NCOEMS Practice Exam 1

Questions and Answers

EMTs should wear high-efficiency particulate air (HEPA) respirators when they are in contact with patients who have which of the following?

HIV (Human Immunodeficiency Virus) or AIDS (Acquired Immune Deficiency Syndrome)

Hepatitis B

Tuberculosis (TB) (correct)

Open Wounds

You are called to assist a 60-year-old female complaining of a severe headache. Upon entering the home, you smell a strong odor of natural gas. What is your first action?

Open all windows and determine the source of the gas leak.

Check the patient's airway, breathing, and circulation.

Insert a nasopharyngeal airway and assess vital signs.

Remove the patient from the house to your ambulance. (correct)

The most common electrical rhythm disturbance that results in sudden cardiac arrest is called:

Asystole

Pulseless electrical activity

Ventricular Fibrillation (correct)

Ventricular Tachycardia

If a non-trauma patient is pulseless and apneic and assisted ventilation is unsuccessful, which of the following is the next most appropriate step?

Check for an airway obstruction. Signup and view all the answers

During cardiac arrest management, the AED gives a 'no shock advised' message. Which of the following conditions most likely prompted this message?

The patient's rhythm is asystole. Signup and view all the answers

As capnography becomes available when hyperventilating a patient suspected of brainstem herniation, what should be the target end-tidal carbon-dioxide level?

30-35 mmHg Signup and view all the answers

Which of the following is the highest priority patient?

57-year-old male with chest pain and systolic blood pressure of 80. Signup and view all the answers

Of the following, which body fluid has the most potential to transmit blood-borne diseases?

Amniotic fluid Signup and view all the answers

Your patient is an 11-month-old female. How can you determine if she has decreased mental status and is responsive to verbal stimuli?

She will attempt to locate her parents' voices when they speak. Signup and view all the answers

What is the best method to assess circulation in an infant?

Palpate the brachial pulse. Signup and view all the answers

A 45-year-old male is experiencing chest discomfort. After placing him in his position of comfort, what should your next action be?

Administer oxygen by nonrebreather mask at 15 L/min. Signup and view all the answers

Which patient should receive a rapid trauma survey to determine hidden injuries?

Alert 2-year-old child in a car seat who was in a medium-speed crash. Signup and view all the answers

Which of the following is a sign of increased pressure in the circulatory system?

Distended jugular veins. Signup and view all the answers

An automated external defibrillator (AED) will shock which of the following rhythms?

Ventricular fibrillation. Signup and view all the answers

To assess the motor functions in the lower extremities of a responsive patient, you would:

Ask the patient to wiggle his toes. Signup and view all the answers

Which patient can safely receive only a focused physical examination rather than a rapid trauma assessment?

20-year-old female who complains of severe pain in her ankle after stepping off a curb. Signup and view all the answers

You are using the OPQRST acronym to assess a responsive medical patient. What question would you ask to assess the P component?

What makes the pain feel worse or better? Signup and view all the answers

What is the first step in the physical assessment of an unresponsive medical patient?

Perform the initial assessment. Signup and view all the answers

Which patient needs a detailed physical examination?

35-year-old female who has been in a single-car collision and who briefly lost consciousness. Signup and view all the answers

Where is a detailed physical exam typically performed?

In the hospital emergency department. Signup and view all the answers

The purpose of the ongoing assessment is to re-evaluate the patient's condition and to:

Check the adequacy of each intervention performed. Signup and view all the answers

Immediately after delivering a shock with an AED to a patient in cardiac arrest, what should you do?

Do CPR. Signup and view all the answers

You should apply an AED to:

Adult patients without respirations or a pulse. Signup and view all the answers

In which of the following situations should you call for immediate assistance?

You must care for two critical patients with gunshot wounds. Signup and view all the answers

What is the structure that prevents food and liquid from entering the trachea during swallowing?

Epiglottis Signup and view all the answers

Pink or bloody sputum is often seen in patients with:

Pulmonary edema Signup and view all the answers

Which occurs during capillary-cellular exchange?

