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Quiz Session - Attempts With Random Questions

NREMT EMR Exam Questions

Page 8 of 25

141.

How many steps does the extrication process include?

  • 7 steps

  • 4 steps

  • 2 steps

  • 1 step

Correct answer: 7 steps

The extrication process consists of 7 steps, beginning with the rescuer's arrival on the scene and ending with the patient's removal from the vehicle entrapment. These steps cover assessing, treating, and removing patients who are trapped in vehicles that have crashed.

As an EMR, you may only be involved with the first 4 steps of extrication, but there are 7 steps in total.

142.

When an automated external defibrillator (AED) is used on an adult patient, how many shocks are given (if indicated) before CPR is resumed?

  • One shock

  • As many as the AED indicates

  • At least two shocks

  • Three shocks

Correct answer: One shock

If the AED indicates that a shock is required, deliver one shock before resuming CPR. Repeat the cycle of two minutes of CPR, one shock (if indicated), and two minutes of CPR.

The AED will only indicate whether a shock is needed after the analyze button is pushed, which is done after two minutes of CPR.

Do not deliver two or three shocks before resuming CPR.

143.

You are working as an EMR, and your protocol and training allow you to administer oxygen. How often should you check the patient's breathing and pulse while administering oxygen?

  • At least every 5 minutes

  • At least every 10 minutes

  • At least every 15 minutes

  • At least every 20 minutes

Correct answer: At least every 5 minutes

Per the current recommendations, check a patient's pulse and breathing rate at least every 5 minutes while oxygen is being administered. If a patient requires oxygen, their condition can quickly deteriorate, so checking their breathing and pulse every 5 minutes allows quick action if their condition does decline. Checking every 5 minutes also offers the patient reassurance.

Checking the patient's pulse and breathing every 10, 15, or 20 minutes would not provide up-to-date information on the patient's condition.

144.

Some healthcare professionals will use the mnemonic XABCs instead of ABCs when assessing a patient, especially when assessing trauma patients.

What does the letter “X” represent?

  • Exsanguinating

  • Exothermically

  • Extenuating

  • Extracellular

Correct answer: Exsanguinating

The “X” in the mnemonic XABCs represents exsanguinating, which refers to heavy external bleeding that poses an immediate threat to the patient’s life if not properly controlled. In this system, the X before ABCs reminds healthcare providers to prioritize bleeding control in these situations. Regardless of which abbreviations healthcare professionals use, EMRs must look for and control any serious bleeding as part of the primary assessment.

The “X” in the mnemonic XABCs does not represent exothermically, extenuating, or extracellular.

145.

You are working on a ski patrol and are EMR-certified. You are called to the lodge for a person complaining of difficulty breathing with a history of COPD.

What is COPD?

  • Chronic obstructive pulmonary disease

  • Critical obstructive pulmonary disease

  • Critical obscure pulmonary disease

  • Chronic-onset pulmonary disease

Correct answer: Chronic obstructive pulmonary disease

Chronic obstructive pulmonary disease (COPD) is caused by a chronic bronchial obstruction called emphysema, which progresses slowly. The airways, alveoli, and pulmonary blood vessels become destroyed over time. The signs and symptoms of COPD include dyspnea, blood-tinged sputum, swelling of the ankles, wheezing, and a chronic cough.

146.

Which of the following is not one of the three recognized advance directives?

  • A last will and testament

  • A living will

  • A do-not-resuscitate order

  • A durable power of attorney for health care

Correct answer: A last will and testament

A last will and testament is not one of the three recognized advance directives. An advance directive is a legal document that specifies how a patient wants their health care and treatment to be handled in case the patient becomes incapacitated and cannot make decisions for themselves. The last will and testament is a legal document that communicates a person's final wishes pertaining to their assets and dependants but does not address their wishes regarding health care.

A living will is a legal document prepared by the patient, their lawyer, and their physician. A living will specifies the type of medical care and treatment the patient wants if they cannot make treatment decisions. Living wills are often written when a patient has a terminal condition, but they do not allow the patient to select another person to make decisions for them.

