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Quiz Session - Attempts With Random Questions

IBSC CCP-C Exam Questions

Page 4 of 20

61.

Which of the following is the accrediting body for medical transport systems?

  • CAMTS

  • CAAHEP

  • JCAHO

  • AAMS

Correct Answer: CAMTS

CAMTS, or the Commission for Accreditation of Medical Transport Systems, began in 1990 and is the premier accreditation body for the aeromedical industry. CAMTS works to ensure the safety of patients and crew members are at the forefront of all air medical transport companies. 

CAAHEP is the Commission on Accreditation of Allied Health Education Programs and is the accrediting body of several medical education programs, such as paramedic programs. 

JCAHO is the Joint Commission on Accreditation of Healthcare Organizations. JCAHO excels in the accreditation of hospitals. 

AAMS is the Association of Air Medical Services and promotes a culture of safety in the field of transport medicine. 

62.

While transporting a patient on an Intra-Aortic Balloon Pump (IABP), the sensors detect changes in gas levels and prompt refilling when required. What gas fills the gas lumen of the IABP?

  • Helium

  • Nitrogen

  • Nitrous oxide

  • Oxygen

Correct answer: Helium

The Intra-Aortic Balloon Pump (IABP) is filled with helium. Volume sensors detect the changes in helium and prompt automatic refilling when necessary. Prior to the automation of the IABP, the management of helium was controlled by the flight transport team every 2,000 feet on ascent and every 1,000 feet on descent. 

Nitrogen, nitrous oxide, and oxygen are not used in an IABP. 

63.

A two-year-old male was found, by police, lying down under a tree in 44° weather. The child had been reported missing by his parents four hours prior. The child presents with an altered mental status, lethargy, an absence of shivering, and a core temperature of 84°. What stage of hypothermia is the patient experiencing?

  • Moderate stage

  • Mild stage

  • Minor stage

  • Severe stage

Correct answer: Moderate stage

Successful management of the hypothermic pediatric patient depends on the stage of hypothermia. Moderate stage hypothermia has a core temperature of 82°-90°. Clinical signs and symptoms of moderate hypothermia are absence of shivering, altered mental status, irrational behaviors, decreased heat production, slurred speech, vasodilation, hypovolemia, decreased cerebral blood flow, extravasation of fluids, decreasing blood pressure, respiratory depression, and diuresis. 

Mild stage hypothermia has a core temperature of 90°-95°. Signs and symptoms of mild stage hypothermia are mild tachycardia, shivering, cyanosis, pallor, vasoconstriction, delayed capillary refill, increased metabolism, and conscious. 

Severe stage hypothermia has a core temperature of below 82°. Clinical signs and symptoms are unconsciousness; absence of shivering; vasodilation; decreased heart rate, stroke volume, and cardiac conduction; slowed nerve conduction; muscle rigidity; fixed and/or dilated pupils; and cardiac dysrhythmias. 

There is no minor stage of hypothermia. 

64.

You are transferring a 28-year-old female post-motorcycle accident. The patient has a closed, mid-shaft right femur fracture and fractured left humerus. While en route to the receiving facility, the patient complains of pain in her right leg with each bump of the ambulance and describes a deep, burning sensation in her leg that is worsening by the minute. 

You should suspect:

  • Compartment syndrome

  • Deep vein thrombosis

  • Crush injury

  • Rhabdomyolysis

Correct answer: Compartment syndrome

Long bone fractures are a common cause of compartment syndrome. Compartment syndrome occurs when the internal pressure increases from bleeding, inflammation, or fluid accumulation, then compresses vessels and causes muscle breakdown. Signs and symptoms of compartment syndrome are deep, burning pain; extreme pain associated with passive movement; pallor; cool skin; and weak or absent distal pulses. 

Deep Vein Thrombosis (DVT) is caused by a blood clot in the leg and doesn't occur immediately following an injury. A DVT can occur secondary to a fracture, but this is not the case. 

A crush injury occurs from a crushing force for a prolonged time. 

Rhabdomyolysis occurs from muscle breakdown and not immediately following a fracture. 

65.

You are dispatched to the scene of a car versus truck accident on the highway. Upon your arrival at the scene, you find a tanker truck on its side with thick, white smoke billowing out of the trailer. You are unable to visualize any placards. The truck driver is lying prone approximately 30 feet on the backside of the truck. 

