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Quiz Session - Attempts With Random Questions

NREMT EMR Exam Questions

Page 9 of 25

161.

An 8-year-old female was found facedown in the family swimming pool. Her father said she was unattended for two minutes while he went to check on her brother who was napping inside the house. The father performed CPR, and the patient vomited. The patient has labored respirations and is coughing up water. You observe vomitus in her airway and are preparing your suction device.

How long can the patient be suctioned before needing supplemental oxygen or ventilation?

  • 10 seconds at a time

  • 15 seconds at a time

  • 20 seconds at a time

  • 5 seconds at a time

Correct answer: 10 seconds at a time

When suctioning a child, suction for no more than 10 seconds at a time before providing ventilation or oxygen. Suctioning draws air and material from the airway, robbing the patient of oxygen. After suctioning for 10 seconds, provide ventilation or supplemental oxygen depending on the patient's condition. Once they have been oxygenated, suctioning can be repeated for 10 seconds at a time, followed by ventilation or oxygen, until the material or secretions are removed.

Adults can be suctioned for 15 seconds at a time since they have larger lungs and do not become oxygen-deprived as quickly as children or infants.

Suctioning for 20 seconds at a time is not recommended for anyone.

For an infant, limit suctioning to 5 seconds at a time because their lungs are much smaller than a child's.

162.

What is the third stage of labor?

  • The delivery of the placenta

  • The delivery of the newborn

  • The delivery of the uterus

  • The delivery of the amniotic sac

Correct answer: The delivery of the placenta

In the third (final) stage of labor, the placenta is delivered. The placenta is also called afterbirth and can take up to 30 minutes to deliver. 

The delivery of the newborn happens in the second stage of labor, not the third.

The uterus does not deliver in the third stage of labor. The uterus is where the fetus develops and is part of the female reproductive system.

The amniotic sac does not get delivered in the third stage of labor. It typically ruptures during labor or within 24 hours before labor starts. 

163.

Which type of lubricant is used to coat a nasal airway before inserting it into a patient's nostril?

  • Water-soluble

  • Oil-based

  • Alcohol-soluble

  • Mineral-based

Correct answer: Water-soluble

A water-soluble lubricant is used to coat a nasal airway before inserting it into a patient's nostril. Water-soluble lubricants are gentle and versatile, and they will not cause irritation to the nostrils. The lubricant makes it easier to insert the nasal airway and helps minimize trauma to the nostrils.

Oil-, alcohol-, and mineral-based lubricants are not used in a prehospital setting, as they can irritate a patient's skin and airways and inflict further damage.

164.

There are five major benefits of the Incident Command System (ICS). Which of the following is not one of these five major benefits?

  • Rapid triage

  • Clear chain of command

  • Common terminology

  • Safety of responders

Correct answer: Rapid triage

Rapid triage is not one of the five major benefits of the ICS structure.

The five major benefits are:

  • clear chain of command
  • common terminology
  • safety of responders
  • achievement of response objectives
  • efficient use of resources

165.

The START triage system is based on three observations. In order of priority, what are these three observations?

  • Breathing, circulation, and mental status

  •  Circulation, breathing, and mental status

  • Airway, breathing, and circulation

  • Mental status, breathing, and circulation

Correct answer: Breathing, circulation, and mental status

The three observations in the START triage system, in order of priority, are breathing, circulation, and mental status. First, assess the patient's breathing rate. Next, assess the patient's circulation by checking the carotid pulse. Finally, assess the patient's mental status by asking them to follow a simple command.

Do not check the patient's circulation or mental status before assessing their breathing.

166.

The American Heart Association (AHA) developed the cardiac chain of survival. What does the AHA emphasize in the second link of the chain?

