exam retake

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1. As you enter the scene of a medical emergency, the Emergency Medical Responder informs you that the patient is not breathing and has pupils that are fixed and dilated. Based on this description, which one of the following are you expecting to see when you reach the patient's side?

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1. **Neither pupil will react when light is directed into the eyes.**

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1. Which plane would show the liver, stomach, and spleen?

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1. **Transverse plane**

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1.  Emergency Medical Responders (EMRs) are on scene. In your community all EMS practitioners are trained according to the National EMS Scope of Practice Model. Which one of the following do you expect the EMRs to be providing?

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1. **Automated external defibrillation**

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A patient with difficulty breathing has a metered-dose inhaler (MDI). Which of the following medications is the MDI most likely to contain?

**Albuterol**

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1. Friends pulled an unresponsive 15-year-old male from a lake. They say they were swimming when they lost track of him. Assessment reveals labored breathing and a weak pulse. Which of the following questions would give the EMT the most information related to the prognosis of the patient?

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1. **"How long was he under the water?"**

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1. Following a call in which you treated a pediatric patient suffering from croup, a new EMT who is in orientation asks you how you can differentiate croup from epiglottitis. Which one of the following responses would be most appropriate?

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1. **"The child with epiglottitis typically drools; the child with croup rarely, if ever, drools."**

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1. After a lengthy response, you arrive at the home of a 62-year-old female who is still seizing. Your immediate action would be to:

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1. **assess the patient's airway and breathing.**

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1. As an EMT, you may assist the patient in taking which of the following prescribed medications?

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1. **Inhalers used for difficulty breathing**

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1. Family directs you to a bedroom where a 62-year-old male is in respiratory distress. During the scene size-up, which of the following most strongly suggests that the patient suffers from a chronic respiratory disease?

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1. **Patient in chair in tripod position**

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1. For the stroke patient to be eligible for a fibrinolytic, it must be given within:

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1. **3 hours of the onset of stroke symptoms**

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1. On scene, you find a 2-year-old male in significant respiratory distress. He is responsive to verbal stimuli and exhibits noisy respirations through an open airway. His breathing is shallow at a rate of 44 breaths per minute. His pulse is rapid. Assessment of the skin shows it to be cool and diaphoretic with cyanosis to the extremities and around the mouth. What is the immediate priority for this patient?

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1. **Start positive pressure ventilation.**

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1. When assessing a 3-year-old male in respiratory distress, the EMT should recognize "see-saw" breathing when he observes:

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1. **movement of the chest and abdomen in opposite directions.**

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1. When reassessing a patient you are treating for an anaphylactic reaction, what finding would be of the most concern to the EMT?

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1. **Respiratory rate change from 28 to 10 breaths per minute**

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1. When using a stroke scale to assess a patient for abnormal speech, the EMT should:

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1. **ask the patient to repeat a common phrase.**

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1. A 27-year-old male was involved in an altercation and was struck in the ribs with a baseball bat. Assessment reveals intact skin with noted bruising to the right lateral chest. When palpating this area, pain, instability, and crepitus are all observed. The patient also complains of difficult and painful breathing. The EMT would recognize:

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1. **chest injury caused by blunt trauma.**

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1. A male driver was ejected from his vehicle after it rolled several times at a high rate of speed. As you approach the patient you note that he is unresponsive and struggling to breathe. He also has a laceration to the left side of his face and multiple contusions to his legs. After assigning another EMT to take manual in-line spinal stabilization, what should you do?

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1. **Open the airway using the jaw-thrust maneuver.**

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1. An awake but confused patient with a diabetic history spilled a pot of hot water on himself while cooking. He has a partial-thickness burn on his right anterior leg. Following an unremarkable primary assessment, which action is your highest priority?

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1. **Check the patient's blood glucose level.**

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1. What mechanism of injury produces the conditions for traumatic asphyxia?