You should do which of the following?

  • Park uphill and upwind and stage back until haz-mat arrives

  • Rapidly remove the driver from the scene to your ambulance

  • Proceed as normal, as white smoke is not harmful

  • Call the company of the wrecked truck and inform them of the accident

Correct answer: Park uphill and upwind and stage back until haz-mat arrives

The white smoke can most definitely be harmful, and you should not proceed on to the scene without knowledge of what the truck was hauling, proper protection, and haz-mat training. It is recommended to park your ambulance uphill and upwind and stage back until trained help arrives. 

Do not step on the scene to remove the driver until the scene has been deemed safe. You must protect yourself first and your partner second. You are no good to the patient if you are harmed by the fumes. 

Unless you can visualize the truck's placards and/or know exactly what the truck was hauling, you cannot assume the white smoke is harmless. Do not take chances. 

Your first action is not to contact the truck's company. This can be done after the scene is assessed and cleared and the patient is treated and transported. 

66.

You are treating a 68-year-old female in your ED with a five-hour history of chest pain radiating to her left arm. Her ECG reveals no ST elevation. Initial blood work shows a slightly elevated troponin I level. 

Which of the following is true about the interpretation of her troponin levels regarding an NSTEMI?

  • Serial measurements of troponin levels are necessary to distinguish NSTEMI from other causes of elevated troponin

  • A single elevated troponin level is sufficient for a definitive diagnosis of NSTEMI

  • Elevated troponin levels alone can rule out other conditions such as myocarditis or pulmonary embolism

  • Troponin levels typically return to normal within 24 hours after an NSTEMI

Correct answer: Serial measurements of troponin levels are necessary to distinguish NSTEMI from other causes of elevated troponin. 

Troponin is a key biomarker used in the diagnosis of myocardial infarction, including NSTEMI. In this case, serial troponin measurements would help confirm the diagnosis of NSTEMI and rule out other potential causes of troponin elevation. Proper interpretation of troponin levels in conjunction with clinical presentation, ECG changes, and other diagnostic findings is essential for effective patient care.

A single elevated troponin level is not sufficient for a definitive diagnosis. It must be interpreted in the context of clinical presentation and serial changes in troponin levels. 

Elevated troponin levels can be seen in a variety of conditions, including myocarditis, pulmonary embolism, and other forms of cardiac or systemic stress. Clinical correlation and additional diagnostic testing are necessary to differentiate these conditions. 

Troponin levels can remain elevated for several days after an NSTEMI, often for seven to fourteen days, depending on the extent of myocardial damage and the specific troponin assay used.

67.

You are treating a 22-year-old male patient from a motorcycle wreck with a right femur fracture. The patient is complaining of extreme, burning pain in his right leg. The patient screams with every subtle movement. The patient has absent pedal pulses in the right leg. 

You should suspect which of the following?

  • Compartment syndrome

  • Crush syndrome

  • Deep vein thrombosis

  • Normal femur fracture symptoms

Correct answer: Compartment syndrome

Compartment syndrome occurs with increased pressure within the compartment space of an extremity or other area of the body from bleeding, fluid accumulation, swelling, or external sources. 

Crush syndrome occurs after the compression of a body part or larger part of the body for four or more hours. 

A deep vein thrombosis is a blood clot in the leg. It is not an acute issue from a fracture. 

These symptoms are not normal for a femur fracture. The extreme pain with passive movement is a hallmark sign of compartment syndrome. 

68.

A 40-year-old female presents to the emergency department with continuous seizure activity lasting more than 30 minutes. She has no history of epilepsy. 

Which of the following is the most appropriate initial pharmacological treatment for her condition?

  • Lorazepam

  • Diazepam

  • Levetiracetam

  • Phenytoin

Correct answer: Lorazepam

Benzodiazepines are the first-line agents for the initial treatment of status epilepticus due to their rapid onset of action and effectiveness in terminating seizures. Lorazepam is preferred in many guidelines due to its longer duration of action compared to diazepam, making it effective in maintaining seizure control until definitive treatment can be initiated.

Diazepam is also effective and commonly used but has a shorter duration of action compared to lorazepam. It may be used if lorazepam is not available. 

