Chapter 15 quiz

Question 0

You have arrived at a residence where a 4-month-old baby was found in his crib in cardiac arrest. Emergency Medical Responders have been on scene for 5 minutes prior to arrival. They began CPR immediately on reaching the patient’s side. You have an AED with adult pads with you, but not pediatric pads. After rechecking and confirming that the patient is in cardiac arrest, you would:
A) continue CPR and transfer to the stretcher for transport.
B) continue CPR for 2 more minutes before placing the AED.
C) place the AED on the patient and follow all prompts.
D) discuss with the parents if they want to proceed with use of the AED.

Answer 0

C) place the AED on the patient and follow all prompts.

Question 1

A 7-year-old boy choked on a grape at school. By the time the obstruction was removed, assessment revealed him to be in cardiac arrest. When you arrive, teachers are performing CPR. The school nurse informs you that CPR has been in progress for 6 minutes. You have an AED, but do not have a pediatric conversion device that reduces the energy of defibrillation from that of an adult to that of a child. Which one of the following should you do immediately?
A) Continue CPR and transfer the boy to the stretcher for immediate transport.
B) Perform five abdominal thrusts and then 1 minute of CPR before using the AED.
C) Instruct the teachers to continue CPR for 2 additional minutes before applying the AED.
D) Place the electrodes on the boy’s chest and follow the AED’s prompts.

Answer 1

D) Place the electrodes on the boy’s chest and follow the AED’s prompts.

Question 2

An unrestrained 37-year-old female is in cardiac arrest after striking a tree head-on at a high rate of speed. Assessment reveals her to have suffered massive blunt trauma to the chest and abdomen. The patient is quickly extricated from the vehicle and placed on a long board for immobilization. It is estimated that the patient has been in cardiac arrest for approximately 10 minutes, during which CPR was not performed. At this time, the EMT would:
A) withhold CPR and perform a focused trauma assessment.
B) perform CPR and contact medical command for permission to use the AED.
C) administer CPR for 2 minutes prior to applying the AED.
D) apply electrodes to the patient’s chest and follow the AED’s instructions.

Answer 2

B) perform CPR and contact medical command for permission to use the AED.

Question 3

You have been assigned to a football game to provide standby coverage. While taking a break, you decide to walk to a nearby concession stand for a soft drink. On the way, you come across a group of people standing around a male patient who collapsed and is on the ground. Your assessment reveals him to be unresponsive, not breathing, and pulseless. A bystander states that the patient collapsed less than a minute earlier. An AED is located less than a minute from your location. The nearest EMT is 5 minutes from your location. Which one of the following should you do immediately?
A) Call for assistance and start CPR.
B) Take manual in-line spinal stabilization.
C) Start CPR and wait for the AED.
D) Run to retrieve the nearby AED.

Answer 3

D) Run to retrieve the nearby AED.

Question 4

A “No Shock Advised” message is provided by the AED. The EMT understands that this could mean:
A) the patient is in ventricular fibrillation.
B) the electrodes may be loose.
C) the patient has regained a pulse.
D) CPR is no longer needed.

Answer 4

C) the patient has regained a pulse.

Question 5

If a cardiac arrest patient were in asystole ("flat line"), which of the following messages would the AED provide?
A) "Shock advised"
B) "Press analyze"
C) "No shock advised"
D) "Check electrodes"

Answer 5

C) “No shock advised”

Question 6

After receiving a “No Shock Advised” message from the AED, it is determined that the patient has a weak pulse and slow and shallow respirations. You would immediately:
A) obtain a blood pressure.
B) provide 2 minutes of CPR.
C) start positive pressure ventilation.
D) transfer to the stretcher for transport.

Answer 6

C) start positive pressure ventilation.

Question 7

When should the EMT transport the cardiac arrest patient?
A) After three “No Shock Advised” messages are received
B) After one shock has been delivered and the patient remains in cardiac arrest
C) Before delivering the first shock when a “Shock Advised” message is received
D) Immediately upon determining that the patient is in cardiac arrest

Answer 7

A) After three “No Shock Advised” messages are received

Question 8

What statement regarding care for the adult patient in cardiac arrest is true?
A) “When using an AED, the machine should be turned on before applying the electrodes.”
B) “It is important to always check for a pulse immediately after the AED has delivered a shock.”
C) “When checking for a patient’s pulse, the EMT should take no more than 5 seconds.”
D) “If two EMTs are performing CPR, a ratio of 30 compressions to two ventilations can be used.”

Answer 8

A) “When using an AED, the machine should be turned on before applying the electrodes.”

Question 9

You have been called for a 57-year-old female who has choked on a large pill. On arrival you find the patient collapsed on the floor with family by her side. Your assessment reveals her to be unresponsive, not breathing, and pulseless. Which one of the following should you do immediately?
A) Start chest compressions.
B) Open the airway and attempt ventilation.
C) Perform five abdominal thrusts.
D) Apply the AED and hit the “analyze” button.

Answer 9

B) Open the airway and attempt ventilation.

