Ch. 5, 6, 7, 10, 11, 12 & 17

Question 1

A backup communication is especially critical when dealing with:

a. mass-casualty incidents
b. motor vehicle collisions
c. simultaneous EMS calls
d. any critically injured patient

Answer 1

a. mass-casualty incidents

Question 2

The combination of two or more signals, which allows the paramedic to talk and transmit an ECG simultaneously on one frequency, is called a:

a. simplex system
b. trunking system.
c. multiplex system.
d. half-duplex system.

Answer 2

c. multiplex system

Question 3

The FIRST principle of communicating by radio is:

a. clarity.
b. accuracy.
c. calmness.
d. thoroughness.

Answer 3

a. clarity

Question 4

Which of the following words would be the MOST difficult to hear over the radio?

a. Yes
b. Negative
c. Affirmative
d. Received

Answer 4

a. Yes

Question 5

Which of the following details is of LEAST importance for the EMD to obtain from the caller?

a. The exact location of the patient
b. An estimate of the situation’s severity
c. The caller’s telephone number
d. The patient’s last known oral intake

Answer 5

d. The patient’s last known oral intake

Question 6

If a patient is reluctant to communicate because he or she feels threatened, the paramedic should:

a. keep his or her hands to the side and move slowly.
b. cross his or her arms and take five steps backward.
c. cautiously approach the patient with palms facing out.
d. maintain a closed posture as this will convey authority.

Answer 6

c. cautiously approach the patient with palms facing out.

Question 7

The process of formulating the words or ideas to be sent and formatting the information for transmission is called:

a. encoding.
b. decoding.
c. biotelemetry.
d. interoperability.

Answer 7

a. encoding

Question 8

Which of the following actions demonstrates that the paramedic has his or her emotions under control?

a. Taking notes while repeating some of the patient’s statements back to him or her
b. Obtaining the patient’s medical history while administering emergency treatment
c. Speaking close to the patient’s ear in a calm voice in an extremely noisy situation
d. Frequently reassuring a seriously injured patient that everything will be okay

Answer 8

c. Speaking close to the patient’s ear in a calm voice in an extremely noisy situation

Question 9

Which of the following questions is the MOST effective when inquiring about a patient’s chest pain?

a. “Is the pain sharp or dull?”
b. “Does the pain feel more like pressure?”
c. “Can you describe the pain to me?”
d. “Does the pain radiate to your arm?”

Answer 9

c. “Can you describe the pain to me?”

Question 10

Ethnocentrism is defined as the:

a. acknowledgement of one’s cultural practices
b. study of different cultures and cultural practices.
c. standards to which a particular culture is held.
d. belief that one’s own culture is superior to others.

Answer 10

d. belief that one’s own culture is superior to others.

Question 11

A _______ receives a weak signal and retransmits it at a higher power on another frequency.

a. multiplex system
b. repeater
c. base station
d. duplex system

Answer 11

b. repeater

Question 12

If you want reliable answers to personal questions, you should:

a. tell the patient that his or her responses to your questions are confidential.
b. tell the patient that personal questions are a routine part of your exam.
c. request law enforcement presence when asking a personal question.
d. manage the scene so you can ask such questions quietly and privately.

Answer 12

d. manage the scene so you can ask such questions quietly and privately.

Question 13

Repeating the key parts of a patient’s responses to your questions demonstrates:

a. an exchange of information.
b. passive communication.
c. active listening.
d. sympathy.

Answer 13

c. active listening.

Question 14

The term “frequency,” as it applies to radio communications, is MOST accurately defined as:

a. a relatively long wavelength that produces audible sound.
b. a predefined station designed for emergency use only.
c. the number of oscillations per second of the carrier wave.
d. the number of megahertz per cycle that the radio transmits.

Answer 14

c. the number of oscillations per second of the carrier wave.

Question 15

Under the instructions of a good EMD, a layperson should be able to:

a. perform chest compressions.
b. assess a patient’s pupils.
c. obtain a blood pressure.
d. immobilize a person’s spine.

Answer 15

a. perform chest compressions.

Question 16

When a caller requests EMS in an area that uses an enhanced 9-1-1 system:

a. the fastest route to the scene will be displayed on the computer.
b. the caller’s name and address are automatically displayed.
c. known hazards at or near the scene will be displayed on the computer.
d. the caller’s GPS coordinates will display on the computer.

Answer 16

b. the caller’s name and address are automatically displayed.

Question 17

When communicating medical information via radio, you should be:

a. thorough yet rapid.
b. simple, brief, and direct.
c. as expeditious as possible.
d. comprehensive but brief.

Answer 17

b. simple, brief, and direct.

