Cervical spondylosis is a degenerative change in the cervical spine that causes:
narrowing of the spinal canal and pressure on the spinal cord
Many veteran EMS providers have embraced a leadership role in primary injury prevention after?
witnessing too many episodes of needless suffering
Prior to unloading a patient from the ambulance, you should:
ensure that the patient is secured to the stretcher
The second impact that occurs when an adult pedestrian is struck by a motor vehicle would MOST likely result in injuries to the:
pelvis and chest
When communicating with a patient whose cultural background differs from the paramedics, it is MOST important for the paramedic to?
treat the patient with utmost respect at all times
Which of the following statements regarding selective serotonin reuptake inhibitors (RRSIs) is most correct?
SSRIs have fewer anticholinergic and cardiac effects than tricyclics.
Fall-related fractures in the elderly occur MOST often to the ___, usually in patients with underlying:
Gathering a patient's medical history and performing an in-depth physical examination should occur:
Once the initial assessment and correction of life threats is completed
Q. The MOST effective way to minimize the risk of hypoxia while intubating a child is to:
limit your intubation attempt to 20 seconds.
The 6-second method for calculating the rate of a cardiac rhythm?
Involves counting the number of QRS complexes in a 6-second-strip and multiplying that number by 10.
The volume of plasma in an adult with a total blood volume of 6.5 liters is approximately?
6.5x0.55 = 3.6L
When a patient takes the "up and over" pathway during a head-on collision:
the anterior part of the neck may strike the steering wheel, resulting in a fractured larynx
A key part of making your practice of prehospital care successful is for you to:
Develop and cultivate your own style of assessment and an overall strategy for evaluating and providing care for the patients you will encounter in the unique and varied circumstances in the field setting
According to the START triage system, if a patient has a strong radial pulse, you should:
control bleeding and assess mental status
Delirium is MOST accurately defined as:
an acute alteration in mentation that indicates an underlying condition
Q. Patients with decompensated asthma or COPD that require positive-pressure ventilation:
may develop a pneumothorax or experience a decrease in venous return to the heart if they are ventilated too rapidly
Sudden deceleration of a motor vehicle that is traveling at 60 mph:
dissipates tremendous forces and causes major injuries
When dispatched to a residence for an injury involving a pregnant woman, you should?
Be alert for evidence of abuse
You have been attempting resuscitation of a middle-aged woman for approximately 15 minutes; however, she has not responded to any of your treatment. There is no evidence of hypothermia or drug ingestion, and the cardiac monitor shows asystole. You should?
consider terminating your resuscitative efforts
You receive a call to a skilled nursing facility for an elderly man with generalized weakness. The patients nurse tells you that he has not eaten anything in the past 18 hours. She presents you with his chart, which states that he has a history of atrial fibrillation, CHF, and hypertension. His medications include Vasotec, digoxin, and Warfarin. As you apply the cardiac monitor, your partner takes the patients vital signs, which reveal a blood pressure of 136/76 mmHg, a rapid and irregular pulse, and respirations of 22 breaths/min. The ECG reveals atrial fibrillation with a variable rate between 110 and 130 beats/min, and a 12-lead ECG tracing reveals the same. After applying supplemental oxygen, you should?
Start an IV line to keep the vein open, administer diltiazem, and transport.
* If a patient sees you as someone with whom it is safe to be, who does not pose a threat, and who honestly cares, then he or she will most likely?
be reassured that you will handle the crisis
Fluid-refractory hypotension following a barbiturate overdose is treated MOST effectively with?
In prehospital care, the priorities of evaluation and treatment are based on:
The degree of threat to the patient's life
Level ___ personal protective equipment would MOST likely be worn during the transport of patients with the potential of secondary contamination.
Q. Which of the following statements regarding translaryngeal catheter ventilation is MOST correct?
ventilation is achieved by the use of a high-pressure jet ventilator
The greatest amount of kinetic energy would be created if a ___ pound driver struck a tree while traveling at ___ mph.
Torsades de pointes?
Is a variant of polymorphic ventricular tachycardia and is often caused by a prolonged Q-T interval.
Which of the following assessment parameters is MOST difficult to interpret when a pregnant woman is injured?
With regard to injury prevention, effective educational techniques include all of the following EXCEPT?
A person taking beta blockers or calcium channel blockers would MOST likely present with:
a slower than usual heart rate
Myocardial ischemia occurs when the heart muscle?
Is deprived of oxygen because of a blocked coronary artery.
Q. Approximately how far should you insert a 5.0mm ET tube in a 4-year-old child?
15 cm (diameter x 3)
The permissible exposure limit (PEL) of a given chemical is the:
maximum concentration of a chemical that a person may be exposed to under OSHA regulations
Which of the following injuries would MOST likely require transport to a level 1 trauma center?
Two or more proximal long bone fractures
Which of the following is NOT a part of your overall job as a paramedic?
Always remember that your overall job as a paramedic is to quickly identify your patient's problem(s), set your care priorities, develop a patient care plan, and quickly and efficiently execute the patient care plan.
Which of the following statements regarding ethics in the workplace is MOST correct?
off-duty misconduct on the part of the paramedic may lessen the public's confidence of EMS in general
A decreased number of pacemaker cells in the sinoatrial node would MOST likely contribute to a decline in cardiac output secondary to:
Complications in a pregnant woman with cystic fibrosis are usually the result of?
reduced pulmonary function
Muscle cramps and paresthesias in a malnourished patient with alcoholism are most likely the result of?
When determining whether a patient is sick, your MOST effective tool is often:
A quick visual assessment based on the chief complaint, respiration's, pulse, mental status, and skin signs and color.
You are dispatched to a residence for a 50-year-old woman with respiratory distress. While you are assessing the patient, she tells you that she began experiencing flu-like symptoms 4 days ago, shortly after delivering mail on the rural mail route for which she is responsible. Due to her illness, she has been unable to return to work. Her blood pressure is 90/50 mmHg, pulse rate is 120 beats/min, and respirations are 26 breaths/min and labored. Auscultation of her breath sounds reveals the presence of coarse crackles. This patient has MOST likely been exposed to:
You arrive at the scene of an injured person. As you and your partner approach the patient, you see that he is bleeding profusely from a large laceration to his neck. As you are about to begin care, a man walks up and states, "I cut him!" You should?
retreat from the scene to a safe area and immediately notify law enforcement
___ is the process in which individual units or different organizations make independent decisions about the next appropriate action.
A person wishes to be an organ donor. He or she must?
have witnessed informed consent, usually in writing
During an explosion, secondary blast injuries occur when:
the patient is struck by flying debris, such as shrapnel
Hypertensive emergencies in the geriatric population:
require a controlled decline in blood pressure that often cannot be achieved in the prehospital setting.
Q. An elderly woman with COPD presents with peripheral edema. The patient is conscious but agitated. She is breathing with slight difficulty but has adequate tidal volume. During your assessment, you note that her jugular veins engorge when you apply pressure to her right upper abdominal quadrant. She tells you that she takes a "water pill" and Vasotec for high blood pressure. You should:
suspect acute right heart failure and administer oxygen
Regardless of what a patient asks, the paramedic should?
immediately acknowledge what the patient asked
Which of the following clinical findings is LEAST suggestive of a peripheral vascular disorder?
An S3 sound during auscultation of the heart.
Which of the following medications would MOST likely be used in the prehospital setting to treat some women with severe premenstrual syndrome?
glucose and fentanyl
You are in the BEST position to decide what, if any, care needs to be provided at the scene versus en route to the hospital once you:
Have qualified whether your patient is sick or not sick, and then you must quantify how sick the patient is.
A do not resuscitate (DNR) order is MOST accurately defined as a?
written order designed to tell health care providers when resuscitation is or is not appropriate
Elderly patients experience a slower physiologic response to hypoxemia and hypercarbia because of:
decreased sensitivity to changes in arterial blood content
Which of the following general statements regarding trauma is MOST correct?
Blunt trauma is difficult to diagnose by paramedics in the field and is often more lethal than penetrating trauma
Which of the following statements regarding growth spurts in adolescents is most correct?
boys generally experience this stage of growth later in life than girls do
Which of the following statements regarding the use of vasopressin in cardiac arrest is MOST correct?
A one-time dose of 40 units of vasopressin may be given to replace the first or second dose of epinephrine.
Which of the following would be of LEAST value when trying to determine the type of hazardous material a commercial tanker truck is carrying?
With hyperbaric oxygen therapy, carbon monoxide is typically eliminated from the body within:
15 to 20 minutes
You are assessing a 36-year-old woman who is in the 33rd week of her pregnancy. The patient complains of bright red vaginal bleeding, but denies abdominal pain or cramping. She tells you that she felt her baby move about 5 or 10 minutes ago. Fetal heart tones are audible at a rate of 130 beats/min. Gentle palpation of her abdomen reveals that it is soft and nontender. Which of your assessment findings is MOST suggestive of placenta previa?
absence of abdominal pain
You will MOST likely make your field diagnosis of a patient based on the:
Patients history and chief complaint.
* Touching a conscious elderly patient in a nursing home without his or her permission?
is nonverbally communicating, "You are not important enough or mentally competent enough to be asked for permission."
A 22-year-old man experienced an acid chemical burn to his left forearm. He complains of intense pain and tingling in his fingers. He is conscious and alert, and denies any other symptoms. You should:
begin immediate irrigation with water
Mittelschmerz is MOST accurately defined as?
unilateral abdominal pain and cramping that occurs during the ovulatory process
Q. Apneustic breathing is characterized by:
short, brisk inhalations with a long pause before exhalation
The paramedic must make a field diagnosis in order to:
Get the info needed to make the best decisions for your patient.
When returning your unit to service following a call, the responsibility of ensuring that the unit is restocked and ready for another call rests with?
everyone on the EMS team
Which of the following will be of MOST benefit in helping the paramedic predict the type of injuries that a patient experienced?
Mechanism of injury
Decreased elasticity of the lungs and calcification of the costochondral cartilage results in:
an increase in residual lung volume
Gestational diabetes is caused by?
increased insulin production and decreased cellular sensitivity to insulin
Q. Patients with pneumonia often experience a coughing fit when they roll from one side to the other because:
pnuemonia often occurs in the lung bases, typically on only one side
The preferred initial method for disentangling a patient who is trapped between the seat and steering wheel involves:
trying to slide the seat back on its track
The shock wave velocity from an explosion is slower and its duration is longer if a person is:
farther from the explosion
What instructions or guidance would an emergency medical dispatcher (EMD) MOST likely provide to a caller?
controlling bleeding and performing CPR
Which of the following statements regarding renal function in older adults is most correct?
aging kidneys respond less efficiently to hemodynamic stress
Which of the following statements regarding the patient assessment process is correct?
(all correct) Ask questions relevant to the patients chief complaint. Think of the assessment as a "fluid process". As the patient interview unfolds, you need to be able to change the sequence of your questioning as the situation or patients condition dictates.
Although the technicalities of EMS DNR orders vary from state to state, the all?
are designed to tell EMS providers when resuscitation is or is not appropriate
Broadly speaking, the finance section chief is responsible for:
documenting all expenditures at an incident and seeking reimbursement
Epinephrine is used to treat patients in anaphylactic shock because of its effects of?
Bronchodilation and vasoconstriction.
On most runs, the two MOST important pieces of patient history information that you need to obtain initially are the:
Patient's Name and Chief Complaint
Q. Intubation of a patient with severe asthma:
is often a last resort because asthmatics are difficult to ventilate and are prone to pneumothoraces
Which of the following conditions is characterized by a lack of progesterone and increased androgen levels, and can lead to hypertension and cardiac problems?
Which of the following is NOT a predisposing risk factor for trauma in the elderly?
Decreased body water
* Conveying calm, unmistakable, genuine concern for someone you've never met before is the most essential challenge as a/an?
After determining that the scene is safe, the FIRST step in approaching a patient is to:
Introduce yourself and to explain that you are a paramedic
An electrical impulse is slightly delayed at the AV node so that the?
Atria can empty into the ventricles.
During normal menstruation, approximately ___ to ___ mL of blood is discharged from the vagina?
Lap belts that are worn alone and high by a pregnant woman:
allow enough forward flexion and subsequent compression to rupture the uterus
Q. Which of the following is NOT performed before, during, or after insertion of a nasogastric (NG) tube in a conscious patient?
keeping the patients head in a flexed position during insertion of the tube
The BEST example the paramedic can set with regard to injury prevention is?
taking care of himself or herself and serving as a role model for others
Which of the following cardiac dysrhythmias is associated with the HIGHEST risk of stroke?
Which of the following is NOT a pre-incident indicator of terrorism?
there is a report of a loud explosion
A cardiac patient with respiratory distress should be assumed to be experiencing?
Heart failure with pulmonary edema.
Asking the patient about the date, time, location, and events surrounding the current situation will enable you to:
Determine if the patient is (A&Ox4) Alert to Person, Place, Time and Event
During the attempted resuscitation of a 79 yo man in cardiac arrest, a young man arrives at the scene and asks you to cease resuscitative efforts. He further tells you that the pt has entrusted him to make all of his medical decisions. You should?
continue full resuscitative efforts and ask the man if the pt has a living will and if he has documentation naming him as the person authorized to make decisions
If a person survives the initial trauma from a shotgun wound at a close range:
contaminants that were driven into the wound can cause a severe infection
Q. The cricothyroid membrane is the ideal site for making a surgical opening into the trachea because:
no important structures lie between the skin covering the cricothyroid membrane and the airway
Requesting a hazardous materials (Haz-Mat) team as early as possible to a scene involving a weapon of mass destruction is MOST important because:
it takes time for the Haz-Mat team to assemble their personnel and equipment
The social assessment component of the GEMS diamond includes:
determining if activities of daily living are being provided by another person
* When cells are hypoxic for more than a few seconds?
they produce substances that may damage other local or distant body systems
A 55-year-old man complains of severe pain between his shoulder blades, which he describes as "ripping" in nature. He tells you that the pain began suddenly and has been intense and unrelenting since its onset. His medical history includes HTN; however, he admits to being noncompliant with his antihypertensive medication. Which of the following assessment findings would MOST likely reinforce your suspicion regarding the cause of his pain?
Difference in blood pressure between the two arms.
During third trimester vaginal bleeding?
the mother may lose as much as 40% of her blood volume before significant signs of hypovolemia occur
Older men often experience difficulty urinating because of:
urethral pressure from an enlarged prostate
The recommended dose and method for administering naloxone to a patient who overdosed on a narcotic and is unresponsive and hypoventilating is:
2 mg injected slowly until the patient's respirations improve
When a patient presents with two seemingly unrelated complaints, it is MOST important for the paramedic to determine:
If the two complaints are related. If they are not related, which one will take priority.
When a person falls from a significant height and lands on his or her feet, axial loading results in:
compression or burst fractures to the lumbar spine
A critical incident is MOST accurately defined as?
an incident that overwhelms the ability of an EMS worker or system to cope with the experience, either at the scene or later
A helicopter landing zone should be:
100 feet by 100 feet in size, and on a surface that is firm, level, and free of debris
An elderly person is more likely to sustain serious injury following trauma due to:
brittle, demineralized bone
Following a head-on collision of a motorcycle and a truck, the motorcyclist would MOST likely experience initial injury to the:
femurs and tibias
Prehospital treatment for a patient who overdosed on aspirin would MOST likely include:
The history of present illness is MOST accurately defined as:
A clear sequence and chronologic account of the patient's sign and symptoms, that is, what happened and when.
There is evidence that a 21-year-old woman was given Rohypnol before being raped. She presents with alcohol on her breath, drowsiness, and memory loss. Her blood pressure is 98/68 mmHg, pulse is 58 beats/min and weak, and her respirations are decreased and shallow. You attempt to administer high-flow oxygen, but she resists. What should you do now?
consider administering naloxone in case she was also given a narcotic drug.
When analyzing a cardiac rhythm strip in lead II, you should routinely evaluate all of the following components, EXCEPT?
When touching a patient as a form of reassurance, the paramedic should?
touch the patient on a neutral part of his or her body
A 25-year-old woman was involved in a motor vehicle accident in which she struck the rear end of another car at a low rate of speed. When you arrive at the scene and exit the ambulance, you immediately hear the patient screaming, "My baby, my baby!" After calming the patient down, she tells you that she is 10 weeks pregnant and that she is afraid that the car accident injured her child. She confirms that she was properly restrained at the time of impact. She is conscious and alert, denies abdominal pain, and has stable vital signs. She refuses spinal motion restriction precautions, but does consent to EMS transport. You should?
administer supplemental oxygen, establish a large-bore IV line and set the rate to keep the vein open, provide emotional support, and transport her to an appropriate hospital.
