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Quiz Session - Attempts With Random Questions

NREMT AEMT Exam Questions

Page 7 of 45

121.

Injury occurring from a knife or bullet, resulting in an open defect in the chest wall, is which of the following?

  • Open chest injury

  • Flail chest

  • Pulmonary contusion

  • Hemopneumothorax

Correct answer: Open chest injury

Thoracic trauma injuries are generally categorized into two groups: closed and open. Open chest injury is typically a result of a penetrating object, such as a knife, shrapnel, or a bullet. Force is delivered to a small area and breaks through the skin. Closed chest injury occurs when the skin overlying the injury remains intact. These are typically due to blunt trauma, such as compression against a steering wheel in an MVC or from a falling object. Force is distributed over a large area, and injuries occur from deceleration, shearing forces, or compression.

Flail chest is a condition in which two or more ribs are fractured in two or more places.

Pulmonary contusion is a bruise of the lung parenchyma.

Hemopneumothorax is a combination of a hemothorax and a pneumothorax, resulting from a collection of blood and air in the pleural cavity.

122.

Basic personal actions someone typically accomplishes during the day are termed:

  • Activities of daily living

  • Activities of normal living

  • Activities of daily action

  • Activities of daily needs

Correct answer: Activities of daily living

Basic personal actions someone typically accomplishes during the day are termed Activities of Daily Living (ADLs). These include things such as bathing and showering, personal hygiene and grooming, dressing, toileting, mobility, and self-feeding. An interruption of ADLs on a frequent or regular basis may indicate a behavioral issue, altered mental status, or mental illness that requires attention.

123.

An adult patient at a mass casualty event is found unresponsive and not breathing by the triage provider. Using START triage guidelines, what action should the provider take? 

  • Open the airway and see if there are spontaneous respirations

  • Tag as red (immediate) and move on to the next

  • Tag as black (expectant) and then move on to the next 

  • Open the airway and provide rescue breaths 

Correct answer: Open the airway and see if there are spontaneous respirations

START (Simple Triage And Rapid Treatment) triage guidelines indicate opening of the airway and assessing for spontaneous respirations. If the patient begins to breathe with an open airway, tag as red (immediate) and move on. If no spontaneous respirations are noted, then tag as expectant (black tag) and move on. Rescue breaths in triage are given to pediatric patients (JUMP-START), not adults. 

124.

During the rapid assessment of a 38-year-old male with a blunt chest injury, you observe paradoxical movement in the right anterior chest. His SpO2 is 74%, and his breathing is shallow. What is the next most appropriate intervention?

  • Assist ventilation using a bag-valve-mask (BVM) with high-flow oxygen

  • Call for a paramedic crew to consider needle decompression

  • Place a sandbag on the flail segment and assess breath sounds

  • Position the patient on his injured side and administer supplemental oxygen

Correct answer: Assist ventilation using a bag-valve-mask (BVM) with high-flow oxygen

This patient is showing signs of severe hypoxemia and inadequate ventilation, indicated by shallow breathing and low SpO2 of 74%. Positive pressure ventilation with a BVM will help improve oxygenation and stabilize the patient.

The paradoxical chest movement suggests a flail chest commonly associated with underlying pulmonary contusion. The primary treatment for this condition is to ensure adequate oxygenation and ventilation, typically through positive-pressure ventilation. While older practices recommended external stabilization of the flail segment with splinting or sandbags, these methods are now considered less effective and could hinder proper ventilation.

Calling for a paramedic crew to consider needle decompression is inappropriate as the immediate intervention. Needle decompression is primarily indicated for tension pneumothorax, not flail chest.

Placing a sandbag on the flail segment is an outdated practice that can restrict chest movement and worsen ventilation.

While sometimes used for comfort, repositioning the patient on the injured side is not the priority. The focus should be on supporting ventilation with a BVM and high-flow oxygen.

125.

What is the preferred method of dislodging a severe airway obstruction in a conscious patient?

  • Abdominal-thrust maneuver

  • Back slaps

  • Reverse endotracheal intubation

  • Retrograde intubation

Correct answer: Abdominal-thrust maneuver

Also called the Heimlich maneuver, abdominal thrusts are an emergency technique to help clear someone's airway. The procedure is done on someone who is choking and also conscious. Most experts do not recommend abdominal thrusts for infants less than one year old. You can also perform the maneuver on yourself. If a patient becomes unresponsive with suspected airway obstruction, start CPR with chest compressions. 

The American Broncho-Esophagological Association states that hitting a person on the back, providing back slaps, drives an object in the trachea downward, lodging it more tightly in the airway; choking persons who can still breathe, even with a piece of food in their throat, often die when back slaps cork their airway.  

