Q&A Hero

Q: When submerged in water, biological death may be delayed if the water temperature is below ________F. A) 70 B) 98.6 C) 50 D) 32

Q: You respond to a construction site on a very hot summer day for a person "not acting right." You find a 38-year-old male patient seated in a work vehicle with the air conditioner on maximum. Coworkers state the patient was working for the last 2 hours pouring concrete when he started "speaking gibberish" and nearly collapsed. The patient is responsive to verbal stimuli. Your initial vital signs are blood pressure 90/60, pulse 136, and respiratory rate 24. The patient's skin is cool to the touch and dry but his shirt is wet with visible salt rings. Which is the best treatment for the patient? A) Apply high-concentration oxygen and rapidly transport to the nearest medical facility. B) Have the patient sip water slowly to replace what he has lost. C) Cool the patient with tepid water. D) Have the patient drink at least 1 liter of water to replace what he has lost.

Q: You respond to a construction site on a very hot summer day for a person "not acting right." You find a 44-year-old male patient seated in a work vehicle with the air conditioner on maximum. Coworkers state the patient was working for the last 2 hours pouring concrete when he started "speaking gibberish" and nearly collapsed. The patient is responsive to verbal stimuli. Your initial vital signs are blood pressure 90/60, pulse 136, and respiratory rate 24. The patient's skin is cool to the touch and dry, but his shirt is wet with visible salt rings. You suspect: A) heat cramps. B) hypernatremia. C) heat exhaustion. D) myocardial infarction.

Q: Your patient is a 44-year-old female with a history of alcoholism. She has been walking around at an outdoor fair on a hot, sunny day. She is disoriented to time; has hot, dry skin; and appears to be generally weak. Which of the following is the appropriate sequence of treatment for this patient? A) Have the patient drink an electrolyte solution or sports drink and apply cold packs to her neck, armpits, and groin. B) Get as much ice as possible from the food vendors at the fair, place the patient in a large container of ice, and apply oxygen by nonrebreather mask. C) Give oxygen by nonrebreather mask, have the patient sip a sports drink or electrolyte solution, remove heavy clothing, and place cold packs on her neck, armpits, and groin. D) Give oxygen by nonrebreather mask, remove heavy clothing, and place cold packs on her neck, armpits, and groin.

Q: Heat stroke is caused by which of the following mechanisms? A) Blockage of blood flow to the brain B) Extreme dilation of all the blood vessels C) Failure of temperature regulation mechanisms D) Heat-induced swelling of brain tissue

Q: You respond to a professional volleyball tournament for a potential heatstroke. Upon arrival you find a 28-year-old male patient seated inside the air-conditioned first aid trailer. He is alert and in obvious distress. He is complaining of severe cramping of his arms and legs. His vital signs are stable. What is the most likely cause of the cramping? A) Heat exhaustion B) Drinking too many sports drinks C) Sweating too much D) Cooling off too quickly

Q: Heat cramps occur due to loss of which of the following substances? A) Water B) Salt C) Magnesium D) Water and potassium

Q: Which patient is the highest priority? A) Patient with a Glasgow Coma Scale of 15 B) Patient with a Revised Trauma Score of 12 C) Patient with a penetrating chest injury D) Patient with a broken femur

Q: What are the three elements of the Revised Trauma Score? A) GCS, pulse rate, and respiratory rate B) GCS, systolic blood pressure, and pulse rate C) GCS, systolic blood pressure, and respiratory rate D) Level of consciousness, systolic blood pressure, and pulse rate

Q: According to CDC guidelines, a systolic blood pressure (BP) of less than ________ indicates a patient should be transported to a trauma center. A) 90 B) 100 C) 110 D) 80

Q: You are transporting a stable patient who was involved in a minor fall from a ladder at a height of about 10 feet to a local community hospital. You assumed full spinal precautions not only because the patient has midline back pain in the sacrum, but also because he was knocked unconscious. While transporting, the patient begins to become increasingly confused, develop an irregular respiratory rate, and experience a drop in heart rate with an increase in blood pressure. You just called in a radio report and are about 7 minutes from the hospital. A trauma center is about 10 minutes away. Which of the following is the BEST transport decision? A) Call medical control for advice from the trauma center. B) Divert to the trauma center because the patient is becoming symptomatic. C) Continue transporting to the local hospital because you've already given report and they accepted the patient. D) Continue transporting to the local hospital since it's the closest facility.

