EMT_101_ FInal Exam Study Guide

you have arrived at the scene of a medical emergency. as you enter the room where the patient is located, you note that he is sitting up and talking w/o difficulty. Emergency medical responders (EMRs) are on scene and providing basic care for the patient. what should you do first

get a report from emergency medical responders

A pt w/ a severe infection is very sick. Circulating toxins from bacteria in his blood have decreased his SVR. which BP change would the EMT correlate to this condition?

BP of 74/26 mmHg

an EMT would perform an urgent move when:

when there is immediate danger to the pt.

under normal circumstances, carbon dioxide is excreted from the body through the:

lungs

as your ninth emergency call during a 12-hour shift, you are summoned to a dance club at 0215 hours for a “drunk person”. while on scene, your partner stands w/ arms crossed, looking down at the floor, and shaking her head negatively as you try to gather the SAMPLE Hx. Her nonverbal behavior may be interpreted by the pt or bystanders as:

anger

a pt has sustained a GSW to his right thorax. when you listen to his breath sounds, they are diminished over the right thorax. what is the most logical explanation for this finding?

the negative pressure btwn the pleural linings has been lost, causing the lung tissue to collapse.

what is the best description of minute ventilation?

amount of air moved into and out of the lungs in 1 minute.

what sit he primary stimulus to breathe in human beings without pulmonary diseases?

level of CO2 in the body

A homeless ppt is sick and is refusing transport. the pt is alert and clearly has the capacity to understand her situation and make a rational decision, but the temperature tonight will be near zero. The EMT picks up the pt and puts her on the cot. the pt continues to refused to allow Tx and transport, despite the EMTs explanation that it will be warm in the hospital and she will be fed. the pt is transported. what could the EMT be charged with?

false imprisonment

to improve your physical fitness and decrease the risk of injury when lifting and moving patients, you should combine proper body mechanics with:

proper nutrition

a 42-year-old female complains of SOB. which question would best assist you in getting additional information about the pt’s CC?

“you appear to be short of breath. are you also having chest pain?”

a pt denies difficulty breathing, but displays signs of respiratory distress. you state, “i know that you said you are breathing fine, but you cannot speak more than two to three words at a time without gasping for air.” you response is an example of:

confrontation

what is required for normal perfusion to occur?

adequate breathing, sufficient RBC, good heart function.

while off duty, an EMT happens upon the scene of a MVC in which a car rolled over the side of an embankment. a young man has been seriously injured; he appears unresponsive, and is bleeding from the head and face. The EMT is alone with his infant baby daughter in the car and cannot leave her to provide help. therefore, the EMT alerts 911 of the emergency and remains in his car with his daughter until EMS arrives. later in the week, he finds out that the patient died. which statement is true regarding this incident?

the EMT had no duty to act and cannot be held liable for the man’s death

a pt has fallen in his upstairs bathroom and is lying on the floor. assessment indicates no life threats to the airway, breathing, or circulation; however, the pt does have pain, deformity, and bruising to his right hip. in this situation, the EMT should recognize the need for which type of move?

non-urgent

for a pt who is acutely bleeding, what is the immediate response of the human body?

increasing HR, baroreceptor activation, sympathetic nervous system activation and vasoconstriction.

a pt w/cancer is receiving chemotherapy. as a side effect of the Tx, her WBC count is critically low. given this situation, which sign or symptom should the EMT find particularly concerning?

Oral Temperature of 102.7

when completing a paper-based PCR, you accidentally write that a laceration was on the left side of a patient’s face when it was actually on the right side of the face. correcting this mistake would include which step?

draw a single line through the term “left” and write the word “right” next to it.

a pt’s lungs are full of fluid and cannot transfer oxygen to the blood. as a result, she is undergoing anaerobic metabolism. she has a decreased LOC with a patent upper airway and inadequate respirations. her pulse is rapid and weak. which prehospital Tx would best address this situation?

PPV w/ supplemental oxygen.

a pt who is weak informs you that she has a Hx of her “iron being too low”. This should concern the EMT because iron is needed to…

carry oxygen throughout the body.

which statement reflects the most appropriate way to alert a receiving hospital that you are en route w/ a patient?”

