EMT Final 1

_______________ is a cardiac arrhythmia characterized by a complete disorganization of electrical activity.

Ventricular fibrillation

A 67 year old female is short of breath and sitting in a tripod position. She is on home oxygen and has had a productive cough over the last few days. During your exam, you note that she is wheezing and breathing with pursed lips. SpO2 is 93%. What should you suspect?

Obstructive pulmonary disease

How should you ventilate an apneic adult patient?

Ventilate once every 5-6 seconds with a bag valve mask

Your 36 year old patient is unresponsive. Upon attempting to insert an oral airway, the patient gags. You should

a. insert a nasal airway

Your 25-year-old male patient has sustained a painful, deformed shoulder, injured while playing baseball. This has happened to him before and he wants to "pop it back in". You should

a. assist the patient in realigning his shoulder.

A 7 year old female fell out of the tree and was unconscious for 2 minutes. The patient is very scared and combative. You should

b. apply a c-collar and backboard.

To protect yourself from injury when lifting a stretcher, you should

a. keep the weight close to your body.

A 60 year old patient with a stoma is apneic. You have been suctioning pink frothy sputum for 10 seconds and you continue to get more material. You should

a. stop suctioning and give a breath.

You are treating a 50 year old male with chest pain. Your written protocol indicates that you should give nitroglycerin. This is known as Select one:

standing order

A patient is in respiratory distress after eating soup brought by her neighbor. Her neighbor states: "She was eating and suddenly her throat got tight." She is sitting bolt upright in a tripod position. You should

anaphylaxis

You are responding to a 23 year old pedestrian who is 7-months pregnant and was struck by a motor vehicle. She is complaining of abdominal pain, her skin is pale and cool, heart rate is 110, respirations are 20. You should

d. position the patient on her left side, administer oxygen and transport emergently.

You should ventilate a newborn once every Select one:

d. three seconds

Early signs and symptoms of hypoperfusion can include

c. decreased blood pressure.

Your fifty-five year old patient complains of chest pain radiating to the left arm. You should first

d. place the patient on oxygen.

Which of the following is an anatomical difference between an adult and an infant airway?

a. The infant's trachea is softer

A 75 year old female patient has a partial thickness, thermal burn on her right forearm. You should

c. place a dry sterile dressing or sheet over the burn.

You are completing a patient care report for a patient injured in a car crash. You notice the smell of alcohol and empty beer cans in the vehicle. The best way to document your findings in the patient care report is to

b. describe the smell of alcohol and empty beer cans which were noted at the scene.

You respond to car accident on a busy city street. You are the first emergency vehicle on scene. Which of the following best describes where you should position your ambulance when arriving on scene?

d. Park beyond the wreckage to protect your truck from being struck by traffic.

Which of the following patients is MOST at risk for hypovolemic shock?

a. A hemophilia patient with a nose bleed

Your 26 year old female patient was involved in 30 MPH head-on collision. She complains of slight stiffness in her neck. She is 36 weeks pregnant. What action should you take?

c. Provide spinal stabilization, oxygen, c-collar, long spine board and transport with patient in left lateral recumbant position.

Consent to treat is implied in which of the following cases?

21 year old unconscious male

An unresponsive ten year old male was hit by a car and is bleeding heavily from an open leg fracture. After securing his airway and manually stabilizing his cervical spine, you should

d. perform a rapid trauma assessment.

You are called to an elderly patient who had a syncopal episode. The patient has had blood-tinged vomiting and general fatigue for the last few days. You suspect

a gastrointestinal bleed.

Your patient is pale, diaphoretic, and complains of chest pressure. Her vitals are R 18, P 58, and BP 88/50. You should suspect

cardiogenic shock.

You are ventilating an apneic infant. His pulse is 54. You are currently ventilating with a bag-valve-mask with supplemental oxygen. You should

begin chest compressions.

When ventilating with a mouth-to-mask you notice the presence of increasing gastric distention. You should

manually reposition the airway.

When infants or children experience breathing difficulties, their pulse may

increase early, then decrease significantly.

A 10 year old male complains of a stiff neck and a fever. He is very confused and complains of extreme fatigue and headache. You should

meningitis.

A conscious 7 year old patient has chemical burns around her mouth from ingesting drain cleaner. Her breathing is adequate. You should

evaluate patient's airway.

A 30 year-old female is experiencing vaginal bleeding and abdominal pain. She is drowsy. Her skin is pale, cool, and clammy. Her vital signs are BP 90/60, P 120 and R. 20. You estimate that she may have lost 500 cc of blood. Which of the following should concern you the MOST?

Hypovolemic shock due to blood loss.

Which following best describes a bipolar patient?

They appear psychotic during manic phases.

What should you initially do to open the airway of a eight month old?

Pad under the head of the child.

Your patient has a gunshot wound to the anterior thigh. You should

expose the wound, control bleeding, and transport rapidly.

Your patient has a fork impaled into his cheek. He is having trouble breathing. You should

carefully remove the fork from the cheek.

