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Quiz Session - Attempts With Random Questions

NREMT EMR Exam Questions

Page 5 of 25

81.

Regarding poisons, what is considered a "base?"

  • A chemical that has a pH level above 7.0

  • A chemical that has a pH level below 7.0

  • A chemical that has a pH level above 14.0

  • A chemical that has a pH level below 14.0

Correct answer: A chemical that has a pH level above 7.0

A "base" is a chemical that has a pH level above 7.0. A base is also known as an alkali or a caustic agent, such as a liquid drain cleaner.

An acid is a chemical substance with a pH level below 7.0, such as battery acid.

The levels of pH range from 0 to 14, with 7.0 being neutral. The pH measures how acidic basic water is, with a pH below 7.0 indicating acidity and above 7.0 representing a base. There are no pH measurements greater than 14.0.

82.

How should a pregnant patient be transported who is showing signs of shock?

  • Lying on their left side

  • Lying on their right side

  • Lying on their back

  • Sitting upright

Correct answer: Lying on their left side

All pregnant patients, including those who are showing signs of shock, should be transported lying on their left side. Placing them on their left side minimizes pressure on the major abdominal organs and the inferior vena cava. 

If the patient was placed on their right side, added pressure would be placed on the abdominal organs and the inferior vena cava, reducing blood flow to the fetus.

Having a pregnant patient lie on their back creates discomfort and does not alleviate the pressure on the organs and inferior vena cava.

Placing a pregnant patient who is showing signs of shock in an upright position can possibly make the shock worse. Patients who are in shock need to lie down to increase the blood flow to their heart. 

83.

In a hazardous materials incident, what is considered the cold zone?

  • The control area that contains the command post and other support functions

  • The contaminated area where people can be exposed to injury from multiple sources

  • The control area where equipment and personnel decontamination and hot-zone support takes place

  • The control area where bystanders are placed

Correct answer: The control area that contains the command post and other support functions

The cold zone during a hazardous materials incident is the control area that contains the command post and other support functions. 

The contaminated area where people can be exposed to injury from multiple sources is considered the hot zone. In the hot zone, people can be exposed to broken glass, sharp metal edges, toxic substances, explosions, and lethal rays.

The control area where equipment and personnel decontamination and hot-zone support takes place is called the warm zone. Only specifically trained and equipped personnel are allowed in the warm and hot zones.

Bystanders should be evacuated and removed from the area to avoid injury.

84.

Why do patients who are diagnosed with angina pectoris have chest pain?

  • There is decreased oxygen to the heart.

  • There is decreased oxygen to the lungs.

  • There is increased oxygen to the heart.

  • There is increased oxygen to the lungs.

Correct answer: There is decreased oxygen to the heart.

Due to the narrowing of the coronary arteries, patients with angina pectoris do not receive an adequate flow of blood and oxygen to the heart. When the oxygen supply is reduced to the heart, the patient will experience chest pain or pressure.

Angina pectoris is not related to the lungs and is not caused by an increased oxygen supply.

85.

You have been dispatched to a residence for an unconscious male. Upon your arrival, the patient's neighbor says they smelled smoke and found the patient unresponsive behind his front door. You notice the patient has a charcoal barbecue grill inside his home and has been cooking hamburgers.

What type of poisoning can patients experience while using charcoal grills inside the home?

  • Carbon monoxide poisoning

  • Carbon dioxide poisoning

  • Nitrogen poisoning

  • Oxygen poisoning

Correct answer: Carbon monoxide poisoning

If outdoor grills are used inside a home that is not properly ventilated, a patient can experience carbon monoxide poisoning. The fumes and smoke from the charcoal and lighter fluid emit carbon monoxide, which is a colorless, tasteless, and odorless gas that cannot be detected by normal senses. Carbon monoxide is poisonous but does not irritate the respiratory tract but will cause sleepiness, unconsciousness, and even death. Many homes have carbon monoxide detectors that will alert when carbon monoxide levels are high.

