EMT Exam 2 Multiple Choice

Which of the following steps is not part of the primary assessment of a responsive patient with a medical problem?

A. Assess the patient's mental status

B. Assess the adequacy of breathing

C. Determine the patient's priority

D. Obtain the patient's blood pressure

D

The general impression is an evaluation of all of the following except:

A. the patient's chief complaint

B. appearance

C. the environment

D. past medical history

D

You are assessing a patient wand making observations about the scene. Finding drug-use paraphernalia a t the scene of an emergency is an example of:

A. an indication of the patient's chief complaint

B. the environment part of the general impression

C. an assessment of the scene safety

D. a medical history of drug addiction

B

When the patient tells you, in his own words, why he requested that an ambulance be called, this is referred to as the:

A. general impression

B. chief complain

C. primary assessment

D. secondary assessment

B

During the general impression, the EMT should:

A. look

B. listen

C. smell

D. all of the above

D

One way to determine the patient's level of responsiveness it to:

A. put ammonia inhalants into each nostril

B. rub the patient's sternum briskly

C. place the patent's hand in water

D. press on the patent's nail beds

B

You are assessing a patient who fell of his bike and landed on hid right shoulder. First you determine his mental status using AVPU. What does the "A" in AVPU stand for?

A. Action

B. Airway

C. Assess

D. Alert

D

You have determined that your patient is a V as far as mental status is concerned. What does the "V" in AVPU stand for?

A. Violent

B. Very painful

C. Verbal

D. Venous

C

You are concerned because your patient may have a depressed mental status. What does the "P" in AVPU stand for?

A. Priority

B. Painful

C. Position

D. Patient

B

One major difference between the primary assessment of a responsive trauma patient and the primary assessment of an unresponsive trauma patient is:

A. the assessment is done more quickly on the responsive patient

B. the unresponsive patient is a higher priority for immediate transport

C. there is no difference between the two assessments

D. a jaw-thrust maneuver should always be used on the responsive patient

B

You are assessing a patient who was involved in a serious motor vehicle collision. She is not alert and her breathing rate is slower than 8. As the EMT in charge, you should:

A. give high-concentration oxygen via nonrebreather mask

B. quickly valuate the patient's circulation and treat for shock

C. suction the patient and perform rescue breathing

D. provide positive pressure ventilations with 100 percent oxygen

D

During your primary assessment of a patient who is alert and has a breathing rate that is greater than 24, you should provide the patient with:

A. positive pressure ventilations with 100 percent oxygen

B. high-concentration oxygen via nonrebreather mask

C. low-concentration oxygen via bag-valve mask

D. medium-concentration oxygen via nasal cannula

B

In the primary assessment, the circulation assessment includes evaluating all of the following except:

A. pulse

B. skin

C. severity of bleeding

C. blood pressure

D

If a patient's skin is warm, dry and a normal color, it indicates:

A. a serious sunburn

B. heat exposure

C. alcohol abuse

D. good circulation

D

Your patient has no life-threatening external hemorrhagic but has skin that is cool, pale and moist. This could be an indication of:

A. increased profusion

B. high blood pressure

C. poor circulation

D. cold exposure

C

To evaluate skin color in a dark-skinned patient, the EMT should also:

A. evaluate the tissues of the lips or nail beds

B. evaluate the tissues of the heels of the feet

C. check the pupils of the eyes

D. do all of these

A

When assessing the circulation during the primary assessment, the EMT should check for and control severe bleeding. This is important to do because:

A. open woulds can become infected

B. it may lead to long-term complications

C. a patient can bleed to death in minutes

D. the blood pressure may drop over time

C

When a life threat is observed in the primary assessment, the EMT should:

A. complete the assessment, then treat

B. treat is immediately

C. determine the patient's priority, then treat

D. package the patient for transport

B

High-priority conditions include:

A. poor general impression

B. unresponsiveness

C. shock (hypoperfusion)

C. all of these

D

All of the following would be considered high-priority conditions except:

A. difficulty breathing

B. responsive but not following commands

C. an uncomplicated childbirth

D. chest pain with systolic pressure less than 100

C

During the primary assessment of an adult medical patient with a chief complaint of chest pain, you note that the breathing rate is 28. You should consider:

A. oxygen by a nasal cannula

B. providing bag-valve mask ventilations

C. administering oxygen by nonrebreather mask

D. using a paper bag to slow down the rate

C

In the adult trauma patient, why is the capillary refill no longer used to ass the circulation?