Question 10

Which one of the following unresponsive patients would the EMT recognize as in cardiac arrest?
A) Male with an absent radial pulse but breathing 20 times a minute
B) Female who is not breathing and has a heart rate of 24 beats per minute
C) Male patient with a heart rate of 16 beats per minute and agonal respirations
D) Female who has an occasional gasp for a breath but no palpable carotid pulse

Answer 10

D) Female who has an occasional gasp for a breath but no palpable carotid pulse

Question 11

While using the AED to treat a patient in cardiac arrest, your partner informs you that he can feel a carotid pulse. Which of the following should you do immediately?
A) Insert an oropharyngeal airway.
B) Reanalyze the patient’s heart rhythm.
C) Assess the patient’s breathing.
D) Obtain a blood pressure.

Answer 11

C) Assess the patient’s breathing.

Question 12

After you apply the AED to a cardiac arrest patient, it delivered a shock. Immediately after the shock, the EMT should do which one of the following?
A) Check the patient for a pulse and reanalyze the rhythm if no pulse is present.
B) Check the patient for a pulse and start CPR if no pulse can be located.
C) Provide five cycles of single-rescuer CPR with a ratio of 15 compressions to two ventilations.
D) Provide 2 minutes of CPR, and then check the patient for a pulse.

Answer 12

D) Provide 2 minutes of CPR, and then check the patient for a pulse.

Question 13

You have just applied the AED to a female patient in cardiac arrest and the machine is ready to analyze the heart rhythm. Which of the following instructions is appropriate at this time?
A) “Stop CPR but continue to check for a pulse.”
B) “Stop chest compressions but continue ventilation.”
C) “Continue CPR until we see if a shock is advised.”
D) “Stop CPR and clear the patient.”

Answer 13

D) “Stop CPR and clear the patient.”

Question 14

You have been called for an elderly male patient who suddenly collapsed. On scene you find an 82-year-old man lying on the garage floor. Assessment reveals him to be unresponsive and not breathing. Which one of the following should you do immediately?
A) Determine the "down time."
B) Check for a carotid pulse. 
C) Start cardiopulmonary resuscitation. 
D) Apply the AED.

Answer 14

B) Check for a carotid pulse.

Question 15

A 47-year-old patient has been in cardiac arrest for 6 minutes. While you set up the AED, you would direct your partner to:
A) perform CPR at a ratio of 30 ventilations to two compressions.
B) start cardiopulmonary resuscitation until the AED is ready.
C) assist you in making sure that the AED is ready for application.
D) perform a primary and secondary assessment.

Answer 15

B) start cardiopulmonary resuscitation until the AED is ready.

Question 16

A patient goes into cardiac arrest at 11:40 A.M. Which of the following treatment descriptions gives the patient the best chance for recovery?
A) Defibrillation at 11:44 A.M. followed by CPR at 11:49 A.M.
B) CPR at 11:41 A.M. and defibrillation at 11:43 A.M.
C) Defibrillation at 11:46 A.M. followed by ACLS at 11:51 A.M.
D) CPR at 11:42 A.M. and advanced cardiac drugs at 11:48 A.M.

Answer 16

B) CPR at 11:41 A.M. and defibrillation at 11:43 A.M.

Question 17

The AED has just been applied to a female cardiac arrest patient. After analyzing the heart rhythm, it provides a “No Shock Advised” message. The EMT should immediately:
A) check the patient for a pulse and blood pressure.
B) check the electrodes for proper placement.
C) resume cardiopulmonary resuscitation.
D) reanalyze the patient’s heart rhythm.

Answer 17

C) resume cardiopulmonary resuscitation.

Question 18

After analyzing a cardiac arrest patient’s heart rhythm, the AED provides a “Deliver Shock” message. After clearing the patient, the EMT’s next step should be to:
A) press the shock button, and then check for the return of a pulse.
B) press the shock button, and then perform CPR for 2 minutes.
C) check for a pulse, and then press the shock button if a pulse is not present.
D) press the shock button, and then allow the AED to analyze the heart rhythm.

Answer 18

B) press the shock button, and then perform CPR for 2 minutes.

Question 19

Which one of the following is a benefit of the automated external defibrillator?
A) Its ability to identify and confirm cardiac arrest
B) The ease and speed by which it can be used
C) The need for little-to-no training
D) Elimination of the need for a primary assessment

Answer 19

B) The ease and speed by which it can be used

Question 20

The AED should never be applied to a patient who is not in cardiac arrest because some patients in:
A) ventricular fibrillation may be conscious and alert.
B) ventricular fibrillation may have a pulse.
C) asystole may still have a pulse.
D) ventricular tachycardia may have a pulse.

Answer 20

D) ventricular tachycardia may have a pulse.

Question 21

Which one of the following links in the American Heart Association's Chain of Survival must occur first, if a patient is to survive cardiac arrest?
A) Early defibrillation 
B) Early advanced life support 
C) Early CPR 
D) Early access

Answer 21

D) Early access

Question 22

You have been dispatched to a residence for a male patient with a cardiac history who is complaining of chest pain. On scene you find a 52-year-old male patient sitting in a chair. He is alert and oriented and states that his chest pain feels like the last time he had a heart attack. He also states that in the hospital his heart stopped and they had to shock him twice before it restarted. He is breathing adequately and has a strong radial pulse. Which one of the following would be appropriate in the care of this patient?
A) Apply the AED to the patient but do not turn it on.
B) Provide positive pressure ventilation with high-concentration oxygen.
C) Open the airway using the head-tilt, chin-lift maneuver.
D) Obtain the heart rate, respiratory rate, and blood pressure.

