Q&A Hero

Q: Which of the following BEST explains the reason for minimizing scene-time for the trauma patient with significant hemorrhage or the potential for significant hemorrhage? A) There is nothing the EMT can do for a patient in shock. B) It gives the EMT less opportunity to make mistakes in the patient's care. C) Studies have indicated that trauma patients who receive surgery within 1 hour of injury have better chances of survival. D) The clock for the "golden hour" of trauma begins at the time of your arrival.

Q: Which of the following is NOT indicated in the management of a patient in shock? A) Minimizing on-scene time B) Delaying a detailed exam until en route to the hospital C) High-speed ambulance transportation D) On-scene spinal precautions, if indicated

Q: When deciding where to transport a patient who is in hypovolemic shock or who has the potential for developing hypovolemic shock, which of the following is the MOST important service to be provided by the receiving hospital? A) Critical-care nursing B) Immediate surgical capabilities C) Availability of a chaplain D) Rehabilitation services

Q: Which of the following is NOT the purpose of making airway management the highest priority of patient care when managing the patient in shock? A) It allows for oxygenation of the lungs. B) It allows for improved elimination of carbon dioxide. C) It minimizes the chances of aspiration of blood or vomit. D) It allows the bronchoconstriction of the smaller airways to be reversed.

Q: Which of the following distinguishes decompensated shock from compensated stage of shock? A) Cell damage and death in the vital organs B) Altered mental status C) Delayed capillary refill time D) Low blood pressure

Q: Which of the following is a classification of the severity of shock? A) Consumption B) Compensated C) Uncompensated D) Non-compensated

Q: Which of the following statements is true when talking about neurogenic shock? A) Neurogenic shock is sometimes caused by spinal injuries. B) Neurogenic shock is the result of the blood vessels decreasing in size. C) Neurogenic shock is caused by the blood vessels overfilling with blood, causing leaking into the nerves. D) Neurogenic shock is very common in the field.

Q: Which of the following circumstances may result in hypoperfusion? A) There is external bleeding. B) Blood vessels are dilated. C) The heart is damaged. D) All of the above

Q: Which of the following is the major cause of shock that the EMT will encounter? A) Vomiting B) High blood pressure C) Hemorrhage D) Excessive sweating

Q: Although many of the signs and symptoms of shock are the same no matter what the cause, the symptoms follow a logical progression as shock develops and worsens. Arrange the following signs and symptoms in the likely order that they will appear. 1. Altered mental status 2. Dropping blood pressure 3. Nausea and vomiting 4. Pale, cool, and clammy skin 5. Increased pulse 6. Increased respirations A) 1, 4, 3, 6, 5, 2 B) 2, 5, 6, 3, 4, 1 C) 1, 3, 4, 5, 6, 2 D) 5, 3, 4, 2, 6, 1

Q: Which of the following signifies a failure in the patient's compensatory response to blood loss? A) Hypotension B) Tachycardia C) Tachypnea D) Pale, cool skin

Q: Which of the following is part of the body's compensatory response to blood loss? A) Blood vessels constrict and the heart rate increases. B) Blood vessels dilate and the heart rate increases. C) Blood vessels dilate and the heart rate decreases. D) Blood vessels constrict and the heart rate decreases.

Q: Which of the following is NOT a consequence of hypoperfusion? A) Cellular waste products are not removed. B) Cells are not supplied with nutrients. C) Cells are not supplied with oxygen. D) Aerobic metabolism will continue in the cell.

Q: Which of the following is responsible for most of the signs and symptoms of early shock? A) Increased respirations of the patient B) Constriction of the peripheral blood vessels C) Dilation of the peripheral blood vessels D) The body's attempts at compensation for blood loss

Q: Which of the following is the MOST sensitive indicator of hypoperfusion? A) Delayed capillary refill B) Dilation of the pupils C) Increased heart rate D) Altered mental status

Q: Which of the following is another name for describing the condition of shock? A) Internal bleeding B) Hypotension C) Hypoperfusion D) Hemorrhage

Q: You will frequently be called upon to deal with internal bleeding. Blunt trauma is the leading cause of internal injuries and bleeding. Which of the following are mechanisms of blunt trauma that may cause internal bleeding? 1. Falls 2. Motor vehicle or motorcycle crashes 3. Auto-pedestrian collisions 4. Blast injuries A) 1, 2, 3 B) 2, 3 C) 1, 2, 3, 4 D) 1, 4

Q: As an EMT, your BEST clue indicating the possibility of internal bleeding may be the presence of: A) a tender, rigid, or distended abdomen. B) painful, swollen, or deformed extremities. C) mechanism of injury. D) bruising, swelling, or pain over vital organs.

