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Quiz Session - Attempts With Random Questions

NREMT AEMT Exam Questions

Page 10 of 45

181.

Which of the following actions can prevent gastric distention while providing artificial ventilations with a bag mask device? 

Select the three answer choices that are correct.

  • Only squeeze the bag long enough to see visible chest rise 

  • Reposition the airway as needed

  • Limit ventilation times to 1 second or less 

  • Place an oral airway 

  • Place the patient on their left side

Any form of artificial ventilation that does not blow air directly into the trachea may result in gastric distention, which can cause aspiration and interfere with lung expansion. Actions that can limit the risk of gastric distention include:

  • Limit ventilation times to one second or less
  • Ventilating only until visible chest rise is seen
  • Reposition the airway as needed
  • Placement of an advanced airway that will isolate the trachea

An oral airway helps keep the airway open, but does not prevent gastric distention. You would not place a patient on their side while performing ventilations. If prolonged ventilations are anticipated placement of an advanced airway should be performed as soon as possible. 

182.

Which of the following can be an indication of jugular venous distension?

  • Right-sided heart failure

  • Hypovolemia

  • Closed pneumothorax

  • Liver disease

Correct answer: Right-sided heart failure

Jugular Venous Distension (JVD) should be measured while the patient is sitting at a 45-degree angle; however, in certain conditions, it may be seen in other positions. JVD can be an indication of a tension pneumothorax, right-sided heart failure, volume overload, or cardiac tamponade. Lack of visible JVD in a supine position, combined with other signs (e.g., tachycardia, thready pulses, altered mental status, and generalized pallor), may indicate hypovolemia.

183.

FDA drug category X classification for use in pregnant women suggests which of the following?

  • Use is contraindicated.

  • Risk outweighs benefits.

  • Benefit may outweigh risk in life-threatening situations.

  • Drug should be given only if benefit outweighs risk.

Correct answer: Use is contraindicated.

Studies in animals or humans have demonstrated fetal abnormalities, and/or there is evidence of fetal risk based on human experience, and the risk of using the drug during pregnancy clearly outweighs any possible benefit. 

The drug is contraindicated in women who are or may become pregnant.

184.

You are called to a single-family residence for a pediatric patient with shortness of breath. According to the patient’s guardians, the patient has a high fever, a barking cough, and stridor. What condition do you expect?

  • Croup 

  • Epiglottitis 

  • Pertussis 

  • Pneumonia 

Correct answer: Croup

Croup is a condition that is seen in pediatric patients. Croup can be a bacterial or viral condition. Patients with croup will present with a fever, barking cough, and stridor. The most significant finding in a patient with croup is a barking cough. Often, this cough is said to sound like the barking sound that a seal makes. Stridor is another significant finding indicating that the upper airway is narrowing.

Epiglottitis is a condition that is most often seen in pediatric patients. Epiglottitis is the infection and subsequent swelling of the epiglottis. Patients with epiglottitis present with a high fever, drooling, and stridor. Patients with epiglottitis do not make any coughing attempts. Extreme caution must be taken to not upset or scare the patient as it may cause the airway to become occluded.

Pertussis, or the “whooping cough,” is characterized by intense coughing that produces a “whooping” sound and a high fever. The “whooping” sound created by pertussis differs from that harsh, barking cough associated with croup.

Pneumonia is an infection in the lung tissue resulting from a virus, bacterium, or foreign object aspiration. Patients who have pneumonia present with fever, chills, and coughing. The coughing will produce green, red, or rust-colored sputum. Sputum production is not characteristic of croup, a dry, barking cough.

185.

Cardiac output is calculated by multiplying which two factors? 

  • Heart rate and stroke volume

  • Heart rate and blood pressure 

  • Systolic and diastolic blood pressure 

  • Stroke volume and Diastolic blood pressure 

Correct answer: Heart rate and stroke volume

Cardiac output is the amount of blood pumped through the circulatory system in one minute. It is expressed in liters per minute, and is calculated by multiplying the stroke volume by the heart rate. The stroke volume is the amount of blood ejected with each contraction of the ventricle. 

