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Q:
As you are assessing a 32-year-old asthmatic woman who has called EMS due to difficulty breathing, her husband enters the home through a back door and shouts, "Get your hands off her; she doesn't need your help. She needs to be taught a lesson about her smart mouth." Which of the following is the best course of action?
A) Attempt to remove the patient from the home and continue treatment en route to the hospital.
B) Continue assessment and respond that the patient is sick and needs medical attention.
C) Leave the scene and patient, then notify police.
D) Let the husband know that his behavior is inappropriate, and if it continues you will call for the police.
Q:
You are on the scene of an explosion at a suspected methamphetamine manufacturing operation. You and your partner are the first to arrive and note two middle-aged men and a woman on the front lawn with burns and cuts on their faces and arms. The fire department is en route. Which of the following resources should be the LEAST important to be requested by the EMT during the scene size-up?
A) Gas company
B) Law enforcement
C) One or two additional ambulances
D) Hazardous material clean-up crew
Q:
Which of the following is true concerning the potential for violence at the scene of an EMS call?
A) An unusual lack of activity at the scene may signal impending violence against the EMT.
B) The chance for violence is very low at emergency scenes.
C) You do not need to worry about violence at an emergency scene once the police have secured it.
D) Signs of impending violence are obvious if you know what to look for.
Q:
You and your partner respond to a residence for a fall. You arrive to find a group of approximately 30 adults surrounding a middle-aged man who appears to be unconscious. A police car pulls in behind you. You should:
A) wait for the police officer to assess the safety of the scene.
B) enter the scene ahead of the police officer to provide care.
C) leave the area and stage until the scene is cleared of people.
D) have the police officer drag the victim over to the ambulance.
Q:
You are on the scene of a tanker truck versus passenger vehicle collision on a rural highway. The vehicles are just beyond a curve in the roadway and there is a distinct odor of diesel fuel. It is dark and there is little traffic. Which of the following should be used to alert oncoming traffic to the situation?
A) Flashing lights on the ambulance
B) Yellow crime scene tape
C) Flares
D) Reflective triangles
Q:
Which of the following is NOT a consideration that should be used by the EMT in establishing the size of the danger zone?
A) Presence of hazardous materials
B) Wind direction
C) Amount of equipment needed
D) Fire
Q:
At the scene of a vehicle collision in which there are no apparent hazards, which of the following guidelines should be followed for establishing a danger zone?A) The danger zone should be 50 feet in all directions.B) The danger zone should be 150 feet in all directions.C) The danger zone should be 15 feet in all directions.D) There is no need to establish a danger zone when there are no apparent hazards.
Q:
As you arrive at the scene of a house fire, a very upset man screams at you to help his young son, who is trapped under a piece of burning wood on the ground. Which of the following should you do first?
A) With the father's help, grab the boy by the arms and pull him from underneath the wood.
B) Size-up the scene before acting.
C) Perform an initial assessment on the patient.
D) Use a blanket to put out the fire on the piece of wood.
Q:
You are called to a motor vehicle collision where the car is on fire. You should ensure safety by:A) borrowing turnout gear from the fire department.B) remaining a safe distance from the car until the fire is out.C) putting your unit back in service and leaving the scene.D) using your fire extinguisher to put out the fire.
Q:
Which of the following situations requires additional action by the EMT during scene size-up?A) A vehicle collision involving a tractor-trailer that appears to be empty.B) The sound of a barking and growling dog upon approaching the door to a residence.C) A bystander who is smoking a cigarette at the scene of an assault at a local park.D) A news media helicopter arrives and hovers overhead at the scene of a vehicle collision.
Q:
At which of the following points should you begin your scene size-up?
A) After exiting the ambulance, but before making patient contact
B) When you arrive on the scene, but before exiting the ambulance
C) As you approach the scene in the ambulance
D) When the patient or family member opens the door to the residence
Q:
At what point is the scene size-up complete?