“St. Elizabeth Hospital, this is BLS ambulance 104. how do you copy?”

when carrying equipment in the right hand, the EMT should:

keep his or her back straight and locked.

a pt’s spouse, who is a doctor, states that an EMT is negligent because he put his wife on low-concentration oxygen when she should have gotten high-concentration oxygen, the patient was having chest pain that was later determined to be caused by anxiety. she was released from the ED later in the day. which statement is true?

the EMT cannot be proven negligent because the Pt suffered no harm or damage.

which statement accurately describes the concept of body mechanics?

body mechanics refers to methods that promote using your body in the safest and most efficient way when moving objects or patients.

for a patient who relies on the hypoxic drive to breathe, the respiratory rate will increase when:

O2 levels decrease

a distraught husband awoke to find his 26-year-old wife not breathing and cold to the touch. since your assessment indicates that the woman haas been dead for some time, you contact medical direction for authorization to withhold emergency care. the medical director agrees and the coroner is notified. at this time, your immediate responsibility is:

providing supportive care to the husband.

your partner accidentally uses a profane word when talking to dispatch. which agency has the power to find him and the ambulance service?

Federal Communications Commission

a chronically elevated afterload increases the patient’s chance for developing which pathological condition?

heart failure

which statement is most appropriate to start with when transferring a pt to the ED and giving the oral report?

“Mr. Hedger called us today because he was having chest pain.”

a pt has been shot three times in the abd and has massive internal hemorrhage and blood loss. which tx will give this pt the best chance at survival?

stop the bleeding

a 16-year-old male was killed after driving at excessive speeds and then losing control of his car. he was not wearing a seat belt. in an attempt to understand why such a tragedy would occur, you would recognize that:

common to this age group is a perceived sense of strength and invulnerability

an EMT would recognize and categorize a 15-year-old female patient as a…

adolescent

which of the sequences best describes the path that oxygen must travel to get into the cells of the body?

oropharynx, larynx, trachea, carina, bronchioles

the EMT should use the jaw-thrust maneuver to open the airway for the pt with which type of presentation?

unresponsive after falling from a porch

on arrival at a lethargic patient’s side, you note her to have gurgling respirations. what is the best tx for the condition?

suction

which of these conditions would the EMT associate with a hypoxic respiratory drive?

COPD

the EMT recognizes a late sign of hypoxia in a pt in a coma when he observes:

cyanosis in fingers

you have been called for a pt who has overdosed on drugs and alcohol. the pt is responsive to painful stimuli, has shallow respiration and is breathing at a rate of 8 times per minute, but exhibits no cyanosis. what is the priority tx?

inadequate respirations; start PPV w/ supplemental oxygen.

which of these patients should the EMT recognize as having a potential occlusion of the upper airway?

a 3-year-old male w/a fever and swelling of the pharynx

when using the OPQRST mnemonic, the EMT is getting information as it applies to the “P” category when she asks:

“is there anything that makes it better or worse?”

you and a paramedic partner are caring for a pt who ODed on a drug that has caused her to become apneic. your EMT student is providing BVM ventilations w/ supplemental oxygen via an ET tube placed by the paramedic. how often should vital signs be reassessed on this pt?

every 5 minutes

when obtaining a BP for a pt, the radial pulse disappears when the gauge reads 130 mmHg. when deflating the cuff, the EMT hears a pulse at 118 mmHg. the pulse disappears at 76 mmHg. given this, which of these statements is true?

the systolic BP is 118 mmHg.

when using the SAMPLE mnemonic, which of these statements made by the patient would be categorized under the letter “M”?

medications - is there any medications you are currently taking? any you shouldn’t be taking? any that you stopped taking?

an EMT has an accurate understanding of systolic BP when he tells you that systolic BP is:

produced when the heart contracts

which of these BP readings is normal for a 7-year-old male?

114/62 mmHg

correctly assessing orthostatic vital signs involves:

taking the BP in the supine, seated, and standing positions.

the EMT understands the primary reason to obtain a medical Hx using the SAMPLE mnemonic when he states:

“after performing the primary assessment, the SAMPLE mnemonic helps guide the EMT in further assessment and care.”

the fire department has requested your assistance at a residence where the family’s carbon monoxide detector has been going off. there are three pt’s. you first assess a 28-year-old female pt who states she has a sinus headache but otherwise feels fine. her vital signs are pulse, 90; respirations, 16 breaths per min; BP, 118/60 mmHg; and SpO2, 100%. Given these assessment findings, you should immediately:

administer high concentration oxygen.

you have been called to a residence of a woman who fell down the stairs. on scene, you find the pt on the couch w/ a large laceration to her forehead. as you begin reassessing and treating her, she states that she did not fall down the stairs, but rather was assaulted by her ex-boyfriend after inviting him into her home. he has since left the residence prior to your arrival. in this situation, which statement would be most appropriate?

