

Cherry red spots or purpulish rash

The EMT should be MOST concerned when a child presents with fever and:

rash

Signs of an upper airway obstruction in an infant or child include all of the following, EXCEPT:

wheezing

An infant with severe dehydration would be expected to present with:

absent urine output

the purpose of the pediatric assessment triangle is to

allow you to rapidly and visually form a general impression of the child.

febrile seizures are most common in children between

6 months to 6 years

Immediate transport is indicated for a child when he or she:

has a history suggestive of a serious illness

which of the following is true regarding the legal implications of child abuse

eMTs must report all suspected cases of child abuse

when assessing an 8 year old you should

talk to the child, not just the caregiver

Submersion injuries in the adolescent age group are MOST commonly associated with:

alcohol

the first of life after birth is referred to as the

Neonatal period

Effective methods for providing pain relief to a child with an extremity injury include:

positioning, ice packs, and emotional support.

Before positioning an infant or child's airway, you should:

place him or her on a firm surface

when administering oxygen to a frighten child it would be most appropriate to

please oxygen tubing through a hole in a paper cup

A normal level of consciousness in an infant or child is characterized by:

age-appropriate behavior, good muscle tone, and good eye contact.

Use of a nonrebreathing mask or nasal cannula in a child is appropriate ONLY if:

his or her tidal volume is adequate

the signs and symptoms of poisoning in children

vary widely, depending on the child's age and weight

which of the Following statements regarding a three month old infant is correct

A three month old infant can distinguish a parent from a stranger

When a child experiences a blunt chest injury:

the flexible ribs can be compressed without breaking

Once entrance and access to the patient have been provided, you should:

a. administer high-flow oxygen

b. allow extrication to commence

c. perform a primary assessment

d. begin treating his or her injuries

c. perform a primary assessment

The reasons for rescue failure can be recalled by the mnemonic FAILURE. According to this mnemonic, the "U" stands for:

a. unprepared to effectively manage the scene

b. underutilizing personnel at the scene

c. undertrained to correctly utilize equipment

d. underestimating the logistics of the incident

d. underestimating the logistics of the incident

When removing a critically injured patient from his or her vehicle, you should:

a. move them in one fast, continuous step

b. release c-spine

c. protect the cervical spine during the entire process

d. remove them using a short backboard

c. protect the cervical spine during the entire process

Which of the following is a typical function of the rescue team?

a. providing emergency care during extrication

b. shutting off power to downed electrical lines

c. initial triage and patient prioritization

d. providing safe entry and access to patients

d. providing safe entry and access to patients

When determining the exact location and position of the patients in a wrecked vehicle, you and your team should routinely consider all of the following, except:

a. the position of the crashed vehicle

b. the make and model of the vehicle

c. hazards that pose a risk to rescuers

d. the possibility of vehicle instability

b. the make and model of the vehicle

Situational awareness is MOST accurately defined as:

a. an ongoing process of information gathering and scene evaluation to determine appropriate strategies and tactics

b. performing an initial scan of the scene to identify hazards that will pose an immediate threat to you and your crew

c. predicting the presence of certain hazards at the scene after receiving initial information from the dispatcher

d. the ability to recognize any possible issues once you arrive at the scene and act proactively to avoid a negative impact

d. the ability to recognize any possible issues once you arrive at the scene and act proactively to avoid a negative impact

