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Quiz Session - Attempts With Random Questions

NREMT EMT Exam Questions

Page 5 of 52

81.

An EMT arrives at the scene where a baby has just been delivered at home. The baby is breathing but is cyanotic and has a heart rate of 80 beats per minute. Which of the following actions should the EMT take first?

  • Perform a rapid assessment and begin ventilations with a bag-valve-mask (BVM). 

  • Begin chest compressions immediately. 

  • Administer 100% oxygen via a pediatric non-rebreather mask. 

  • Place the baby on the mother's chest for skin-to-skin contact and reassessment in 10 minutes.

Correct answer: Perform a rapid assessment and begin ventilations with a bag-valve-mask (BVM).

The initial step in neonatal resuscitation for a baby showing signs of distress (cyanosis and a heart rate below 100 bpm) is to ensure that the airway is clear and start ventilation to improve oxygenation. This action is critical to increase the heart rate and improve color.

Chest compressions are indicated if the heart rate is below 60 bpm despite adequate ventilation. This baby's heart rate is above this threshold.

While administering oxygen is a component of neonatal resuscitation, the priority for a baby with a heart rate of 80 bpm and cyanosis is to establish effective ventilation rather than providing oxygen via a non-rebreather mask.

Skin-to-skin contact is beneficial for warming and bonding but does not address the immediate need for assisted ventilation in a baby with signs of poor perfusion and inadequate respiratory effort.

82.

Overaggressive ventilation with a bag-valve-mask device can complicate a respiratory failure situation and can cause which of the following?

Select the three answer options which are correct.

  • Gastric distention

  • Vomiting

  • Barotrauma

  • High carbon dioxide

Overaggressive ventilation with a bag-valve-mask device can cause barotrauma from too much tidal volume or excessive pressure in the airway. Overaggressive ventilation with a bag-valve-mask device also causes gastric distension, which can lead to vomiting and aspiration. Hypocapnia, an excessive loss of carbon dioxide, is also common in overaggressive ventilation due to high minute volume.

Too much carbon dioxide (hypercapnia) is common in airway obstruction or a low respiratory drive, such as a narcotic overdose, and it is not a result of overaggressive ventilation. Aggressive ventilation can actually cause low carbon dioxide (hypocapnia).

83.

Which of the following is a contraindication for aspirin administration in a prehospital setting? 

  • All of these

  • Liver damage

  • Asthma

  • Bleeding disorders

Correct answer: All of these 

Aspirin acts as an antipyretic (fever reducer), analgesic (pain reducer), anti-inflammatory agent (inflammation reducer), and platelet-aggregation inhibitor (prevents clots from forming or growing in size). It does not affect vessel size. It is often used after an acute myocardial infarction (AMI) or regularly for cardiac patients to help prevent future AMIs. 

Aspirin may cause bleeding and/or stomach ulcers. Contraindications to aspirin include allergy (absolute), preexisting liver damage (absolute), bleeding disorders (relative), and asthma (relative).

84.

Which of the following is a likely indication for the prehospital administration of epinephrine?

  • Wheezing due to an allergic reaction

  • Hypoglycemia due to an adjusted insulin dose

  • Hives due to an allergic reaction

  • Chest pain secondary to acute myocardial infarction

Correct answer: Wheezing due to an allergic reaction

Epinephrine is a sympathomimetic that is used to counteract signs of an allergic reaction/anaphylaxis. It can increase heart rate and blood pressure, as well as constrict blood vessels and dilate passages to the lungs.

Oral glucose is indicated for patients with hypoglycemia. 

Hives may indicate an allergic reaction, which should be managed with an antihistamine. Signs of a severe allergic reaction or anaphylaxis requiring epinephrine include the presence of hives with airway symptoms such as stridor, angioedema, and wheezing.  A patient experiencing an acute myocardial infarction should not receive epinephrine. Nitroglycerin and aspirin are indicated for those with acute myocardial infarction.

85.

A 31-year-old woman (G2P1) at 35 weeks gestation is lying in a pool of blood, with active bleeding from the vagina. She is drowsy but responds to questions. Peripheral pulses are weak bilaterally. Which of the following would be increased?

  • Systemic vascular resistance

  • Cardiac output

  • Systolic blood pressure

  • Cardiac preload

Correct answer: Systemic vascular resistance

This patient is presenting with signs of hypovolemic shock due to bleeding. A loss of intravascular volume decreases cardiac preload, resulting in decreased cardiac output and decreased systemic blood pressure. The sympathetic nervous system responds with an increased heart rate and peripheral vasoconstriction (systemic vascular resistance) to maintain cardiac output and redirect blood flow to the vital organs (brain, heart, kidneys). This response causes the cool, clammy skin that is observed in shock.

