EMTB9e: Registry Review

Link: AAOS

Link: Jones and Bartlett Publishers

Registry Review

Cover

Please read each question and select your answer from the choices provided. You must complete all of the questions in order to view your results.

1: Which of the following is NOT a sign of internal bleeding?
	A: Vomiting bile
	B: Bruising
	C: Painful, swollen, or deformed extremities
	D: A tender, rigid abdomen

2: How many vertebrae are in the lumbar spine?
	A: 2
	B: 3
	C: 5
	D: 7

3: You are called to the scene where a 6-year-old child has fallen from the back of a pickup truck and is complaining of right arm pain. There is an obvious deformity of the right arm. The arm needs to be immobilized prior to transport. You should:
	A: have a parent distract the child, and quickly splint his or her arm.
	B: tell the child the treatment you perform will not hurt him or her.
	C: not splint the arm if it is going to hurt the child at all.
	D: be honest, telling the child it might hurt when you splint the arm, but he or she can be honest about his/her fear, concerns, and pain.

4: Which of the following is true of a patient with a brain injury?
	A: Decreased blood pressure, increased pulse
	B: Decreased blood pressure, decreased pulse
	C: Increased blood pressure, increased pulse
	D: Increased blood pressure, decreased pulse

5: If you are splinting a severely deformed extremity, or distal circulation is compromised or absent, you should:
	A: align to anatomic position using gentle traction.
	B: push protruding bones back into place.
	C: immobilize in the position you found it in.
	D: not immobilize at all and transport immediately.

6: A patient is not sure he wants to be treated. After you explain the possible consequences of refusing treatment, the patient agrees to be treated and transported. When you arrive at the hospital, the emergency department is very busy, and no one can locate someone to take over care of your patient. The department clerk says you can leave the patient by the trauma room and she will make sure the next available nurse takes over care of your patient. This option:
	A: is acceptable because the patient has been safely delivered to the emergency department.
	B: is acceptable only if the patient is in critical condition.
	C: is acceptable because the department clerk is a hospital employee and has basic medical knowledge.
	D: is not acceptable because it would be considered abandonment.

7: When treating an open abdominal injury with evisceration, you should:
	A: gently push the protruding organ back into the abdomen and cover with an occlusive dressing.
	B: gently push the protruding organ back into the abdomen and cover with a bulky dressing.
	C: not push the organ back into place, but cover with an occlusive dressing.
	D: not push the organ back into place, but cover with a moist, bulky dressing.

8: What layer(s) does a partial-thickness burn involve?
	A: Epidermis
	B: Epidermis and dermis
	C: Epidermis, dermis, and subcutaneous layers
	D: Epidermis, dermis, subcutaneous layers, and muscle

9: You are dispatched to a nursing home for a 78-year-old man who was found not breathing, with no pulse. CPR has not been started. The nurse on scene says the patient is a "no code" because she knows for sure he has a DNR. However, the papers have not been found. Without these papers, your best option for action would be to:
	A: begin CPR.
	B: transport the patient without treatment.
	C: allow the staff as much time as they need to find the DNR.
	D: call the coroner.

10: The FIRST thing an EMT-B should do when arriving at the scene of a vehicle collision is:
	A: check to see whether the vehicles involved have deployed air bags.
	B: determine whether there is patient entrapment and how you will extricate.
	C: determine whether patients are low or high priority.
	D: evaluate hazards and calculate the need for additional support.

11: In what order should these phases of the rescue process occur? 1. Stabilizing the vehicle 2. Gaining access 3. Sizing up the situation 4. Untangling the patient
	A: 3,1,2,4
	B: 1,3,2,4
	C: 4,2,1,3
	D: 2,1,4,3

12: You and your crew are called to the home of an older woman who has fallen. She is complaining of severe wrist pain. During the physical exam, you gently palpate the affected arm and wrist. Which of the following correctly lists the order of the bones in the arm from proximal to distal?
	A: Humerus, radius and ulna, carpals, metacarpals, phalanges
	B: Femur, patella, tibia and fibula, tarsals, metatarsal, phalanges
	C: Phalanges, metacarpals, carpals, ulna and radius, humerus
	D: Frontal, parietal, temporal, occipital, sphenoid

13: If a patient goes into cardiac arrest during transport, the driver should:
	A: drive faster.
	B: contact the hospital emergency department.
	C: stop the ambulance and assist with CPR.
	D: stop the ambulance, contact the hospital, and wait for someone to tell you what to do.

