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Quiz Session - Attempts With Random Questions

NREMT EMT Exam Questions

Page 8 of 52

141.

Which of the following is part of the upper airway?

  • Uvula

  • Carina

  • Bronchioles

  • Alveoli

Correct answer: Uvula

The upper airway begins at the mouth and nose, consisting of everything superior to the vocal cords, part of the larynx. Other parts of the upper airway include the nasopharynx, oral cavity, tongue, and remaining parts of the mouth, uvula, laryngopharynx, and larynx, which houses the thyroid cartilage, cricoid cartilage, epiglottis, glottis, and vocal cords.

The lower airway begins below the vocal cords. It includes the trachea, carina, mainstem bronchi, smaller bronchi, bronchioles, and alveoli.

142.

When is it not appropriate to apply pressure to a bleeding head wound?

  • When a skull fracture is suspected

  • When a cervical spine injury is suspected

  • When neurological deficits are evident

  • When the patient has an altered mental status

Correct answer: When a skull fracture is suspected

Excessive pressure on an open bleeding head wound is inappropriate if a skull fracture is suspected. Intracranial pressure may be increased, or bone fragments may be pushed into the brain.

A cervical spine injury, neurological deficits, or an altered mental status do not prohibit the use of direct pressure on an open head wound. However, neurological deficits or an altered mental status may suggest a skull fracture.

143.

The Department of Transportation's (DOT) North American Emergency Response Guidebook (ERG) classifies Hazardous Materials into nine different groups. Which of the following are groups that are identified in the ERG?

Select the three correct answer options.

  • DOT Class 1: Explosives 

  • DOT Class 5: Oxidizers and organic peroxides 

  • DOT Class 8: Corrosives 

  • DOT Class 4: Organic Materials

Here are the nine DOT classes of hazardous materials recognized in the ERG: 

  • DOT Class 1: Explosives
  • DOT Class 2: Gases
  • DOT Class 3: Flammable/combustible liquids
  • DOT Class 4: Flammable solids that are dangerous when wet or water-reactive
  • DOT Class 5: Oxidizers and organic peroxides
  • DOT Class 6: Toxic substances and infectious substances
  • DOT Class 7: Radioactive
  • DOT Class 8: Corrosive substances
  • DOT Class 9: Miscellaneous hazards

144.

Which of the following is true regarding the use of a pocket mask to ventilate an adult patient who is not breathing? 

  • A one-way valve prevents the backflow of secretions, vomitus, and gases.

  • Supplemental oxygen cannot be connected to the barrier device.

  • There is direct contact between the rescuer and the patient’s mouth.

  • Oxygen levels of 100% may be achieved.

Correct answer: A one-way valve prevents the backflow of secretions, vomitus, and gases.

A barrier device is a protective plastic tool that prevents direct patient contact. The one-way valve that accompanies the barrier device prevents the backflow of secretions, vomitus, and gases. Supplemental oxygen can be attached to a barrier device and provide approximately 55% oxygen to the patient, assuming a flow of 15 liters per minute.

145.

Which of the following medications are used in managing or treating asthma? 

Select the two correct answer options.

  • Albuterol

  • Ipratropium

  • Lasix

  • Digoxin

Many medications are used to manage asthma. EMTs should recognize some of the most commonly prescribed medications used in asthma management. These include:

  • albuterol
  • beclomethasone
  • fluticasone
  • ipratropium
  • levalbuterol
  • montelukast
  • salmeterol

Lasix is a diuretic drug that prevents the body from absorbing too much salt. Digoxin is used to treat heart failure.

146.

When delivering a newborn, you notice the umbilical cord wrapped around the baby's neck. What should you do first?

  • Gently lift the cord over the baby's head if possible.

  • Immediately clamp and cut the cord.

  • Leave the cord alone and proceed with delivery.

  • Place the mother in a supine position to relieve pressure.

Correct answer: Gently lift the cord over the baby's head if possible.

Gently lifting the cord over the baby's head is recommended to safely relieve the cord's compression around the baby's neck without cutting off the oxygen supply from the placenta before the baby starts breathing on its own.