The EMT's role at the scene of a search and rescue attempt is to:

a. accompany search team members and provide care

b. direct the search effort from a centralized location

c. report to a location where the patient will be carried

d. stand by at the command post until the person is located

d. stand by at the command post until the person is located

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:

a. obtain baseline vital signs and transport at once

b. apply oxygen via a nonrebreathing mask

c. direct your partner to begin ventilatory assistance

d. stabilize her legs with long board splints

c. direct your partner to begin ventilatory assistance

Upon arriving at the scene of a law enforcement tactical situation, you should ensure your own safety and then:

a. locate all injured personnel and begin treatment

b. begin immediate triage of any injured personnel

c. apprise medical control of the tactical situation

d. report to the incident commanded for instructions

d. report to the incident commanded for instructions

In contrast to simple access, complex access:

a. does not involve the breaking of glass

b. involves forcible entry into a vehicle

c. often involves simply unlocking a door

d. is a skill commonly taught to EMTs

b. involves forcible entry into a vehicle

Disentanglement involves:

a. removing a patient from a dangerous position

b. extrication techniques that EMTs are trained in

c. gaining access to a patient in a crashed vehicle

d. the use of a simple access tools such as a pry bar

a. removing a patient from a dangerous position

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:

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

b. request the rescue team to extricate him

c. ask the patient if he can unlock the door

d. break the window and unlock the door

c. ask the patient if he can unlock the door

Trench collapses usually involve large areas of falling dirt that weigh approximately _______ per cubic foot.

a. 200 lbs

b. 50 lbs

c. 100 lbs

d. 150 lbs

c. 100 lbs

Your primary concern when arriving at the scene of a motor vehicle crash is:

a. immediately beginning triage

b. surveying the area for hazards

c. gaining access to the patient

d. requesting additional resources

b. surveying the area for hazards

Which of the following is the best example of gaining simple access to a patient?

a. entering a vehicle through an open window

b. removing the roof access to a critical patient

c. breaking glass to gain access to the patient

d. using a pry bar to open a damaged door

a. entering a vehicle through an open window

Extrication is defined as:

A. using heavy equipment to access a patient.

B. removal from a dangerous situation or position.

C. dismantling an automobile to remove a victim.

D. immobilizing a patient before moving him or her.

B. removal from a dangerous situation or position.

If a technical rescue team is required at the scene, but is not present when you arrive, you should:

a. check with the incident commander to ensure that the team is en route

b. remain with your ambulance until the rescue team arrives at the scene

c. have fire personnel initiate the rescue process if they are at the scene

d. don personal protective equipment and begin the rescue process

a. check with the incident commander to ensure that the team is en route

The scene size-up at a motor vehicle crash or other incident:

a. determines who is allowed to safely enter the hot zone

b. is a quick visual assessment of the scene prior to entry

c. should be performed by the most experienced EMT

d. is an ongoing process until the incident is terminated

d. is an ongoing process until the incident is terminated

Which of the following situations would require the use of a specialized rescue team?

a. a patient found floating face down in a swimming pool

b. a patient trapped in a cave or a confined space

c. an obese patient who must be moved to the ambulance

d. a patient in a badly damaged car, not entrapped

b. a patient trapped in a cave or a confined space

Which of the following statements regarding trench rescue is correct?

a. rescue vehicles should park at least 250' from the scene

b. ground vibration is a primary cause of secondary collapse

c. a trench less than 15' deep usually does not require shoring

d. most deaths involving cave-ins are caused by head injury

b. ground vibration is a primary cause of secondary collapse

Elevation of the rib cage during inhalation occurs when:

A. intrathoracic pressure decreases.

B. the diaphragm descends.

C. the intercostal muscles contract.

D. abdominal contents descend.

C. the intercostal muscles contract

A patient who presents with profound cyanosis following a chest injury:

A. has most likely experienced a ruptured aorta.

B. is most likely experiencing severe blood loss.

C. should be placed in Trendelenburg's position.

D. requires prompt ventilation and oxygenation.

D. requires prompt ventilation and oxygenation

During your assessment of a patient with blunt chest trauma, you note that the patient has shallow breathing and paradoxical movement of the left chest wall. You should:

A. apply high-flow oxygen via nonrebreathing mask.

B. assist ventilations with a bag valve mask.

C. request a paramedic to decompress the chest.

D. make note of it and continue your assessment.

B. assist ventilations with a bag mask

If a person's tidal volume decreases, but his or her respiratory rate remains unchanged:

A. minute volume will decrease.

B. minute volume will increase.

C. minute volume will remain unchanged.

D. excess carbon dioxide will be eliminated.

A. minute volume will decrease

Following a stab wound to the left anterior chest, a 25-year-old male presents with a decreased level of consciousness and signs of shock. Which of the following additional assessment findings should increase your index of suspicion for a cardiac tamponade?