14: In the case of sudden infant death syndrome, the EMT-B should always:
	A: declare the infant dead.
	B: transport the body without care.
	C: make sure there is no evidence of child abuse.
	D: attempt resuscitation and transport to the hospital.

15: You are called to the scene of a 76-year-old man in severe respiratory distress. He has a medical history of emphysema and is currently a three-pack-a-day cigarette smoker. He is distressed and fatigued, and has a difficult time speaking with you. You can see frothy sputum in his mouth. He is breathing approximately 30 breaths/min. In what order should you administer treatment?
	A: Suction, insert nasopharyngeal airway, and give supplemental oxygen via a nonrebreathing mask at 15 L/min
	B: Suction, insert an oropharyngeal airway, and give supplemental oxygen via a nasal cannula at 6 L/min
	C: Immediately insert a nasopharyngeal airway and give supplemental oxygen via a bag-valve-mask device every 5 seconds
	D: Suction, insert an oropharyngeal airway, and give supplemental oxygen via a bag-valve-mask device every 3 seconds

16: If you suspect a conscious toddler of being in respiratory distress, you should do all of the following EXCEPT:
	A: open the airway.
	B: administer high-concentration oxygen.
	C: allow the child to sit up.
	D: insert something into the child's mouth.

17: A common occurrence in a child with a very high or rapidly rising temperature is:
	A: vomiting.
	B: unresponsiveness.
	C: seizure.
	D: dehydration.

18: Your crew is called to the home of a 78-year-old man complaining of severe, nonradiating chest pain. His skin is cool and clammy, and he is pale. His pulse is weak and irregular. You are unable to obtain a blood pressure. He has nitroglycerin tablets. After consulting medical direction, you are ordered to assist the patient in taking his nitroglycerin tablets. What should your main concern with administering nitroglycerin be in this situation?
	A: He may have taken Viagra and not been honest about it with you.
	B: His nitroglycerin may not be effective because he has had them for several months.
	C: You are unable to obtain a blood pressure, therefore you cannot be sure it is adequate for administration of nitroglycerin.
	D: You are not sure he remembers whether he has previously taken any of the nitroglycerin tablets.

19: At a scene where hazardous materials are present, the "safe zone" should be located where?
	A: Upwind and downhill
	B: Downwind and at the same level
	C: Downwind and downhill
	D: Upwind and at the same level

20: The type of consent based on the idea that an unconscious patient would consent to life-saving treatment if he or she were conscious is:
	A: expressed consent.
	B: implied consent.
	C: informed consent.
	D: indirect consent.

21: You are called to the residence of a 34-year-old woman who is "not acting right," according to her husband. She has a history of diabetes. She is conscious, but has slurred speech and is not making sense when answering questions. Medical direction advises that you give the patient glucose in the cheek. However, by the time you prepare the medication, the patient is unconscious. What should you do?
	A: Follow the advice of medical direction and administer the oral glucose, then transport.
	B: Consider calling ALS for some other way to administer her medication.
	C: Transport the patient immediately, and do not administer any medication at all.
	D: Transport the patient immediately, calling medical control en route to ask for direction because the patient's condition has changed.

22: Forcing a competent adult patient to receive care and/or go to the hospital can result in ________ charges against the EMT-B.
	A: negligence
	B: assault and battery
	C: abandonment
	D: kidnapping

23: When treating a critically injured patient with an organ donor card, you should:
	A: withhold any lifesaving measures that would potentially damage the organs.
	B: assume the patient has a DNR.
	C: treat the patient as you would any other patient, but inform the emergency physician that the patient is an organ donor when you turn over care.
	D: concentrate only on giving the patient oxygen to make sure the organs stay perfused.