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1. **Person pinned between a truck and wall of a building**

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1. A 7-year-old has fallen and exhibits deformity of his left wrist. He will not cooperate with you as you attempt a closer examination of the wrist. Which of the following statements would be appropriate given the patient's age and behavior?

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1. **"I know that you are scared, but I need to see your hand."**

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1. You have been called to a residence for a 21-year-old female in labor. On location you immediately see that the head of the baby is out of the vagina. While delivering the head, the mother screams that she is having twins. The EMT should immediately:

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1. **call for another EMT crew.**

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1. A bleacher at a college has collapsed, and you are the first EMS unit to arrive on the scene. As you enter the gym, several patients are walking around with various injuries. What instruction is most appropriate for these ambulatory patients?

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1. **"Go outside and wait by the red fire truck in the parking lot and stay there."**

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1. The rescue captain has asked that you disconnect a car's battery to shut down all power to the vehicle completely. How should you do this safely?

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1. **Remove the negative battery cable first.**

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1. Which one of the following actions is appropriate when using a helicopter on the scene of an emergency?

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1. **Always approach the helicopter from the front and never from behind.**

While a factory employee is moving a container of a radioactive​ liquid, some of the liquid splashes onto his arm. This situation is best be described​ as:

contamination

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1. While responding to an emergency call, what should you do if you encounter a school bus unloading students?

1. you and partner are first on scene, as you exit ambulance you notice several patients sitting around debris from the scene, what is considered first

2. Stop and wait for all children to cross the road safely.

You and your partner are first on the scene of a bleacher collapse at a local raceway. As you exit the ambulance, you note several patients seated around debris from the seats. In this situation, which one of the following actions would you perform first

Determine the number of patients

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1. 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, he 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?

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1. **leave scene and only return when police say its safe to do so**

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1. You are an assistant instructor for an Emergency Medical Responder course. One of the students asks you how the head-tilt, chin-lift airway maneuver works to open the airway. Your response is:

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1. **It opens the airway by lifting the tongue from the back of the throat**

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1. You have been dispatched to a residence for an 89-year-old female patient with a nonspecific complaint. When assessing this patient, what should you do first to develop an initial impression regarding emergency?

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1. **Determine whether the complaint is medical or trauma related**

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1. During the primary assessment, how should you best determine the adequacy of a patient's breathing?

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1. **Examine the rise and fall of the chest**

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1. A shooting at a public mall leaves three people dead and nine injured, several critically. As operations wind down, many rescuers are physically and emotionally upset. Which event may be most appropriate at this specific time?

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1. **A gathering that allows the rescuers to vent their emotions**

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1. Which of the following anatomical statements is true?

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1. **The knee is proximal to the ankle**

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1. Which line divides the body into right and left halves?

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1. **Midline**

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1. As you arrive on scene, an Emergency Medical Responder informs you that the patient has agonal respirations. By this description, you should expect the patient's breathing to be:

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1. **occasional, and gasping**

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1. The pediatric airway differs from adult airways in that:

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1. **The child's tongue takes up proportionately more spaces in the mouth.**

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1. The EMT shows correct understanding of the circulatory system when e identifies the primary function of the heart as:

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1. **pumping blood throughout the body**

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1. The left atrium

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1. **Receives blood from the pulmonary veins**

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1. When palpating a pulse on top of the foot, the EMT is assessing blood flow to what vessel?

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1. **Dorsalis pedis artery**

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1. The EMT would best recognize normal cellular metabolism as:

Aerobic

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1. The EMT is administering oxygen at 95% through a nonrebreather face mask. He would document this as an FiO2 of:

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1. **0.95**

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1. A 20-year-old female has called 911 for chest pain. On scene you find that she has shallow breathing with an SpO2 reading of 91% on room air. She states she was in a car crash yesterday and diagnosed in the hospital with broken ribs. She says that her pain is right where the ribs are broken and rates it a 10/10. Breath sounds are present bilaterally. In this situation, the EMT should attribute the hypoxia to which one of the following?