A) When crashed vehicles have been stabilized
B) At the end of the call
C) Upon stabilization of the c-spine
D) When the number of patients has been determined
Q:
Which of the following is NOT determined in a scene size-up?
A) Chief complaint
B) Mechanism of injury
C) Potential hazards to the EMS crew
D) Need for additional resources
Q:
Concerning the use of humidified oxygen, which of the following is true?
A) It should only be used when assisting ventilations with a bag-valve-mask device.
B) The water in the reservoir should be treated with chlorine tablets to prevent the growth of bacteria.
C) It is not of great benefit during short transports but can make the patient more comfortable.
D) The water reservoir should be changed on a weekly basis.
Q:
Which of the following is necessary to deliver oxygen to patients at a safe pressure?
A) Filter
B) Float ball
C) Regulator
D) Flowmeter
Q:
The safe residual for an oxygen cylinder is ________ psi.
A) 200
B) 300
C) 500
D) 1,000
Q:
Which of the following colors identifies an oxygen cylinder?
A) Orange and red
B) Black and tan
C) Blue and yellow
D) Green and white
Q:
Of the three types of oxygen flowmeters, which one can only be used upright?
A) Bourdon gauge flowmeter
B) Hudson gauge flowmeter
C) Constant flow selector valve
D) Pressure-compensated flowmeter
Q:
Which of the following is acceptable for maintaining a seal between an oxygen cylinder and regulator?
A) Pop-off valve
B) Gasket
C) Grease plug
D) Medical grade adhesive tape
Q:
You are attempting to replace the oxygen cylinder in your truck. After removing the regulator from the old cylinder, removing the old cylinder, and placing the new cylinder in the oxygen compartment, you attempt to connect the regulator. The new cylinder has a yellow stripe around it instead of a green one but was stored with the green cylinders. You are unable to get the regulator to seat properly and it will not turn. You should:
A) attempt to force the regulator onto the cylinder.
B) remove the cylinder and get a green cylinder.
C) replace the oxygen regulator with a new one.
D) put the old cylinder back on the truck.
Q:
Which of the following oxygen cylinders would normally run out after 50 minutes when flowing at 10 liters per minute?
A) M tank
B) D tank
C) G tank
D) E tank
Q:
The oxygen flow rate for a nasal cannula should not exceed ________ liters per minute.
A) 8
B) 4
C) 6
D) 2
Q:
Venturi masks are designed to mix oxygen with:
A) nitrogen.
B) inhaled air.
C) humidified air.
D) carbon monoxide.
Q:
A ________ is NOT typically used in the prehospital setting for oxygen administration.
A) nasal cannula
B) partial rebreather mask
C) regulator
D) tracheostomy mask
Q:
Which of these patients would require a tracheostomy mask for supplemental oxygen administration?
A) A patient with a stoma
B) A patient with quadriplegia
C) A patient with chronic bronchitis
D) A patient with upper airway inflammation
Q:
Before applying a nonrebreather mask, the EMT should take what action?
A) Insert a properly sized oropharyngeal airway.
B) Connect the mask to a humidified oxygen source and wait for the patient's heart rate to slow.
C) Make sure the oxygen supply has greater than 2,000 psi in the tank.
D) Inflate the reservoir bag and make sure the bag does not deflate during inspiration.
Q:
You are transporting a 44-year-old female with chest pain and sudden respiratory distress. She is agitated, anxious, and refuses to have a nonrebreather mask applied. Which of the following is the best option?
A) Use a nasal cannula instead.
B) Have her breathe into a paper bag to control her hyperventilation.
C) Do not make further attempts to administer oxygen as it will only agitate the patient further.
D) Consult with medical control about restraining the patient.
Q:
A nonrebreather mask at 12 to 15 liters per minute will generally provide the patient what percentage of oxygen?
A) 80-100
B) 16-21
C) 24-44
D) 90-100
Q:
Your patient is a 65-year-old male with a history of COPD. He is sitting up and complaining of a severe shortness of breath. You should:
A) suction the airway with a rigid suction catheter.