Body cells give up carbon dioxide and capillaries give up oxygen. Signup and view all the answers

Which of the following is a sign of inadequate breathing?

Accessory muscle use. Signup and view all the answers

A patient complaining of facial paralysis on one side of his face with tearing, localized pain, and sensitivity may be suffering from the most common form of facial paralysis called:

Bell's Palsy Signup and view all the answers

A gurgling sound heard with artificial ventilation is a sign that:

The patient must be suctioned immediately. Signup and view all the answers

The first step in artificial ventilation with a bag-valve mask unit in patients with no suspected trauma is to:

Place the patient's head in a hyperextended, sniffing position. Signup and view all the answers

You take a report from a first responder who describes a patient as postictal; based on this report, you would expect to find the patient:

Confused. Signup and view all the answers

When suctioning a patient, how far should you insert a soft suction catheter?

As far as the base of the tongue. Signup and view all the answers

What is the correct procedure for a patient who has secretions or emesis that suctioning cannot easily remove?

Logroll the patient and clear the oropharynx and nasopharynx. Signup and view all the answers

What is the purpose of the head-tilt/chin-lift technique?

To lift the tongue and epiglottis out of their obstructing position. Signup and view all the answers

After opening the airway, what is the next step in patient management?

Assess adequacy of respirations. Signup and view all the answers

A patient should receive high-flow oxygen if he or she exhibits:

Cyanosis. Signup and view all the answers

The first step in the delivery of high-flow oxygen via a nonrebreather mask is to:

Turn on the oxygen source. Signup and view all the answers

When providing mouth-to-mask ventilation with supplementary oxygen, what is the first step after sealing the mask to the patient's face?

Exhale slowly over the ventilation port for 1.5 to 2 seconds. Signup and view all the answers

The correct rate of artificial ventilations for an adult patient is:

12 ventilations per minute. Signup and view all the answers

When using the two-person bag-valve mask procedure, one EMT ventilates the patient while the other:

Maintains the mask seal and monitors chest rise. Signup and view all the answers

Where is the cricoid cartilage located?

Inferior to the larynx. Signup and view all the answers

Your patient is awake, confused, and disoriented. How would you grade her using the AVPU scale?

V. Signup and view all the answers

A bulb syringe is used to suction infants up to the age of:

3-4 months. Signup and view all the answers

The right ventricle pumps blood into the:

Lungs via the pulmonary artery. Signup and view all the answers

A 56-year-old female patient complains of mild chest discomfort, what should you do?

Maintain a high index of suspicion for cardiac compromise. Signup and view all the answers

Your patient is a 62-year-old male with a history of heart disease. He is experiencing chest pain. What should your first action be?

Place him in a comfortable position and administer high-flow oxygen. Signup and view all the answers

The EMT-Basic should request prehospital ACLS for the care of the cardiac arrest patient because:

ACLS intervention provides higher survival rates. Signup and view all the answers

Your patient is a 29-year-old male who has fallen off a ladder. He is bleeding profusely from a wound on his right forearm and has severe pain in his left thigh. Which of the following is an appropriate initial treatment for this patient?

Stop the bleeding by applying a tourniquet near the elbow. Signup and view all the answers

Touching the patient when the semiautomatic external defibrillator (SAED) is analyzing the rhythm:

Can cause the SAED to misinterpret a rhythm. Signup and view all the answers

What should you do for the cardiac arrest patient found in the rain?

Move the patient inside, away from the rain. Signup and view all the answers

Kinetic energy is described as the:

Energy an object has while in motion. Signup and view all the answers

A bystander is performing CPR when you arrive. You evaluate the scene, practice body substance isolation, and begin your initial assessment by having the bystander:

Stop CPR. Signup and view all the answers

Your patient is bleeding from a wound to the forearm. The blood flows in a steady, dark-red stream. What type of bleeding should you suspect?

Venous. Signup and view all the answers

Your patient is restless, anxious, and complaining of thirst. She exhibits increased heart rate and pale, clammy skin. You should do all the following EXCEPT:

Give the patient small amounts of liquid to drink. Signup and view all the answers

If a person was hit by an object described in the following, which would have the potential to cause the most damage?