Carbon dioxide is eliminated as waste from the body. It is carried in the blood to the lungs, where the gas exchange occurs in the alveoli, and is eliminated from the body upon exhalation.

Nitrogen and oxygen are the main parts of air and do not cause poisoning.

86.

While working on a basic-life-support ambulance, you are the first on the scene of a mass-casualty incident after a bus crashed into a minivan. You quickly determine there are approximately 15 patients.

Using the rule of thumb in mass-casualty incidents, how many additional ambulances would you request from dispatch?

  • Two additional ambulances

  • Four additional ambulances

  • Six additional ambulances

  • Eight additional ambulances

Correct answer: Two additional ambulances

When requesting additional ambulances during a mass-casualty incident, you should assign one ambulance to every five patients. Most ambulances can carry a variety of injured patients, with some patients on gurneys and backboards and others sitting on the bench seat, front seat, or jumpseats. Since you are already on the scene with one ambulance, you should request two additional ambulances for a total of three ambulances for 15 patients.

Requesting four, six, or eight additional ambulances would be taxing on the EMS system. Follow your agency's protocols for mass-casualty incident response.

87.

If a patient is breathing inadequately with noisy respiration, what condition is present?

  • There is a partial blockage or constriction along the respiratory tract.

  • There is a complete blockage along the respiratory tract.

  • There is a partial or complete blockage in air moving into the lungs.

  • There is a partial or complete blockage in air moving from the lungs.

Correct answer: There is a partial blockage or constriction along the respiratory tract

When a patient has noisy respiration, such as wheezing or gurgling, suspect a partial blockage or constriction somewhere along the respiratory tract. They may have a blockage from a foreign object, infection, inflammation, or constriction from an illness or disease. Besides noisy respiration, patients may develop pale or cyanotic skin, especially around the lips or fingernail beds.

If there was a complete blockage along the respiratory tract, noisy respiration would not be audible since there would be no passage of air.

88.

A man is lying face down on a walking trail. How do you establish unresponsiveness in an adult patient?

  • Gently shake the patient's shoulder while asking if they are okay

  • Gently pat the patient on the cheek while asking if they are okay

  • Roughly shake the patient's shoulder while asking if they can hear you

  • Roughly rub the patient's chest while asking if they can hear you

Correct answer: Gently shake the patient's shoulder while asking if they are okay

To establish unresponsiveness in an adult patient, gently shake the patient's shoulder while asking if they are okay. If there is no response, call for additional help while activating EMS. If bystanders are around, you can ask them to bring an AED if one is available.

Avoid patting a patient on their face, as this could be construed as abuse. The correct way to determine unresponsiveness is by gently shaking their shoulder.

Do not roughly shake the patient or rub their chest to determine if they are responsive. If a patient is injured, roughly shaking them or rubbing their chest could cause further injury and also be construed as abuse.

89.

While working as an EMR at a volunteer fire station, you hear honking. You look outside and see a woman in a vehicle honking and frantically waving to you. As you approach the vehicle, you see an unresponsive infant in a car seat and a small boy sitting next to the infant. The woman says she was driving when her son said the baby was not breathing. You pull the infant out of the car seat and begin rescue breathing.

How is rescue breathing done on an infant?

  • Cover the infant's nose and mouth with your mouth and give a puff of air for one second

  • Cover the infant's mouth with your mouth and give a puff of air for two seconds

  • Pinch the infant's nose, cover their mouth with your mouth, and give a puff of air for one second

  • Cover the infant's nose and mouth with your mouth and give a puff of air for two seconds

Correct answer: Cover the infant's nose and mouth with your mouth and give a puff of air for one second

For an unresponsive infant who needs rescue breaths, cover the infant's nose and mouth with your mouth and give a puff of air for one second. After the chest has risen and fallen, repeat one more rescue breath. After the initial two rescue breaths, continue rescue breathing, giving one breath every 2 to 3 seconds, for a total of 20 to 30 rescue breaths per minute.