  • Immediate CPR with high-quality chest compressions

  • Immediate CPR with high-quality ventilation

  • Immediate CPR with rapid defibrillation

  • Immediate CPR with airway adjuncts

Correct answer: Immediate CPR with high-quality chest compressions

The second link in the chain of survival is immediate CPR with high-quality chest compressions. The AHA teaches that high-quality chest compressions will keep the blood circulating in the patient's body and increase the efficacy of rapid defibrillation. As a result, CPR starts with chest compressions before ventilation. 

Rapid defibrillation is the third link in the chain of survival, after high-quality chest compressions.

The use of airway adjuncts is included in the fourth link of the chain of survival, which covers basic and advanced emergency medical care.

167.

A 5-year-old female has partial-thickness burns to her right shoulder and arm after pulling a hot pan of grease off the stove. The patient's mother has been cooling the burns under running water before your arrival.

How should you treat this patient's burns?

  • Cover the burns with dry, sterile dressings or a burn sheet

  • Apply burn ointment and cover the burns with dry, sterile dressings or a burn sheet

  • Apply antibiotic cream and cover the burns with dry, sterile dressings or a burn sheet

  • Cover the burns with moist, sterile dressings or a burn sheet

Correct answer: Cover the burns with dry, sterile dressings or a burn sheet

When a patient has partial-thickness burns, first cool the burn area if it is still warm, as this patient's mother already did. Then, cover the burns with a dry, sterile dressing or burn sheet. When applying the dressing or burn sheet, avoid breaking any blisters, if present. The blisters will provide a barrier against infection and should remain intact.

Do not apply burn ointment or antibiotic cream. The hospital needs to clean the burns when the patient arrives, and the ointment or cream will make this process more difficult and more painful for the patient.

Moist dressings will cool the patient and can lead to hypothermia in cases of extensive fluid loss.

168.

You are called to a preschool for a 4-year-old male with a human bite on his arm. The patient was playing with another child and was bitten on the forearm, breaking the skin and leaving a bite mark. The preschool teacher washed the wound with soap and water before your arrival, and the patient's mother arrived as you start assessing the child. You have wrapped the wound with a sterile bandage, and the bleeding is controlled.

What would you recommend to the patient's mother regarding further treatment?

  • Have the patient seen by a physician

  • Take the patient home and call 911 if needed

  • Have the patient remain at school and call 911 if needed

  • Take the patient home and change the bandage twice a day

Correct answer: Have the patient seen by a physician

All patients who have been bitten by an animal or another person must be treated by a physician. Bites from an animal or another person carry a high risk of infection, and the patient needs to be evaluated at the hospital.

The hospital staff will advise the mother on proper care after the patient has been evaluated at the hospital.

169.

When a conscious patient has difficulty breathing, in what position are they usually most comfortable?

  • Sitting

  • Standing

  • Lying on their side

  • Lying on their back

Correct answer: Sitting

A patient who has difficulty breathing is generally most comfortable when sitting. This provides better expansion of the lungs. The sitting position allows the breathing accessory muscles to pull up the ribs, which helps draw in more air.

Patients who are having trouble breathing may feel more comfortable standing, but typically the patient will feel weak from the exertion of breathing and will be more comfortable sitting. The majority of patients with difficulty breathing will be sitting when help arrives.

Most patients have greater difficulty breathing when lying on their side or back and feel as if their lungs cannot fully expand. Some illnesses or diseases contribute to difficulty breathing when lying down, especially if the patient has fluid in their lungs. They will describe feeling like they are being suffocated.

170.

Which mnemonic would be most useful during the assessment of a patient with chest pain?

  • SAMPLE

  • AVPU

  • DOTS

  • DCAP-BTLS

Correct answer: SAMPLE

For a patient with a medical complaint, the SAMPLE mnemonic would be the most useful. 

SAMPLE is the mnemonic used when obtaining a patient's medical history. SAMPLE stands for:

  • Signs and symptoms
  • Allergies
  • Medications
  • Pertinent past medical history
  • Last oral intake
  • Events leading to the illness or injury

The mnemonic AVPU is used to assess mental status, and DOTS and DCAP-BTLS are used for signs of injury.

171.