One pound object moving at 30 mph. Signup and view all the answers

Which heart rhythm often converts to ventricular fibrillation?

Ventricular tachycardia. Signup and view all the answers

What is the reason for stopping CPR before applying the AED?

To allow the AED to analyze the heart rhythm. Signup and view all the answers

After receiving three consecutive 'no shock indicated' messages on the AED, you should do which of the following?

Begin transporting to the hospital. Signup and view all the answers

You are transporting a patient who has been resuscitated but is still unresponsive. You should check the patient's pulse every:

Thirty seconds. Signup and view all the answers

The medical direction physician orders you to deliver additional shocks to a patient in cardiac arrest while en route to the hospital. What is the correct procedure to follow?

Stop the vehicle before reanalyzing the rhythm. Signup and view all the answers

What is the primary action of nitroglycerin?

Dilate the coronary vessels. Signup and view all the answers

Patients commonly describe heart attack pain as which of the following characteristics?

Crushing or squeezing. Signup and view all the answers

In pedestrian versus automobile impacts, which of the following statements is true?

Children often turn toward the impact and are often thrown down and under the vehicle. Signup and view all the answers

Where should you place your hands when using the head-tilt/chin-lift maneuver to open an unconscious patient's airway?

On the forehead, with the fingertips of the other hand under the lower jaw. Signup and view all the answers

Your patient is found lying on the ground after falling off a roof. He is unconscious and apneic. Which method should you use to open the patient's airway?

Modified jaw thrust. Signup and view all the answers

Following an explosion, a patient is trapped in a collapsed structure and suffers crush injuries to both lower extremities. How would the injuries be classified based on the blast-injury phase?

Tertiary blast injury. Signup and view all the answers

When splinting an injured limb, you should assess pulse, motor function, and sensation distal to the injury:

Before and after applying the splint. Signup and view all the answers

When performing the modified jaw-thrust maneuver to open your patient's airway, which of the following steps is NOT correct?

Tilt the head by applying gentle pressure to the forehead. Signup and view all the answers

The golden hour in emergency medicine refers to the first 60 minutes after the:

Occurrence of multisystem trauma. Signup and view all the answers

Your unconscious patient has blood in his airway. You should:

Use a suction unit to immediately clear the airway. Signup and view all the answers

Your patient is behaving abnormally but refuses treatment after falling down a flight of stairs. Before transporting the patient without consent, you should:

Contact medical direction for advice. Signup and view all the answers

You should not suction a patient's airway for more than 15 seconds because:

The patient will become hypoxic during this time. Signup and view all the answers

Which of the following is true regarding using a pocket mask to ventilate a nonbreathing patient?

A one-way valve prevents exhaled air from contacting the rescuer. Signup and view all the answers

The focused history for patients with altered mental status should include questions about a history of trauma, diabetes, seizures, and which of the following?

Fever. Signup and view all the answers

All of the following may be signs of an allergic reaction EXCEPT:

Decreased heart rate. Signup and view all the answers

Under medical direction, the EMT-Basic may administer epinephrine to a patient with respiratory distress or hypoperfusion resulting from an allergic reaction if the:

Medication has been prescribed for this patient. Signup and view all the answers

Ethics is best described as:

The principles of conduct; concerns for what is right or wrong, good or bad. Signup and view all the answers

Your patient is a 25-year-old female who is severely hypothermic after having plunged into an icy river. Although she was rescued after only a few minutes in the water, she is showing a diminished level of responsiveness. Your care should include:

Covering the patient in blankets and turning up the heat in the ambulance. Signup and view all the answers

A sign of generalized cold emergency, or hypothermia, is cool skin on the:

Abdomen. Signup and view all the answers

Two important principles in the emergency treatment of local cold injuries are to remove the patient from the cold environment and to:

Prevent further tissue damage. Signup and view all the answers

Which of the following indicates that a patient with hyperthermia is in serious danger?