Q: Which of the following should increase the EMT's suspicion of internal bleeding? A) Penetrating trauma to the chest or abdomen B) High-speed motor vehicle collision C) Fall from a height three or more times the patient's height D) All of the above

Q: The most common form of a hemostatic agent is hemostatic: A) granules. B) dressings. C) tourniquet. D) powders.

Q: If you do not have a commercial tourniquet available, what common device found on the ambulance can be used as a substitute? A) Air or vacuum splint B) Blood pressure cuff C) Ice packs tied in place with triangle bandage D) Use a rope tie-down to make a tourniquet

Q: Your patient is a 12-year-old boy who ran his arm through a glass window and has an 8-inch laceration on his anterior forearm. You have applied a pressure dressing and bandage, but these have become saturated due to continued bleeding. Which of the following should you do now? A) Remove the pressure dressing and bandage, apply an ice pack to the wound, and bandage it in place with an elastic bandage. B) Elevate that arm and prepare to apply a tourniquet or consider administering a hemostatic agent. C) Apply additional dressing material, bandage it in place, and apply pressure to the brachial artery. D) Remove the pressure dressing and bandage, apply direct pressure with your gloved hand, and elevate the arm.

Q: Your patient is a 28-year-old male who cut his thigh with a chain saw. It appears that he has lost about 600 cc of blood. Which of the following is NOT part of the proper management of this patient? A) Use of a tourniquet B) Replacement of fluid level by giving the patient adequate amounts of water C) Using direct pressure to control the bleeding D) Administering oxygen

Q: Which of the following is the MOST effective way of controlling external bleeding? A) Running cold water over the wound B) Using direct pressure with a dressing C) Elevating the affected part D) Using an ice pack

Q: Which one of the following is incorrect in the application of a tourniquet? A) The tourniquet should be placed approximately 2 inches above the bleeding. B) The tourniquet should be 2 to 4 inches wide. C) A blood pressure cuff can be used as a tourniquet. D) If possible, the tourniquet should be placed on a joint.

Q: Which of the following is recommended in situations in which a tourniquet must be used? A) Apply a bulky dressing and bandage over the tourniquet. B) Apply the tourniquet over the elbow or knee. C) Use a material that is wide and thick. D) Remove the tourniquet as soon as bleeding is controlled to minimize further damage to the limb.

Q: Cold is sometimes used to help control bleeding. When using cold, the following guidelines and statements are true except: A) it should not be used alone but rather in conjunction with other manual techniques. B) it should be applied directly to the skin; it will not be effective if anything is between the cold agent and the wound. C) it should not be left in place for more than 20 minutes. D) it will reduce pain.

Q: Which of the following is the LEAST effective method of controlling bleeding? A) Direct pressure B) Elevation C) Tourniquet D) Hemostatic agent

Q: Which of the following may occur when there is bleeding from a large vein? A) Transmission of bloodborne illnesses B) Air embolism C) Hypoperfusion D) All of the above

Q: Your patient has attempted suicide by slitting his wrists. You notice that he has run the knife across his wrist, perpendicular to the arm, and that the wound is rather deep. Which of the following statements is true regarding the likelihood for serious blood loss? A) You should expect severe blood loss. B) There is most likely tremendous internal blood loss. C) Blood loss is probably not life-threatening. D) A tourniquet will probably be necessary.