Answer 22

D) Obtain the heart rate, respiratory rate, and blood pressure.

Question 23

A 52-year-old male has collapsed on his front porch and his family dialed 911. When you arrive, the daughter informs you that the patient has been down for approximately 8 minutes. Assessment reveals him to be in cardiac arrest. Which one of the following should you do immediately?
A) Hold CPR so that the AED can be checked and applied for use.
B) Start CPR while the AED is readied for use.
C) Contact medical direction for permission to use the AED given the downtime.
D) Perform five cycles of CPR at a ratio of 15 compressions to two ventilations (single rescuer CPR).

Answer 23

B) Start CPR while the AED is readied for use.

Question 24

You have arrived at a residence for a 66-year-old female who is in cardiac arrest. In the living room, you find Emergency Medical Responders performing CPR on the patient. They quickly report that they found the patient in cardiac arrest and have been doing CPR for 5 minutes. Which one of the following statements should you make at this time? A) "Let's continue CPR while I talk with the family to see if they want us to continue." B) "Let's stop CPR so I can check the airway, breathing, and circulation." C) "Let's continue CPR for another 2 minutes, and then I will put the AED on." D) "Let's stop CPR so I can put the electrodes of the AED on her chest."

Answer 24

B) "Let's stop CPR so I can check the airway, breathing, and circulation."

Question 25

Which one of the following statements about the heart rhythm of ventricular fibrillation is true? A) "The AED is designed to identify ventricular fibrillation and give a 'No Shock Advised' message when it is present." B) "When a patient's heart is in ventricular fibrillation, it is unable to pump blood throughout the body." C) "Ventricular fibrillation occurs when the heart rate is so slow and weak that a pulse cannot be felt." D) "The most effective treatment for converting ventricular fibrillation to a healthy heart rhythm is CPR."

Answer 25

B) "When a patient's heart is in ventricular fibrillation, it is unable to pump blood throughout the body."

Question 26

``` As you arrive at a metal scrap yard for an unknown medical emergency, you observe a male supine on the ground with AED electrodes on his chest. The AED operator has just ordered coworkers to clear the patient because the AED is going to shock. Within seconds, the AED delivers a shock without the operator pressing a "shock" button. The EMT should recognize what type of AED? A) Manual B) Biphasic D) Fully automated D) Semi-automated ```

Answer 26

D) Fully automated

Question 27

It is critical that the EMT never apply the AED to a person who is not in cardiac arrest because an accidental shock could: A) produce full thickness burns and lead to a deadly infection. B) cause the patient to lose his eyesight. C) cause the beating heart to go into cardiac arrest. D) cause the patient extreme pain.

Answer 27

C) cause the beating heart to go into cardiac arrest.

Question 28

Which one of the following statements about the AED and its use in the treatment of cardiac arrest is true? A) "AEDs have simplified the treatment of cardiac arrest to the point where the EMT does not have to be worried about inappropriately shocking a patient." B) "To use an AED, the EMT must be able to identify some basic cardiac arrest heart rhythms so that he or she can tell the AED to shock or not shock the patient." C) "Research has shown that the first shock delivered by an AED is often faster than the first shock delivered by a manual defibrillator." D) "The AED is advantageous in that it will determine if a patient is in cardiac arrest and whether or not to shock."

Answer 28

C) "Research has shown that the first shock delivered by an AED is often faster than the first shock delivered by a manual defibrillator."

Question 29

Within two minutes of going into cardiac arrest, an AED is applied, the patient is shocked, and a pulse is restored. The EMT should recognize that the heart was in: A) asystole and now is in an organized rhythm. B) ventricular fibrillation and now is in asystole. C) ventricular fibrillation and now is in cardiac arrest. D) ventricular fibrillation and now is in an organized rhythm.

Answer 29

D) ventricular fibrillation and now is in an organized rhythm.

Question 30

``` A patient has just gone into cardiac arrest. His heart is most likely in what rhythm? A) Ventricular tachycardia B) Pulseless electrical activity C) Ventricular fibrillation D) Asystole ```

Answer 30

C) Ventricular fibrillation

Question 31

Your service has a new AED. During the in-service on the new device, the instructor informs you that it is a semi-automated AED and uses a biphasic wave form, as opposed to the monophasic form used by the previous AED. As a knowledgeable EMT, you should recognize that: A) the new AED will defibrillate with higher amounts of electrical energy. B) the new AED will defibrillate with lower amounts of electrical energy. C) less energy but more shocks will be needed to treat cardiac arrest. D) the EMT will not need to press a "shock" button to shock the patient.

Answer 31

B) the new AED will defibrillate with lower amounts of electrical energy.

