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Quiz Session - Attempts With Random Questions

NREMT EMT Exam Questions

Page 10 of 52

181.

Which of the following medications are anticonvulsants that an EMT may see prescribed for a patient with a seizure disorder?

Select the two answer options which are correct.

  • Clonazepam (Klonopin)

  • Carbamazepine (Tegretol)

  • Donepezil (Aricept)

  • Warfarin (Coumadin)

Phenytoin (Dilantin), carbamazepine (Tegretol), valproic acid (Depakene), levetiracetam (Keppra), and topiramate (Topamax) are common anticonvulsant medications.

Donepezil (Aricept) is prescribed for the management of dementia and is not an anticonvulsant. Warfarin (Coumadin) is used to treat or prevent blood clots in veins or arteries, which can reduce the risk of stroke, heart attack, or other serious conditions.

182.

Which of the following terms is not used to characterize a pulse? 

  • Full 

  • Bounding

  • Regular 

  • Thready

Correct answer: Full

Pulse quality and rhythm characterize a person's pulse. A pulse that is strong with a regular rhythm is considered normal.

Bounding refers to a pulse that is stronger than normal. Thready or weak refers to a pulse that is not as strong as normal. An irregular rhythm, or a rhythm that is too fast or too slow, is considered abnormal.

Full is a term that describes the vasodilation of a blood vessel. It is not used to describe a normal pulse. 

183.

Which of the following are venomous snakes found in North America? 

Select the three answer options which are correct.

  • Rattlesnake

  • Cottonmouth

  • Copperhead

  • Bullsnake 

  • Cobra

  • King Snake

Commonly encountered venomous snakes in North America include:

  • rattlesnakes (timber rattler, prairie rattler, diamondback)
  • cottonmouths
  • copperheads
  • coral snakes

Bullsnakes are some of the largest snakes found in North America, but they are not venomous. 

184.

A three-year-old boy pulled a boiling pan of oil off the stove. He has third-degree burns over his entire head and the front of his trunk. Using the rule of nines, what percentage of the child's body's surface area is affected?

  • 36%

  • 18%

  • 27%

  • 45%

Correct answer: 36%

The rule of nines is a standardized method that is used to assess how much Body Surface Area (BSA) has been burned on a patient. This rule is only applied to partial-thickness (second-degree) and full-thickness (third-degree) burns.

  • Rule of 9s for adults: 9% for head, 18% for chest, 18% for back, 9% for each arm, 18% for each leg, and 1% for genitalia
  • Rule of 9s for children: 18% for head, 18% for chest, 18% for back, 9% for each arm, 13.5% for each leg, and 1% for genitalia

The child in this scenario is three years old, yielding the following: 

  • Head: 18%
  • Trunk (front): 18%

The total BSA involved is 36%.

185.

Which of the following are potential continuous positive airway pressure (CPAP) administration complications?

Select the three correct answer options.

  • Claustrophobia

  • Gastric distention

  • Hypotension

  • Bradycardia

  • Hypertension

Some patients may find CPAP claustrophobic and will not tolerate the mask, complicating the ventilation process. Do not force the application for these patients; instead, choose another treatment. The pressure of CPAP is generally helpful but can lead to gastric distention. Although rare, CPAP may also increase intrathoracic pressure, which reduces the preload available to the heart, resulting in hypotension. It is important to monitor blood pressure in patients receiving CPAP closely. 

Bradycardia is not known to be a complication of CPAP application. CPAP is likely to cause a drop in the blood pressure, not hypertension. 

186.

For which of the following wounds would an occlusive dressing be indicated? 

Select the 2 answer options which are correct.

  • Penetrating injury to the anterior neck

  • Penetrating injury to the chest

  • Burn injury to the face

  • Avulsion to the finger 

Occlusive dressings are used to keep air or fluid from entering the wound. Examples include penetrating wounds to the trachea, chest, mediastinum, or great vessels of the neck.  

Burn injuries should be covered with dry, sterile dressings that are non-adherent if possible, not an occlusive dressing. An avulsion to the finger would not be managed with an occlusive dressing but with sterile gauze and dressings. 

187.

For at least how long should you rub your hands when washing with soap and water?

  • 20 seconds

  • 45 seconds

  • 30 seconds

  • 10 seconds

Correct answer: 20 seconds

When washing with soap and water, the hands should be rubbed together for at least 20 seconds to lather. A longer time may be necessary if the hands are excessively soiled.

