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NREMT EXAM 2 SAMPLE QUESTIONS,
ANSWERS AND RATIONALE
When the site of a seizure is a discrete area in one hemisphere of the brain, it is classified as ... - Correct answer partial seizure partial seizure = the site of a seizure is a discrete area in one hemisphere of the brain 2 most common types of partial seizure are simple partial and complex partial. Once a major incident has been declared, an incident commander establishes sectors. Which of the following sectors tracks the use of all additional personnel, resources, and equipment? - Correct answer support/supply sector The support/supply sector records all requests for and receipts of supplies and support services. Members of this team track the use of all additional personnel, resources, and equipment. They coordinate with the transportation center frequently. Which of the following colors indicates that a cylinder contains oxygen? - Correct answer green The mucus and blood that may come out of the vagina as labor begins is - Correct answer bloody show The mucus and blood that may come out of the vagina as labor begins is known as the bloody show. Labor is the time and process beginning with the first uterine muscle contraction until delivery of the placenta. pulse is caused by the - Correct answer The left ventricle contracts sending a wave of blood through the arteries to create a pulse. The right ventricle pumps blood to the lungs. In terms of mental status in the RPM triage process, the patient's mental status is evaluated by - Correct answer his ability to follow a simple command
local cold emergencies can happen when feet have prolonged exposure to cold and water - Correct answer trenchfoot (immersion foot) gas exchange: - Correct answer The partial pressure of carbon dioxide (PCO2) is higher in the capillaries than in the alveoli, which allows for diffusion into the alveoli where it is exhaled during expiration Gas is exchanged between the alveoli and the pulmonary capillaries via diffusion. The partial pressure of oxygen (PO2) is lower in the alveoli in comparison to the external environment. Which of the following is most likely to result in fat emboli in the pulmonary circulation? - Correct answer long bone fracture Fat enters the pulmonary circulation most commonly when released from the bone marrow following long bone fractures. The presence of fat in the pulmonary circulation injures the endothelial lining of the capillary, increasing permeability and alveolar flooding. In terms of spinal injuries, patients with trauma to C5 or above are at high risk for ... - Correct answer respiratory paralysis Patients with trauma to C5 or above are at high risk for respiratory paralysis. you are treating a patient complaining of "crushing" chest pain. the patient has a history of angina pectoris, which you suspect is causing the pain now. the most appropriate medication for this patient is? - Correct answer nitroglycerin nitro for angina. nitro relaxes the smooth muscle of blood vessel walls and dilating coronary arteries, which increases blood flow and O2 supply to the heart you are treating an arterial bleed just above the elbow. direct pressure and gauze doesnt seem to be helping, as the wound continues to spurt bright red blood. what should be your next course of action? - Correct answer place a tourniquet proximal to the injury
which patient would be the most likely to require insulin injections? - Correct answer 25 yr old male with type 1 diabetes patients with type 1 diabetes are not able to produce their own insulin. type 2 can use diet + exercise you are called to the scene of an amusement park. as you approach the scene, you witness a man grab his chest and collapse. your patient is a 72 yr old male who has no pulse and is not breathing. after confirming cardiac arrest, you begin CPR. your partner should do what? - Correct answer ready the AED apply the AED as soon as possible, after shock is delivered then manage airway If you reach the site where a woman of advanced age has fallen and injured her ribs, and when you check you find she is breathing rapidly and shallowly, the rate being 40, how can you confirm that this emergency is life threatening? - Correct answer There is a risk of her volume per minute diminishing use of an endotracheal tube - Correct answer For insertion inside the patient's trachea Once inside the patient's trachea, the endotracheal tube separates the trachea and the oesophagus, creating a patent airway. Sellick's maneuver is meant to - Correct answer reduce vomiting risk sellick's maneuver = reduces vomiting risk when oesophagus is directly collapsed + makes vocal cords visible Once you have the endotracheal tube in place, and as you perform auscultation, you realize the patient's right side has sounds from the lungs but the left does not, or they are minimal. What should be your next move?
- Correct answer Ensure the cuff is deflated, then pull out the tube three to four centimeters sounds in right lung not left after intubation = tube penetrated right bronchi
You have been instructed by medical control to help a patient who has a metered dose inhaler. What must you ensure before you can begin to help the patient? - Correct answer right patient, not expired (right date) what is a spontaneous pneumothorax? - Correct answer a sudden build up of air within the patient's pleural space spontaneous pneumothorax is common for COPD patients. What would you consider a suitable intervention to treat an apneic person?