Question 32

Because of a shortage of paramedics at your ambulance service, it has been announced that there will be AEDs placed on every ambulance for use by EMT crews. Which of the following statements indicates an understanding of how this will affect the EMTs? A) "EMTs will have to learn how to interpret ECG tracings." B) "The AED will let us know whether or not to shock the patient." C) "Cardiopulmonary resuscitation will no longer be needed." D) "EMTs will now be able to shock all patients in cardiac arrest."

Answer 32

B) "The AED will let us know whether or not to shock the patient."

Question 33

The EMT should request advanced life support (ALS) backup for a patient in cardiac arrest because: A) paramedics must be present in order for the EMT to use the AED. B) ALS care is superior to basic life support care, even with the AED. C) cardiac arrest patients must be transported by ALS personnel. D) ALS treatment decreases the possibility of the patient going back into cardiac arrest once successful defibrillation has occurred.

Answer 33

D) ALS treatment decreases the possibility of the patient going back into cardiac arrest once successful defibrillation has occurred.

Question 34

``` A patient arrests at 1313. E-911 is activated and dispatches an ambulance at 1315. The ambulance arrives on scene at 1319 and the EMTs reach the patient's side and start care at 1321. After transporting the patient, the patient is transferred to the ED staff at 1346. Based on that information, which one of the following is true? A) Total down time is 6 minutes. B) Down time is 25 minutes. C) Down time is 8 minutes. D) Total down time is 31 minutes. ```

Answer 34

C) Down time is 8 minutes.

Question 35

After two cardiac arrests, a large home improvement center has purchased a fully automated AED. You have been asked to provide education on its use. During an instructional session, a student asks you what will happen when the AED indicates that a shock is indicated. Your response should be: A) "The AED will automatically shock the patient." B) "You will need to press the shock button." C) "You will need to reanalyze the heart rhythm." D) "The AED will prompt you to recheck the pulse."

Answer 35

A) "The AED will automatically shock the patient."

Question 36

Why is defibrillation in the first few minutes of cardiac arrest so critical? A) In the first few minutes of cardiac arrest the heart is still warm, but begins to cool rapidly making it less receptive to a defibrillatory shock. B) If cardiac arrest is not treated within the first few minutes, ventricular fibrillation will convert to asystole, a non-shockable heart rhythm. C) Research has shown that a heart in cardiac arrest will continue to pump blood for a few minutes before cardiac output drops to zero. D) In the first few minutes of cardiac arrest, the blood pressure is still normal, but will drop quickly, making successful defibrillation less likely.

Answer 36

B) If cardiac arrest is not treated within the first few minutes, ventricular fibrillation will convert to asystole, a non-shockable heart rhythm.

Question 37

You have been called to a public pool for an unresponsive patient. On arrival you find lifeguards performing CPR with a pocket mask and oxygen on a 67-year-old male. They report that the patient was in the water and was seen clutching his chest seconds before going unresponsive. He was immediately pulled from the water and CPR was initiated. They estimate that CPR has been performed for 5 minutes. Assessment shows the man to be unresponsive, apneic, and pulseless. Which one of the following is your first response? A) "Let's start ventilation with a bag-valve mask and oxygen." B) "Stop CPR and let's apply the AED." C) "We need to quickly dry him from head to toe before applying the AED." D) "Let's take a towel and dry off his chest."

Answer 37

D) "Let's take a towel and dry off his chest."

Question 38

An EMT has just received a "Shock Advised" message from the AED. Just before delivering the shock, the EMT must: A) press the analyze button once more. B) hold the patient's head to avoid injury when shocking. C) remove the oral airway to prevent possible choking. D) ensure that all rescuers are clear of the patient.

Answer 38

D) ensure that all rescuers are clear of the patient.

Question 39

``` Immediately following the onset of cardiac arrest, brain cells begin to die after: A) 15 minutes. B) 10 minutes. C) 1 minute. D) 5 minutes. ```

Answer 39

D) 5 minutes.

Question 40

You are by the side of an unresponsive 6-month-old with a history of congenital heart disease. The patient's airway is patent, but he is not breathing. A heart rate of 24 beats per minute is noted. At this time, it is essential that you: A) start positive pressure ventilation with high-concentration oxygen. B) start cardiopulmonary resuscitation. C) place the patient on the stretcher for immediate and emergent transport. D) apply the AED with pediatric pads.

Answer 40

B) start cardiopulmonary resuscitation.