Q: You encounter an accident on a busy intercity street while on duty. Calling into dispatch, you make note that the occupants of both vehicles are outside, and you request additional units to proceed non-emergently. You approach an elderly male who is rubbing his back and left shoulder. During secondary assessment of past medical history, you make note of several important details: the patient is on high blood pressure medications, and has had a heart attack in the past. He is complaining of midline thoracic pain on palpation of his spine and left shoulder pain, which may have been from the seat belt, but is refusing care and transport. The patient did not lose consciousness. Based on this information, which transport decision would be most appropriate for this patient? A) Take the patient to a trauma center. B) Allow the patient to sign a refusal. C) Call for ALS intercept. D) Take the patient to a local community hospital.

Q: You respond to a 32-year-old male who fell 20 feet off a ladder. He is responsive to painful stimuli. He has snoring respirations at 20 a minute with decent chest rise and fall. He has a broken femur, a broken wrist, and a lacerated radial artery that is bleeding profusely. Which of these injuries is the highest priority? A) Arterial bleed B) Snoring respirations C) Broken wrist D) Femur fracture

Q: Which of the following is the most significant mechanism of injury for a driver in a vehicle accident? A) Spidering of the windshield B) Encroachment greater than 12 inches of the driver's compartment C) Death of a passenger in the same vehicle D) Rear-end collision

Q: Which of the following choices is NOT a justifiable reason for delaying transport of a critical trauma patient? A) Suctioning the airway B) Awaiting arrival of the patient's parents on-scene C) Ventilating a patient in respiratory distress D) Immobilizing the patient to a long spine board

Q: You are dispatched to a motorcycle crash with one patient involved. What is the most important intervention to perform first? A) Begin chest compressions. B) Manually stabilize the cervical spine. C) Suction the vomit and secretions from the airway. D) Stabilize the pelvis to a long spine board.

Q: Which of the following trauma triage criteria would justify transportation to a trauma center based on mechanism of injury alone? A) Vehicle rollover B) Vehicle crash-generated telemetry data C) Intrusion into the occupant area greater than 8 inches D) Auto versus pedestrian

Q: What criteria based on the CDC guidelines allows a discretionary approach to trauma triage? For example, a patient not meeting ordinary trauma triage criteria may be transported to a trauma center based on what consideration? A) Review of morbidity and mortality B) CDC "No-protocol Protocol" C) "Golden Hour" criteria D) EMS provider judgment

Q: A respiratory rate of less than ________ in infants is a significant finding and indicates a critical patient, who should be immediately transported to a trauma center if secondary to trauma. A) 20 B) 25 C) 18 D) 30

Q: You are dispatched to a motor vehicle crash on a rural mountain highway. You have a patient who was unconscious on arrival, had a seizure, and is currently awake but combative. You suspect he may have a head injury. What is considered the BEST approach regarding transport of this patient? A) Dispatch and await the medical helicopter, which is 20 minutes away. B) Transport to a local community hospital approximately 15 minutes away via ground. C) Begin transport to the trauma center on the ground, which is 1.5 hours' driving time. D) Dispatch the medical helicopter to meet your unit at the community hospital.

Q: What is the BEST option an EMT has when encountering poor BVM compliance when attempting to ventilate a patient? A) Begin chest compressions. B) Place the patient on supplemental oxygen. C) Address ventilation en route to the hospital or ALS intercept. D) Involve two people in the procedure.

Q: You are getting ready to transport an unresponsive 25-year-old female patient. She was hit by a vehicle while crossing the street. She is 26 weeks pregnant. You are 10 minutes away from the nearest facility, 15 minutes away from a Level I Trauma Center, and 15 minutes away from a hospital that specializes in high-risk obstetrics. You should transport the patient to which hospital? A) The nearest facility: she is unresponsive and unstable B) The trauma center: the fetus will need specialized neonatology surgeons C) The trauma center: the patient will need specialized trauma surgeons D) The high-risk obstetric hospital: the fetus will need specialized neonatology surgeons

Q: Which patient is the most unstable? A) Unresponsive patient with hypotension B) Patient who only responds to verbal stimuli C) Unresponsive patient with tachycardia D) Patient responsive to painful stimuli only