Question 18

When communicating with a patient whose cultural background differs from the paramedic’s, the paramedic should:

a. use his or her own culture as the sole reference.
b. know the specifics about the patient’s culture.
c. treat the patient with the utmost respect at all times.
d. agree with the patient’s cultural differences.

Answer 18

c. treat the patient with the utmost respect at all times.

Question 19

When providing patient care, it is MOST important that you maintain effective communication with:

a. the dispatcher.
b. your partner.
c. bystanders.
d. medical control.

Answer 19

b. your partner.

Question 20

When transmitting information via radio, you should:

a. break long messages into 60-second segments.
b. use a normal conversational tone of voice.
c. keep your mouth 1 inch from the microphone.
d. speak with your voice slightly elevated.

Answer 20

b. use a normal conversational tone of voice.

Question 21

The patient care report:

a. provides for a continuum of patient care upon arrival at the hospital.
b. is a legal document and should provide a brief description of the patient.
c. should include the paramedic’s subjective findings or personal thoughts.
d. is only held for a period of 24 months, after which it legally can be destroyed.

Answer 21

a. provides for a continuum of patient care upon arrival at the hospital.

Question 22

Which of the following documentation styles would likely be MOST difficult and time consuming to apply in EMS?

a. SOAP method
b. CHARTE method
c. Body systems approach
d. Chronological approach

Answer 22

c. Body systems approach

Question 23

When documenting a statement made by the patient or others at the scene, you should:

a. document the exact time that the statement was made.
b. include the statement in an addendum to your run report.
c. translate the statement into appropriate medical terminology.
d. place the exact statement in quotation marks in the narrative.

Answer 23

d. place the exact statement in quotation marks in the narrative.

Question 24

If you receive another call before completing the patient care report accurately for the previous call:

a. you should submit what you have completed to the receiving facility.
b. pertinent details about the previous call may be omitted inadvertently.
c. your patient care report must be completed within 36 hours after the call.
d. you should ask the dispatcher to send another paramedic crew to the call.

Answer 24

b. pertinent details about the previous call may be omitted inadvertently.

Question 25

Which of the following statements regarding revisions or corrections to a patient care report is correct?

a. The original patient care report should be destroyed if a revision is necessary.
b. Only the person who wrote the original report can revise or correct it.
a. A patient care report cannot be revised or corrected after submission.
d. If a report needs revision, the revision must be made within 12 hours.

Answer 25

b. Only the person who wrote the original report can revise or correct it.

Question 26

HIPAA requires that:

a. a patient’s personal information must be shared with the patient’s immediate family members.
b. patient information shall not be shared with entities or persons not involved in the care of the patient.
c. a penalty will be imposed for any release of any portion of a patient’s personal information to any entity.
d. patient information can only be shared with the receiving physician in the emergency department.

Answer 26

b. patient information shall not be shared with entities or persons not involved in the care of the patient.

Question 27

Which of the following laws or entities requires that a statement of medical necessity be clearly documented on a patient care report?

a. HIPAA
b. Medicare
c. Medicaid
d. State law

Answer 27

b. Medicare

Question 28

If a patient with decision-making capacity adamantly refuses treatment for an injury or condition that clearly requires immediate medical attention, the
paramedic should:

a. request law enforcement assistance at once.
b. contact online medical control for guidance.
c. make other arrangements for patient transport.
d. ask the patient to sign a refusal of treatment form.

Answer 28

b. contact online medical control for guidance.

Question 29

What should occur if a physician on scene performs an intervention that is outside of the paramedic’s scope of practice?

a. The paramedic is required to disallow the physician to perform the intervention.
b. The physician is required to accompany the patient in the back of the ambulance.
c. The medical director must authorize the physician to perform the intervention.
d. The paramedic must allow the intervention and then transport the patient.

Answer 29

b. The physician is required to accompany the patient in the back of the ambulance.

Question 30

In which of the following situations would a medical necessity for ambulance transport MOST likely be required?

a. The patient was able to walk to the ambulance.
b. The patient required a splint prior to moving.
c. The patient does not require emergent transport.
d. The patient has minor bleeding that is controlled.

Answer 30

b. The patient required a splint prior to moving.

Question 31

Additions or notations added to a completed patient care report by someone other than the original author:

a. may raise questions about the confidentiality practices of the EMS agency.
b. must be initialed by the original author or the patient care report will be deemed null and void.
c. are not legal and may result in criminal action against the original author.
d. are generally acceptable, provided the additions are made by a paramedic.

Answer 31

a. may raise questions about the confidentiality practices of the EMS agency.

Question 32

Components of a thorough patient refusal document include:

a. willingness of EMS to return to the scene if the patient changes his or her mind.
b. notification of the patient’s physician to apprise him or her of the situation.
c. assurance by the paramedic that the patient’s ability to pay is of no concert.
d. documentation of a complete assessment, even if the patient refused assessment.

