NREMT

Treatment for a responsive 4-year-old child with a mild airway obstruction, who has respiratory distress, a strong cough, and normal skin color, includes:

supplemental oxygen and transport

Finger sweeps are ONLY indicated if

the patient is unresponsive and you can see the object in his or her mouth

Cellular respiration and cellular metabolism are best described as

the use of oxygen and carbohydrates to produce energy and the creation of carbon dioxide and water byproducts.

An absence seizure, also called a petit mal seizure, is characterized by

a blank stare and an absence of tonic-clonic motor activity.

A focal motor seizure

is isolated to one part of the body, such as an extremity, but can progress to a generalized (full body) seizure.

You should assist with the delivery of the baby's head by:

placing your fingers on the bony part of the skull and applying gentle pressure

A child between 3 to 5 would have normal vitals if they are?

Respirations b/w 20-30
Pulse 80-120
Systolic bp 80-110

You receive a call for a 3-year-old girl with respiratory distress. When you enter her residence, you see the mother holding the child, who does not acknowledge your presence. This finding indicates that the child:

has severe hypoxia

When is it MOST appropriate to clamp and cut the umbilical cord?

as soon as the cord has stopped pulsating

Which of the following is the MOST common cause of shock in infants and children?

dehydration

A 5-year-old boy was struck by a car when he ran out into the street. When you arrive at the scene and approach the child, you see him lying supine approximately 15 feet from the car. Based on the child's age and mechanism of injury, which of the following should you suspect to be his PRIMARY injury?

pelvic injury

You are called to the scene of a man down. Dispatch reports the man is pulseless and bystanders are doing CPR. According to the NREMT Cardiac Arrest management/AED skill sheet, which of the following sequences is appropriate?

Complete 1 cycle of CPR, attach AED, have everyone stand clear during rhythm check.

Your patient is a 41 year old female who was found lying prone in the kitchen. She does not appear to be conscious andthere is a pool of saliva next to her head. You and your partner log roll her into a supine position while maintaining c-spine stabilization. Just as you get the woman rolled over her husband tells you that she has a previous history of heart attacks. What would be the most appropriate course of action to take next?

Do a jaw thrust to open her airway.

Which position is MOST appropriate for a mother in labor with a prolapsed umbilical cord?

supine with hips elevated

You are treating a 5-year-old child who has had severe diarrhea and vomiting for 3 days and is now showing signs of shock. Supplemental oxygen has been given and you have elevated his lower extremities. En route to the hospital, you note that his work of breathing has increased. You should:

lower the extremities and reassess the child

After an advanced airway device (eg, ET tube, multilumen airway, supraglottic airway) has been inserted during cardiac arrest, ventilate the patient at a rate of_____________ breaths per minute (one breath every __________ seconds). This ventilation rate applies to all age groups, except the newborn.

8 to 10, 6 to 8

Excessive ventilation (eg, hyperventilation) is detrimental because it causes an increase in intrathoracic pressure, which

impedes blood flow back to the heart and decreases coronary perfusion

A 6-year-old boy presents with a high fever, a headache, and a stiff neck. He is conscious, but is not acting as a normal 6-year-old boy should. His mother told you that he vomited once before your arrival. You should be MOST concerned with:

the risk of permanent neurological damage

Signs and symptoms of Cushing's triad include all the following except

tachycardia

Your assessmment of a newborn reveals cyanosis to the chest and face and a heart rate of 90 beats/min. What should you do first?

begin artificial ventilations

Oxygen and other nutrients are transferred to the developing fetus via the:

umbilical vein

Hypoxia-induced unresponsiveness during a submersion injury is usually the result of:

laryngospasm

General rules to follow when attempting to rescue a patient from the water include

reach, row, throw, then go

You and your partner arrive at the home of a 60-year-old man with shortness of breath. As you enter the residence, you find the patient sitting in his recliner; he is in obvious respiratory distress. As you approach him, he becomes verbally abusive, stating that it took you too long to get to his home. A small handgun is sitting on a table next to his recliner. You should:

slowly back out of the residence and call law enforcement

Which of the following statements regarding the function of insulin is correct?

facilitates the uptake of glucose from the bloodstream into the cell

Which of the following is found just above the kidneys in the abdomen?

pancreas

By the age of two months, an infant should be able to

recognize faces and focus on things near to him

Because fibrinolytic therapy decreases the blood's ability to clot, its use is limited to patients with ______ strokes.

ischemic

Which of the following are characteristics of late adulthood?

lung elasticity is diminished, pain perception is diminished, and metabolism is increased

It would increase __________ in patients with hemorrhagic stroke; therefore, fibrinolytic therapy is contraindicated for these patients.

intracerebral bleeding

You will also find that most postictal patients are __________; this is the result of an adrenalin surge that occurs during the tonic-clonic phase of the seizure.

tachycardic

Ticks can carry two infectious diseases:

Lyme disease and Rocky Mountain spotted fever

The age that a person begins to develop a self-concept or self awareness is

school-age

Lyme disease signs/symptoms

rash beginning about 3 days after bite that may resemble bullseye pattern in 1/3 of patients
swelling of joints (especially knees)

The Adam's Apple is also known as the

larynx

Often, the first sign of inadequate breathing is

a change in respiratory rate

To determine the length of a catheter when suctioning an adult oropharynx, you would

measure from the corner of the patient's mouth to the patient's ear.