Q: What type of trauma triage criteria regarding transport would a finger amputation receive? A) Any hospital, as long as on-line medical direction approves the facility's capabilities B) Any hospital with surgical facilities C) Trauma center D) Patient's choice of destination

Q: Which one of the following patients would justify the need to directly transport to a trauma center based on special patient considerations? A) An end-stage renal disease (ERSD) patient who tripped and fell and is complaining of shoulder pain on the same side as his shunt B) An unlicensed teenage driver who has a pulse rate of 120 after a MVC and a 4 minute EMS response C) A pregnant female in the third trimester who is spotting (showing small amounts of vaginal bleeding) following a low mechanism of injury MVC D) An elderly patient on anticoagulants who slipped out of her wheelchair and is complaining of pelvic pain

Q: Which trauma patient is the most critical? A) Patient with decerebrate posturing B) Patient with a Glasgow Coma Scale of 7 C) Patient with decorticate posturing D) Patient who withdraws to painful stimuli

Q: A respiratory rate of less than ________ and greater than ________ in cases of trauma are criteria for immediate transportation to a trauma center according to the CDC physiologic guidelines. A) 8; 32 B) 10; 29 C) 12; 20 D) 5; 45

Q: You are on the scene of a 50-year-old male who lacerated his arm on a sheet of plate glass. He is pale, diaphoretic, and mumbling incoherently. You have controlled an arterial bleed with direct pressure. His blood pressure is 70/40, pulse 120, and respiratory rate of 28. Which of the following signs is the most concerning? A) Tachycardia B) Altered mental status C) Respiratory rate D) Blood pressure

Q: What is the height from which an adult fall would meet trauma triage criteria set forth by the CDC? A) 10 feet B) 25 feet C) 20 feet D) 15 feet

Q: What is the Glasgow Coma Score (GCS) measurement of altered mental status, which according to CDC guidelines necessitates transport to a trauma center? A) 12 B) 13 C) 8 D) 14

Q: What trauma triage guidelines did the Centers for Disease Control and Prevention (CDC) release in order to guide the most injured patients into trauma centers? A) Teamwork, timing, and transport B) Physiological determinants, anatomic criteria, and mechanism of injury C) Determining patient priority, amount of time on-scene, and hospital transport decision D) Lights, sirens, and diesel

Q: What are some of the most important critical decisions an EMT can make on the scene of a serious trauma? A) Determining patient priority, amount of time on-scene, and hospital transport decision B) Whether to await ALS care on-scene or begin BLS transport C) Load and go versus stay and play D) Physiological determinants, anatomic criteria, and mechanism of injury

Q: Based on the following presentations of patient injuries, which one would be considered MOST severe, justifying immediate transportation to a trauma center? A) Midline cervical spine pain B) Open (compound) midshaft femur fracture C) Closed head injury D) Flail chest

Q: You respond to a 22-year-old male patient who fell while exiting the local bar. Bystanders state he drank at least 10 beers and could not keep his balance. Physical exam reveals that the patient is alert to verbal stimuli only. He has a Glasgow Coma Scale of 3, 4, 6; slurred speech; and an obvious scalp laceration to the back of his head. He is refusing treatment and transport and wants his friends to drive him home. The nearest hospital is 5 minutes away, a Level II Trauma Center is 10 minutes away, and a Level I Full Service Trauma Center is 30 minutes away. Which of these is the most appropriate facility for the patient? A) The nearest community facility B) Level I Trauma Center C) Level II Trauma Center D) Nowhere, since the patient is an adult and refusing; as such, you cannot take him

Q: What are three elements of successful trauma care that field practitioners can use which will ultimately translate into greater rates of survival? A) Teamwork, timing, and transport B) Ground ambulances, air helicopters, and trauma centers C) Lights, sirens, and diesel D) Physiological determinants, anatomic criteria, and mechanism of injury

Q: You are the first on the scene of a two-car vehicle collision. Your patient is a front passenger who is unresponsive inside the vehicle. The patient is trapped and the vehicle is on fire. The fire department is still en route. You should: A) perform an emergency move. B) perform an urgent move. C) use your fire extinguisher to put out the fire. D) have the fire department rescue the patient.

Q: Which one of the following is NOT a key decision for the EMT when faced with a multisystem or multiple trauma patient? A) Should I transport to a trauma center? B) Do I need to minimize on-scene time? C) Should I allow police to interview the patient on-scene? D) Is the patient seriously injured?