- Correct answer apneic = no breathing = OPA, BVM, intubation what kind of injury leads to paradoxical motion affecting a person's chest? - Correct answer flail chest Often, cardiac arrest in children is the result of: - Correct answer Compromised respiratory function When carrying out artificial ventilation using a bag-value-mask to help patient whom you consider to have no trauma, you should first: - Correct answer Put the patient's head in a 'sniffing' posture that is hyper-extended sequence of emergency moves: first, put head in 'sniffing' position + hyper extended. If need be, insert airway, then use both hands to fix the mask. Finally, have an assistant squeeze the mask bag to ensure the patient's chest rises. If a 70-year-old patient whose complaint is being sort of breath has had emphysema in the past, what should you do? - Correct answer Provide oxygen since often, hypoxic drive does not have an impact Utilizing a rigid suction catheter when treating infants and young children risks stimulation of the back of the throat, which may: - Correct answer Lead to differences in the rhythm of the heart If a rigid catheter is used when suctioning infants or tiny children, you need to be careful to avoid touching the back of their throat because if that area is stimulated that could lead to bradycardia due to patient's vagus nerve being stimulated.
If you think a patient has fractured the talus bone, what is the most suitable treatment you would recommend - Correct answer Splinting of the patient's ankle, application of ice, followed by elevation Your 33-year-old male patient has a big laceration on his abdomen, with his abdominal organ protruding out if that opening. What is this kind of injury called? - Correct answer evisceration evisceration = removal/protrusion of internal organs The most suitable means of handling an amputated extremity is: - Correct answer Wrapping it in a sterilized dressing and then keeping it cool using ice If, during transportation of a trauma patient, you observe he is becoming worse, what is the best thing to do? - Correct answer Research the patient You have been called because a male, 16 years if age, has fallen from around 15feet. You should consider the call: - Correct answer An injury mechanism that is not significant 16 years old is medically considered an adult, and any adult fall below 20 feet is not considered an injury mechanism with significance. When you find a 32-year-old man with complaints of pain in the abdomen as well as weakness, you assess him, and he tells you he also has Addison's disease from the use of steroids when he was a teenager. You do not find any conditions that are a threat to his life as far as his airway, breathing and circulation are concerned. Specifically, where vital signs are concerned, pulse is 110 bpm, respiration is 16 every minute; blood pressure is 110/72 mmHg while SpO2 is 98 percent gauged against room air. Considering the medical history of the patient, your best option is: - Correct answer To access the level of blood glucose The most common cause of anaphylaxis is: - Correct answer Treatment using penicillin In the course of planning a seminar that is part of continuing education us conjunction while the medical director, it is decided there is need to
address emergencies of a behavioral nature. The medical director would like to know how you define 'normal' behavior. What is your response? - Correct answer behavior acceptable to society Your patient is a 52-year-old woman whom neighbors found behaving oddly. She seems fatigued as well as confused, and her speech is slurred. You note she is able to breathe on her own and you can feel her pulse. Her skin is not only cool but mottled. When you take her vital, you note that her pulse is 68bpm and respiration 14 every minute. Her blood pressure us 108/60 mmHg while her temperature is 92.7°F. You found no trauma signs. She has prescriptions for some medications in the house, namely Verapamil and Digoxin, as well as Synthroid and also nitroglycerin. Nobody knows about her possible allergies, that apartment she is in has a temperature of 55°F. Considering all those findings, which of the conditions listed below is most probable to have led to his patient's health condition? - Correct answer hypothyroidism A patient who has peptic ulcers is treated with medications like : - Correct answer antibiotics A 17-years-old teenager has all of a sudden begun to be short of breath, and as you assess him, you learn he has Marfan's syndrome. You also observe the sounds from the lungs, on the left of the chest, have diminished and the patient is dyspncic. What, in your view, is the most likely reason the patient is short of breath? - Correct answer sponatneous pneumothorax Insulin has a physiological role in the enhancing how well the cells utilize glucose. What happens to someone whose insulin level is low? - Correct answer Glucose remains outside the cells, and nothing can break it down Which drug below is in the opiate category? Ativan Heroin Librium Cocaine - Correct answer heroin At a resort on a mountain stop is a patient who complains of suddenly being short of breath and coughing. After assessing the patient, you realize there are basilar crackles in the lungs and the patient is anxious. The
What would be your major concern if you found someone having seizures?