A bag valve mask that is not hooked up to oxygen will deliver ______% of oxygen to a patient and _____% of oxygen if hooked up.

21/100

A respiratory disease where the patient loses surface area, causing them to trap air in their lungs is called:

emphysema

The respiratory disease that causes a patient to attempt to compensate for los of available surface area in their lungs by making more red blood cells is called:

emphysema

The structure used by both the respiratory system and the digestive system is called

pharynx

You are treating a 4 year old female patient who has a barking cough that sounds like a seal. You expect that this patient has:

croup, resulting in swelling of the larynx

You have used an AED on a patient in a cardiac arrest situation. You know it is time to transport the patient when

the patient regains a pulse, a total of 6 shocks have been delivered, the AED has given 3 consecutive no shocks advised, the patient regains consciousness

Rocky Mountain spotted fever signs/symptpoms

symptoms begin 7 to 10 days after infected bite
nausea, vomiting, headache, weakness, paralysis, and possibly cardiopulmonary failure.

Which of the following is a physiologic effect of epinephrine when used to treat anaphylactic shock?

as a bronchodilator and vasoconstrictor, it improves the patient's breathing and constricts the blood vessels and increases the patient's blood pressure.

You are dispatched to a residence for a 20-year-old male with respiratory distress. When you arrive, you find that the patient has a tracheostomy tube and is ventilator dependent. His mother tells you that he was doing fine, but then suddenly began experiencing breathing difficulty. You should:

remove him from the mechanical ventilator and ventilate him manually.

You have a patient who just started a new medication today. You arrive on scene and she is complaining of difficulty breathing. As you walk in, you hear a high pitched wheezing sound as she breathes. This means that

her laryngeal airway is swelling

Wind chill is an example of

convection

You respond to a scene to find a patient who you expect to be the victim of prolonged hypothermic exposure; you can assume the patient is severe when

the patient is not responding appropriately

All of the following are signs and symptoms of superficial injury to tissue except

firm or frozen feeling on palpation (indicates deep tissue damage)

You receive a call to a restaurant where a 34-year-old man is experiencing shortness of breath. When you arrive, you immediately note that the man has urticaria on his face and arms. He is conscious, but restless, and is in obvious respiratory distress. You should:

place a nonrebreathing mask set at 15 L/min on the patient

When timing the contraction duration, it should be timed from the

beginning of the contraction until the uterus relaxes

If your patient has an arterial bleed on the forearm, the brachial artery would be

medial to the injury - apply pressure to the wound and assess the need for a tourniquet

In general, you should avoid rewarming a frostbitten body part in the field if:

the affected body part could refreeze after rewarming

You are transporting a 30-year-old man who is experiencing an emotional crisis. The patient does not speak when you ask him questions. How should you respond to his unwillingness to speak?

remain silent until the patient speaks to you

Jaundice (yellow sclera and skin) and right upper quadrant abdominal pain are not common early manifestations of hepatitis; they usually develop within ___________ into the disease process.

1 to 2 weeks

A 73-year-old male presents with confusion; cool, pale, clammy skin; absent radial pulses; and a blood pressure of 70/40 mm Hg. The patient's wife tells you that he has had abdominal pain for a week and began vomiting a coffee-ground substance yesterday. His past medical history includes hypertension and gastric ulcer disease. Your MOST immediate concern should be that:

he is in shock and requires prompt transport

Patients with severe hypothermia (core body temperature < 86°F) who are in cardiac arrest should be managed with

basic life support (chest compressions and ventilations), passive external rewarming (ie, removal of wet clothing, applying warm blankets) and rapid transport to the hospital where they can be actively rewarmed.