Hot skin. Signup and view all the answers

Your patient has been stung by a bee, and the stinger is present in the wound. You should attempt to remove it by:

Scraping it away with a rigid object. Signup and view all the answers

In legal terms, a tort is a(n):

Civil wrong committed by one individual against another. Signup and view all the answers

Which of the following are the signs of early respiratory distress in children and infants?

Increased rate of breathing, nasal flaring, intercostal or supraclavicular retractions, mottled skin color, abdominal muscle use. Signup and view all the answers

Your patient is an 8-year-old female who had a single, brief seizure at school. Her mother arrives at the same time you do and reports that her daughter has seizures often and is under medical treatment. What should you do?

Ensure a patent airway and request medical direction regarding transport. Signup and view all the answers

All of the following are signs of possible child abuse EXCEPT:

A single, severe traumatic event that occurred for no reason. Signup and view all the answers

The head of a newborn infant has just delivered. You should:

Suction the baby's mouth and nostrils with a bulb syringe. Signup and view all the answers

Emergency care for a responsive 7-year-old child with a foreign-body airway obstruction includes:

Standing behind the child and performing sub-diaphragmatic thrusts. Signup and view all the answers

A 2-year-old male is in respiratory failure when he has:

Altered mental status and breathing rate of 68 per minute. Signup and view all the answers

A sign or symptom of a predelivery emergency is:

Profuse vaginal bleeding. Signup and view all the answers

Select the correct-size oral airway for a small child by measuring from the corner of the patient's mouth to what structure?

Angle of the jaw. Signup and view all the answers

Vitreous humor is found:

Behind the lens of the eye. Signup and view all the answers

You are assisting with childbirth in the field. As the infant's head is delivered, you discover that the umbilical cord is wrapped tightly around the neck. You should immediately:

Clamp the cord in two places and cut it between clamps. Signup and view all the answers

You have just assisted in delivering an infant with a pink body, a pulse rate of 106 per minute, and good muscle tone. The infant is crying lustily. How should you care for this newborn?

Wrap the newborn in clean towels and give her to the mother to hold during transport. Signup and view all the answers

The presence of a bloody show during the first stage of labor is a sign that:

Labor is progressing normally. Signup and view all the answers

Your patient has experienced a spontaneous abortion or miscarriage. You should:

Treat the patient for shock. Signup and view all the answers

What is the first treatment when a mother bleeds excessively from her vagina after delivery?

Massage her abdomen gently. Signup and view all the answers

Emergency care for an infant when meconium is present in the amniotic fluid includes:

Suctioning and notifying the hospital that meconium was present. Signup and view all the answers

Study Notes

Infection Control and Safety

EMTs must wear HEPA respirators when interacting with patients with Tuberculosis (TB), as it is highly infectious.

Emergency Response Protocols

Upon detecting natural gas during an emergency, immediately remove the patient from the hazardous environment before any medical assessment.
The most common cause of sudden cardiac arrest is Ventricular Fibrillation (V-fib).

Airway Management Strategies

In cases of pulseless, apneic patients, check for airway obstruction if ventilation attempts fail.
The target end-tidal carbon-dioxide level for hyperventilating suspected brainstem herniation patients should be 30-35 mmHg.

Patient Assessment and Priority

A 57-year-old male with severe chest pain and low blood pressure is the highest priority patient.
Amniotic fluid has the highest potential for transmitting blood-borne diseases.

Pediatric Assessment Techniques

An 11-month-old’s responsiveness can be gauged by her attempts to locate her parents' voices.
The best way to assess circulation in infants is by palpating the brachial pulse.

Cardiac Emergencies

Upon management of a cardiac arrest, the AED indicating asystole suggests no shocks are advised.
For chest discomfort patients, oxygen should be administered via a non-rebreather mask at 15 L/min.

Trauma Management

A rapid trauma survey is indicated for an alert 2-year-old child who was in a medium-speed crash.
Distended jugular veins can signal increased pressure in the circulatory system.

Defibrillation Protocols

An AED will only shock rhythms like Ventricular Fib (V-fib) but not asystole or pulseless electrical activity.
After delivering a shock with an AED, commence CPR immediately if only a pulse is absent.