You are ventilating an apneic asthmatic patient with a BVM, but notice there is inadequate chest rise. What should you do?

Reassess the airway for an obstruction.

You have an unconscious patient with blood in the airway. You should

A. use a suction unit to immediately clear the airway

You are conducting a physical exam on a responsive female toddler. You should

use a toes-to-head approach for the examination.

Immediately upon returning to the station from a scene where a child died, the crew members discuss the call. This is an example of

D. an informal debriefing

You are treating an unconscious 50 year old diabetic patient. You shouldSelect one:

c. transport the patient as soon as possible.

A five year old female with asthma is having intercostal retractions. She cannot hold her head up to talk. You should

b. contact medical control before assisting patient with prescribed inhaler.

The use of a traction splint for femur fractures is important in order to

d. reduce further nerve and blood vessel damage.

Your patient is a 65 year old male complaining of chest pain. Which of the following would be a contraindication for assisting with the administration of sublingual nitroglycerin?

c. Systolic blood pressure >100

Your 18 month-old patient has pale cool skin, decreased mental status, and delayed capillary refill. The mother tells you that the child's diaper has been dry for most of the day. First responders have applied oxygen. You should

b. rapidly transport and monitor vital signs.

A victim of smoke inhalation has developed difficulty breathing. He does not like the smell of the mask you are using to deliver oxygen. You should

a. explain that the mask is very important and continue its use.

Your twelve-year-old patient has a penetrating wound to the abdomen. You may provide care based on

d. implied consent.

A patient complains of left side chest discomfort. The vital signs are BP 108/68, P 104, R 24, SpO2 90%, and her hands are cyanotic. You should

d. administer oxygen by nonrebreather at 15L/minute.

Your patient's pulse returns after the use of the AED. You should first

a. continue ventilations.

Your patient is a 56 year old male who collapses while mowing the lawn. He is apneic and pulseless immediately following collapse. What is the patient most likely experiencing?

d. Cardiac arrest

your patient is short of breath, wheezing, and is cyanotic after eating shrimp. He has a known allergy to shellfish. What should you do?

c. Administer his EpiPen

Which of the following is the most appropriate way to measure for an oropharyngeal airway adjunct?

d. From the center of the patient's mouth to the earlobe

You are called to the scene of a motor vehicle crash, where you find a three year old female sitting in an unsecured car seat. She has abrasions to her forehead and right arm. She is alert to voice, her skin is pink and dry, and she appears to breathing normally. You should

c. place a short back board behind the child and gently extricate her from the car seat.

A 16 year old football player received a blow to his left femur. You can see deformity and the patient is in extreme pain. He does not remember how the injury happened. You should

c. apply a traction splint to the injured leg.

A 75 year old patient is complaining of shortness of breath. Vital signs are BP 160/88, P 130, and R 22 with crackles in the bases of the lungs. You should

d. administer oxygen via mask.

A 72 year old with heart problems fell out of bed. He is confused and has pale and sweaty skin. You should

b. take spinal precautions and rapidly transport.

A 72 year old female patient is unresponsive following an ejection from a vehicle crash. She has an open jaw fracture and a dilated right pupil. What is the best way to open this patient's airway?

b. Insert a nasal airway

A good EMS quality improvement (QI) program includes

c. education and feedback regarding patient care.

A 62 year old female is complaining of crushing chest pain that radiates to between her shoulder blades. She is very pale, diaphoretic, and feels nauseous. You should suspect a/an

d. cardiac event.

Which of the following is TRUE about the insertion of an oropharyngeal airway (OPA)?

b. If properly inserted, the OPA will keep the tongue out of the airway.

You are called to an elementary school for a 10 year old who fell at the playground. When you arrive you find the school nurse and a teacher's aide performing CPR. What is the most appropriate action for you to take?

c. Ask the nurse to stop CPR while you check for breathing and a pulse.

Allowing for appropriate time on exhalation when assisting ventilations can reduce/alleviate

c. gastric distention.

A 62 year old female who has been drinking alcoholic beverages is feeling dizzy. She cannot walk and she complains of a severe headache. You should suspect

b. acute alcohol intoxication.

A patient becomes unresponsive. You find she is apneic and pulseless. You should

a. start CPR and apply the AED.

You are transporting a 62-year-old patient complaining of chest pain. Vital signs are: BP 88/40, P 90, R 12. Online medical control orders you to assist the patient in taking his prescribed nitroglycerin. You should

c. repeat the vital signs and confirm the order.

You are transporting a 68-year-old female from a nursing home to the hospital. She has a valid DNR. During transportation, she begins to have trouble breathing. You should

c. provide oxygen and position the patient for comfort.

A 19 year old sexual assault victim is bleeding from an external vaginal laceration. You should

c. keep anything from touching the injury.

A 45-year-old diabetic patient is experiencing left arm pain and is sweating profusely. You should

c. administer oral glucose.

Which of the following is the best definition of hypoperfusion?

c. inadequate oxygen delivery to cells.

A 45 year old male farmer has been working with dry lime. The patient has large amounts of this powder on both legs. You should

d. gently brush off excess powder and transport.