Q: You are dispatched to a multiple vehicle collision on a busy interstate highway. Your crew identifies a critical patient entrapped in a small sedan with significant intrusion into the occupant area on the front and left side. One of your crew members, dressed in fully protective gear, volunteers to enter the vehicle to begin assessment and treatment. Given that access to the patient is limited, you tell him to concentrate on assessing which of the following parts of the patient's body? A) Head, posterior torso, and lower extremities B) Head, chest, and upper extremities C) Torso, pelvis, and lower extremities D) Head, chest, and torso

Q: Multiple trauma and multisystem trauma patients are situations in which the EMT is expected to perform which of the following? A) Anticipate and treat problems with a greater level of complexity than usual. B) Provide the best quality care possible, including definitive care on-scene. C) Respond above and beyond the call of duty. D) Practice outside the scope of practice in order to provide the greatest good.

Q: What is the most important intervention an EMT can perform for an unstable multisystem trauma patient? A) Oxygen B) Airway management C) Cervical spine precautions D) Rapid transport

Q: What is the definition of multisystem trauma? A) Multiple injuries that affect more than one body system B) Trauma in which the patient has more than one serious injury C) A trauma in which there are multiple casualties D) A trauma that requires the response of multiple agencies

Q: What is the definition of multiple trauma? A) A trauma in which the patient has more than one serious injury. B) A trauma in which there are multiple casualties. C) A trauma that requires the response of multiple agencies. D) Multiple injuries that affect more than one body system.

Q: Your patient is a 16-year-old male who ran his truck off of the road and into a ditch. He was driving just fast enough to cause the air bag to deploy when he hit the ditch. He is complaining of some neck and shoulder pain. His vital signs are respirations 20, pulse 110, blood pressure 116/80, and pupils equal and reactive. How should you manage this patient? A) Perform a rapid extrication and spinal immobilize him on a long spine board. B) Use a short spine board or vest device, then transfer him to a long spine board. C) Apply a cervical collar, and then rotate him to a long spine board. D) Place him on oxygen, and then slowly move him to the stretcher.

Q: You are called for a young man who was diving head first off a dock into a lake. Bystanders say he struck his head on the bottom because the water was too shallow. They said he was not breathing when they pulled him from the water and they have been performing rescue breathing for him. He is awake, but he is unable to breathe on his own. What type of damage or injury does this indicate? A) Damage to C-3, C-4, or C5 B) Damage to his thoracic spine C) Closed head injury D) Open head injury

Q: Your patient has been injured by a fall down a flight of steps. He is alert and oriented but complains of back and neck pain. You spinal immobilize him on a long spine board with a cervical collar on his neck as a precaution because you know that the: A) cervical spine is the most vulnerable part of the spine. B) lumbar area is rarely injured due to the rib support. C) thoracic spine is especially vulnerable to injury. D) coccyx is easily dislocated.

Q: Your 38-year-old male patient has been injured in an assault. He has several facial lacerations and a large knot on his head. Bystanders say that he was thrown over a large table and landed on his head and shoulder. As part of your scene size-up and primary assessment, you should: A) wait for ALS to treat the patient. B) immobilize his cervical spine. C) splint any other bone or joint injuries. D) complete an initial set of vital signs.

Q: Which of the following may be a hazard of an improperly fitting cervical collar? A) Allows hyperextension of the neck B) Prevents the patient from opening his mouth C) Allows flexion of the neck D) All of the above

Q: Which of the following describes the proper position of the patient's head for spinal immobilization? A) Chin tilted upward for airway maintenance B) Neutral, in-line "eyes forward" position C) Stabilized in position found D) The "sniffing" position

Q: At which point may manual stabilization of the cervical spine be terminated? A) Only when directed to do so by medical control B) When the patient is secured to a long backboard C) After a short immobilization device has been applied D) After a cervical collar has been applied

Q: Which of the following measures is NOT appropriate for a patient with a significant isolated head injury? A) Treat for shock by elevating the foot of the backboard. B) Keep the patient from becoming overheated. C) Try to keep the patient from being agitated. D) Control bleeding from head wounds.

