emt exam 2

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after performing a head tilt-chin life maneuver to open the airway of an unresponsive patient, you should:

suction as needed and insert an airway adjunct

a patient with profuse sweating is referred to as being

diaphoretic

the golden period begins when an injury occurs and ends when...

the patient receives definitive care

if a patient develops diff breathing after your primary assessment, you should immediately:

reevaluate his airway status

when performing a reassessment of your patient, you should first:

repeat the primary assessment

when evaluating a patient with multiple complaints, the EMT's responsibility is to:

determine which complaint poses the greatest threat to the patient's life

treatment and transport priorities at the scene of a MCI should be determined after:

all patients have been triaged

a full body scan should be performed on:

patients with a signification MOI and unresponsive medical patients

a crackling sound produced by air bubbles under the skin:

subcutaneous emphysema

when interviewing a patient, you can show him or her that you understand the situation by:

repeating statements back to him or her

which of the following pateints does not have an altered mental status:

patient w/ an acute allergic reaction and dizziness

when it is most appropriate to consider requesting additional ambulances at an accident scene?

when you determine there are multiple patients

which of the following conditions would be least likely to cause an altered level of consciousness?

acute anxiety

a 29-year old with a head injury opens his eyes when you speak to him, is confused as to the time and date, and is able to move all of his extremities on command. His glasgow coma scale score is:

13

which of the following actions would not be performed during the scene size up?

rapidly assessing a patient's respiratory status

in which of the following situations is a pertinent negative identified:

a 59-y/o man comlpains of crushing chest pain but denies shortness of breath

observations made when forming a general impression of a patient include all of the following EXCEPT:
a) appearance
b) pulse strength
c) race and gender
d) level of distress

pulse strength

which of the following pupillary changes would indicate depressed brain function?

both pupils dilate with introduction of a bright light

when assessing a patient's abdomen, you will typical evaluate for all of the following except:
a) subcut emphysema
b) open wounds or eviscerations
c) gross bleeding and tenderness
d) rigidity and obvious bleeding

a subcutaneous emphysema

when you shine a light into one pupil, the normal reaction of the other pupil should be to:

become smaller

palliating factors regarding a patient's pain involve those that:

alleviate the pain

which of the following is a symptom?
a)headache
b) tachycardia
c) hypertension
d) cyanosis

headache

the diastolic pressure represents the:

minimum amount of pressure that is always present in the arteries

a 40 y/o male crashed his motorcycle into a tree. He is a semiconscious has snoring respirations, and has a laceration to the forearm with minimal bleeding. you should:

open his airway with the jaw-thrust maneuver

a 50 y/o male is found unconscious in his car, there were no witnesses to the event. when gathering medical history

determine if the patient has a medical alert bracelet or wallet card

during a 30-minute transport of a stable patient, you should reassess him or her at least __ times

2

when a patient's respiration's are shallow:

tidal volume is markedly reduced

when using the pulse oximeter as part of your assessment of a patient, it is important to remember that:

any situation that causes vasoconstriction or loss of RBC's, such as anemia or bleeding, and may result in an inaccurate or misleading value

reassessment is performed to determine all of the following, EXCEPT:
a) the nature of any newly identified problems
b) the patient's response to your treatment
c) the reason why the patient called EMS
d) whether or not the patient is deteriorating

the reason why the patient called EMS

which of the following findings indicates that your patient has a patent airway:

forceful coughing

which of the following patient responses would establish the "E" in SAMPLE?

"i was mowing the lawn when the pain began"

you are dispatched to the county jail for an inmate who is "sick." when you arrive, you find the patient, a 33 y/o male, unresponsive. his airway is patent and his respiration's are rapid. your initial action should be to:

provide assisted ventilation

which of the following abnormal breath sounds indicates obstruction of the upper airway:

stridor

you are assessing a 72 y/o man with abdominal pain. the patient is sitting in a chair, he is conscious, alert and calm, as you are talking to the patient, your partner discreetly directs your attention to a handgun which is located on a nearby table. you should:

position yourself in between the patient and the gun and ask your partner to request law enfrocement

which of the following situations or conditions warrants immediate transport:

severe chest pain and cool, pale skin

Hypotension in a child with blunt or penetrating trauma is particularly significant because:

it often indicates the loss of half of his or her Blood volume

An oxygen cylinder should be taken out of service and refilled when the pressure inside it is less than:

500 psi

Which of the following is the MOST reliable indicator of adequately performed bag-mask ventilations in an apneic adult with a pulse?

adequate rise of the chest when squeezing the bag

Pulmonary edema and impaired ventilation occur during:

cardiogenic shock

You are performing mouth-to-mask ventilations with oxygen connected and set at a flow rate of 15 L/min. What percentage of oxygen is your patient receiving?