A 2 year old boy has a circumferential burn to his hand up to the wrist. The mother tells you a pot of boiling water spilled onto the boy. You should

a. transport and inform the ER that you suspect abuse.

All of the following are indications for the use of nitroglycerin EXCEPT

d. the patient's systolic blood pressure is less than 90.

A diabetic patient was reported missing last evening. He is found unresponsive, lying in a ditch along the road in approximately two inches of water. Vital signs are BP 96/40. P 38, R 6. You should

b. wrap the patient in blankets and transport.

An intoxicated 33 year old female was fighting with the police. You note some minor scrapes on the patient's leg and face. The patient is being verbally abusive to you. The police want your approval to take the patient to jail. You should

b. restrain and transport the patient with police escort.

Five minutes after delivery of a newborn, your patient is moving all extremities, has pink skin, a weak cry, is grimacing and has a pulse of 96. The APGAR score is

d. 8.

You respond to a scene where a mentally ill adult is threatening to kill himself. He is refusing transportation to a hospital. You should

c. ask law enforcement for assistance.

Your patient is nine months pregnant with her first child. Her contractions are 10 minutes apart, lasting for 20 seconds. She tells you that she is "having this baby now". You should

d. transport the patient on her left side and monitor.

Which of the following indicates the correct flow range and delivery percentage for a nasal cannula?

b. 1-6 lpm / 40%

A 23 year old construction worker twisted his foot climbing up a ladder. He has an obvious deformity on the right leg just below the knee. The lower leg and foot are cyanotic and pulseless. You should

b. Apply an air splint and transport

You respond to a twenty-two year old male with an altered mental status. His skin is warm and diaphoretic and has a known seizure history. It is likely your patient is

b. postictal.

A pulseless and apneic 68 year old male has an implanted pacemaker in his right shoulder. Without delaying defibrillation where should you apply the AED pads?

a. Right shoulder (directly over the pacemaker) and the left lower chest

You are at the scene of a car crash. Which of the following situations would require rapid extrication?

d. Your patient blocks access to a critical patient.

A 73 year old male is sitting in the tripod position. As you approach, he motions for assistance in using his inhaler. What should you do?

c. Assess his airway status

You are dispatched to a 68 year old female complaining of discomfort in her upper back. She is nauseous and appears to be sweaty. Based on these symptoms, which of the following possible causes is most life-threatening?

b. Cardiac compromise

After air passes through the vocal cords during inhalation, which structure does it reach next?

c. Trachea

An alert and oriented male is complaining of severe chest pain, but he refuses transportation against medical advice. You should

c. ask family to help convince him to be transported.

A father has dialed 911 because his 5 year old daughter is choking. She is coughing vigorously. You should

a. encourage the patient to keep coughing

When responding to an incident involving an unidentified hazardous material, the most appropriate place to position the ambulance is

d. upwind and uphill from the incident.

You respond to a conscious thirty-four year old male burned in a fire with full thickness burns to both hands and forearms and partial thickness burns to his chest. You should

c. carefully wrap the burned areas with a dry sterile dressing.

Of the following communicable diseases, which one is MOST likely to be transmitted through airborne droplets?

c. German measles (rubella)

When you assess a pulse you are feeling the

c. contraction of the left ventricle.

Your 54 year old patient is refusing to answer your interview questions. You should

a. make eye contact and try to gain his trust.

You are giving a verbal report to the hospital during transport. You should

b. cover only the pertinent facts and be brief.

You are transporting a patient who has been restrained due to hostile behavior. He is complaining that he has no feeling in his hands, and is threatening to sue you if you don't remove the restraints. He has been very cooperative since the restraints were placed. You should

b. assess the patient's distal circulation frequently.

Your patient was exposed to an unknown chemical that has soaked their clothing. You should immediately

c.removeallclothing

You are called to an elderly male who is having trouble breathing. Respirations are at a rate of 24 and labored and the patient is cyanotic. Your patient is conscious but unable to speak in full sentences. Enroute to the hospital your patient goes into respiratory arrest. You should

c. assist ventilations with BVM and 100% O2.

A 67 year old female just had a syncopal episode while using the toilet. Vitals are: BP 100/60, P 110 irregular, R 12. She is weak and dizzy. You should suspect a

d. cardiac rhythm disturbance.

A patient with chest discomfort becomes unresponsive during transportation to the hospital. What is the most appropriate action?

a. Confirm pulselessness, initiate CPR, stop the vehicle and apply an AED.

A 45 year old female patient complaining of left sided chest discomfort. Her vital signs are BP 108/68, P 104, R 20, and her fingers are blue. You should

a. administer oxygen by nonrebreather at 15L/minute.

One of the most problematic side effects of nitroglycerin is

b. hypotension.

When suctioning a patient you should

a. suction on the way out for no more than 15 seconds.

You are dispatched to a patient who has intentionally overdosed on pain medication. The patient is refusing transport. You should

d. convince the patient that they should be transported and can return home after seeing a doctor.