A. it is not a good indicator

B. only children have capillary refill

C. it is still a very important step

D. because EMT's have difficulty remembering to use it

A

The steps of the primary assessment:

A. are patient dependent

B. depend on the baseline vital signs

C. must be followed in order

D. depend on the age and sex of the patient

C

When doing an assessment on a patient who is apparently lifeless, the approach is adapted to include:

A. the pulse check for at least 20 seconds

B. the C-A-B approach per AHA Guidelines

C. the routine A-B-C approach per AHA Guidelines

D. none of these are appropriate

B

One of the key contributions to improvement in EMS over the years has been"

A. the type II, van-style ambulance vehicle

B. development of radio links among dispatcher, mobile units, and hospitals

C. the military antishock trousers

D. air conditioning in the transport vehicles

B

Components of a communications system include:

A. base stations

B. mobile units

C. portable radios

D. all of these

D

You will need to be alerting the trauma center of the patient's condition directly from the scene. because your portable radio does not have the power to reach the hospital from the scene, you will need to rely on a device that picks up radio signals from lower-powered units and re-transmits them at a higher power. This device is called a:

A. mobile

B. cellular

C. repeater

D. portable

C

the government agency that maintains order on the airwaves is called the:

A. FCC

B. FAA

C. FEMA

D. DOT

A

The purpose of always following the general principles of radio transmission are to allow all persons to use frequencies and to;

A. avoid having to repeat orders for medical direction

B. enable the EMT to talk in code language

C. prevent delays

D. all of these

C

Of the following components of a medical radio report, which is in the correct order?

1 - major past illness

2 - chief complaint

3 - unit identification and level of provider

4 - emergency care given

A. 4, 1, 2, 3

B. 3, 4, 1, 2

C. 3, 2, 1, 4

D. 1, 2, 4, 3

C

You arrive on the scene that includes a 58 year old male patient. The ambulance was called because he has had chest pain for the past hour. The "chest pain" in this situation is called the:

A. major past illness

B. chief complaint

C. presenting diagnosis

D. call type

B

You are en route to the hospital with a 27 year old female who is in pain. During your radio report you say, " the patient's abdomen feels rigid." You are actually advising the hospital of:

A. the baseline vital signs

B. the emergency medical care given

C. the reponse of the patient to the emergency medical care

D. pertinent findings of the physical exam

D

During you radio report, you state, "the patient's mental status has not changed during our care." You are attempting to advise the hospital of the:

A. the baseline vital signs

B. the emergency medical care given

C. the reponse of the patient to the emergency medical care

D. pertinent findings of the physical exam

C

Your local protocols require a direct medical order to allow you to assist the patient with her bronchodilator device.Whenever you request an order for medical direction over the radio, it is good practice to:

A.repeat the physician's order word for word back to the physician

B. question all verbal orders that are given

C. speak quickly because the physician is busy

D. call the physician back to verify

A

If you receive an order from the on-line physician for ten times the normal dose of a medication (i.e. 1,500 mg of ASA instead of 150 mg), what should you do?

A. switch to another frequency to find another physician

B. question the physician about the order

C. follow the physician's order as stated

D. ignore the order and do what you believe is correct

B

It is three in the morning and your partner is interviewing a patient with a minor complaint. You notice that he is standing with arms crossed looking down at the patient. What nonverbal message could he be sending to the patient?

A. I am here to help you

B. I am not really interested

C. I can empathize with your problem

D. I am afraid of catching your disease

B

You are treating a patient who was struck by an automobile. It is obvious that the patient has broken left because a bone is protruding through the skin. the patient asks you "Is my leg broken?" What would be the most appropriate response?

A. Relax and stay calm. You will be all right

B. I am not qualified to make that determination

C. No, its a bad cut, and I'll control the bleeding with a bandage

D. Yes, it is, and I will be as gentle as possible splinting it.

D

When treating a toddler who is sitting on the couch complaining of stomach pain, the best approach is to:

A. kneel down so you are at the child's level

B. speak louder so the child can hear you above all the crying

C. star directly into the child's eyes

D. tell the child you are a friend of his parents

A

The PCR serves as a legal document as well as a(n):

A. press release form for your EMS agency

B. receipt for the patient

C. aid to research, education, and administrative efforts

D. form to report all calls to the local police department

C

Why is it necessary to complete a PCR if, on each call, you give the emergency department staff a good oral report?