B) administer 4 lpm of oxygen via nasal cannula.
C) insert a nasal airway and ventilate.
D) apply a nonrebreather mask giving 15 lpm of oxygen.
Q:
Which of the following is the best device to deliver high-concentration oxygen to a breathing patient?
A) Simple face mask
B) Nonrebreather mask
C) Nasal cannula
D) Oropharyngeal airway
Q:
Your patient is a 55-year-old man with a history of chronic bronchitis. You have been called to his home today because of an increase in his level of respiratory distress. The patient is on 2 liters per minute of oxygen by nasal cannula at home. Your assessment reveals difficulty speaking due to shortness of breath, leaning forward to breathe, a productive cough, and a respiratory rate of 32 per minute. Which of the following is true concerning the best course of action for this patient?
A) Because increased blood levels of carbon dioxide are the primary stimulus to breathe, you should encourage the patient to rebreathe his exhaled air from a paper bag.
B) You should increase the patient's oxygen flow rate to deliver adequate amounts of oxygen to his tissues. If his respiratory rate decreases, you can assist him with a bag-valve-mask device.
C) You should increase the patient's oxygen flow rate until his respiratory rate decreases and then resume oxygen administration at 2 liters per minute.
D) You should not increase the patient's oxygen flow rate because of his likely dependence on a hypoxic drive to stimulate breathing.
Q:
What is the percentage of oxygen provided by connecting a high flow of oxygen to the oxygen inlet found on a pocket mask?
A) 50%
B) 21%
C) 100%
D) 16%
Q:
A 21-year-old patient presents with labored breathing and audible wheezes, heart rate of 124, respiration 36; he has significantly altered mentation. What is the treatment for this patient?
A) Supplement the breaths with high-concentration oxygen through a nonrebreather mask.
B) Use a pocket mask, which will provide adequate oxygen to improve the patient's condition.
C) Ventilate with a bag-valve mask with high oxygen or FROPVD.
D) Give mouth-to-mouth breathing with a nasal cannula, providing the patient with an increase of oxygen.
Q:
You and your EMT partner are preparing to ventilate an elderly non-trauma patient who has a stoma. Your partner performs the head-tilt, chin-lift maneuver and you ask him to return the patient's head to a neutral position. "Why? This is not a pediatric patient!" your partner protests. What would you say?
A) Elderly patients should never have their heads tilted back because spinal curvatures are common and can prevent airway positioning.
B) It is not necessary to position the airway of a stoma breather when providing ventilations.
C) Stoma breathers should only have their airways positioned after placement of the ventilation device.
D) Using the head-tilt, chin-lift prior to clearing any mucus plugs from the stoma can cause airway occlusion.
Q:
You are aggressively ventilating an adult patient with a bag-valve mask when you notice that his previously strong pulse is getting weaker. You should:
A) increase the concentration of oxygen.
B) reduce the concentration of oxygen.
C) reduce the volume of the ventilations.
D) begin chest compressions.
Q:
What is NOT one of the basic parts of a bag-valve-mask system?
A) Self-refilling shell
B) Non-jam valve
C) Be nonrebreathing
D) 15/25 respiratory fitting
Q:
What device is used to perform mouth-to-mask ventilation?
A) Pocket face mask
B) Bag-valve mask
C) Stoma
D) Automatic transport ventilator
Q:
You are ventilating an adult patient with a bag-valve mask when you notice that his abdomen is getting bigger. You should:
A) apply cricoid pressure.
B) decrease the flow of oxygen.
C) apply pressure to the abdomen.
D) suction the airway.
Q:
Which of the following patients does NOT require the administration of supplemental oxygen?
A) A 60-year-old woman with a history of chronic obstructive pulmonary disease (COPD) who can speak two or three words at a time without a breath
B) A 6-year-old male with a history of asthma whose breath sounds are silent and who is drowsy
C) A 31-year-old male who is unresponsive due to an overdose of narcotics
D) A 24-year-old woman who is breathing 28 times per minute after being in an argument with her husband
Q:
Your patient is a motorcyclist who was ejected after striking a guard rail. The patient is unresponsive to painful stimuli and is breathing shallowly six to eight times per minute. Which of the following should you do first?