55%

A 19-year-old male was stung multiple times by fire ants. He is experiencing obvious signs and symptoms of anaphylactic shock. You administer 100% oxygen and give him epinephrine via subcutaneous injection. Upon reassessment, you determine that his condition has not improved. You should:

repeat the epi injection after consulting with medical control

A ventilation/perfusion (V/Q ratio) mismatch occurs when:

a disruption in blood flow inhibits the exchange of oxygen and carbon dioxide in the lungs, even though the alveoli are filled with fresh oxygen.

Which of the following would MOST likely result in hemorrhagic shock?

liver laceration

A construction worker fell approximately 30 feet. He is semiconscious with rapid, shallow respirations. Further assessment reveals deformity to the thoracic region of his spine. His blood pressure is 70/50 mm Hg, his pulse is 66 beats/min and weak, and his skin is warm and dry. In addition to spinal immobilization and rapid transport, the MOST appropriate treatment for this patient includes:

assisted ventilation, thermal management, and elevation of lower extremities

The partial pressure of oxygen in the alveoli is _______ mm Hg, while the partial pressure of carbon dioxide in the alveoli is _______ mm Hg.

104, 40

Capillary sphincters are:

circular muscular walls that regulate blood flow through the capillaries.

Which of the following clinical signs is unique to anaphylactic shock?

wheezing

A 27-year-old male was stabbed in the chest during a disagreement at a poker game. As you approach him, you see that a knife is impaled in his chest. Before you make physical contact with the patient, it is MOST important to:

follow standard precautions

The __________ cartilage is a firm ring that forms the inferior part of the larynx.

cricoid

Clinical signs of compensated shock include all of the following, EXCEPT:

absent peripheral pulses

Gas exchange in the lungs is facilitated by:

adequate amounts of surfactant

At a flow rate of 6 L/min, a nasal cannula can deliver an approximate oxygen concentration of up to:

44%

A 51-year-old female presents with a sudden onset of difficulty breathing. She is conscious and alert and able to speak in complete sentences. Her respirations are 22 breaths/min and regular. You should:

administer 100% oxygen via a NRM mask

You are transporting a 33-year-old male who was involved in a motor vehicle crash. You have addressed all immediate and potentially life-threatening conditions and have stabilized his condition with the appropriate treatment. With an estimated time of arrival at the hospital of 20 minutes, you should:

reassess his condition in 5 minutes

A 59-year-old male presents with severe vomiting and diarrhea of 3 days' duration. He is confused and diaphoretic, and his radial pulses are absent. His blood pressure is 78/50 mm Hg. After applying 100% supplemental oxygen, you should:

prepare for immediate transport

When testing a mechanical suctioning unit, you should turn on the device, clamp the tubing, and ensure that it generates a vacuum pressure of more than:

300 mm Hg

The primary waste product of aerobic metabolism is:

carbon dioxide

The pressure of gas in a full cylinder of oxygen is approximately _______ pounds per square inch (psi).

2000

What is the minute volume of a patient with a tidal volume of 500 mL, a dead space volume of 150 mL, and a respiratory rate of 16 breaths/min?

5600 mL

In an acute injury setting, neurogenic shock is commonly accompanied by:

hypothermia

How does CPAP improve oxygenation and ventilation in patients with certain respiratory problems?

