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Quiz Session - Attempts With Random Questions

NREMT EMT Exam Questions

Page 7 of 52

121.

 Which of the following would be the best question to get information about the "S" of the "OPQRST" mnemonic? 

  • "On a scale of zero to ten, how would you rate your symptom?"

  • “Does anything make the symptoms better or worse?”

  • "When did the symptom start? "

  • “What does the symptom feel like?”

Correct answer: On a scale of zero to ten, how would you rate your symptom? 

The OPQRST mnemonic is useful for gathering background information on a patient’s chief complaint. OPQRST stands for onset, provocation/palliation, quality, region/radiation, severity, and timing. Common questions for each item are listed below.

  • Onset: “What were you doing when the symptoms began?”
  • Provocation/palliation: “Does anything make the symptoms better or worse?”
  • Quality: “What does the symptom feel like?”
  • Region/radiation: “Where do you feel the symptom? Does it move anywhere?”
  • Severity: “On a scale of zero to ten, how would you rate your symptom?”
  • Timing: “When did the symptom start? How long as has it been occurring? Has it been constant, or does it come and go?"

122.

Which of the following pairs indicate hypovolemic shock?

  • Tachycardia and cool, clammy skin

  • Tachycardia and normal blood pressure

  • Bradycardia and hypotension

  • Itching or rash

Correct answer: Tachycardia and cool, clammy skin

Different types of shock have varying signs and symptoms. Hypovolemic shock, which is due to inadequate fluid or volume in the circulatory system, can be caused by bleeding (hemorrhagic) or dehydration (non-hemorrhagic). Common signs and symptoms include an altered mental status, a rapid and weak pulse, hypotension, tachypnea, cyanosis, and cool, clammy skin.

Tachycardia and normal blood pressure can occur in psychogenic shock. Bradycardia, hypotension, and possible neck injury are common in neurogenic shock. Anaphylactic shock may cause itching, a rash, vascular dilation, and/or generalized edema; it can progress rapidly and cause death.

123.

Which of the following statements are false regarding partial airway obstructions in a responsive patient?

Select the two correct answer options.

  • Allowing a patient to drink something will clear most partial airway obstructions

  • A patient cannot clear a partial airway obstruction on their own

  • Performing the Heimlich maneuver is not recommended for patients with a partial airway obstruction

  • Encourage the patient to cough if they have a partial airway obstruction

If a possibly choking patient is coughing or can speak, they have a partial airway obstruction. If the patient is unable to speak and is not coughing, they have a complete airway obstruction. 

The abdominal thrust maneuver (Heimlich) is the most effective method of dislodging a complete airway obstruction in a conscious patient. However, do not attempt the Heimlich maneuver on a patient with a partial airway obstruction, as it can cause the object to shift down into the airway. The best treatment is to reassure the patient and encourage them to try to cough forcefully. Allowing the patient to drink something is not recommended.

124.

When providing assisted ventilation to an adult via a bag-valve mask, which approximate tidal volume will cause a noticeable rise of the chest?

  • 500 mL

  • 400 mL

  • 800 mL

  • 1000 mL

Correct answer: 500 mL

An adult bag-valve mask has a volume capacity of between 1200 and 1600 mL. When providing assisted ventilation via a bag-valve mask, squeeze the bag to cause a noticeable rise of the patient's chest. The approximate volume is about 500 mL provided over one second. This tidal volume helps reduce the risk of gastric distension.

125.

Which of the following is an effect of aspirin?

  • Inhibition of platelet aggregation

  • Anticoagulation

  • Vasodilation

  • Prevention of stomach ulcers

Correct answer: Inhibition of platelet aggregation

For people who have had a heart attack or stroke or experience certain forms of cardiovascular disease (disease affecting the heart or blood vessels), taking daily, low-dose aspirin significantly reduces the risk of having another heart attack or stroke or of dying from cardiovascular disease.

Aspirin non-selectively and irreversibly inhibits cyclooxygenase, reducing prostaglandin and thromboxane A2 synthesis, producing analgesic, anti-inflammatory, and antipyretic effects, and reducing platelet aggregation.

Adverse effects of aspirin include GI pain, ulceration, bleeding, hepatotoxicity, hearing loss, and nausea.

Blockade of cyclooxygenase with even low-dose aspirin causes collateral vessel constriction with a decrease in collateral blood flow. However, nitroglycerin can fully reverse aspirin-induced collateral vasoconstriction and restore flow to baseline levels.

126.

Which of the following patients requires rapid transport?

