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Final Exam Question 1 The person who is responsible for authorizing EMTs to perform emergency medical care in the field is the: Not yet answered Select one: Question 1 A. EMS administrator. B. shift supervisor. C. medical director. D. field training officer. The co...

Final Exam Question 1 The person who is responsible for authorizing EMTs to perform emergency medical care in the field is the: Not yet answered Select one: Question 1 A. EMS administrator. B. shift supervisor. C. medical director. D. field training officer. The correct answer is: medical director. Question 2 Which of the following statements is not appropriate to document in the narrative section of a PCR? Not yet answered Select one: Question 2 A. “The patient admits to smoking marijuana earlier in the day.” B. “After oxygen was administered, the patient’s breathing improved.” C. “General impression revealed that the patient was intoxicated.” D. “Significant damage was noted to the front end of the vehicle.” The correct answer is: “General impression revealed that the patient was intoxicated.” Question 3 Which of the following statements regarding standing orders is correct? Not yet answered Select one: Question 3 A. Standing orders require you to contact medical control first before providing an intervention. B. Standing orders should be followed when physician contact is not possible. C. Standing orders only highlight the care that you may provide. D. Standing orders have less legal authority than orders given via radio. The correct answer is: Standing orders should be followed when physician contact is not possible. Question 4 A body part that is nearer to the head from a specific reference point is said to be: Not yet answered Select one: Question 4 A. superior. B. medial. C. distal. D. lateral. The correct answer is: superior. Question 5 It is important to understand medical terminology in order to: Not yet answered Select one: Question 5 A. avoid being sued as a result of poor documentation. B. identify and treat immediately life-threatening conditions. C. communicate effectively with other healthcare members. D. explain a patient’s medical condition to him or her accurately. The correct answer is: communicate effectively with other healthcare members. Question 6 Stimulation of the parasympathetic nervous system would result in: Not yet answered Select one: Question 6 A. a strong pulse. B. tachycardia. C. a slower heart rate. D. vasoconstriction. The correct answer is: a slower heart rate. Question 7 The __________ fills the entire anteroposterior depth of the right upper quadrant of the abdomen. Not yet answered Select one: Question 7 A. liver B. spleen C. pancreas D. stomach The correct answer is: liver Question 8 Which of the following are central pulses? Not yet answered Select one: Question 8 A. Brachial and radial B. Femoral and carotid C. Popliteal and ulnar D. Temporal and pedal The correct answer is: Femoral and carotid Question 9 Infants are often referred to as “belly breathers” because: Not yet answered Select one: Question 9 A. their rib cage is less rigid, and the ribs sit horizontally. B. their intercostal muscles are not functional. C. their diaphragm does not receive impulses from the brain. D. an infant’s ribs are brittle and are less able to expand. The correct answer is: their rib cage is less rigid, and the ribs sit horizontally. Question 10 Why does the incidence of diabetes mellitus increase with age? Not yet answered Select one: Question 10 A. Increased physical activity, increased food intake, and increased insulin production B. Decreased physical activity, increased weight gain, and decreased insulin production C. Decreased physical activity, increased weight gain, and decreased blood sugar levels D. Decreased food intake, decreased weight gain, and decreased blood sugar levels The correct answer is: Decreased physical activity, increased weight gain, and decreased insulin production Question 11 General guidelines for carrying a patient on a stretcher include: Not yet answered Select one: Question 11 A. leaning back from your waist when lifting. B. maintaining slight flexion of your back. C. constant communication with your partners. D. slightly twisting your body when carrying. The correct answer is: constant communication with your partners. Question 12 Which of the following is an example of closed-loop communication? Not yet answered Select one: Question 12 A. The EMT requests permission from medical control to assist a patient with his prescribed nitroglycerin. B. The team leader assigns the EMT a task, and the EMT repeats the request back to the team leader. C. The EMT corrects the team leader, who states that chest compressions should be greater than 3 inches deep. D. EMTs decide not to attempt resuscitation because the patient has rigor mortis and is cold to the touch. The correct answer is: The team leader assigns the EMT a task, and the EMT repeats the request back to the team leader. Question 13 During your assessment of a 6-month-old male with vomiting and diarrhea, you note that his capillary refill time is Not yet answered approximately 4 seconds. From this information, you should conclude that the infant’s: Select one: Question 13 A. systolic blood pressure is normal. B. peripheral circulation is decreased. C. respiratory status is adequate. D. skin temperature is abnormally cold. The correct answer is: peripheral circulation is decreased. Question 14 Observations made when forming a general impression of a patient would include all of the following, EXCEPT: Not yet answered Select one: Question 14 A. pulse strength. B. level of distress. C. race and gender. D. appearance. The correct answer is: pulse strength. Question 15 Which of the following statements regarding the mechanism of injury (MOI) is correct? Not yet answered Select one: Question 15 A. The MOI may allow you to predict the severity of a patient’s injuries. B. A significant MOI usually results in patient death or permanent disability. C. A nonsignificant MOI rules out the possibility of serious trauma. D. The exact location of a patient’s injuries can be determined by the MOI. The correct answer is: The MOI may allow you to predict the severity of a patient’s injuries. Question 16 A ventilation/perfusion (V/Q ratio) mismatch occurs when: Not yet answered Select one: Question 16 A. 