It forces the alveoli open and pushes more oxygen across the alveolar membrane.

shock is the result of

hypoperfusion to the cells of the body

A 23-year-old male experienced severe head trauma after his motorcycle collided with an oncoming truck. He is unconscious, has rapid and shallow breathing, and has copious bloody secretions in his mouth. How should you manage his airway?

alternate 15 seconds of oral suctioning with 2 mins of assisted ventilation

Which of the following injuries would MOST likely cause obstructive shock?

cardiac tamponade

To select the proper size oropharyngeal airway, you should measure from the:

corner of the mouth to the earlobe

The MOST significant complication associated with oropharyngeal suctioning is:

hypoxia due to prolonged suction attempts

When perfusion to the core of the body decreases:

blood is shunted away from the skin

A nasopharyngeal airway is inserted:

B. with the bevel facing the septum if inserted into the right nare.

You are ventilating a patient with a stoma; however, air is escaping from the mouth and nose. To prevent this, you should:

seal the mouth and nose

Central chemoreceptors located in the medulla provide feedback to increase the rate and depth of breathing when they sense:

slight elevations in carbon dioxide or a decrease in the pH of the cerebrospinal fluid.

most prehospital cardiac arrests occur as the result of:

a cardiac arrhythmia

After establishing that an adult patient is unresponsive, you should:

assess for breathing

Which of the following is considered an obvious sign of death and would not require the initiation of CPR?

dependent blood pooling

The MOST appropriate treatment for a patient with a mild upper airway obstruction includes:

administering oxygen and transporting immediately

What is the correct ratio of compressions to ventilations when performing two-rescuer child CPR?

15:2

A patient should be placed in the recovery position when he or she:

is unconscious, uninjured, and breathing adequately

after ___ mins without oxygen, brain damage is likely

6

The main benefit of using a mechanical piston or load-distributing band device for chest compressions is:

the elimination of rescuer fatigue that results from manual compressions

When assessing the pulse of an unresponsive infant, you should palpate the ________ artery.

brachial

A 60-year-old male is found to be unresponsive, pulseless, and apneic. You should:

begin CPR until an AED is available

After the patient's airway is intubated during two-rescuer CPR, you should:

deliver one rescue breath every 6-8 seconds

In two-rescuer adult CPR, you should deliver a compression to ventilation ratio of:

30:2

Signs of a sudden severe upper airway obstruction include all of the following, EXCEPT:
A. grasping the throat.
B. forceful coughing.
C. inability to speak.
D. acute cyanosis.

forceful coughing

Which of the following statements regarding ventricular fibrillation (V-fib) is MOST correct?
A. AEDs should not be used to defibrillate patients in V-fib.
B. It is an uncommon dysrhythmia in patients with sudden cardiac arrest.
C. The only indication for immediate defibrillation is V-fib.
D. Survival rates decrease by 7% to 10% for each minute that V-fib persists.

D. survival rates

Several attempts to adequately open a trauma patient's airway with the jaw-thrust maneuver have been unsuccessful. You should:

carefully perform the head tilt-chin lift maneuver

Which of the following is NOT a BLS intervention?

cardiac monitoring

In MOST cases, cardiopulmonary arrest in infants and children is caused by:

respiratory arrest

What is the minimum number of chest compressions that should be delivered per minute to a 4-month-old infant?

100

CPR will NOT be effective if the patient is:

prone

Which of the following is NOT an indication to stop CPR once you have started?
A. Care is transferred to a bystander.
B. Pulse and respirations return.
C. You are physically exhausted.
D. A physician directs you to do so.

A. (this would be neglect)

Acute pulmonary edema would MOST likely develop as the result of:

toxic chemical inhalation

A patient who presents with a headache, fever, confusion, and red blotches on his or her skin should be suspected of having:

meningitis

Syphilis is a:

bloodborne disease that can successfully be treated with penicillin.

You are assisting an asthma patient with his prescribed metered-dose inhaler. After the patient takes a deep breath and depresses the inhaler, you should:

instruct him to hold his breath for as long as he comfortably can

In addition to looking for severe bleeding, assessment of circulation in the conscious patient should involve:

checking the radial pulse and noting the color, temperature, and condition of his or her skin.

Which of the following statements regarding anaphylaxis is correct?

Anaphylaxis is characterized by airway swelling and hypotension.

A young female is unconscious after intentionally ingesting a large amount of aspirin. You will MOST likely find her respirations:

deep and rapid

Patients with tuberculosis pose the greatest risk for transmitting the disease when they:

cough

In contrast to the assessment of a trauma patient, assessment of a medical patient:

is focused on the nature of illness, the patient's chief complaint, and his or her symptoms.