A do-not-resuscitate (DNR) order is a written request to withhold resuscitation efforts during cardiac arrest. Some DNR orders will specify certain things that can be done (e.g., compressions can be administered but withhold ventilation). DNR orders need to be carefully read to make sure the patient's wishes are followed.

The last type is a durable power of attorney for health care or medical power of attorney. This advance directive allows a patient to designate another individual to make medical decisions for them if they cannot do so themselves.

147.

One-rescuer CPR is being performed on an infant. Which hand or finger placement is needed to compress their chest?

  • Place your index finger just below the nipple line in the center of the patient's chest, compressing the sternum with your middle and ring fingers

  • Place your thumb just below the nipple line in the center of the patient's chest, compressing the sternum with your middle and ring fingers

  • Place your index finger just below the nipple line in the center of the patient's chest, compressing the sternum with the palm of your hand

  • Place the palm of your hand just below the nipple line in the center of the patient's chest, compressing the sternum with your palm

Correct answer: Place your index finger just below the nipple line in the center of the patient's chest, compressing the sternum with your middle and ring fingers

When performing one-rescuer CPR on an infant, place your index finger just below the nipple line in the center of the patient's chest, compressing the sternum with your middle and ring fingers. After determining the proper location with your index finger, use the middle and ring fingers to perform compressions.

Do not place your thumb just below the nipple line. Instead, place your index finger to determine the proper location.

Using the palm of your hand is not recommended when performing chest compressions on infants. Infants are smaller and more fragile than children and adults, so not as much force is needed when performing chest compressions.

148.

The acronym SLUDGEM summarizes the signs and symptoms of exposure to a nerve agent or organophosphate insecticide. What does the "U" in this acronym represent?

  • Urination

  • Unresponsive

  • Unconscious

  • Unusual smell

Correct answer: Urination

SLUDGEM is an acronym that helps EMRs to remember the signs and symptoms of exposure to organophosphate insecticides or nerve agents. 

  • S: salivation, sweating
  • L: lacrimation (excessive tearing of the eyes)
  • U: urination
  • D: defecation, drooling, diarrhea
  • G: gastrointestinal upset and cramping
  • E: emesis
  • M: muscle twitching, miosis (pinpoint pupils)

The "U" does not stand for unresponsive, unconscious, or unusual smell.

149.

An infant patient was found in their crib unresponsive and not breathing. You feel a brachial pulse and are ready to begin rescue breathing.

After the initial two rescue breaths, how often will you give a rescue breath?

  • Every 2-3 seconds

  • Every 1-2 seconds

  • Every 3-4 seconds

  • Every 5-6 seconds

Correct answer: Every 2-3 seconds

For an infant, give a rescue breath every 2-3 seconds after the initial 2 rescue breaths. Be careful not to overinflate the patient's lungs, as they are smaller than a child's or an adult's lungs. Use small puffs of air, just enough to make the chest rise with each breath. Providing a breath every 2-3 seconds gives 20 to 30 rescue breaths per minute.

Giving a rescue breath every 1-2 seconds would not allow the patient's chest to recoil after the breath.

Infants breathe faster than adults because their lungs are smaller, so they need a rescue breath every 2-3 seconds.

150.

Which of the following is not a type of force related to the mechanism of injury (MOI)?

  • Thrusting force

  • Direct force

  • Indirect force

  • Twisting force

Correct answer: Thrusting force

Thrusting force is not a type of force related to the mechanism of injury. 

Three mechanisms of injury cause musculoskeletal injuries: direct force, indirect force, and twisting force. Direct force is when an object directly strikes a person, such as a car hitting a bicyclist. Indirect force is when a person falls onto their buttocks and the energy is transferred to their spine, fracturing vertebrae. An example of twisting force is when a soccer player is knocked down as they are turning. As their leg twists, the knee or ankle sustains a severe injury.

151.

Which structure delivers nutrients and oxygen to a fetus?