Immediately clamping and cutting the cord could jeopardize the baby's oxygen supply before it is established through breathing, especially if the baby has not taken its first breath yet.

Leaving the cord alone and proceeding with delivery might risk further tightening the cord around the neck, potentially compromising oxygenation.

Changing the mother's position does not directly address the issue of the cord around the baby's neck and might not alleviate the potential compression on the cord.

147.

A 95-year-old female is experiencing chest pain. Her pulse is 99 beats per minute, blood pressure is 120/60 mm Hg, and respirations are 22 breaths per minute with an oxygen saturation of 96%. She is deemed competent and refuses further treatment or transport to the hospital. 

Which of the following is the appropriate next step?

  • Discuss the risks, benefits, and alternatives to transport and have the patient sign documentation with a witness, indicating her understanding and refusal

  • Contact medical control for orders

  • Attempt to contact the patient's family to gain consent to transport her

  • Contact the patient's medical power of attorney to get permission to treat and transport her

Correct answer: Discuss the risks, benefits, and alternatives to transport and have the patient sign documentation with a witness, indicating her understanding and refusal 

An alert, competent adult patient may refuse treatment. Ensure the patient has all pertinent information (assessment, treatment options, consequences of refusal) before accepting a refusal of treatment. Any refusal of treatment/transport should be documented and signed by the patient with a witness. An adult patient must be conscious, alert, and able to make decisions in order to refuse treatment/transport. A parent or guardian may refuse treatment/transport for a child in non-emergent situations.

Contacting the patient's family will be of no benefit in this case, as the patient is deemed competent and can refuse. 

Contacting medical control will be of no benefit and will only tie up resources needed for other EMS units or agencies. 

Contacting the medical power of attorney is only needed if the patient is unable to make decisions. Since this patient is deemed competent, she can refuse. 

148.

A 55-year-old male has an extensive cardiac history and may be experiencing cardiac compromise. When is the most appropriate time to attach automated external defibrillator (AED) pads?

  • If he becomes pulseless and apneic

  • When his condition starts to deteriorate

  • If assisted administration of nitroglycerin does not alleviate his chest pain

  • Upon learning that his cardiac history includes previous acute myocardial infarction

Correct answer: If he becomes pulseless and apneic

An automated external defibrillator (AED) is indicated for use on unresponsive and pulseless patients. Defibrillation is not a substitute for high-quality CPR but is another factor that promotes survival.

The deterioration of the patient's condition (excluding the absence of a palpable pulse), the ineffectiveness of nitroglycerin use, and any part of a patient's history are neither indications for nor contraindications to the use of an AED.

149.

Which of the following describes type I diabetes? 

  • The production of antibodies to pancreatic beta cells

  • A condition in which insulin resistance develops

  • An abnormally high blood glucose level

  • An abnormally low blood sugar

Correct answer: The production of antibodies to pancreatic beta cells

Type 1 diabetes is an autoimmune disorder in which the immune system produces antibodies to pancreatic beta cells, decreasing insulin production by the pancreas.

Type 2 diabetes is an acquired disorder in which insulin resistance develops in response to increased blood glucose levels.

Hypoglycemia is an abnormally low blood glucose level. Hyperglycemia is an abnormally high blood glucose level. These can both occur in type I and II diabetes. 

150.

Which of the following is responsible for carrying oxygen throughout the body?

  • Hemoglobin

  • Carbonic acid

  • Platelets

  • Lactic acid

Correct answer: Hemoglobin

Hemoglobin is the part of a red blood cell (erythrocyte) that carries oxygen, giving red blood cells their coloring. A small percentage of carbon dioxide is carried by hemoglobin.

Carbonic acid is a compound that is dissolved in the plasma of the blood. When oxygen is exchanged for carbon dioxide in the body, it is converted into carbonic acid.

Platelets are tiny, disc-shaped elements that are smaller than cells and are responsible for the formation of blood clots.

Lactic acid is a waste product in the body. It is not involved in oxygen transportation.

151.

Which of the following are goals established by the American Heart Association (AHA) for the pre-hospital management of a suspected STEMI (ST-Segment Elevation Myocardial Infarction) patient? 

Select the three answer options which are correct.