Answer 32

a. willingness of EMS to return to the scene if the patient changes his or her mind.

Question 33

In order to ensure that all recorded times associated with an incident are accurate, the paramedic should:

a. get a copy of the dispatch log after the call.
b. frequently glance at his or her watch.
c. radio the dispatcher after an event occurs.
d. document the time that each event occurs.

Answer 33

c. radio the dispatcher after an event occurs.

Question 34

Prior to submitting a patient care report to the receiving hospital, it is MOST important for:

a. the quality assurance team to review the report for accuracy.
b. the paramedic who authored the report to review it carefully.
c. the EMS medical director to review the report briefly.
d. your partner to review the report to ensure accuracy.

Answer 34

b. the paramedic who authored the report to review it carefully.

Question 35

The MOST significant problem associated with making up your own medical abbreviations and documenting them on the patient care report is:

a. an error in patient care.
b. confusion at the hospital.
c. a potential lawsuit.
d. insurance denial.

Answer 35

a. an error in patient care.

Question 36

The National Emergency Medical Services Information System (NEMSIS):

a. collects relevant data from each state and uses it for research.
b. defines the minimum data that must be collected on each call.
c. defines the scope of practice for all levels of EMS provider.
d. is a nationwide billing system that any EMS provider can use.

Answer 36

a. collects relevant data from each state and uses it for research.

Question 37

When a competent adult patient refuses medical care, it is MOST important for the paramedic to:

a. ensure that the patient is well informed about the situation at hand.
b. perform a detailed physical exam before allowing the patient to refuse.
c. obtain a signed refusal from the patient as well as a witness signature.
d. contact medical control and request permission to obtain the refusal.

Answer 37

a. ensure that the patient is well informed about the situation at hand.

Question 38

Which of the following is a significant benefit of electronic documentation?

a. The use of drop-down boxes, which minimizes the possibility for errors
b. The elimination of the need to complete a narrative section
c. The ability of the data to be shared between health care facilities
d. The ease with which it can be applied during mass-casualty incidents

Answer 38

c. The ability of the data to be shared between health care facilities

Question 39

Which of the following is a subjective finding?

a. A complaint of chest pressure
b. Pale, cool, clammy skin
c. Blood pressure of 110/60 mm Hg
d. Obvious respiratory distress

Answer 39

a. A complaint of chest pressure

Question 40

Which of the following statements includes a pertinent negative?

a. “The patient complains of nausea but denies vomiting.”
b. “The rapid head-to-toe exam revealed abrasions to the chest.”
c. “The patient rates his pain as an 8 on a scale of O to 10.”
d. “The possible smell of ETOH was noted on the patient.”

Answer 40

a. “The patient complains of nausea but denies vomiting.”

Question 41

Topographically, the term distal means:

a. near the trunk.
b. near a point of reference.
c. farther from the trunk.
d. toward the body’s midline.

Answer 41

c. farther from the trunk.

Question 42

During your assessment of a trauma patient, you note the presence of bilateral femur fractures. This means that:

a. one femur is broken.
b. both femurs are broken.
c. one femur is broken in two places.
d. the lateral aspect of one femur is broken.

Answer 42

b. both femurs are broken.

Question 43

An unconscious, adequately breathing patient should be placed in the recovery position, which is:

a. supine
b. prone.
c. semi-sitting.
d. laterally recumbent.

Answer 43

d. laterally recumbent.

Question 44

Movement of an extremity toward the midline of the body is called:

a. supination.
b. pronation.
c. adduction.
d. abduction.

Answer 44

c. adduction.

Question 45

The Greek prefix gloss/o refers to the:

a. back.
b. face.
c. tongue.
d. kidney.

Answer 45

c. tongue

Question 46

Eupnea is a medical term that means:

a. fast breathing.
b. slow breathing.
c. normal breathing.
d. shallow breathing.

Answer 46

c. normal breathing.

Question 47

You have administered 1 mg of a drug to a patient. This is equivalent to:

a. 0.001 mcg.
b. 1,000 mcg.
c. 10,000 mcg.
d. 0.01 mcg.

Answer 47

b. 1,000 mcg

Question 48

Which of the following terms BEST describes a clinical finding on the same side of the body as an injury?

a. Bilateral
b. Unilateral
c. Ipsilateral
d. Contralateral

Answer 48

c. Ipsilateral

Question 49

A patient with dysphasia has:

a. difficulty swallowing.
b. painful swallowing.
c. difficulty speaking.
d. an inability to speak.

Answer 49

c. difficulty speaking.

Question 50

The term supraventricular refers to:

a. within the ventricles.
b. below the ventricles.
c. above the ventricles.
d. outside of the ventricles.