An 82-year-old man presents with confusion that has worsened progressively over the past 2 weeks. Because of his confusion and the fact that he is hearing impaired, you obtain the majority of your medical history information from his daughter. She tells you that her father has high blood pressure but refuses to take medication for it. She also tells you that she thinks he fell about 3 weeks ago, although he denies falling. The patient's blood pressure is 168/98 mmHg, his pulse rate is 60 beats/min and occasionally irregular, and his respirations are 22 breaths/min and regular. This patient MOST likely:
is experiencing a subdural hematoma
EMS providers can be MOST effective in helping reduce the incidence of suicide, domestic violence, and child abuse by?
noting risk factors at the scene and reporting data
From an anatomic and physiologic perspective, inhaled toxins:
quickly reach the alveoli and rapidly gain access to the circulatory system.
If a level 1 trauma center is 30 miles away, and a level 2 trauma center is 10 miles away, it would be MOST appropriate to transport the patient with a severe traumatic brain injury:
via air transport to the level 1 trauma center
Q. You are transporting an intubated patient and note that the digital capnometry reading has quicky fallen below 30 mmHg. You should:
take immediate measures to confirm proper placement of the ET tube
The MOST important initial pieces of equipment to bring to the side of an unconscious patient are the?
Defibrillator and airway management equipment.
Where would you MOST likely find a Material Safety Data Sheet (MSDS) that provides information about a hazardous material?
A permanent manufacturing or storage facility
Which of the following questions would be of LEAST pertinence when trying to determine a patient's current health status?
" You will also need to ask about any accidents or injuries the patient had within the last month or so and about any operations or hospitalizations within the last 6 months or so.
General principles for backing up an ambulance include:
stopping the vehicle if you lose sight of your spotter
If a patient is unable to tell you who he or she is, where he or she is, and what day of the week it is?
you should suspect decreased blood flow to the brain
If a pregnant woman is injured and bleeding severly?
blood flow will be diverted away from the uterus
If an EMS agency's call volume is too heavy to allow response within an appropriate time frame?
mutual aid resources are not legally required to assist
In contrast to chronic leukemia, acute leukemia occurs when:
bone marrow is replaced with abnormal lymphoblasts.
The heart hypertrophies with age, MOST likely in response to:
a chronically increased afterload caused by arteriosclerotic blood vessels
The peak magnitude of the pressure wave experienced by a person:
lessens as the person is farther away from the center of the explosion
Which of the following questions will allow you to gain insight quickly when performing a check of a patient's body systems?
"Has your doctor ever told you that you have a heart, lung or brain problem?"
Which of the following statements regarding second-degree heart block is MOST correct?
Second-degree heart block occurs when an impulse reaching the AV node is occasionally prevented from proceeding to the ventricles and causing a QRS complex.
A patient who ingested a significant amount of ethylene glycol 6 hours ago would MOST likely present with:
slurred speech and ataxia
If the windshield of a wrecked vehicle is cracked or broken:
the front seat occupant has a cervical injury until proven otherwise
is a rare complication associated with untreated Chlamydia and is characterized by arthritis and skin lesions
The interaction of two hazardous materials that produces a much greater impact than either chemical alone is called:
Which of the following statements regarding Alzheimer's disease is NOT correct?
Age alone is thought to be the underlying cause of Alzheimer's disease
Your patient will MOST likely develop a good first impression of you if you:
Your appearance should be professional and your demeanor positive and friendly.
A closed, or contained, mass casualty incident is a situation that:
is not expected to produce more patients than initially present
Adverse drug reactions in elderly people are the result of:
changes in drug metabolism due to diminished hepatic function
Q. When placing a dislodged tracheostomy tube, it is MOST important that you:
take appropriate BSI precautions
Relative to younger adults, older adults generally have a harder time breathing because the?
natural elasticity of the lungs decreases
Which of the following statements regarding an ectopic pregnancy is MOST correct?
in ectopic pregnancy, a fertilized egg implants somewhere other than the uterus
Working to ensure a patient's privacy, confidentiality, and comfort level will:
Will go a long way toward establishing positive patient rapport and encourage more honest, open communication.
In contrast to a type II ambulance, a type III ambulance:
is a specialty van that usually has a modular ambulance body
The paramedic should always address a patient:
Ask the patient his/her name and how he/she would like to be addressed.
You receive a call to a residence for a 44-year-old man who is "ill." The patient, who receives dialysis treatments three times a week, tells you that he has missed his last two treatments because he was not feeling well. As your partner takes the patient's vital signs, you apply the ECG, which reveals a sinus rhythm with tall T waves. The 12-lead ECG reveals a sinus rhythm with inverted complexes in lead aVR. On the basis of your clinical findings, you should be MOST suspicious that the patient is:
You should be MOST suspicious that a patient has systemic iron toxicity if he or she presents with:
According to the Haddon matrix, which of the following is an example of a pre-event strategy used to prevent injury in a child who is riding in a motor vehicle?
reducing driving during high-risk times
Physiologic age-related decreases in skin elasticity are the result of:
decreased collagen and elastin production
The headache commonly experienced by a women during their menstrual cycle is caused by?
The most effective way to reinforce your interest in and concern for your patient is to?
use a calm and steady tone of reassurance
The primary determinants of the extent of trauma a patient sustains are the:
amount of energy in the object and the mechanism by which the object is delivered to the body
Using casual nicknames can be especially problematic when:
Cultural differences exist between you and the patient.
You receive a call to a residence in a rural area of your jurisdiction for a patient with an acute COPD exacerbation. Upon arriving at the scene, you knock on the door and identify yourself. The patient, an elderly-sounding man, tells you that you took too long to get to him, and that he has a shotgun. You should:
immediately retreat to the ambulance and notify law enforcement
At a minimum, a level 2 trauma center should:
be able to initiate definitive care for all injured patients
Elderly people are more susceptible to intracranial bleeding because of:
enlargement of the subdural space
EMS providers who read off a list of questions to the patient to fill in all the blanks on the run report:
Tend to make little or no eye contact.
Pelvic inflammatory disease (PID) commonly affects all of the following organs, EXCEPT the?
Q. One of the hallmarks of a pulmonary embolism is:
cyanosis that does not resolve with oxygen therapy
The severity with which a hazardous material interferes with the body's internal processes is LEAST affected by the:
part of the body exposed
Hypotension and orthostatic vital sign changes would MOST likely occur in elderly people who take:
Q. Neuromuscular blocking agents:
convert a breathing patient with a marginal airway into an apneic patient with no airway
When applying the precordial leads, lead I should be placed in the:
fourth intercostal space at the right sternal border.
When summoning an air transport service to transport a critically injured patient, it is MOST important to:
activate the service as soon as possible
When transferring a geriatric patient from a hospital to an extended care facility, it is MOST important to:
Review the patient's transfer paperwork.
Which of the following questions is the MOST important to ask when obtaining a patient's gynecologic history?
"When was your last menstrual period?"
Which of the following statements regarding belt noise is MOST correct?
it is the squealing sound related to a load on one of the belt-operated appliances.
A pt has requested to be transported to a specific hospital; however, the hospital does not have the proper resources to meet the patient's needs. You should?
determine if there is a more appropriate medical facility within a reasonable distance
Q. Several cycles of basic life support maneuvers have failed to relieve a severe airway obstruction in an unconscious 44-year-old woman. You should:
perform direct laryngoscopy and attempt to remove the obstruction with Magill forceps
Structural protection afforded to a motorcycle rider during a crash comes from:
protective gear worn by the rider
The MOST important thing you can do to facilitate the exchange of information between you and your patient is to:
Therapeutic doses of certain drugs may reach toxic levels in older people due to deterioration of the:
Which of the following statements regarding the umbilical cord is MOST correct?
the umbilical vein carries oxygenated blood from the placenta to the fetus
Aging is a linear process, which means that:
the rate at which we lose functions does not increase with age
Mass casualty equipment and supplies needed for airway control include all of the following, EXCEPT:
large-bore IV catheters for thoracic decompression
Q. End-tidal carbon dioxide (ETCO2) detection is a reliable method for confirming proper ET tube placement because:
carbon dioxide is not present in the esophagus
The MOST appropriate initial question to ask a patient who complains of chest pain is:
Can you describe the pain?
What type of injuries would MOST likely occur if a passenger is wearing his or her lap belt above the pelvic bone during a frontal impact?
Abdominal and lumbar spine
Which of the following interventions generally is preferred for a patient who overdosed on a barbiturate more than 1 hour ago?
Which of the following is NOT a critical point addressed by the "White Paper" written in 1966, that was entitled "Accidental Death and Disability: The Neglected Disease of Modern Society"?
ensuring that paramedics responded to every call
You are caring for a 44-year-old woman who was sexually assaulted by several men. She is conscious but very quiet. Your partner, a female paramedic, quickly examines her and finds no immediate life threatening injuries. The patient tells you that all she wants to do is go home and take a shower. After multiple attempts to convince the patient to consent to transport, you are unsuccessful. Your MOST appropriate action should be to?
ask the patient if there is a friend you can call with whom she can stay.
A metallic taste in the mouth, explosive diarrhea, and a skin rash are MOST indicative of:
Barotrauma secondary to bag-mask ventilations in an infant means that your ventilations?
were too forceful
Common signs and symptoms of gardnerella vaginitis include?
a "fishy" vaginal odor, itching, irritation, and vaginal discharge
In a patient with left heart failure and pulmonary edema:
increased pressure in the left atrium and pulmonary veins forces serum out of the pulmonary capillaries and into the alveoli.
Patient autonomy is MOST accurately defined as the?
patient's right to direct his or her own care and to decide how end-of-life care should be provided
Q. When auscultating the lungs of a patient with pulmonary edema, you will MOST likely hear:
crackles in the bases of the lungs at the end of inspiration
Reflection is a powerful tool for getting a good patient history because:
Two reasons: 1) Reflection usually does not break the flow of your patient's thoughts. It helps you both stay focused. 2 )The information you will obtain is not biased by "leading the patient".
Routine pre-hospital treatment for a patient with internal hemorrhage and shock includes all of the following, EXCEPT:
analgesia if the systolic BP is greater than 70 mmHg
When transporting one stable and one critical patient in the same ambulance, you should:
load the most critical patient last so he or she can be unloaded first.
Which of the following statements regarding aging is MOST correct?
Health care providers may attribute genuine disease symptoms to age, resulting in inadequate care
During shock, norepinephrine release causes:
the body to shunt blood from areas of lesser need to areas of greater need
During your initial assessment of a patient with a hematologic disorder, your priority should be to:
note any signs and symptoms that may be immediately life threatening.
Q. The ___ are pyramid-like structures that form the posterior attachment of the vocal cords.
The proper compression-to-ventilation ratio for two-rescuer adult CPR when an oropharyngeal airway is in place is:
When a patient tells you that he or she takes a "water pill," it is MOST important for you to:
Clarify what they mean.
An empathetic attitude:
"Putting yourself in his or her shoes". Empathy can help you set your patient on a path to healing ~ no matter what the diagnosis.
If your only protection from gunfire in a residence is behind a frame wall, you should:
stand near the door or window frame, which usually contain more wood than other areas of the wall.
In addition to meeting the metabolic needs of the developing fetus, the mother's blood supply increases significantly in order to perfuse her own organs, especially the?
uterus and kidneys
Q. Chronic obstructive pulmonary disease (COPD) is characterized by:
changes in pulmonary structure and function that are progressive and irreversible
The appropriate dosing regimen for epinephrine in cardiac arrest is:
1 mg of a 1:10,000 solution every 3 to 5 min
What aggregates in a clump and forms much of the foundation of a blood clot during the process of coagulation:
Which of the following psychosocial changes is common during adolescence?
fixation on public image and fear of embarrassment
During the irreversible (terminal) phase of shock:
the body attempts to shunt blood from the liver, kidneys, and lungs to keep the heart and brain perfused
If your department has its own technical rescue team:
technical rescue protocols should be established
Q. Which of the following findings is MOST clinically significant in a 30-year-old woman with difficulty breathing and a history of asthma?
Prior ICU admission for her asthma
The effort to rehabilitate a person who has survived an injury is called?
tertiary injury prevention
The emotional state of craving a drug to maintain a feeling of well-being is defined as:
When asking a patient if he or she uses illegal drugs, you will MOST likely get accurate information if you:
Remain professional and nonjudgmental.
When assessing an older person, you should remember that it is common for him or her to:
respond slowly to questions
Which of the following is not an example of an open-ended question?
"Does the pain radiate to your arm or jaw?"
After falls, ___ is/are the second leading cause of accidental death among the elderly people.
motor vehicle accidents
If a patient refuses to give you information, you should:
Infer what could be causing the distress and then ask the patient if you are right (i.e, "So, if I understand you correctly...")
If you suspect internal bleeding during the initial assessment, you should:
keep the patient warm and administer oxygen
In contrast to the lesions associated with other skin disorders, the lesions associated with smallpox:
are identical in size and shape
Q. Open cricothyrotomy is generally contraindicated in all of the following situations, EXCEPT:
any patient who is younger than 16 years of age
Which of the following statements regarding protocols is MOST correct?
protocols are usually developed in conjunction with national standards
You and an EMT-B are performing CPR on an elderly woman in cardiac arrest as your paramedic partner prepares to intubate her. After the patient has been intubated and proper ET tube placement has been confirmed, you should:
perform asynchronous CPR while ventilating the patient at a rate of 8 to 10 breaths/min.
You will distance yourself from your patient as a person if you?
use complicated medical terminology
A 39-year-old man in asystole has been unresponsive to CPR and 2 doses of epinephrine. The patient is intubated and an intraosseous catheter is in place. What intervention should you perform next?
Administer 1 mg of atropine.
Before asking a patient how he or she is feeling, you must FIRST:
Ask for facts first, then follow up. Establish a rapport before asking how they are feeling.
If a woman's prepregnancy resting heart rate is 70 bpm, you would expect her heart rate to range between ___ and ___ at term.
Which of the following situations would be LEAST likely to require a critical incident stress debriefing (CISD)?
death of a 91 yo pt with lung CA
Which of the following statements regarding radiation is MOST correct?
it is impossible to recognize the type of radiation emitted from a given source
You are dispatched to an assisted living center for an 80-year-old woman who is vomiting bright red blood. Upon your arrival, you find the patient sitting in a chair. She is conscious and alert, but is markedly pale and diaphoretic. Her medical history is significant for hypertension, congestive heart failure, type 2 diabetes, hypothyroidism, and osteoarthritis. Her medications include Toprol, lisinopril, Glucophage, Synthroid, and ibuprofen. Her blood pressure is 76/56 mmHg, pulse is 76 beats/min and weak, and respirations are 24 breaths/min and shallow. Which of the following statements regarding this scenario is MOST correct?
This patient, who is in shock, probably has a bleeding peptic ulcer secondary to ibuprofen use, and the lack of compensatory tachycardia is likely the result of the beta blocker she is taking.
* Which of the following questions would MOST like reveal a hidden medical condition when communicating with a patient who has a severe headache?
"What happened the last time you felt this way?"
A hypertensive emergency is MOST accurately defined as:
An acute elevation in blood pressure with signs of end-organ damage
Anemia resulting from an autoimmune disorder occurs when:
red blood cells are destroyed by the body's own antibodies.
If you discover that a seemingly ordinary EMS call is actually a hazardous materials incident, you should:
immediately notify the dispatcher and request the appropriate resources
Q. When administering a nebulized bronchodilator, the oxygen flow rate should be set to at least ___ liters per minute.
The MOST effective way to deal with stress is to?
identify the stress triggers and take action to minimize their effects
The MOST significant factor that determines how well the body compensates for blood loss is:
the period of time over which the blood is lost
When examining the placenta, you should suspect fetal anemia if?
the maternal side of the placenta is pale
Which of the following questions would be MOST appropriate to ask when attempting to determine the quality of a patient's pain?
Does the pain come and go, or is it constant?
You are called to a residence for a 74-year-old woman who fainted. During your assessment, the patient's son tells you that he was standing next to his mother when she fainted and that he caught her before she fell to the floor. He further tells you that his mother has angina pectoris and kidney disease. The patient is now conscious but confused. Her blood pressure is 80/50 mmHg, pulse is 110 beats/min and weak, and her respirations are 22 breaths/min and regular. As your partner administers supplemental oxygen to the patient, you should:
assess for the presence of a nitroglycerin patch on the patient and remove it if she is wearing one.
A regular rhythm with inverted P waves before each QRS complex, a ventricular rate of 70 beats/min, narrow QRS complexes, and a P-R interval of 0.16 seconds should be interpreted as a/an:
accelerated junctional rhythm.