Cardiac output, systolic blood pressure, and cardiac preload would be decreased in this case due to blood loss.

86.

Which of the following is not an effective technique for stress reduction?

  • Working extra hours

  • Limiting agitation over situations that are outside your control

  • Expanding a support system beyond coworkers

  • Avoiding negative/hostile personalities

Correct answer: Working extra hours

Stress is any event, thought, or action that is perceived as a threat. It is imperative to manage stress appropriately to promote personal safety, scene safety, and patient care.

Some strategies to help manage stress include the following: 

  • minimizing/eliminating stressors as much as possible
  • avoiding negative/hostile personalities
  • changing work hours
  • cutting back on overtime
  • changing work environments
  • changing attitudes about stressors
  • talking with trusted people
  • seeking professional help if needed
  • not obsessing over situations that are out of one's control
  • adopting a more relaxed outlook
  • expanding one's social support system beyond coworkers
  • regular stretching/yoga
  • slow, deep breathing
  • regular physical exercise
  • progressive muscle relaxation
  • meditation
  • limiting caffeine, alcohol, and tobacco use

87.

Which of the following types of injuries would not require spinal motion restriction? 

  • Shoulder injury

  • Hip injury

  • Pelvic injury

  • Spinal injury

Correct answer: Shoulder injury

Spinal motion restriction should be considered for patients with multisystem trauma injuries or suspected hip, pelvic, spinal, and lower extremity injuries. Follow local protocols, but spinal motion restriction may be accomplished with a C-collar.

A shoulder injury does not necessarily require a long backboard. A shoulder injury is immobilized in a position of comfort and placed in a sling and swathe.

88.

A seven-year-old female fell off of her bicycle and has a suspected broken wrist. She denies any other trauma, and there are no signs of internal injuries. After providing necessary care at the scene, you initiate transport. Her father insists on the use of lights and the siren during transport. Which of the following is the most appropriate next step?

  • Refuse and explain that this is a safer method of transport and the siren is not necessary

  • Contact medical direction for permission to use the lights and siren

  • Ask the police to restrain the father

  • Turn on the lights and siren

Correct answer: Refuse and explain that this is a safer method of transport and the siren is not necessary

Non-emergency transport (no lights and siren) is an appropriate and safe method of travel for patients with this kind of injury. Medical direction does not need to be obtained to make this determination.

High-priority patients require rapid transport. Examples of high-priority patients include those who are unresponsive, are responsive but unable to follow commands, yield a poor general impression, have difficulty breathing, have uncontrolled bleeding, have severe chest pain, have severe pain in any area of the body, have pale skin/signs of poor perfusion, or are pregnant with expected complicated childbirth.

There is no indication that the patient's father is combative; police intervention is not necessary at this time.

89.

An EMT is called to assist a woman in labor. Upon examination, the EMT notices that the umbilical cord has prolapsed. What is the EMT's best course of action?

  • Elevate the mother's hips and administer high-flow oxygen.

  • Immediately push the cord back into the vagina.

  • Place the mother in a supine position with her legs flat.

  • Administer oxygen to the mother and prepare for rapid transport.

Correct answer: Elevate the mother's hips and administer high-flow oxygen.

Elevating the mother's hips reduces pressure on the prolapsed cord, which can improve fetal oxygenation. Administering high-flow oxygen to the mother can also help increase fetal oxygenation. Once you have the patient positioned, insert your gloved hand into the vagina and carefully relieve pressure off of the cord from the baby's head. Transport rapidly to the closest hospital.

Attempting to push the cord back can cause further damage or compression, worsening the situation.

Placing the mother in a supine position with her legs flat can increase pressure on the cord, potentially reducing fetal oxygenation.

While administering oxygen and preparing for rapid transport are part of the management, these actions alone are insufficient without addressing the need to relieve pressure on the umbilical cord.

90.

An adult patient may be suffering from an ischemic stroke. After ensuring a patent airway and adequate oxygenation, which of the following should be the next priority?

  • Establish a timeline of onset and provide rapid transport

  • Determine the patient's blood glucose level, medical history, and medications and provide rapid transport

  • Determine the patient's blood pressure bilaterally and provide rapid transport

  • Complete a detailed medical examination prior to transport

Correct answer: Establish a timeline of onset and provide rapid transport

An ischemic stroke is the most common type of stroke, accounting for more than 80% of all cases. A blockage (blood clot/thrombosis, embolus, or plaque) does not allow blood flow to a specific area of the brain or brainstem. Atherosclerosis is a calcium and cholesterol buildup that forms plaque inside the walls of a blood vessel. Blood clots or plaque buildups may occur elsewhere in the body, break off, and travel to the brain. A timeline of symptoms is important in the case of an ischemic stroke. Ideally, thrombolytic therapy (clot-dissolving medications) should be administered within three hours of onset; mechanical methods of treatment should be administered within six hours of onset. Spend as little time on site as possible. Ensure adequate oxygenation and ventilation, then transport rapidly to a stroke-capable hospital.  