Which of the following signs is LEAST suggestive of a diabetic emergency?

bradycardia

narcotics

heroin, morphine, codeine, and meperidine (Demerol), propoxyphene (Darvon)

barbiturates

phenobarbital

benzodiazepines

Valium, Klonopin, and Xanax

difference between exertional heat stroke and classic heat stroke

classic heat stroke patients usually have dry skin while exertional heat stroke patients tend to have moist skin

Why should you not apply ice to a snakebite?

this will cause local vasoconstriction and may force the venom deeper into the patient's circulation

You have just controlled bleeding from an extremity using a pressure dressing. You should now

check distal pulses, motor function, and sensory function

accessory muscles used for inspiration

sternocleidomastoids, scalene muscles, pectoralis minor muscles

accessory muscles used for expiration

abdominal muscles, intercostal muscles

All of the following are functions of the skin except

it serves as an area for blood vessels to be protected and flow through the body.

The depression between the base of the tongue and the epiglottis is called

vallecula

The area that the endotracheal tube passes through is known as the

the glottic opening

In a rush, which of the following can give you a good idea of the appropriate tube size for a pediatric patient?

compare tube size to the patient's finger

Post successful intubation, placing an oropharyngeal airway can be recommended because

the OPA can function as a bite block

Which of the following intubating blades puts pressure on the glossoepiglottic ligament?

MacIntosh - curved blade that allows the vocal cords to be seen by putting pressure on the glossoepiglottic ligament

Before intubating an adult patient, you should

hyperventilate your patient at a rate of 24 times a minute for 1 to 2 minutes

Which of the following is the most common cause of airway obstruction?

the tongue

For which of the following patients could you use a Combitube or dual lumen device?

A 78 year old female who is uncsoncious

Which condition below is generally not included in the class of COPD?

lung cancer

A 24 year old tells you in broken sentences that he used his metered dose inhaler shortly prior to your arrival with little relief. Medical control has given you authorization to assist the patient with his inhaler. What is the proper dose to administer?

the dose depends on what Medical Control tells you to use

Who is most susceptible to contracting respiratory disease?

Elderly

Your patient is breathing in a shallow to deep pattern with periods of apnea. You suspect

End stage brain tumor

What is the name of the tracheal ring that sits directly inferior to of the larynx?

cricoid cartilage

Which of the following actions would eliminate more carbon dioxide?

increased ventilatory rate and depth

Your patient is breathing inadequately. To deliver the highest concentration of oxygen, you should use a

bag valve mask resuscitator at 15 LPM

You find an unresponsive patient. You open the airway and give the first breath, air does not go in. You should:

let the patient's head fall back into a neutral position and retilt the head

Your apneic patient has a tracheal stoma. First responders have begun ventilating her by placing a pediatric mask over the stoma, but there is no chest rise. They have sealed the patient's mouth and nose, but ventilation is still difficult. You suction the stoma but are still notadequately ventilating the patient. You should attempt re-ventilation by

sealing the stoma and ventilating through the mouth with a head tilt chin lift maneuver

A patient was ejected in a vehicle rollover. You note crepitus and paradoxical left chest movement. You should

Secure affected area with bulky dressing and transport

Why would you never suction a patient for longer than 15 seconds?

it can lead to hypoxia

In which of the following situations could it be appropriate to place a Combitube or dual lumen airway device?

Multi-system trauma with Glasgow Coma Score of less than 4

The hypoxic drive is regulated by

high oxygen saturation percentage

When using a bag valve mask to ventilate a patient, one rescuer

squeezes the bag with two hands while the other rescuer opens the airway and seals the mask with two hands

In a suspected head injury patient what is the most important thing to pay attention to as you care for the patient?

decreasing mental status

The type of injury to the brain that results from shearing, tearing, and stretching of nerve fibers is a

diffuse axonal injury (typical in car accidents and sports injuries)

You are caring for a patient with an abdominal injury. The patient was hit in the upper abdomen and is complaining of dull diffuse pain. His vital signs are stable-normal. Which of the following is most likely?

the patient has injured his liver

A general rule to splinting joint injuries is to

immobilize the injury above and below the joint.

You arrive on scene and find a patient that is complaining of neck pain, weakness, and loss of motor function but can still feel light touch below the injury site. What could you tell the hospital that you have in your call in report?

anterior cord syndrome - the loss of the ability to feel pain and crude touch and will likely cause loss of motor functions, but patient will typically be able to feel below level of injury.

You have been given a trauma patient from another crew on scene. The patient does not seem to be awake or alert and is already fully immobilized. You exposed the chest and recognize a large section of the chest wall that is moving in on inspiration and out on expiration. How can you treat this injury?

provide the patient with positive pressure ventilations so that the chest wall will overcome the negative pressure during ventilation and this will allow the chest wall to function cohesively

An advantage of using a bag valve mask is that it

can be used on spontaneously breathing patients

You understand that it is important to use the proper size OP airway. To do this you should size the airway by

measuring from the center of the mouth to the angle of the jaw

Which statement is true in regards to the pediatric airway

the narrowest part of the airway is the cricoid cartilage

The proper liter flow for a nasal cannula is 4-6 LPM

false