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. B. ventilation is compromised, resulting in the accumulation of carbon dioxide in the bloodstream, alveoli, and the tissues and cells of the body. C. ventilation is inadequate due to a traumatic injury or medical condition, which results in an impairment in pulmonary gas exchange. D. a traumatic injury or medical condition impairs the body’s ability to effectively bring oxygen into the lungs and remove carbon dioxide from the body.  The correct answer is: 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. Question 17 Which of the following statements regarding normal gas exchange in the lungs is correct? Not yet answered Select one: Question 17 A. The oxygen content in the alveoli is highest during the exhalation phase. B. The actual exchange of oxygen and carbon dioxide occurs in the capillaries. C. Oxygen and carbon dioxide diffuse across the alveolar walls and capillaries. D. Blood that returns to the lungs from the body has low levels of carbon dioxide. The correct answer is: Oxygen and carbon dioxide diffuse across the alveolar walls and capillaries. Question 18 A drug is contraindicated for a patient when it: Not yet answered Select one: Question 18 A. is used to treat a multitude of conditions. B. may cause harm or has no positive effect. C. is used to treat a specific medical condition. D. produces actions other than the desired ones. The correct answer is: may cause harm or has no positive effect. Question 19 For which of the following conditions is albuterol prescribed? Not yet answered Select one: Question 19 A. Bronchospasm B. Hypertension C. Heart disease D. Stroke The correct answer is: Bronchospasm Question 20 A 19-year-old male was stung multiple times by fire ants. He is experiencing obvious signs and symptoms of Not yet answered anaphylactic shock. You administer high-flow oxygen and give him epinephrine via intramuscular injection. Upon reassessment, you determine that his condition has not improved. You should: Select one: Question 20 A. request a paramedic unit that is stationed approximately 15 miles away. B. transport him immediately and provide supportive care while en route. C. consider that he may actually be experiencing an acute asthma attack. D. repeat the epinephrine injection 5 minutes after the first dose.  The correct answer is: repeat the epinephrine injection 5 minutes after the first dose. Question 21 When treating an 80-year-old patient who is in shock, it is important to remember that: Not yet answered Select one: Question 21 A. medications older patients take for hypertension often cause an unusually fast heart rate. B. compensation from the respiratory system usually manifests with increased tidal volume. C. changes in gastric motility may delay gastric emptying, which increases the risk for vomiting. D. the older patient’s central nervous system usually reacts more briskly to compensate for shock. The correct answer is: changes in gastric motility may delay gastric emptying, which increases the risk for vomiting. Question 22 Your assessment of an unresponsive patient reveals that her breathing is inadequate. Your MOST immediate Not yet answered action should be to: Select one: Question 22 A. administer high-flow oxygen. B. ventilate her with a bag-mask device. C. move her to the ambulance stretcher. D. check her airway for obstructions. The correct answer is: check her airway for obstructions. Question 23 After an advanced airway device has been inserted during two-rescuer CPR, you should: Not yet answered Select one: Question 23 A. increase rescue breathing to a rate of 14 breaths/min. B. pause compressions to deliver ventilations. C. decrease the compression rate to about 80 per minute. D. deliver one rescue breath every 6 seconds. The correct answer is: deliver one rescue breath every 6 seconds. Question 24 You should deliver chest compressions to an unresponsive adult patient in cardiac arrest by: Not yet answered Select one: Question 24 A. placing the heel of your hand on the xiphoid. B. depressing the sternum more than 2.5 inches in depth. C. compressing quickly and releasing slowly. D. compressing the sternum between the nipples.  The correct answer is: compressing the sternum between the nipples. Question 25 When performing a secondary assessment on a conscious patient with nontraumatic abdominal pain and stable Not yet answered vital signs, you should: Select one: Question 25 A. prepare the patient for transport first. B. only palpate tender areas of the abdomen. C. examine the patient from head to toe. D. focus on his or her chief complaint. The correct answer is: focus on his or her chief complaint. Question 26 Which of the following statements regarding methicillin-resistant Staphylococcus aureus (MRSA) is correct? Not yet answered Select one: Question 26 A. The communicable period for MRSA is 10 days to 2 weeks after being infected. B. Studies have shown that fewer than 1% of health care providers are MRSA carriers. C. MRSA is a bacterium that causes infections and is resistant to most antibiotics. D. Most cases of MRSA transmission occur following an accidental needlestick. The correct answer is: MRSA is a bacterium that causes infections and is resistant to most antibiotics. Question 27 A 62-year-old man with a history of congestive heart failure presents with severe respiratory distress and with an Not yet answered 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: Select one: Question 27 A. force fluid from his alveoli by hyperventilating him with a bag-valve mask at a rate of at least 20 breaths/min. B. place him in a supine position and assist his ventilations with a bag-valve mask and high-flow oxygen. C. apply a CPAP device, monitor his blood pressure, and observe him for signs of improvement or deterioration. D. place him in a position of comfort, deliver oxygen via nasal cannula, and closely monitor his breathing. The correct answer is: apply a CPAP device, monitor his blood pressure, and observe him for signs of improvement or deterioration. Question 28 In a healthy individual, the brainstem stimulates breathing on the basis of: Not yet answered Select one: Question 28 A. increased oxygen levels. B. increased carbon dioxide levels. C. decreased oxygen levels.  