Hyperglycemia and hypoglycemia have no bearing on the treatment for a patient suffering from an ischemic stroke.

A disparity in blood pressure between the upper extremities may be indicative of a dissected aortic aneurysm.

A detailed medical examination would require too much time on site.

91.

A 63-year-old patient was found unresponsive and pulseless. CPR has been initiated by another rescuer. An automated external defibrillator (AED) is available. What is the most appropriate next step?

  • Turn on the AED

  • Apply the AED

  • Analyze the patient's heart rhythm with the AED

  • Wait until five cycles (two minutes) of CPR have been completed before using the AED

Correct answer: Turn on the AED

An AED should be applied to a pulseless and unresponsive patient as soon as it is available. First, turn on the AED. The application of the AED pads is done after the AED is turned on. The AED cannot analyze a heart rhythm if it is not turned on.

It is inappropriate to wait to turn on the AED and apply AED pads until five cycles of CPR have been completed.

92.

Which of the following patients would be considered a high priority?

  • A 62-year-old female with severe chest pain

  • A 35-year-old male with moderate traumatic pain from a leg injury

  • A 69-year-old female who appears confused but responds to commands

  • A 28-year-old female in labor with contractions six minutes apart and no signs of complications or imminent childbirth

Correct answer: A 62-year-old female with severe chest pain

High-priority patients require rapid transport (i.e., spending as little time as needed at the scene). Examples of high-priority patients include those who are unresponsive, are responsive but unable to follow commands, yield a poor general impression, have difficulty breathing, have uncontrolled bleeding, have severe chest pain, have severe pain in any area of the body, and have pale skin/signs of poor perfusion, as well as pregnant patients with likely complicated childbirth. 

93.

You find an unconscious adult patient with no one present who knows them. What type of consent is needed prior to initiating care and transport of this patient to the appropriate medical facility?

  • Implied consent

  • Implicit consent

  • No need for consent

  • In loco guardianos 

Correct answer: Implied consent

Implied consent is determined if a patient is unconscious or otherwise incapable of making a rational, informed decision. Examples of this are patients who are intoxicated by drugs or alcohol, mentally impaired, or suffering from a condition that precludes making a rational, informed decision (e.g., head injury). Implied consent only applies when a serious medical condition exists (i.e., a threat to life or limb). Every effort should be made to obtain consent from an available relative prior to treatment, but lifesaving care should not be delayed by waiting for such consent.

Expressed consent is the verbal authorization for, or otherwise acknowledgment of, treatment and/or transport. A child cannot give this consent. For expressed consent to be legitimate, the patient must be informed. Informed consent is given after the risks, benefits, and alternatives to treatment/transport, as well as consequences of the refusal of treatment, are explained to the patient. 

An adult patient must be conscious, alert, and able to make decisions in order to refuse treatment/transport. Ensure that the patient has all pertinent information (e.g., assessment, treatment options, consequences of refusal) before you accept a refusal of treatment. A parent or guardian may refuse treatment/transport for a child in non-life-threatening circumstances. Refusal of treatment/transport should be documented and signed by the patient; a witness to the signature, such as a family member or police officer, is appropriate.

Implicit consent is not a term used in health care. In loco parentis is consent given by an authority figure in the position or place of a parent on behalf of a minor. This individual must be capable of giving expressed consent. Ideally, a parent/guardian should be contacted regarding consent; however, in an emergency situation, in loco parentis or implied consent is likely appropriate. In loco guardianos is a fictional term.

94.

Which of the following diabetic patients would likely benefit from the administration of oral glucose?

  • A confused patient who is cool and clammy with a patent airway

  • A confused patient who has hemiparesis and dysphagia

  • An unconscious patient who may have accidentally taken too much insulin

  • An alert and oriented patient who has hot, dry skin

Correct answer: A confused patient who is cool and clammy with a patent airway

Oral glucose is indicated for patients with hypoglycemia. A patient who does not require oral glucose will not be harmed by it, so it should be given if hypoglycemia is suspected. Hypoglycemia often causes a rapid onset of altered mental status, particularly in a patient with a history of diabetes. Other signs and symptoms include pale, cool, moist skin; hypotension; a rapid, weak pulse; and possibly shallow respirations in severe cases. Oral glucose should not be given to an unresponsive/unconscious patient or a patient without a gag reflex due to the risk of aspiration.