Q: Which of the following is NOT recommended when controlling epistaxis? A) Pinching the nostrils together B) Keeping the patient calm and quiet C) Having the patient tilt the head backward to elevate the nose D) Placing the unconscious patient in the recovery position

Q: Your patient is a 33-year-old man who has a gunshot wound to his right leg and has active, steady, dark red bleeding. He is awake, pale, and diaphoretic. He has a strong radial pulse of 112 per minute, a respiratory rate of 24 breaths per minute, and a blood pressure of 122/82 mmHg. He has no other injuries or complaints. Which of the following is the BEST sequence of steps in the management of this patient? A) High-concentration oxygen, elevation of the extremity, and application of ice B) Cervical spine immobilization, high-concentration oxygen, direct pressure, and pressure point compression C) High-concentration oxygen, tourniquet, PASG, and elevation of the extremity D) Direct pressure, high-concentration oxygen, and splinting the leg

Q: Which of the following is the most important reason for controlling external bleeding? A) To prevent hypoperfusion B) To prevent the spread of infectious diseases C) To make clean-up of the ambulance and your equipment easier after the call D) To prevent the patient from becoming upset at the sight of blood

Q: Which of the following must be kept in mind when considering the severity of external bleeding? A) Signs of shock do not appear until a large amount of blood has been lost. B) The amount of blood loss is easily estimated by the amount of blood visible on the ground. C) A younger person can tolerate more blood loss than an adult. D) All of the above

Q: In the average adult, the sudden loss of ________ cc of blood is considered serious. A) 150 B) 500 C) 1,000 D) 750

Q: External bleeding may be classified according to types. Which one of the following is one of those types? A) Cardiac bleeding B) Brain bleeding C) Capillary bleeding D) Liver bleeding

Q: Which of the following is a characteristic of venous bleeding? A) It commonly requires the use of pressure point compression. B) It can be profuse, but is generally easily controlled. C) It cannot lead to life-threatening amounts of blood loss. D) It often requires the use of a tourniquet.

Q: Which of the following is a characteristic of arterial bleeding? A) Steady flow B) Dark red color C) Spurting under pressure D) Both B and C

Q: Your patient is a 6-year-old child who has fallen down while running on a sidewalk. She has abrasions on both knees and the palms of both hands, which are oozing blood. This is an example of bleeding from which of the following types of vessels? A) Veins B) Arteries C) Lymphatic vessels D) Capillaries

Q: Which of the following vessels contain blood under the highest amount of pressure? A) Veins B) Arteries C) Venules D) Capillaries

Q: Which of the following blood vessels CANNOT stop bleeding by constricting? A) Arteries B) Capillaries C) Venules D) Arterioles

Q: Which of the following BEST describes the delivery of oxygen and nutrients at the body's cellular level? A) Hydrostatic pressure B) Perfusion C) Osmosis D) Circulation

Q: In which of the following vessels does the vital exchange take place and also has the thinnest walls through which oxygen, nutrients, and wastes can pass? A) Capillaries B) Microvenules C) Arterioles D) Veins

Q: Which of the following is NOT part of the circulatory system? A) Heart B) Brain C) Blood vessels D) Blood

Q: Which of the following BEST describes the function of blood? A) It is a life-giving liquid that supports all the body's functions to maintain hypoperfusion. B) It clots, flows, transports, protects, and excretes on a daily basis. C) It transports gases along with nutrients, aids in excretion, and provides protection and regulation. D) It flows from the heart with the vital gases and nutrients to maintain lack of perfusion.

Q: Which of the following types of vessels have valves to maintain one-way blood flow? A) Arteries B) Capillaries C) Veins D) Arterioles

Q: Which of the following vessels has the thickest muscular walls that allow constriction and dilation? A) Arteries B) Capillaries C) Veins D) Lymphatic vessels

Q: Shock is the circulatory system's failure to provide sufficient blood and oxygen to all the body's tissues. Which of the answers is NOT a major type of shock? A) Hypovolemic B) Hemorrhagic C) Hypervolemic D) Cardiogenic

Q: Prehospital management of all the urinary system problems of the kidney transplant patient by the EMT can be characterized by: A) very invasive techniques. B) varied pharmacological interventions. C) supportive care. D) intensive lab testing.