D. decreased carbon dioxide levels. The correct answer is: increased carbon dioxide levels. Question 29 You are assessing a patient with respiratory distress and are unsure if the cause is congestive heart failure or Not yet answered chronic obstructive pulmonary disease (COPD). Which of the following clinical signs would be the MOST helpful in determining whether the patient has chronic heart failure or COPD? Select one: Question 29 A. Jugular vein distention B. Cyanosis of the skin C. Altered mental status D. Rapid breathing The correct answer is: Jugular vein distention Question 30 Nitroglycerin relieves cardiac-related chest pain by: Not yet answered Select one: Question 30 A. constricting the coronary arteries and improving cardiac blood flow. B. dilating the coronary arteries and improving cardiac blood flow. C. contracting the smooth muscle of the coronary and cerebral arteries. D. increasing the amount of stress that is placed on the myocardium. The correct answer is: dilating the coronary arteries and improving cardiac blood flow. Question 31 Which of the following is NOT a function of the sympathetic nervous system? Not yet answered Select one: Question 31 A. Dilation of blood vessels in the muscles B. Constriction of blood vessels in the muscles C. Constriction of blood vessels in the digestive system D. Increases in the heart and respiratory rates The correct answer is: Constriction of blood vessels in the muscles Question 32 The left cerebral hemisphere controls: Not yet answered Select one: Question 32 A. breathing and blood pressure. B. the right side of the face. C. the right side of the body.  D. heart rate and pupil reaction. The correct answer is: the right side of the body. Question 33 You are caring for a 70-year-old female with signs and symptoms of an acute stroke. She is conscious, has Not yet answered secretions in her mouth, is breathing at a normal rate with adequate depth, and has an oxygen saturation of 96%. You should: Select one: Question 33 A. administer one tube of oral glucose and transport. B. suction her oropharynx and transport immediately. C. assist her ventilations with a bag-valve mask. D. insert an oral airway, apply oxygen, and transport. The correct answer is: suction her oropharynx and transport immediately. Question 34 A 59-year-old male presents with sudden-onset severe lower back pain. He is conscious and alert, but very Not yet answered restless and diaphoretic. Your assessment reveals a pulsating mass to the left of his umbilicus. You should: Select one: Question 34 A. vigorously palpate the abdomen to establish pain severity. B. request a paramedic unit to give the patient pain medication. C. place the patient in a sitting position and transport at once. D. administer oxygen and prepare for immediate transport. The correct answer is: administer oxygen and prepare for immediate transport. Question 35 Injury to a hollow abdominal organ would MOST likely result in: Not yet answered Select one: Question 35 A. impairment in the blood’s clotting abilities. B. profound shock due to severe internal bleeding. C. pain secondary to blood in the peritoneum. D. leakage of contents into the abdominal cavity. The correct answer is: leakage of contents into the abdominal cavity. Question 36 A 37-year-old female with a history of diabetes presents with excessive urination and weakness of 2 days’ Not yet answered duration. Her blood glucose level reads 320 mg/dL. If this patient’s condition is not promptly treated, she will MOST likely develop: Select one: Question 36  A. irreversible renal failure. B. acidosis and dehydration. C. hypoxia and overhydration. D. severe insulin shock. The correct answer is: acidosis and dehydration. Question 37 Kussmaul respirations are an indication that the body is: Not yet answered Select one: Question 37 A. severely hypoxic and eliminating excess CO2. B. attempting to eliminate acids from the blood. C. trying to generate energy by breathing deeply. D. compensating for decreased blood glucose levels. The correct answer is: attempting to eliminate acids from the blood. Question 38 Anaphylaxis is MOST accurately defined as a(n): Not yet answered Select one: Question 38 A. moderate allergic reaction that primarily affects the vasculature. B. severe allergic reaction that typically resolves without treatment. C. allergic reaction that causes bronchodilation and vasoconstriction. D. extreme allergic reaction that may affect multiple body systems. The correct answer is: extreme allergic reaction that may affect multiple body systems. Question 39 Signs of absorbed poison exposure include all of the following, except: Not yet answered Select one: Question 39 A. severe nausea, vomiting, and diarrhea. B. burns, itching, or irritation to the skin. C. liquid or powder on a patient’s skin. D. redness of skin in light-skinned people. The correct answer is: severe nausea, vomiting, and diarrhea. Question 40 When caring for a known alcoholic patient with severe trauma to the chest and abdomen, you should be Not yet answered concerned that: Select one: Question 40 A. signs and symptoms of shock might be masked by the stimulant effects produced by alcohol.  