It is appropriate to ask, "Would you say the pain is similar to or worse than with previous episodes?" when determining the ¬¬¬___ of a patient's pain.
Q. Common clinical findings in patients with obstructive lung disease include all of the following, EXCEPT:
a decreased expiratory pause
Upper respiratory tract infections are more common in toddlers than in infants because?
of a loss of passive immunity
When caring for any pt, it is important to remember that?
your moral standards may conflict with the pts best interests
Which of the following statements regarding the use of emergency escorts is MOST correct?
Many drivers will only see the first emergency vehicle and assume that it is clear once that vehicle has passed
Which of the following factors would MOST likely cause vague or atypical signs of acute myocardial infarction?
female sex and diabetes
Which of the following statements regarding endometriosis is MOST correct?
untreated endometriosis may result in septic shock
Widespread dilation of the resistance vessels, capacitance vessels, or both, leads to:
* The induction phase of the immune response begins when?
part of the immune system recognizes an antigen
A third-service EMS system is one in which:
a public agency not affiliated with the fire department provides EMS service
During the proliferative phase?
estrogen stimulates the endometrium to increase in thickness in preparation for the reception and future growth of a fertilized egg.
For the EMS provider, the process of collecting and analyzing data regarding injury prevention begins with?
completing a legible PCR
Pharmacologic management for a black widow-spider bite may include all of the following, EXCEPT:
Q. The MOST significant complication associated with the use of multilumen airways is:
unrecognized displacement of the tube into the esophagus
The mnemonic "OPQRST" is a tool that:
Offers an easy-to-remember approach to analyzing a patient's chief complaint that is simple and effective.
The preferred antiarrhythmic medication and initial dose for a patient with refractory ventricular fibrillation or pulseless ventricular tachycardia is:
amiodarone, 300 mg.
A patient's vital signs, ECG findings, and blood glucose reading should be?
disclosed to the patient if he or she inquires about them
A woman who does not take prenatal vitamins during the course of her pregnancy is at GREATEST risk for?
Air ambulances are advantageous for all of the following reasons, EXCEPT:
more experience of the flight paramedics
During compensated shock:
an increase in respiratory rate and depth creates a compensatory respiratory alkalosis to offset the metabolic acidosis
Q. Which of the following patients has the lowest minute volume?
Tidal volume of 350 mL; respiratory rate of 12 breaths/min
Untreated depression in people over 65 years of age:
is associated with a higher suicide rate than any other age group
When documenting the severity of a patient's pain, it is also important to:
Note how distressed the patient appears: mild, moderate, or severe.
When wearing gloves while taking care of a pt, you should?
take them off before you drive the ambulance to the hospital
You are dispatched to a residence for a 29-year-old woman with difficulty breathing. The patient was recently diagnosed with leukemia and has just completed her first round of chemotherapy and radiation therapy. Upon arriving at the scene, you find the patient sitting in a recliner. Her level of consciousness is markedly diminished and her breathing is shallow. Her husband, obviously frightened, pleads with you to do something. You should FIRST:
move her to the floor and open her airway
Dysmenorrhea that occurs before, during, and after menstrual flow?
may signal an underlying illness.
Polypharmacy is MOST accurately defined as:
the prescribing of multiple drugs to treat multiple conditions
Q. The cricothyroid membrane:
is relatively avascular and is covered by skin and minimal subcutaneous tissue
Throughout the patient assessment process:
Look for nonverbal communication, such as changes in facial expression, heavy sighs, or aggressive gestures (finger pointing)
You are caring for a patient with non-life-threatening injuries in the treatment section of a mass casualty incident when you are approached by several TV reporters who are seeking details regarding the incident. You should:
direct the reporters to the public information officer
You arrive at the scene of a major motor vehicle crash. The pt, a 29 yo man, is in cardiac arrest from a severe head injury and has been receiving bystander CPR for approximately 10 min. A law enforcement official advises you that the pt's driver's license identifies him as an organ donor. You should?
begin full resuscitative efforts and transport the patient to a trauma center because certain tissues may be viable for harvesting
You would expect a person to be hypertensive and tachycardic following exposure to all of the following, EXCEPT:
You would MOST likely see an increased end-tidal CO2 reading in an otherwise healthy older adult because?
residual volume increases with age, resulting in stagnant air remaining in the alveoli and hampering gas exchange
A woman finds her 50-year-old husband unresponsive on the couch. When you arrive and begin your assessment, the wife tells you that her husband experienced an episode of chest discomfort 2 days prior, but refused to seek medical attention. The patient is unconscious and unresponsive; is breathing with a marked reduction in tidal volume; and has rapid, thready radial pulses. Your partner reports that the patient's systolic BP is 70 mmHg. The MOST appropriate treatment for this patient involves:
assisting his ventilations, applying a cardiac monitor, intubating if necessary, auscultating his lungs, transporting at once, establishing vascular access en route, administering a 200-mL crystalloid bolus if his lungs are clear, and considering a dopamine infusion.
Abnormal neurologic signs that accompany hypertensive encephalopathy occur when:
pressure causes a breach in the blood brain barrier and fluid leaks out, causing an increase in intracranial pressure.
For the first year of life, an infant has naturally acquired passive immunities because?
he or she maintains some of the mother's immunities
When assessing a patient who is under the influence of alcohol, it is MOST important to remember that:
Do not assume that all that you are told is completely accurate and keep your best professional attitude as you work with patients you suspect of using drugs or alcohol. Alcohol may mask any number of signs and symptoms.
Which of the following changes occurs in the respiratory system of a pregnant woman?
minute ventilation increases by as much as 50%, which causes the PaCO2 to drop by about 5%.
Which of the following disease processes would MOST likely present with signs and symptoms that mimic those seen with normal aging?
Which of the following statements regarding loading and securing a patient in the back of the ambulance is MOST correct?
Whether the patient is lying on the stretcher or sitting on the bench seat, he or she must be properly seat-belted.
You are caring for an alcoholic patient who has been abstinent for about two days. The patient is confused, restless, and tells you that he sees snakes crawling on the walls. His blood pressure is 76/52 mmHg, pulse rate is 140 bpm and weak, and respirations are 24 breaths/min with adequate depth. In addition to administering oxygen, you should:
treat his hypotension with crystalloid fluid boluses.
A paramedic is considered a health care professional, and as such should?
meet societal expectations whether he or she is on or off duty
Atherosclerosis is a process in which:
plaque infiltrates the arterial wall, decreasing its elasticity and narrowing its lumen.
If you suspect that a patient has been abused, you should:
Never hesitate to call for law enforcement personnel.
The dieffencachia plant is also referred to as "dumb cane" because:
ingestion can result in the patient being unable to speak.
The goal of volume replacement for a patient with hemorrhagic shock is to:
maintain perfusion without increasing internal or uncontrollable external bleeding
You respond to a residence for an unknown emergency involving an 83-year-old man. When you arrive, you find the patient, who is conscious and alert, sitting on his couch with his head held over a bowl. He tells you that his nose starting bleeding about 20 minutes ago and he cannot get it to stop. As your partner assists the patient in controlling the bleeding, you inquire about his medical history. He tells you that he has chronic atrial fibrillation, high blood pressure, and is occasionally depressed. When you ask him about compliance with his medications, he tells you, "I take my medicine every day, but the writing on the bottles is so small." The patient's blood pressure is 112/58 mmHg, pulse rate is 88 beats/min and irregular, and respirations are 18 and unlabored. This patient has MOST likely inadvertently:
overdosed on his warfarin
Considering the physiologic changes that occur with age, which of the following interventions would pose the GREATEST risk for harm when caring for an elderly patient with a severe burn that is complicated by a spinal injury?
In the late stage of syphilis?
the patient is usually asymptomatic, but damage to the brain, heart, blood vessels, and liver is occurring
Older adults are prone to subdural hematomas because?
age-related shrinkage of the brain stretches the bridging veins that return blood from the brain to the dura mater
Q. A critical step when using a continuous positive airway pressure (CPAP) unit to treat a patient with severe respiratory distress is:
ensuring an adequate mask seal with minimal leakage
The bioavailability and excretion rate of a toxin are influenced MOST by the:
amount of the toxin and the relative speed at which it is metabolized
The husband of a terminally ill woman called 911 because he thinks that his wife is about to die. The pt has a valid living will and an out-of-hospital DNR order. You should?
treat the husband and his wife with respect and provide emotional support
Which of the following findings would make you the LEAST suspicious for abuse or domestic violence?
(Suspicious findings WOULD INCLUDE) injuries inconsistent with the information you are given, or multiple injuries in various stages of healing.
While preparing to receive patients at the scene of a hazardous material spill, you see a middle-aged man approaching your ambulance. He is covered with a green liquid, is dyspneic, and states that he "barely got out of there alive!" You should:
tell him to stop immediately and inform the incident commander that the patient has not been decontaminated.
You are assessing a conscious and alert middle-aged male who complains of chest discomfort and nausea. His blood pressure is 112/70 mmHg, pulse is 90 beats/min and regular, and respirations are 20 breaths/min and regular. The patient's past medical history is significant for hypothyroidism and hyperlipidemia. His medications include Synthroid, Lipitor, Cialis, and 1 baby aspirin per day. Which of the following medications would you LEAST likely administer?
A patient with a medical condition that requires antiplatelet therapy would MOST likely be taking:
Just after birth, the ductus arteriosus constricts and closes, resulting in?
circulation through the pulmonary system
Q. Whether you are using the PtL or the Combitube:
both devices are inserted blindly into the posterior pharynx
When a pt minimizes his or her symptoms by stating, "I'm fine," the paramedic should?
find a reliable informant among the pt's family or friends
When asking questions pertaining to a patient's sexual history, it is MOST important to remember that:
Private setting is essential, also certain factors may inhibit truthful response.
When functioning at the scene of a major incident, communication should:
be face to face to minimize radio traffic
Which of the following central nervous system functions does NOT change as a person ages?
Which of the following interventions is influenced strongly by the amount of time that has elapsed since a patient ingested a toxic substance?
Which of the following statements regarding hypotension and shock is MOST correct?
Hypotension is a classic sign of shock, but it occurs late
Which of the following statements regarding the human papillomavirus (HPV) is MOST correct?
HPV has been identified as a causative agent in cervical cancer
An increase in maternal cardiac output can cause a benign systolic flow murmur, which results from?
hypertrophy of the heart and dilation across the tricuspid valve
External bleeding would be the LEAST difficult to control in a patient with a large laceration to the ___ and a BP of ___ mmHg.
Brachial artery, 68/46
If a patient does not respond to a question within a couple of seconds, he or she:
May simply be searching for the answer. Trying to decide if he can trust you.
If you are at the scene of an incident that potentially involves a weapon of mass destruction and other emergency resources are en route, it is MOST important for you to give the dispatcher information regarding the:
optimal route of approach
Q. Paradoxical respiratory movement is characterized by:
the epigastrium and thorax moving in opposite directions
Which of the following is the MOST common respiratory infection that causes death in the elderly population?
While caring for an 80 yo man with a possible fractured arm, you discover other injury patterns that are suggestive of abuse. The patient is conscious and alert. You should?
splint the pt's arm, transport him to the hospital, and report your suspicions to the emergency dept physician
* By properly introducing yourself to a patient, you are also saying that?
you are in charge of the patient's health care, regardless of the indignities of treatment, and that the patient can communicate with you as an equal
A patient who is overly talkative during your assessment:
May just be that way, also multiple clinical causes for over talkativeness (eg. fight/flight recovery). May have abused methamphetamines.
In contrast to delirium, dementia is:
a progressive disease that produces irreversible brain failure
Q. What type of medication dries secretions in the airway and prevents the cilia from removing them effectively?
The primary function of the treatment section is to:
separate and treat patients based on their triage category
Which of the following statements regarding toxic shock syndrome (TSS) is MOST correct?
patients with TSS may show signs of liver failure
You are caring for a 66 yo man with terminal CA. He is conscious and alert without evidence of mental incapacitation. You offer him O2, but he refuses to accept it, stating "Just let me die with dignity!" You should?
respect the pt's wishes and ask him if he wants to be transported to the hospital
You are dispatched to a restaurant for a patient that is choking. Upon arrival, you find the patient, a 30-year-old man, in obvious respiratory distress. His face is flushed and his arms are covered with hives. You are unable to obtain a blood pressure because the patient is restless; however, you are able to palpate his pulse, which is rapid and weak. In addition to ensuring adequate oxygenation and ventilation, the MOST important treatment for this patient involves:
administering epinephrine as soon as possible
After obtaining an elderly patient's chief complaint, gathering additional information about the history of present illness would MOST likely be complicated because:
chronic problems may affect the acute problem
An organ or tissue that is considerably colder than 98.6°F is better able to resist damage from hypoperfusion because:
the body's metabolic rate is slower
If you were unsure whether a conscious cardiac patient requires immediate transport versus continued assessment at the scene, you should:
continue with the focused assessment to obtain more information.
Q. If you see a soft tissue bulge on either side of the airway when performing nasotracheal intubation:
you have probably inserted the tube into the pyriform fossa
When dealing with a patient who has multiple complaints, the MOST effective way to develop an appropriate care plan is to:
Prioritize the pt complaints.
Your unit is the first to arrive at the scene of a traffic accident. Numerous bystanders are surrounding the wrecked vehicle. The driver appears to be unconscious. You should?
assess the scene carefully and notify other responding units of any hazards that may be present
Hemoglobin functions by:
binding to oxygen that is absorbed in the lungs and transporting it to the tissues
Human chorionic gonadotropin (HCG) hormone sends signals to the corpus luteum, which in turn?
produces hormones designed to support the pregnancy until the placenta has developed
If you know common hand signs or slang used by gangs:
it would be dangerous for you to use them around gang members because you are not a member of the group
In contrast to a 30-year-old man, if a 70-year-old were to consume an excessive amount of alcohol:
he will experience a higher blood alcohol concentration due to decreases in body mass and total body water
The paramedic must always keep in mind that the information he or she fails to obtain:
Could be the info needed to treat the pt.
Which of the following is NOT a reason why EMS providers are in the ideal position to serve as advocates for injury prevention?
most EMS systems require their personnel to participate actively in injury prevention programs
Which of the following statements regarding sickle cell disease is MOST correct:
patients with sickle cell disease become hypoxic because their misshapen red blood cells are poor carriers of oxygen
Failure of the body's compensatory mechanisms to preserve perfusion results in all of the following, EXCEPT:
an increase in preload
If you are trained in hazardous materials at the awareness level, you should be able to:
recognize potential hazards and the need for additional resources
Implied consent is based on the premise that a pt?
would consent to care because of the seriousness of his or her injury
Potential contraindications to fibrinolysis include all of the following, EXCEPT:
significant closed head trauma within the past 3 months.
Q. Unlike bronchodilator therapy, corticosteroid therapy:
takes a few hours to produce bronchial edema
The MOST negative immediate consequence of providing inappropriate reassurance to your patient in the prehospital setting is:
Your patient could choose not to share quite as much information as he or she might have under other circumstances, leaving you with less information rather than more.
Which of the following conditions poses the LEAST risk for shock due to vaginal bleeding?
Appropriate care for postpartum bleeding in the prehospital setting includes all of the following, EXCEPT?
carefully placing sanitary pads in the vagina
Clinical signs and symptoms following exposure to a toxin will manifest MOST rapidly if the patient:
breathes in the toxic chemical
If a patients family member is hostile and begins shouting at you, you should:
Tell the person directly that if he or she continues to shout, you will not feel safe enough to do your assessment and will need to call law enforcement personnel.
It would be MOST appropriate to ask a patient a closed-ended question when?
you are trying to obtain medical history information
Q. Which of the following statements regarding pediatric endotracheal intubation in the prehospital setting is MOST correct?
Bag-mask ventilation can be as effective as intubation for EMS systems that have short transport times
When a certain level of tissue hypoperfusion is reached:
the cells convert to anaerobic metabolism, the byproduct of which is lactic acid
When assessing an unresponsive older person's airway, it is MOST important to remember that:
delayed gastric emptying increases the risk of aspiration
* The body's rejection of an organ following transplantation is MOST likely the result of?
If a hostile family member suddenly leaves the room, especially in the middle of a conversation with him or her, you should:
Follow the person, while working to calm him or her and defuse the situation. What you are also doing is making certain the person doesn't get a gun and shoot you,your partner or their spouse.