Q: The medications that transplant patients need to take for the rest of their lives to prevent organ rejection also often lead to high susceptibility of: A) infection. B) renal failure. C) ulcers. D) congestive heart failure.

Q: The most frequently transplanted organ is the: A) liver. B) heart. C) kidney. D) pancreas.

Q: You are dispatched to a private residence for a sick person. When you arrive you are told by the patient that due to the snow storm yesterday he missed his scheduled appointment at the dialysis center and is not feeling well. Your assessment does not reveal anything remarkable outside of the fact that he has missed his dialysis. Which of the steps below would NOT be part of your care? A) Assess the ABCs. B) When you obtain vital signs, obtain a blood pressure on an arm that does not have a fistula. C) Place the patient in a supine position. D) Administer oxygen at 15 lpm by nonrebreather mask.

Q: Why might you consider contacting medical direction before applying a tourniquet in the case of uncontrollable bleeding from an AV fistula? A) Damage to the fistula may occur. B) The patient may be in danger of losing the limb. C) Medical direction should be contacted before any use of tourniquets by the EMT. D) Hemodialysis anticoagulants may make bleeding more severe.

Q: Once you encounter uncontrolled bleeding from an AV fistula, which of the following methods would you consider using to control bleeding in addition to direct pressure and elevation? A) Internal wound management B) Tourniquet C) Hemostatic dressings D) Pressure points

Q: You are dispatched to an unconscious hemodialysis patient. On arrival to the dialysis clinic, the patient is unresponsive, apneic, and pulseless. You secure the ABCs, begin ventilation, and initiate chest compressions. However, the patient's cardiac arrest rhythm is continuously unresponsive to defibrillations with your AED. The best approach is to: A) call online medical control to terminate the code. The probability of survival is too low to continue resuscitation efforts. B) begin transporting and contact an ALS intercept. The patient's dysrhythmia may be related to kidney failure. C) run a "no-electricity" code in which compressions and ventilation are continued. No additional defibrillations are necessary. D) continue defibrillating as the monitor recommends. The myocardium becomes increasingly responsive to successive defibrillations.

Q: You are attending to an end-stage renal disease (ESRD) patient who has missed dialysis. Which of the following statements is most accurate? A) Patients who have missed dialysis and who become unresponsive and pulseless respond very well to the use of an AED. B) Patients who have missed dialysis and who become unresponsive and pulseless do not respond very well to the use of an AED. C) Calling for ALS would not be very helpful since they cannot really do anything that an EMT cannot do in these situations. D) You should delay transport if necessary to wait for ALS.

Q: A patient with renal disease who is currently on dialysis and missed an appointment may present with dangerously high levels of the electrolyte: A) phosphorous. B) potassium. C) sodium. D) calcium.

Q: One of the more serious diseases of the body is called renal failure. Renal failure occurs when the: A) adrenal glands stop working. B) kidneys fail to function as required. C) liver fails to function properly. D) pancreas stops working.

Q: Dialysis patients who have missed an appointment may present with signs of ________, which is a similar presentation to ________. A) pulmonary edema; congestive heart failure B) shortness of breath; pneumonia C) chest pain; acute myocardial infarction D) neurological disturbances; stroke

Q: Two chronic medical conditions that dialysis patients frequently have in addition to kidney failure are ________ and ________. A) blood clots; COPD B) high cholesterol; cerebral aneurysms C) heart failure; stroke D) hypertension; diabetes

Q: You are dispatched to a private residence for a sick person. You arrive and find a 47-year-old male patient who recently completed his peritoneal dialysis and complains of severe abdominal pain that is worsened by movement. One of the more serious complications of this type of dialysis is a bacterial infection within the peritoneal cavity. What would be the tell-tale sign that this is what is happening in this case? A) The patient's dialysis fluid appears cloudy when it is drained from the peritoneal cavity rather than its normal clear appearance. B) The patient's dialysis fluid appears clear when it is drained from the peritoneal cavity rather than its normal cloudy appearance. C) The patient has trouble urinating. D) The patient has swollen ankles.