Question 41

You are reassessing a young female who sustained blunt trauma to the chest in a motor vehicle collision. What assessment finding best indicates that she is deteriorating and in the decompensatory phase of shock? A) Blood pressure 88/50 mmHg B) Blood continuing to ooze from an abdominal laceration C) Heart rate 100 beats per minute D) Restless and confused mental status

Answer 41

A) Blood pressure 88/50 mmHg

Question 42

``` What cardiac arrest rhythm is the AED designed to shock? A) Ventricular fibrillation B) Bradycardia C) Pulseless electrical activity D) Asystole ```

Answer 42

A) Ventricular fibrillation

Question 43

When presenting information on cardiac arrest and automated external defibrillation to a community group, a man asks why people should perform CPR prior to the arrival of EMS if they are going to provide a shock. Your response would be: A) "CPR is needed to keep blood flowing through the body so the EMTs can give the patient IV medications when they arrive." B) "Immediate CPR can prolong the period in which the heart can be shocked following cardiac arrest." C) "In the American Heart Association's Chain of Survival, CPR is the most important link in surviving cardiac arrest." D) "In many cases, CPR can reverse the cardiac arrest, making a shock by the AED unnecessary."

Answer 43

B) "Immediate CPR can prolong the period in which the heart can be shocked following cardiac arrest."

Question 44

You have been asked to describe the American Heart Association's Chain of Survival to a group of Emergency Medical Responder students. What description is best? A) A sequence of care that provides instructions on how to use an AED B) A treatment plan, that if followed, guarantees the survival of cardiac arrest C) A sequence of events that, if enacted quickly, gives the best chance for surviving cardiac arrest D) A treatment plan that helps to prevent and treat cardiac arrest in the general population

Answer 44

C) A sequence of events that, if enacted quickly, gives the best chance for surviving cardiac arrest

Question 45

``` Resuscitation, started during what phase of cardiac arrest, provides the patient with his or her best chance of survival? A) Metabolic B) Electrical C) Bradycardic D) Circulatory ```

Answer 45

B) Electrical

Question 46

Your cardiac arrest patient has regained a pulse after two shocks. Which of the following actions would be appropriate? A) Canceling the ALS assistance and proceeding directly to the hospital B) Transporting the patient supine and secured to a back board C) Removing the AED once it is determined that a pulse has returned D) Reanalyzing the patient's heart rhythm with the AED every 5 minutes

Answer 46

B) Transporting the patient supine and secured to a back board

Question 47

A 51-year-old male who suffered cardiac arrest has regained a pulse after one shock from the AED. The dispatcher informs you that the paramedic unit you have requested for assistance is coming from the eastern end of the county and has a 20-minute ETA. The hospital is 15 minutes west of your location. Which one of the following would be most appropriate? A) Load the patient and meet the paramedic unit at a halfway point. B) Start transport to the hospital and inform ALS of your intent. C) Load the patient in the ambulance and wait on scene for the paramedic unit. D) Wait on scene for the paramedic unit to arrive.

Answer 47

B) Start transport to the hospital and inform ALS of your intent.

Question 48

You are instructing a first-aid class at a local chemical plant. The course includes instruction regarding an AED that is to be placed in the plant. What point would you emphasize about the most common cause of AED failure? A) "An extra set of electrodes should be kept in the AED." B) "Always check the electrode wires for cracks." C) "The AED should be kept clean and undamaged." D) "The batteries must be checked regularly."

Answer 48

D) "The batteries must be checked regularly."

Question 49

``` You have applied the AED's electrodes to an obese male patient in cardiac arrest. When you press the analyze button, the AED gives you a "check electrode" message. In looking at the patient, which one of the following would most likely be responsible for this message? A) Hairy chest B) History of asthma C) Obese chest and abdomen D) AED pads placed too far to the left ```

Answer 49

A) Hairy chest

Question 50

You are transporting a 57-year-old male who went into cardiac arrest at home. After two shocks and CPR, he regained a pulse, but remains unresponsive and in respiratory arrest. During transport, your reassessment reveals the absence of a carotid pulse. Which one of the following should you do first? A) Reapply the AED and analyze the heart rhythm. B) Provide five cycles of CPR prior to using the AED. C) Stop the ambulance and analyze the heart rhythm with the AED. D) Start CPR and continue emergency transport.

Answer 50

C) Stop the ambulance and analyze the heart rhythm with the AED.

Question 51

Proper care of cardiac arrest for a 6-year-old pediatric patient when there are no available pediatric AED pads would include: A) placement and use of the adult pads with adult energy levels. B) compressing the chest to a maximum of 1½ inches in depth. C) 2 EMTs providing a 30:2 ratio of compressions to ventilations. D) CPR with no AED placement due to lack of pediatric pads.

Answer 51

A) placement and use of the adult pads with adult energy levels.

Question 52

Which of the following is appropriate when two EMTs are performing CPR on an adult patient? A) Compressions of at least 100 per minute B) Compression to ventilation rate of 15:2 C) Delivery of ventilations while compressions are being provided D) Airway reassessment after every 30 compressions

Answer 52

A) Compressions of at least 100 per minute

Question 53

``` You have been called to transport a patient in septic shock from the emergency department of a local hospital to the critical care unit of another. Two nurses will be accompanying you. As a knowledgeable EMT, you recognize that this state of shock has been caused by: A) blood loss. B) failing heart. C) fluid volume loss. D) infection. ```

Answer 53

D) infection.