188.

A nasal cannula is an appropriate oxygenation method for which of the following patients?

  • A patient with mild respiratory distress and adequate pulse oximetry who cannot tolerate devices over their mouth

  • A COPD patient with 89% pulse oximetry reading

  • A geriatric patient who is confused and feeling short of breath

  • An unresponsive patient with unobtainable pulse oximetry

Correct answer: A patient with mild respiratory distress and adequate pulse oximetry who cannot tolerate devices over their mouth

A nasal cannula delivers 24% to 44% oxygen, with a supplemental flow of one to six liters per minute. A nasal cannula should be used if the patient has adequate oxygenation and is unable to tolerate a non-rebreather mask. A nasal obstruction will not allow adequate oxygenation to be obtained from a nasal cannula. Primarily, a non-rebreather mask should be used.

For a patient in respiratory distress (e.g., a severely dyspneic patient, pulse oximetry less than 90%), assisted ventilation, likely from a bag-valve-mask with a reservoir bag, is appropriate to deliver nearly 100% oxygen and provide the appropriate rate of ventilation.

Confusion and other altered mental statuses or unresponsiveness are potential signs of hypoxia and should be treated with high-flow oxygenation until an alternate cause can be determined or the patient has appropriate oxygenation.

189.

An 80-year-old male is pulseless, apneic, and exhibiting dependent lividity. Which of the following best describes dependent lividity?

  • Discoloration of the skin at the lowest point of the body

  • A stiffening of the body muscles

  • Decomposition of body tissue

  • A blue tint of the skin

Correct answer: Discoloration of the skin at the lowest point of the body

Dependent lividity is when blood settles at the lowest point of the body; this causes a discoloration of the skin at that point. This is a definitive sign of death.

Rigor mortis is the stiffening of the muscles caused by chemical changes within the tissue. This is also a definitive sign of death.

Putrefaction is the decomposition of body tissues, which can occur between 40 and 96 hours after death.

Cyanosis is a blue coloring of skin, lips, mucous membranes, or nail beds. This is a sign of low levels of oxygen in the blood. If it is severe, cyanosis can also be a sign of death.

190.

In addition to DCAP-BTLS, which of the following should be assessed in the extremities of a trauma patient?

  • Neurovascular status

  • Paradoxical motion

  • Reflexes

  • Retractions

Correct answer: Neurovascular status

In addition to evaluations for specific injuries (DCAP-BTLS), the neurovascular status of the extremities should be assessed in a conscious patient: distal pulses, motor function, sensory function. Assessment should include palpating the radial, posterior tibial, and dorsalis pedis pulses; asking the patient to make a fist and/or wiggle the toes (this should be stopped if any pain is elicited); and checking for sensation in the extremities (e.g., the tips of fingers/toes, lateral and medial surfaces of the limbs).

Retractions (muscle movement above the clavicle, indicating abnormal breathing) and paradoxical motion (unilateral chest rise on inspiration), are related to an assessment of the chest. Peripheral reflexes are not part of a prehospital assessment.

191.

A non-trauma patient presents with apnea and bradycardia. Assisted ventilation is attempted but is unsuccessful. If the patient's head is repositioned and repeated ventilation is unsuccessful, which of the following is the most appropriate next step?

  • Check for an airway obstruction

  • Attempt ventilation using an alternative method

  • Continue to reposition the head until assisted ventilation is successful

  • Continue with chest compressions only

Correct answer: Check for an airway obstruction

All patients in respiratory distress or failure (including apnea) require assisted ventilation. If attempted ventilation is unsuccessful, reposition the head if possible. If, after repositioning, assisted ventilation remains unsuccessful, check for an airway obstruction. If no airway obstruction exists, attempt to ventilate the patient using an alternative method.

It is not appropriate to continue to reposition the head, as this will not improve the situation.

Do not deny assisted ventilation to a patient who requires it before all possible methods of ventilation are exhausted.

192.

Which of the following are signs of decompensated shock from blood loss?

Select the 3 answer options which are correct.

  • Ashen, mottled, cyanotic skin

  • Systolic blood pressure below 90 mmHg

  • Weak or absent peripheral pulses

  • Constricted pupils 

  • Bounding pulse 

Decompensated shock occurs when the body can no longer compensate for blood loss. Signs that a patient is in decompensated shock include:

  • systolic blood pressure below 90 mmHg
  • declining mental status
  • labored or irregular bleeding
  • ashen, mottled, cyanotic skin
  • thready or absent peripheral pulses
  • dull eyes; dilated pupils
  • poor urinary output

193.