Answer 50

c. above the ventricles.

Question 51

If the body is sliced so the result is a top and bottom portion, this is referred to as the:

a. transverse plane.
b. cross section.
c. midsagittal plane.
d. body’s midline.

Answer 51

a. transverse plane.

Question 52

llium and ileum are examples of:

a. homonyms.
b. synonyms.
c. eponyms.
d. antonyms.

Answer 52

a. homonyms.

Question 53

Medical control requests you to administer 50 micrograms of a drug. You should recognize that this is equivalent to:

a. 0.5 mg.
b. 500 mg.
c. 0.005 mg.
d. 0.05 mg.

Answer 53

d. 0.05 mg.

Question 54

Something that is homogenous is:

a. the same.
b. different.
c. large.
d. small.

Answer 54

a. the same.

Question 55

Tetralogy of Fallot is a congenital anomaly involving ___ anatomic abnormalities of the heart.

a. five
b. two
c. three
d. four

Answer 55

d. four

Question 56

The abbreviation “amp” refers to:

a. single dose.
b. ampule.
c. infusion dose.
d. bolus dose.

Answer 56

b. ampule.

Question 57

The Greek prefix burs/o refers to the:

a. tongue.
b. face.
c. kidney.
d. back.

Answer 57

d. back.

Question 58

The topographic term used to describe the location of body parts that are closer to the midline is:

a. midaxillary.
b. lateral.
c. medial.
d. midclavicular.

Answer 58

c. medial.

Question 59

Which of the following would be a proper way of documenting a drug dosage?

a. 25.0 mg
b. 5 mg
c. 0.10 mg
d. 2.0 mg

Answer 59

b. 5 mg

Question 60

Which of the following would be the MOST significant complication associated with incorrect use of medical terminology?

a. The paramedic could be held legally accountable.
b. The patient could lose trust in the paramedic.
c. The medical director could be sued.
d. Ineffective treatment could be rendered.

Answer 60

d. Ineffective treatment could be rendered.

Question 61

At birth, an average pulse rate of __ beats/min and a respiratory rate of __ breaths/min are considered normal.

a. 110, 20
b. 120, 25
c. 140, 40
d. 180, 65

Answer 61

c. 140, 40

Question 62

What is the average systolic blood pressure range for a newborn?

a. 52 to 60 mm Hg
b. 67 to 84 mm Hg
c. 85 to 104 mm Hg
d. 90 to 100 mm Hg

Answer 62

b. 67 to 84 mm Hg

Question 63

You may observe more abdominal expansion than chest expansion in a newborn because:

a. their rib cages are more rigid than an adult’s.
b. their intercostal muscles are not innervated.
c. they rely mostly on their diaphragm to breathe.
d. their ribs are not fully attached to the sternum.

Answer 63

c. they rely mostly on their diaphragm to breathe.

Question 64

For the first year of life, an infant has naturally acquired passive immunities because:

a. vaccinations are given within the first year of life.
b. he or she receives antibodies through breastfeeding.
c. he or she is producing antibodies exponentially.
d. he or she maintains some of the mother’s immunities.

Answer 64

d. he or she maintains some of the mother’s immunities.

Question 65

Upper respiratory tract infections are more common in toddlers than in infants because:

a. they put things in their mouths.
b. they do not produce antibodies.
c. of a loss of passive immunity.
d. they are exposed to other children.

Answer 65

c. of a loss of passive immunity.

Question 66

The pulse rate of a 16-year-old adolescent typically ranges between:

a. 60 and 80 beats/min.
b. 60 and 100 beats/min.
c. 80 and 110 beats/min.
d. 90 and 120 beats/min

Answer 66

b. 60 and 100 beats/min.

Question 67

As a result of the increase in diastolic blood pressure associated with aging:

a. the heart valves become stiff and impede blood flow through the heart.
b. the left ventricle works harder, becomes thicker, and loses its elasticity.
c. cardiac output progressively increases secondary to decreased afterload.
d. the ventricles overfill with blood, resulting in chronic congestive heart failure.

Answer 67

b. the left ventricle works harder, becomes thicker, and loses its elasticity.

Question 68

Relative to younger adults, older adults generally have a harder time breathing because the:

a. natural elasticity of the lungs decreases.
b. diaphragm ascends much higher into the thorax.
c. rib cage becomes flexible due to hypocalcemia.
d. phrenic nerves send fewer signals to the diaphragm.

Answer 68

a. natural elasticity of the lungs decreases.

Question 69

Which of the following statements regarding renal function in older adults is correct?

a. Renal filtration begins to deteriorate at the age of 70 years.
b. In older adults, renal changes are more structural than functional.
c. Aging kidneys respond less efficiently to hemodynamic stress.
d. A 20-year-old patient has already experienced a 10% loss of nephrons

Answer 69

c. Aging kidneys respond less efficiently to hemodynamic stress.

