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Quiz Session - Attempts With Random Questions

NREMT AEMT Exam Questions

Page 9 of 45

161.

Scene

Which of the following treatments should be performed on scene for the patient in this scenario?

Select the 3 answer options which are correct.

  • Place cool packs in the groin and axilla

  • Administer IV fluid

  • Obtain a 12-lead ECG

  • Administer 50% dextrose IV

  • Administer a sports drink such as Gatorade

This patient is exhibiting signs and symptoms of heatstroke. Management on the scene should include a 12-lead ECG, administering IV fluids, and using cool packs to cool the patient.

Be careful to avoid over-cooling the patient as this can cause shivering, worsening the condition. Do not give oral fluids to patients with altered mental status. There is no indication this patient needs IV dextrose; his blood glucose level is 100.

162.

What is the first step in caring for the victim of a snakebite from a pit viper?

  • Calm the patient.

  • Locate the bite area, and clean it with soap and water.

  • Monitor the patient's vital signs.

  • Notify the hospital that you have a patient with a snakebite.

Correct answer: Calm the patient.

The emergency care for a pit viper bite is similar to that for a coral snake bite. In treating a snakebite from a pit viper, follow these steps:

  1. Calm the patient.
  2. Locate the area and clean it gently with soap and water.
  3. If the bite is on an arm or leg, consider use of the pressure immobilization bandage.
  4. Be alert for any anaphylactic reaction.
  5. Do not give anything by mouth.
  6. If the patient is bitten on the trunk, keep them supine and calm, and transport as quickly as possible.
  7. Monitor the patient's vital signs, and mark the skin with a pen over the area that is swollen, proximal to the swelling, so that you can identify if the swelling is increasing.
  8. If the patient develops signs of shock, place them supine and administer 100% oxygen.
  9. If the snake has been killed, bring it with you, or take a photo so that physicians can identify it and administer the proper antivenin.
  10. Notify the hospital that you are bringing in a patient for snakebite.
  11. Transport the patient promptly.
  12. Call for paramedic backup if needed.

163.

Post-Scene

Which of the following statements should be included in the radio report to the hospital during the transport of the patient in the given scenario?

  • The patient is exhibiting signs and symptoms of cholecystitis

  • The patient is exhibiting signs and symptoms of pancreatitis

  • The patient is exhibiting signs and symptoms of peritonitis

  • The patient is exhibiting signs and symptoms of splenic rupture

Correct answer: The patient is exhibiting signs and symptoms of cholecystitis

Upper right quadrant abdominal pain, nausea, tenderness, and a positive Murphy's sign (cessation of inspiration during examination of the URQ) are most consistent with cholecystitis.

Signs of pancreatitis would include upper left quadrant pain and a positive Grey Turner sign. Signs of peritonitis would include diffuse pain that would not radiate to the shoulder. A splenic rupture would present with pain in LUQ that radiates to the left shoulder.

164.

Scene

Which of the following is the most appropriate initial intervention for the child in this scenario?

  • 30 chest compressions and then attempt to ventilate

  • 5 abdominal thrusts and a blind finger sweep

  • 15 chest compressions and a blind finger sweep

  • 5 back slaps and 5 chest thrusts

Correct answer: Foreign body airway obstruction removal

This child most likely has a foreign body airway obstruction. The immediate intervention for this patient is 30 chest compressions and an attempt to ventilate. If you are unable to ventilate the patient after 30 chest compressions and can see the object in the mouth, remove it with a finger sweep.

Never perform blind finger sweeps of a child's mouth; you may lodge the object further. Abdominal thrusts are used on conscious children and adults, and back slaps and chest thrusts are used on infants.

165.

Gestational diabetes can cause which of the following?

  • Larger fetus

  • Smaller fetus

  • Low blood sugar 

  • A decrease in urination 

Correct answer: Larger fetus

Gestational diabetes can occur during pregnancy due to increased insulin resistance due to hormone levels. This leads to high blood sugar, frequent urination, and the fetus may begin producing its own insulin, which will result in an increased uptake of glucose by fetal cells. This causes the fetus to become large, known as macrosomia. 