Typical chief complaints in patients with an infectious disease include:

fever, rash, nausea, and difficulty breathing

A 62-year-old man with a history of congestive heart failure presents with severe respiratory distress and an oxygen saturation of 82%. When you auscultate his lungs, you hear widespread rales. He is conscious and alert, is able to follow simple commands, and can only speak in two- to three-word sentences at a time. You should:

apply a continuous positive airway pressure (CPAP) device, monitor his blood pressure, and observe him for signs of improvement or deterioration.

Which of the following statements regarding the H1N1 virus is correct?

It is only one type of influenza among the many other strains of influenza that exist and infect humans.

Which of the following medications would the EMT LEAST likely administer to a patient with a medical complaint?
A. albuterol
B. aspirin
C. oral glucose
D. naloxone (Narcan)

D.

End-tidal carbon dioxide (ETCO2) monitoring is clearly indicated for patients who present with:

respiratory distress

Weakening of the airway in patients with chronic bronchitis is the result of:

destruction of protective mechanisms that remove foreign particles

asthma is caused by a response of the:

immune system

Which of the following statements regarding hepatitis A is correct?
A. Hepatitis A can only be transmitted by a patient who has an acute infection.
B. Although there is no vaccine against hepatitis A, treatment is usually successful.
C. Hepatitis A is primarily transmitted via contact with blood or other body fluids.
D. Infection with hepatitis A causes chronic illness with a high mortality rate.

Hepatitis A can only be transmitted by a patient who has an acute infection.

Which of the following statements regarding severe acute respiratory syndrome (SARS) is correct?
A. SARS is caused by a virus and usually starts with flulike symptoms that deteriorate to pneumonia and respiratory failure.
B. SARS is caused by a virus that occurs naturally in the bird population, although it usually does not cause illness in humans.
C. Although SARS can cause pneumonia and other respiratory infections, it rarely causes death, even in immunocompromised patients.
D. Most cases of SARS are caused by a bacterium that is spread from person to person via direct contact with infected blood.

A.

Hepatitis B is more virulent than hepatitis C, which means that it:

has a greater ability to produce disease

When auscultating the lungs of a patient with respiratory distress, you hear adventitious sounds. This means that the patient has:

abnormal breath sounds

Which of the following conditions is NOT categorized as a psychiatric condition?

substance abuse

Which of the following statements regarding pulse oximetry is correct?

Pulse oximetry measures the percentage of hemoglobin that is saturated with oxygen, but does not measure the actual hemoglobin content of the blood.

Factors that increase the risk for developing methicillin-resistant Staphylococcus aureus (MRSA) include:

prolonged hospitalization, especially in an intensive care unit.

Early signs and symptoms of viral hepatitis include all of the following, EXCEPT:

jaundice and abdominal pain

A 30-year-old male presents with acute shortness of breath, widespread hives, and facial swelling. He denies any past medical history and takes no medications. During your assessment, you hear wheezing over all lung fields. His blood pressure is 90/50 mm Hg and his heart rate is 110 beats/min. In addition to giving him 100% oxygen, the MOST important treatment for this patient is:

epinephrine

You are dispatched to a residence for a 67-year-old female who was awakened by shortness of breath and sharp chest pain. Her husband tells you that she was recently discharged from the hospital after having hip surgery. Your assessment reveals dried blood around her mouth, facial cyanosis, and an oxygen saturation of 88%. This patient's presentation is MOST consistent with:

acute pulmonary embolism

A patient who was bitten by a mosquito and presents with signs and symptoms of illness should be suspected of having:

west nile

Which of the following conditions would LEAST likely result in hypoxia?
A. severe anxiety
B. prolonged seizures
C. pleural effusion

A. severe anxiety

Which of the following statements regarding severe acute respiratory syndrome (SARS) is correct?

SARS is a viral infection that often begins with flulike symptoms.

A conscious and alert 29-year-old female with a history of asthma complains of difficulty breathing that began after her morning jog. The temperature outside is 40°F (5°C). On exam, you hear bilateral expiratory wheezing. After providing 100% oxygen, you should:

determine if she has been prescribed a beta-agonist inhaler.

A 22-year-old female patient is complaining of dyspnea and numbness and tingling in her hands and feet after an argument with her fiancé. Her respirations are 40 breaths/min. You should:

provide reassurance and give oxygen as needed

Paroxysmal nocturnal dyspnea (PND), rales, and dependent edema are clinical indicators of:

Congestive heart failure

At the onset of an acute asthma attack, patients commonly experience difficulty breathing and:

expiratory wheezing

An infectious disease is MOST accurately defined as:

a medical condition caused by the growth and spread of small harmful organisms within the body.