Which of the following statements is true regarding splinting?

  • Neurovascular status should be assessed before and after splinting

  • Clothing should be left on suspected fractures when splinting

  • Move a potentially affected limb to assess for crepitus prior to splinting

  • Stabilize the bone immediately above and below a suspected fracture but allow for mobility of adjacent joints

Correct answer: Neurovascular status should be assessed before and after splinting

Splinting is used to protect and maintain the position of an injured extremity while inhibiting motion. Fractures, dislocations, and sprains should be splinted prior to moving the patient, assuming there is no immediate danger. Splinting helps prevent further damage from broken bone ends, restricted distal blood flow due to the pressure of bone ends on blood vessels, excessive bleeding at the injury site, increased pain, and paralysis resulting from a damaged spine.

Clothing should be removed from suspicious areas to inspect for deformities, contusions, abrasions, penetrations or perforations, burns, tenderness, lacerations, and swelling (DCAP-BTLS); open wounds should be covered prior to splinting.

Splinting should include stabilization of the bone above and below a suspected joint fracture and the joint above and below a suspected bone fracture. All rigid splints should be padded to prevent discomfort.

Minimize movement of the affected extremity during splinting. Traction may be used to align severe deformities; if resistance is felt during traction, splint the affected region in the deformed position.

194.

An adult female fell approximately 20 feet onto the ground. She is complaining of pain in both of her arms and severe abdominal pain. A deformity is noted in the humeri bilaterally, about four inches above the elbows. Her abdomen is distended, rigid, and painful on palpation. The patient's heart rate is 130 beats per minute, and her capillary refill is delayed. Her skin is cool, pale, and diaphoretic. Findings suggest an internal injury. 

Which of the following is the appropriate way to obtain a blood pressure reading?

  • Take the blood pressure of the thigh

  • Take the blood pressure of the least injured arm

  • Do not take a blood pressure reading due to bilateral arm injuries

  • None of these

Correct answer: Take the blood pressure of the thigh

A thigh-sized sphygmomanometer is used for obese patients, patients with exceptionally well-developed arm muscles, or patients who have injuries to both arms.

Taking a blood pressure reading over an injury may worsen damage to the affected area.

It is not appropriate to avoid obtaining a blood pressure reading if one can be measured.

195.

A 28-year-old female involved in a motor vehicle collision is found still restrained in the driver's seat of her car. She is conscious and alert but complains of neck and back pain. Which of the following should be asked to help assess for possible spinal injuries?

  • "Can you squeeze my hands?"

  • "What is the day of the week?"

  • "Are you able to lift both legs and hold them together?"

  • "How did the accident happen?"

Correct answer: "Can you squeeze my hands?"

In addition to DCAP-BTLS, neurovascular status (perfusion, motor function, and sensation) in all extremities should be checked. Strength is assessed by having the patient squeeze the EMT’s hands and gently push each foot against the EMT's hands. Excessively moving a body part (e.g., having the patient lift the legs) is not appropriate.

Assessment of level of consciousness (including orientation to person, place, time, and event) should be completed prior to the initial assessment; it will not help distinguish the presence or absence of a spinal injury.

196.

A 30-year-old male has suffered a fractured wrist due to a fall. He is alert and refusing care and transport to the hospital for definitive care. His vitals are within normal ranges and a peripheral pulse is noted in the injured arm. Which of the following actions would be most appropriate in this case?

  • Explain the risks, benefits, and alternatives to treatment and its refusal, and have him sign a refusal-of-care form with a witness

  • Ask law enforcement to put him into protective custody

  • Have law enforcement coerce the patient to allow treatment and transport

  • Explain that because he has a fractured extremity, he cannot refuse treatment

Correct answer: Explain the risks, benefits, and alternatives to treatment and its refusal, and have him sign a refusal-of-care form with a witness

An alert, competent adult patient may refuse treatment; however, the risks, benefits, and alternatives to the treatment and its refusal must be explained to the patient prior to accepting a refusal. Any refusal of treatment/transport should be documented and signed by the patient, with a witness. EMS personnel would not be liable in this situation as long as the patient was fully aware of the consequences of his actions.