  • Umbilical cord

  • Placenta

  • Uterus

  • Amniotic sac

Correct answer: Umbilical cord

The umbilical cord delivers nutrients and oxygen to the fetus. The umbilical cord is often called the fetus's "supply line" because it carries blood back and forth between the baby and the placenta.

The placenta provides a connection between the patient and the fetus through the umbilical cord. The placenta does provide nutrients and oxygen to the fetus after delivery via the umbilical cord.

The uterus houses the fetus until birth.

The amniotic sac surrounds the fetus during pregnancy. The sac is filled with amniotic fluid, which protects the fetus from injury and regulates their temperature.

152.

A young boy dove into a pool and struck his head on the bottom. After diving in the water after him, you find the boy to be conscious and disoriented after reaching the surface. The patient tells you his head and neck hurt. Another lifeguard came to assist with a backboard.

How should you place the patient on a backboard while maintaining spinal precautions?

  • Place the patient on the backboard while he is in the water

  • Place the patient on the backboard after you remove him from the water by yourself

  • Have two people assist you with their hands to remove him from the water, then place him on a backboard

  • Have four people assist you with their hands to remove him from the water, then place him on a backboard

Correct answer: Place the patient on the backboard while he is in the water

When a patient is in the water and requires spinal precautions, they will be placed on the backboard while they are in the water. This minimizes movement of the patient's head and spine.

Do not remove the patient from the water by yourself because you would be unable to take proper spinal precautions and you could cause further injury.

If a backboard was not available, a patient can be removed from the water with the assistance of six people using their hands. However, a backboard is available in this scenario.

153.

What is the definition of an epidemic?

  • An infectious disease or condition that affects many people at the same time in the same geographic area

  • An infectious disease or condition that affects a few people at the same time in the same geographic area

  • An infectious disease or condition that affects many people at the same time in a different geographic area

  • An infectious disease or condition that affects a few people at the same time in a different geographic area

Correct answer: An infectious disease or condition that affects many people at the same time in the same geographic area

An epidemic is defined as an infectious disease or condition that affects many people at the same time in the same geographic area. For example, if a city or county had an influenza outbreak that was limited to their geographic area, it would be called an epidemic. If the outbreak spreads to different parts of the world, it would be called a pandemic.

154.

What are the two types of fractures?

  • Open and closed

  • Minor and major

  • Minimal and maximal

  • Severe and minor

Correct answer: Open and closed

Like head injuries, fractures are classified as open and closed. An open fracture consists of a broken bone and lacerated overlying skin. The bone can be sticking out of the skin or can be under the skin, but it is visible because the skin is broken. An open wound can be caused by a penetrating object or by a fractured bone breaking the skin. Open fractures are often contaminated by dirt and other debris and pose a high risk of infection. Patients who suffer an open fracture have a longer recovery process than those with a closed fracture. A closed fracture consists of a broken bone underneath the skin without any damage to the overlying skin.

Minor, major, and severe could be used to describe an injury, but these terms are not used to classify fractures.

155.

Poisons can enter the body by four primary routes. Through which route does a poison enter through intact skin and spread via the circulatory system?

  • Absorption

  • Ingestion

  • Inhalation

  • Injection

Correct answer: Absorption

Absorption occurs when a poison enters the body through intact skin and spreads via the circulatory system. 

Ingestion occurs when a poison enters the body through the mouth and is absorbed by the digestive system.

Through inhalation, a poison enters the body through the mouth or nose and is absorbed by the mucous membranes lining the respiratory system.

Injection occurs when a poison enters the body through a small opening in the skin and spreads throughout the circulatory system (e.g., from a sting, bite, or hypodermic needle).

156.

There are three characteristics in burn classification. What are these characteristics?

  •  Depth, extent, cause (or type)

  •  Depth, age, cause (or type)

  •  Percentage, extent, cause (or type)

  •  Severity, extent, cause (or type)

Correct answer: Depth, extent, cause (or type)

The three characteristics for burn classification are depth, extent, and cause (or type). To classify a burn, first determine if the burn is a superficial, partial-thickness, or full-thickness burn. Then, calculate the extent of the burn using the rule of nines to see how much of the patient's body surface is affected. Finally, determine the cause or type of the burn, such as a burn from a campfire or a chemical burn.