  • Rapid transport to a hospital that offers Percutaneous Coronary Intervention (PCI).

  • Fibrinolytic administration should begin within 30 minutes of the patient’s arrival in the ED if a cath lab is not available.

  • Obtain a 12-lead ECG within ten minutes of EMS contact with the patient.

  • Obtain a 12-lead ECG within 20 minutes of EMS contact with the patient.

  • Obtain a 12-lead ECG within 15 minutes of EMS contact with the patient.

  • Rapid transport to the closest facility.

For a patient with STEMI, AHA management guidelines include the following:

  • obtain a 12-lead ECG within 10 minutes of EMS contact with the patient
  • arrange rapid transport to a hospital that offers Percutaneous Coronary Intervention (PCI)
  • begin PCI within 90 minutes from first medical contact to balloon inflation in a cardiac cath lab
  • begin fibrinolytic administration within 30 minutes of the patient’s arrival in the ED (Emergency Department) if a cath lab is not available

Transport to the closest facility may not always be appropriate; you want to transport an ACS patient to the closest appropriate facility–one with interventional cardiology capability.

152.

Which chamber of the heart is responsible for sending deoxygenated blood to the lungs for reoxygenation?

  • Right ventricle

  • Left ventricle

  • Right atrium

  • Left atrium

Correct answer: Right ventricle

The right ventricle pumps deoxygenated blood to the lungs, to be oxygenated, via the pulmonary artery. Oxygenated blood returns to the left atrium via the pulmonary vein. Oxygenated blood flows from the left atrium to the left ventricle through the mitral valve. The left ventricle pumps the blood to the body via the aorta. Deoxygenated blood returns from the body to the right atrium via the superior and inferior vena cavae. Deoxygenated blood flows from the right atrium to the right ventricle through the tricuspid valve.

153.

Which of the following are common over-the-counter (OTC) medications?

Select the 3 answer options which are correct.

  • Aspirin

  • Diphenhydramine

  • Ibuprofen

  • Ipratropium 

Over-the-counter (OTC) medication can be purchased without a prescription. Aspirin, acetaminophen (Tylenol), diphenhydramine (Benadryl), and ibuprofen (Advil, Motrin) are common OTC medications. 

Prescription medications cannot be purchased without a prescription from a healthcare provider. Ipratropium (Atrovent) is a prescription medication. 

154.

Which of the following defines dysphagia? 

  • Difficulty swallowing

  • Difficulty urinating

  • Difficulty breathing

  • Difficulty speaking

Correct answer: Difficulty swallowing

Dysphagia can mean difficulty swallowing or eating, depending on the context.

Dyspnea is difficulty breathing. Common causes of dyspnea include pulmonary edema, hay fever, pleural effusion, airway obstruction, hyperventilation syndrome, environmental/industrial exposure, carbon monoxide poisoning, and drug overdose.

Dysuria is difficult or painful urination. Difficulty speaking is referred to as dysarthria.

155.

Which of the following are antidote kits that may be used after exposure to a nerve agent? 

Select the two correct answer options.

  • DuoDote

  • Mark 1

  • Pasadena 

  • Cyanokit

  • Narcan

The DuoDote and Mark 1 antidote kits both contain atropine and pralidoxime, which are nerve agent reversals. Mark 1 is older and has two separate injections, and the DuoDote consists of one injection. The military form of the combination injector is the Antidote Treatment Nerve Agent Auto-Injector (ATNAA).

Pasadena and Cyanokit are used for cyanide, not nerve agent exposure. Narcan is an over-the-counter opioid overdose treatment.

156.

A 4-year-old female has suffered an injury and is very upset. Which of the following is an appropriate way to interact with this patient?

  • Tell the child what is going to be done immediately before doing it

  • Discuss all interventions with the patient's guardian instead

  • Tell the patient that none of the interventions will hurt

  • All of these are appropriate in this case 

Correct answer: Tell the child what is going to be done immediately before doing it

Preschool-aged children (three to six years) can use simple language effectively. Children at this age have a vivid imagination, so interventions should be explained simply and directly before they are done to ensure the child has no time to develop frightening fantasies.