Question 70

Older adults are prone to subdural hematomas because:

a. age-related shrinkage of the brain stretches the bridging veins that return blood from the brain to the dura mater.
b. older adults experience an increase in intracranial blood flow as well as a predisposition to falls.
c. excessive alcohol use, which is very common in older adults, causes the brain to atrophy prematurely.
d. age-related hypertension weakens the cerebral veins, which predisposes them to damage from even minor trauma.

Answer 70

a. age-related shrinkage of the brain stretches the bridging veins that return blood from the brain to the dura mater.

Question 71

By definition, infancy begins at:

a. birth.
b. 18 months of age.
c. 12 months of age.
d. 1 month of age

Answer 71

d. 1 month of age

Question 72

By the age of 1 year, an infant’s tidal volume ranges from:

a. 10 to 15 mL/kg.
b. 10 to 12 mL/kg.
c. 6 to 8 mL/kg.
d. 8 to 10 mL/kg.

Answer 72

a. 10 to 15 mL/kg

Question 73

In contrast to infants, toddlers:

a. have a slower respiratory rate.
b. have a slightly higher pulse rate.
c. gain weight at a faster rate.
d. have a lower systolic blood pressure.

Answer 73

a. have a slower respiratory rate.

Question 74

In conventional reasoning, school-age children:

a. act out so that they can get what they want.
b. act almost purely to avoid punishment.
c. seek approval from their peers and society.
d. make decisions guided by their consciences.

Answer 74

c. seek approval from their peers and society.

Question 75

Teething is commonly accompanied by:

a. ear infections.
b. fever.
c. diarrhea.
d. a rash.

Answer 75

b. fever.

Question 76

The decline in cardiac function associated with aging is largely related to:

a. bradycardia.
b. rheumatic heart disease.
c. hypotension.
d. atherosclerosis

Answer 76

d. atherosclerosis

Question 77

Vascular compensation for changes in blood pressure decreases with age due to:

a. reduced elasticity of the peripheral vessels secondary to decreases in elastin and collagen.
b. left ventricular hypertrophy and the subsequent decrease in cardiac output that it causes.
c. a 60% to 70% decrease in sympathetic nervous system stimulation and catecholamine release.
d. a marked reduction in renal function with increased sodium reabsorption in the renal tubules.

Answer 77

a. reduced elasticity of the peripheral vessels secondary to decreases in elastin and collagen.

Question 78

Which of the following physical changes occurs in adults over 25 years of age?

a. Hyperactivity of the reflexes
b. A decrease in the body’s fatty tissue
c. An increase in muscle strength
d. Settling of the disks in the spine

Answer 78

d. Settling of the disks in the spine

Question 79

Which of the following statements regarding growth spurts in adolescents is correct?

a. Girls typically experience a growth spurt later in life than boys do.
b. When this period of growth has finished, girls are generally taller than boys.
c. Blood volume typically remains unchanged during a growth spurt.
d. Boys generally experience this stage of growth later in life than girls do.

Answer 79

d. Boys generally experience this stage of growth later in life than girls do

Question 80

Which of the following statements regarding middle adults is correct?

a. Middle adult males are at greater risk for cardiovascular disease than middle adult females.
b. Middle adults focus less on achieving their life’s goals because of “empty nest” syndrome.
c. Menopause in middle adult females causes an overall increase in bone density.
d. Middle adults view crisis as a challenge to be overcome rather than a threat to be avoided.

Answer 80

d. Middle adults view crisis as a challenge to be overcome rather than a threat to be avoided.

Question 81

In prehospital care, the priorities of evaluation and treatment are based on:

a. the degree of threat to the patient’s life.
b. your overall experience as a paramedic.
c. the receiving physician’s online orders.
d. standard treatment guidelines and algorithms.

Answer 81

a. the degree of threat to the patient’s life.

Question 82

Your patient will MOST likely develop a good first impression of you if you:

a. look and act professional and confident.
b. tell him or her that everything will be okay.
c. address him or her as “dear” or “honey.”
d. quickly determine his or her chief complaint.

Answer 82

a. look and act professional and confident.

Question 83

It is appropriate to ask, “Would you say the pain is similar to or worse than with previous episodes?” when determining the _____ of a patient’s pain.

a. severity
b. quality
c. region
d. progression

Answer 83

a. severity

Question 84

Blood pressure is the product of:

a. stroke volume and heart rate.
b. left ventricular ejection fraction and afterload.
c. cardiac output and peripheral vascular resistance.
d. right atrial preload and ventricular stroke volume.

Answer 84

c. cardiac output and peripheral vascular resistance.