The patient's age is not used to classify a burn. 

The percentage is determined using the "extent" characteristic, and severity is noted using the "depth" and "extent" characteristics.

157.

What does PSAP refer to with regard to a dispatch facility?

  • Public safety answering point

  • Public service answering place

  • Public safety answering place

  • Public service answering point

Correct answer: Public safety answering point

PSAP refers to a public safety answering point. A dispatch facility is a center where members of a community can call to request emergency medical care or to report a fire or a crime. Most centers are part of the 911 system that receives emergency calls at a public safety answering point (PSAP). Once the call is received, the dispatcher will send fire, police, and/or EMS assistance.

PSAP does not refer to public service or an answering place.

158.

Your paramedic partner asks you to place a nasal cannula on a patient who is having respiratory difficulties. At a flow of 1 to 6 liters per minute (L/min), how much oxygen will be delivered to the patient?

  • 24% to 44% oxygen

  • 50% to 75% oxygen

  • 21% oxygen

  • Up to 90% oxygen

Correct answer: 24% to 44% oxygen

A nasal cannula delivers between 24% and 44% oxygen when supplied at 1 to 6 L/min. Some patients will have different medical conditions, such as chronic respiratory issues, that may require a lower concentration of oxygen. Low-flow oxygen can also be used for fairly stable patients such as those with mild shortness of breath or slight chest pain. Some patients will be on home oxygen and already have a nasal cannula in place. If so, leave the patient's nasal cannula at their home prior to transport to the hospital and place a new one.

Nasal cannulas do not provide 50% to 75% oxygen. They are incapable of providing high concentrations of oxygen via the two small nostril prongs.

Room air provides 21% oxygen.

Non-rebreather masks provide up to 90% oxygen when administered at a flow rate of 10 to 15 L/min.

159.

You and your partner are called to a local park for a 24-year-old female who is having difficulty breathing after being stung by a bee. Upon your arrival, the patient's sister explains that she forgot her EpiPen at home, and your local protocols do not allow you to carry EpiPens in your ambulance. The patient is in respiratory arrest, and your partner calls for advanced life support backup while you prepare to administer a rescuer ventilation. 

Where should you position yourself in relation to the patient?

  • Kneel above the patient's head

  • Kneel on the right side of the patient's head

  • Kneel on the left side of the patient's head

  • Straddle the patient's body

Correct answer: Kneel above the patient's head

To position for a rescuer ventilation, kneel at the patient's head. In this position, keep the airway open by maintaining the neck in an extended position, make a tight seal on the mask, and squeeze the bag. The bag-mask device does not maintain the patient's airway in an open position; it needs to be maintained by the rescuer. During ventilation, continue to stabilize the head in an extended position via the head tilt-chin lift maneuver or a neutral position if the jaw-thrust maneuver is used.

Kneeling on the right or left side or straddling the patient does not allow you to maintain their airway, make a tight seal on the mask, and squeeze the bag. These steps can only be accomplished by kneeling at the patient's head.

160.

You are responding to a call for an unresponsive man. Upon your arrival, the patient's grandson meets you at the front door. He is an emergency room physician and has just found his grandfather with rigor mortis.

What is rigor mortis?

  • The temporary stiffening of a patient's muscles that occurs several hours after death

  • A reddish-purple coloring caused by blood seeping into the tissues that are closest to the ground

  •  The decay of a patient's tissues after they have been dead for at least one day

  • The temporary stiffening of a patient's muscles that occurs very soon after death

Correct answer: The temporary stiffening of a patient's muscles that occurs several hours after death

Rigor mortis is caused by chemical changes that take place in the muscles after death. Rigor mortis indicates that a patient has been dead for a prolonged period, so resuscitation efforts are not needed.

When a patient has been dead for several hours, they will develop dependent lividity in the tissues closest to the ground. The reddish-purple coloring is caused by blood seeping into the dependent (i.e., lower) tissues.

Decomposition is the decay of a patient's tissues after they have been dead for at least one day.

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