Communication and Patient Privacy

Do not disclose patient transport information to journalists; maintain confidentiality by refusing to comment.

Respiratory Conditions

Pink or bloody sputum is indicative of pulmonary edema.
Inadequate breathing signs include the use of accessory muscles, indicating respiratory distress.

Neurological Emergencies

Bell's Palsy is a common form of facial paralysis characterized by symptoms such as tearing and localized pain.

Suctioning and Artificial Ventilation

A gurgling sound during ventilation suggests a need for immediate suctioning due to airway obstruction.
The proper technique for artificial ventilation using a bag-valve mask involves positioning the patient’s head to optimize airflow.

Vital Signs and Ongoing Assessment

The first step in assessing an unresponsive medical patient is performing an initial assessment followed by vital sign checking.
Continuous assessment after treatment aims to evaluate the effectiveness of interventions.

CPR and AED Use

During CPR, if assistance is unavailable, ensure that defibrillator use follows the verification of pulselessness.
Maintain a high suspicion of cardiac issues for any patient with atypical chest pain, especially in females.

Trauma Assessment Settings

A detailed exam typically occurs in the ambulance during transport.

Treatment of Shock

In shock treatment, avoid giving patients anything to drink; rather, maintain an open airway and provide oxygen.

Mechanics of Injury

Kinetic energy increases with the speed of an object, impacting the severity of injuries sustained.

Cardiac Rhythm Management

Ventricular Tachycardia can convert to Ventricular Fibrillation, necessitating rapid intervention.

Patient Monitoring During Transport

For a resuscitated, unresponsive patient, check the pulse every thirty seconds while en route to the hospital.

These notes summarize crucial concepts in emergency medical treatment, highlighting key actions, assessments, and patient care protocols.### Airway Management

Head-Tilt/Chin-Lift Maneuver: Place hands on the forehead and under the lower jaw to open the airway.
Modified Jaw Thrust: Required for unconscious patients with possible neck injuries; aims to minimize cervical spine movement.
Unconscious Patient with Airway Issues: Use suction to clear blood immediately when present.

Emergency Response and Treatment Protocols

Golden Hour: Refers to the first 60 minutes post-multisystem trauma for optimal emergency care.
Assessing Limb Injuries: Always check pulse, motor function, and sensation both before and after applying splints.
Treatment for Allergic Reactions: Administer epinephrine as per medical direction, if prescribed previously.

Hypothermia and Cold Emergencies

Response to Severe Hypothermia: Warm the patient with blankets and increase ambulance heat; avoid exertion.
Signs of Hypothermia: Cool skin, especially on the abdomen; signals loss of body heat.

Hyperthermia and Poisoning

Severe Hyperthermia Indicators: Hot skin is a critical sign of danger.
Bee Sting Management: Remove stinger by scraping with a rigid object only, not by pinching or squeezing.

Child Assessment and Abuse Indicators

Early Respiratory Distress in Children: Increased breathing rate, nasal flaring, and retractions.
Possible Child Abuse Signs: Multiple bruises, conflicting injury histories; a single severe event is not an indicator.

Pediatric Emergency Care

Seizure Management: Ensure a patent airway and consult medical direction for transport protocols.
Foreign-Body Obstruction: For children, perform abdominal thrusts effectively while they are upright.

Obstetric Emergencies

Blood Show During Labor: Indicates normal progression to delivery.
Miscarriage Treatment: Focus on treating for shock; avoid removing tissues.
Excessive Vaginal Bleeding Post-Delivery: Initial response should involve abdominal massage.

Newborn and Neonatal Care

Newborn with Meconium: Suctioning is crucial to clear the airways; notify hospital.
Characteristics of a Healthy Newborn: Crying, good muscle tone, and stable heart rate at birth indicate a well-being process.

Ethical Considerations in Care

Fundamentals of Ethics: Key principles of conduct focused on determining right and wrong in patient treatment decisions.

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Test your knowledge with these flashcards designed for the NCOEMS practice exam. The questions focus on critical care situations, EMT responsibilities, and infection control measures. Perfect for preparing for emergency medical technician certifications.