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NREMT PRACTICE TEST GRADED A+
Which of the following illustrates a basic medical supply that must be carried on an ambulance? - Correct answer Exam gloves If a car, driven by an unrestrained male, strikes a utility pole at 35 mph, which of the following is true? - Correct answer The internal organs struck the inside of the body at 35 mph. Which of the following best describes the path that oxygen must travel to get into the cells of the body? - Correct answer Oropharynx, larynx, trachea, carina, bronchioles You are assessing an unresponsive patient who overdosed on a narcotic pain medication. Given the situation, what is the greatest concern regarding potential airway occlusion? - Correct answer Relaxation of the tongue Which one of the following patients should the EMT recognize as having an actual or potential occlusion of the upper airway? - Correct answer 3-year- old male with a fever and swelling of the larynx Which one of the following statements indicates that the EMT has an accurate understanding of the bronchioles? - Correct answer "They are small passages located in the lower airway that have smooth muscle surrounding them." Assessment findings on an elderly patient with congestive heart failure indicate that her failing heart is causing fluid to collect and fill her alveoli. Based on this pathophysiology, for which pulmonary complication should the EMT treat the patient? - Correct answer Decreased gas exchange If an injured patient has lost all use of his diaphragm, the EMT should recognize that the patient: - Correct answer has lost a major portion of his ability to breathe. The EMT exhibits an accurate understanding of breathing when he states: - Correct answer "Inhalation requires energy, while exhalation for most patients is a passive process."
When a person's diaphragm contracts and the intercostal muscles pull the ribs upward, which one of the following will occur? - Correct answer Air will flow into the lungs. Which one of the following patients is most likely to lose neurological control and regulation of the respiratory system? - Correct answer 31-year- old with a severe injury to the head When assessing the airway, breathing, and circulation, which one of the following best indicates that the patient has an open airway? - Correct answer The patient speaks with ease. You have been called to a long-term nursing care facility for a 77-year-old female patient with Parkinson's disease. According to the nursing staff, she is more confused than normal and is to be transported to the emergency department for evaluation. Since the patient neither understands nor can answer any of your questions, which one of the following signs provides the best evidence that her breathing is adequate? - Correct answer Pulse oximeter reading at 98% Your medical director is holding an in-service focusing on the prehospital management of adult patients with respiratory complaints. He asks the group to explain how they can determine if the patient is breathing adequately. Which one of the following responses is most appropriate? - Correct answer "For an adult patient to be breathing adequately, the rate should be within 8 to 24 breaths per minute with a full chest rise with each breath." You have been called for a patient who has overdosed on drugs and alcohol. The patient is responsive to painful stimuli and is breathing shallowly at 8 times per minute, but exhibits no cyanosis. You should recognize and do which one of the following? - Correct answer Inadequate respirations; start positive pressure ventilation with supplemental oxygen Which one of the following patients should the EMT recognize as being mildly hypoxic? - Correct answer 18-year-old male who is restless and breathing shallowly at 16 times per minute with no cyanosis
performs a primary assessment, you should immediately prepare to: - Correct answer suction the airway While you are transporting a patient with altered mental status, he suddenly vomits partially digested food along with large blood clots. The vomitus is too big for the rigid suction catheter. The EMT should immediately place the patient on his side and: - Correct answer perform a finger sweep You must suction a male patient who has a decreased ability to swallow secondary to a previous stroke. He also has a history of smoking and lung cancer. Which one of the following represents the most appropriate personal protective equipment that you should use with this patient? - Correct answer Gloves, mask with face shield A young child with multiple physical and developmental abnormalities has a severe nose bleed. You must suction his nasopharynx to decrease the amount of blood he is swallowing. Which of the following would be included in this care? - Correct answer Insert a soft catheter into the nose the same length as the distance from the patient's nose to the tip of his ear. You are caring for a 46-year-old male patient who is unresponsive. Which one of the following statements made by your partner indicates the need to immediately stop suctioning the patient's airway and resume positive pressure ventilation? - Correct answer "His heart rate is 48 beats per minute." Which one of the following statements made by an EMT shows that she understands how to suction patients in a field setting? - Correct answer "I only activate the suction device when I am withdrawing the suction catheter." You must suction frothy secretions from the mouth and pharynx of a 31- year-old male patient whose respiration rate is 4 breaths per minute. Which one of the following interventions is most appropriate given the patient's condition? - Correct answer Suction for no more than 15 seconds at a time followed by 2 minutes of positive pressure ventilation Which one of the following statements made by an EMT shows he understands the use of the pocket mask? - Correct answer "In comparison