Levetiracetam has a role in seizure management but is typically used after benzodiazepines and phenytoin in the treatment algorithm for status epilepticus. 

Phenytoin is a second-line agent used for ongoing seizure control but is not recommended as the initial treatment in status epilepticus due to its slower onset of action.

69.

You are treating a 44-year-old male who was stabbed multiple times in the neck, face, and arms with a large steak knife. The patient is complaining of difficulty breathing and has two large puncture wounds to the anterior neck with bubbles noted coming from both wounds. You also note several puncture wounds to bilateral forearms with significant bleeding. 

What should you do?

  • Apply an occlusive dressing to the neck

  • Apply a tourniquet to bilateral arms proximal to the wounds

  • Apply high-flow oxygen via a non-rebreather

  • Apply a trauma dressing to the neck and administer oxygen

Correct answer: Apply an occlusive dressing to the neck

When assessing the trauma patient, it is important to first assess for life or limb-threatening issues. In this patient, there are multiple injuries and all appear critical. The first step in treating this patient is to address the airway issue with the injuries to the neck allowing air to escape. Immediately apply an occlusive dressing to the neck wounds and then continue with the primary assessment. The first step is to apply the occlusive dressing because of the escaping air. 

At this time, tourniquets are not indicated in the forearm injuries. 

Oxygen may certainly be warranted in this patient, but the first step is to apply the occlusive dressing. A trauma dressing is not indicated in this patient as it will not prevent air from escaping. 

A trauma dressing may be used for the foream injuries. 

70.

You are working in the ED when a 35-year-old male patient is brought in after being found unconscious outside in cold weather. The patient's body temperature is measured at 32°C (89.6°F). Upon assessment, the patient is shivering and has altered mental status.

Based on the body's response to hypothermia, which of the following statements is most accurate?

  • Peripheral vasoconstriction is a protective mechanism in hypothermic patients to conserve heat and maintain core temperature

  • Shivering ceases once the body temperature drops below 30°C (86°F) due to the depletion of glycogen stores

  • Bradycardia and hypotension are common findings in hypothermic patients due to decreased sympathetic nervous system activity

  • Hypothermia causes an increase in metabolic rate and oxygen consumption to maintain core body temperature

Correct answer: Peripheral vasoconstriction is a protective mechanism in hypothermic patients to conserve heat and maintain core temperature

Peripheral vasoconstriction is a physiological response to hypothermia aimed at conserving heat and maintaining core body temperature. This mechanism reduces blood flow to the skin and extremities, redirecting blood flow to vital organs to prevent further heat loss. 

Shivering is an involuntary response to hypothermia that generates heat through muscular activity. 

Bradycardia and hypotension are common findings in severe hypothermia due to decreased metabolic rate and sympathetic nervous system activity, which serve to conserve energy and oxygen consumption. 

Hypothermia decreases metabolic rate and oxygen consumption to preserve energy and minimize heat loss rather than increasing metabolic rate as seen in hyperthermia. 

Therefore, peripheral vasoconstriction is the most accurate statement regarding the physiological response to hypothermia.

71.

You are completing an interfacility transfer of a 37-year-old cardiac patient. Per requirement, you must obtain the form required by insurers for reimbursement. This form must be signed and represent the patient's condition at the time of transport. Which of the following is the correct name of the form?

  • Physician Certification Statement

  • History and Physical

  • Physician Specialty Notes

  • Transport Certification Statement

Correct answer: Physician Certification Statement

The Physician Certification Statement, also known as the medical necessity certification statement, is required on all inter-facility transfers. The form provides the reason for transfer, the transfer risks, the treatment and monitoring required by the patient, and the patient's condition at the time of transport. 

The History and Physical (H&P) accompanies all patient paperwork and provides a detailed record of the patient's medical history and current physical status. The H&P is not required for reimbursement and provides valuable information to the healthcare team during transport. 

Physician Specialty Notes are an objective resource that can be used by the critical care transport paramedic to help guide patient assessment. 

Transport Certification Statement is a fictional term. 

72.

A 6-year-old male is experiencing a severe asthma attack. The patient's father states the patient has progressively gotten worse over the past three hours. He states the patient's albuterol inhaler didn't seem to work. You have administered two rounds of albuterol and ipratropium without significant improvement. The patient's pulse oximetry has gone from 92% to 84%, and his end-tidal CO2 is increasing. Vital signs are P 141, R 35, BP 110/72. 