Once you have succeeded in establishing verbal contact with a man who is in the process of being rescued, it is MOST important to:
remain in contact with him
The relatively high use of nonsteroidal anti-inflammatory drugs by older patients predisposes them to:
peptic ulcer disease
Which of the following statements regarding uterine fundus measurement is MOST correct?
measurement of the fundus in centimeters corresponds to the number of gestational weeks
You are administering a normal saline bolus to a patient in hypovolemic shock secondary to severe external blood loss. How much saline will remain in the patient's intravascular space after 20 minutes if you have infused a total of 500 mL?
Children are at higher risk for serious injury than adults because of?
a proportionately larger head
Heat gain or loss in response to environmental changes is delayed in elderly people for all of the following reasons, EXCEPT:
Pulse oximetry will not provide a true assessment of arterial oxygenation in patients with carbon monoxide (CO) toxicity because:
the device cannot determine whether CO or oxygen is bound to the hemoglobin.
Q. A 76-year-old woman with empyhsema presents with respiratory distress that has worsened progressively over the past two days. She is breathing through pursed lips and has a prolonged expiratory phase and an oxygen saturation on 76%. She is on home oxygen at 2L/min. Your initial action should be to:
place her in a position that facilitates breathing
When noncolloid solutions are used in the treatment of shock:
you should give two to three times the volume of blood lost
Which of the following is an example of homeostatic failure?
salt and water retention and a blood pressure of 170/98 mmHg
Which of the following statements regarding an intoxicated patient is MOST correct?
(ALL CORRECT) Taking a good medical history becomes very difficult. Intoxication may mask symptoms, such as pain. With intoxication also comes a decrease in patience.
While en route to a motor vehicle accident, the dispatcher advises you that law enforcement is at the scene and reporting that numerous bystanders are suddenly becoming ill. After receiving this information, you should:
keep a safe distance from the scene and view it with binoculars
You are dispatched to a residence at 4:00 am for an elderly man with shortness of breath. The patient tells you that he was awakened with the feeling that he was smothering. You note traces of dried blood around his mouth. The patient tells you that he has some type of "breathing problem," for which he uses a prescribed inhaler. Based on the information you have obtained thus far, you should be MOST suspicious for:
left-sided heart failure
An effective injury prevention program should focus on all of the following data, EXCEPT?
current EMS call volumes
If a patient refuses to talk, and he or she is not exhibiting signs of decreased mental status, it is MOST appropriate for the paramedic to?
advise the patient that his or her silence will only hamper your ability to determine what is wrong
In contrast to younger patients, elderly patients:
tend not to complain, even when they have legitimate symptoms
Q. If a patient's initial presentation makes you suspicious about a particular respiratory condition, you must:
confirm your suspicions with a thorough assessment
The MOST effective way to obtain a medical history from a patient who is crying is to:
Keep a calm demeanor and patient approach; appropriate touch, such as a hand on the shoulder; and a quite, "I'm in control now" tone of voice will help get the crying to stop.
What is the MOST correct sequence of treatment for a patient with a suspected acute myocardial infarction?
Oxygen, aspirin, nitroglycerin, morphine.
When conduction the scene size-up of a call involving a gynecologic emergency, it is MOST important to?
assess for danger because any scene should be considered volatile
Which of the following factors would have the MOST negative effect on the body's process of hemostasis?
You arrive at the scene of a motor vehicle crash in which a small passenger car struck a power pole at a high rate of speed. As you size-up the scene, you can see that the driver is severely entrapped in his car and is screaming in pain. The fire department is en route to the scene with extrication equipment. You should:
stay away from the car until the absence of any utility hazards is confirmed
* If a parent insists on monitoring your conversation with his or her adolescent son or daughter, you should?
communicate the situation to the emergency department physician and document it accurately
Initial signs and symptoms of toxic shock syndrome (TSS) include all of the following, EXCEPT?
Q. You are attempting to intubate a 5-year-old girl when you note that her heart rate has fallen from 120 beats/min to 80 beats/min. A patent IV line has been established. The MOST appropriate action is to:
abort the attempt and ventilate with a bag-mask device and 100% oxygen
The son of a 76-year-old woman called 911 because his mother is "ill." The patient presents with mild confusion, poor skin turgor, and tachycardia. She is incontinent of urine and asks you for a glass of water. Her son tells you that she had not been feeling well for the past several weeks, but would not allow him to take her to the doctor. Which of the following assessment parameters will MOST likely reinforce your suspicion regarding the underlying cause of this patient's condition?
If your patient becomes seductive or makes sexual advances towards you, you should advise the patient that your relationship with him or her is strictly professional and then:
Try to keep your partner, law enforcement, or a family member in the room with you at all times.
Men who have been abused by their female spouses:
are often too humiliated to report the incident as it happened
Proximate cause is MOST accurately defined as?
a link between the paramedic's improper action and the pt's injury
Q. ___ breath sounds are the MOST commonly heard breath sounds, and have a much more obvious inspiratory component.
Which of the following bandages is associated with the HIGHEST risk of blood flow compromise?
Which of the following ECG abnormalities is MOST suggestive of cocaine toxicity?
Prolongation of the QT interval
Which of the following items of information is typically NOT obtained by the dispatcher prior to sending rescue units to the scene?
the patient's medical history
A patient who gives the emergency department physician completely different information than he or she gave to you in the field:
Patients may be too frightened or embarrassed to give particular information to a paramedic but will give a physician the information. May have an organic condition such as a brain tumor.
Q. A 66-year-old man with chronic bronchitis presents with severe respiratory distress. The patient's wife tells you that he takes medications for high blood pressure and bronchitis, is on home oxygen threapy, and has recently been taking an over-the-counter antitussive. She further tells you that he has not been compliant with his oxygen therapy. Auscultation of his lungs reveals diffuse rhonchi. What is the MOST likely cause of this patient's respiratory distress?
recent antitussive use
The MOST common and reliable sign of pit viper envenomation is:
rapidly developing edema around the bite area
Which of the following statements regarding documentation is MOST correct?
a thorough and accurate medical record is the paramedic's best protection in court
Which of the following statements regarding hostage situations is MOST correct?
The physiological effects of being held hostage are often of greater concern than physical problems
Which of the following wounds usually requires substantial irrigation and debridement prior to closure?
You are dispatched to a grocery store for a woman with severe abdominal pain. When you arrive, you find the patient lying on her side in the manager's office. She is confused, diaphoretic, and appears to be bleeding from her vagina. Her blood pressure is low, and her pulse and respiratory rates are elevated. You should?
apply high-flow oxygen, visually inspect her vagina and cover it with sterile dressings, keep her warm, begin transport, establish at least one large-bore IV en route, and administer enough crystalloid fluid to maintain radial pulses
You receive a call to a residence for an "unknown injury." Upon arrival at the scene, you are greeted at the door by a well-dressed man, who tells you that his 39-year-old wife fell down a small flight of stairs and is in the living room. As you are assessing the patient, you note multiple bruises to the left side of her face and an area of redness to her anterior neck. When her husband leaves the room for a brief period, she states, "Mike's really a good man, but he does have somewhat of a temper." You should:
continue your assessment as your partner notifies law enforcement
Changes in cardiac contractility may be induced by medications that have a positive or negative ___ effect.
When arriving at a residence for any EMS call, you should make it a routine habit to:
pay attention and listen for loud, threatening voices
When caring for a patient who is mentally challenged:
You may need to get information from family members, friends, or another caregiver.
Which of the following cardiac medications has a small therapeutic window and the GREATEST propensity to reach toxic levels?
Which of the following was NOT a required component identified by the Emergency Medical Services System Act of 1973?
national EMS certification
While caring for an unresponsive young woman who was apparently sexually assaulted, you note that her respirations are slow and shallow, her pulse is slow and weak, and her blood pressure is low. There is a small amount of dried blood on her thigh, but no grossly active bleeding. Immediate care for this patient involves?
maintaining her airway and providing ventilatory assistance.
A 56-year-old man presents with an acute onset of chest pressure and diaphoresis. He has a history of hypertension and insulin-dependent diabetes. His airway is patent and his breathing is adequate. You should:
administer high-flow oxygen.
If a pt makes a decision regarding his or her own health care and the paramedic does not agree with that decision, the paramedic should?
respect the pt's wishes, assuming he or she has decision-making capacity
In which of the following situations would a transfusion reaction MOST likely occur?
A person with type O blood receives type AB blood
Q. Uncontrollable coughing and hemoptysis in a cigarette smoker are clinical findings MOST consistent with:
When your patient is a non-English-speaking person, his or her child is often able to function as an interpreter because:
Children absorb a new language quickly in their school.
Which of the following is NOT characteristic of the secondary stage of syphilis?
single or multiple chancres
Which of the following statements regarding a hazardous materials toxicity level is NOT correct?
Most ambulances carry protective gear that would be required for dealing with level 2 and above hazardous materials.
A patient taking ___ would MOST likely experience a delay in the healing of a wound.
Child neglect is MOST accurately defined as:
harm or endangerment to a child that occurs when a caregiver fails to provide basic necessities or engages in dangerous child-rearing practices
Cyanide blocks the utilization of oxygen at the cellular level by:
combining with cytochrome oxidase
If a physician insists that you perform an intervention that you are not properly trained to perform, it would be MOST appropriate to?
ask the physician if he or she can suggest another alternative
If you must break a window to gain access to a patient trapped in his or her vehicle, you should:
ensure that the patient and all rescuers are protected properly
Which of the following is NOT an effective way of obtaining a medical history from a patient who is totally deaf?
The following are effective ways: When addressing a patient who is totally deaf but can read lips, address them face-to-face, slowing your speech slightly so that you are speaking clearly. Use an interpreter who knows ASL. Write out the communication.
A man stormed into a daycare center and opened fire with a semiautomatic rifle. The scene has been secured by law enforcement, and you are in the process of triaging the injured children. The first child you assess, a 4-year-old boy, is unresponsive and apneic but has a pulse. After manually opening his airway, he remains apneic. You should:
provide five rescue breaths and reassess his respiratory status
All of the following have been identified as potential complications of child maltreatment, EXCEPT:
criminal behavior beginning in late adulthood
Atrial fibrillation can be interpreted by noting:
an irregularly irregular rhythm and absent P waves.
Objective patient information is:
Objective (based on fact or observable) information is obtained from a pt about his or her overall state of health
Q. Which of the following statements regarding anatomic dead space is MOST correct?
anatomic dead space is about 1 mL per pound of body weight.
When caring for a confused elderly patient, it is MOST important for the paramedic to?
explain what he or she is doing at all times
Which of the following statements regarding the black widow spider is MOST correct?
Following a black widow spider bite, the patient's abdomen is often rigid due to severe muscle spasms
You are the first unit to arrive at the scene of a small building collapse. As you exit the ambulance, you can see a man pinned under a large metal beam. You should:
immediately request a special rescue team
___ entails gently striking the surface of the body, typically where it overlies various body cavities.
A patient with nerve compromise following an open injury to the hand:
requires prompt transport to the hospital
In contrast to sexual assault, rape:
involves penile penetration of the genitalia without the victim's consent
It is important to remember that if a patient is not personally sensitive to modesty because of an impaired mental state:
the patient's family likely will be
Q. After inserting the needle into through the cricothyroid membrane, you should next:
insert the needle about 1 cm farther and then aspirate with a syringe.
The paramedic's #1 priority is to?
be prepared to respond to and treat injuries that inevitable will occur
Upon arriving at a scene in which the incident command system has already been established, you should:
locate the medical staging officer to receive your assignment
During the second stage of disseminated intravascular coagulopathy:
decreased clotting factors cause uncontrolled hemorrhage
If a mortally injured patient's wishes regarding organ donation are not know?
consent must be obtained from a family member
Other than overall patient appearance, the patient's ___ is/are the MOST objective data for determining his or her status.
Q. It would be appropriate to insert a nasopharyngeal airway in patients who:
have an altered mental status with an intact gag relfex
Which of the following statements regarding idioventricular rhythm is MOST correct?
Most patients with an idioventricular rhythm are hemodynamically unstable.
Your index of suspicion for elder abuse should increase if:
a mentally competent patient allows the caregiver to respond to your questions
A 25-year-old woman presents with acute abdominal pain and vaginal bleeding. She tells you that she has soaked 8 high-absorbency tampons in the past 2 hours. Approximately how much blood has she lost externally?
Inadvertent lithium toxicity would MOST likely occur in a patient who is taking:
a tricyclic antidepressant
Lactated Ringer's is a/an ___ solution because its solute concentration is equal to that of the inside of the cell.
Safe practices when parking your emergency vehicle on a roadway at night include all of the following, EXCEPT:
leaving the headlights on
The firing of an artificial ventricular pacemaker causes:
a vertical spike followed by a wide QRS complex.
The residual pressure in the circulatory system while the left ventricle is relaxing is called the:
Which of the following caregiver characteristics is LEAST suggestive of abusive behavior?
underreaction to child misbehavior
Because extrication and rescue are medically complex:
the officers responsible for these functions usually function under the EMS branch of the incident command system
Blood pressure is the product of:
Cardiac output & peripheral vascular resistance, so it includes two components: systolic and diastolic pressure
During the inflammation phase of the healing process:
histamine causes vasodilation and increased blood flow to the injury
If you want reliable answers to personal questions, you should?
manage the scene so you can ask such questions quietly and privately
The MOST immediate forms of reperfusion therapy for an injured myocardium are:
fibrinolytics and placement of a coronary stent.
Which of the following scenarios reflects a violation of the Emergency Medical Treatment and Active Labor Act (EMTALA)?
a hospital transfers an unstable patient to another facility
* Dehydration is generally a more serious concern in elderly patients than in younger adults because?
total body water constitutes only 45% of body weight in older people
A paramedic's actions are considered to be grossly negligent if he or she?
willfully or wantonly deviates from the standard of care
An unresponsive, pulseless, apneic patient presents with ventricular tachycardia on the cardiac monitor. After defibrillating the patient with 360 joules, you should:
resume CPR and reassess the patient after 2 minutes.
How should you position your ambulance upon arriving at the scene of a victim who was found slumped over the steering wheel of his car?
At least 15 feet behind the parked vehicle, at a 10 degree angle to the drivers side, facing the shoulder
Motor vehicle trauma accounts for nearly 70% of trauma in pregnancy?
but only about 20% of maternal deaths
Q. The external jugular veins run ___ and are located ___ to the cricothyroid membrane.
To obtain a heart rate in infants younger than 1 year of age, you should:
Palpate the brachial artery to assess the pulse
A conscious patient's respiratory rate should be measured:
By inspection of the patient's chest, but respiratory movements can also be assessed by visualizing portions of the abdominal wall, neck, face, and overall accessory muscle use.
A sick or injured patient who is thinking clearly?
should be able to answer simple questions that make sense within 1 second
All of the following are functions of the skin, EXCEPT:
providing the immune system response for the body
When approaching a van at night to determine if the driver, who is reportedly unconscious, is in need of medical assistance, you should:
move 10 to 15 feet away from the passenger side and walk parallel to the van
Which of the following statements regarding the initiation of resuscitative efforts on an infant with sudden infant death syndrome (SIDS) is MOST correct?
initiating resuscitative efforts on the infant may not be ethically appropriate and may cause the family additional suffering
You are assessing a 79-year-old man who presents with an altered mental status. The patient's 50-year-old son, who lives with the patient, tells you that his father's present condition is "normal for him." Your assessment of the patient reveals a large hematoma to the back of his head and numerous skin tears to his arms. You should:
assess the patient and correct any immediately life-threatening conditions
Because of the physical and psychological injuries that abused children experience:
they may become abusive or neglectful caregivers as adults
In general, normal psychosocial factors that affect the life of the 35-year-old person include all of the following, EXCEPT:
Mild effects of cyanide exposure:
generally resolve by simply removing the victim from the environment and administering oxygen
Q. With regards to pulse oximetry, the more hypoxic a patient becomes:
the faster he or she will desaturate
When a dying person enters the acceptance stage?
it is often the family that is in need of the most help
When a patient's leg is entrapped under a crushing object for a prolonged period of time, toxic metabolic waste products are released into the systemic circulation:
after the patient's leg is freed from entrapment
When using a tympanic device to obtain a patient's body temperature, you should:
Be aware of extrinsic factors that may increase or decrease the temperature reading.
You are caring for a young woman with constant, diffuse abdominal pain, referred pain to both shoulders, and vaginal bleeding. She states that her last menstrual period was 2 months ago, but she adamantly denies being pregnant. Her blood pressure is 86/50 mmHg, pulse rate is 120 beats/min and weak, and respirations are 24 breaths/min and regular. Which of the following interventions is NOT appropriate for this patient?