Q: In which of the following circumstances should a helmet be removed? A) If you suspect a skull fracture and need to palpate the head B) If you want to place a nasal cannula on the patient but cannot because his ears are covered by the helmet C) If the helmet interferes with airway management D) If the helmet fits so snugly that you cannot inspect the ears for the presence of blood or fluid

Q: Your patient was ejected from his motorcycle when he struck a deer late at night on a deserted highway. He is drowsy and unable to communicate clearly. As you immobilize him on the long spine board, you find that you are unable to obtain neutral alignment of his spine due to the large helmet he has on. You should: A) pad under his shoulders to straighten his neck. B) tip his head back to gain neutral alignment. C) place towels on either side of the helmet to stabilize it. D) remove the helmet to better manage proper alignment.

Q: What is the first step in a rapid takedown of a standing patient ? A) Applying a properly sized cervical collar B) Positioning a long spine board behind the patient C) Applying oxygen D) Manually stabilize the patient's head and neck

Q: Which of the following is the correct sequence for securing the straps on a long spine board? A) Legs, torso, head B) Head, torso, legs C) Torso, legs, head D) Head, legs, torso

Q: When log-rolling a patient with a suspected spinal injury, which of the following EMTs directs the move? A) EMT at the head of the patient B) EMT with the highest level of training C) EMT with the most seniority D) EMT at the heaviest portion of the patient

Q: Your patient is pregnant at 20 weeks' gestation and has been thrown from a horse. She is complaining of back pain. Which of the following is the correct procedure for immobilizing her spine? A) Use a short immobilization device and transport the patient in a sitting position. B) Place the patient supine on the backboard. C) Place the patient on her left side on the backboard. D) Place the patient supine on the backboard, then put a pillow under the right side of the backboard.

Q: Your patient is a 30-year-old female involved in a motorcycle crash. She was not wearing a helmet and struck her head on the pavement. She is unresponsive and has a blood pressure of 152/110 mmHg. Her pulse is 60 beats per minute and respirations are 8 breaths per minute and shallow. Which of the following is an appropriate intervention? A) Elevate the legs. B) Provide cervical spine immobilization. C) Hyperventilate at a rate of 24 breaths per minute using supplemental oxygen. D) Apply a pressure dressing to her scalp lacerations.

Q: For which of the following patients would the use of a short spine immobilization device be appropriate? A) 52-year-old female who crashed her vehicle into the front of a convenience store and who is awake, oriented, and complaining of neck pain B) Unresponsive driver who was found in the driver's seat of a pickup truck that crashed into a tree C) 15-year-old male who struck a curb with his motorized scooter and flipped over the handlebars D) 77-year-old female who fell down a flight of stairs and is in an awkward position lying on her side on the landing

Q: When using a short spine immobilization device, which part of the body is secured last? A) Arms B) Torso C) Head D) Legs

Q: Your patient is a 38-year-old male driver of a vehicle that left the roadway and struck a bus stop shelter and a tree. He is conscious and alert, he has some abrasions on his forehead, his skin is warm and dry, and he has a strong radial pulse and no difficulty breathing. Which of the following descriptions represents the MOST appropriate way for removing the patient from the vehicle? A) Apply a cervical collar and perform rapid extrication onto a long backboard. B) Have the patient stand up and then do a "standing take-down" onto a long backboard. C) Place the backboard on the stretcher and have the patient stand, turn, and lie down on the backboard while you maintain manual in-line stabilization of the cervical spine. D) Apply a cervical collar and short spine immobilization device before removing to a long backboard.

Q: Which of the following pieces of equipment is acceptable for use in the prehospital stabilization of suspected cervical spine injuries?A) Soft cervical collarsB) Five-pound sand bagsC) Rigid cervical collarsD) 2- 4- wood cribbing

Q: Which of the following may result from the application of a cervical collar that is too large for the patient? A) Rotation of the head and neck B) Hyperflexion of the neck C) Hyperextension of the neck D) Excessive lateral movement of the mandible

Q: Your patient has a suspected cervical spine injury from falling from a rope swing. His vital signs are pulse 62, respirations 20, and blood pressure 90/56. He has no feeling below his mid-chest area but is able to breathe on his own. You should suspect: A) cardiogenic shock. B) hypovolemic shock. C) neurogenic shock. D) psychogenic shock.