- Correct answer What is the patency of the airway? You have a patient who has had epileptic fits in the past, and this time, according to his family, he has failed to recover as he usually does after having a seizure. The patient suffers another seizure just as you accessing him. What is the term given to such a condition? - Correct answer status epilepticus There is a form of seizure that causes a patient to simpler stare into space and not experience massive muscular contractions. What is it called? - Correct answer petit mal common with young age, petit mall is brief, no postictal period As an EMT, it is not uncommon to encounter case of allergic reaction, and this is not surprising as many people with allergies are bound to find themselves exposed to the nuisance allergens at one time or another. The process of exposing someone to an allergen is termed _______. - Correct answer sensitization One of the entry routes below is the most common as far as anaphylactic reaction causes as concerned, which is it? - Correct answer injection insect bite (bee sting) / meds (penicillin) Once EMT's arrive at the emergency scene, their initial concern with regards to the patient is: - Correct answer Is the airway swelling and is there effort of a respiratory nature? Anaphylactic shock is a kind of distributive shock, and in this case, the blood vessels are: - Correct answer dilated Following appropriate control of a patient's airway is an emergency situation, administration of epinephrine should follow. Why is epinephrine preferable? - Correct answer it speeds up the heart, dilates the bronchioles, constricts blood vessels
Syncope is caused by different things. When does a patient experience a syncopal episode? - Correct answer upon standing (postural hypotension) There are different entry routes through which accidental poisoning can happens. Which among those possible routes is most common? - Correct answer ingestion There are many poisons that adversely affects people, but there are only a handful of antidotes. What, then, can one use as a treatment when there is a case of poisoning, but an antidote is not available? - Correct answer limitation of absorption to limit absorption of a poison, use activated charcoal, flush with water Diagnosing food poisoning from a hospital environment can be difficult because there is a wide range of symptoms associated with food poisoning. It may take quite some time after food poisoning for the affected person to fall ill. Below is a list of ailments that are all foodborne apart from one. Which is it? E. coli salmonella encephalitis chmpylobactor - Correct answer encephalitis pulse for a newborn = 140 - 160 pulse for ages 1 to 6 = 100 - 120 - Correct answer pulse for child over 6 = 80 - 100 accurate blood flow from heart through the lungs - Correct answer Superior/ inferior venae cava through the right atrium to the right ventricle, through the lungs to the left atrium and left ventricle, then finally to aorta difference between angina pectoris and a myocardial infarction is - Correct answer angina pectoris is caused by mental/physical stress, usually 10mins purpose of the mitral valve - Correct answer Stopping the flow of the blood to the left atrium
When a patient isn't responsive to your loud verbal stimuli and you come across these Medications -Lipitor and Glucophage - what is the most likely source of problem? - Correct answer Reaction causes by diabetes With a diabetic patient that gets 4 injections of insulin a day and has 18 breathes each minutes, what would be the most likely reason he was found unresponsive, tachycardic and diaphoretic? - Correct answer Hypoglycemia A diabetic patient dependent on Insulin with the stated symptoms is highly likely to be hypoglycemic. The disphoresis and tachycardia are from a catecholamine release trying to mobilize more glucose. It is likely that the patient has high blood pressure, but that isn't the cause of unresponsiveness. A clinician would give 15 grams oral instant glucose to a diabetic patient that is experiencing hypoglycemia but not if the patient is _______ - Correct answer Half-awake without being able to swallow Which one of these is the first sign of diabetes in a lot of young patients and is often a fatal complication? - Correct answer Diabetic ketoacidosis (DKA) More often than not, the first symptoms of diabetes are Diabetic ketoacidosis. When there isn't fuel-glucose - for the cell to burn, they will burn fat, and fat doesn't necessarily burn clean. The burning will produce acids that build up and, if not treated vigorously, this condition can be fatal. High blood pressure and heart diseases are deep-rooted diabetic diseases. Symptoms of a stroke are often similar to other various medical problem, and so, in order to prevent administering the wrong treatment, it is mandatory to work through the differences. An example is how hypoglycaemia is usually confused for a cerebral vascular accident. How could one rule out the difference? - Correct answer Check blood sugar Which of the statement below is correct when it comes to assessing cardiac compromised patients? - Correct answer The extent of any cardiac damage done cannot be determined in the field
It is not possible to know the severity of damaged tissue in the field. Therefore the reason for focused assessment is to collect information for the facility that will receive the patient. Always ask about medications. A focused history is not linked to the use of an AED. Cardiac paints have many presentations which make it very difficult to distinguish them from other conditions. Which of the statement below is true regarding the heart's left atrium? - Correct answer The pulmonary veins delivers blood to the left atrium AED pads are best applied to patients when they - Correct answer are apneic and do not have a pulse Which valve is located between the heart's right atrium and ventricle? - Correct answer Tricuspid valve which of the following behaviors is suggestive of a patient who is suspected of experiencing hypothermia? lethargy complaints of a headache extreme thirst rapid, fluent speaking - Correct answer lethargy which of the following is a common cause of seizures in adults? myocardial infarction burn injuries pelvic fracture poisoning - Correct answer poisoning which of the following is an example of a likely reporting situation? mass casualty incidents error in documentation patient reluctant to treatment witnessing a crime off duty - Correct answer mass casualty incidents which of the following is a potential effect when the parasympathetic nervous system is stimulated? bronchodilation bradycardia constricted blood vessels