* As the smooth muscles of the lower airway weaken with age:
beta-agonistic bronchodilators become an ineffective treatment for acute bronchospasm
The skin helps regulate body temperature through:
the production of sweat, which is evaporated from the surface of the skin
What do tabun, sarin, soman, and V agent all have in common?
The onset of symptoms following exposure is immediate
Which of the following factors would likely NOT skew a pulse oximetry reading?
(ARE LIKELY) hypotensive or cold patient, carbon monoxide poisoning, abnormal hemoglobin (ie, sickle-cell disease), vascular dyes, patient motion, and incorrect placement. (WOULD NOT) hypertension
Which of the following is NOT a typical question to answer when evaluating and interpreting research?
will the research study be published in a notable journal?
Which of the following is NOT characteristic of the secondary stage of syphilis?
single or multiple chancres
Which of the following questions often yields the LEAST reliable answer when questioning a patient who intentionally exposed himself or herself to a toxic substance?
Why did you take the substance?
Abused elders generally do not seek help for all of the following reasons, EXCEPT:
disorders such as Parkinson's disease
An appropriate sized blood cuff should:
The cuff should be one half to two thirds the size of the upper arm.
Compared to the bleeding from an open wound, bleeding from a closed wound:
is limited because the skin is unbroken
During the acute inflammatory response:
transient arteriolar constriction is followed by anteriolar dilation, which allows an influx of blood under increased pressure
Law enforcement request that you respond to a local apartment complex for a young woman who was sexually assaulted. When you arrive at the scene, you find the patient sitting on her couch, clearly upset. You see a small amount of blood on her shorts, near the groin area. What is your initial priority in the care of this patient?
identifying and treating immediate life threats
Q. You would MOST likely observe a grossly low respiratory rate and volume in a patient who overdosed on:
Upon arriving at the scene of a patient who is reportedly unconscious in his or her parked vehicle, you should:
notify the dispatcher of your location and the number and state of the vehicle's license plate
A 25-year-old woman presents with acute abdominal pain and vaginal bleeding. She tells you that she has soaked 8 high-absorbency tampons in the past 2 hours. Approximately how much blood has she lost externally?
A regular cardiac rhythm with a rate of 104 beats/min, upright P waves, a P-R interval of 0.14 seconds, and a narrow QRS complexes should be interpreted as:
At a very large incident, the operations section is responsible for:
managing the tactical operations job usually handled by the incident commander on route EMS calls
If the receiving facility does not have adequate resources to take care of your patient, you should next determine whether?
there is an appropriate facility within a reasonable distance
Q. Abnormal breath sounds associated with pneumonia and congestive heart failure are MOST often heard in the:
bases of the lungs
Which of the following statements regarding the reporting of suspected child abuse is MOST correct?
in most states, the paramedic is a mandated reporter in cases of child abuse and neglect
Which of the following statements regarding your general survey of the patient is MOST correct?
(ALL CORRECT). The general survey begins as you approach the scene, simultaneously sizing up the situation and the patients overall presentation. A quick look at the environment and the general appearance of the patient provides a substantial amount of info before you ask the first question. The expression "sick or not sick" sums up the approach.
A patient who overdosed on heroin and is unconscious with slow, shallow respirations would MOST likely experience?
decreased PaCO2 levels
If a woman who is 35 weeks pregnant is placed in supine position?
atrial preload may be reduced markedly
Q. Once you have confirmed that the lighted stylet-ET tube comination has entered the trachea, you should:
hold the stylet in place and advance the tube about 2 to 4 cm into the trachea.
The BEST indicator of possible child abuse is:
evidence gathered from a thorough physical exam and case history
The skin becomes ___ when red blood cell perfusion to the capillary beds of the skin is poor.
Which of the following statements MOST accurately describes an acute myocardial infarction (AMI)?
Necrosis of a portion of the myocardium due to a prolonged lack of oxygen
While attempting to resuscitate a middle-aged woman in cardiac arrest, you perform effective CPR, but do not evaluate the pt's cardiac rhythm until 10 min into the resuscitation attempt. When the cardiac monitor is finally applied, the pt is in asystole. The pt is transported, but is pronounced dead upon arrival at the hospital. Which of the following statements regarding this scenario is MOST correct?
the delay in evaluating the pt's cardiac rhythm constitutes a breach of duty and could be proven to be the proximate cause of her death
After you have safely approached a parked vehicle and are ready to alert the apparently ill driver of your presence, you should:
do so without moving past the B column into the driver's door area
During your assessment of a 7-year-old boy with a fractured arm, you note that the child has a flat affect and will not tell you how the injury occurred. The child's father, who is in the same room, is clearly apprehensive and rudely interrupts you when you question the child by stating, "I'll answer for my own kid; he can't tell you what happened!" You should:
continue your assessment as your partner discreetly returns to the ambulance to notify law enforcement
Injury to or disease of the ___ may cause prolapse of a cardiac valve leaflet, allowing blood to regurgitate from the ventricle into the atrium.
Q. Compared with an onen cricothyrotomy, needle cricothyrotomy:
allows for subsequent attempts to intubate the patient
Spray paints and lacquer thinner contain ___, and typically cause ___ when they are inhaled recreationally.
Toluene, hallucinations and mania
A discipline within ethics that discusses and debates the health care of human beings is called?
Flushed skin is commonly seen as a result of all the following, EXCEPT:
SIGNS INCLUDE: Patient's with fever, and it may be seen in patients experiencing an allergic reaction.
In addition to bleeding and contamination, the MOST immediate danger associated with an avulsion is:
a loss of blood supply to the avulsed flap
Law enforcement requests your assistance to assess a 33-year-old woman who was sexually assaulted. When you arrive at the scene, you find the patient sitting on the curb outside her apartment complex. She is conscious and crying, but does not have any gross injuries. When you begin to assess her, she tells you that all she wants to do is go home and clean herself up. She further tells you that she does not need your help. You should:
remain empathetic and advise the patient that she needs medical care, and that cleaning herself up may destroy any potential evidence.
Which of the following factors typically does NOT affect the vital signs for a 65-year-old patient?
You are dispatched to a residence for a 34-year-old woman who is "sick." Upon your arrival, the patient greets you at the door. She states that she recently had her menstrual period, which was accompanied by more pain than usual. Her vital signs are stable, she is conscious and alert, and denies vaginal bleeding or fever. This patient MOST likely has?
a ruptured ovarian cyst
* All of the following factors would cause potassium to shift into the cell, EXCEPT:
increased vagal tone
From an injury prevention standpoint, the term "intervention" is defined as?
specific prevention measures or activites designed to increase positive health and safety outcomes
Motor vehicle trauma accounts for nearly 70% of trauma in pregnancy?
but only about 20% of maternal deaths
Q. The MOST clinically significant finding when questioning a patient with a chronic respiratory disease is:
prior intubation for the same problem
The presence of dizziness in a patient with a suspected myocardial infarction is MOST likely the result of:
a reduction in cardiac output
The use of wet dressings in the field is limited because:
they provide a medium for pathogens to grow
When approaching an overturned tanker truck that is not displaying a warning placard, it is MOST important for the paramedic to maintain a high index of suspicion because:
tankers carrying small amounts of a hazardous material may not be required by law to display a warning placard
You are assessing an injured 9-year-old girl. The child's father, who appears to be intoxicated, is sitting on the couch and does not seem concerned about his daughter's injury. When asked when the injury occurred, the father tells you, "I can't remember, but it's been at least a few hours ago." You should:
elicit your partner's help and conduct a thorough assessment of the child
You receive a call to a residence for a patient who is "sick." Upon arriving at the scene, you find the patient, a 39-year-old woman, lying on the couch with a wet washcloth on her forehead. She is conscious and alert, and tells you that she has had several episodes of diarrhea and noticed bright red blood in her stool. Her pulse rate is rapid and weak, her skin is cool and clammy, and her blood pressure is 98/58 mmHg. Her medical history is significant for hemophilia, for which she is receiving factor VIII therapy. As you pull out a nonrebreathing mask, she tells you that her husband will be home in a few hours, and that he will take her to the hospital. You should:
advise her that her condition dictates immediate transport to the hospital and that delaying transport could result in deathTre
Changes in hair growth or loss of hair are LEAST suggestive of:
An underlying endocrine disorder, such as diabetes, or may result from treatment modalities for disease processes (eg, chemotherapy or radiation treatment of cancer). (least suggestive of) an infection
If a patient avoids answering a specific question, you should?
redirect him or her to the question to elicit a response
If a pt experiences prolonged hypotension or requires prolonged CPR, his or her ___ would be inappropriate for organ or tissue donation.
If a young female with a known history of gonorrhea presents with abdominal pain, nausea and vomiting, and bleeding between periods?
she most likely has pelvic inflammatory disease
Q. A 21-year-old man experienced an acute onset of pleuritic chest pain and dyspnea while playing softball. He is noticeably dyspneic, has an oxygen saturation of 95% on room air, and diminished breath sounds to the upper right lobe. The MOST appropriate treatment for this patient involves:
administering high flow supplemental oxygen and transporting at once.
The area of conduction tissue in which electrical activity arises at any given time is called the?
You are at the scene of a drive-by shooting in which a 15-year-old man was shot in the chest. Law enforcement personnel are at the scene. The patient is conscious, has an actively bleeding entry wound to his left anterolateral chest, and is breathing with difficulty. You should:
provide only the amount of care needed to prevent his condition from deteriorating and quickly move him to the ambulance.
You are dispatched to a residence for a man who cut his hand with a chainsaw. Upon arriving at the scene, your first action should be to:
carefully assess the scene for safety hazards
A young man is found unresponsive by his girlfriend. Your assessment reveals marked respiratory depression, a slow, weak pulse, and pinpoint pupils. There are numerous medication bottles found in his home. Of these, he has MOST likely ingested:
Law enforcement request that you respond to a local apartment complex for a young woman who was sexually assaulted. When you arrive at the scene, you find the patient sitting on her couch, clearly upset. You see a small amount of blood on her shorts, near the groin area. What is your initial priority in the care of this patient?
identifying and treating immediate life threats
Patients with decision-making capacity?
have the right to refuse all or part of the emergency medical care offered to them
Q. Continuous positive airway pressure (CPAP) in the emergency setting is used to treat patients with certain obstructive airway diseases by:
improving patency of the lower airway through the use of positive-end expiratory pressure.
The brief pause between the P wave and QRS complex represents:
A momentary conduction delay at the AV junction.
The pulse of the superficial temporal artery can be felt:
Just anterior to the ear in the temporal region.
What level of personal protective equipment is typically worn by the hazardous materials decontamination team in the warm zone?
When assessing an older adult's pupils and ocular movements, you should recall that?
it is not uncommon for lens deterioration to cause the pupils to be sluggish to react
Which of the following interventions encourages drainage from the site of a closed wound and reduces swelling?
Which of the following is NOT consistent with the profile of a person who abuses elders?
younger than 50 years of age
* Common signs and symptoms of ulcerative colitis include all of the following, EXCEPT?
bloating after milk ingestion
A child has probably NOT been abused if he or she:
looks to the parent for reassurance after being injured
A major complication associated with atrial fibrillation is:
clot formation in the fibrillating atria.
EMS protocol development, training methodologies, and equipment use decisions are based mainly on?
Examination of the head is MOST important when assessing a patient who:
Is a trauma patient or a patient with altered mental status or are unresponsive.
If a woman who is 35 weeks pregnant is placed in supine position?
atrial preload may be reduced markedly
Q. While transporting an intubated 8-year-old boy, he suddenly jerks his head and becomes cyanotic shortly thereafter. His oxygen saturation and capnometry readings are both falling, and he is becoming bradycardic. You attempt to auscultate breath sounds, but are unable to hear because of the drone of the engine. What has MOST likely happened?
When checking the ambulance engine, the odor of sewer gas:
indicates that the acid in the battery has boiled
Which of the following statements regarding compartment syndrome is MOST correct?
Compartment syndrome is more likely to occur with closed injuries
A crushing or tearing amputation:
can result in excessive blood loss due to hemorrhage if the paramedic does not intervene rapidly
Bulging of a child's anterior fontanelle is:
Common while crying, pathologic when observed in a quiet child.
If a young female with a known history of gonorrhea presents with abdominal pain, nausea and vomiting, and bleeding between periods?
she most likely has pelvic inflammatory disease
Q. Removal of a dental appliance after intubating a patient is:
dangerous and may cause dislodgement of the tube.
The first EMT textbook, Emergency Care and Transportation of the Sick and Injured, was published in 1971 by the?
American Academy of Orthopaedic Surgeons (AAOS)
The hazardous materials team has deemed it safe for you to enter and remove patients from an office building that exploded. As you are moving the patients, it is MOST important to:
remain alert to the possibility of a secondary explosive device
When you ask a patient an uncomplicated question in plain English, and he or she responds with an unnecessarily complicated or inappropriate response, you should consider that the patient is?
possibly lying due to the stress of the situation
Which of the following statements regarding an abusive parent is MOST correct?
Abusive parents have unrealistic expectations of their children and try to control their children through negative and authoritarian means
You are transporting a young female who intentionally ingested a large quantity of her prescribed Pamelor. She is conscious, but drowsy, and complains of a dry mouth and blurred vision. The cardiac monitor reveals sinus tachycardia at 120 beats/min. You are administering high-flow oxygen and have established a patent IV line. With regard to her ECG rhythm, you should be especially alert for:
You have applied the defibrillator pads to a pulseless and apneic 60-year-old woman and observe a slow, wide QRS complex rhythm. Your next action should be to:
immediately begin CPR.
* At birth, a pulse rate of up to ___ beats/min and a respiratory rate of up to ___ breaths/min are considered normal.
If your unit is the first to arrive at an incident, you should keep yourself safe, size up the scene, and then:
notify dispatch, identify your unit, apprise dispatch of the situation, and assume command.
When an ambulance collides with a citizen's vehicle at an intersection?
the driver of the ambulance may be charged criminally
When managing a patient who is entrapped by a crushing object, it is MOST important to:
make every effort to treat the patient before removing the crushing object
At 10:20 PM, you are dispatched for a woman reportedly slumped over the steering wheel of her car alongside the highway. Upon arriving at the scene, you should:
park your ambulance at least 15 feet behind the patient's vehicle
Full-thickness circumferential burns to the chest:
may cause significant restriction of respiratory excursion
The MOST immediate danger to a deeply unconscious patient with acute alcohol intoxication is:
aspiration of vomitus
When assessing visual acuity in the prehospital setting, you should:
Simple test such as light/dark discrimination and finger counting. Test each eye in isolation.
Which of the following is the BEST example of a teachable moment?
advising the unrestrained passenger with minor injuries following a MVC that she easily could have been killed
Q. The barrel-chest appearance classically seen in emphysemic patients is secondary to:
air trapping in the lungs.
The diameter and reactivity of a patient's pupils to light:
Reflect the status of the brain's perfusion, oxygenation, and condition.
The egg is referred to as a blastocyst when?
it has been fertilized and enters the uterus and begins absorbing uterine fluid through the cell membrane
The equipment and supplies that are carried in the back of an ambulance:
must be stowed safely yet easily accessible
The hyperpnea and tachypnea associated with methyl alcohol intoxication is secondary to:
The paramedic is in the BEST position to formulate an appropriate treatment plan for an ill patient if the paramedic?
is able to identify the etiology of the patient's illness
When educating citizens who live in an area where EMS response times will be lengthy, the MOST important skill to teach them is?
rescue breathing and chest compressions
You are called to a local gym for the patient with nausea. Your patient, a 29-year-old man, tells you that he thinks he has a "stomach bug." He is conscious and alert, denies CP or SOB, and tells you that he has been nauseated for the last 4 hours, but has not vomited. His blood pressure is 124/66 mmHg, pulse is 46 beats/min and strong, respirations are 20 breaths/min and regular, and room air oxygen saturation is 99%. The cardiac monitor reveals a sinus bradycardia. You should:
administer oxygen via nasal cannula, start an IV of normal saline, consider administering an antiemetic, and transport.
Asymmetry of the pupils:
(Anisocoria, which can be found in 20 % of the population) may indicate significant ocular or neurologic pathology, but must be correlated with the Pt overall presentation.
Nasotracheal intubation of a patient with upper airway burns:
is a complicated procedure and should be avoided
The ___ has the authority and responsibility to stop an emergency operation if he or she believes a rescuer is in danger.
The ability of the heart to vary the degree of its contraction without stretching is called:
When assessing a patient with a developmental disability, the MOST effective way of determining the extent to which he or she can interact and understand is to:
speak to the patient
Which of the following conditions, if it remains undetected until puberty, can result in acute pain, severe constipation, and low back pain at the onset of menses?