A. Engorged jugular veins

B. Widening pulse pressure

C. Diminished breath sounds

D. A rapid, irregular pulse

A. engorged jugular veins

Hemoptysis is defined as:

A. coughing up blood.

B. abnormal blood clotting.

C. vomiting blood.

D. blood in the pleural space.

A. coughing up blood

A simple pneumothorax:

A. is caused by penetrating chest trauma.

B. heals on its own without any treatment.

C. often has a nontraumatic cause.

D. is commonly caused by blunt chest trauma.

D. is commonlu caused by blunt chest trauma

Which of the following organs or structures does not reside within the mediastinum?

A. Esophagus

B. Vena cavae

C. Lungs

D. Trachea

C. lungs

An open pneumothorax is:

A. extreme pleural pressure that causes the lung to rupture.

B. an open chest wound through which air moves during breathing.

C. a fractured rib that perforates the tissue of the lung surface.

D. the entry of air into the pleural space from a perforated lung.

B. an open chest wound through which air moves during breathing

A 19-year-old male is unresponsive, apneic, and pulseless after being struck in the center of the chest with a softball. Based on the mechanism of injury, what most likely occurred?

A. Asystole secondary to massive intrathoracic hemorrhage due to traumatic rupture of the aorta

B. Fracture of the sternum that caused a rupture of the myocardium and led to a cardiac dysrhythmia

C. Collapse of both lungs due to fractured ribs that perforated the lung tissue and caused cardiac arrest

D. Ventricular fibrillation when the impact occurred during a critical portion of the cardiac cycle

D. ventricular fibrillation when the impact occurred during na critical portion of the cardiac cycle

Patients with rib fractures will commonly:

A. develop a sucking chest wound.

B. breathe rapidly and shallowly.

C. prefer to lie in a supine position.

D. take a series of deep breaths.

B. breathe rapidly and shallowly

A flail chest occurs when:

A. a segment of fractured ribs bulges during the inhalation phase.

B. multiple ribs are fractured on both sides of the thoracic cage.

C. more than three ribs are fractured on the same side of the chest.

D. a segment of the chest wall is detached from the thoracic cage.

D. a segment of the chest wall is detached from the thoracic cage

Subcutaneous emphysema is an indication that:

A. at least half of one lung has completely collapsed.

B. blood is slowly accumulating within the tissue of the lung.

C. air is escaping into the chest wall from a damaged lung.

D. your patient is experiencing a pericardial tamponade.

C. air is escaping into the chest wall from a damaged lung

You have sealed the open chest wound of a 40-year-old male who was stabbed in the anterior chest. Your reassessment reveals that he is experiencing increasing respiratory distress and tachycardia, and is developing cyanosis. You should:

A. call for a paramedic ambulance.

B. partially remove the dressing.

C. begin ventilatory assistance.

D. begin rapid transport at once.

B. partially remove the dressing

The thoracic cavity is separated from the abdominal cavity by the:

A. intercostal margin.

B. diaphragm.

C. anterior rib cage.

D. costovertebral angle.

B. diaphragm

A man called EMS 12 hours after injuring his chest. Your assessment reveals a flail segment to the right side of the chest. The patient is experiencing respiratory distress, and his oxygen saturation is 78%. His breath sounds are equal bilaterally, and his jugular veins are normal. You should suspect:

A. traumatic asphyxia.

B. tension pneumothorax.

C. massive hemothorax.

D. pulmonary contusion.

D. pulmonary contusion

A rapid, irregular pulse following blunt trauma to the chest is most suggestive of a:

A. pericardial tamponade.

B. myocardial contusion.

C. ruptured aorta.

D. tension pneumothorax

B. myocardial contusion

The ________ nerves supply the diaphragm.