A) Use a bag-valve mask with supplemental oxygen.
B) Perform a rapid trauma assessment.
C) Apply a cervical collar.
D) Apply a nonrebreather mask with an oxygen flow rate of 15 lpm.
Q:
You have arrived at the scene of a call for a "man down." As you enter the residence you note that your patient is a male in his mid-60s who is awake but does not seem to acknowledge your presence. He is perspiring profusely, has cyanosis of his ears and lips, and has rapid, shallow respirations. Which of the following should you do first?
A) Check for a radial pulse.
B) Obtain the patient's medical history.
C) Listen to his lung sounds.
D) Assist ventilations with a bag-valve mask and supplemental oxygen.
Q:
Which of the following BEST describes inadequate breathing?
A) The respiratory rate is slower than normal.
B) The minute volume is less than normal.
C) The minute volume is greater than normal.
D) The respiratory rate is faster than normal.
Q:
When does respiratory distress change to respiratory failure?
A) When the respiratory challenge continues, the systems fail with the demand for oxygen, pupils dilate, and the skin becomes hot and dry.
B) When the respiratory challenge continues, the systems cannot keep up with the demand, and skin color and mental status change.
C) When the patient who is short of breath, with noisy respiration, presents in the tripod position but then suddenly has the condition clear up and return to normal.
D) When the compensatory mechanism is no longer needed and the patient goes into arrest.
Q:
A 16-year-old patient presents with labored breathing and increased respiratory rate, increased heart rate, and leaning forward with his hands on his knees. His skin is pink and his accurate pulse oximetry is 96. This patient is suffering from respiratory:
A) failure.
B) hypoxia.
C) distress.
D) arrest.
Q:
What is the relatively rare condition that can cause respiratory depression?
A) Lungs can react unfavorably to oxygen when the concentration is too high for a long period of time and this can depress breathing.
B) Chronic obstructive pulmonary disease (COPD) has changed the stimulus to breathe to the hypoxic drive and high concentration can depress breathing.
C) High concentration of oxygen can depress breathing when the patient has an allergic reaction from the oxygen.
D) The eyes can develop scar tissue on the retina from a high concentration of oxygen.
Q:
The movement of oxygen and carbon dioxide across the cell membranes from the capillaries is called:
A) external respiration.
B) dehydration.
C) internal respiration.
D) oxygenation.
Q:
Why does a patient involved in an auto crash who has major internal abdominal bleeding require oxygen to maintain internal respiration?
A) The red blood cells have a reduction of hemoglobin that reduces the amount of oxygen that can be transported.
B) A lack of oxygen in the air decreases the oxygen diffused into the bloodstream, which creates an increase of carbon dioxide.
C) The swelling of the abdominal space causes the diaphragm to be restricted, which will reduce the thorax space.
D) A lack of circulating volume decreases the oxygen and carbon dioxide transport capability.
Q:
The movement of oxygen and carbon dioxide between the alveoli and circulating blood is called:
A) internal respiration.
B) osmosis.
C) cellular respiration.
D) pulmonary (external) respiration.
Q:
Which of the following statements BEST describes the exchange of gas in the alveoli?
A) Blood moves by way of the pulmonary capillaries, air arrives at the alveoli, and osmosis occurs.
B) Blood moves from the left heart to the lungs, air arrives in the alveoli sacks, and diffusion occurs.
C) Air moves into the airway, blood arrives via the pulmonary veins, and osmosis occurs.
D) Air moves into the alveoli, blood is transported by the pulmonary capillaries, and diffusion occurs.
Q:
To calculate the minute volume, you need to multiply what two measurements?