Which of the following general statements regarding injuries and injury prevention is MOST correct?
EMS has the greatest impact in preventing unintentional injuries
Which of the following physical changes occurs in adults over 25 years of age?
settling of the discs in the spine
A 23-year-old woman with sickle cell disease presents with severe joint pain and fever (102.5). She is conscious and alert, and tells you that her symptoms began yesterday and suddenly worsened today. Her blood pressure is 118/76 mmHg, pulse rate is 120 beats/min and regular, and respirations are 24 breaths/min with adequate depth. After applying high-flow oxygen, and initiating transport, you should:
ensure that she is in a comfortable position, cover her with a blanket, start an IV line at a KVO rate, and monitor her throughout transport.
A Computer-Aided Management of Emergency Operations (CAMEO) device is used by hazardous materials teams to:
help predict downwind concentrations of hazardous materials based on the input of environmental factors into a computer model.
Common complaints in patients experiencing an acute coronary syndrome (ACS) include all of the following, EXCEPT:
If your EMS system protocols permit you to administer oxytocin to the mother following delivery of the placenta, it is MOST important to?
ensure that she is not delivering a second baby
Q. The pressure relief valve on an automatic transport ventilator (ATV) may lead to unrecognized hypoventilation in patients with all of the following conditions, EXCEPT:
Stimulation of the nervous system during the fight-or-flight response causes?
When assessing a patient's conjunctivae, you note they are injected. This means that the conjunctivae are:
Injected means RED. The conjunctivae ought to be pink-not cyanotic, pale, or overly reddened.
As the first responding unit to arrive at the scene of a confined space rescue, what is the MOST important information to share with the technical rescue team when they arrive?
Whether the incident has changed significantly since your arrival
Q. You are transporting a middle-aged man on a CPAP unit for severe pulmonary edema. An IV line of normal saline is in place. Prior to applying the CPAP device, the patient was tachypneic and had an oxygen saturation of 90%. When you reassess him, you note that his respirations have increased and his oxygen saturation has dropped to 84%. You should:
remove the CPAP unit, assist his ventilations with a bag-mask device, and prepare to intubate him.
When assessing an anxious patient who presents with tachycardia, you must:
determine if the tachycardia is causing hemodynamic instability.
When establishing communication with a conscious and alert patient who is speech impaired, you should FIRST:
determine how he or she is most comfortable communicating with you
Which of the following statements regarding carbon monoxide (CO) poisoning is MOST correct?
Never rule out CO poisoning because of the absence of cherry red skin
Which of the following statements regarding methyl alcohol is MOST correct?
Methyl alcohol is also known as wood alcohol, and is present in paints, paint removers, windshield washer fluid, and varnishes.
* When functioning at a noisy scene, communication will be MOST effective if you?
move the patient to the ambulance as soon as you can
A 4-year-old boy pulled a pot of boiling water off the stove and experienced partial-thickness splash burns to his neck, anterior trunk, and both anterior arms. During your assessment, you note that the child is conscious, but is not crying. He is tachypneic and tachycardic and his skin is cool and moist. Other than the burns, there are no other gross injuries. Which of the following statements regarding this scenario is MOST correct?
The child may be hypoglycemic and requires assessment of his blood glucose level
Administering a drug that possesses a positive chronotropic effect will have a direct effect on:
the heart rate
Frank blood or clear, watery fluid draining from the ear canal following head trauma is MOST suggestive of a/an:
Basilar skull fracture.
In contrast to conductive deafness, sensorineural hearing loss:
may be congenital or secondary to a birth injury
Q. Use of a spacer device in conjunction with a metered-dose inhaler:
collects medication as it is released from the canister, allowing more to be delivered to the lungs and less to be lost to the environment.
The MAIN benefit to online medical control is that it?
provides an immediate and specific patient care resource
You are transporting a 55-year-old woman to the hospital. The patient has lymphoma and complains of generalized, severe pain. She is receiving supplemental oxygen and has an IV line of normal saline established. Her blood pressure is 110/64 mmHg, pulse rate is 104 beats/min and regular, and respirations are 22 breaths/min and adequate. You should:
administer narcotic analgesia as needed while closely monitoring her blood pressure
According to the rule of nines, an adult man with partial- and full-thickness burns to his head, face and anterior chest has burns to ___% of his total body surface area (TBSA).
Implantation of a fertilized egg within a fallopian tube?
can cause severe intra-abdominal hemorrhage
Q. The major advantage of the multilumen airway is that:
effective ventilation is possible if the tube enters the esophagus or the trachea
Research that is based on a group of individuals over an outlined time frame is called ___ research.
The goal of a system status management (SSM) is to:
minimize response times by deploying EMS resources strategically
When caring for a patient with cerebral palsy, it is MOST important to:
be prepared for seizures and have suction ready
Which of the following vital signs is NOT consistent with that of a child between 1 and 3 years of age?
heart rate of 80 beats/min
All of the following are adventitious breath sounds, EXCEPT:
(ALL CORRECT) Rales, Rhonchi, Wheezes, stridor.
All of the following events occur during the prodromal stage of labor, EXCEPT:
contractions at 5- to 15- minute intervals
The outer zone of an entrance or exit wound caused by a contact electrical burn is:
the red zone of coagulation necrosis
Upon entering the residence of a vision-impaired patient, the FIRST thing you should do is:
make your presence known
When heroin passes through the liver:
it is metabolized into acetyl-morphine, which continues to exert narcotic effects that may outlast the effects of naloxone
A burn patient with a history of chronic obstructive pulmonary disease:
may be triaged as a critically burned patient, even if the burn injury is small
A pt's wife called 911 because the pt was complaining of a severe headache and nausea. The pt is conscious and alert, but obviously upset that his wife called 911 without consulting him first. As you pull out the BP cuff, the pt folds his arms and turns away from you. From this pt's actions, you should conclude that?
you do not have consent to treat him
An early complex that breaks the regularity of the underlying rhythm, and is characterized by a narrow QRS complex and an upright P wave that differs in shape and size from the P waves of the other complexes, MOST accurately describes a/an:
premature atrial complex
Cerebral palsy is a:
nonprogressive, bilateral neuromuscular disorder in which voluntary muscles are poorly controlled
One aspect of the technique of contact and cover involves:
one paramedic making contact with the patient to provide care while the second paramedic obtains patient information from another person while gauging his or her level of tension
Percussion of the chest produces ___ if the pleural space is full of BLOOD.
hyporesonance or dullness
Q. You should be MOST suspicious of tube misplacement following an open cricothyrotomy if:
a crackling sensation is noted when palpating the neck.
The highest form of mental function in a human being is the?
spontaneous expression of appropriate humor
The MOST common cause of death following a tricyclic antidepressant overdose is:
a cardiac dysrhythmia
A morbidly obese 40-year-old man, whom you find lying supine in his bed, presents with respiratory distress. He is conscious, but can only speak in two-word sentences. His face is flushed and his ankles are notably edamatous. Your MOST immediate action should be to:
place him in a semi-Fowler's position
Acute coronary syndrome (ACS) is a term used to describe:
any group of clinical symptoms consistent with acute myocardial ischemia
If a liquid leaking from a tank has a high boiling point, and the air temperature is low:
the risk of vapor inhalation is relatively low
Q. Why are children more prone to croup when they acquire a viral infection than adults infected with the same virus?
A child's airway is narrower than an adult's, and even minor swelling can result in obstruction.
Which of the following scenarios MOST accurately depicts abandonment?
a pt with a possible fracture of the radius wishes to go to the hospital, but does not have transportation, so you arrange for a friend to take him to the emergency department the next day
Which of the following statements regarding a patient's physical pain is MOST correct?
a patient should never have to be a patient about any pain that the paramedic can alleviate
A patient with full-thickness burns surrounded by areas of superficial and partial-thickness burns should be treated with all of the following, EXCEPT:
Appropriate prehospital treatment for a patient who has overdosed on a stimulant and is excessively tachycardic and violent includes all of the following, EXCEPT:
Death in the pre-hospital setting following an acute myocardial infarction is MOST often the result of:
If a 17-year-old woman with a gynecologic problem answers your question, "Is there any possibility that you are pregnant" with a firm "No way!," you should?
ask the patient why she is sure she is not pregnant
Vascular compromise for changes in blood pressure decreases with age due to?
reduced elasticity of the peripheral vessels secondary to decreases in elastin and collagen
When assessing a patient who is disabled from a previous injury, you should:
ask the patient's family what is normal for him or her
A known alcoholic man is found unresponsive by a law enforcement officer. An empty container of antifreeze was found near him. Your assessment reveals that his respirations are deep and rapid, his pulse rate is rapid and weak, and his pupils are dilated and sluggishly reactive. As your partner administers high-flow oxygen to the patient, you should:
start an IV line and begin administering a saline fluid bolus
If the wife of a critically ill man asks you if her husband is going to die, the MOST appropriate response should be?
"He is very sick, but we are doing everything we can to help him."
Multiple sclerosis is:
a chronic central nervous system disease caused by destruction of the myelin and nerve axons within the brain and spinal cord
Q. Two attempts to ventilate an unconscious 10-year-old boy have been unsuccessful. You should next:
perform chest compressions
The fourth heart sound (S4):
Considered a "gallop" rhythm, is a moderately pitched sound that occurs immediately before the normal S1 sound; it's always abnormal. The S4 sound represents either decreased stretching (compliance) of the left ventricle or increased pressure in the atria. "bla" sound.
The MOST important aspect in the care of a woman with severe vaginal bleeding is?
treating for shock and transporting rapidly
Which of the following statements regarding an EMS provider's role during a trench rescue is MOST correct?
EMS providers should attempt to make contact with the patient, but should not enter the trench and attempt rescue
You have just performed synchronized cardioversion on a patient with unstable ventricular tachycardia. Upon reassessment, you note that the patient is unresponsive, apneic, and pulseless. You should:
ensure that the synchronizer is off, defibrillate one time, and check for a pulse.
If, when responding to a call for a pt in cardiac arrest, you run every stop sign and drive with unnecessary speed?
you are not a credible advocate for injury prevention
Injury to the inferior wall of the myocardium would present with:
ST segment elevation in leads II, III and aVF.
Q. If the ET tube is placed in the trachea properly, the colorimetric paper inside the ETCO2 detector should:
turn yellow during inspiration
The MOST common type of ovarian cyst is the ____ cyst, which generally develops during the?
functional, menstrual cycle
The MOST important prehospital treatment intervention for a patient with carbon monoxide poisoning is:
The term mid-life crisis BEST describes a person who?
makes a dramatic gesture in a bid to reclaim his or her youth
Upon arriving at the scene of a multiple vehicle crash, you call for additional resources and begin triaging patients using the START triage system. The first patient you assess is a young male who is unconscious and apneic. After manually opening his airway, you note that he starts breathing shallowly. You should:
categorize him as an immediate patient
When auscultating heart sounds, you should place your stethoscope at the:
At the fifth intercostal space over the apex of the heart.
Which of the following statements regarding cancer is MOST correct?
Cancer is defined as the uncontrolled growth of normal tissue cells
* Which of the following statements regarding nervous system function in the older adult is MOST correct?
cerebral metabolism and oxygen consumption remain constant throughout life
Body substance isolation (BSI) differs from universal precautions in that BSI?
is designed to approach all body fluids as being potentially infectious
Common complications associated with cerebral palsy include all of the following, EXCEPT:
If a patient's aortic aneurysm is not compressing on any adjacent structures:
he or she will likely be asymptomatic.
Q. In contrast to a needle cricothyrotomy, an open cricothyrotomy:
enables the paramedic to provide greater tidal volume
Which of the following statements regarding cold water submersion is NOT correct?
Water that is colder than 70 degrees F will cause a marked increase in oxygen demand
With regard to a thermal burn injury, the zone of coagulation:
is the central part of the burn and suffers the most damage
A painless, progressive enlargement of the lymphoid glands that most commonly affects the spleen and lymph nodes is called:
If a burn patient presents with a hoarse voice and states, "I'm cold," your MOST immediate concern should be:
Immediate treatment for a patient with acute myocardial infarction involves:
reducing myocardial oxygen demand.
Patients with congenital prolongation of the Q-T interval are at GREATEST risk for?
Q. Which of the following medications is safest to use in patients with borderline hypotension or hypovolemia?
Prior to transporting a 66 yo woman with CP to the hospital, she expresses the need to retrieve her bible and say a prayer. You should?
leave the room if your religious beliefs are not consistent with hers
The purpose of estimating a patient's total body surface area (TBSA) burns in the prehospital setting is to:
help the paramedic determine the most appropriate destination hospital
Which of the following is the safest method for preparing to enter a residence?
Stand to the doorknob side of the door, knock, and announce that you are a paramedic.
Which of the following statements regarding Rh disease during pregnancy is MOST correct?
During subsequent pregnancies, the Rh antibody will cross the placental barrier and attack the fetal red blood cells
A partial-thickness burn is considered to be critical if it:
involves more than 30% of the body surface area
Distention of the jugular veins indicates:
Depending on the clinical situation, patients with JVD may be experiencing cardiogenic shock or have a ruptured cardiac valve. In the setting of chest trauma, neck vein distention and hypotention may symbolize a tension pneumothorax or pericardial tamponade. Indicates increased venous capacitance
Q. You are dispatched to a residence for a 59-year-old man with difficulty breathing. The patient, who has a history of COPD, is conscious and alert. During your assessment, he tells you that he developed chills, fever, and a productive cough 2 days ago. Auscultation of his lungs reveals rhonchi to the left lower lobe. This patient is MOST likely experiencing:
Rheumatoid arthritis is MOST accurately defined as:
an autoimmune disorder that causes progressive joint destruction
Unlike dermal exposure to a strong acid, dermal exposure to a strong alkali:
requires longer irrigation with water because alkalis are less water soluble
When caring for a prolapsed umbilical cord, you should?
Keep the presenting part of the baby off the umbilical cord during rapid transport to the hospital
When using limb leads, any impulse moving toward a positive electrode will:
cause a positive deflection on the ECG.
You are assessing the circulation status of an injured patient using the START triage system. The patient, a 33-year-old man, has strong radial pulses bilaterally. You should:
control any bleeding and assess his mental status
You arrive at the scene of a shooting. The pt, a 19 yo man, has a GSW to the side of his head with a large amount of exposed brain mater. Further assessment reveals that the pt is apneic and pulseless. Law enforcement personnel advise you that the person who shot the patient is in their custody. You should?
avoid unnecessary contact with the pt and document the finding of your visual assessment of the pt and scene
As a result of the increase in systolic blood pressure associated with aging:
the left ventricle works harder, becoming thicker, and loses its elasticity
Depolarization, the process by which muscle fibers are stimulated to contract, occurs when:
cell wall permeability changes and sodium rushes into the cell.
Q. When determining the correct-sized nasogastric tube for a patient, you should measure the tube:
from the nose to the ear and to the xiphoid process.
The onset of menses is called ___, and typically occurs between the ages of?
Menarche, 11 and 14 years
Upon arriving at the scene of an incident involving a chlorine gas spill, you should:
remove all patients from the scene
When a person experiences an injury and seeks redress for that injury?
the judicial process must determine who is responsible
When examining the anterior abdomen of a patient who complains of abdominal pain:
It's best to make the patient as comfortable as possible. The patient must be in the supine position.
Which of the following statements regarding paralysis is MOST correct?
A paralyzed patient has lost the ability to voluntarily move a body part
While at the scene of an incident in which several patients were possibly exposed to Lewisite, you are informed that an unresponsive patient with multiple blisters on his body and inadequate breathing is being brought to you for treatment. You should:
ensure that the patient has been decontaminated before initiating any treatment
You are transporting a conscious but confused 29-year-old man after he was electrocuted. The patient is on high-flow oxygen, has an IV line of normal saline in place, is on a cardiac monitor, and has his spine fully immobilized. During transport, it is especially important for you to:
remain alert for lethal cardiac dysrhythmias and to be prepared to defibrillate
* Renin is a protein that is released into the bloodstream by the ___ in response to changes in the ___.
kidneys, blood pressure
A patient who is absolutely still and resists any movement should be suspected of having:
After stabilizing the scene, you must next:
get access to the patient and determine his or her degree of entrapment
During you assessment of a 33-year-old woman who you suspect is under the influence of a drug, the patient tells you that she was "listening to the painting on the wall" before you arrived. Her pulse rate and blood pressure are both elevated. This clinical presentation is MOST consistent with the use of:
Q. Approximately ___ mL of air remain in the anatomic dead space of an adult with a tidal volume of 500 mL.
Thousands of fibrils that are distributed throughout the ventricles, which represent the end of the cardiac condition system, are called the:
Which of the following would MOST likely encourage manufacturers to remove dangerous products from the market or make them safer?
product liability litigation
A 16-year-old man presents with shortness of breath and a productive cough. During your exam, you note that the tips of his fingers are cyanotic and clubbed. His breath sounds reveal coarse crackles bilaterally and his oxygen saturation is 85% on room air. This patient MOST likely has:
A 74-year-old man experienced partial- and full-thickness burns to his arms and chest resulting from a fire that started after he fell asleep while smoking his cigar. The patient's son, who arrived at the scene shortly after you, states that his father has congestive heart failure, rheumatoid arthritis, and atrial fibrillation. In addition to administering supplemental oxygen, it is MOST important for you to:
auscultate his breath sounds before administering IV fluids
Any electrical impulse that originates in the ventricles will produce:
wide QRS complexes and a rate between 20 and 40 beats/min.