B. long-bone fractures are likely because chronic alcohol consumption weakens the structure of the bones. C. internal bleeding might be profuse because prolonged alcohol use might impair the blood’s ability to clot. D. delirium tremens (DTs) are commonly induced by physical trauma and can lead to life-threatening seizures. The correct answer is: internal bleeding might be profuse because prolonged alcohol use might impair the blood’s ability to clot. Question 41 It is MOST important for the EMT to remember that suicidal patients may: Not yet answered Select one: Question 41 A. have a definitive plan. B. be homicidal as well. C. inject illicit drugs. D. be self-destructive. The correct answer is: be homicidal as well. Question 42 When assessing a patient who is displaying bizarre behavior, the EMT should: Not yet answered Select one: Question 42 A. check his or her blood glucose level only if he or she has a history of diabetes. B. carefully document his or her perception of what is causing the patient’s behavior. C. avoid asking questions about suicide because this may give the patient ideas. D. consider that an acute medical illness may be causing the patient’s behavior. The correct answer is: consider that an acute medical illness may be causing the patient’s behavior. Question 43 Injuries to the vagina and external genitalia are serious because: Not yet answered Select one: Question 43 A. external injury is always associated with internal injury. B. severe infection occurs in nearly all cases of external injury. C. most injuries to these areas are unnoticed by the patient. D. these areas are rich with blood vessels and nerves. The correct answer is: these areas are rich with blood vessels and nerves. Question 44 Which of the following findings should make the EMT especially suspicious that a woman was sexually assaulted? Not yet answered Select one: Question 44 A. Signs of shock on assessment B. A prescription for alprazolam (Xanax) C. Inability to remember the event  D. The odor of alcohol on her breath The correct answer is: Inability to remember the event Question 45 The driver of a sport utility vehicle lost control and struck a utility pole head-on. The driver was killed instantly. The Not yet answered passenger, a young female, is conscious and alert and has several small abrasions and lacerations to her left forearm. Treatment for the passenger should include: Select one: Question 45 A. transport to a community hospital. B. transport to a trauma center. C. a focused exam of her forearm. D. a secondary assessment at the scene. The correct answer is: transport to a trauma center. Question 46 You should consider air medical transport of a trauma patient if: Not yet answered Select one: Question 46 A. he or she was involved in a motor vehicle crash in which another occupant in the same vehicle was killed, even if your patient’s injuries are minor. B. ground transport will take your ambulance out of service for an extended period of time, regardless of the severity of the patient’s injuries. C. the patient requires advanced life support care and stabilization, and the nearest ALS-ground ambulance is more than 5 to 10 minutes away. D. traffic conditions hamper the ability to get the patient to a trauma center by ground within the ideal time frame for the best clinical outcome. The correct answer is: traffic conditions hamper the ability to get the patient to a trauma center by ground within the ideal time frame for the best clinical outcome. Question 47 A 70-year-old man presents with a severe nosebleed. His medical history includes chronic obstructive pulmonary Not yet answered disease, depression, and a hemorrhagic stroke three years ago. His BP is 190/110 mm Hg, his pulse is 100 beats/min, and his respirations are 24 breaths/min. His medications include albuterol, sertraline (Zoloft), and multivitamins. Which of the following is most likely causing his nosebleed today? Select one: Question 47 A. Hemorrhagic stroke B. Diabetic complications C. High blood pressure D. His prescribed albuterol The correct answer is: High blood pressure Question 48 Regardless of the type of tourniquet used, it is important to remember that: Not yet answered Select one: Question 48 A. you should try to control the bleeding by applying pressure to a proximal arterial pressure point first. B. the tourniquet should be applied directly over a joint if possible because this provides better bleeding control. C. bulky dressings should be securely applied over the tourniquet to further assist in controlling the bleeding. D. the tourniquet should only be removed at the hospital because bleeding might return if the tourniquet is released. The correct answer is: the tourniquet should only be removed at the hospital because bleeding might return if the tourniquet is released. Question 49 A 17-year-old male was shot in the right anterior chest during an altercation. As your partner is applying oxygen, Not yet answered you perform a rapid assessment and find an open chest wound with a small amount of blood bubbling from it. You should: Select one: Question 49 A. place a sterile dressing over the wound and apply direct pressure. B. control the bleeding from the wound and prepare to transport at once. C. direct your partner to assist the patient’s ventilations with a bag-mask device. D. apply an occlusive dressing to the wound and continue your assessment. The correct answer is: apply an occlusive dressing to the wound and continue your assessment. Question 50 Which of the following is a sign of compartment syndrome? Not yet answered Select one: Question 50 A. Absence of pain at the injury site B. Pain upon passive movement of the injury site C. A bounding pulse distal to the injury