Which hormone is produced in the pancreas? 

  • Insulin

  • Progesterone

  • Testosterone

  • Estrogen

Correct answer: Insulin

The pancreas produces a hormone called insulin that enables glucose (sugar), which is carried by the blood, to move into individual cells to be used as fuel. Insulin is produced in the pancreas in response to rising glucose in the bloodstream. After a person eats a meal, any carbohydrates that were eaten are broken into glucose and passed into the bloodstream. The pancreas detects this rise in blood glucose and starts to secrete insulin. 

Progesterone, testosterone, and estrogen are produced in the adrenal cortex and reproductive organs. Progesterone is a female sex hormone involved in the menstrual cycle, pregnancy, and development of embryos. Testosterone is the primary male sex hormone responsible for the development of male reproductive tissues, increased muscle and bone mass, and the growth of body hair. Estrogen is a female sex hormone that is responsible for the development and regulation of the female reproductive system and secondary sex characteristics.

172.

You are called to a private residence for an unknown medical emergency involving an infant. When you arrive, a woman meets you at the front door holding an infant who is having a seizure. The woman states that her daughter was nursing and suddenly started seizing. The patient is hot to the touch, and the mother reports the infant has had a fever for the past 12 hours. The patient is 10 months old with no past medical history.

How should you manage this patient's airway and breathing?

  • After the seizure ends, maintain an adequate airway and provide supplemental oxygen.

  • While the patient is seizing, provide supplemental oxygen.

  • After the seizure ends, provide supplemental oxygen.

  • While the patient is seizing, try to open their airway and provide supplemental oxygen.

Correct answer: After the seizure ends, maintain an adequate airway and provide supplemental oxygen.

To maintain an adequate airway and breathing, wait until the seizure ends, then maintain an adequate airway and provide supplemental oxygen. While an infant is having a seizure, keep them safe by holding them or placing them on the floor or a bed. Once the seizure is over, assess their airway and breathing and provide supplemental oxygen using a pediatric non-rebreather mask. 

Do not try to assess their airway or breathing during a seizure. The best treatment during a seizure is to keep the patient from injuring themselves.

Once the seizure ends, provide supplemental oxygen after maintaining an adequate airway.

173.

What is the first priority for a patient with a suspected stroke?

  • Maintain an open airway

  • Administer oxygen

  • Ask them to smile

  • Ask them to lift their arms

Correct answer: Maintain an open airway

Maintaining an open airway is the first priority for any patient. If the airway is not open and the patient cannot breathe, they will die without artificial ventilation. 

Administering oxygen will happen after the airway is opened and maintained.

Asking the patient to smile is the first assessment on the Cincinnati Prehospital Stroke Scale, but it is not the chief priority. Asking the patient to lift their arms is the second assessment on the Stroke Scale. An open airway is the first priority.

174.

What causes thermal burns?

  • Heat

  • Radiation

  • Electricity

  • Chemicals

Correct answer: Heat

Thermal burns are caused by heat (e.g., from hot liquids, fire, hot metal, hot surfaces, and steam). When a patient has a thermal burn, stop the burning process by cooling the skin with clean, cold water. After the burned area is cooled, cover the burn with a dry, sterile dressing or burn sheet.

Radiation causes radiation burns, which are typically caused by excessive exposure to ultraviolet rays of the sun.

Electricity causes electrical burns, which can be due to a lightning strike or contact with electricity.

Chemicals cause chemical burns, which happen on contact with a patient's skin or eyes.

175.

During two-rescuer CPR on an adult patient, what is the rate of compression?

  • 100 to 120 compressions per minute

  • 100 to 110 compressions per minute

  • 100 to 130 compressions per minute

  • 90 to 110 compressions per minute

Correct answer: 100 to 120 compressions per minute

The rate of compression on all patients is 100 to 120 compressions per minute. Infants, children, and adults all receive the same rate of compression, which is roughly one compression every one to two seconds. The depth of compression will change depending on whether the patient is an infant, child, or adult. 