Q. The MOST obvious risk associated with extubation is:
overestimating the patient's ability to protect his or her own airway
The single MOST important process to ensure ongoing rescuer safety at a technical rescue incident is:
the accountability system
Which of the following patients is NOT an emancipated minor?
17 yo woman who goes to college and lives with her parents
Which of the following statements regarding ascites is MOST correct?
Typically seen in patients who suffer from liver disease. Ascites is the collection of fluid within the peritoneal cavity
Which of the following statements regarding leukemia is MOST correct?
Leukemia is the result of abnormal white blood cell development
You are in the process of assisting a woman in labor. She is 38 weeks pregnant with her second child and her contractions are 3 minutes apart and are strong and regular. Her first baby was delivered by cesarean section. As you prepare for imminent delivery, the woman tells you that her contractions have decreased significantly, and that she is very dizzy. Assessment of her vaginal area reveals moderate vaginal bleeding. You quickly assess her and note that she is diaphoretic, tachycardic, and hypotensive. You should be MOST suspicious for?
* What hand gesture is interpreted by many Arabic and some Latin countries as the equivalent of an extended middle finger?
the thumbs-up sign
A female paramedic is attempting to ask a hearing-impaired man about his past medical history. However, when she asks him a question, he looks at her male partner and smiles. The male partner should:
attempt to communicate with the patient, as his voice will likely have a lower pitch
Burn shock is caused by:
fluid loss across damaged skin and volume shifts within the rest of the body
If a paramedic is on duty receives a 911 call in his or her jurisdiction?
he or she is not covered by the Good Samaritan law
If a woman who is being treated with the antibiotic metronidazole for bacterial vaginosis consumes alcohol during treatment?
She may develop severe nausea and vomiting
Normal sinus rhythm (NSR) is characterized by all of the following, EXCEPT:
QRS complexes that are less than 0.14 seconds.
Preparedness in a given area should involve decisions and planning about:
the most likely disasters for the area, among other disasters
Q. A 40-year-old man fell 20 feet from a tree while trimming branches. Your assessment reveals that he is unconscious. You cannot open his airway effectively with the jaw-thrust maneuver. You shoud:
carefully open his airway with the head tilt-chin lift maneuver.
What part of the abdominal exam is of LEAST value in the prehospital setting?
Auscultation of the abdomen.
Abdominal guarding is MOST commonly encountered in patients with:
Peritoneal irritation (i.e, organ becomes inflammed or hollow organ ruptures and empties contents into paritoneal cavity)
After an adult victim is struck by lightning and experiences cardiac arrest:
his or her heart may resume beating spontaneously
Cervical effacement occurs when?
The less muscular lower part of the uterus is pulled upward over the presenting part of the baby
During a lengthy confined-space rescue in which the patient has experienced a crush injury, the paramedic should be especially concerned about the potential for:
If a patient asks you for advice regarding a treatment decision that his or her physician made, you should?
advice the patient that he or she should speak with his or her physician
Which of the following is NOT an anatomic characteristic of a person with Down syndrome?
small retracted tongue
While en route to a call for an emotionally distrubed patient, law enforcement notifies you by radio that the pt has become extremely violent. You should?
wait for law enforcement to advise you that they have the pt under control
You are transferring a 60-year-old man with COPD from a community hospital to a metropolitan hospital. The patient is mildly dyspneic, but is otherwise stable. He is receiving oxygen via nasal cannula, has an IV line of normal saline in place, and an ECG applied. When reading his chart, you note that he has polycythemia, a history of a prior stroke, and HTN. The patient tells you that he feels a fluttering sensation in his chest. You glance at the cardiac monitor and see a narrow complex tachycardia at a rate of 160 beats/min. The patient's blood pressure is 116/70 mmHg and he remains conscious and alert. You should:
ensure adequate oxygenation and ventilation, administer 6 mg of adenosine, and reassess his cardiac rhythm
Common actions performed by the dispatcher after receiving an emergency call include all of the following, EXCEPT?
determining if an ambulance should be dispatched
Gross distortions of reality, withdrawal from social contacts, and bizarre behavior are MOST characteristic of?
If intubation of a burn patient becomes necessary, you should avoid cutting the ET tube down to make it shorter because:
facial edema may cause tube dislodgement 2 to 3 days after the burn
The recommended first-line treatment for third-degree heart block associated with bradycardia is:
Visceral abdominal pain is:
Less discrete guarded tenderness to palpation. Can be associated with various degrees of bowel obstruction.
A 30-year-old woman complains of an "achy" pain to both lower abdominal quadrants, which she states is made worse by walking. She further tells you that she recently finished her menstrual period. She has a fever of 101.9F. Her blood pressure is 122/62 mmHg, pulse rate is 84 beats/min and strong, and respirations are 14 breaths/min and unlabored. After gathering the rest of her medical history, you should?
Provide emotional support, make her as comfortable as possible, and safely transport her to an appropriate hospital.
Assessment of the female genitalia:
Performed in a limited and discreet fashion. Reasons to examine include concern over life-threatening hemorrhage or imminent delivery in chidbirth. Limit exam to inspection only.
Poisoning with ___ is MOST often the result of improper food storage or canning:
Q. Which of the following devices is NOT used to deliver oxygen via positive pressure?
simple face mask
The symptoms and medical management of patients poisoned by ___ are identical to those of the nerve agents.
When you address a patient by saying, "Hi, my name is Stephen Rahm and I'm a paramedic. What's your name?", the patient:
must go through a variety of very specific sequence of physical and mental responses that amounts to a mini-mental status examination
Which of the following statements regarding pre-hospital vascular access and fluid therapy in the severely burned patient is MOST correct?
At least one large-bore IV should be started while en route to the hospital
You should prioritize the needs of your patient based on the?
injury or illness that requires the most urgent treatment
* When communicating with older patients, it is MOST important to remember that:
their illnesses may be more complex because they have more than one disease process and may be taking several medications concurrently
If you are treating a patient with a suspected benzodiazepine overdose, and find that the patient is hypotensive, bradycardic and comatose:
you should consider concomitant overdose with another CNS depressant
If your partner is injured while approaching a parked vehicle, you should:
back the ambulance away from the danger zone and request law enforcement
Q. When present at low levels, oxygen binds easily to hemoglobin molecules, resulting in:
large changes in oxygen saturation when small changes in PaCO2 occur.
Which of the following burn injuries would MOST likely require transport to a burn specialty center?
Burns that involve the hands, feet, or major joints
Which of the following clinical findings is LEAST suggestive of left side heart failure?
While caring for a woman with acute SOB, your partner, a dedicated paramedic for many years, tells the pt that she should have driven herself to the hospital instead of calling EMS. Your partner's behavior is MOST consistent with?
A 51-year-old woman sustained a large laceration to her cheek when she was cut by a knife during a robbery attempt. The patient is conscious and alert and has severe oral bleeding. She denies any other trauma. Your FIRST action should be to:
ensure that she is sitting up and leaning forward
Clinical signs of an inflamed joint include all of the following, EXCEPT:
SIGNS INCLUDE: swelling, tenderness, increased heat, redness, ecchymosis, decreased function, deformity, diminished strength, atrophy or asymmetry from one side to the other
If you must move a vision-impaired patient, it is MOST important to:
tell the patient what is happening
Uterine inversion occurs when?
The placenta fails to detach properly and adheres to the uterine wall when it is expelled
Which of the following statements regarding vehicle stabilization is MOST correct?
Vehicles that are positioned upright on all four wheels should be stabilized
A 19-year-old woman fell from a second story window and landed on her head. She is unconscious with a blood pressure of 148/94 mmHg, heart rate of 58 beats/min, and irregular respirations of 8 breaths/min. Further assessment reveals blood draining from her nose and bilaterally dilated pupils that are slow to react. In addition to employing full spinal precautions, the MOST appropriate treatment for this patient involves:
intubating her trachea after preoxygenating her for 2 to 3 minutes with a bag-mask device, transporting immediately, starting at least one large-bore IV en route, applying a cardiac monitor, and performing frequent neurologic assessments.
In addition to identifying and evaluating any hazards, scene stabilization typically involves all of the following components, EXCEPT:
determining if air transport is available
Structural integrity of the pelvis is assessed by:
Applying pressure to the iliac crests and pushing in and then down
When troubleshooting a hearing aid that is not working, you should:
avoid attempting to clean the device
Which of the following statements regarding the amniotic sac and fluid is MOST correct?
In the latter stages of pregnancy, the fetus swallows amniotic fluid and passes wastes out into the fluid
Bleeding from a scalp laceration with an underlying skull deformity:
may contribute to hypovolemia in adults
The diagnosis of a problem involving the shoulder can often be made by simply:
Simply by noting the patient's posture at the time of first contact
Which of the following is a potential complication of pelvic inflammatory disease (PID)?
In MOST ambulance collisions:
the ambulance was not traveling in the proper lane or the operator was driving with excessive speed
Lower extremity shortening and/or internal or external rotation are findings often associated with:
An injury to the proximal aspects of the lower extremity
When making initial contact with a mentally impaired patient, you should:
have your team members remain at a distance until you can establish a rapport with the patient
You are en route to the hospital with a conscious middle-aged man who experienced trauma to the anterior neck during an assault. He is on supplemental oxygen, has spinal precautions in place, and has a large-bore IV line of normal saline in place. When you obtain a repeat set of vital signs, you note that his blood pressure is 90/64 mmHg, his pulse rate is 120 beats/min, and his respirations are 22 breaths/min with adequate depth. You should:
keep the patient warm and infuse enough isotonic crystalloid solution to maintain adequate perfusion
Intermittent claudication is MOST accurately defined as:
Cramp-like pain in the lower legs due to poor circulation
Upon arriving at the scene of a woman with shortness of breath, you find the patient, a 450-pound woman, lying in her bed. She is conscious and alert, but is experiencing obvious respiratory distress. As you begin your initial assessment, you should ask your partner to:
request lifting assistance
All of the following are examples of real or physical evidence, EXCEPT:
oral documentation by a witness
In addition to massive bleeding, injury to a carotid or vertebral artery would MOST likely cause:
Within a few days after having a therapeutic abortion, a 33-year-old woman presents with malaise, fever, constipation, and pelvic pain. Her blood pressure is124/84 mmHg, pulse rate is 104 beats/min and strong, and respirations are 22 breaths/min and regular. You should be MOST suspicious for?
When managing the airway of an unresponsive patient with serious anterior neck trauma and inadequate breathing, you should:
assist ventilations with a bag-mask device and prepare to intubate
You are assisting in the delivery of a baby. As the infant's head begins to emerge from the vagina, you should support the head as it turns and then?
Assess for a nuchal cord
Your unit is the first to arrive at the scene of a bus crash. As you approach the scene, you see multiple patients, some of them lying on the ground not moving and others walking around in a dazed state. You should:
remain aware of the potential for hazards
Proper documentation of an incident in which a patient was injured during a crime should include all of the following, EXCEPT:
your estimate of when the injury occurred
When communicating with an aphasic patient, you should:
use focused questions rather than open-ended questions
Which of the following statements regarding abdominal trauma during pregnancy is MOSt correct?
Use of a lap belt increases the risk of uterine injury
You would MOST likely encounter bilateral dependent edema in a patient with:
1st- heart failure, 2nd- hepatic cirrhosis.
Communicating with a hearing-impaired patient would MOST likely be enhanced by:
using one person to ask interview questions
Following exposure to mustard:
the patient experiences a progressive reddening of the affected area, which will gradually develop into large blisters
A diffuse axonal injury (DIA):
involves stretching, shearing, or tearing of the extension of the neuron that conducts electrical impulses away from the cell body.
Which of the following disorders or conditions is related to decreased glycogen stores in the newborn?
small for gestational age
Which of the following statements regarding stuttering is MOST correct?
stuttering often worsens when the person is under stress
A level 1 material:
would cause irritation on contact but only mild residual injury, even without treatment
Which of the following would MOST likely make intubation of a patient with Down syndrome difficult?
small oral cavity
A young man was assaulted and has extensive maxillofacial injuries. Your initial assessment reveals that he is semiconscious, has poor respiratory effort, and has blood draining from the corner of his mouth. Initial management for this patient involves:
manually stabilizing his head in a neutral position, suctioning his oropharynx, and assisting ventilations with a bag-mask device and 100% oxygen
According to the JumpSTART triage system, if an infant or child is not breathing, you should:
immediately assess for a pulse
If a vision-impaired patient who owns a service dog is hemodynamically unstable, you should:
take the dog and the patient to the hospital
Which of the following statements regarding fever in children is MOST correct?
fever is generally a sign of underlying illness
If a sufficient concentration of a hazardous material mixes with the air and reaches its lower explosive limit:
the material can burn in the air or explode
Unlike sinus tachycardia, reentry supraventricular tachycardia in infants is characterized by?
an unvarying pulse rate
You respond to call for a 67-year-old man with respiratory distress. When you arrive, the patient's wife greets you at the door. As she is escorting you to her husband, she tells you that he has myasthenia gravis and type 2 diabetes. As you begin your assessment of the patient, you note that he is responsive to pain only, is breathing at a slow rate with shallow depth, and has perioral cyanosis. You should:
insert a nasopharyngeal airway and assist his ventilations with a bag-mask device
A moderate diffuse axonal injury:
produces an immediate loss of consciousness and residual neuorologic deficits when the patient wakes up
If the parent or caregiver of a sick or injured child is emotionally distraught:
provide support, but remember that your first priority is the child
When communicating with a patient who is hearing impaired, you should:
avoid exaggerated lip movement
Which of the following statements regarding windshield removal is MOST correct?
When the windshield is struck with a center punch, a small break occurs but the structure of the glass remains intact
If a patient is able to shrug his or her shoulders and turn his or her head from left to right, the ___ nerve is likely intact.
In contrast to viruses and bacteria, neurotoxins:
are not contagious, but do have a faster onset of symptoms
Which of the following statements regarding poliomyelitis (polio) is NOT correct?
any warm-blooded animal can be a host for the poliomyelitis virus
If a patient's trigeminal nerve is intact, he or she should be able to:
Motor:Chew; Sensory:face, sinuses, teeth.(Table 13-2) Check jaw clench; touch both sides of of face at forehead, cheeks, and jaw.
Mental retardation is MOST accurately defined as:
insufficient development of the brain that results in the inability to learn and socially adapt at the usual rate
A subdural hematoma is classified as being acute if clinical signs and symptoms develop:
within 24 hours following the injury
Cardiac dysrhythmias in patients with cystic fibrosis are MOST often secondary to:
During transport of a newborn, timely intervention of acute deterioration is most effectively achieved by?
ongoing observation and frequent assessment
When staging at an appropriate distance from the scene until the hazardous materials team arrives to investigate the chemical leaking from an overturned tanker, you should:
check the wind direction periodically and be prepared to relocate
What is the pathophysiology of cystic fibrosis?
A defective gene that makes it difficult for chloride to move through the cells, which causes unusually high sodium loss and abnormally thick mucus secretions
When scoring a patient's deep tendon reflexes, normally active reflexes would be assigned a score of:
2+ "Active (expected response)".
Which of the following statements regarding body armor is MOST correct?
Sound survival skills to avoid dangerous situations provide more protection than body armor
A 19-year-old man with Down syndrome presents with a decreased mental status. According to the patient's mother, this is not normal for him. She further tells you that he had not been feeling well lately and has not had an appetite. As your partner provides appropriate airway management, you should:
assess his blood glucose level
An infant born with a pink body and blue extremities, a pulse rate of 90 beats/min, a strong cry, and active movement, should be assigned an initial Apgar score of?