A) Tidal volume and respiratory rate
B) Alveolar ventilation and respiratory rate
C) Respiratory rate and bronchial dilation
D) Tidal volume and dead space air
Q:
Which of the following describes why fast respiration may decrease minute volume?
A) The lungs may not have the time to fill and exchange gas.
B) The rate causes turbulence in the trachea that increases the friction and decreases the amount of air movement.
C) It is due to the delay in the movement of the intercostal muscles and the pleural space.
D) The rate does not decrease minute volume; it actually increases.
Q:
The normal stimulus to breathe is stimulated by the chemoreceptors that measure the change of what two gases?
A) Low hydrogen and high carbon monoxide
B) High carbon monoxide and low oxygen
C) High hydrogen and low carbon dioxide
D) High carbon dioxide and low oxygen
Q:
The process of air moving in and out of the chest is called:
A) tidal volume.
B) inhalation.
C) respiration.
D) ventilation.
Q:
Why is inhalation described as an active process?
A) It requires the diaphragm to relax and use energy to move, creating a positive pressure.
B) It requires chest muscles to relax and use energy to move, creating a positive pressure.
C) It requires chest muscles to contract and use energy to move, creating a negative pressure.
D) It uses oxygen to assist chest muscles to contract, creating a negative pressure.
Q:
In assessing a patient's breathing, what is your first question?
A) Is he breathing?
B) Is he alive or dead?
C) Is his breathing adequate or inadequate?
D) Is he big sick or little sick?
Q:
What signs and symptoms would indicate inadequate breathing in a patient?
A) Increased effort to breathe, increased depth of respiration, pink dry skin, normal mental status
B) Rapid breathing, pale skin, and a normal mental status
C) Decreased depth of respiration, decreased rate of breathing, hot clammy skin, normal mental status
D) Increased effort to breathe, cyanosis, cool clammy skin, altered mental status
Q:
What are the signs of hypoxia?
A) Warm dry skin, with difficulty in breathing, and hypertension
B) Commonly seen as blue or gray skin, deterioration of patient's mental status like confusion or restlessness
C) Disease process that robs the patient of adequate breathing and perfusion
D) Shock caused from the lack of blood flowing to the vital organs like the brain and heart that is irreversible
Q:
For life to be maintained, a balance of oxygen and carbon dioxide is needed. The condition when oxygen levels are low is called:
A) hypotension.
B) hypercarbia.
C) hyperventilation.
D) hypoxia.
Q:
You are ventilating an 85-year-old male without difficulty. A nurse tells you that the patient has dentures. To ensure a good mask seal, you should:
A) tape the dentures in place.
B) remove the dentures.
C) leave the dentures in place.
D) use an infant mask over the nose.
Q:
You have performed a head tilt-chin lift maneuver on a 17-month-old boy and are attempting to ventilate him with a bag-valve mask. You are experiencing a lot of resistance with each breath and the chest is barely rising. Prior to attempting ventilations again, you should:
A) finger sweep the airway.
B) tilt the head back further.
C) perform chest thrusts.
D) ease the head forward a little.
Q:
Which of the following should be kept in mind when assessing and managing the airway of a pediatric patient?
A) The trachea is easily obstructed by swelling.
B) The tongue is not as likely to obstruct the airway as in an adult.
C) Due to their short necks, pediatric patients require a greater degree of hyperextension to open the airway than do adults.
D) Gastric distention is unlikely.
Q:
Which of the following is the correct method of suctioning?
A) Suction intermittently, both while inserting and withdrawing the suction tip or catheter.
B) Insert the catheter or tip to the desired depth prior to applying suction.
C) Begin suctioning as you insert the suction tip or catheter into the mouth.
D) Suction continuously, both while inserting and withdrawing the suction tip or catheter.
Q:
Which of the following is true concerning the procedure for inserting a nasopharyngeal airway (NPA)?
A) The bevel should be turned toward the nasal septum.
B) If a water-soluble lubricant is not available, a silicon spray can be substituted.
C) It can only be placed in the right nostril.