24: Your ambulance responds to a call for a 23-year-old female with extreme difficulty breathing. You are told by a family member that she is allergic to peanuts, and she just finished a meal at a local restaurant. She is pale, sitting in a tripod position, and is beginning to panic. She has an EpiPen, but it is not with her. A bystander happens to be allergic to bees, and is carrying her EpiPen. What should you do?
	A: Contact medical control for permission to administer the bystander's EpiPen because it is a respiratory emergency.
	B: Call for ALS and try to meet them en route to the hospital.
	C: Give the patient oxygen via a nonrebreathing mask at 15 L/min and transport.
	D: Help the patient administer the bystander's EpiPen in order to alleviate her respiratory distress, then transport.

25: The right atrium of the heart:
	A: pumps blood to the body.
	B: pumps blood to the lungs.
	C: receives blood from the pulmonary veins.
	D: receives blood from the venae cavae.

26: In what order does oxygen travel from the environment to the lungs?
	A: Nose, bronchi, larynx, trachea, lung
	B: Epiglottis, trachea, bronchi, alveoli
	C: Mouth, pharynx, trachea, bronchi, alveoli
	D: Larynx, esophagus, trachea, bronchi, alveoli

27: You are called to a scene in which a child has ingested a cleaning product containing lye. You call poison control and are advised to immediately transport the child. You also call medical direction and are advised to administer activated charcoal en route to the hospital. You know that lye is a caustic substance and that administering activated charcoal is contraindicated. What should you do?
	A: Administer the charcoal anyway, following the directions of medical control.
	B: Argue with medical control, telling them that poison control advised you to transport only.
	C: Follow the advice of poison control only, and do not inform medical control of your decision.
	D: Repeat the orders of poison control to medical control, and question the contraindication that you know exists.

28: The pressure on the walls of an artery when the left ventricle contracts is:
	A: diastolic.
	B: systolic.
	C: venous.
	D: arterial.

29: Inadequate breathing can be defined as:
	A: breathing too fast.
	B: breathing too slowly.
	C: breathing too fast or too slowly.
	D: breathing too deeply.

30: Your crew responds to a call for a 33-year-old man complaining of severe chest pain and difficulty breathing. When you arrive, you find the patient sitting in a tripod position and breathing 35 breaths/min. He is pale, and his skin is cool and sweaty. He tells you the chest pain was sudden, and is sharp and nonradiating. He also tells you he has no history or chest pain or any other pertinent medical history. He did have a water skiing accident 12 days ago. How would you appropriately treat this patient?
	A: Perform a detailed physical exam, give patient oxygen via a nasal cannula at 4 L/min, and transport.
	B: Give the patient oxygen via a nonrebreathing mask at 15 L/min and rapidly transport.
	C: Give the patient oxygen via a nasal cannula at 4 L/min and call medical control to ask if you should administer nitroglycerin.
	D: Tell patient to take two baby aspirin and call his family physician.

31: What is most likely the problem for the patient in question 30?
	A: Pulmonary embolism
	B: Impending heart attack
	C: Angina
	D: Indigestion

32: How should an oropharyngeal airway be inserted in an adult patient?
	A: Anatomically correct.
	B: Upside down, then turned 180 degrees over the tongue.
	C: Into the left side of the mouth, and turned to hold the tongue out of the airway.
	D: Into the right side of the mouth and turned to hold the tongue out of the airway.

33: If a choking patient refuses care and then becomes unconscious, the EMT-B should:
	A: treat the patient, because being unconscious means implied consent.
	B: ask family members for permission to treat the patient.
	C: call medical direction.
	D: refuse to treat or transport the patient.

34: If you are called to treat an unconscious child whose parents are not present, you should:
	A: assume expressed consent and treat the child.
	B: assume implied consent and treat the child.
	C: call medical direction for permission to treat the child.
	D: refuse to treat the child until you obtain permission from a parent or guardian.

35: What was founded in 1970 to establish professional standards for EMS personnel?
	A: US Department of Transportation
	B: National Highway Traffic Safety Administration
	C: American Medical Association
	D: National Registry of Emergency Medical Technicians

36: Your crew is called to an office complex for a 51-year-old female complaining of dizziness. When you arrive, the patient is unconscious on the floor. She is breathing. Her co-workers inform you that a few minutes ago she had fallen to the floor and "shook violently" for about a minute and a half. After establishing scene safety, how would you treat this patient?
	A: Check airway, breathing and circulation, perform a rapid physical exam, and transport.
	B: Insert an oropharyngeal airway, provide oxygen via a nonrebreathing mask at 15 L/min, and transport.
	C: Perform a detailed physical exam, take care of any life-threatening injuries, and transport.
	D: Check airway, breathing, and circulation, insert an oropharyngeal airway, provide oxygen via a bag-valve-mask device at 15 L/min, and transport.