When dispatched to an emergency call, the paramedic must:
decide which route will be used to arrive at the scene safely
In addition to an IV dextrose bolus, the MOST important treatment for newborn hypoglycemia is?
proper thermal management
In contrast to dementia, delirium is:
More consistent with an acute sudden change in mental status, secondary to some significant underlying aberration.
When establishing intravenous (IV) access in a patient with paralysis to the right side of the body, it would be MOST appropriate to:
establish the IV on the side of the body that is not paralyzed
When landing a helicopter at night, you should:
avoid shining a spotlight up at the descending aircraft
Failure of a child's SaO2 to increase despite high-flow oxygen is MOST indicative of?
congenital heart disease
Following a traumatic brain injury, initial swelling of the brain occurs due to:
When assessing a hemodynamically stable child, the toe-to-head approach is generally indicated for children who are:
1 to 3 years of age.
Proper documentation of your physical examination of a patient is MOST important because it:
Ensures that an accurate historical accounting of the patients problems prior to entering the hospital will legally exist in the formal medical records.
Spina bifida occurs when:
the fetus's spinal column does not close properly or completely and vertebrae do not develop, leaving a portion of the spinal cord exposed
Documentation of your physical examination should be:
When you are recording examination finding's, note objective signs, pertinent negatives, and other similar relevant information.
How much naloxone should you give to a 6.5-pound newborn with a respiratory depression secondary to maternal narcotic administration?
Unlike a cerebral concussion, a cerebral contusion is:
associated with physical brain damage and more pronounced neurologic deficits
When treating a patient with an ocular injury, what should you do to avoid an increase in intraocular pressure (IOP)?
Discourage the patient from coughing
Which of the following actions will provide the BEST personal protection when caring for a patient on uneven terrain?
take the time to make all lifts and moves safe/controlled
Which of the following statements regarding hearing aids is NOT correct?
properly maintained hearing aids can restore hearing to normal
When a child who is too young to verbalize is in significant pain:
your ability to assess accurately for physiologic abnormalities is impaired
Which of the following types of skull fracture would be the LEAST likely to present with gross physical signs?
Common medications used to treat pediatric seizures in the prehospital setting include all of the following, EXCEPT:
Prehospital treatment of the patient with a traumatic brain injury must focus primarily on:
maintaining cerebral perfusion pressure
Progressive deterioration of the myocardium that results in a decreased ejection fraction is called:
Whether your patient's problem is medical or traumatic in origin, you must:
Ask two questions, first "Is my patient sick?" a yes or no answer. Second "How sick is my patient?" attempts to rate the events severity. Answer both within 60-90 sec.
A young child who falls from a significant height would MOST likely experience?
a traumatic brain injury
It is MOST important to identify the age and sex of your patient because:
Age can change how a patient presents.
Upon arriving at the scene of a patient receiving home health care and conducting your scene size-up, it is MOST important to remember that:
you must determine that the environment is safe for the patient
After performing your initial assessment of a patient, your next action should be to:
Do a focused history and physical exam.
Epiglottitis in children:
is rare now that children are vaccinated against Haemophilus influenza type B
The MOST significant complication associated with a full bladder in a patient with spinal cord disruption and paralysis is:
a dangerous elevation in blood pressure
The purpose of hospice care is to:
provide quality end-of-life care through pain and symptom management
When assessing an injured patient's mental status, the patient knows his name but is unable to recall the events that preceded the injury. From this, you can conclude that:
This patient is A&O X1 to person and has his long-term memory but his short-term memory has been effected.
Which of the following statements regarding anisocoria is MOST correct?
Anisocoria is a condition in which the pupils are unequal
You have just delivered a little girl that was born 4 weeks premature. There is no evidence of meconium in the amniotic fluid. After drying, warming, suctioning, positioning,and stimulating the infant, she remains acrocyanotic and is not crying. You should:
open her airway and assess respirations
A newborn is at GREATEST risk for meconium aspiration if he or she:
is born at more than 42 weeks gestation
Swelling of the arm, neck, or shoulder in a patient with a central venous catheter is MOST suggestive of:
Which of the following statements regarding a closed head injury is MOST correct?
In a closed head injury, the dura mater remains intact.
In contrast to serous exudate, purulent exudate is:
pus that consists of white blood cells and bacteria
Proper treatment for an open wound to the neck includes:
sealing the wound with an occlusive dressing
What is the Glasgow Coma Scale (GCS) score of a patient who opens her eyes when you call her name, is confused when she speaks, and points to her area of pain?
Which of the following statements regarding acrocyanosis is MOST correct?
Acrocyanosis is cyanosis of the hands and feet, and is a normal finding in infants younger than 2 months of age who are cold.
Patients with an ileostomy:
have a stoma that connects the small intestine to the outside of the abdomen where a collection bag is attached
Sonorous respirations are MOST likely caused by:
"position problem"- likely from the tongue partially obstructing the airway
Vascular injury following trauma to the anterior neck would MOST likely present with:
Because significant force is required to fracture the mandible:
it is often fractured in more than one place and is unstable to palpation
Choanal atresia is MOST accurately defined as a:
bony or membranous obstruction of the back of the nose
Unlike a midline venous catheter, a peripherally inserted central catheter (PICC) can be used for:
long-term fluid therapy
If manual positioning of a patient's head is required to keep his or her airway open, you should:
you must choose an airway adjunct
When assessing and caring for a 17-year-old gang member, it is MOST important to remember that he or she:
may have a weapon and a reputation to earn
In contrast to negative-pressure ventilation, positive-pressure ventilation:
alters the body's hemodynamics by reducing the venous return to the heart
Tidal volume is MOST effectively assessed by:
The book refers back to chapter 11 for an explanation of tidal volume, but the only info that is given, is the average tidal volume for an adult (approx. 500 mL).
You are caring for a man with a chemical burn to both eyes. The patient, who has contact lenses in place, is in severe pain and tells you that he can't see. Proper care for this patient includes:
carefully removing his contact lenses, flushing both eyes for at least 20 minutes, and transporting with continuous eye irrigation
A chronically ill patient who has been on home oxygen therapy for several years would MOST likely call EMS when:
his or her oxygen demand exceeds the current supply
A patient with a blood pressure of 210/100 mm Hg would be expected to have a pulse that is:
a patient who is hypertensive will produce a pulse that is more forceful than usual
Upon arriving at the scene of a 4-year-old boy with respiratory distress, you enter the residence and see the child, who is conscious, sitting on his father's lap. The father is aware of your presence, but the child is not. Your inital action should be to?
visually assess the child from across the room for any signs of increased work of breathing
Following removal of an ostomy device and cleansing the stoma, you should:
place a clean gauze pad over the stoma
A 4-year-old girl presents with a fever of 103.2F. The child's mother states that the fever came on suddenly and was not preceded by any symptoms. The child is conscious and alert with unlabored tachypnea, tachycardia, and a blood pressure that is consistent with her age. Prehospital treatment for this child includes all of the following, EXCEPT:
81 mg of aspirin
An unresponsive patient who has been breathing slowly and shallowly for an extended period of time would MOST likely have ___skin.
"dusky gray or blue (cyanosis)"
Once you have arrived at the residence of a patient who receives home health care from his or her family:
the law requires you to assume responsibility for care of the patient
The MOST common reasons for ineffective bag-mask ventilations in the newborn are:
inadequate mask-to-face seal and incorrect head position
When assessing the severity of a traumatic brain injury, the single most important assessment parameter is the patient's:
level of consciousness
You are assessing a 70-year-old man with terminal cancer who is on home oxygen therapy. The patient is conscious and complains of severe generalized pain. His blood pressure is 108/68 mmHg, his pulse rate is 100 beats/min, and his respirations are 22 breaths/min. The patient's caregiver, a registered nurse, presents you with a valid out-of-hospital no not resuscitate order. On the basis of this document, you should:
administer analgesia for pain relief and determine if the patient wishes to be transported to the hospital
The body's reaction to increased internal or external temperature would MOST likely cause the skin to become:
Hot and moist
The MOST disastrous consequence of a severe traumatic brain injury is:
a decrease in cerebral perfusion pressure
Which of the following statements regarding the Apgar score is MOST correct?
If resuscitation is necessary, the Apgar score is completed to determine the result of the resuscitation
You are dispatched to a residence for an elderly woman with a decreased level of consciousness. When you arrive, the patient's caregiver tells you that the patient has Alzheimer's disease and was lucid 30 minutes earleir. Now, the patient responds only to painful stimuli. You should:
administer high-flow oxygen as your partner assess the patient's blood glucose level
A patient in shock due to internal bleeding will benefit MOST from:
limited scene time and rapid transport
A terminally ill patient with a valid do not resuscitate order would most likely NOT receive:
When dealing with the caregivers of an infant who died suddenly, you should:
find out the infant's name and use it
For a responsive patient with a medical complaint, you will MOST likely form your working diagnosis based on information gathered during the:
You have been providing bag-mask ventilation to a newborn with a sustained heart rate of 75 beats/min for approximately 5 minutes. The infant's abdomen is markedly distended. Although you are properly trained, your protocols do not allow you to intubate newborns. The MOST appropriate intervention involves:
inserting an orogastric tube
Open soft-tissue facial trauma following a significant mechanism of injury:
suggests that the patient may have a closed head injury or spinal injury
The history of present illness is MOST accurately described as:
information about the chief complaint, obtained using the OPQRST mnemonic
The risk of newborn complications is HIGHEST if the amniotic sac:
ruptured more than 24 hours before the time of birth
Which of the following statements regarding infection in immunocompromised patients is MOST correct?
fever is often the only sign of infection in the immunocompromised patient
A male patient with a closed head injury opens his eyes in response to pain, makes incomprehensible sounds, and responds to pain with flexion of his arms. His Glasgow Coma Scale (GCS) score is ___, and the MOST appropriate treatment for him involves:
7; intubation, ventilations performed at a rate of 10 breaths/min, IV fluids as needed to maintain a systolic BP of at least 90 mmHg, and maintaining his oxygen saturation at greater than 95%
After moving a bedridden 80-year-old man from his bed to your stretcher, you note an open wound to his lower back. Assessment of the wound reveals that it is red, inflamed, and is draining purulent exudate. The patient has a fever and chills, and complains of moderate pain to the wound. You should:
cover the wound with a sterile dressing, make the patient comfortable, and transport him while providing reassurance en route
The focused physical exam of a patient is guided by:
information you gathered during the initial assessment and history-taking phase.
If a newborn does not respond to the initial steps of resuscitation, the need for further intervention is based upon:
respiratory effort, pulse rate, and color
Prior to replacing an ostomy device in a patient, it is MOST important to:
wash your hands and take appropriate BSI precautions
The galea aponeurotica is:
a tendon expansion that connects the frontal and occipital muscles of the cranium
During the delivery of a post-term baby, you note the presence of particulate meconium in the amniotic fluid. Your post-delivery assessment of the newborn reveals that it is active, has a strong cry, and has a heart rate of 110 beats/min. You should:
ensure that the infant is warm and dry, administer free-flow oxygen if needed, and provide continuous monitoring
Several attempts to clear a plugged tracheostomy tube with suction have failed. The patient, who is on a mechanical ventilator, has a pulse rate of 150 beats/min and is making exaggerated attempts to breathe. You should:
remove the tracheostomy tube, place a mask over the stoma, and ventilate with a bag-mask device
The presence of rales during auscultation of the chest indicates all of the following conditions:
pulmonary edema, heart failure, toxic inhalation, submersion.
Which of the following statements regarding the hypothalamus is MOST correct?
The hypothalamus is the most inferior portion of the diencephalon and controls functions such as hunger, sleep, and vomiting.
A flattened appearance to the face and loss of sensation over the chest following blunt facial trauma is MOST indicative of a/an:
Diffuse pain caused by hollow organ obstruction and stretching of the smooth muscle wall is called ___ pain.
Epinephrine is indicated during newborn resuscitation if:
the heart rate remains below 60 beats/min after 30 seconds of effective ventilation and an additional 30 seconds of chest compressions
You are transporting a 49-year-old man to the hospital for evaluation of a new onset of fever. The patient has renal carcinoma, is being treated with chemotherapy, and has a central venous access device in place. The patient is conscious, but complains of fatigue, slight nausea, and a decreased appetite. During transport, it is MOST important for you to:
apply a mask on the patient to minimize his risk for infection
In contrast to a complex febrile seizure, a simple febrile seizure:
lasts less than 15 minutes and occurs in children without underlying neurologic abnormalities
What portion of the brain stem is responsible for maintenance of consciousness, specifically one's level of arousal?
Reticular activating system
What type of pain has its origin in a particular location, but is described by the patient as pain in a different location?
When suctioning and cleaning the tracheostomy of a ventilator-dependent patient, it is MOST important to:
keep the patient well-oxygenated
A patient is generally considered to have orthostatic vital signs (a positive tilt test) when:
the patient's blood pressure shows a decrease in systolic pressure (up to 20mmHg), an increase in diastolic pressure of 10mmHg (a narrowing pulse pressure), and an increase on the heart rate by 20 beats/min.
Appropriate treatment for a conscious child with anaphylaxis includes:
0.01 mg/kg epinephrine 1:1,000 IM
Signs and symptoms of retinal detachment include:
flashing lights, specks or floaters in the field of vision
When caring for a patient who has a central venous access device, you should:
avoid taking a blood pressure on the arm with the access device
The MOST reliable means of attempting to determine an unresponsive medical patient's problem is:
you must rely on a thorough head-to-toe physical examination plus the normal diagnostic tools
The single MOST common cause of seizures in both term and preterm infants is:
hypoxic ischemic encephalopathy
What should you do prior to inserting an indwelling urinary catheter if a home health patient has sensation in the penile area?
coat the end of the catheter with an anesthetic gel
A 39-year-old man crashed his vehicle into a wooded area and was not found for approximately 8 hours. When you arrive at the scene and assess him, you note that he is conscious but anxious. He is unable to feel or move below his mid-thoracic area and complains of a severe headache. His blood pressure is 210/130 mmHg, heart rate is 48 beats/min, and respirations are 22 breaths/min. This patient's clinical presentation is MOST consistent with:
Common causes of a large bowel obstruction include all of the following, EXCEPT:
improperly dissolved medications
Serial vital signs:
(second and additional sets) provide comparative data to help you evaluate whether the patient's condition is improving, status quo, or worsening
You are assessing a 7-month-old infant who presents with listlessness, pallor, and increased work of breathing. The infant's mother tells you that the child was born 2 months premature and was in the neonatal intensive care unit for 3 weeks. She denies any recent vomiting, diarrhea, or fever. The infant's oxygen saturation is 89% and does not improve with supplemental oxygen. Her heart rate is rapid and weak and does not vary with activity. When you apply the cardiac monitor, you will MOST likely encounter a:
narrow QRS complex rhythm with absent P waves and a heart rate greater than 220 beats/min
A motorcycle or football helmet should be removed if:
the patient is breathing shallowly and access to the airway is difficult
Which of the following mechanisms of injury would be the LEAST likely to cause life-threatening injuries?
HIGH POTENTIAL: ejection from any vehicle (car, motorcycle, or all-terrain vehicle), death of another patient in the same passenger compartment, falls from more than 20' (or 3x the patient's height), vehicle rollover (unrestraintd occupant), high-speed motor vehicle crash, vehicle-pedestrian collision, motorcycle crash, or penetrating wounds to the head, chest or abdomen
Which of the following statements regarding central venous access devices is MOST correct?
flushing the device with heparin may cause heparin-induced thrombocytopenia
A compression or burst fracture of the cervical spine would MOST likely occur following:
a significant fall in which the patient lands head first
Which of the following significant mechanisms of injury is unique to the infant and child?
falls from more than 10', a bicycle collision, or being struck by a vehicle
You are assisting in the delivery of a baby. After the baby's bead emerges from the vagina, you should quickly assess for the presence of a nuchal cord and then:
suction its mouth and nose
A 9-year-old, 55-pould girl presents with generalized hives, marked facial swelling, and loud inspiratory stridor. She is conscious, but appears sleepy. You can MOST rapidly improve the child's condition by:
administering 0.25 mg of epinephrine intramuscularly
A deformed steering wheel in conjunction with a deployed airbag indicates that the:
seatbelt was not used (up-and-over collision, another source of life threatening internal injuries.)
A skier wiped out while skiing down a large hill. He is conscious and alert and complains of being very cold; he also complains of neck stiffness and numbness and tingling in all of his extremities. A quick assessment reveals that his airway is patent and his breathing is adequate. You should:
immobilize his spine and quickly move him to a warmer environment
Indwelling urinary catheters predispose the patient to urinary tract infections because:
the catheter keeps the bladder sphincter open and provides a continuous route of entry for bacteria