“aside from your head are you hurt anywhere else?”

dispatch has sent you to the scene of a fight at a local sporting event. since the EMS system is busy and there are very few ambulances available, dispatch has instructed you to call for additional units after arrival on scene. on scene, you find that the police are present and what appear to be 10 to 12 people are seated or lying on the ground, many with blood on their faces and clothing. when would you call for additional ambulances?

before getting out of the ambulance

you arrive on the scene at an extended care facility where you see the facility employees removing the residents via wheelchairs and hospital beds. as you exit the ambulance, an employee walks up to you and identifies herself as the night-shift charge nurse. she states that the facility had a furnace malfunction and the carbon monoxide alarms are sounding. there are probably 30 residents already int he parking lot a safe distance away, and there are reportedly 15 more inside who are unresponsive. given the number of patient overall, the EMT should:

alert dispatch of the need for additional resource.

you have been called to a bar full of intoxicated patrons for a 46-year-old man who fell off his stool, injuring his left arm, as you assess his arm, the pt screams in pain. several of the patrons get angry and yell for you to give him something for pain. someone in the back throws a bottle in your direction. what should you do next?

leave the scene and only return when the police made it safe to do so.

you have been directed to a car that struck another vehicle at a moderate rate of speed. you note deformity and staring of the windshield on the driver’s side. what should you do to determine whether the deformity to the windshield was caused by the driver hitting his head or by the airbags?

assess the pt’s head

on scene, frantic family members direct you into the basement where their 67-year-old mother has shot herself in the chest with a small handgun. she is unresponsive and breathing 6 times per minute. the gun remains in her hand by her side. which action should you take immediately?

pick up the gun by the edge of the grip and carefully remove it.

you are entering the scene where a 32-year-old intoxicated male has fallen down 13 stairs leading to the basement. he is seated on the floor of the basement, holding a bloody towel over his face. during the initial scene size-up, what is it essential that the EMT quickly identify?

possible need for additional personnel

dispatch has sent you to a residence for a female pt with a possible broken arm. on scene, you find the pt seated in a chair holding her left arm. her arm appears deformed and she has blood and bruises on her face. she tells you that an intruder, whom she believes lives in her neighborhood, broke into her home and robbed her. prior to fleeing, he beat her, leaving her as you find her. with this information, you would immediately:

contact law enforcement, assess, the pt, and initiate care.

the pt’s family states that their 16-year-old daughter has a hx of asthma and has been complaining of SOB for the past two days. she has been taking her MDI with some relief, but this morning, they found her lethargic and struggling to breathe. your assessment reveals the patient to be unresponsive to verbal stimuli with an open airway and shallow respirations of 44 breaths per minute. you hear minimal wheezing in both lungs. what is your immediate action in caring for this patient?

start PPV

an intoxicated 19-year-old female pt has fallen through a large plate glass window. as you approach, you not her to be sitting up and holding her hand over a large laceration on her opposite arm that is still spurting bright red blood. in this situation, you would immediately:

apply direct pressure to the laceration

a 44-year-old male pt was cutting limbs from high in a tree when he fell. he is found to be unresponsive with snoring respirations. his breathing is inadequate at a rate of 8 breaths per minute and his carotid pulse is weak and difficult to locate. following the primary assessment and initial management of life threats, which of these actions will the EMT complete while performing the secondary assessment?

obtain vital signs and get a PMH from the family.

you are by the side of a 64-year-old male pt who collapsed at home. after reassessing his LOC, airway, and breathing, you determine that he is unresponsive with an open airway, but not breathing. the patient still has a carotid pulse. which instruction should you immediately give to your partner?

“let’s attempt to place an OPA or NPA and start ventilations.”

on scene, you find a 84-year-old female pt who fell down two steps after suddenly complaining of a severe headache. she is unresponsive with gurgling respirations. which instruction should you immediately give your partner after manual spine motion restriction is applied?