site D. Extreme redness to the injury site The correct answer is: Pain upon passive movement of the injury site Question 51 The most significant complication associated with facial injuries is: Not yet answered Select one: Question 51 A. mandibular immobility. B. cervical spine injury. C. airway compromise. D. damage to the eyes. The correct answer is: airway compromise. Question 52 When caring for a patient with an open facial injury, the EMT’s immediate priority should be to: Not yet answered Select one: Question 52 A. consider the mechanism of injury. B. wear gloves and facial protection. C. closely assess the patient’s airway. D. manually stabilize the patient’s head. The correct answer is: wear gloves and facial protection. Question 53 An indicator of an expanding intracranial hematoma or rapidly progressing brain swelling is: Not yet answered Select one: Question 53 A. rapid deterioration of neurologic signs. B. an acute increase in the patient’s pulse rate. C. acute unilateral paralysis following the injury. D. a progressively lowering blood pressure. The correct answer is: rapid deterioration of neurologic signs. Question 54 When the parasympathetic nervous system is activated: Not yet answered Select one: Question 54 A. blood is shunted away from the digestive organs. B. the heart rate decreases and the blood vessels dilate. C. heart rate and blood pressure increase. D. hormones are released that prepare the body for stress. The correct answer is: the heart rate decreases and the blood vessels dilate. Question 55 Immediate death from blunt chest trauma following a motor vehicle crash is most often the result of: Not yet answered Select one: Question 55 A. a massive cardiac contusion. B. traumatic aortic rupture. C. a tension pneumothorax. D. penetrating lung injuries. The correct answer is: traumatic aortic rupture. Question 56 To avoid exacerbating a patient’s injury, it is especially important to use extreme caution when providing positive- Not yet answered pressure ventilation to patients with a: Select one: Question 56 A. flail chest. B. pneumothorax. C. cardiac tamponade. D. myocardial contusion. The correct answer is: pneumothorax. Question 57 A 20-year-old male was accidentally shot in the right upper abdominal quadrant with an arrow during an archery Not yet answered contest. Prior to your arrival, the patient removed the arrow. Your assessment reveals that he is conscious and alert with stable vital signs. The entrance wound is bleeding minimally and appears to be superficial. You should: Select one: Question 57 A. carefully probe the wound to determine its depth. B. clean the wound and apply a dry, sterile dressing. C. assume that the arrow injured an internal organ. D. transport only if signs of shock begin to develop. The correct answer is: assume that the arrow injured an internal organ. Question 58 A football player was struck by another player in the right flank area just below the posterior rib cage. He Not yet answered complains of severe pain and point tenderness to the area. Your assessment reveals that there is a small amount of blood in his underwear. You should be most suspicious for: Select one: Question 58 A. external genitalia injury. B. blunt injury to the kidney. C. a lacerated liver or spleen. D. a ruptured urinary bladder. The correct answer is: blunt injury to the kidney. Question 59 A 54-year-old male accidentally shot himself in the leg while cleaning his gun. Your assessment reveals a small Not yet answered entrance wound to the medial aspect of his right leg. The exit wound is on the opposite side of the leg and is actively bleeding. The patient complains of numbness and tingling in his right foot. You should: Select one: Question 59 A. assess distal pulses as well as sensory and motor functions. B. control the bleeding and cover the wound with a sterile dressing. C. manually stabilize the leg above and below the site of injury. D. gently manipulate the injured leg until the numbness dissipates.  The correct answer is: control the bleeding and cover the wound with a sterile dressing. Question 60 Which of the following scenarios is an example of a direct injury? Not yet answered Select one: Question 60 A. A person lands on his or her feet and fractures the lumbar spine. B. A passenger fractures her patella after it strikes the dashboard. C. A child dislocates his elbow after falling on his outstretched arm. D. A skier dislocates his knee after a twisting injury to the ankle. The correct answer is: A passenger fractures her patella after it strikes the dashboard. Question 61 When the body loses sweat, it also loses: Not yet answered Select one: Question 61 A. nutrients. B. erythrocytes. C. plasma. D. electrolytes. The correct answer is: electrolytes. Question 62 Which of the following most accurately describes hyperthermia? Not yet answered Select one: Question 62 A. Heat evaporates a significant amount of body water. B. The body is exposed to more heat than it can lose. C. The core body temperature exceeds 99.5°F (37°C). D. The body eliminates more heat than it can generate. The correct answer is: The body is exposed to more heat than it can lose. Question 63 A nuchal cord is defined as an umbilical cord that: Not yet answered Select one: Question 63 A. is wrapped around the baby’s neck. B. has separated from the placenta. C. has abnormally developed blood vessels. D. is lacerated due to a traumatic delivery. The correct answer is: is wrapped around the baby’s neck. Question 64 If a newborn’s heart rate is less than 60 beats/min following delivery, you should: Not yet answered Select one: Question 64 A. begin chest compressions. B. re-suction the mouth only. C. flick the soles of its feet. D. provide ventilations for 30 seconds. The correct answer is: provide ventilations for 30 seconds. Question 65 Signs and symptoms of preeclampsia include: Not yet answered Select one: Question 65 A. dyspnea and bradycardia. B. marked hypoglycemia. C. headache and edema. D. dysuria and constipation. The correct answer is: headache and edema. Question 66 Early signs of respiratory distress in the pediatric patient include all of the following, except: Not yet answered Select one: Question 66 A. tachypnea. B. cyanosis. C. retractions. D. abnormal airway noise. The correct answer is: cyanosis. Question 67 The components of the pediatric assessment triangle (PAT) are: Not yet answered Select one: Question 67 A. skin condition, respiratory rate, and level of alertness. B. mental status, heart rate, and systolic blood pressure. C. appearance, work of breathing, and skin circulation. D. activity, respiratory quality, and level of consciousness. The correct answer is: appearance, work of breathing, and skin circulation. Question 68 Blood levels of medications might rise in the elderly, sometimes to toxic levels. This is most likely due to: Not yet answered Select one: Question 68 A. splenic dysfunction. B. intentional overdose. C. pancreatic failure. D. renal insufficiency. The correct answer is: renal insufficiency. Question 69 Which of the following statements regarding a decreased level of consciousness in the elderly patient is correct? Not yet answered Select one: Question 69 A. The AVPU scale is an ineffective tool when assessing an elderly patient’s level of consciousness. B. Most elderly patients have some deterioration in their level of consciousness. C. A decreased level of consciousness is most often the result of chronic dementia. D. A decreased level of consciousness is not a normal part of the aging process. The correct answer is: A decreased level of consciousness is not a normal part of the aging process. Question 70 Airway management can be challenging in patients with Down syndrome because their: Not yet answered Select one: Question 70 A. teeth are misaligned, and they have a large tongue. B. occiput is round, which causes flexion of the neck. C. mandible is large, which inhibits a mask-to-face seal. D. tongue is relatively small and falls back in the throat. The correct answer is: teeth are misaligned, and they have a large tongue. Question 71 Cerebral palsy is a condition that results from damage or injury to the: Not yet answered Select one: Question 71 A. peripheral nervous system. B. voluntary muscles. C. brain. D. spinal cord. The correct answer is: brain. Question 72 Aggressive ambulance driving might have a negative effect on other motorists because: Not yet answered Select one: Question 72 A. they might become enraged and attempt to run you off the road. B. they move to the right or drive as close to the curb as possible. C. they often freeze when they see the lights in the rearview mirror. D. it might not allow for their reaction time to respond to your vehicle. The correct answer is: it might not allow for their reaction time to respond to your vehicle. Question 73 Maintaining a cushion of safety when operating an ambulance means: Not yet answered Select one: Question 73 A. driving about 2 to 3 seconds behind any vehicles in front of you and exceeding the posted speed limit by no more than 20 to 25 mph. B. driving at the posted speed limit, regardless of the patient’s condition, and routinely using your lights and siren when driving on a freeway. C. keeping a safe distance between your ambulance and the vehicles in front of you and remaining aware of vehicles potentially hiding in your mirrors’ blind spots. D. remaining in the far right-hand lane when transporting a critical patient and refraining from passing other motorists on the left side. The correct answer is: keeping a safe distance between your ambulance and the vehicles in front of you and remaining aware of vehicles potentially hiding in your mirrors’ blind spots. Question 74 The rescue team is in the process of extricating a 40-year-old male from his truck. The patient’s wife, who was Not yet answered uninjured in the crash, is calmly observing the extrication and asks you if her husband will be all right. You should: Select one: Question 74 A. allow her to talk to her husband during the extrication. B. ask her follow-up questions about the details of the crash. C. ensure that she is in a safe area, away from the scene. D. allow her to observe the extrication and keep her calm. The correct answer is: ensure that she is in a safe area, away from the scene. Question 75 To evaluate hazards present at the scene and determine the number of patients, you should: Not yet answered Select one: Question 75 A. perform a 360° walkaround of the scene. B. request the fire department at all scenes. C. interview bystanders present at the scene. D. use the information provided by dispatch.  The correct answer is: perform a 360° walkaround of the scene. Question 76 If an incident increases in scope and complexity, the incident commander should consider: Not yet answered Select one: Question 76 A. relinquishing command to someone with more experience. B. requesting a second incident commander to assist him or her. C. maintaining responsibility for all of the command functions. D. ceasing all operations until a revised plan is established. The correct answer is: relinquishing command to someone with more experience. Question 77 You are triaging four patients who were involved in a head-on motor vehicle crash. Which of the following patients Not yet answered should be assigned the highest (red) triage category? Select one: Question 77 A. A 50-year-old male with an open head injury and no pulse B. A 49-year-old female with diabetes and difficulty breathing C. A 36-year-old female with back pain and numb extremities D. A 29-year-old male with bilaterally closed femur deformities The correct answer is: A 49-year-old female with diabetes and difficulty breathing Question 78 A persistent or nonvolatile chemical agent can: Not yet answered Select one: Question 78 A. remain in the environment for many weeks. B. evaporate quickly when left on a surface. C. remain on a surface for more than 24 hours. D. explode without warning and release gases. The correct answer is: remain on a surface for more than 24 hours. Question 79 A weapon of mass destruction is most accurately defined as: Not yet answered Select one: Question 79 A. a nuclear or chemical weapon that can be launched from one country to another country. B. a device or agent used to destroy a specific area or region within a given geographic location. C. any device used for the express purpose of creating carnage to make a particular point. D. any agent used to bring about mass death, casualties, or massive infrastructural damage.  