186.

Your patient has a history of asthma, and they are prescribed several medications. Which medication does the patient use to decrease the amount of secretions that are produced in the lungs?

  • Fluticasone

  • Proventil 

  • Cromolyn 

  • Advair Diskus

Correct answer: Fluticasone

Fluticasone is the generic name for Advair Diskus. Advair is a medication that is used in the chronic treatment of asthma. Advair is unique among chronic asthma medications because it decreases the production of secretions in the lower airways of asthmatic patients.

Proventil is the trade name for albuterol. Albuterol is a medication used to acutely treat reactive airway diseases such as asthma, COPD (Chronic Obstructive Pulmonary Disease), and bronchitis. Albuterol dilates the smaller distal airways that become constricted during an acute exacerbation; it does not decrease the amount of secretions that are created in the lungs.

Cromolyn is the generic drug name for Intal, a medication used in the chronic treatment of asthma. Intal works by decreasing the amount of histamine released by the body. Excessive histamine can cause swelling in the distal airways and it can contribute to asthma exacerbation.

The Flovent Diskus is the trade name for the drug Fluticasone. Fluticasone is approved for the chronic treatment of asthma. Fluticasone is an anti-inflammatory medication that reduces the swelling in the lower airways associated with chronic asthmatics.

187.

A man is stabbed in the chest outside a bar during a fight. He is semiconscious with shallow breathing at a rate of 18 per minute. Your partner is assessing ventilation while you perform a rapid assessment and see a single stab wound to the left side of the sternum. During inspiration, you observe signs of shock, increased jugular venous pressure, and diminished radial pulse. Which of the following should you do?

  • Maintain SBP above 85 mmHg with 0.9% normal saline boluses

  • Insert a laryngeal mask airway and begin ventilation

  • Administer a minimum of three saline boluses of 20 mL/kg each

  • Request a paramedic unit to perform a needle chest decompression

Correct answer: Maintain SBP above 85 mmHg with 0.9% normal saline boluses

IV fluid therapy during thoracic trauma should be closely monitored and administered according to local protocol. The goal is to maintain adequate perfusion without causing a distinct increase in pressure.

The American College of Surgeons Committee on Trauma's fluid resuscitation guidelines recommend 250 mL boluses with frequent reassessment, which may be repeated up to four times before medical consultation. Large bore catheters are preferred; 18 gauges are generally sufficient to support flow rates for rapid ministration. Interosseous access is recommended if establishing an 18-gauge IV line is not possible in the context of hemodynamic instability. Establishing two large bore catheter lines is preferred, but establishing a second line should not delay transport.

Routine use of catheters larger than 18 gauge is not recommended due to the decreased likelihood of first-attempt success and increased discomfort for the patient.

188.

En-Route

While responding to the call in the given scenario, what PPE items should you anticipate the need for?

Select the 3 answer options which are correct.

  • Sterile gown

  • Surgical mask

  • Eye protection

  • Standard gloves

  • Face shield

Based on the dispatch information, there is a possibility of a field delivery. PPE required for assisting childbirth is more than standard precautions and includes:

  • Sterile gown
  • Surgical mask
  • Eye protection (a full face shield is not required; safety glasses are recommended)
  • Sterile gloves

189.

You are directed to assume the role of triage at a mass-casualty incident. Your patient is a 22-year-old male lying motionless on the ground, unresponsive and not breathing. You're unsure if he has a pulse. What color triage tag should be assigned? 

  • Black tag

  • Yellow tag

  • Green tag

  • Red tag

Correct answer: Black tag

This patient is already dead or has little chance of survival. He should be categorized as fourth priority, expectant.

Patients who are already dead or have little chance for survival should receive a black, or fourth priority, tag. Salvageable patients should be treated before these patients. Typical injuries are obvious death and obviously non-survivable injury such as major open brain trauma, cardiac arrest, and, if there are limited resources, respiratory arrest.

190.