37: A continuous self-review with the purpose of identifying and correcting parts of the EMS system that need improvement is called:
	A: protocols.
	B: standing orders.
	C: CISM.
	D: quality improvement.

38: The legal limits of the EMT-B's job duties are formally defined by the:
	A: medical director.
	B: scope of practice.
	C: Department of Transportation.
	D: state in which the EMT-B works.

39: You respond to a call for a 42-year-old man with an altered mental status. He lives alone and is unable to coherently answer your questions. You examine him and find that he has a dry mouth and his breath has a faint odor, somewhat like alcohol. His pulse is weak and regular. His blood pressure is 96/94 mm Hg. His respirations are 24 breaths/min. His skin is warm, dry, and pink. He complains of nausea. How would you treat this patient from this point?
	A: Tell dispatch you believe he is simply intoxicated and leave.
	B: Assume the patient has diabetes and give him oral glucose.
	C: Check the patient's blood glucose level with a glucometer, and if it is too low, ask medical direction if you can give him oral glucose. Follow medical direction's advice, and then transport.
	D: Tell medical control you believe the patient has diabetes, obtain permission to give him oral glucose, and if his vital signs and mental status return to normal, leave.

40: What important act established a path in which emergency response workers can find out if they have been exposed to life-threatening infectious diseases?
	A: Ryan White CARE Act
	B: Highway Safety Act of 1966
	C: AIDS Protection Act
	D: Emergency Medical Act of 1973

41: _______ are described in a comprehensive guide explaining the EMT's scope of practice, while __________ are part of protocols, and designate what the EMT is required to do for a specific condition.
	A: Offline medical direction; on-line medical direction
	B: On-line medical direction; offline medical direction
	C: Protocols; standing orders
	D: Standing orders; protocols

42: You are called to the scene of a one-vehicle collision where a car has hit a pole holding power lines. There is only one person in the vehicle. He seems to be unconscious. Damage to the vehicle is minimal. Which of the following is the BEST answer for what you might look for in your scene size-up before you treat the patient?
	A: Downed power lines, any fluids leaking from the vehicle, any smoke rising from the vehicle, oncoming traffic
	B: Broken glass from the vehicle, signs that another vehicle was involved and fled the scene, hazardous materials, whether or not the police have secured the scene
	C: Whether the car is too damaged for easy access to the patient, whether an airbag has deployed or may threaten your safety upon extrication of the patient
	D: Whether the pole the car hit is stable or unstable, whether the patient's injuries may require more than just minimal body substance isolation precautions

43: Medical direction has to be given and transferred to the EMT-B by the physician himself. True or False?
	A: TRUE
	B: FALSE

44: What would be the LAST choice for ventilating a patient?
	A: Mouth-to-mask with high-flow supplemental oxygen
	B: Flow-restricted oxygen-powered ventilation device
	C: One-rescuer bag-valve-mask ventilation
	D: Two-rescuer bag-valve-mask ventilation

45: You are called to the apartment of a college student with an "unknown" medical issue. When you arrive, you find a woman lying in bed. Prescription medication bottles and beer cans are on the nightstand. The patient is conscious, but crying, and will not answer any of your questions but does not appear to have an altered mental status. As she's crying, you can see that there are some pill fragments in her mouth. What should you do?
	A: Tell the patient you are going to remove the fragments that you can see in her mouth, and then slowly and calmly remove the fragments you can easily see.
	B: Ask the patient to spit out the fragments. If she does not comply, tell her you will have to use a suction device to remove them.
	C: Leave the fragments of pills in her mouth, they will probably do no more harm than the pills she has already taken.
	D: Give the patient water or some other way to wash the fragments down so that they do not compromise her airway.