If you only cover the infant's mouth and do not include the nose, your breath will escape from their nostrils. Both the mouth and nose need to be covered, and each breath is given for one second, not two seconds. Take care not to overinflate their tiny lungs.

Do not pinch the nose of an infant, as this only is appropriate for children and adults.

90.

What is the primary immediate danger for a trauma patient with severe facial injuries?

  • Airway obstruction

  • Uncontrollable bleeding

  • Spinal injury

  • Concussion

Correct answer: Airway obstruction

Severe damage to the facial bones can cause bleeding and collapse of the bones, leading to airway complications. This often results from motor vehicle accidents where the patient’s face hits the windshield or steering wheel.

Severe facial injuries can produce a lot of blood, but the bleeding can usually be controlled and is rarely life-threatening.

Spinal injuries and concussions are always a concern for patients who have severe facial injuries, but they are not the primary immediate danger. 

91.

You are called to a memory care facility for patients with dementia and Alzheimer's disease. On arrival, you find an unresponsive patient who is not breathing and has no pulse. The staff report that the patient does have a DNR order but cannot find it. 

Which of the following is the most appropriate action you should take? 

  • Begin resuscitation attempts

  • Do not attempt resuscitation, a verbal DNR is acceptable

  • Contact medical control for orders

  • Wait until the staff can find the DNR order to attempt anything

Correct answer: Begin resuscitation attempts

DNR is an advance directive that stands for "do not resuscitate." It is a written request permitting medical professionals to withhold resuscitation in the event of cardiac arrest. DNR orders are typically used for patients who have a terminal illness or in nursing homes or other care facilities. The DNR must be signed by the patient and their physician to be valid. 

A DNR is a legal document that must accompany the patient to be considered valid by emergency medical responders. A verbal order from family members or other medical professionals does not suffice. 

Contacting medical control or waiting for the staff to find the order will only delay lifesaving resuscitation attempts. Unless presented with a signed, valid DNR order, always attempt resuscitation if there are indications for it. 

92.

Your partner asks you to insert a nasopharyngeal airway (nasal airway) into an unconscious patient. The patient sustained severe trauma to their jaw, and an oral airway is not recommended.

What is one disadvantage of a nasal airway?

  • It cannot support through-suctioning.

  • It cannot be used for conscious patients.

  • It does not allow accurate size measurements.

  • It cannot be used in patients with an intact gag reflex.

Correct answer: It cannot support through-suctioning.

One disadvantage of a nasopharyngeal airway is that you cannot suction through it. The inside diameter of the nasal airway is too small for the standard whistle-tip catheter suction tip. When using an oral airway, you can suction around the airway once it is in place, which is an advantage to using an oral airway, but it is not recommended in this scenario.

The nasopharyngeal airway can be used in conscious and unconscious patients. 

The nasal airway can be accurately measured by measuring the airway from the patient's earlobe to the tip of their nose.

Nasal airways can be used in patients with a gag reflex, whether they are conscious or unconscious.

93.

What does a dose-attenuating system do in relation to an AED?

  • Reduces energy

  • Increases energy

  • Distributes energy

  • Delays energy

Correct answer: An energy reducer

A dose-attenuating system is used with an AED and pediatric pads. If one is available, the dose-attenuating system reduces the amount of energy that is delivered to an infant or a child. If a dose-attenuating system is not available, the infant or child can still be defibrillated without the system.

A dose-attenuating system does not increase, distribute, or delay energy.

94.

CPR compressions are most effective for a patient when performed on what type of surface?

  • A firm, horizontal surface

  • A soft, horizontal surface

  • A firm, vertical surface

  • A soft, vertical surface

Correct answer: A firm, horizontal surface

CPR compressions are most effective when performed on a firm, horizontal surface. If a patient is lying in bed and CPR is needed, the patient must be moved to a hard surface, such as the floor. If a patient is to be transported, place the patient on a backboard before placing them on the gurney to achieve the best compressions.

It is not advisable to perform compressions on a soft surface since it is impossible to compress the chest effectively. 