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1. **Pain from rib injury prevents full expansion of the chest cage**

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1. Which of the following statements indicates that the EMT has an accurate understanding of the bronchioles?

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1. **"they are all passages located in the lower airway that have smooth muscle surrounding them."**

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1. When assessing the airway, breathing, and circulation, which one of the following best indicates that the patient has an open airway?

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1. **The patient speaks with ease**

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1. While you are transporting a patient with altered mental status, he suddenly vomits partially digested food along with large blood clots. The vomitus is too big for the rigid suction catheter. The EMT should immediately place the patient on his side and:

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1. **Perform a finger sweep**

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1. You must suction frothy secretions from the mouth and pharynx of a 31-year-old male patient whose respirations rate is 4 breaths per minute. Which one of the following interventions is most appropriate given the patient's condition?

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1. **Suction for no more than 15 seconds at a time followed by 2 minutes of positive pressure ventilation**

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1. An EMT student asks you if it matters if the blood pressure cuff seems too small for a patient, even though a reading can still be obtained. You should respond:

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1. **Cuffs that are too small provide inaccurately high readings."**

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1. You are called for a 2-year-child who is sick. When testing her capillary refill, which one of the following would be the most cause for concern?

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1. **3-second capillary refill time.**

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1. Which one of the following statements made by an EMT student indicates that he correctly understands the use of capillary refill when assessing a patient?

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1. **"Capillary refill is a more reliable sign of blood circulation in children under 6 years of age than in adolescents or adults."**

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1. When should the EMT evaluate the scene of an emergency for hazards that may threaten or harm him?

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1. **Throughout the entire call**

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1. Which of the following standard precautions must the EMT take on every call?

Gloves

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1. You are by the side of a patient complaining of shortness of breath with a history of heart problems, including congestive heart failure (CHF). When assessing the airway, which one of the following observations best indicates that it is patent?

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1. **She easily tells you that she is having chest pain.**

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1. An EMT is assessing a 9-month-old infant who is "not acting right" per his mother. Assessment reveals him to be extremely irritable, crying weakly, and shows he does not want to be touched by the EMT. Which one of the following best describes this infant's mental status?

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1. **Alert**

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1. To best evaluate the adequacy of breathing in an unresponsive adult, the EMT should:

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1. **observe the chest rise.**

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1. You are assessing a 4-year-old patient 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:

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1. **say loudly, "Open your eyes!"**

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1. You have been called for an adult patient who suffered a seizure. He is sitting on the floor, and looks at you as you enter the room. When questioned, he cannot remember the date or where he is. The patient's mental status can best be described as:

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1. **Alert but confused**

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1. When assessing a sick or injured patient, which of the following indicates the appropriate order?

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1. **Scene size-up, primary assessment, secondary assessment**

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1. You have been dispatched to an apartment for an elderly male complaining of shortness of breath. When do you start the process of forming a general impression about this patient?

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1. **as you and your partner approach him**

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1. To stabilize the cervical spine of a trauma patient while simultaneously opening the airway, how should you position her head?

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1. **Neutral and in-line**

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1. The EMT shows she understands the importance and reason for forming a general impression when she states:

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1. **"Forming a general impression provides me with a rough idea of the patient's overall status."**

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1. A 62-year-old female was struck by a car traveling approximately 45 miles per hour. After being struck, she was thrown 15 feet onto the sidewalk, impacting the pavement with her head and chest. The primary assessment has been completed and life threats addressed. The patient's husband is by her side. When performing the secondary exam on this patient, which of the following should the EMT perform first?

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1. **Assess the patient from head to toe for additional injuries.**

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1. Which patient would be classified as unresponsive?

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1. **46-year-old-male who does not respond when his fingers are pinched**

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1. Which of these patients would the EMT identify as having the most adequate breathing, free from any respiratory distress?