“get the suction out and clear the airway”

you are assessing a 4-year-old pt whose panicked mother states that she cannot wake him. the child is breathing but his eyes are closed. to best determine the child’s mental status you should first:

say loudly, “open your eyes.”

a 26-year-old male pt has been ejected from a car after it rolled several times in the median of the interstate. as you perform the primary assessment, you find him prone and unresponsive. your immediate action is to:

logroll him to supine position.

you arrive at the scene of a fall, where a 42-year old woman fell backward off a stepladder while cleaning her kitchen windows. she is seated on the floor and complains of pain to her ankle. she tells you, “if i had just gone to work today instead of using vacation time, this would have never happened!” based on information thus far, what can you conclude?”

the pt is alert w/ an open airway

which of these medications are included in the EMT’s scope of practice?

activated charcoal, NTG, oral glucose.

as an EMT you may assist pt’s in taking which kind. of prescribed medication?

inhalers used for difficulty breathing

after administering oral glucose to a pt with altered mental status, which of these findings best indicates a positive therapeutic effect or response to the medication?

mental status that is now alert and oriented.

you are by the side of an alert and oriented 56-year-old male patient who complains of generalized weakness and a pounding headache. his pulse is 104, respirations are 18 breaths per minute, and BP is 218/110 mmHg, he has a hx of hypertension, for which he takes lisinopril. he states that he has not taken the lisinopril for 2 weeks and hands you a container with the medication inside. you would:

continue tx and transport the pt to the hospital

a pt with chest pain tells you that he fells the same now as when he had a heart attack 2 years ago. he is diaphoretic, nauseated, and vomiting; he has a pulse of 84, respirations of 16 breaths per minute, and a BP of 78/50 mmHg. the patient is allergic to ASA. he asks you to assist him in taking on of his NTG pills because his arthritis makes it too hard for him to open the medication bottle. which of the assessment findings represent a contraindication to the NTG?

BP of 78/50

which medical emergency would most likely be treated with the use of epinephrine by the EMT?

bee stinga pt

a pt with a cardiac hx complains of chest pain. he already took four baby ASA’s, and medical direction has given you permission to assist the pt with his NTG dose. after you administer NTG to the pt, he complains of a headache. what would be your most appropriate next step?

realize that the headache is an undesirable side effect of the NTG and continue care. a d

a driver was ejected from his vehicle in a rollover type collision. assessment findings reveal the pt to be unresponsive, with bruising to the abd and pelvic areas as well as an open femur fracture. the pt has an open airway an is breathing 22 breaths per minute. when you listen to breath sounds, you find them to be absent over the alveolar areas of the lungs. the patient’s skin is cool and clammy and the radial pulses weak. manual spine motion restriction is being maintained. what should you next intervention be?

assist respirations

you have been called to a public pool for an unresponsive pt. on arrival, you find lifeguards performing CPR with a pocket mask and oxygen on a 67-year-old male swimmer. they report that the patient was in the water and was seen clutching his chest seconds before going unresponsive. he was immediately pulled from the water and CPR was initiated. the lifeguards estimate that CPR has been performed for 5 minutes. assessment shows the man to be unresponsive, apneic, and pulseless. what should be your first response?

“let’s take a towel and dry off his chest”

you are assessing an elderly pt with decreased LOC. your assessment reveals the pt to have a patent airway, labored respirations, and weak, rapid, pulses. the skin is pale, cool, and cyanotic in the extremities. you also observe diaphoresis and a delayed capillary refill. vital signs for this patient are heart rate, 136 beats/min; BP, 66/40 mmHg; and respirations, 40 and shallow. auscultation of the lungs reveals profound rales located throughout each lung. the pt’s temperature is 99F and there is obvious JVD and pedal edema. additionally, family states that the pt has an extensive cardiac and diabetic hx. based on this information, you should suspect which kind of shock?

cardiogenic

you have been called to an industrial warehouse for a young adult male pt who was exposed to an unknown chemical gas. the pt was immediately removed from the environment and presents to you w/ a patent airway, burning to the throat with inspiration, and complaint of SOB. his vital signs are pulse, 120; respirations 28 breaths/min; BP 164/60 mmHg; and SpO2 90%. in addition, you not bilateral wheezing to the lungs. what should be your first action in caring for this pt?

administer supplmental oxygeny

you are summoned to a grocery store for a female pt found having a “fit” by store employees. upon arrival, you are escorted to the side of an alert but mildly confused 41-year-old woman who is diaphoretic and appears exhausted. after 2-3 more minutes, she becomes more alert and informs you that she has a hx of seizures and just had a generalized seizure. despite your urging, she refuses transport to the hospital. your safest action would be to:

advise medical direction of the situation

a pt who experienced an apparent syncopal episode refuses transport to the hospital. prior to the pt signing a refusal, which of these statements should you make to the pt?