  • A 28-year-old male with an allergic reaction to a bee sting who has dyspnea and a rapid pulse

  • A 53-year-old female with alleviated chest pain after assisted administration of nitroglycerin

  • A 24-year-old female at 40 weeks of gestation with crowning but no complications

  • A 13-year-old female who fell off a bicycle with a possible fractured wrist, minor cuts, and bruising

Correct answer: A 28-year-old male with an allergic reaction to a bee sting who has dyspnea and a rapid pulse

High-priority patients require rapid transport. Examples of high-priority patients include those who are unresponsive or those who 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 or signs of poor perfusion, or are pregnant with likely complicated childbirth.

Crowning indicates that birth is imminent. Delivery should be considered at the scene.

127.

An unresponsive adult patient is found soaked and outside in the rain. They are apneic and pulseless. What is the most appropriate initial intervention?

  • Begin CPR while moving the patient out of the rain in anticipation of using an AED

  • Begin CPR and defibrillate the patient via an AED before moving the patient

  • Provide 2 rescue breaths

  • Defibrillate the patient via an AED

Correct answer: Begin CPR while moving the patient out of the rain in anticipation of using an AED

CPR should be initiated on any pulseless patient. While early defibrillation is important, CPR should not be delayed or withheld. The use of an automated external defibrillator (AED) is indicated for unresponsive and pulseless patients. 

An AED should not be used on a patient who is immersed in water or the rain; an AED may be used after quickly drying a patient's chest if needed or if the patient is in a small puddle or snow. Allowing this patient to remain in the rain during defibrillation may subject rescuers to shocks from the AED or decrease its effectiveness.

128.

Which measure provides legal protection to someone who helps an injured person?

  • Good Samaritan law

  • Malpractice insurance 

  • First Responders Act

  • Medical Protection Act

Correct answer: Good Samaritan law

Good Samaritan laws are based on the common-law principle that when an individual reasonably helps another person, that individual should not be liable for errors or omissions that are made in giving good-faith emergency care. These laws typically require that the individual acted in good faith by rendering care, rendered care without expectation of compensation, acted within the scope of their training, and did not act in a grossly negligent manner.

Malpractice Insurance is used to help cover the legal expenses of a healthcare provider who is accused of negligence but does not offer legal protection under the law.  

There is no such thing as the First Responders Act or the Medical Protection Act.

129.

Which of the following are acceptable methods of bleeding control that an EMT can use?

Select the 3 answer options which are correct. 

  • Application of topical hemostatic agents with direct pressure

  • Application of a pressure dressing 

  • Application of a tourniquet

  • Application of cold pack with a pressure dressing

Several methods are available for the EMT to use for bleeding control, depending on local protocols. They include:

  • direct pressure
  • pressure dressings and/or splints
  • tourniquets
  • hemostatic dressings
  • wound packing

The use of a cold pack is not appropriate for bleeding control. 

130.

Which of the following signs or symptoms is least likely to be present in a patient who is experiencing a severe allergic reaction to a bee sting?

  • Bradycardia

  • Wheezing

  • Hypotension

  • Anxiety

Correct answer: Bradycardia

An allergic reaction occurs when the immune system overreacts to a harmless substance known as an allergen. Substances such as pollen, certain foods, latex, mold, pet dander, dust mites, or insect stings can trigger the production/release of antibodies called immunoglobulin E (IgE), causing symptoms in the nose, lungs, throat, sinuses, ears, lining of the stomach, and skin. Bradycardia is not likely to be present in a severe allergic reaction.

Anaphylaxis is a serious, life-threatening systemic allergic reaction. Any allergic reaction involving swelling of the mouth or throat should be considered life-threatening and may require advanced airway management. Request ALS assistance for any allergic reaction involving the mouth or throat.

Common signs and symptoms of a localized allergy are sudden pain, swelling, localized heat, urticaria, and redness at the site.

Anaphylaxis may present with tachycardia, bronchospasms, wheezing, chest tightness, coughing, dyspnea, hypotension, anxiety, and gastrointestinal complaints.

131.

An adult patient has substernal chest pain. In which of the following situations should nitroglycerin be withheld?

  • If the patient has taken tadalafil (Cialis) within the past 24 hours

  • If the patient is experiencing non-radiating chest pain

  • If the patient has a history of acute myocardial infarction (AMI)

  • If the patient's diastolic blood pressure is 80 mm Hg

Correct answer: If the patient has taken tadalafil (Cialis) within the past 24 hours

Nitroglycerin effectively reduces ischemic chest discomfort, has beneficial hemodynamic effects, and reduces mortality in patients suffering from myocardial infarction. Physiologically, nitrates reduce ventricular preload (left and right) through the dilation of peripheral vasculature (both arterial and venous).