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1. **A 34-year-old male with abdominal pain who is alert and oriented with good chest rise and fall**

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1. When performing the primary assessment of a 45-year-old patient, which of these skin findings should concern the EMT?

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1. **Cool and moist skin**

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1. Which medication is included in the EMT scope of practice?

Oxygen

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1. A patient with difficulty breathing has a metered-dose inhaler. Which of the following medications is the MDI most likely to contain?

Albuterol

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1. A patient with chest pain tells you that he feels the same as when he had a heart attack two years ago. He is diaphoretic, nauseated, vomiting, and has a pulse of 84, respirations 16, and a blood pressure of 78/50 mmHg. He is allergic to aspirin. He asks you to assist him in taking one of his nitroglycerin pills. Which one of the assessment findings that follows represents a contraindication to the nitroglycerin?

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1. **Blood pressure 78/50 mmHg**

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1. A patient with a history of diabetes is confused and irritable. According to family members, he accidentally took too much insulin this morning and did not eat breakfast. Since he is conscious with an intact gag reflex, medical command orders you to administer oral glucose. Which one of the following best represents the indication for the medication?

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1. **Confusion and irritability**

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1. After administering oral glucose to a patient with altered mental status, which one of the following best indicates a positive therapeutic effect or response to the medication?

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1. **Mental status that is now alert and oriented**

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1. Which of the following medications should be administered by the EMT only if the patient has a prescription for it?

Nitroglycerin

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1. The label on your patient's prescribed metered-dose inhaler reads as follows: "Administer three puffs as needed for shortest of breath." Your protocols state that you can only assist with two puffs. The patient is extremely short of breath. You should:

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1. **Contact medical direction for orders**

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1. As you approach a female patient, she appears unresponsive, with her arms and legs jerking violently. On the prehospital care report, you would document that the patient was found in which phase of a generalized seizure?

Clonic

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1. You arrive on scene and find Emergency Medical Responders with a seizing patient. Which of these questions should you ask first?

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1. **"How long has the patient been seizing?"**

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1. Which of these patients should be categorized as the highest priority for transport?

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1. **A pregnant female with no history of seizures who is seizing**

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1. After a lengthy response, you arrive at the home of a 62-year-old female who is still seizing. Your immediate action would be to:

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1. **assess the patient's airway and breathing**

You have been summoned for a diabetic patient with altered mental status. What sign would cause you to suspect that the patient is suffering from hyperosmolar hyperglycemic nonketotic syndrome​ (HHNS)?

Complaint of thirst and dry mouth

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1. What is the best action to take prior to administering oral glucose?

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1. **Determine the patient's blood glucose level**

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1. A​ patient's glucometer reads 39​ mg/dL. The patient is​ alert, but confused. The​ patient's son states that he has a friend who becomes unresponsive when his sugar is less than 50​ mg/dL; therefore, the reading on his father cannot be correct. Which one of the following statements would be your best​ response?

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1. **​"The response to a low blood sugar can vary from patient to​ patient."**

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1. Family members have called you for a young female patient with a diabetic history who took insulin earlier in the day. She is confused and combative. Which of the following questions is MOST important for you to immediately ask the​ family?

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1. **"Did she eat after taking the​ insulin?"**

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1. You have been called to a residence for a 14-year-old male who states that he intentionally took some medication to kill himself. Assessment indicates that he is​ alert, oriented, and has an open airway and adequate breathing. Given the​ situation, it is imperative that the​ EMT's next action​ be:

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1. **check the radial pulse and skin.**

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1. A patient who is conscious and breathing has been pulled from a stream of cold water. To decrease her loss of heat via the mechanism of conduction, the EMT should immediately:

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1. **remove her wet clothing.**

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1. A 31-year-old groundskeeper has been stung by wasps three times in his right arm and left ankle. After performing the primary and secondary assessments, what should you do next?