Question 54

When comparing the pediatric chain of survival to the adult chain of survival, the EMT would note that the pediatric version contains what difference? A) Less attention to post-resuscitation care B) Emphasis of ventilations over compressions C) Highlight of ALS over BLS D) Prevention of cardiac arrest

Answer 54

D) Prevention of cardiac arrest

Question 55

At a continuing education seminar on shock, the presenter asks if anyone can tell him something about irreversible shock. What statement made by an EMT is correct? A) "To survive, the patient in irreversible shock needs a large amount of IV fluids immediately." B) "Even with treatment, if shock has reached the irreversible stage, death will result." C) "If the pupils are dilated and pulse is rapid, the patient is in irreversible shock." D) "In irreversible shock, the carotid pulse is weak, but the radial pulse remains strong."

Answer 55

B) "Even with treatment, if shock has reached the irreversible stage, death will result."

Question 56

Which of the following patient remarks best reinforces your suspicion that he is in the early stages of hypovolemic shock? A) "I fell last night and think I hurt my belly; see the bruise?" B) "I have had diarrhea for the past four days." C) "I have been coughing up green mucus and feel weak." D) "I must have fallen and hit my head. I am very confused and restless."

Answer 56

B) "I have had diarrhea for the past four days."

Question 57

``` A 66-year-old female patient has been struck by a car. Your assessment reveals gurgling respirations, rapid breathing, and cool, diaphoretic skin. You also note bruising to her chest and abdomen. Which one of the following should you do immediately? A) Determine the blood pressure. B) Evaluate for shock. C) Suction the airway. D) Administer high-concentration oxygen. ```

Answer 57

C) Suction the airway.

Question 58

Which one of the following statements best indicates an understanding of the prehospital role in caring for the patient in shock? A) "The job of the EMT is to recognize that a person is in shock and get him or her to the hospital so treatment can be started." B) "Because shock is a life-threatening condition, it is important that the EMT identify the exact cause so the proper care can be given." C) "If shock is in the compensatory or early stage, it is not yet life-threatening and the EMT can take his time in assessing and treating the patient." D) "Since shock is best treated in the hospital, the EMT should provide care to maintain perfusion to the vital organs and transport."

Answer 58

D) "Since shock is best treated in the hospital, the EMT should provide care to maintain perfusion to the vital organs and transport."

Question 59

A 44-year-old male has been shot in the abdomen. What assessment findings would lead you to believe that the patient is in compensated shock? A) Alert and anxious, pulse 96, BP 134/88 mmHg, pale and cool skin B) Confused and anxious, pulse 144, BP 82/palpation, cool skin that is mottled C) Confused, pulse 44, BP 110/68 mmHg, cool and cyanotic skin D) Slightly confused, pulse 116, BP 112/90 mmHg, warm skin that is flushed

Answer 59

A) Alert and anxious, pulse 96, BP 134/88 mmHg, pale and cool skin

Question 60

While cleaning a gun, a 44-year-old patient accidentally shot himself in the abdomen. On arrival, you observe the patient on the floor lying on his side with his legs drawn to his chest. Blood is evident on his shirt and pants. Which one of the following indicates the correct sequence of events when caring for this patient? A) Perform primary and secondary assessments, move to the stretcher for immediate transport, start positive pressure ventilation en route to the hospital B) Transfer to the ambulance, perform the primary assessment and rapid secondary assessment, provide oxygen therapy, rapid transport C) Perform the primary assessment, administer high-concentration oxygen, perform a rapid secondary assessment, transfer to the stretcher, rapid transport D) Transfer to the ambulance, rapid transport, primary assessment and oxygen therapy performed en route to the hospital

Answer 60

C) Perform the primary assessment, administer high-concentration oxygen, perform a rapid secondary assessment, transfer to the stretcher, rapid transport

Question 61

When a person is in shock, what is occurring in the body? A) The cells are not getting enough oxygen and waste products are accumulating. B) The amount of oxygen to the cells is adequate, but CO2 is not being eliminated. C) The cells are getting glucose and other nutrients, but not oxygen. D) The blood has an adequate amount of oxygen, but not enough nutrients for cell survival.

Answer 61

A) The cells are not getting enough oxygen and waste products are accumulating.

Question 62

A 28-year-old male was cutting limbs from a tree when he lost his footing and fell approximately 20 feet. He is unresponsive and breathing shallowly at 28 times per minute. His radial pulse is weak and thready, and his skin is cool to the touch. Emergency Medical Responders (EMRs) have placed him on a nonrebreather face mask and are holding manual in-line cervical spine stabilization. His respirations are snoring. Based on these assessment findings, which one of the following instructions would you provide to the EMRs? A) "Let's take off the oxygen mask and start positive pressure ventilation to assist his breathing." B) "He has snoring respirations, so let's go ahead and open the airway with the head-tilt, chin-lift." C) "Let's go ahead and elevate his legs 8 to 12 inches so more blood gets to his vital organs." D) "Do not cover him with a blanket because that will cause his blood vessels to dilate and drop his BP."

Answer 62

A) "Let's take off the oxygen mask and start positive pressure ventilation to assist his breathing."

Question 63

``` A driver was ejected from his vehicle in a rollover-type collision. Assessment findings reveal the patient to be unresponsive with bruising to the abdominal and pelvic areas along with an open femur fracture. The patient has an open airway and is breathing 32 times per minute. His skin is cool and clammy and the radial pulses weak. Manual in-line spinal stabilization is being maintained. The EMT's next intervention would be to: A) assist respirations. B) apply a cervical collar. C) examine the fracture site. D) obtain a blood pressure. ```

Answer 63

A) assist respirations.