Reverse endotracheal intubation, or retrograde intubation, is useful for patients who are breathing and have an anatomic problem that makes orotracheal intubation impossible or dangerous.

126.

Which of the following is a common cause of respiratory alkalosis? 

  • Anxiety 

  • Opioid overdose

  • Alcohol overdose 

  • Nasogastric suctioning 

Correct answer: Anxiety 

Respiratory alkalosis results from hyperventilation, which decreases carbon dioxide levels in the body, resulting in an increase in the pH. Common causes of respiratory alkalosis include fever, anxiety, and aspirin overdose. 

Opioid overdoses result in hypoventilation and subsequent respiratory acidosis.

Alcohol overdoses can cause respiratory acidosis due to suppression of the respiratory drive and hypoventilation.

Nasogastic suctioning often causes metabolic alkalosis due to excessive loss of acids from the GI (Gastrointestinal) tract. 

127.

Your 26-year-old female patient is complaining of lower right abdominal pain that increases with movement of her leg. She has rebound tenderness in her lower right quadrant, a fever, and vomiting. She reports the symptoms started two days ago and have progressed. What should the AEMT suspect? 

  • Appendicitis

  • Ectopic pregnancy 

  • Diverticulitis 

  • Ulcerative colitis

Correct answer: Appendicitis

Appendicitis results from inflammation of the appendix. Signs include lower right abdominal quadrant pain, fever, nausea and vomiting, and rebound tenderness. 

An ectopic pregnancy, diverticulitis, and ulcerative colitis may also produce abdominal pain, but the fever and rebound tenderness are not commonly found in these conditions. 

128.

Your patient presents with significant head trauma and respiratory pattern changes. What respiratory pattern do you expect to see in this patient?

  • Cheyne-Stokes respirations 

  • Kussmaul respirations 

  • Agonal respirations 

  • Apnea 

Correct answer: Cheyne-Stokes respirations

A patient with Cheyne-Stokes respirations is an abnormal respiratory pattern that consists of a gradual increase of respiratory depth and rate followed by a decrease of depth and rate. In between, the patient will experience periods of apnea.

Kussmaul Respirations are associated with diabetic ketoacidosis. Patients with Kussmaul respiration present with rapid, deep respirations that do not change in rate or depth, like Cheyne-Stokes respirations.

Agonal respirations are slow, shallow, and ineffective. Agonal respirations are not a form of effective breathing and signal brain anoxia.

Apnea is the ceasing of all breathing and respiratory effort.

129.

Which of the following can result in respiratory acidosis? 

Select the three answer choices that are correct.

  • Opioid overdose

  • Chest trauma

  • Pulmonary edema 

  • Hyperventilation from a panic attack

Respiratory acidosis is always related to hypoventilation. Decreased lung tidal volumes result in the retention of carbon dioxide and subsequent lowering of the pH. Common causes of respiratory acidosis include:

  • Airway obstruction
  • Cardiac Arrest
  • Opioid overdose
  • Submersion
  • Respiratory arrest
  • Pulmonary edema
  • Closed head injury
  • Chest Trauma

Hyperventilation is a common cause of respiratory alkalosis. 

130.

Which of the following is one of three important guidelines for treating penetrating injury to the eye?

  • Never exert pressure or manipulate the injured eye

  • Leave the injured eye uncovered to minimize potential damage

  • Press firmly on the eyeball and bandage with a moist sterile dressing to prevent ocular movement

  • If part of the eyeball is exposed, apply a dry sterile dressing

Correct answer: Never exert pressure or manipulate the injured eye

The three guidelines for treating penetrating injury to the eye are as follows:

  1. Never exert pressure on or manipulate the injured eye in any way.
  2. If part of the eye is exposed, gently apply a moist, sterile dressing to prevent drying.
  3. Cover the injured eye with a protective metal eye shield, cup, or sterile dressing. Apply soft dressings to both eyes and provide prompt transport to the hospital.

If there is a laceration to the globe itself, then apply no pressure to the eye. Compression can interfere with the blood supply to the back of the eyes and result in vision loss. Pressure may squeeze vitreous humor, iris, lens, or even the retina out of the eye and cause irreparable damage or blindness.

131.

Which of the following is a Schedule V drug?