The proper depth and the proper rate of compression increase the chance that an AED will successfully defibrillate the heart while keeping blood and oxygen flowing to the heart and brain.

176.

 You are treating a patient who was an unrestrained driver in a vehicle accident. The patient struck the steering wheel and is complaining of chest pain and difficulty breathing. Upon examination, one side of the patient’s chest moves outward when they exhale and inward when they inhale. 

Which condition do you suspect the patient is experiencing?

  • Flail chest

  • Cardiac tamponade

  • Penetrating chest injury

  • Abdominal aortic aneurysm

Correct answer: Flail chest

The patient is exhibiting signs and symptoms of a flail chest, which occurs when three or more ribs are broken in at least two places, causing the injured portion of the chest wall to not move at the same time as the rest of the chest. The injured part will bulge outward when the patient exhales and inward when the patient inhales. When a patient has a flail chest, less oxygen and carbon dioxide are exchanged in the lungs, worsening the patient's breathing.

Cardiac tamponade occurs when fluid collects in the sac around the heart, causing the heart to be compressed. Cardiac tamponade will not resemble a flail chest.

A penetrating chest injury occurs when a patient has been stabbed, shot, or sustained another type of instrument penetration of the chest.

An abdominal aortic aneurysm is an enlarged area in the lower part of the aorta. It does not resemble a flail chest.

177.

What is the rate of chest compressions for all patients who need CPR?

  • 100 to 120 compressions per minute

  • 80 to 100 compressions per minute

  • 90 to 110 compressions per minute

  • 120 to 140 compressions per minute

Correct answer: 100 to 120 compressions per minute

The rate of chest compressions for infants, children, and adults is 100 to 120 compressions per minute, yielding 1 to 2 compressions per second. This compression rate circulates blood and oxygen efficiently throughout the patient's body. In the past, the compression rate was different for infants, children, and adults. The American Heart Association has standardized the rate to be 100 to 120 for all patients, which makes it easier to remember for those learning CPR.

178.

A seizure that can cause a brief lapse of consciousness is known as which of the following?

  • Absence seizure

  • Grand mal seizure 

  • Petit mal simplex seizure

  • Petit mal complex seizure 

Correct answer: Absence seizure

A seizure that causes a brief lapse in consciousness is most likely an absence seizure. Patients experiencing an absence seizure may blink their eyes, stare vacantly, or jerk one part of their body. Absence seizures were formerly known as petit mal or simple complex seizures but would not be known as petit-mal complex or petit-mal simplex.

If a patient has experienced an absence seizure, you should recommend they be transported so a physician can evaluate them, especially if they have never had an absence seizure before. Even though the patient's vital signs are stable, they are slightly disoriented and cannot refuse care. They may also have another seizure, and their ABCs need to be monitored. A grand mal seizure results in tonic-clonic movement of muscles during loss of consciousness and can last several minutes. 

179.

A patient has been bitten by a snake on their arm. You decide to splint the extremity. Where will you place the splinted extremity in relation to the heart?

  • Below the level of the patient's heart

  • Above the level of the patient's heart

  • At an equal level to the patient's heart

  • At whatever level is comfortable for the patient

Correct answer: Below the level of the patient's heart

If a patient has been bitten by a snake on their arm and you decide to splint the extremity, place the splinted extremity below the level of the patient's heart. Placing the extremity below the patient's heart decreases the absorption of the venom. Any other position would not allow for decreased absorption. 

180.

Which piece of patient immobilization equipment is not recommended as part of an EMR life support kit?

  • Backboard

  • Cervical collar

  • Conforming splint

  • Cardboard splint

Correct answer: Backboard

Backboards are considered patient immobilization equipment, but they are too large to be carried in an EMR life support kit. Backboards are carried by ambulances, fire engines, lifeguard vehicles, and other types of first-responder vehicles.

An EMR life support kit would contain cervical collars, conforming splints, and cardboard splints, which are smaller.

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