Question 64

Which one of the following actions performed by the EMT indicates appropriate care with the AED when treating a patient in cardiac arrest? A) He places the AED pads two inches away from a transdermal medication patch on the patient's chest. B) He places, then quickly removes, a set of electrodes in an attempt to remove hair from a patient's chest. C) He applies one electrode over the top of the power source for a pacemaker located on the patient's chest. D) He intentionally withholds a shock on a patient in cardiac arrest who has an implantable defibrillator.

Answer 64

B) He places, then quickly removes, a set of electrodes in an attempt to remove hair from a patient's chest.

Question 65

You are transporting a patient in cardiac arrest. The AED is being used and a shock has been advised. Prior to administering the shock, what should you do? A) Withhold all shocks because metal will conduct the shock into the ambulance. B) Ensure that no rescuer is touching the stretcher. C) Stop the ambulance and have all rescuers exit prior to shocking with the AED. D) Move the patient from the metal stretcher to a nonmetal surface.

Answer 65

B) Ensure that no rescuer is touching the stretcher.

Question 66

``` You suspect that a patient involved in a motor vehicle collision is in shock. What sign or symptom of shock would you expect to see last? A) Tachycardia B) Decreased blood pressure C) Increased respirations D) Pale and diaphoretic skin ```

Answer 66

B) Decreased blood pressure

Question 67

A patient has fallen down a flight of stairs and is restless and confused. The airway is open, and he is adequately breathing 22 times per minute. He has a radial pulse of 92 beats per minute and is moderate in strength. Emergency Medical Responders are maintaining manual in-line spinal stabilization. Your next action would be to: A) immobilize the patient with a cervical collar and long spine board. B) check the blood pressure and assess for injuries causing blood loss. C) apply oxygen at 15 liters per minute via nonrebreather face mask. D) insert an oral airway and start positive pressure ventilation with oxygen.

Answer 67

C) apply oxygen at 15 liters per minute via nonrebreather face mask.

Question 68

``` A confused and anxious patient fell 20 feet from a ladder. What sign suggests that the patient is in shock? A) Contusion to his head B) Deformity to the left arm C) Heart rate of 110 D) Constricted pupils ```

Answer 68

C) Heart rate of 110

Question 69

``` When performing the primary assessment, what sign or symptom best indicates that the patient is in hypovolemic shock? A) Radial pulse of 72 beats per minute B) Skin that is cool and diaphoretic C) Crackles heard in both lungs D) Constricted pupils ```

Answer 69

B) Skin that is cool and diaphoretic

Question 70

``` You are assessing an elderly patient with a decreased level of consciousness. Your assessment reveals the patient to have a patent airway, labored respirations, and weak, rapid pulses. The skin is pale, cool, and cyanotic in the extremities. You also observe diaphoresis and a delayed capillary refill. Vital signs for this patient are: HR 136 bpm, BP 66/40 mmHg, and respirations 40 and shallow. Auscultation of the lungs reveals profound rales located throughout each lung. His temperature is 99°F and there is obvious JVD and pedal edema. Additionally, family states that the patient has an extensive cardiac and diabetic history. Based on this information you should suspect what kind of shock? A) Cardiogenic B) Distributive C) Hypotensive D) Hypovolemic ```

Answer 70

A) Cardiogenic

Question 71

You believe that a young male patient, who has been shot in the lower abdomen, is bleeding internally and is in the early stage of shock. Which item indicates the appropriate prehospital care of this patient? A) Oxygen therapy and warm packs to the abdomen B) Oxygen therapy and rapid transport to the hospital C) "Shock" position and administration of water by mouth D) Semi-Fowler's position and direct pressure over the injury site

Answer 71

B) Oxygen therapy and rapid transport to the hospital

Question 72

The owner of a day care center for adults with Alzheimer's disease calls you to ask about an AED at her facility. Specifically, she asks if she will need a physician to oversee the AED program. Your reply should be: A) "You will need to have a physician medical director since the AED can only be used with his or her permission under his or her license." B) "A medical director is only needed if you are going to bill insurance companies for the provision of care; if you are not, a medical director is not needed." C) "If you get a semi-automated AED, you will need a physician medical director. Since fully automated AEDs are easier to use, a medical director is not needed." D) "If you intend to use the AED on anyone under the age of 50 years, a medical director will be needed."

Answer 72

A) "You will need to have a physician medical director since the AED can only be used with his or her permission under his or her license."