A. costal

B. phrenic

C. vagus

D. intercostal

B. phrenic

If a patient with a chest injury only inhales small amounts of air per breath, he or she:

A. must increase his or her respiratory rate to maintain adequate minute volume.

B. often breathes at a slower rate because of lung damage caused by the injury.

C. will maintain adequate minute volume if his or her respiratory rate stays the same.

D. will eliminate more carbon dioxide than if he or she were breathing deeply.

A. must increase his or her respiratory rate to maintain adequate minute volume

Following blunt trauma to the chest, an 18-year-old female presents with respiratory distress, shallow breathing, and cyanosis. Her blood pressure is 80/50 mm Hg and her pulse is 130 beats/min and thready. You should:

A. perform a rapid head-to-toe physical assessment.

B. provide ventilation assistance with a bag valve mask.

C. place her supine and elevate her lower extremities.

D. apply 100% oxygen via a nonrebreathing mask.

B. provide ventilaiton assistance with a bag valve mask

Pleural fluid is contained between the:

Select one:

A. visceral and parietal pleurae.

B. visceral pleura and the lung.

C. parietal pleura and the chest wall.

D. parietal pleura and the heart.

A. visceral and parietal pleurae.

Common signs and symptoms of a chest injury include all of the following, except:

Select one:

A. hematemesis.

B. tachypnea.

C. chest wall ecchymosis.

D. localized pain.

A. hematemesis.

Pneumothorax is defined as:

Select one:

A. blood collection within the pleural space.

B. accumulation of air between the lungs.

C. blood collection within the lung tissue.

D. accumulation of air in the pleural space.

D. accumulation of air in the pleural space.

Very young children tend to breathe predominantly with their diaphragm because:

Select one:

A. their intercostal muscles are not fully developed.

B. there is no nerve innervation of the intercostal muscles.

C. they require less tidal volume per breath.

D. their chest wall and ribs are very pliable.

A. their intercostal muscles are not fully developed.

A patient with a chest injury has a blood pressure of 100/60 mm Hg and a pulse rate of 120 beats/min. Which of the following additional findings should make you suspect a pericardial tamponade?

Select one:

A. Unilaterally absent breath sounds

B. Flattening of the jugular veins

C. Repeat BP of 90/68 mm Hg

D. A pulse that becomes irregular

C. Repeat BP of 90/68 mm Hg

The phrenic nerves control the diaphragm and exit the spinal cord at:

Select one:

A. C3 and C4.

B. C3, C4, and C5.

C. C1, C2, and C3.

D. C1 and C2.

B. C3, C4, and C5.

A spinal cord injury at the level of C7 would most likely result in:

Select one:

A. immediate cardiac arrest.

B. paralysis of the diaphragm.

C. paralysis of the intercostal muscles.

D. paralysis of all the respiratory muscles.

C. paralysis of the intercostal muscles.

You are transporting a stable patient with a possible pneumothorax. The patient is receiving high-flow oxygen and has an oxygen saturation of 95%. During your reassessment, you find that the patient is now confused, hypotensive, and profusely diaphoretic. What is most likely causing this patient's deterioration?

Select one:

A. Blood accumulation in the pleural space

B. Hidden bleeding in the thoracic cavity

C. Compression of the aorta and vena cava

D. A total collapse of the affected lung

C. Compression of the aorta and vena cava

A 28-year-old male was struck in the chest with a baseball bat during an altercation. He is conscious and alert and complains of severe chest pain. Your assessment reveals a large area of ecchymosis over the sternum and a rapid, irregular pulse. In addition to providing supplemental oxygen, you should:

Select one:

A. determine if he has cardiac problems.

B. prepare for immediate transport.

C. apply an AED and assess his BP.

D. apply bulky dressings to the sternum.

B. prepare for immediate transport.

Immediate death from blunt chest trauma following a motor vehicle crash is most often the result of:

Select one:

A. penetrating lung injuries.

B. a tension pneumothorax.

C. traumatic aortic rupture.

D. a massive cardiac contusion.

C. traumatic aortic rupture.

While jogging, a 19-year-old male experienced an acute onset of shortness of breath and pleuritic chest pain. He is conscious and alert with stable vital signs. Your assessment reveals that he has diminished breath sounds over the left side of the chest. You should:

Select one:

A. circumferentially tape a dressing around his chest.

B. immediately perform a rapid head-to-toe exam.

C. administer oxygen and transport to the hospital.

D. recognize that he needs a needle decompression.

C. administer oxygen and transport to the hospital.

The most critical treatment for a tension pneumothorax involves:

Select one:

A. surgically removing the portion of the lung that is damaged.

B. assisting the patient's breathing with increased tidal volume.

C. inserting a needle through the rib cage into the pleural space.

D. placing a bulky dressing over the affected side of the chest.

C. inserting a needle through the rib cage into the pleural space.

When assessing a patient with a hemothorax, you will most likely find:

Select one:

A. signs and symptoms of shock.

B. ipsilateral tracheal deviation.

C. distant or muffled heart tones.

D. jugular venous engorgement.

A. signs and symptoms of shock

Irritation or damage to the pleural surfaces that causes sharp chest pain during inhalation is called:

Select one:

A. pneumothorax.

B. pneumonitis.

C. dyspnea.

D. pleurisy.

D. pleurisy.

Signs and symptoms of a tension pneumothorax include all of the following, except:

Select one:

A. collapsed jugular veins.

B. profound cyanosis.

C. unilaterally absent breath sounds.

D. altered mental status.

A. collapsed jugular veins

When a person is lying supine at the end of exhalation, the diaphragm:

Select one:

A. descends below the level of the navel.

B. contracts and flattens inferiorly.

C. is less prone to penetrating trauma.

D. might rise as high as the nipple line.

D. might rise as high as the nipple line.

You arrive at the scene of a major motor vehicle crash. The patient, a 50-year-old female, was removed from her vehicle prior to your arrival. Bystanders who removed her state that she was not wearing a seatbelt. The patient is unresponsive, tachycardic, and diaphoretic. Your assessment reveals bilaterally clear and equal breath sounds, a midline trachea, and collapsed jugular veins. You should be most suspicious that this patient has experienced a:

Select one:

A. pericardial tamponade.

B. laceration of the aorta.

C. tension pneumothorax.

D. massive hemothorax.

B. laceration of the aorta.

To avoid exacerbating a patient's injury, it is especially important to use extreme caution when providing positive-pressure ventilation to patients with a:

Select one:

A. myocardial contusion.

B. flail chest.

C. pneumothorax.

D. cardiac tamponade.

C. pneumothorax.

A 37-year-old male was pinned between a flatbed truck and a loading dock. On exam, you find bruising to the chest, distended neck veins, bilaterally diminished breath sounds, and bilateral scleral hemorrhaging. You should:

Select one:

A. request a paramedic ambulance.

B. suspect a severe hemopneumothorax.

C. perform a secondary assessment.

D. aggressively manage his airway.

D. aggressively manage his airway

You respond to a residence for a 40-year-old female who was assaulted by her husband; the scene has been secured by law enforcement. Upon your arrival, you find the patient lying supine on the floor in the kitchen. She is semiconscious with severely labored breathing. Further assessment reveals a large bruise to the left anterior chest, jugular venous distention, and unilaterally absent breath sounds. As your partner is supporting her ventilations, you should:

Select one:

A. insert an oropharyngeal airway.

B. immediately request ALS support.

C. obtain a set of baseline vital signs.

D. perform a focused secondary exam.

B. immediately request ALS support.