46: An EMT-B must switch oxygen cylinders before the pressure gauge reads ______ psi.
	A: 200
	B: 400
	C: 600
	D: 800

47: Which ventilation device is contraindicated for use on infants or children?
	A: Nonrebreathing mask
	B: Bag-valve-mask device
	C: Pediatric pocket mask
	D: Flow-restricted, oxygen-powered ventilation device

48: In scenario number 15, which of the following would you do first?
	A: Initial assessment
	B: Baseline vital signs
	C: SAMPLE history
	D: Detailed physical exam

49: When arriving on scene where there are already police, fire vehicles, and other ambulances present, you should conduct your own scene size-up. True or False?
	A: TRUE
	B: FALSE

50: What is the key element of body substance isolation (BSI) equipment?
	A: Determine what BSI is needed after you have done your initial assessment of the patient.
	B: Always have all personal protective equipment readily available.
	C: Always wear all personal protective equipment, and take off what you don't need once you have done your initial assessment of the patient.
	D: Put personal protective equipment on the patient as well as yourself.

51: You respond to a call for a 44-year-old man working in a chemical manufacturing plant. You are told on arrival by his coworkers that he was burned when a container of lye powder broke open as he was moving it, covering most of his body. The Hazmat team has been called, but their estimated arrival time is nearly 30 minutes. What should you do?
	A: Put on gloves, a face shield, a breathing mask and a gown, and then attempt to help the patient remove his clothing. Then provide constant irrigation with water until HazMat arrives.
	B: Do nothing until HazMat arrives, and then follow their instructions.
	C: Instruct the patient to dust himself off the best that he can, move to an area away from the dry powder, and wait for the HazMat team to arrive.
	D: Stand far enough away to not compromise your own safety and monitor his breathing and mental status until HazMat arrives.

52: While treating a patient for headache, nausea, and weakness, your eyes begin to water and you begin to feel nauseous. Your partner is feeling the same. What should you do?
	A: Call the police and fire departments.
	B: Call for additional ambulances.
	C: Evacuate all people from the area/building.
	D: Call medical direction for advice.

53: How would you accurately evaluate the skin color of a dark-skinned patient?
	A: Look at the color of the bottom of the patient's feet.
	B: Look at the color of the lips and nail beds.
	C: Look at the color of the palms of the hands.
	D: All of the above.

54: If you are called to respond to a scene in which a patient was found floating in a frozen lake, and you are told that the patient was underwater approximately 3 to 5 minutes, the patient is cold to the touch and cyanotic, how long should you assess for pulselessness before starting CPR?
	A: 5 seconds
	B: 15 seconds
	C: 25 seconds
	D: 45 seconds

55: When considering the pulse of an adult patient, which of the following means that something may be seriously wrong with the patient?
	A: A sustained pulse below 50 beats/min
	B: A sustained pulse above 120 beats/min
	C: A sustained irregular and weak pulse
	D: All of the above

56: The skin of a patient with serious liver problems will appear:
	A: jaundiced (yellow).
	B: red and blotchy.
	C: pale.
	D: cyanotic.

57: If you are instructed by medical control to provide active, rapid rewarming of areas of a patient's body affected by deep cold injury, this would be best accomplished by:
	A: covering the areas with a room temperature blanket.
	B: applying warm, but not hot, circulating water to the affected areas.
	C: massaging affected areas to restore circulation.
	D: immersing affected areas in hot water.

58: A patient's pupils may become _________ due to blood loss, drug use, use of eye drops, or extreme fright.
	A: unequal
	B: unreactive
	C: dilated
	D: constricted

59: A pulse oximeter will produce falsely high readings in patients with:
	A: drug overdose.
	B: hypoxia.
	C: carbon monoxide poisoning.
	D: COPD.

60: You and your crew respond to a call for a 23-year-old man complaining of weakness, nausea, fatigue, and joint pain. He believes he is coming down with a cold or flu, but you are told he felt fine when he went on a scuba diving trip early that morning. He denies medical conditions or any pertinent medical history. On the way to the hospital, the patient has a full body seizure and does not regain consciousness. What is the probable diagnosis for this patient?
	A: Hypoglycemia brought on by the patient's nausea
	B: Decompression sickness
	C: Barotrauma
	D: Undiagnosed epilepsy

61: With a severe head injury, clear fluid draining from the ears and nose would be:
	A: cerebrospinal fluid.
	B: lymphatic fluid.
	C: synovial fluid.
	D: tears.