A 58-year-old man complains of chest discomfort and nausea. He is conscious and alert; his blood pressure is 140/90 mm Hg, his pulse is 104 beats/min, and his respirations are 16 breaths/min. Your partner has applied supplemental oxygen. Prior to assisting the patient with one of his prescribed nitroglycerin tablets, you ask him if he takes medication to treat erectile dysfunction and he tells you that he does. You should:

ask him what he takes, how much, and when he last took it.

The determination of whether a medical patient is a high-priority or low-priority transport is typically made:

after the primary assessment has been completed.

Albuterol is a generic name for:

Proventil

Common signs and symptoms of acute hyperventilation syndrome include:

tachypnea and tingling in the extremities.

The primary prehospital treatment for most medical emergencies:

addresses the patient's symptoms more than the actual disease process.

In what area of the lungs does respiration occur?

alveoli

harsh high-pitched inspiratory sounds are characteristic of:

stridor

which of the following statements regarding HIV is correct?

the risk of HIV infection is greatest when deposited on a mucous membrane or directly into the bloodstream

when administering supplemental oxygen to a hypoxemic patient with a chronic lung disease you should:

adjust the flow rate accordingly until you see symptom improvement, but be prepared to assist his or her ventilations

while auscultating a woman's breath sounds u hear low-pitched "rattling" sounds at the bases of both of her lungs. with which of the following conditions is this finding MOST consistent

aspiration pneumonia

when forming your gen impression of a patient with a medical complaint, it is important to remember that:

the conditions of many medical patients may not appear serious at first

you and your EMT partner arrive at the residence of a 50-year-old man who complains of weakness. your primary assessment reveals that he is critically il and will require aggressive treatment. the closest hospital is 25 miles away. you should:

manage all threats to the airway, breathing, and circulation and consider requesting an ALS unit

when caring for a patient who takes numerous meds, it is best to:

take all of the patient's medications with you to the hospital and document them on your PCR

a 60-year-old male presents with acute resp. distress. he is conscious and alert, has pink and dry skin, and has respiration's of 24 breaths/min with adequate depth. which of the following treatment modalities is MOST appropriate for this patient?

oxygen via NRM mask and a focused secondary assessment

the two processes that occur during respiration are:

expiration and inspiration

you have just completed your primary assessment of a 48-year-old man with crushing chest pain. the patient has been given 324 mg of aspirin and is receiving high-flow oxygen via NRM. as you begin your secondary assessment, you note that his mental status has deteriorated and he is now bradycardic. you should:

prepare patient for immediate transport

ten days after treating a 34-year-old patient with his tuberculosis, you are given a tuberculin skin test which yields a positive result. this MOST likely indicates:

you were exposed to another infected person prior to treating the 34-year-old patient

an alert patient presents w/ regular pattern of inhalation and exhalation and breath sounds that are clear and equal on both sides of the chest. these findings are consistent with:

adequate air exchange

you are dispatched to an apartment complex where a 21 y/o female has apparently overdosed on several narcotic meds. she is semiconscious and has slow, shallow respirations. you should:

insert a NPA and begin assisted ventilation

which of the following assessment findings is MOST indicative of a cardiovascular problem?
a. jugular venous distention
b. palpable pain to the epigastrium
c. use of accessory muscles

jugular venous distention

in which of the following situations would it be MOST appropriate to utilize an air medical transportation service?
A. 43-year-old man experiencing a heart attack and the closest appropriate hospital is 15 mins away
B. a 61-year-old man with signs and syptoms of a stroke and ground transport time is 50 mins

B.

when assessing a patient with a medical complaint, which of the following would MOST likely reveal the cause of his or her problem.

History taking

which of the following statements regarding the hypoxic drive is MOST correct?

the hypoxic drive stimulates a person to breathe on the basis of low oxygen levels

in addition to obtaining a SAMPLE history and asking questions related to the chief complaint, what else should you inquire about when assessing a patient with a potentially infectious disease?

recent travel

which of the following statements regarding MRSA is correct?

MRSA is a bacterium that causes infections and is resistant to most antibiotics

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