  • Narcotic cough medicines

  • Fenfluramine

  • Darvon

  • Zolpidem

Correct answer: Narcotic cough medicines

The rate of potential drug abuse is a determinant factor in the DEA drug scheduling scheme. Schedule I drugs have a high potential for abuse and the potential to create severe psychological and/or physical dependence. As the drug schedule number goes up, the abuse potential goes down—Schedule V drugs represent the least potential for abuse. Some examples are listed below:

  • Schedule I: Heroin, LSD, marijuana (cannabis), peyote, and MDMA (Ecstasy)
  • Schedule II: Hydromorphone,  methadone, meperidine, oxycodone, fentanyl, methylphenidate, codeine, and hydrocodone
  • Schedule III: Codeine-mixed ingredient products with <90mg per dose unit (e.g., acetaminophen with codeine), dronabinol, buprenorphine, ketamine, anabolic steroids
  • Schedule IV: Zolpidem, Librium, fenfluramine, Darvon, benzodiazepines (e.g., alprazolam, clonazepam)
  • Schedule V: Pregabalin, cough preparations containing less than 200 milligrams of codeine per 100 milliliters or per 100 grams, and ezogabine

132.

En-Route

While responding to the given scenario, your EMT partner asks where the ambulance should be positioned. Which of the following is correct?

  • Park the ambulance 100 feet past the scene on the same side of the road if possible

  • Position the ambulance 50 feet in front of the scene in the fend-off position

  • Position the ambulance downhill and downwind if hazardous materials are involved

  • Position the ambulance 100 feet before the scene in the fend-off position

Correct answer: Park the ambulance 100 feet past the scene on the same side of the road if possible

If law enforcement or fire rescue have secured the scene, the ambulance should be parked 100 feet past the crash, on the same side of the road. If this is not possible, try to park at least 50 feet from the wreckage. If hazardous materials are involved, park upwind and uphill. If law enforcement or fire rescue have not secured the scene, position the ambulance 50 feet in front of the scene in the fend-off position. Since law enforcement and fire rescue are on scene, park 100 feet past the crash if possible.

133.

Which of the following is called the outer layer of the adrenal gland, which produces aldosterone and cortisol?

  • Adrenal cortex

  • Adrenal medulla

  • Adrenal capsule

  • Zona reticularis

Correct answer: Adrenal cortex

The adrenal glands are located on the superior pole of each kidney and consist of two layers, the cortex and the medulla. The outer layer, the cortex, produces corticosteroids, which help to regulate the metabolism (cortisol), salt and water balance (aldosterone), and sexual function (androgens).

The inner layer, the medulla, synthesizes and secretes catecholamines (epinephrine and norepinephrine), which regulate the "fight or flight" syndrome and affect heart rate, blood pressure, and other aspects of the sympathetic nervous system.

The adrenal capsule is a fatty capsule that surrounds the glands; it has no known synthetic function.

The cortex is comprised of three main zones, or layers, each producing a different set of hormones. From outside to inside, the layers are 1) zona glomerulosa, which produces aldosterone, 2) zona fasciculata, which produces cortisol, and 3) zona reticularis, which produces androgens.

134.

What is the potential blood loss from a femur fracture?

  • 500–1,500 mL

  • 1,500–3,000 mL

  • 250–500 mL

  • 500–800 mL

Correct answer: 500–1,500 mL

Fractures often damage vascular structures and may lead to significant blood loss. Understanding the body's vasculature, including diameter and susceptibility to injury, is critical to preventing shock and compartment syndrome. Potential blood loss from a femur fracture is 500 to 1,500 mL of blood (about 20% of total volume).

Pelvic fracture (because of the number of proximal vessels) is particularly susceptible to blood loss and, with a greater area to fill, is less likely to tamponade bleeding from compression.

Shock is a major concern because up to 3 L of blood can be lost before clotting begins. 

Fractures of the upper extremity or distal portion of the lower limbs can result in blood loss of 150–500 mL.

135.

Your patient is a 74-year-old male with crushing chest pain that is rated 10/10. It started suddenly while he was sitting in a recliner. His vital signs are BP 128/90; HR 96; RR 20; SpO2 92% on room air. The AEMT should administer all the following treatments (if protocols allow) except:

  • Abuterol 

  • Supplemental oxygen

  • Nitroglycerin

  • Aspirin 

Correct answer: Albuterol 

This patient is exhibiting signs of acute coronary syndrome. Treatment for this patient should include oxygen, aspirin, and nitroglycerin. The AEMT should also establish an IV and obtain a 12-lead ECG. Albuterol is a bronchodilator, and is not indicated in this patient.

136.

 Exposure to or overdose of atropine, scopolamine, antihistamines, antipsychotics, or Jimsonweed is known as what toxidrome? 