The correct answer is: any agent used to bring about mass death, casualties, or massive infrastructural damage. Question 80 A 19-year-old female is found unconscious by her roommate. Your primary assessment reveals that her breathing Not yet answered is inadequate. As you insert an oropharyngeal airway, she begins to gag violently. You should: Select one: Question 80 A. remove the airway and be prepared to suction her oropharynx. B. continue to insert the airway as you suction her oropharynx. C. insert the airway no further but leave it in place as a bite block. D. select a smaller oropharyngeal airway and attempt to insert it. The correct answer is: remove the airway and be prepared to suction her oropharynx. Question 81 A 23-year-old male experienced severe head trauma after his motorcycle collided with an oncoming truck. He is Not yet answered unconscious, has agonal gasps, and has copious bloody secretions in his mouth. How should you manage his airway? Select one: Question 81 A. Suction his oropharynx with a rigid catheter until all secretions are removed. B. Alternate oropharyngeal suctioning and ventilation with a bag-mask device. C. Insert a nasopharyngeal airway and provide suction and assisted ventilations. D. Provide continuous ventilations with a bag-mask device to minimize hypoxia. The correct answer is: Alternate oropharyngeal suctioning and ventilation with a bag-mask device. Question 82 A man was found unresponsive in his bed at home. There is no evidence of injury, and the patient’s medical Not yet answered history is not known. The patient’s face is cherry red, yet the pulse oximeter reads 98%. Which of the following would MOST likely explain this? Select one: Question 82 A. Carbon monoxide poisoning B. Severe pulmonary edema C. Cold extremities D. Increased body temperature The correct answer is: Carbon monoxide poisoning Question 83 All of the following will help minimize the risk of gastric distention when ventilating an apneic patient with a bag- Not yet answered mask device, EXCEPT: Select one: Question 83 A. ventilating the patient at the appropriate rate.  B. ensuring the appropriate airway position. C. increasing the amount of delivered tidal volume. D. delivering each breath over 1 second. The correct answer is: increasing the amount of delivered tidal volume. Question 84 A 56-year-old male is found semiconscious by his wife. Your assessment reveals that his respirations are rapid Not yet answered and shallow, his pulse is rapid and irregular, and his blood pressure is low. The patient’s wife states that he complained of left arm pain and nausea the day before, but would not allow her to call 9-1-1. The MOST likely cause of this patient’s present condition is: Select one: Question 84 A. severe septic hypoperfusion. B. acute myocardial infarction. C. dehydration from GI virus. D. a ruptured aortic aneurysm. The correct answer is: acute myocardial infarction. Question 85 A construction worker fell approximately 30 feet. He is semiconscious with rapid, shallow respirations. Further Not yet answered 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: Select one: Question 85 A. assisted ventilation, thermal management, and spinal motion restriction in place. B. oxygen via nonrebreathing mask, blankets for warmth, and elevation of his head. C. assisted ventilation, preventing hyperthermia, and elevating his lower extremities. D. oxygen via nonrebreathing mask, thermal management, and elevation of his legs. The correct answer is: assisted ventilation, thermal management, and spinal motion restriction in place. Question 86 Patients develop septic shock secondary to: Not yet answered Select one: Question 86 A. an infection that weakens cardiac contractions. B. weak vessel tone caused by nervous system damage. C. failure of the blood vessels to adequately dilate. D. poor vessel function and severe volume loss. The correct answer is: poor vessel function and severe volume loss. Question 87 When assessing a patient with signs and symptoms of shock, it is important to remember that: Not yet answered Select one: Question 87 A. blood pressure may be the last measurable factor to change in shock. B. irreversible shock often responds well to a prompt blood transfusion. C. the patient’s respirations are deep during the early stages of shock. D. multiple fractures are the most common cause of hypovolemic shock. The correct answer is: blood pressure may be the last measurable factor to change in shock. Question 88 A young female is unconscious after intentionally ingesting a large amount of aspirin. You will MOST likely find her Not yet answered respirations: Select one: Question 88 A. rapid and shallow. B. deep and rapid. C. slow and shallow. D. slow and deep. The correct answer is: deep and rapid. Question 89 The respiratory distress that accompanies emphysema is caused by: Not yet answered Select one: Question 89 A. massive constriction of the bronchioles. B. chronic stretching of the alveolar walls. C. repeated exposure to cigarette smoke. D. acute fluid accumulation in the alveoli. The correct answer is: chronic stretching of the alveolar walls. Question 