It is inappropriate to ignore any patient. It is also inappropriate to lie to any patient, particularly preschool-aged children, as their trust is hard to regain.

157.

A 65-year-old female fell and hurt her ankle. The ankle has an obvious deformity. After splinting the ankle, which of the following is appropriate to assess?

  • Cardiovascular and neurological function of the affected limb

  • Pulse, proximal to the injury

  • Sensation, proximal to the injury

  • Cardiovascular and neurological function of all limbs

Correct answer: Cardiovascular and neurological function of the affected limb

Any extremity that requires splinting (e.g., due to being painful, swollen, or deformed) requires an assessment of cardiovascular and neurological function before and after the application of a splint. This is accomplished via distal pulses and motor and sensory function, respectively.

158.

What is the best way to lift a patient who is lying on a stretcher?

  • Bend at the knees and lift with palms facing upward

  • Bend at the knees and lift with palms facing downward

  • Bend at the waist and lift with palms facing upward

  • Bend at the waist and lift with palms facing downward

Correct answer: Bend at the knees and lift with palms facing upward

General guidelines for safely lifting a patient include the following:

  • keeping the legs shoulder-width apart
  • keeping the back in a straight, locked-in position
  • keeping the patient's weight as close to one's body as possible
  • bending at the knees, not the waist, when lifting
  • avoiding lifting and reaching simultaneously
  • avoiding twisting the body while lifting
  • lifting with the palms facing upward
  • communicating constantly with other partners or team members

159.

What is the purpose of the head-tilt/chin-lift technique?

  • To relieve an obstruction blocking an otherwise-patent airway when spinal trauma is not suspected

  • To relieve an obstruction blocking an otherwise-patent airway when spinal trauma is suspected

  • To allow access to a foreign body for removal

  • To prevent further damage until a C-collar can be applied

Correct answer: To relieve an obstruction blocking an otherwise-patent airway when spinal trauma is not suspected

The head-tilt/chin-lift maneuver is the primary method used to open the airway of non-trauma patients. Possible obstructive objects include the tongue, foreign objects (e.g., food, small toys, teeth/dentures), blood clots, damaged tissues, and aspirated vomitus. The head-tilt/chin-lift maneuver is completed by placing the patient in a supine position and the rescuer beside the patient's head. The heel of one hand is placed on the patient's forehead, and firm pressure is applied to tilt the patient's head back. The fingertips of the alternate hand are placed under the lower jaw, near the bony part of the chin; the chin is then lifted upward. The forehead is held to maintain the backward tilt.

If spinal trauma is suspected, the jaw-thrust maneuver is performed. The rescuer kneels above the patient's head with fingers behind the angles of the lower jaw. The jaw is then moved upward with the index and middle fingers, and the thumbs help position the lower jaw.

A patient is log-rolled to the side to help assist in the removal of foreign bodies. Only visible foreign bodies are to be removed.

Inline stabilization of the cervical spine is used to ensure no further damage occurs until a C-collar can be applied.

160.

During a mass-casualty incident, which of the following patients would be tagged "immediate" according to START triage guidelines?

  • A semiconscious patient with an open head injury

  • A patient who is alert, oriented, and complaining of abdominal pain

  • An alert patient with a tibial fracture and no severe bleeding

  • A patient who is unresponsive, pulseless, and not breathing

Correct answer: A semiconscious patient with an open head wound

During a mass-casualty incident, triage is used to categorize patients by care priority. The START triage system is used to categorize adult patients. The four categories that are typically used, in order of highest priority first, are immediate (red), delayed (yellow), minimal (green), and expectant (black). Examples of each are listed below.

Immediate:

  • airway and breathing compromise
  • uncontrolled or severe bleeding
  • severe medical problems
  • signs of shock/hypoperfusion
  • severe burns
  • open chest or abdominal injuries

Delayed:

  • burns without airway compromise
  • major or multiple bone/joint injuries
  • back injuries with or without spinal cord damage

Minimal:

  • minor fractures
  • minor soft-tissue injuries

Expectant:

  • obvious death
  • obvious nonsurvivable injury (e.g., open brain trauma)
  • respiratory or cardiac arrest
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