What is your next step?

  • Administer epinephrine IM

  • Assist ventilations with a bag-mask device

  • Administer a third dose of inhaled albuterol

  • Perform rapid sequence intubation

Correct answer: Administer epinephrine IM

The patient is not responding to the albuterol and ipratropium treatments. The next best step is to increase bronchodilation by administering IntraMuscular (IM) epinephrine. 

Assisting ventilations with a bag-mas device is not recommended for this patient, as he is still breathing and awake.  

Albuterol has already proved ineffective, so there is no need for a third administration. 

Intubation should be avoided in asthma patients until it there is no other treatment available. 

73.

You are treating a 21-year-old female injured in an ATV accident. The patient is complaining of severe abdominal pain. Her abdomen is bruised all over, distended, and tender on palpation. You are performing a FAST exam to look for intra-abdominal bleeding. 

Where should the transducer be placed to visualize Morrison's pouch?

  • Midaxillary line over the 7th-11th ribs on the right side

  • Midaxillary line over the 2nd-8th ribs on the right side

  • Midclavicular line over the 6th-12th ribs on the left side

  • Midclavicular line over the 11th-13th ribs on the left side

Correct answer: Midaxillary line over the 7th-11th ribs on the right side

The Focused Abdominal Sonography in Trauma (FAST) exam has become a standard of care for trauma resuscitation in many trauma centers and critical care transport units. Morrison's pouch is a common space for blood to collect from an injured abdominal organ. It can be found by placing the ultrasound transducer midaxillary line over the 7th-11th ribs on the right side. This view will reveal the liver, kidney, and right leaf of the diaphragm. 

The other answer options are incorrect.

74.

You are treating a 68-year-old male with end-stage kidney disease. The patient is exhibiting a decline in mental status over the last couple of days. The patient is lethargic and confused. Vital signs are P 44, R 24, BP 88/62. The ECG shows wide QRS complexes and tented T-waves. You suspect which of the following?

  • Hyperkalemia

  • Hypokalemia

  • Hypernatremia

  • Low ammonia

Correct answer: Hyperkalemia

Widened QRS complexes and tented T-waves are indicative of hyperkalemia. Hyperkalemia is common in patients with end-stage kidney failure. Altered mental status is also a symptom of hyperkalemia.

Hypokalemia presents on the ECG with a decrease in T wave amplitude. 

Patients with end-stage kidney disease often present with hypernatremia. Hypernatremia can present with a shortened PR interval and depressed ST segments on the ECG. 

Ammonia levels are governed by the liver and not the kidneys. 

75.

You determine that your 54-year-old male patient is a difficult airway patient. You are providing bag-mask ventilations with 100% oxygen and cannot maintain pulse oximetry above 90%. What is your next step? 

  • Begin the failed airway algorithm

  • Consider Blind Nasotracheal Intubation (BNTI)

  • Perform a surgical cricothyrotomy

  • Continue manual ventilations until SpO2 rises above 90%

Correct answer: Begin the failed airway algorithm

The Failed Airway algorithm is activated when you are unable to effectively oxygenate and ventilate your patient during attempts at airway management. According to the Difficult Airway algorithm, if the clinician is unable to maintain SpO2 at or above 90% with bag-mask ventilation, then the next step is to enact the Failed Airway algorithm. 

According to the Failed Airway algorithm, the clinician should consider BNTI if the clinician can successfully maintain SpO2 at or above 90% with bag-mask ventilation. 

A surgical cricothyrotomy is performed when standard means of airway management are unsuccessful. This occurs in the Failed Airway algorithm when the clinician is unable to place a supraglottic airway. 

It is not recommended in the Difficult or Failed Airway algorithms to continue bag-mask ventilations until SpO2 possibly rises at or above 90%. 

76.

A 30-year-old pregnant woman at 42 weeks gestation presents with severe headache, visual disturbances, and generalized tonic-clonic seizures lasting two minutes. She is now unconscious and exhibiting signs of hypoxia, with an oxygen saturation of 85%. 

Which of the following is the most appropriate initial management for this patient?