Law enforcement will not force a competent adult to comply with requests for treatment. If the patient is deemed incompetent and becomes aggressive or abusive, law enforcement intervention may be necessary. There is no such thing as protective custody for law enforcement.

197.

A 74-year-old female is complaining of chest pain and trouble catching her breath. She has a cough that produces pink, frothy sputum. Crackles are noted on auscultation of the lungs. Which of the following is most likely causing her signs and symptoms?

  • Congestive heart failure

  • Stable angina pectoris

  • Cardiogenic shock

  • Emphysema

Correct answer: Congestive heart failure

Congestive heart failure occurs when the ventricular heart muscle is permanently damaged and can no longer keep up with the returning blood flow from the atria. It can occur after a myocardial infarction, heart valve damage, or long-standing hypertension. When the ventricular muscle can no longer contract effectively, the body attempts to maintain cardiac output by increasing heart rate and/or enlarging the left ventricle. Eventually, these adaptations no longer maintain cardiac output, and congestive heart failure develops. Patients may demonstrate pulmonary and peripheral edema, easier breathing while sitting up, distended neck veins, hypertension, tachycardia, tachypnea, retractions, cyanosis, diaphoresis, or crackles on auscultation; chest pain may or may not be evident. Pink, frothy sputum may occur due to pulmonary edema.

Stable angina pectoris will typically cause chest pain, dyspnea, and diaphoresis that are all relieved with rest.

Emphysema, a type of chronic obstructive pulmonary disease (COPD), is a loss of elastic material within the alveolar air space. Adventitious breath sounds (e.g., crackles, rhonchi, wheezing) may be heard on lung auscultation. Dyspnea, chronic coughing, chronic sputum, and long expiration phases are possible in patients with COPD.

Cardiogenic shock is when the heart lacks enough power to force the appropriate volume of blood throughout the body. As with most types of shock (hypoperfusion), restlessness and anxiety are early signs. Patients can then develop dyspnea; cool, clammy skin; a weak, thready pulse; tachycardia; rapid, shallow breathing; nausea/vomiting; and hypertension that can eventually become hypotension.

198.

Which of the following is the opposite of urinary incontinence?

  • Urinary retention

  • Cystitis

  • Kyphosis

  • Renal calculi

Correct answer: Urinary retention

Incontinence is the inability to postpone voiding or bowel movements. If a patient is unable to void, they are suffering from urinary retention. A common cause of urinary retention in males is an enlarged prostate. If urinary retention progresses, renal failure may occur.

Cystitis is a urinary tract infection of the bladder. These infections may cause inflammation and potential renal damage as well.

Kyphosis is the forward curling of the back caused by an increased curvature of the spine.

Renal calculi are kidney stones. If a stone blocks a ureter, pressure will build behind the stone, and the kidney will swell.

199.

During the transport of a pregnant patient who suddenly develops seizures, what is the most important treatment priority?

  • Provide supplemental oxygen

  • Administer oral glucose

  • Perform a rapid glucose test

  • Initiate an intravenous line with magnesium sulfate

Correct answer: Provide supplemental oxygen

Providing supplemental oxygen is crucial during seizures to ensure adequate oxygenation to both the mother and fetus, especially in the context of potential eclampsia.

Administering oral glucose is not appropriate during seizures due to the risk of aspiration and the fact that seizures in this context are likely not due to hypoglycemia.

While assessing blood glucose levels is important in some scenarios, it is not the immediate priority during seizures in a pregnant patient.

Although starting an IV with magnesium sulfate may be indicated for eclampsia, the immediate priority during a seizure is to ensure adequate oxygenation.

200.

Your patient is experiencing a postpartum hemorrhage immediately after delivering at home. Which of the following is the most appropriate initial step?

  • Perform uterine massage to encourage contraction.

  • Administer oral fluids to maintain hydration.

  • Administer supplemental oxygen.

  • Elevate the patient's legs to increase blood flow to vital organs.

Correct answer: Perform uterine massage to encourage contraction.

Uterine massage is a first-line intervention to encourage the uterus to contract, which can help control bleeding by compressing the blood vessels within the uterine wall.

While maintaining hydration is important, oral fluids will not address the immediate need to control the hemorrhage.

Administration of oxygen may be necessary if the bleeding continues, but the initial step to help control postpartum bleeding is to provide uterine massage.

Elevating the legs can help increase perfusion to vital organs but does not directly address stopping the hemorrhage.

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