166.

What are the two basic types of underlying behavioral emergencies?

  • Organic and functional

  • Environmental and social

  • Substance abuse and dementia

  • Mood disorders and personality disorders

Correct answer: Organic and functional

You should know that the two basic types of underlying causes of behavioral emergencies are organic, or physical, and functional, or psychological.

A person's environment exerts a tremendous influence on behavior, and that environment includes both psychosocial and sociocultural influences. When a person's basic needs are threatened and that individual faces a crisis, there are two basic alternatives for dealing with the threat: cope with it or attempt to alleviate the discomfort by escaping the stress.

167.

Which of the following is true regarding mechanical CPR devices? 

Select the three answer choices that are correct. 

  • CPR devices may be used, but manual compressions are the standard of care.

  • There are different types of manual CPR devices. 

  • Responders must be well-trained and practice using these devices. 

  • Chest compressions can be interrupted for a longer period to place these devices.

  • Mechanical CPR devices eliminate the need to request resources during a cardiac arrest. 

Manual CPR devices are a reasonable alternative to conventional chest compressions. They may free up responders to perform other tasks, and help reduce rescuer fatigue. Manual compressions remain the standard of care. Responders must train frequently with these devices to ensure chest compression interruption is kept to a minimum during their placement. Even though you may carry a mechanical CPR device on your ambulance, request additional resources for help when a patient is in cardiac arrest. 

168.

Your patient is a 34-year-old female with a history of sickle cell disease. Several people in her household have tested positive for Covid-19. She presents with shortness of breath, fever, productive cough, and gradual onset chest pain. You should suspect which of the following?

  • Acute chest syndrome

  • Hemolytic crisis 

  • Splenic sequestration 

  • Pulmonary embolism 

Correct answer: Acute chest syndrome 

Acute chest syndrome is a vaso-occlusive crisis that is associated with pneumonia in patients with sickle cell disease. This patient most likely contracted Covid-19, which leads to pneumonia, putting her at risk for acute chest syndrome. 

A hemolytic crisis is an acute drop in the patient's hemoglobin level and can cause weakness, very pale skin, and shortness of breath.

Splenic sequestration crisis is common in sickle cell disease and causes severe abdominal pain.

A pulmonary embolism can result from Covid-19 but presents with acute onset sharp chest pain and a dry cough. 

169.

Post-Scene

While transporting the patient in the given scenario, you see a sudden drop in the end-tidal Co2 level. Which of the following are potential causes you should consider?

Select the 3 answer options which are correct.

  • Decreased cardiac output

  • Pulmonary embolism

  • Equipment failure

  • Low body temperature

  • Hypertension

  • Stroke

After the return of spontaneous circulation (ROSC), a sudden drop in end-tidal carbon dioxide (EtCO2) can indicate several potential issues:

  • Decreased cardiac output: A sudden drop in EtCO2 may indicate decreased cardiac output. This could be due to factors such as reoccurrence of cardiac arrest, hypovolemia, tension pneumothorax, or cardiac tamponade.
  • Pulmonary embolism: A sudden decrease in EtCO2 can be a sign of pulmonary embolism, where blood flow to the lungs is obstructed, leading to decreased carbon dioxide exchange.
  • Hypoventilation: A drop in EtCO2 can also indicate hypoventilation, where inadequate ventilation leads to decreased carbon dioxide elimination.
  • Disconnection or obstruction of the airway device: If the airway device becomes disconnected or obstructed, it can result in a sudden drop in EtCO2.
  • Equipment failure: A malfunction of the capnography equipment or sampling line can also cause a sudden drop in EtCO2 readings.

A sudden drop in EtCO2 after ROSC warrants immediate attention and further evaluation to identify and address the underlying cause. It may require interventions such as reassessment of CPR quality, optimization of ventilation, administration of fluids or vasopressors, or addressing mechanical issues with the airway or equipment. Stroke, low body temperature, and hypertension are not causes of decreased EtCO2 levels.