62: Stable patients should be reassessed every _____ minutes, while unstable patients should be reassessed every ______ minutes.
	A: 10; 3
	B: 15; 5
	C: 20; 10
	D: 30; 15

63: In a behavioral emergency, if a patient denies treatment, who is the best person(s) to give you advice on providing care against that patient's will if you believe he may harm himself or others?
	A: Law enforcement personnel
	B: The patient's family doctor
	C: The patient's family members
	D: Your medical director

64: Blind finger sweeps are NEVER performed on an infant or child. True or False?
	A: TRUE
	B: FALSE

65: A situation in which a drug should not be used because it may cause harm to the patient or offer little effect in improving their condition is called a(n):
	A: adverse reaction.
	B: side effect.
	C: contraindication.
	D: indication.

66: When responding to a call for a patient who is 7 months' pregnant with her first child, she tells you she has been ill with flu-like symptoms for the last 3 days. She asks that you transport her to the emergency department. How should she be transported?
	A: On her left side
	B: Flat on her back with her legs elevated
	C: Flat on her back with her head lower than her feet
	D: The position makes no difference.

67: Why is nitroglycerin given to a patient having chest pain?
	A: It constricts blood vessels and raises blood pressure.
	B: It dilates blood vessels and decreases the workload of the heart.
	C: It increases blood flow to the brain.
	D: It is a painkiller.

68: Which one of the following is NOT a shockable rhythm?
	A: Asystole and pulseless electrical activity
	B: Ventricular tachycardia
	C: Ventricular fibrillation
	D: Pulseless ventricular tachycardia

69: You are called to the home of a woman in labor with her fourth child. She is full term, and her water has broken. When you examine her, you see a loop of umbilical cord protruding from the vaginal opening. How do you treat her?
	A: Prepare the area and the patient for a home delivery.
	B: Gently push the umbilical cord back into the birth canal, put the patient on her left side, and transport rapidly.
	C: Leave the umbilical cord where it is, and rapidly transport.
	D: Put the patient in a position with her knees to her chest, gently push the fetus away from the cord, and keep the cord moist while rapidly transporting.

70: If a patient has a pacemaker and needs to be defibrillated, you should:
	A: not worry about the pacemaker and perform defibrillation as you would with any other patient.
	B: increase the joules on the AED.
	C: remove the pacemaker.
	D: place the defibrillator pad several inches away from the pacemaker.

71: A patient who has continuous seizures, one after another, is experiencing:
	A: convulsions.
	B: repeating seizure disorder.
	C: brain damage.
	D: status epilepticus.

72: While transporting a woman 8 months' pregnant with her first child, she says she feels the need to push. Upon examining her, you see one of the infant's arms hanging from the vaginal opening. What should you do?
	A: Go ahead and deliver the infant in the ambulance.
	B: Gently push the infant's arm back into the birth canal and rapidly transport the mother to the emergency department.
	C: Adjust the stretcher so that the mother's pelvis is higher than her head, tell her to do her best not to push, and rapidly transport.
	D: Leave the mother as is, tell her not to push, and rapidly transport.

73: If a patient has signs and symptoms of a stroke, but all signs and symptoms disappear in less than 24 hours, the patient experienced a(n):
	A: cerebrovascular accident (CVA).
	B: transient ischemic attack (TIA).
	C: altered mental status (AMS).
	D: acute myocardial infarction (AMI).

74: In what order would the following bleeding control measures be used to stop serious bleeding? 1. Tourniquet 2. Firm pressure on the wound 3. Pressure on a pressure point 4. Elevation of the wound in addition to pressure
	A: 1,2,3,4
	B: 2,4,3,1
	C: 3,1,2,4
	D: 4,3,1,2

75: You respond to the scene of a sexual assault of a 31-year-old woman. Police have secured the scene. Your patient states she was hit in the head with a bat, fell to the ground, and was then raped. What are necessary interventions?
	A: Spinal immobilization, focused history and physical exam, and rapid transport
	B: Letting law enforcement transport the patient after you address any bleeding or other injuries
	C: Focused physical exam of all injuries, an exam to determine whether or not the patient was actually raped, then transport
	D: Using a c-collar for immobilization, focused physical exam, allowing her to clean up, and completion of the police report before transport

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