A. The QI committee needs something to hold you to

B. It provides a means for the ED staff to review the patient's prehospital care

C. The ED usually does not listen to oral reports

D. Duplication is helpful in emergency call documentation

B

The copy of the PCR left at the hospital:

A. is returned to the state for quality review and follow-up

B. is thrown out once it is key-punched and added to computer file

C. should become part of the patient's permanent hospital record

D. is sent to the regional Emergency Medical Services agency

C

You are called to court to testify about a civil matter when a patient sues the city for a injury that occurred in a public place. Which of the following will best help you recall the events of the call?

A. the questioning by the defense's attorney

B. the questioning of the plaintiff's attorney

C. a complete and accurate PCR

D. your tape recording of the call dispatch

C

The person who completed a PCR may be called to court to testify about:

A. the call in a criminal proceeding

B. the care provided to the patient

C. the call in a civil proceeding

D. all of these

D

The routine review of PCRs for conformity to current medical and organizational standards is a process called:

A. initial feedback

B. quality improvement

C. stress debriefing

D. system research

B

Each individual box on a PCR is called a:

A. narrative

B. data element

C. key punch

D. assessment

B

According to the NHTSA, in addition to other data elements, the minimum data set on a PCR should include all of the following except:

A. respiratory rate and effort and skin color and temperature

B. times of incident, dispatch, and arrival at the patient

C. patient's SSN

D. capillary refill for patients less than 6 years old

C

The time of dispatch is an example of ___ data on the PCR?

A. assessment

B. run

C. patient

D. narrative

B

Examples of patient data on a PCR would be:

A. date of birth and age

B. time of arrival at the hospital

C. ambulance identification number

D. the hospital transported to

A

Experienced EMT's consider a good PCR as one that:

A> protects them against QA review

B. is vague enough to prevent lawsuit

C. paints a picture of the patient

D. identifies symptoms overlooked by the patient

C

A statement such as "the patient has a swollen, deformed extremity" on the narrative of the PCR is an example of:

A. subjective information

B. objective information

C. pertinent negative information

D. police officer's statment

B

All of the following are examples of information that be put in quotation marks on the PCR except:

A. bystander information

B. chief complain

C. objective information

D. police officer's statments

C

In the narrative section of a PCR, the EMT should:

A. list his or her conclusions about the situate

B. include pertinent negatives

C. use the radio codes for each treatment

D. list the vital signs and times obtained

B

Medical abbreviations should be used on a PCR:

A. to save space in the narrative section

B. to replace all words you cannot spell

C. only if they are standardized

D. to ensure correct interpretation by physicians

C

You are treating a 22 year old who fell off his motorcycle. He has some road rash and no major injuries and is mostly concerned about his bike. He does not want to go to the hospital and had a friend who can drive him home and take care of him. Before leaving the scene, you should:

A. document assessment findings and care report

B. try again to persuade the patient to go to the hospital

C. ensure the patient is able to make rational, informed decision

D. the patient's definitive diagnosis

D

When completing a PCR on a patient refusal, the EMT should document all of the following except:

A. that he or she was willing to return if the patient changed his or her mind

B. the complete patient assessment

C. that alternative methods of care were offered

D. the patient's definitive diagnosis

D

If the EMT forgot to administer a treatment that is required by the state treatment protocols, he or she should:

A. document on the PCR only treatment that was actually given

B. be sure to document an excuse for why the treatment was skipped

C. record that the patient was given the forgot treatment

D. do none of these

A

You are in a rush during a call and did not have time to take a second set of vital signs. Your partner says, just write in another set ten minutes after the first one. Falsification of information on a PCR may lead to:

A. suspension or revocation of your license or certification

B. better EMT education

C. longer response times

D. none of these

A

To correct an error discovered while writing the PCR, the EMT should:

A. scribble out the error so it cannot be seen

B. draw a line through the error, initial it, and write the correct information

C. place his or her initials over the error

D. erase the error completely, and then write the correction

B

On returning to the station after a call, you have the chance to reread your PCR. If information was omitted by mistake, you should:

A. prepare another report and substitute that for the earlier one

B . notify the service Medical Director immediately

C. add a note with the correct information, the date, and initial it

D. do nothing because information should never be added after the call

C

Occasionally, EMT's may have only a limited amount of information about the patient to document on the PCR. An example of an instance in which it would not be unusual of the EMT to obtain only a limited amount of information is:

A. during a multiple-casualty incident

B. during an interhospital transfer

C. while performing a nonemergency run

D. when encountering a child abuse case

A

You were just on a call about which your agency medical director requires you to complete a special incident report. Special situation (incident) reports:

A. document events that should be reported to local regulatory authorities

B. can be submitted at any time after the call

C. need not be accurate and or objective

D. are required on each call

A

Ambulance services and EMS personnel are required by ___ to take steps to safeguard patient confidentiality:

A. OSHA law

B. HIPAA

C. the NHTSA

D. the U.S. DOT

B

There are laws, both state and federal, that protect patient privacy. An example of a method that an ambulance service would use to safeguard patient confidentiality is:

A. requiring employees to place completed PCRs in a locked box

B. using only patient last names during radio transmission

C. allowing only PCRs with patient name to be distributed during QA meetings

D. none of these is an acceptable procedure

A

The policy an ambulance service develops concerning patient rights and confidentiality must take into consideration:

A. state regulations

B. local regulations

C. HIPAA

D. all of these

D

The term used to describe the conclusion that an EMT makes about a patient's condition after assessing that patient is called the:

A. presumptive diagnosis

B. EMT diagnosis

C. EMS diagnosis

D. all of these are correct

D

The analytical process that assists the EMT in reaching a field diagnosis is referred to as:

A. active assessment

B. passive assessment

C. critical thinking

D. detailed assessment

C

The basic approach that clinicians use to arrive at a diagnosis includes each of the following except:

A. gather information

B. administer many lab tests

C. consider the possibilities

D. reach a conclusion

B

When a clinician draws up a list of conditions that may be the cause of the patient's condition today, this is referred to as the:

A. admission diagnosis

B. presenting problem

C. differential diagnosis

D. assessment finding

C

The signs or symptoms that suggest the possibility of a particular problem that is very serious is referred to as a(n):

A. red flag

B. black triage tag

C. unstable situation

D. none of these

A

When a highly experienced physician comes to a diagnosis, he or she most likely used:

A. heuristics

B. pattern recognition

C. shortcuts

D. all of these

D

The traditional approach to diagnosis involves:

A. narrowing down a long list

B. jumping to conclusions

C. taking lots of shortcuts

D. eliminating similar conditions

A

Each of the following are considered common heuristics or biases except:

A. illusory correlation

B. availability

C. representativeness

D. underconfidence

D

When a clinician is specifically looking for evidence that supports the diagnosis he or she already has in mind, he or she is committing a(n) _____ bias.

A. anchoring

B. confirming

C. satisfying

D. illusionary

B

When a patient does not fit the classic pattern, such as a cardiac patient without crushing chest pain, the EMT has to be careful not to make a(n) ___ error or bias.

A. confirmation

B. representativeness

C. overconfidence

D. availability

B

An EMT recently had a patient with heat stroke. The next time he or she has a patient in a warm environment, the EMT is more likely to think of this as the diagnosis as opposed to more common problems, such as dehydration. This bias is referred to as:

A. overconfidence

B. illusory correlation

C. confirmation

D. availability

D

The EMT should be skeptical about on condition being the actual cause of another condition a patient presents with. Drawing conclusions about the cause of a diagnosis can lead to a(n):

A. anchoring adjustment

B. illusory correlation

C. search satisfying bias

D. availability bias

B

You are treating a patient who was found on the floor in the nursing home. It seems evident that he has a fractured hip as he lies on the floor in pain. If you stop the search for diagnosis as soon as you come up with the cause of today's problem, this can lead to:

A. missing out on the secondary diagnosis

B. overconfidence and misdiagnosis

C. overestimating the frequency of the problem

D. all of these

A

If you are an EMT who wants to think like a highly experienced physician in your assessment of patients, you should try to:

A. learn to hate ambiguity

B. utilize a single strategy in all cases

C. understand the limitations of technology and people

D. reflect on what others have learned

C

The EMT who wants to think like a highly experienced physician tries to do each of the following techniques except:

A. organize data in her or his head

B. reflect on what he or she has learned

C. realize that no one strategy works for everything

D. try not to learn from others

D

You are an EMT treating a patient who has developed a rash and uticaria on her chest and face. If you were to begin treating this patient as a victim of a severe allergic reactions rather than questioning her about previous development of a similar rash, you would be exhibiting an example of:

A. an availability bias

B. an illusionary correlation

C. having overconfidence in your judgement

D. an appropriate shortcut to take

B

When evaluating a patient during the focused physical exam, the EMT needs to ____ each body part.