170.

You are on the scene of an unwitnessed cardiac arrest of adult male. You have attempted three rounds of CPR and the AED has given three consecutive "no shock advised" messages. A paramedic unit is still 12 minutes out from your location but there is a hospital nine minutes from the scene. Which of the following is the most appropriate course of action? 

  • Begin transport 

  • Place an endotracheal tube

  • Terminate resuscitation efforts

  • Continue resuscitation attempts at the scene

Correct answer: Begin transport 

Transport of a cardiac arrest patient is recommended ( if local protocols agree) if one of the following occurs:

  • The patient regains a pulse
  • Six to nine shocks have been delivered
  • The AED gives three consecutive "no shock advised" messages

Always follow local protocols. Placement of an edotracheal tube is beyond the AEMT scope of practice. Terminating efforts is not advised without contacting medical control (always follow local protocols). 

171.

Which of the following is the body cavity containing the major organs of digestion and excretion?

  • Abdomen

  • Epigastrum

  • Peritoneum

  • Pelvis

Correct answer: Abdomen

The body cavity that contains the major organs of digestion and excretion is the abdomen, which extends from the diaphragm to the pelvis. Keep in mind that the diaphragm is curved and mobile; depending on the phase of respiration, it may be located as high as the nipple line. Any penetrating wound between the nipples and the pubis should be considered an abdominal wound.

The epigastrum is the upper central region of the abdomen.

The peritoneum is the serous membrane that forms the lining of the abdominal cavity.

The pelvis is the lower part of the trunk of the human body between the abdomen and the thighs.

172.

Which of the following is an extrinsic factor affecting pulmonary ventilation?

  • Foreign body airway obstruction

  • Airway occlusion by the tongue

  • Infection

  • Allergic reaction

Correct answer: Foreign body airway obstruction

There are many factors that affect pulmonary ventilation. Extrinsic factors include trauma and foreign body airway obstruction.

The most common cause of obstruction in an unresponsive patient is the tongue obstructing the airway, which is an intrinsic factor. Other intrinsic factors include infection, allergic reaction, and pulmonary edema. 

173.

Splinting a suspected fracture properly achieves all the following except:

  • Prevent further fractures 

  • Provide pain relief 

  •  Prevent further nerve or muscle damage

  • Prevent blood loss 

Correct answer: Prevent further fractures

Properly splinting a suspected fracture can prevent blood loss, prevent further nerve or muscle injury, and relieve pain. Fractures occur due to a force being applied, resulting in injury. A splint would not prevent further fractures. 

174.

What does the Cullen sign indicate?

  • Ecchymosis in the umbilical region

  • Ecchymosis in the lower abdomen and flanks

  • Shoulder tip pain resulting from retroperitoneal bleeding

  • Blood in the urine

Correct answer: Ecchymosis in the umbilical region 

The Cullen sign is ecchymosis in the umbilical region; Grey Turner is ecchymosis present in the lower abdominal and flank regions. Both are a result of intraabdominal bleeding, such as liver, kidney, pancreas, or spleen, typically appearing 12-24 hours post-injury.

The Kehr sign is referred shoulder tip pain from retroperitoneal bleeding, typically from a splenic laceration, irritating the phrenic nerve of the diaphragm. Blood in the urine is hematuria.

175.

A two-hour-old human is called a(n):

  • Newborn

  • Fetus

  • Infant

  • Neonate

Correct answer: Newborn 

Newborn describes the phase of life from the first few minutes to the first hours after birth.

Neonate is the term for the phase of life that occurs during the first 28 days after birth. Fetus describes the developing, unborn offspring inside the uterus. The embryo becomes the fetus at the beginning of the ninth week of gestation. Infant describes a baby from one month of age to one year of age.

176.

En-Route

While responding to the call in this scenario, which of the following complications of dialysis should be considered that may be occurring with the patient?

Select the 3 answer options which are correct.