Q: Which of the following is the underlying cause of neurogenic shock? A) Blood loss from damaged spinal blood vessels B) Failure of the heart to adequately pump blood C) Extreme emotional response to paralysis D) Dilation of blood vessels

Q: Which of the following is NOT a common field finding in spinal injuries? A) Deformity B) Impaired breathing C) Tenderness D) Pain

Q: In most cases, which of the following is the correct way to provide initial management of a suspected cervical spine injury? A) Hold the patient's head still in a neutral, "eyes forward" position. B) Gently apply pressure to the top of the patient's head. C) Maintain the patient's head and neck in the position they are found. D) Provide approximately 15 pounds of upward cervical traction.

Q: You are treating a 35-year-old male patient that has been involved in a motorcycle incident. The patient is unresponsive with a blood pressure of 60/40, a pulse of 66 beats per minute, and respirations of 18 breaths per minute. The patient's presentation is most likely caused by which of the following? A) Cardiogenic shock B) Septic shock C) Increased intracranial pressure D) Neurogenic shock

Q: A 17-year-old girl was injured when her car was struck from behind while she was stopped at a red light. She is complaining of a headache with neck and back pain. You suspect she has sustained a(n): A) distraction injury. B) compression fracture. C) extension injury. D) whiplash injury.

Q: Your patient is a 10-year-old male whose jacket hood caught on a branch as he jumped out of a tree. He was momentarily suspended about 12 inches off the ground but was immediately lowered to the ground by his brothers. Which of the following injuries should you suspect? A) Cervical spine injury B) Lumbar spine injury C) Soft-tissue injury of the neck only D) Thoracic spine injury

Q: Which of the following observations may the EMT use to rule out a spinal injury in a trauma patient? A) Patient is able to walk at the scene. B) There is a lack of mechanism of injury. C) There is a lack of numbness and paralysis of the extremities. D) Patient denies pain in his spine.

Q: Your patient has had his throat slashed during a robbery attempt. You are concerned since it is apparent that the vessels in his neck have been lacerated. A breach in which of the following vessels would be most likely to lead to an air embolism? A) Capillaries B) Arterioles C) Arteries D) Veins

Q: When a patient has a serious open wound to the neck, you are concerned about the possibility of an air embolism. The reason an air embolism can occur is because of: A) the higher pressure in the vessels of the neck. B) the negative pressure in the chest. C) vessel pressure that is lower than atmospheric pressure. D) damage to the trachea.

Q: Your patient has sustained a serious laceration to his neck. He appears to have lost a lot of blood and you are considering how you will control the bleeding. Your primary treatment should be to place a(n): A) pressure dressing. B) occlusive dressing. C) dry, sterile dressing. D) bulky dressing.

Q: While assessing a patient with a laceration to the neck, the EMT must be aware that which of the following conditions may develop? A) Deep vein thrombosis B) Air embolus C) Air thrombosis D) Deep vein embolus

Q: You are en route to the trauma center with a patient who was injured when he was thrown from a horse. You suspect multiple trauma injuries including a closed head injury. You will monitor his mental status using the Glasgow Coma Scale (GCS) per your protocols. Which of the following will you check? A) Eye-opening, motor response, and verbal response B) Motor response, verbal response, and attentiveness C) Speech patterns, motor patterns, and mental status D) Verbal responses, motor skills, and mental status

Q: Glasgow Coma Scale (GCS) is a neurological assessment that looks at which of the following? A) Eye opening, verbal response, and motor response B) Grip strength, verbal response, and eye opening C) Verbal response, motor response, and AVPU D) Motor response, arm movement, and speech

Q: Which of the following is NOT used to calculate a patient's GCS? A) Eye movement B) Verbal response C) Work of breathing D) Motor response

Q: When should the EMT calculate a GCS with a patient who suffered a fall of 20 feet from his apartment building? A) At the hospital before writing the care report B) En route to the hospital C) As he approaches the patient D) Before departing from the scene

Q: What is the Glasgow Coma Scale (GCS) of your adult male patient who has fallen off a horse, has his eyes open, can follow your commands to squeeze his hands, but is confused about what happened and his whereabouts? A) 12 B) 14 C) 15 D) 13

Q: Your patient is a 27-year-old male who has been involved in a motorcycle collision in which he was not wearing a helmet. He does not respond when you speak to him, but he makes incomprehensible sounds when you press your knuckles on his sternum. Which of the following BEST describes his level of consciousness? A) Alert B) Verbal C) Painful D) Unresponsive