A. auscultate and visualize

B. percuss and palpate

C. inspect and palpate

D. visualize and percuss

C

When a patient tells you that he called because he cut his wrist with a razor, this is called the:

A. primary assessment

B. chief complaint

C. SAMPLE history

D. secondary assessment

B

The history of the present illness or injury for a trauma patient include:

A. the direction and strength of the force

B. actions taken to prevent or minimize injury

C. equipment used to protect the patient

D. all of these

D

The physical exam includes the basics of the inspection, auscultation , and :

A. interaction

B. intuition

C. palpation

D. observation

C

The "P" in DCAP-BTLS refers to:

A. punctures/penetrations

B. palpation/pulse

C. priapism/penetrations

D. paradoxical motion/punctures

A

The "S" in DCAP-BTLS refers to:

A. soft tissue

B. stable

C. swelling

D. stomach

C

Your patient was thrown from his motorcycle when he stopped suddenly. His thighs are very painful and a strange shape. When a body part is injured and it no longer has its normal shape, this is referred to as a:

A. hematoma

B. deformity

C. fracture

D. crepitation

B

Your patient has been outdoors in the sun most of the day. He has reddened and blistered areas on his shoulders and neck called:

A. abrasions

B. burns

C. lacerations

D. contusions

B

In the secondary assessment, you will be checking the patient from head to foot for pain and tenderness. The difference between pain and tenderness is:

A. pain occurs only when you squeeze an injury site, whereas tender areas hurt all the time

B. pain is considered unbearable, whereas tenderness is usually bearable

C. tenderness may not hurt unless the area is palpated, whereas pain is evident without palpation.

D. pain hurts only for the first 10 minutes, whereas tenderness doesn't go away

C

A common result of injured capillaries bleeding under the skin is called:

A. swelling

B. puncture

C. laceration

D. abrasion

A

When is it appropriate to apply a cervical collar?

A. If the mechanism of injury exerts great force on the upper body

B. If there is any pain in the abdomen

C. If there is any burn injury to the neck

D. If the patient has experienced any trauma

A

You are treating a pitcher who was hit in the face with a ball that was hit by the batter. You remember from your EMT training that any blow above the ___ may damage the cervical spine.

A. clavicles

B. diaphragm

C. femur

D. pelvis

A

Experienced EMT's often refer to a soft cervical collar as:

A. the device of choice for a neck injury

B. a "neck warmer"

C. the requirement for all auto collision patients

D. the preferred extrication collar

B

If a cervical collar is the wrong size, it may:

A. cause additional injury to the spine

B. make breathing more difficult or obstruct the airway

C. prevent the patient from moving her neck

D. take too much time to adjust and apply correctly

B

The need for cervical immobilization should be based on:

A. the trauma patient's level of responsiveness

B. the location of injuries to the patient

C. the mechanism of injury

D. all of these

D

When assessing and interviewing a patient, we ask about and look for signs and symptoms. What is a sign?

A. A photograph of the patient's wrecked vehicle

B. The patient's description of how the injury occur ed

C. An objective finding you can see, hear, or feel when examining the patient

D. A subjective finding that the patient tells you about his current condition

C

When considering the mechanism of injury (MOI), which of the following would not be considered a significant MOI in an adult?

A. high-speed motorcycle crash

B. vehicle-pedestrian collision

C. a 10-foot fall

D. Rollover vehicle collision

C

You are treating a patient who was in the front seat of an automobile involved in a collision. You observe a spider-web crack in the windshield and the facial lacerations on the patient. Most likely the patient:

A. will have a life-threatening head injury

B. did not ear a seat belt or three-point harness

C. will also complain of leg injuries

D. was involved in a rollover collision

B

The EMT should list and look under the airbag after the patient has been removed from the vehicle in order to:

A. obtain the serial number of the airbag

B. see if a hazardous chemical had been released

C. note any visible damage to the steering wheel

D. determine if it deployed properly

C

When assessing the head of an adult male critical trauma patient, the EMT should inspect.palpate for ___ in addition to wounds and deformities.

A. hematoma

B. scalp lacerations

C. crepitation

D. abraisions

C