  • Air embolism

  • Hypotension

  • Hyperkalemia

  • Infection

Complications of dialysis that would lead to a medical emergency include hemorrhage, hypotension, chest pain, severe hyperkalemia, disequilibrium syndrome, and the development of an air embolism. Infection is a common complication of dialysis appliance devices such as fistulas or grafts. However, infection is unlikely to lead to a rapid decline in consciousness.

177.

Which of the following is called the top portion of the uterus?

  • Fundus

  • Grand multipara

  • Gravida

  • Amniotic sac

Correct answer: Fundus

The top portion of the uterus is the fundus.

Grand multipara describes a woman who has delivered five or more viable infants. Gravida describes the number of times a woman has been pregnant. The amniotic sac, also called the bag of waters or the membranes, is the sac in which the embryo and later fetus develops.  

178.

The portion of tidal volume that does not reach alveoli and does not participate in gas exchange is called:

  • dead space

  • tidal volume

  • residual volume

  • vital capacity

Correct answer: dead space

Dead space is the amount of tidal volume that does not reach the alveoli, and therefore does not participate in gas exchange. Tidal volume is the amount of air which is moved through the airway during inhalation or exhalation in one breath. Residual volume is the amount that remains after maximal expiration. Vital capacity is the maximum volume of air expelled after maximal inspiration.

179.

Your patient is a known asthmatic who reports difficulty breathing despite using their rescue inhaler. You auscultate inspiratory and expiratory wheezing in all fields. What component of the asthma triad is your finding of wheezing consistent with?

  • Bronchospasms 

  • Airway edema 

  • Increased mucus production 

  • Hypotension 

Correct answer: Bronchospasm

Bronchospasms result from the narrowing of the airway passages in the lungs and trachea. Bronchospasms are reversible, and in the case of asthma, bronchospasms are the result of a stimulus. The narrowing bronchospasms create turbulent airflow in the distal airways, resulting in wheezing on auscultation. If bronchospasms are severe, lung sounds may be absent or faint, resulting from the accumulation of trapped air. Bronchospasms should be treated with a nebulized bronchodilator.

Airway edema is another portion of the asthma triad. Edema, or swelling, occurs in the upper and lower airways during an asthma exacerbation. The airway's swelling contributes to the airways' narrowing and may result in stridor being observed. Airway edema is best treated with IV or IM corticosteroids.

An increase in mucus production is the last portion of the asthma triad. Mucus production rises to excessive proportions during an asthma attack. Increased mucus is the body's attempt at trapping foreign particles that trigger the asthma attack in the airways before they make it to the alveoli. This response is often excessive, creating more turbulent airflow through the already narrowed airways. Asthma patients will cough as they try to expel the excess mucus from their airways. These patients will most often benefit from the administration of expectorants.

Hypotension is not a part of the asthma triad but is common in patients with severe asthma exacerbation. As intrathoracic pressure builds in the chest due to air trapping, venous return to the heart decreases, resulting in hypotension.

180.

Your 67-year-old patient has a history of CHF (Chronic Heart Failure), and had a syncopal episode. She is awake upon your arrival and complaining of chest pain and shortness of breath. You note dependent edema, crackles in all lung fields, and cyanosis around the lips. Her vitals are BP 184/90; HR 112; RR 26; SpO2 89%. Your management of this patient should include which of the following?

Select the three answer choices that are correct. 

  • Oxygen administration

  • CPAP 

  • Nitroglycerin 

  • 250 mL IV fluid bolus 

Management of a patient with a heart failure exacerbation should be the same as other causes of chest pain and includes all the following (always follow local protocols):

  • Supplemental oxygen
  • CPAP/BiPAP (Continuous Positive Airway Pressure/Bi-Level Positive Airway Pressure)
  • Nitroglycerin
  • IV access
  • Position upright for optimal ventilation
  • 12 lead ECG (Electrocardiogram)

Heart failure patients are fluid overloaded, so fluid bolus administration is contraindicated, and may worsen the condition. 

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