Question 85

Asymmetry of the pupils:

a. is a normal finding in up to 40% of the population.
b. indicates a significant ocular or neurologic pathology.
c. is normal when a light is shone into one of the pupils.
d. must be correlated with the patient’s overall presentation.

Answer 85

d. must be correlated with the patient’s overall presentation.

Question 86

Arterial pulses are a physical expression of:

a. pressure in the vena cavae.
b. left ventricular contraction.
c. the diastolic blood pressure.
d. right ventricular contraction.

Answer 86

b. left ventricular contraction.

Question 87

Which of the following actions will provide the BEST personal protection when caring for a patient on uneven terrain?

a. Wearing a back brace whenever you lift
b. Wearing boots that provide good traction
c. Using at least four personnel when moving a patient
d. Making lifts and moves as controlled as possible

Answer 87

d. Making lifts and moves as controlled as possible

Question 88

It is MOST important to identify the age and sex of your patient because:

a. age and sex can change how your patient presents.
b. the differential diagnosis is modified for older patients.
c. this is required information for the patient care report.
d. the patient should be assessed by a medic of the same sex.

Answer 88

a. age and sex can change how your patient presents.

Question 89

The body’s reaction to increased internal or external temperature would MOST likely cause the skin to become:

a. warm and dry.
b. hot and dry.
c. pale and hot.
d. hot and moist.

Answer 89

d. hot and moist.

Question 90

You are transporting a conscious middle-aged woman who fell from a second-story balcony while watering her plants. Full spinal motion restriction
precautions have been implemented, supplemental oxygen is being administered, and an IV line of normal saline is in place. With a 15-minute estimated time of arrival at the hospital, the patient’s mental status markedly decreases and her respirations become shallow and are making a gurgling sound. Your FIRST action should be to:

a. immediately suction her oropharynx.
b. perform immediate endotracheal intubation.
c. insert a nasal airway and assist ventilations.
d. contact the receiving facility to update them.

Answer 90

a. immediately suction her oropharynx.

Question 91

A patient with dysarthria has:

a. slurred speech.
b. painful joints.
c. a flat affect.
d. severe stuttering.

Answer 91

a. slurred speech

Question 92

During a 20-minute transport of a critical patient, you should make a concerted effort to reassess the patient __ times.

a. three
b. one
c. four
d. two

Answer 92

c. four

Question 93

More often than not, the paramedic will form his or her general impression of a patient based on:

a. conditions found in the primary assessment.
b. baseline vital signs and SAMPLE history.
c. a rapid, systematic head-to-toe assessment.
d. the initial presentation and chief complaint.

Answer 93

d. the initial presentation and chief complaint.

Question 94

Objective patient information:

a. cannot be quantified.
b. is perceived by the patient.
c. is based on fact or observation.
d. is observed by the patient.

Answer 94

c. is based on fact or observation.

Question 95

On most runs, the two MOST important pieces of patient history information that you need to obtain initially are the:

a. chief complaint and patient’s address.
b. patient’s name and family physician.
c. patient’s name and chief complaint.
d. chief complaint and the patient’s sex.

Answer 95

c. patient’s name and chief complaint.

Question 96

When examining the anterior abdomen of a patient who complains of abdominal pain:

a. auscultate bowel sounds for at least 5 minutes.
b. it is often necessary to administer analgesia first.
c. you should first percuss over the four quadrants.
d. routinely palpate the least painful area(s) first.

Answer 96

d. routinely palpate the least painful area(s) first.

Question 97

The paramedic should address a patient:

a. in a manner that the paramedic deems most professional.
b. by the patient’s first name whenever possible.
c. by using the patient’s formal name.
d. as the patient wishes to be addressed.

Answer 97

d. as the patient wishes to be addressed.

Question 98

Sonorous respirations are MOST likely caused by:

a. secretions or blood in the airway.
b. an anatomic airway obstruction.
c. swelling of upper airway structures.
d. severe inflammation of the epiglottis.

Answer 98

b. an anatomic airway obstruction.

Question 99

Which of the following hazards would you LEAST likely encounter at the scene of a motor vehicle crash?

a. Moving traffic
b. Hazardous materials
c. Broken glass
d. Unruly patient

Answer 99

d. Unruly patient

Question 100

Your entire assessment of a patient should:

a. not deviate at all from a strict format.
b. yield a definitive field diagnosis.
c. appear to be a seamless process.
d. only focus on his or her complaint.

Answer 100

c. appear to be a seamless process.

Question 101

Synthesizing information about a patient with multiple medical conditions involves:

a. determining the validity of each of the patient’s medical problems.
b. ruling out each condition as the cause of the patient’s chief complaint.
c. determining the patient’s perception of his or her multiple conditions.
d. assessing each condition’s potential for having a life-threatening impact.