“syncope may indicate a serious underlying condition, so please follow up with a doctor.”

which of these statements about seizures is true?

seizures may be caused by a variety of medical conditions

you arrive on scene and find emergency medical responders with a seizing patient. which of these questions should you ask first?

“how long has the pt been seizing?”

while taking an emt class, you come across a test question that asks you to define the pathophysiology of a seizure. which answer would you select?

“a seizure occurs when there is a massive and uncoordinated electrical discharge in the brain”

which type of seizure occurs in children and is caused by high core temperature?

febrile

for altered mental status to occur, which body system must be affected?

central nervous systemwh

which of these statements made by a patient suggests that he is suffering from a tension headache?

“the pain started at the top of my head and spreads down my back.”

during a continuing education program, the lecturer is talking about the RACE scale as a newer tool the EMT can use to help determine whether a neurologic problem is present. which neurologic problem does the RACE scale address?

structural vs. metabolic cause of unresponsiveness

a 30-year-old pt with a hx of migraine headaches has called 911 for a suspected migraine headache. she says the headache follows her usual pattern of headaches, the pain is a 10/10, and she is nauseated. her vital signs are pulse, 108; respirations, 18 breath/min; and BP 154/90 mmHg. which of these tx is indicated in the care of this pt?

providing darkened environment during transport.

with the cincinnati prehospital stroke scale, which of these patient parameters is assessed?

facial droop

while you are teaching a public awareness class about stroke, a participant asks you if all pt’s with stroke are paralyzed on one side of their bodies. your reply would be:

“no. some stroke pt’s may have only slight weakness to one side of their bodies.”

which of these conditions would the EMT recognize as not likely signaling a neurologic deficit?

paralysis

your pt is a 66-year-old female who has regained a pulse after a shock with an AED; however, she remains unresponsive and is not breathing adequately. which of the following should be done next?

assist ventilations w/ BVM device and supplemental oxygen and anticipate that the pt may go back into cardiac arrest.

which of the following is the goal of early CPR in cardiac arrest.

bringing in oxygen into the brain and to keep oxygen flowing.

automatic defibrillation is not appropriate in most cases of infant cardiac arrest due to which of the following?

v-fib is not the primary cause of cardiac arrest in pediatric pt.

which of the following is NOT a role of the EMT in providing emergency cardiac care?

administer of epinephrine

your pt is a 60-year-old male who is complaining of severe chest pain and difficulty breathing. he is pale and sweaty and pleads with you, “don’t let me die, i think i’m going to die.” which of the following measures is NOT part of your initial tx of this patient?

applying the defibrillator pads to his chest.

which of the following best describes the intended role of the EMT in the ideal provision of emergency cardiac care?

early defibrillation

which of the following heart chambers pump oxygenated blood to the body?

left ventricle

you know an MET is correctly using a glucometer when she performs which procedural step?

waste the first drop of blood obtained from the pt’s finger.

after you administer oral glucose to a pt with diabetes, his LOC deteriorates and he becomes unresponsive with snoring respirations. which action should you take immediately?

manage the airway

you are called to an outpatient clinic to transfer a 39-yar-old male pt in DKA to an acute-care hospital. when assessing this patient, which sign or symptom would you expect to find?

fruity or acetone odor in his breath.

you have been called for a 32-year-old female pt with altered mental status. on scene, you find the patient lethargic and confused. although information is sketchy, it appears that she has a history of diabetes as well as renal failure for which she receives dialysis. you note no deficits in the primary assessment and the vital signs are pulse, 124; respirations, 28; BP, 106/68 mmHg; and SpO2 97%. your partner reports a blood sugar reading of 774 mg/dL based on this information, the EMT would understand that definitive care of this patient would involve the administration of which medication at the hospital?

insulin

five minutes after administering oral glucose to a confused patient with diabetes, you do not see any improvement in her mental status. which action should you take?

continue to monitor pt.