  • Intubate and mechanically ventilate

  • Administer magnesium sulfate

  • Administer labetalol to control blood pressure

  • Initiate an immediate cesarean section

Correct answer: Intubate and mechanically ventilate

If the patient is unconscious and hypoxic (O2 saturation of 85%), securing the airway through intubation and providing mechanical ventilation is the most immediate and critical step. While other treatments are also necessary, addressing hypoxia takes priority, as it directly impacts both maternal and fetal survival.

Magnesium sulfate is the treatment of choice for seizure control in eclampsia. It should be administered as soon as possible, but in the setting of acute hypoxia and unconsciousness, airway management takes precedence. 

Controlling blood pressure is important in managing preeclampsia and eclampsia. However, in the context of acute hypoxia and seizures, it is not the immediate priority. 

Delivery is the definitive treatment for preeclampsia and eclampsia. However, it is not the first step in the acute management of an unstable, hypoxic patient. Stabilizing the mother takes precedence.

77.

You are treating a 17-year-old male patient who was bit on the right ankle by a pit viper snake. The patient's lower right leg is severely swollen and red, and the patient rates his pain a 8/10. The patient is diaphoretic and nauseated. Which of the following is indicated in the treatment of this patient?

  • Crofab

  • Anascorp

  • Amyl nitrate

  • Mucomyst

Correct answer: Crofab

Pit vipers are members of the Crotalidae family and are common throughout the United States and Canada. Characterized by a pit midway between their eye and nostril bilaterally, pit viper bites present with one or two puncture wounds, localized swelling, edema, and pain. Patients may also exhibit chills, diaphoresis, paresthesias, nausea, hypotension, faintness, weakness, muscle fasciculations, and coagulopathies. CROtalidae polyvalent immune FAB (Crofab) is the antivenin of choice for pit viper bites. 

Anascorp is for scorpion stings, amyl nitrate is for cyanide poisoning, and Mucomyst is for acetaminophen overdose.

78.

According to OSHA regulations, hearing protection is required for employees exposed to average noise levels of 85 dB or greater. What is the average sound level produced by a running helicopter?

  • 90-100 dB

  • 150-200 dB

  • 75-85 dB

  • 120-140 dB

Correct answer: 90-100 dB

Hearing protection must be provided to employees if the average noise levels are 85 dB or greater. Because the average noise level of a running helicopter is 90-100 dB, HEMS employers are required to provide hearing protection. Hearing protection includes ear plugs, ear muffs, and flight helmets.

The other answer options are incorrect.

79.

You are treating a 68-year-old female who complains of abdominal cramping, nausea, and diarrhea. The patient has a history of NIDDM and renal failure. The patient's serum potassium level is 7.1 mEq/L. Which of the following ECG changes would you expect to find? 

  • Widened QRS complex

  • Shortened QT interval

  • Peaked T waves

  • Widened QT interval

Correct answer: Widened QRS complex

The patient is obviously hyperkalemic with a serum potassium of 7.1 mEq/L. In patients with potassium over 7.0 mEq/L, it is common to see widened QRS complexes and prolonged PR intervals on the ECG. The increase in potassium primarily affects repolarization. 

A shortened QT interval and peaked T waves are indicative of increased potassium in the range of 5.5 mEq/L - 6.5 mEq/L. 

A widened QT interval is not associated with hyperkalemia. 

80.

You are transporting a pregnant 19-year-old female from a two-vehicle MVC. The patient has full spinal precautions taken. The patient is complaining of neck pain and right leg pain. Vital signs are BP 148/90, P 101, R 16. Approximately 10 minutes from the hospital, the patient becomes confused, and her pulse rate increases. Her blood pressure is now 101/64. 

You should do which of the following?

  • Tilt the spineboard to the left

  • Administer a 500 mL fluid bolus

  • Elevate the foot of the stretcher

  • Administer 15 lpm oxygen via NRB

Correct answer: Tilt the spineboard to the left

The patient is exhibiting symptoms of supine hypotensive syndrome. By lying supine, there is pressure on the inferior vena cava reducing venous return from the lower extremities causing hypotension. The recommendation is to tilt the spineboard to the left to reduce the pressure. 

Administering a fluid bolus and oxygen may be required in this patient after tilting the spineboard to the left, but it is not the first step. 

It is not recommended to elevate the legs, as research shows this does not improve the blood pressure in pregnant and non-pregnant patients. 

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