Avoid the use of nitroglycerin if it is suspected or known that the patient has taken sildenafil or vardenafil within the previous 24 hours or tadalafil within 48 hours. These agents (phosphodiesterase inhibitors, PDEs) are generally used for erectile dysfunction or in cases of pulmonary hypertension, and in combination with nitrates, they may cause severe hypotension refractory to vasopressor agents. Monitor blood pressure closely.

Nitroglycerin is contraindicated in patients who have a systolic blood pressure below 100 mm Hg, patients with a head injury, patients who have taken erectile dysfunction medications [e.g., sildenafil (Viagra), tadalafil (Cialis), avanafil (Stendra) or vardenafil (Levitra, Staxyn)] within the previous 48 hours, and patients who have already taken their maximum dose (typically three doses).

Most patients are allowed to repeat doses (typically up to three) if the pain remains after five minutes. Because of the previously mentioned contraindication, blood pressure should be assessed before administration of initial or repeated nitroglycerin.

A diastolic blood pressure of 80 mm Hg is not a contraindication to nitroglycerin use.

132.

A semiconscious adult patient requires suctioning due to copious amounts of mucus without likely foreign bodies in the oropharynx. What is the most appropriate method of suctioning?

  • Turn the head to the side (if no spine injury is suspected)

  • Suction during withdrawal, ensuring the vacuum has a pressure of at least 150 mmHg

  • Suction during insertion for no more than 15 seconds

  • Suction during withdrawal for no more than 30 seconds

Correct answer: Turn the head to the side (if no spine injury is suspected)

Suctioning removes oxygen and can result in hypoxia. It is important to insert the catheter no further than can be visualized and to suction during withdrawal for no more than 10 seconds for adult or pediatric patients. The suctioning unit should have at least 300 mmHg of vacuum pressure.

Prolonged suctioning can actually obstruct an airway. Aggressive suctioning may cause vagal stimulation, especially in children, which may cause further hypoxia or bradycardia. It is recommended to limit suction attempts for patients of all ages to 10 seconds. Some textbooks may reflect 15 seconds, but the current recommended practice is 10 seconds.

133.

Which of the following statements describe the correct location of key elements of a HAZMAT scene? 

Select the 2 answer options which are correct.

  • The decontamination corridor is in the warm zone.

  • The command post is in the cold zone.

  • The incident command post is in the warm zone.

  • Triage occurs in the hot zone.

HAZMAT scenes are divided into safety zones based on the hazard, amount spilled, and other factors. These zones are established to help ensure the safety of responders. 

The hot zone is the contaminated zone in which only trained responders with proper PPE are allowed. The warm zone surrounds the hot zone and is where the decontamination corridor is established. Responders working in the warm zone must be properly trained and have proper PPE. The cold zone is established to provide a buffer from the hazards and requires no special training or PPE. 

The command post is established in the cold zone. Triage is generally completed in the cold zone after decontamination.

134.

A patient has had skin contact with a poison. For how long should their skin be flooded with water?

  • 15–20 minutes

  • 20–30 minutes

  • Five to ten minutes

  • At most five minutes

Correct answer: 15–20 minutes

Contact with a poison may cause chemical burns, rash, itching, irritation, or erythema. Absorption of toxic substances through the skin is a common problem in the agricultural and manufacturing industries, as toxic solvents, insecticides, herbicides, and pesticides can be irritating to the skin or cause systemic signs and symptoms.

Emergency management of contact poisoning includes avoiding self-contamination by EMS personnel and removal of the irritating or corrosive substance from the patient. If the chemical is dry, brush off the remaining chemical, flush with water for 15–20 minutes, and then wash with soap and water. Cases of liquid exposure should be flushed for 15 to 20 minutes. Ensure communication with hazardous materials teams and decontaminate after treating the patient.

135.

Which of the following best defines the term "standard of care?"

  • Written, accepted levels of emergency care based on training and profession

  • A scope of care that an Emergency Medical Technician (EMT) is able to provide for a patient

  • A code of conduct affecting character, conduct, and conscience

  • An established process to determine the qualifications necessary to practice a particular profession or function

Correct answer: Written, accepted levels of emergency care based on training and profession

The standard of care is the written, accepted levels of emergency care expected for a person's training and profession. This level of care is established by local customs, statutes, ordinances, protocols, medical literature, textbooks, administrative regulations, and case law. The purpose of the standard of care is to ensure patients are not exposed to unreasonable risk or harm.