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1. **Attempt removal of any embedded stingers.**

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1. Assessment findings of a driver who was ejected from his vehicle in a​ rollover-type collision include unresponsiveness and bruising to the abdominal and pelvic​ areas, along with an open femur fracture. The patient has an open airway and is breathing at 32 times per minute. His skin is cool and diaphoretic and the radial pulses are weak. Manual​ in-line spinal stabilization is being maintained. The​ EMT's next action would be​ to:

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1. **start positive pressure ventilation.**

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1. A construction worker has a metal rod impaled in his right forearm. Assessment of the injury indicates heavy bleeding from around the impaled object. What should you do​ first?

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1. **Apply direct pressure around the rod.**

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1. Which bodily activity is a function of a voluntary muscle?

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1. **Chewing food**

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1. The secondary assessment of a patient who complains of right leg pain after falling down several stairs reveals a break in the skin where a fractured tibia bone broke through and then recessed back into the leg. The EMT should recognize this as which type of injury?

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1. **Open fracture**

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1. Assessment of a​ 79-year-old female with a long history of medical complaints reveals tenderness and deformity to her left hip. Staff at the personal care home state that she slipped in some water and fell onto her buttocks.​ Currently, she is alert and oriented and stating the pain is​ 10/10. Regarding care of her​ leg, which one of the following is most​ appropriate?

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1. **Maintain the leg in the position found and transfer to a long spine board.**

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1. A patient has suffered partial- and full-thickness thermal burns to the anterior chest, abdomen, and arms in an industrial accident. What action would be appropriate in the care of this patient?

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1. **Cool the burns with water for 90 seconds and cover the burns with a sterile, dry burn sheet**

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1. A paramedic tells you that a patient with a probable spinal injury still retains his plantar reflexes. As a knowledgeable EMT, you should understand that the patient has reflex activity in what part of the body?

Feet

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1. Which EMS crew has satisfied the platinum ten minutes?

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1. **Assessed, immobilized, and initiated transport within 10 minutes of arriving on scene**

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1. A 2-year-old boy fell down a flight of stairs. Which instruction would you provide to other EMTs who are immobilizing the patient?

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1. **"Let's place a folded towel under his shoulders to help maintain head alignment."**

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1. When obtaining a medical history, which of the following patient statements seemingly indicates that he is suffering from classic angina?

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1. **"When I stopped cutting the grass, the pain went away."**

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1. You have been called for a patient who suddenly became confused. What assessment finding should concern you most?

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1. **Heart rate of 180 but regular**

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1. You have determined an alert elderly male to have garbled speech and weakness to the right arm and leg. His vital signs and SpO2 level are within normal limits. The family informs you that he has a history of heart problems and diabetes. Which one of the following should you do immediately?

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1. **Check the patient's blood glucose level (if local protocol allows).**

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1. A panicked and anxious patient tells you that he is allergic to peanuts and thinks he may have accidentally eaten some. He states that the last time he ate peanuts he almost died and needed to have a "tube put in his throat." When assessing the patient, which of the following signs or symptoms would provide the best evidence that the patient is having an allergic, and possibly an anaphylactic, reaction?

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1. **Hives on his chest**

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1. 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

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

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1. A chemical agent used by terrorists is described as having a high volatility. You should recognize this as meaning that the chemical​ is:

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1. **Easily evaporated**

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1. You have arrived on the scene of an industrial plant where a female worker had a chemical splashed into her eye. She now complains of severe pain in the eye and is flushing it with tap water over a sink. Which question is it most important that the EMT ask first?.

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1. **"Are you wearing contact lenses?"**

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1. You arrive at the scene where a patient has a possible fracture of the left hip. You note that she is lying on her back and her left leg is turned inward. You would document this position as:

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1. **supine with medial rotation of the left lower extremity.**

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1. What role does the Federal Communications Commission​ (FCC) play in​ EMS?

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1. **The FCC establishes and enforces regulations related to the use of radio operations**