The National Incident Management System (NIMS) consists of which components? 

Select the three correct answer choices.

  • Resource Management

  • Command and Coordination

  • Communications and Information Management

  • Finance and Logistics 

The NIMS provides a consistent, nationwide approach to incident management. NIMS is used to prepare for, respond to, and recover from domestic incidents. NIMS is composed of:

  • Fundamentals and Concepts of NIMS
  • Resource Management
  • Command and Coordination
  • Communications and Information Management

Finance and logistics are sections of the Incident Command System (ICS).

191.

Which of the following is most likely to be caused by blunt force trauma to the chest? 

  • Myocardial contusion

  • Myocardial myxoma

  • Myocardial infarction

  • Pneumomediastinum

Correct answer: Myocardial contusion

A myocardial contusion is the term for a bruise to the heart after an injury. It is usually a consequence of blunt trauma to the anterior chest wall, and the right ventricle is thought to be most commonly affected due to its anatomic location as the most anterior surface of the heart.

An atrial myxoma is a benign tumor of the heart, most commonly found within the left and then the right atria on the interatrial septum.

Myocardial infarction is a blockage of blood flow to a part of the heart, causing damage to the heart muscle.

Pneumomediastinum is the abnormal presence of air or other gas in the mediastinum. It can be caused by blunt trauma to the chest but is more likely a result of penetrating trauma or lung disease.

192.

Management of a laryngeal or tracheal injury should include which of the following?

  • Provide oxygenation and ventilation.

  • Avoid suctioning.

  • Delay transport to provide definitive care.

  • Apply a rigid cervical collar.

Correct answer: Provide oxygenation and ventilation.

Management of a laryngeal or tracheal injury should include oxygenation and ventilation, preferably with careful two-person bag mask ventilation. Patients with injuries to the anterior portion of the neck may experience associated facial fractures, which can make ventilation difficult. Apply a soft cervical collar, as rigid collars may cause further damage. Be alert to the need for frequent suctioning. Do not delay transport, as immediate surgical intervention may be the best treatment option. Call for paramedic rendezvous for advanced airway management, especially if the patient is apneic.

193.

A newborn has a pulse of 70 and a weak cry after 30 seconds of drying and stimulation. Which of the following is the next most appropriate step?

  • Provide PPV and begin SpO2 monitoring

  • Administer blow-by oxygen and begin SpO2 monitoring

  • Start CPR with 3:1 compression-to-ventilation ratio

  • Start CPR with 5:1 compression-to-ventilation ratio

Correct answer: Provide PPV and begin SpO2 monitoring

The steps in neonatal resuscitation include:

  1. Provide warmth, position the head in the "sniffing" position to open the airway, clear the airway, dry the baby, stimulate breathing.
  2. If HR is 60–100, provide PPV and begin SpO2 monitoring
  3. If HR < 60 after 30 seconds of PPV, continue PPV and begin chest compressions with a 3:1 compression-to-ventilation ratio.
  4. If HR < 60 after 60 seconds of CPR, call for paramedic backup for epinephrine administration

194.

Which of the following is a bruise of the lung?

  • Pulmonary contusion

  • Pleural contusion

  • Pleural effusion

  • Pulmonary embolism

Correct answer: Pulmonary contusion

Blunt force trauma that causes injury to the underlying lung tissue, inhibiting normal diffusion of oxygen and carbon dioxide, is known as a pulmonary contusion. A process known as “self-splinting” uses intercostal muscles to limit chest wall movement and minimize pain. This can limit breathing and the body's ability to compensate for the injury.

Pleural effusion, sometimes referred to as “water on the lungs,” is the build-up of excess fluid between the layers of the pleura outside the lungs. The pleura are thin membranes that line the lungs and the inside of the chest cavity and act to lubricate and facilitate breathing.

A Pulmonary Embolism (PE) is a blood clot that develops in a vein and travels to the lung, blocking blood flow.

195.

Which of the following groups are included in the medical branch in a Mass-Casualty Incident (MCI)?

Select the three answer choices that are correct.