epistaxis = nose bleed melena (bloody stool) = upper digestive tract what is the name of the cartilaginous ridge where the trachea divides into the right and left main-stem bronchus? carina vocal cords bronchiole alveoli - Correct answer carina which of the following is true regarding physical restraints? - Correct answer physical restraints should only be used when necessary to prevent injury a trauma patient has sustained several fractures. which of the following fractures would be considered the most critical injury? pelvic femoral shaft tibia humerus - Correct answer pelvic fracture - most critical fracture an asthma patient is experiencing dyspnea (shortness of breath). she states she feels better after self-administering a nebulized albuterol inhaler prior to EMS arrival. what is the primary function of albuterol? dilating bronchioles decreasing myocardial oxygen demand causing smooth muscle relaxation reducing swelling - Correct answer dilating bronchioles when competing a secondary assessment on an adult trauma patient, what is the first area to be assessed? heart face including eyes lungs - Correct answer face including eyes in which of the following scenarios are gloves likely to be the only personal protective equipment required? suctioning a patient's airway treating a patient who is actively vomiting
assisting with the emergency birth of a child attempting to stop minor bleeding from a suspected capillary source - Correct answer attempting to stop minor bleeding from a suspected capillary source which of the following type of motor vehicle accident involving an ambulance is most common? railroad crossing crashes hydroplaning intersection crashes pedestrian walks - Correct answer intersection crashes a patient was shocked while working on a high transmission line and has suffered severe electrical burns. which of the following is another possible concern for this patient? cardiac arrest internal bleeding heat shock - Correct answer cardiac arrest which of the following are signs of hypovolemic shock? bradycardia and hypotension tachycardia and cool, clammy skin tachycardia and normal blood pressure itching or rash - Correct answer tachycardia and cool clammy skin which of the following is not an appropriate strategy to manage stress? medication limit tobacco use shrug and move on talk with trusted people - Correct answer shrug and move on what is the maximum oxygen concentration that can be delivered via a nasal cannula?
0.36 - Correct answer 0. which of the following patients would be considered high priority?
- woman with severe chest pain
E
D
H
M - Correct answer H size tank which of the following agencies is responsible for enforcing guidelines concerning reducing hazards in the workplace? - Correct answer OSHA what chamber of the heart pumps oxygenated blood to the body - Correct answer left ventricle which of the following should be included in the "O" section of a document completed using the SOAP method? past medical history physical findings on examination chief complaint treatment provided - Correct answer "O" in soap = physical examination SOAP=subjective, objective, assessment, and plan while transporting a patient, he threatens to kill EMS personnel after being released from hospital. this is: - Correct answer assault libel = writing poorly about someone's character battery = unconsented physical touch what can be said is occurring when an adult's diaphragm and intercostal muscles relax? ataxic respirations exhalation phase of spontaneous respiration inhalation phase of spontaneous respiration apnea - Correct answer exhalation phase of spontaneous respirations an adult patient has substernal chest pain. in which of the following situations should nitroglycerin be withheld?
- if the patient has taken sildenafil (Viagra) within the past 24 hrs
- if the patient is experiencing non-radiating chest pain
- if the patient has a history of an acute myocardial infaction
- if the patient's diastolic blood pressure is 80mmHg - Correct answer if the patient has taken viagra within the past 24hrs = withhold nitroglycerin
how does an angina pectoris attack differ from an acute myocardial infarction? - Correct answer heart muscle can be permanently damaged with an acute myocardial infarction which of the following best describes crowning? - Correct answer the top of the babys head begins to appear at the vaginal opening which of the following is possibly the earliest signs/symptoms of compensated shock?
- shallow rapid breathing
- falling blood pressure
- restlessness
- weak, rapid pulse - Correct answer restlessness = earliest sign of compensated shock which of the following blood vessels provides oxygenated blood to the heart muscle?
- carotid arteries
- cerebral arteries
- femoral arteries
- coronary arteries - Correct answer coronary arteries = give O2 blood to heart muscle what law provides legal protection to someone who helps an injured person? - Correct answer good Samaritan law which of the following diabetic situations would likely benefit from the administration of oral glucose?
- confused patient, cool + clammy with patent airway
- unconscious patient who may have accidentally taken too much insulin
- confused patient who has hemiparesis and dysphagia
- an alert and oriented patient who has hot dry skin - Correct answer a confused patient who is cool and clammy with a patent airway = oral glucose hemiparesis (weakness on one side of the body) dysphagia (difficulty swallowing)