D) The length of the device is not as important as it is with oropharyngeal airways.
Q:
When inserting an oropharyngeal airway, how many degrees do you need to rotate the airway so the tip is pointing down into the patient's pharynx?
A) 45
B) 90
C) 180
D) 270
Q:
When suctioning the airway, suction should never be applied for longer than ________ seconds.
A) 10
B) 30
C) 45
D) 60
Q:
You are ventilating a cardiac arrest patient when he begins to vomit copious amounts of large pieces of undigested food. Which of the following would be most effective in clearing the airway?
A) Using a rigid pharyngeal suction tip
B) Irrigating the mouth with sterile water to dilute the material before suctioning
C) Using a 14 French suction catheter
D) Using large bore suction tubing without a tip or catheter attached
Q:
To be effective, a suction unit must be able to generate air flow of ________ liters per minute and create a vacuum of ________ mmHg.
A) 300; 30
B) 30; 30
C) 300; 330
D) 30; 300
Q:
On which of the following types of calls should you bring your portable suction unit to the patient's side upon arrival on the scene?
A) Motor vehicle collision
B) Cardiac arrest
C) Seizure
D) All of the above
Q:
Which of the following is an advantage of using a nasopharyngeal airway (NPA)?
A) It eliminates the need for manual positioning of the patient's head to keep the airway open.
B) It is ideal for patients with a suspected skull fracture.
C) It may be tolerated by many patients with a gag reflex.
D) All of the above
Q:
Which of the following is a disadvantage of oropharyngeal airways (OPAs)?
A) They cannot be used in patients with a suspected skull fracture.
B) They do not come in pediatric sizes.
C) They require the use of a water-soluble lubricant.
D) They cannot be used in a patient with a gag reflex.
Q:
The jaw-thrust maneuver is the only ________ airway procedure for an unconscious patient with possible head, neck, or spine injury or unknown mechanism of injury.
A) recommended
B) required
C) prohibited
D) forbidden
Q:
Which of the following patients should NOT have their airway opened using a head-tilt, chin-lift maneuver?
A) A 35-year-old diabetic woman who is in the driver's seat of the car in her driveway, who becomes unresponsive while speaking to her husband.
B) A homeless person of undetermined age found lying unresponsive in an alley with no bystanders.
C) A 50-year-old woman who choked on a piece of food while dining in a restaurant and was lowered to the floor by a waiter.
D) A 25-year-old man who is still unresponsive after a grand mal seizure.
Q:
Which of the following is a sign of an inadequate airway?
A) Regular chest movements
B) Nasal flaring
C) Equal expansion of both sides of the chest when patient inhales
D) Typical skin coloration
Q:
Your patient is breathing 4 shallow breaths per minute due to overdosing on his pain medication but he has a palpable radial pulse. He vomited prior to your arrival and is choking. You should:
A) insert an oropharyngeal airway and ventilate.
B) roll him over onto his side to clear the airway.
C) perform chest thrusts to clear the lungs.
D) move the patient to the ambulance and suction.
Q:
What is the sound of the soft tissue of the upper airway creating impedance or partial obstruction to the flow of air?
A) Stridor
B) Hoarseness
C) Snoring
D) Gurgling
Q:
Perhaps the simplest way to determine if a patient has a patent airway is to:
A) say "hello."
B) check for adequate chest rise.
C) determine a respiratory rate.
D) auscultate for breath sounds.
Q:
All of the following can result in airway obstructions, except:
A) burns.
B) infections.
C) the tongue.
D) facial trauma.
Q:
What is the danger that an altered mental status can pose to a patient's breathing?
A) Depressed alveolar function
B) Loss of muscle tone and airway collapse
C) Bronchospasms
D) Hyperoxia
Q:
Which of the following structures is found in the lower airway?
A) Bronchi
B) Uvula
C) Pharynx
D) Tonsils
Q:
The trachea branches off at the ________ and forms two mainstem bronchi.
A) bronchioles
B) pleura
C) alveoli
D) carina