Dysphagia is difficulty swallowing or an inability to swallow; therefore, this patient is at risk for aspiration of any medication.

Hot, dry skin is not a common symptom of hypoglycemia, so this patient will not likely benefit from oral glucose administration.

95.

Which of the following are phases of a rescue operation? 

Select the 3 answer options which are correct.

  • Arrival and scene size-up

  • Disentanglement

  • Gaining access 

  • Decontamination

Rescue situations may take many forms, but the rescue will generally follow these phases: 

  1. Arrival and scene size-up
  2. Hazard control
  3. Gain access to the patient
  4. Medical treatment
  5. Disentanglement
  6. Patient packaging
  7. Transportation

Decontamination would be a phase of a hazmat operation.  

96.

What is the primary action of nitroglycerin?

  • Relaxation of the muscles of blood vessel walls

  • Contraction of the heart muscles

  • Relaxation of the heart muscles

  • Contraction of the muscle of blood vessel walls

Correct answer: Relaxation of the muscle of blood vessel walls

Nitroglycerin is a vasodilator; it acts by relaxing the muscle of the blood vessel walls and dilating coronary arteries, which subsequently increases blood flow and oxygen supply to heart muscles and decreases the workload of the heart. It dilates blood vessels throughout the body, so hypotension and headache can occur; tachycardia and bradycardia are also possible side effects.

Nitroglycerin does not have a direct effect on heart muscles.

97.

Which of the following is the most likely cause of a tension pneumothorax?

  • Blunt trauma to the chest

  • Penetrating trauma to the chest

  • Ruptured, torn, or lacerated coronary artery or vein

  • Penetrating trauma to the neck

Correct answer: Blunt trauma to the chest

A pneumothorax is a partial or complete accumulation of air in the pleural space. A tension pneumothorax commonly results from trauma to the chest, more commonly a closed, blunt injury that causes a fractured rib to lacerate a lung or bronchus. A tension pneumothorax can be spontaneous, but this is rare. Chest pain, respiratory distress, decreased lung sounds, tachycardia, and signs of shock can appear in patients with a tension pneumothorax.

An open pneumothorax is due to an open or penetrating wound to the chest wall. It is also known as a sucking chest wound because a sucking sound can be heard as the patient inhales. 

Cardiac tamponade is commonly the result of penetrating—but sometimes blunt—chest trauma that causes a ruptured, torn, or lacerated coronary artery or vein to release blood into the pericardial sac.

98.

Which of the following are signs of compartment syndrome? 

Select the 3 answer options which are correct. 

  • Tenderness 

  • Pain

  • Numbness 

  • Flaccid muscle tone

The "Ps" are often associated with compartment syndrome. They are as follows:

  • pain (intense pain and tenderness, especially when the muscle is stretched, which seems much worse than would normally be expected for the injury)
  • pallor (pale skin tone)
  • paresthesia (numbness feeling)
  • pulselessness (faint pulse)
  • paralysis (weakness with movements)

Flaccid muscle tone is associated with nerve impairment, not compartment syndrome. Tight muscle tone often occurs in an affected limb with compartment syndrome. 

99.

Assuming the assessment of a patient's pulse and breathing are done simultaneously, what is the maximum time these assessments should take?

  • 10 seconds

  • 15 seconds

  • 30 seconds

  • 60 seconds

Correct answer: 10 seconds

After a patient is deemed unresponsive, assess for a pulse and breathing. These assessments can be done simultaneously and should take no longer than 10 seconds in total. A pulse assessment should occur at the carotid. If no pulse is palpable, CPR should be initiated, beginning with chest compressions.

100.

An ambulance is responding to a call for an apneic patient. Lights and sirens are used as the ambulance approaches a four-way intersection controlled by traffic lights. The light for the direction of the ambulance's travel begins to change from green to yellow upon approach. 

Which of the following is the safest way to proceed through the intersection?

  • Come to a brief stop at the light, look for motorists and pedestrians before proceeding, and move forward when it is safe

  • Slow down, change the tone of the siren, and move through the intersection

  • Reduce speed, change the tone of the siren, and prepare for an emergency maneuver if necessary

  • Use the air horn to warn that an emergency vehicle is approaching the intersection

Correct answer: Come to a brief stop at the light, look for motorists and pedestrians before proceeding, and move forward when it is safe

Intersection crashes are the most common and typically the most serious crashes in which ambulances are involved. If a call is urgent or transportation needs to be rapid, come to a brief stop at an intersection and look for other motorists and pedestrians prior to proceeding through the intersection. Some motorists "time" the traffic lights, which causes an additional hazard. If you are following another vehicle through an intersection, be extra vigilant; other motorists may not be expecting a second vehicle to pass.

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