Question 73

``` Your ambulance service director has given you the go ahead to replace an old AED with a new AED produced by a different manufacturer. Before making the purchase, you must receive authorization to do so by the: A) AED medical director. B) old manufacturer. C) shift supervisor. D) American Heart Association. ```

Answer 73

A) AED medical director.

Question 74

You are treating a patient with severe chest pain and believe she is in cardiogenic shock. As such, which of the following is most appropriate? A) Application of the AED B) Supplemental oxygen C) Rapid transport with the patient supine D) Administration of nitroglycerin

Answer 74

B) Supplemental oxygen

Question 75

``` A patient with a severe gastrointestinal bleed is in shock. Which of the following would best correct the patient's underlying problem? A) Intravenous fluids B) Blood replacement C) High-concentration oxygen D) Replace lost electrolytes ```

Answer 75

B) Blood replacement

Question 76

``` As you approach a patient, you observe a 1-inch circle of dark blood on his shirt. He appears confused, pale, and diaphoretic. Which one of the following should you do first? A) Assess his airway. B) Cut his shirt. C) Apply oxygen. D) Treat for shock. ```

Answer 76

A) Assess his airway.

Question 77

A patient in early shock informs the EMT that that he has had severe diarrhea and vomiting over the past four days. Given this history, the EMT should recognize the pathophysiology of the shock as: A) leakage of the capillaries. B) decreased formed elements in the blood. C) loss of plasma volume. D) loss of red blood cells.

Answer 77

C) loss of plasma volume.

Question 78

Which one of the following activities related to the use of an AED would a medical director carry out? A) Reviewing cases in which an AED was used but no shock was advised B) Overseeing repairs to AEDs that are in need of service or repair C) Obtaining funding for supplies like batteries, razors, and electrodes D) Responding to calls in which the EMT is using the AED

Answer 78

A) Reviewing cases in which an AED was used but no shock was advised

Question 79

``` A patient in shock with abdominal pain indicates he noticed a lot of blood in the toilet after having a bowel movement this morning. The EMT should suspect what type of shock? A) Nonhemorrhagic hypovolemic B) Hypoxic hypovolemic C) Hemorrhagic hypovolemic D) Septic hypovolemic ```

Answer 79

C) Hemorrhagic hypovolemic

Question 80

You are transporting an unresponsive 31-year-old female patient who suffered cardiac arrest. On scene Emergency Medical Responders (EMRs) shocked her once with the AED and she regained a pulse. She remains unresponsive and is breathing shallowly. Ventilations are being provided with a bag-valve mask. An EMR has agreed to ride to the hospital with you to provide assistance in caring for the patient. Which one of the following instructions given to the EMR is most appropriate? A) "Place her in the semi-Fowler's position so her airway is clear if she vomits." B) "Leave the AED on her, even though she is breathing and has a pulse." C) "Please check her breathing and pulse every 5 minutes." D) "Place her on a nonrebreather with 15 liters per minute of oxygen."

Answer 80

B) "Leave the AED on her, even though she is breathing and has a pulse."

Question 81

``` A patient has been involved in a very serious motor vehicle collision and is in shock. Assessment findings indicate that he sustained blunt trauma to the abdominal and pelvic areas. What type of shock is the patient most likely suffering? A) Distributive B) Hypovolemic C) Cardiogenic D) Obstructive ```

Answer 81

B) Hypovolemic

Question 82

Which one of the following conditions could be responsible for causing obstructive shock? A) Infection throughout the body B) Loss of blood in the urine C) Poor transfer of oxygen at the capillary level D) Blood clots in the lungs

Answer 82

D) Blood clots in the lungs

Question 83

The EMT knows that the cause underlying distributive shock is: A) dilation of the blood vessels. B) damaged heart with poor contractility. C) loss of blood volume. D) poor fluid intake.

Answer 83

A) dilation of the blood vessels.

Question 84

Which one of the following statements made by a patient's family member would cause the EMT to suspect that a patient is suffering from hypovolemic shock? A) "He cannot stop throwing up." B) "He got up this morning and was having a hard time breathing." C) "He has had a rash for the past three days." D) "He has been taking an antibiotic for a chest cold."

Answer 84

A) "He cannot stop throwing up."

Question 85

The major categories of shock include: A) hypoglycemic, obstructive, distributive, and hypovolemic. B) hemorrhagic, distributive, hypoxic, and obstructive. C) hypovolemic, cardiogenic, obstructive, and distributive. D) burn, hypovolemic, distributive, and hypoxic.

Answer 85

C) hypovolemic, cardiogenic, obstructive, and distributive.

Question 86

The EMT understands that when paramedics administer IV fluids as treatment for hemorrhagic shock, the fluids will: A) enable the lungs to better oxygenate the blood. B) reverse the shock by increasing the blood pressure. C) do nothing to get more oxygen to the cells. D) stabilize the shock by restoring needed electrolytes.

Answer 86

C) do nothing to get more oxygen to the cells.

Question 87

``` The EMT would recognize which of the following as the most probable case of cardiogenic shock? A) Myocardial infarction B) Severe vomiting and diarrhea C) Systemic infection D) Gastrointestinal bleed ```

Answer 87

A) Myocardial infarction

Question 88

The EMT realizes that the best means of preventing failure of the AED is to: A) check the AED and its supplies at the beginning of each shift. B) always make sure that the AED is kept clean and free of damage. C) obtain a second set of batteries when the original set is no longer functional. D) check the electrodes monthly and replace when expired.

Answer 88

A) check the AED and its supplies at the beginning of each shift.