Answer 101

d. assessing each condition’s potential for having a life-threatening impact.

Question 102

If a patient’s clinical presentation is not addressed in a specific algorithm, the paramedic must:

a. focus exclusively on the patient’s ABCs.
b. determine what is in the patient’s best interest.
c. perform a comprehensive head-to-toe exam.
d. provide supportive care and transport promptly.

Answer 102

b. determine what is in the patient’s best interest.

Question 103

Knowledge of anatomy, physiology, and pathophysiology is MOST important during the __________ stage of critical thinking.

a. data interpretation
b. concept formation
c. reflection in action
d. application of principle

Answer 103

a. data interpretation

Question 104

A negative attitude about any patient or patient care situation:

a. constitutes negligence and carries legal ramifications with it.
b. is usually not sensed by the patient because he or she is frightened.
c. is often observed in paramedics with many years of experience.
d. almost guarantees that the care you provide will be suboptimal.

Answer 104

d. almost guarantees that the care you provide will be suboptimal.

Question 105

Which of the following scenarios MOST accurately depicts reflection in action?

a. Noting a patient’s heart rate before you administer any medication
b. Obtaining a room air pulse oximetry reading before applying oxygen
c. Reassessing a patient’s blood pressure after administering nitroglycerin
d. Administering aspirin and then immediately applying a cardiac monitor

Answer 105

c. Reassessing a patient’s blood pressure after administering nitroglycerin

Question 106

_____________ occurs after a call is over and commonly is associated with the run review or critique.

a. Reflection in action
b. Reflection on action
c. Data interpretation
d. Application of principle

Answer 106

b. Reflection on action

Question 107

Which of the following would have the LEAST impact on the care you provide to a patient who fell?

a. The height of the fall
b. How the patient landed
c. Object from which the patient fell
d. Object the patient landed on

Answer 107

c. Object from which the patient fell

Question 108

When a patient advises you of his or her chief complaint, you should:

a. quickly perform a head-to-toe exam to identify immediate life threats.
b. carefully evaluate all of the medications the patient is taking.
c. obtain a 12-lead ECG to rule out a cardiac-related cause of the problem.
d. ascertain whether this is a new problem or worsening of a preexisting condition.

Answer 108

d. ascertain whether this is a new problem or worsening of a preexisting condition.

Question 109

Given the number of possible diagnoses in any situation and the limited physical and technical resources of the field, you will MOST likely:

a. regularly be treating patients who can only be diagnosed at the hospital.
b. have difficulty providing supportive care secondary to medical ambiguity.
c. regularly be able to formulate a definitive diagnosis of the patient’s current condition.
d. not be able to stabilize the patient’s condition adequately in the field setting.

Answer 109

a. regularly be treating patients who can only be diagnosed at the hospital.

Question 110

No matter how sure he or she is of the working diagnosis, the thinking paramedic must:

a. confer with online medical control to confirm his or her diagnosis.
b. always keep part of the thought process open to other possibilities.
c. implement a treatment plan based solely on the working diagnosis.
d. remain confident that his or her working diagnosis is an accurate one.

Answer 110

b. always keep part of the thought process open to other possibilities.

Question 111

After gathering information from the patient, scene, and any bystanders, you must next:

a. determine the most likely cause of the patient’s problem.
b. formulate a care plan based on the information.
c. determine which information is valid and which may be invalid.
d. synthesize the information to form a thought process.

Answer 111

c. determine which information is valid and which may be invalid.

Question 112

In EMS, the process of concept formation involves:

a. interpreting a patient’s signs and symptoms.
b. knowing which treatment algorithm to use.
c. gathering information about your patient.
d. determining the validity of obtained data.

Answer 112

c. gathering information about your patient.

Question 113

The care plan that you implement based on your working field diagnosis of a patient is almost always defined by:

a. your EMS system’s patient care protocols or standing orders.
b. your previous experience with patients who had a similar condition.
c. a combination of your and your partner’s knowledge and experience.
d. direct orders from the physician at the receiving medical facility.

Answer 113

a. your EMS system’s patient care protocols or standing orders.

Question 114

The main disadvantage of patient care algorithms is that they:

a. discourage contact with direct medical control.
b. are often overridden by medical control.
c. are revised or updated too frequently.
d. only address classic patient presentations.

Answer 114

d. only address classic patient presentations.

Question 115

When caring for a critically ill patient, three or more sets of vital signs will allow you to:

a. determine what body system is in dysfunction, which will further facilitate the provision of specific care
b. determine how fast the patient’s condition is deteriorating and whether cardiac arrest is imminent.
c. assess trends and reassess whether the patient’s condition is stabilizing, getting better, or getting worse.
d. quantify that the patient’s condition is stabilizing, even if he or she has an altered level of consciousness.