  • Anticholinergic 

  • Cholinergic

  • Sympathomimetic

  • Stimulant

Correct answer: Anticholinergic

Atropine, scopolamine, antihistamines, antipsychotics, and Jimsonweed can cause anticholinergic toxidrome. This results from antagonism of acetylcholine at muscarinic receptors. Central inhibition leads to an agitated (hyperactive) delirium, typically including confusion, restlessness, and picking at imaginary objects. Always consider anticholinergic toxicity in young children who present somnolent or lethargic. Remember the mnemonic "red as a beet, dry as a bone, blind as a bat, mad as a hatter, hot as a hare, full as a flask."

Cholinergic toxidrome results from acetylcholine accumulation at muscarinic receptors that produces an increase in secretions which can manifest as bronchorrhea, salivation, tearing and sweating, bronchoconstriction, tightness in the chest, wheezing, bradycardia, vomiting, increased gastrointestinal motility, abdominal tightness, diarrhea, and cramps. Exposure to carbamates and organophosphates are often the cause of this toxidrome.

Sympathomimetic or stimulant toxidrome results from excess adrenal receptor stimulation. It is similar to anticholinergic but not the same. Symptoms include tachycardia, hypertension, altered mental status, seizures, dilated pupils, and heart arrhythmias. Some common medications that can cause this toxidrome are epinephrine, norepinephrine, amphetamines, methamphetamine, caffeine, nicotine, cocaine, pseudoephedrine, methylphenidate, LSD, PCP, and ecstasy (MDMA).

137.

Your patient is a 39-year-old male who is exhibiting strange behavior in a grocery store. As you approach, he threatens violence toward you and your partner, and you think he has a weapon. What would be the most appropriate? 

  • Leave the area until law enforcement secures the scene.

  • Attempt to reason with the patient.

  • Subdue and restrain the patient.

  • Threaten the patient.

Correct answer: Leave the area until law enforcement secures the scene.

As an AEMT, you have a limited legal authority to require a patient to undergo emergency medical care in the absence of a life-threatening emergency. Always consult medical control or contact law enforcement for help before restraining a patient. If the patient poses an immediate threat, leave the area until law enforcement secures the scene.

138.

Your patient is a six-year-old female who presents with difficulty breathing, expiratory wheezing with rhonchi lung sounds, and pale skin with capillary refill of three seconds. You note retractions and slightly labored respirations. Her mother reports she has had a fever for four days with a runny nose and a productive cough. Her immunizations are up to date. Vital signs are: BP 92/56; HR 112; RR 28; SpO2 92%; Temp 99.7° F. Your treatment plan for this patient should include which of the following? 

Select the three answer choices that are correct. 

  • Administration of humidified oxygen 

  • Administration of a bronchodilator 

  • Position of comfort

  • IV access 

  • Administration of epinephrine 

This patient most likely has a lower airway infection such as pneumonia, RSV (Respiratory Syncytial Virus), bronchiolitis, or SARS/COVID-19. The AEMT should manage this patient with a position of comfort, humidified oxygen, and an inhaled bronchodilator if local protocols allow. This patient does not warrant IV access at this point, which may actually upset the patient and worsen her difficulty breathing. This patient does not exhibit signs of anaphylaxis or severe asthma, so epinephrine is not indicated, 

139.

A quick way to assess the temperature of a patient with suspected cold injury is to do which of the following?

  • Pull back your glove and place the back of your hand on the patient's abdomen.

  • Pull back your glove and place the palm of your hand on the patient's abdomen.

  • With your gloved hand, place the palm of your hand on the patient's abdomen.

  • With your gloved hand, place the back of your hand on the patient's abdomen.

Correct answer: Pull back your glove and place the back of your hand on the patient's abdomen.

Using the back of your ungloved hand is a preferred method to feel the temperature of a patient's skin. A rectal thermometer is the most accurate way to obtain a core body temperature, but this method can allow the AEMT to quickly assess the temperature of the skin. Management of hypothermia in the field consists of stabilizing the airway, breathing, and circulation, and preventing further heat loss. All patients who are injured are at risk for hypothermia. 

In most cases, remove the patient from the cold environment to prevent further heat loss. Do not allow the patient to walk, as this could further damage the feet. Remove any wet or frozen clothing unless it is frozen to the skin. Place dry blankets over and under the patient. Always handle patients gently to prevent any further injury to the skin. Do not massage extremities. Do not allow the patient to eat or use any stimulants such as coffee, tea, cola, or tobacco. If the patient is alert and shivering, core body temperature is likely between 90°F and 95°F.

140.

What is the term for maintaining the balance between heat production and heat release?

  • Thermoregulation

  • Thermogenesis

  • Thermolysis

  • Convection

Correct answer: Thermoregulation

Thermoregulation is the balance between heat production and heat loss.

Thermogenesis as the physiologic process of heat production. Thermolysis is the process of heat loss. Convection is one method of thermolysis.

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