90 While auscultating an elderly woman’s breath sounds, you hear low-pitched “rattling” sounds at the bases of both Not yet answered of her lungs. This finding is MOST consistent with which of the following conditions? Select one: Question 90 A. Aspiration pneumonia B. Early pulmonary edema C. Acute asthma attack D. Widespread atelectasis The correct answer is: Aspiration pneumonia Question 91 A patient with atherosclerotic heart disease experiences chest pain during exertion because: Not yet answered Select one: Question 91 A. the lumen of the coronary artery is narrowed and cannot accommodate increased blood flow. B. the ragged edge of a tear in the coronary artery lumen causes local blood clotting and arterial narrowing. C. tissues of the myocardium undergo necrosis secondary to a prolonged absence of oxygen. D. the coronary arteries suddenly spasm and cause a marked reduction in myocardial blood flow. The correct answer is: the lumen of the coronary artery is narrowed and cannot accommodate increased blood flow. Question 92 Cardiac output may decrease if the heart beats too rapidly because: Not yet answered Select one: Question 92 A. there is not enough time in between contractions for the heart to refill completely. B. a rapid heartbeat causes a decrease in the strength of cardiac contractions. C. as the heart rate increases, more blood is pumped from the ventricles than the atria D. the volume of blood that returns to the heart is not sufficient with fast heart rates. The correct answer is: there is not enough time in between contractions for the heart to refill completely. Question 93 Which of the following would cause the greatest increase in cardiac output? Not yet answered Select one: Question 93 A. Increased heart rate and increased stroke volume B. Decreased stroke volume and decreased heart rate C. Decreased stroke volume and increased heart rate D. Decreased heart rate and increased stroke volume The correct answer is: Increased heart rate and increased stroke volume Question 94 Which of the following statements regarding secondary brain injury is correct? Not yet answered Select one: Question 94 A. Signs are often present immediately after an impact to the head. B. Hypoxia and hypotension are the two most common causes of secondary brain injury. C. It results from direct brain trauma following an impact to the head. D. Because cerebral edema develops quickly, it is considered to be a primary brain injury. The correct answer is: Hypoxia and hypotension are the two most common causes of secondary brain injury. Question 95 Which of the following statements regarding the EMS medical director and an EMT’s scope of practice is correct? Not yet answered Select one: Question 95 A. An EMT’s scope of practice may be expanded by the medical director after proper training and state approval. B. An EMT’s scope of practice is exclusively regulated by the state EMS office, not the EMS medical director. C. The EMS medical director can expand or limit an individual EMT’s scope of practice without state approval. D. The EMS medical director can expand the EMT’s scope of practice but cannot limit it without state approval. The correct answer is: An EMT’s scope of practice may be expanded by the medical director after proper training and state approval. Question 96 Why are prehospital emergency care guidelines updated on a regular basis? Not yet answered Select one: Question 96 A. The federal government requires the implementation of changes to existing emergency care protocols at least every five years. B. Additional information and evidence indicate that the effectiveness of certain interventions has changed. C. Statistical data indicate that an increasing number of people are being diagnosed with a particular illness. D. EMS providers should be encouraged to actively participate in research and become familiar with data analysis. The correct answer is: Additional information and evidence indicate that the effectiveness of certain interventions has changed. Question 97 Which of the following signs would indicate that your partner is experiencing significant stress? Not yet answered Select one: Question 97 A. Increased interest in daily activities B. Hyperactivity during an EMS call C. Acute increase in appetite D. Isolation from the rest of the crew The correct answer is: Isolation from the rest of the crew Question 98 While providing care to a patient, blood got onto the ambulance stretcher. Because the stretcher was not properly Not yet answered cleaned afterward, a virus was transmitted to another emergency medical technician (EMT) several days later. Which route of transmission does this scenario describe? Select one: Question 98 A. Direct contact B. Indirect contact C. Airborne transmission D. Vector-borne transmission  The correct answer is: Indirect contact Question 99 A patient regains consciousness en route from his office to the emergency department. The patient tells you that Not yet answered he feels fine and does not want to go to the hospital. Under these circumstances, you should: Select one: Question 99 A. document the patient’s request but continue to transport him. B. assess whether the patient’s mental condition is impaired. C. have the patient sign a refusal form and return him to his office. D. request that the police place the patient under protective custody. The correct answer is: assess whether the patient’s mental condition is impaired. Question 100 Which of the following scenarios is an example of informed consent? Not yet answered Select one: Question 100 A. A patient advises an EMT of why he or she is refusing care. B. A patient is advised by an EMT of the risks of refusing care. C. An EMT initiates immediate care for an unconscious adult. D. An EMT advises a patient of the risks of receiving treatment. The correct answer is: An EMT advises a patient of the risks of receiving treatment.