Answer 115

c. assess trends and reassess whether the patient’s condition is stabilizing, getting better, or getting worse.

Question 116

When reading the scene, the paramedic must remember that:

a. safety issues must be addressed while you are caring for the patient.
b. scene information becomes unavailable once transport is initiated.
c. noting the mechanism of injury is the first element to evaluate.
d. bystanders are a reliable source of information regarding an incident.

Answer 116

b. scene information becomes unavailable once transport is initiated.

Question 117

When you introduce yourself to your patient and ask why 9-1-1 was called, the patient looks at you, shakes your hand, and answers your questions appropriately. From these findings, you can gather that the patient:

a. will likely not require medication therapy.
b. has a Glasgow Coma Scale score of 15.
c. has not experienced a traumatic injury.
d. does not have a life-threatening condition.

Answer 117

b. has a Glasgow Coma Scale score of 15.

Question 118

Which of the following actions has the LEAST impact on the paramedic’s ability to think under pressure?

a. Taking a moment to scan the situation
b. Staying calm and maintaining mental control
c. Taking a moment to stop and think
d. Memorizing all patient care algorithms

Answer 118

d. Memorizing all patient care algorithms

Question 119

Which of the following conditions or situations is the BEST example of a critical life threat that needs immediate care?

a. An early onset of renal insufficiency
b. Partial-thickness burns on an extremity
c. A patient with multiple disease etiologies
d. Acute presentation of a chronic condition

Answer 119

d. Acute presentation of a chronic condition

Question 120

While treating a patient with chest pain, you administer fentanyl. Shortly after, you ask him if his pain has improved. This is an example of:

a. data interpretation.
b. reflection on action.
c. application of principle.
d. reflection in action.

Answer 120

a. data interpretation.

Question 121

What layer of the heart is responsible for cardiac contraction and efficient ejection of blood?

a. Myocardium
b. Endocardium
c. Epicardium
d. Pericardium

Answer 121

a. Myocardium

Question 122

The S1 heart sound represents:

a. closure of the mitral and tricuspid valves.
b. the end of ventricular contraction.
c. closure of the aortic and pulmonic valves.
d. the beginning of atrial contraction.

Answer 122

a. closure of the mitral and tricuspid valves.

Question 123

Approximately 70% to 80% of ventricular filling occurs:

a. by gravity.
b. during systole.
c. when the semilunar valves are open.
d. when the AV valves close.

Answer 123

a. by gravity.

Question 124

Which of the following statements regarding the right side of the heart is correct?

a. It receives blood exclusively from the venae cavae
b. The right side of the heart is a low-pressure system.
c. It pumps against the high resistance of the pulmonary circulation.
d. The right side of the heart pumps blood through the pulmonary veins.

Answer 124

b. The right side of the heart is a low-pressure system.

Question 125

The AV junction:

a. includes the AV node but not the bundle of His.
b. is the dominant and fastest pacemaker in the heart.
c. receives its blood supply from the circumflex artery.
d. is composed of the AV node and surrounding tissue.

Answer 125

d. is composed of the AV node and surrounding tissue.

Question 126

Repolarization begins when:

a. the sodium and calcium channels close
b. calcium ions slowly enter the cardiac cell.
c. potassium ions rapidly escape from the cell.
d. the inside of the cell returns to a positive charge.

Answer 126

a. the sodium and calcium channels close

Question 127

A patient with orthopnea:

a. experiences dyspnea during periods of exertion.
b. prefers a semisitting position to facilitate breathing.
c. experiences worsened dyspnea while lying down.
d. sleeps in a recliner due to severe right heart failure.

Answer 127

c. experiences worsened dyspnea while lying down.

Question 128

Myocardial ischemia occurs when the heart muscle:

a. is deprived of oxygen because of a blocked coronary artery.
b. undergoes necrosis because of prolonged oxygen deprivation
c. suffers oxygen deprivation secondary to coronary vasodilation.
d. experiences a decreased oxygen demand and an increased supply.

Answer 128

a. is deprived of oxygen because of a blocked coronary artery.

Question 129

Which of the following MOST accurately describes an acute myocardial infarction?

a. Death of the myocardium secondary to spasm of a major coronary artery
b. Injury to a portion of the heart muscle secondary to atherosclerotic disease
c. Damage to the left ventricle following occlusion of the left coronary artery
d. Necrosis of a portion of the myocardium due to a prolonged lack of oxygen

Answer 129

d. Necrosis of a portion of the myocardium due to a prolonged lack of oxygen

Question 130

The QT interval would MOST likely be prolonged in patients:

a. who take digitalis
b. who are hypocalcemic.
c. with a rapid heart rate.
d. who are hypercalcemic.

Answer 130

b. who are hypocalcemic.