Q: Patients who dialyze at home are at high risk for what type of infection? A) Peritonitis B) Decubitus ulcers C) Cellulitis D) Fistula infection

Q: How frequently does the majority of peritoneal dialysis require treatment? A) Three to five times a week B) Once a day C) Multiple treatments a day D) Once a week

Q: There are two main types of dialysis, hemodialysis and peritoneal dialysis. The main difference between them is hemodialysis: A) is usually done at a special facility and peritoneal dialysis is usually done at home. B) is usually done at home and peritoneal dialysis is usually done at a special facility. C) filters the blood and peritoneal dialysis filters the urine. D) filters the urine and peritoneal dialysis filters the blood.

Q: How many times a week do the majority of American hemodialysis patients receive treatment? A) Five B) Three C) Seven D) One

Q: How long does a typical hemodialysis treatment last? A) 7 to 8 hours B) 3 to 4 hours C) 1 to 2 hours D) 10 to 12 hours

Q: What is a cycle of filling and draining of the abdominal cavity during peritoneal dialysis called? A) Exchange B) Set C) Rotation D) Trade

Q: Peritoneal dialysis allows patients to dialyze at home through: A) a dialysis machine. B) the abdomen. C) an AV fistula. D) the urethra.

Q: Hemodialysis is used to help the kidneys filter ________ and remove excess ________. A) electrolytes; hormones B) urine; poisons C) blood; cholesterol D) toxins; fluids

Q: Approximately what percentage of United States dialysis patients treat themselves at home? A) 50% B) 8% C) 25% D) 16%

Q: Approximately how many Americans are currently on some type of dialysis? A) 200,000 B) 50,000 C) 100,000 D) 400,000

Q: You are dispatched to a sick call. The patient was just extricated from a bathtub where he was trapped under the shower door for 2 weeks. This 72-year-old male had limited access to water from the bathtub faucet. The patient is complaining of disorientation, nausea, and vomiting. What do you think is the underlying cause for the illness? A) Chronic renal failure B) End-stage renal disease C) Acute renal failure D) Gastrointestinal infection

Q: Which of the following pathologies make patients at high risk for acute renal failure? A) Polycystic kidney disease B) Shock C) Uncontrolled diabetes D) Hypertension

Q: The kidney's major function(s) include(s): A) maintaining blood volume. B) balancing electrolytes. C) excreting urea. D) All of the above

Q: What is one of the most common diseases to affect the renal and urinary system? A) Urinary tract infections B) Acute renal failure C) End-stage renal disease D) Kidney stones

Q: You are dispatched to a private residence for a 52-year-old African American male sitting in his living room complaining of chest pain. During your assessment, he discloses that he has the sickle cell trait. Because of this you should: A) administer high-concentration oxygen. B) monitor for signs of inadequate respiration. C) be prepared to treat for shock if he also has a high fever. D) treat the patient as any other 52-year-old with chest pain.

Q: Patients with a history of chronic sickle cell anemia (SCA) may present with which of the following signs and symptoms? A) Bluish discoloration of the skin and shortness of breath B) Yellowing of the skin and dyspnea on exertion C) Flushed appearance and shortness of breath D) Pale appearance and dyspnea on exertion

Q: A patient with a medical history of sickle cell anemia is complaining of chest pain and shortness of breath. The patient is breathing 26 times a minute in short, shallow respirations. However, the patient's oxygen saturation via pulse oximetry is 100% on room air. The best approach regarding supplemental oxygen is to: A) do nothing; no supplemental oxygen is necessary. B) place the patient on a nonrebreather mask. C) place the patient on a nasal cannula. D) place the patient on a simple face mask.

Q: You encounter a patient who has been having diffuse abdominal pain for one week. The patient has a pulse rate of 86, a blood pressure of 140/90, and a respiratory rate of 20. However, the patient appears pale, and complains of generalized weakness and shortness of breath during everyday activities. You suspect the patient is experiencing: A) anxiety disorder. B) chronic anemia. C) sickle cell anemia. D) acute anemia.

Q: Because of abnormally shaped hemoglobin, sickle cell anemia (SCA) patients may occasionally experience ________, causing a blockage of small blood vessels. A) sludging B) aggregation C) clotting D) clumping