The outline of care that an Emergency Medical Technician (EMT) is able to provide for a patient is the scope of practice, and it may include actions that are not required for or relevant to a particular patient.

Morality is a code of conduct that can be defined by society, religion, or a person, affecting their character, conduct, and conscience.

Credentialing is the established process to determine the qualifications necessary to be allowed to practice a particular profession or to function as an organization.

136.

Which of the following is a sign of increased intracranial pressure?

  • Non-reactive pupils

  • Tachycardia

  • Hypotension

  • Anxiety

Correct answer: Non-reactive pupils

An increase in intracranial pressure (ICP) is due to the accumulation of blood or swelling of the brain within the skull from trauma or a stroke. To perfuse the brain, arterial pressure (i.e., mean arterial pressure) must be greater than intracranial pressure. The Cushing reflex is a physiological response of the CNS to maintain perfusion, resulting in a triad of increased mean arterial blood pressure, irregular breathing, and bradycardia. This is an ominous sign of acute head injury that may indicate imminent brain herniation. 

Other signs of increased intracranial pressure are a headache, altered mental status (lethargy, obtundation, nonreactive pupils), decerebrate posturing, bradycardia, nausea, vomiting, and changes in respiration (Cheyne-Stokes, ataxic rhythms).

137.

A 50-year-old male is breathing at a rate of 30 breaths per minute with normal breath depth and tidal volume. Which medical term describes this patient's respiration rate?

  • Tachypnea

  • Eupnea 

  • Bradypnea

  • Hyperpnea

Correct answer: Tachypnea

Tachypnea is the condition of rapid breathing. Bradypnea is slower-than-normal breathing.

Hyperpnea describes rapid and deep breathing. 

Eupnea describes normal breathing.

138.

Which of the following describes the appropriate sizing of a sphygmomanometer?

  • Wrapped around the arm 1 to 1.5 times, spanning two-thirds the length of the armpit to the elbow crease

  • Wrapped around the arm 2 times, spanning half the length of the armpit to the elbow crease

  • Wrapped around the arm 1 to 1.5 times, spanning half the length of the armpit to the elbow crease

  • Wrapped around the arm 1 time, spanning two-thirds the length of the armpit to the elbow crease

Correct answer: Wrapped around the arm 1 to 1.5 times, spanning two-thirds the length of the armpit to the elbow crease

An appropriately sized sphygmomanometer will wrap around the arm 1 to 1.5 times and span two-thirds the length of the armpit to the elbow crease. An inaccurate blood pressure reading may occur if a sphygmomanometer is inappropriately sized.

139.

An adult female patient is showing signs and symptoms of shock and has a tender, rigid abdomen. She reports vomiting material that looked like coffee grounds. Which of the following is most likely causing her symptoms?

  • Upper gastrointestinal tract bleeding

  • Appendicitis

  • Hemorrhoids

  • Renal calculi

Correct answer: Upper gastrointestinal tract bleeding

Gastrointestinal (GI) bleeding can occur in the upper GI tract (from the esophagus to the upper small intestine) or the lower GI tract (from the upper small intestine to the anus). Common causes of upper GI tract bleeding include esophagitis, esophageal varices, and Mallory-Weiss tears. Vomiting bright red blood or coffee-ground material is typical of an upper GI tract bleed. Lower GI bleeding can occur due to bowel inflammation, diverticulosis/diverticulitis, malignancy, or hemorrhoids. Melena (dark tarry stools) will often occur due to partially digested blood.

Appendicitis is an inflammation of the appendix. Right lower quadrant pain and rebound tenderness are common. Nausea and vomiting are likely, but not with a coffee-ground appearance. 

Patients with renal calculi (kidney stones) will complain of vague flank pain that can radiate to the groin and hematuria (blood in the urine).

140.

Which of the following steps is not part of a rapid exam to assess life-threatening injuries?

  • Assess pupillary response

  • Assess the head while maintaining inline spinal stabilization

  • Assess the pelvis by gently compressing downward and inward, looking for tenderness or instability

  • Assess the chest by listening for equal, bilateral breath sounds

Correct answer: Assess pupillary response

A rapid exam is a focused assessment of specific life-threatening injuries that must be addressed prior to transport. A rapid exam should take no more than 60-90 seconds.

Areas to assess in the rapid exam are the head, neck, chest, abdomen, pelvis, extremities, and back.

Many people use the mnemonic DCAP-BTLS to remember important clinical signs to look for in each anatomical location: deformities, contusions, abrasions, punctures, burns, tenderness, lacerations, and swelling.

Neurologic function, including pupillary response, is a part of the secondary assessment, which is a more detailed exam.

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