  • Triage

  • Treatment

  • Transport

  • Communications

The medical branch at an MCI includes triage, treatment, and transport. Each of these groups will have a group supervisor. Communications is not one of the groups included in the medical branch; it may be a division or group of the logistics and resources branch. 

196.

Which of the following is not considered an initial therapy for all patients suspected of hypothermia?

  • Initiate oral rehydration protocols

  • Remove wet garments

  • Avoid rough movements and excess activity

  • Monitor cardiac rhythm

Correct answer: Initiate oral rehydration protocols

Initial therapy for all patients with suspected hypothermia includes the following:

  1. Remove wet garments
  2. Protect against heat loss and wind chill
  3. Maintain horizontal position
  4. Avoid rough movement and excess activity
  5. Monitor CBT
  6. Monitor cardiac rhythm

After initial therapy is begun, assess responsiveness for breathing and pulse. If pulse or breathing is absent, begin CPR. If pulse and breathing are present, monitor core body temperature. For mild hypothermia, provide passive rewarming; for moderate hypothermia, provide active external rewarming; for severe hypothermia, provide active internal rewarming using warmed IV or I/O fluids or warm, humidified oxygen. Rewarming efforts should continue until core body temperature rises above 95°F. Avoid giving anything orally until a physician approves. 

197.

Which of the following causes reduces blood flow to the myocardium? 

  • Atherosclerosis

  • Myocaridal Infarction 

  • Aneurysm

  • Acute coronary syndromes 

Correct answer: Atherosclerosis

Atherosclerosis is the buildup of fats, cholesterol and other substances in and on the artery walls. This buildup is called plaque. The plaque can cause arteries to narrow, blocking blood flow. Acute coronary syndrome includes Myocardial Infarction (MI), and are the result of reduced blood flow or obstruction to a coronary artery, not the cause. An aneurysm is an abnormal bulge or ballooning in the wall of the aorta. 

198.

A 30-year-old female presents with altered mental status, hypoxia, bradycardia, and pinpoint pupils. Management of this patient by an AEMT should include which of the following? 

  • Nalaxone (Narcan) 2mg IN

  • Immediate placement of a KingLT airway 

  • Nalaxone (Narcan) 10mg IN

  • Epinephrine 1:1000 1mg IM 

Correct answer: Nalaxone (Narcan) 2mg IN

This patient is exhibiting signs of opioid overdose, which includes the AEMT management of:

  • Supporting airway and oxygenation
  • Administration of Narcan (nalaxone) 0.4 to 2 mg IN or IM (IN is preferred because a needle is not required)
  • Airway management if needed

Immediate placement of a KingLT airway is not indicated. Support this patient's airway while nalaxone is being administered. If the narcan does not restore adequate airway patnentcy, then it can be considered. There are no signs of anaphylaxis, so epinephrine is not indicated for this patient. 

199.

Pulse oximetry measures which of the following?

  • Effectiveness of oxygenation

  • Amount of oxygen consumed

  • Amount of carbon dioxide produced

  • Alveolar minute volume

Correct answer: Effectiveness of oxygenation 

Pulse oximetry can be used to evaluate the effectiveness of oxygenation. It does not measure the amount of oxygen consumed, carbon dioxide produced, or alveolar minute volume.

Capnography measures the amount of exhaled carbon dioxide and provides a waveform that can be used to gauge the effectiveness of respiration. Alveolar minute volume is a calculated pulmonary test, which multiplies the tidal volume (less dead space) with the respiratory rate.

200.

What is the most common error with the operation of an AED? 

  • Failure to have a charged and operable battery 

  • Failure to place pads correctly 

  • Failure to dry the patient before use 

  • Failure to ensure no one is touching the patient during defibrillation 

Correct answer: Failure to have a charged and operable battery 

The most common error with the operation of an AED is failure to ensure the battery is charged and operable. It is important that batteries are checked in the AED as often as the manufacturer recommends. The other conditions listed can be causes of AED error, but battery failure is the most common. 

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