1. B- The first step in treating a patient with potential cardiac arrest is to administer oxygen. At that point, you should obtain a patient history and perform a physical exam to obtain baseline vital signs.
2. D- When a patient loses consciousness, the first step is to open the airway. If you find the patient to be in cardiac arrest based on your initial assessment, you should attach an automated external defibrillator.
3. B- In addition to administering oxygen, the most effective way to decrease oxygen demand is to calm and reassure the patient. Driving at high speed, flashing lights, or turning on the siren will only heighten the patient’s distress.
4. C- In a young child with possible airway obstruction, attempts to remove a mild obstruction may result in severe obstruction. Back blows and chest thrusts should only be performed in the case of a severe obstruction, and finger sweeps only when the child is unconscious and the object is visible in the mouth. The most appropriate course of action is to avoid agitating the child and provide immediate transport to the hospital.
5. A- Young children typically fear a stranger in their environment and will maintain eye contact with that person. Thus, inattentiveness to your presence is indicative of an altered mental state.
6. D- High fever, generalized rash, and altered mental state are indicative of meningitis, or inflammation of the tissue protecting the brain and spinal cord. Because a child with meningitis is at high risk for seizures, his or her condition should be carefully monitored during transport to the hospital.
7.C- Rapid trauma assessment is indicated in patients with significant mechanisms of injury, such as penetrating wounds to the head, neck, chest, or abdomen, falls from a height of >15 feet (such as from a tall building), or multiple long bone fractures.
8. D- In patients with acute ischemic stroke, administering oxygen is the most important first step, followed by rapid transport to the hospital for fibrinolytic therapy. Fibrinolytic therapy must be performed within 3 hours of symptom onset.
9. C- Crowning indicates that the second stage of labor has begun and delivery is imminent. After stopping the ambulance, gentle pressure should be applied to the infant’s head to avoid explosive delivery.
10. B- If the umbilical cord continues to pulsate and the infant is not breathing adequately, the cord should remain attached and the head of the infant kept at the level of the mother’s perineum until arrival at the hospital. The umbilical cord should not be clamped or cut until the cord has stopped pulsating and the infant has begun to breathe normally.
11. B- It may be difficult to extend the head and flex the neck of an elderly person because of arthritic conditions. The head of an elderly person should never be forced back. Rather, the jaw should be thrust forward and the tongue pulled out of the airway.
12. A- Two major risk factors for airway obstruction in elderly patients are poorly chewed food and dentures. If dentures are loose or ill-fitting and/or obstruct efforts to ventilate the patient, they should be removed.
13. C- When a patient begins to make gurgling sounds, whether before, during, or after ventilation, he or she should be suctioned immediately; however, a patient should be properly oxygenated before suctioning.
14. C- An EMT-B can help prevent future falls in an elderly patient by assessing the patient’s home for potential hazards, such as slippery rugs or obstructive furniture.
15. D- Oral glucose, activated charcoal, and oxygen are carried on an ambulance and may be administered to a patient under certain circumstances.
16. A- If previously prescribed for the patient, the EMT-B may assist him or her in taking nitroglycerin, epinephrine, or inhalers. Permission from medical direction may be required.
17. B- Blood loss, trauma, particularly from abdominal injury, infection, and dehydration resulting from diarrhea or vomiting are the most common causes of hypoperfusion in infants and children. Bleeding that may not seem serious in an adult may lead to hypoperfusion in a child.
18. C- Signs of hypoperfusion in a child include rapid respiratory rate, pale, clammy skin, weak or absent peripheral pulse, and decreased urinary output.
19. D- Because infants and children may go into decompensated shock rapidly, never wait for signs of decompensated shock to develop. Supplemental oxygen should be provided, external bleeding managed, and artificial ventilation begun if necessary. The child should be kept warm and transported immediately to the hospital.
20. A- Although a cardiac condition is the most likely cause of cardiac arrest in adults, respiratory failure is the most likely cause in children. Breathing difficulties in children may result from airway obstruction or respiratory disease.
21. C- Because the patient has been lying in the cold all night, he is most likely suffering from hypothermia. Signs of hypothermia include muscular rigidity, amnesia, and loss of contact with environment.
22. D- The best course of action to prevent additional body heat loss in an injured patient trapped in cold environment is to create a barrier to the cold. Blankets or articles of clothing can be used to protect the patient from exposure to wind or water. Active rewarming may result in cardiac arrest, and ingestion of stimulants in impaired circulation.
23. A- Individuals under the influence of alcohol or drugs may be more susceptible to hypothermia. The fact that the patient had been drinking and was trapped overnight in a cold environment places him at high risk of hypothermia.
24. B- The signs and symptoms of carbon monoxide poisoning may resemble those of the flu, including nausea and headache.
25. A- The first step in treating a patient with an absorbed poison is to remove the poison from the eyes or skin immediately. This may be accomplished by irrigating the eye or skin with clean water for 20 minutes. Attempting to neutralize the absorbed substance with other solutions such as vinegar or baking soda may make the injury worse.