CPR cannot be done on a patient who is vertical (i.e., in the upright position).

95.

Your patient is 33 weeks pregnant and in labor. The baby would be considered which of the following? 

  • Preterm 

  • Normal term 

  • Overdue 

  • False labor 

Correct answer: Preterm 

Normal term pregnancy is 40 weeks.  A birth that takes place before the 37th week is considered preterm or premature. 

A birth occurring after 42 weeks of pregnancy is considered overdue. False labor is contractions that feel like labor but last only briefly. If this baby was already delivered, they would be considered preterm. 

96.

The US Department of Transportation uses three methods to label hazardous materials inside a container or cargo tank. Which of the following is not one of these three methods?

  • Stickers

  • Labels

  • Placards

  • Markings

Correct answer: Stickers

The US Department of Transportation identifies hazardous materials inside a container or cargo tank using labels, placards, and markings, such as those found in the Emergency Response Guidebook. They do not use stickers.

97.

Certain signs and symptoms characterize different illnesses, indicating which body system is being affected. Which body system is affected if a poisoned patient is unconscious with constricted pupils?

  • The central nervous system

  • The digestive system

  • The cardiovascular system

  • The respiratory system

Correct answer: The central nervous system

If a patient is unconscious with constricted pupils after being poisoned, the central nervous system is affected. The brain is highly susceptible to poisons, which cause central nervous system depression or stimulation. Since the patient is unconscious with constricted pupils, that is a clue that the central nervous system is being affected.

Nausea and vomiting, abdominal pain, and diarrhea occur when the digestive system is affected.

If the patient complained of chest pain or presented with an abnormal or absent pulse, it would indicate the cardiovascular system is affected.

Patients with respiratory system findings have difficulty breathing, an irregular respiratory rate, and an irregular depth of breathing.

98.

If a patient has been exposed to a nerve agent, there is a kit that contains two drugs that can be administered as an antidote to the agent.

What is the name of this kit?

  • The DuoDote Auto-Injector

  • The Dual Antidote Auto-Injector

  • The DuoDote Auto-Injection

  • The Dual Antidote Auto-Injection

Correct answer: The DuoDote Auto-Injector

If you have or a patient has been exposed to a nerve agent, the antidote kit is called the DuoDote Auto-Injector. The kit is to be used on you and the patient if either of you is experiencing signs and symptoms of nerve agent or organophosphate poisoning. You must have the approval of your medical director and receive proper training before using the kit. It contains one auto-injector syringe with two drugs—atropine and pralidoxime chloride.

99.

You are assessing an unresponsive patient who was riding a motorcycle without a helmet and crashed into a tree. Your paramedic partner asks you to check the patient’s ears and nose for cerebrospinal fluid (CSF).

What does CSF look like?

  •  Clear, watery, and straw-colored

  • Clear, gelatinous, and straw-colored

  • Clear, watery, and white

  • Clear, gelatinous, and yellow

Correct answer: Clear, watery, and straw-colored

CSF is a clear, watery, and straw-colored liquid found within the tissues that surround the brain and spinal cord. It cushions the brain within the skull and acts as a shock absorber for the central nervous system. CSF also circulates chemicals and nutrients that are filtered from the blood and removes waste products from the brain. If a patient has CSF coming from their ears or nose, it indicates a tear or hole in the outermost layer of connective tissue (called the dura matter) that surrounds the brain and spinal cord.

CSF is not gelatinous or white or yellow.

100.

What is the purpose of triage?

  • To determine the order in which patients should be treated based on the severity of their injuries

  • To treat as many patients as possible based on the severity of their injuries

  • To treat as many patients as possible at a time

  • To determine the number of patients and to call for additional resources if needed

Correct answer: To determine the order in which patients should be treated based on the severity of their injuries

Triage allows rescuers to do the most good for the greatest number of patients. Most people associate triage with a mass-casualty incident (MCI), but it can be done for smaller incidents, too. For example, for an emergency with more than one patient, providers will triage the patients to determine who needs to be treated and transported first.

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