to the bag-valve mask, the pocket mask can deliver a just as good, if not better, tidal volume." You have opened the airway using a head-tilt, chin-lift and are ready to ventilate an apneic patient with a pocket mask. The first ventilation you attempt is unsuccessful. You should immediately: - Correct answer use a jaw-thrust maneuver When using a pocket mask to ventilate an unresponsive adult patient, the EMT must remember to always: - Correct answer maintain the head-tilt, chin-lift or jaw-thrust maneuver. You are assessing a young male patient who is responsive to painful stimuli and breathing agonally after being ejected from an automobile at a high rate of speed. His pulse is weak and thready, and his skin is cool and diaphoretic. When addressing his airway and breathing, the EMT must immediately: - Correct answer perform the jaw-thrust and begin artificial ventilations with the bag-valve mask Which one of the following setups on the bag-valve mask (BVM) will enable the EMT to deliver the highest concentration of oxygen to the patient? - Correct answer BVM with oxygen reservoir attached, receiving oxygen at 15 lpm Which one of the following statements about the bag-valve mask (BVM) is true? - Correct answer A 15/22 mm adapter allows the BVM to be attached to advanced airways such as the endotracheal tube. You have arrived next to a patient who reportedly had a seizure. Assessment reveals him to be apneic with vomitus in the airway. He has a radial pulse, and his skin is cool and diaphoretic. Which one of the following should you do immediately? - Correct answer Suction the airway. Which one of the following statements shows that the EMT knows how to correctly position the BVM on the patient's face? - Correct answer "I place the narrow part of the mask over the bridge of the nose, and the bottom part in the cleft above the chin." You are teaching a group of firefighters who are in class to become Emergency Medical Responders. The topic is artificial ventilation with the
The EMT shows that he is correctly using the flow-restricted, oxygen- powered ventilation device when he: - Correct answer stops ventilating as soon as the patient's chest begins to rise. Which one of the following statements about ventilation of a nonbreathing patient through a stoma is true? - Correct answer The EMT should ventilate through the stoma with a child-sized face mask attached to a bag-valve mask. The EMT has just placed an oropharyngeal airway in a patient. By doing so, which one of the following has the EMT accomplished? - Correct answer Secured the tongue away from the back of the airway The EMT shows that she understands how to use an oropharyngeal airway when she states: - Correct answer "I must watch the patient for vomiting or spasm of the vocal cords even with proper insertion." For which one of the following patients is placement of an oropharyngeal airway indicated? - Correct answer Unresponsive patient who has no gag or cough reflex You are observing an EMT insert an oropharyngeal airway into the airway of a 36-year-old male who has overdosed on a street drug. Which one of the following observations indicates correct technique? - Correct answer The airway is inserted into the mouth upside-down and is then turned 180 degrees once it contacts the soft palate. Which one of the following statements shows that the EMT knows how to properly size an oral airway prior to placement? - Correct answer "The airway should approximate the distance from the front teeth to the angle of the jaw." The EMT should recognize that the oropharyngeal airway has been appropriately inserted when: - Correct answer ) its flange rests on the teeth. While the EMT is inserting an oropharyngeal airway, the patient gags. The EMT should: - Correct answer remove the airway and maintain the head- tilt, chin-lift
You are transferring an unresponsive patient from her house to the ambulance on the stretcher. An oral airway has been placed and ventilations with the bag-valve mask are being administered. Suddenly, the patient regains consciousness and starts to gag. Your immediate action should be to: - Correct answer remove the oral airway When inserting a nasopharyngeal airway, the EMT should remember that the: - Correct answer nasal mucosa may bleed even with proper insertion. The EMT is appropriately sizing the nasal airway when she measures the: - Correct answer distance from the nose to earlobe. Which one of the following best describes oxygen? - Correct answer A gas classified as a drug Which one of the following statements about different sizes of oxygen cylinders is true? - Correct answer G and E tanks have the same psi when full. You must transport a patient with carbon monoxide poisoning to a specialized facility for treatment. Transport time is estimated at an hour and a half. The patient is on a nonrebreather face mask with a continuous oxygen flow of 15 lpm. On the ambulance, you have a G tank with 1, psi inside. Knowing that the cylinder constant is 2.41, what action should the EMT take in relation to the amount of available oxygen and transport time? - Correct answer Replace the G cylinder after the transport. You are watching an EMT prepare the ambulance for the upcoming shift. In regards to oxygen cylinders and equipment, which one of the following requires immediate intervention? - Correct answer He cleans a dirty oxygen tank with a petroleum-based agent. You arrive at work and note that the portable oxygen tanks in the ambulance are now yellow instead of green as during the previous shift. As a knowledgeable EMT you should: - Correct answer remove the tank and retrieve a green cylinder A paramedic has asked you to place the patient on a nonrebreather mask at 15 liters per minute. To administer oxygen at this flow rate, you should: - Correct answer ) select 15 on the oxygen therapy regulator.
which he takes medications. How should you administer oxygen to this patient? - Correct answer Nasal cannula Despite coaching and explaining the benefits of a nonrebreather face mask, a moderately short of breath and hypoxic patient with lung cancer states that she cannot tolerate the mask over her face. The more that she panics, the worse the shortness of breath becomes. Your best course of action is to: - Correct answer disconnect the nonrebreather and replace it with a nasal cannula. What is the preferred method of providing high-concentration oxygen in the prehospital setting? - Correct answer Nonrebreather face mask Which one of the following oxygen administration systems will provide the patient with the greatest amount of oxygen? - Correct answer Nonrebreather face mask at 15 liters per minute of oxygen When monitoring a patient receiving oxygen through a nasal cannula, which one of the following observations warrants immediate intervention? - Correct answer Oxygen flow rate of 15 liters per minute An elderly male who is short of breath is on home oxygen. He is wearing a nasal cannula connected to an oxygen tank with the flow regulator set to 3 liters per minute. As a knowledgeable EMT, you should recognize that the patient is getting approximately what percentage of oxygen with each breath? - Correct answer 32% Which one of the following statements about a nasal cannula is true? - Correct answer "When the nasal cannula is set to the highest appropriate oxygen flow rate, a large portion of the air inspired by the patient is ambient air." Which one of the following statements about an automatic transport ventilator (ATV) is true? - Correct answer It can help minimize gastric distention associated with positive pressure ventilation You are using an automatic transport ventilator (ATV) for a patient who has a poor respiratory effort. Which one of the following is the best indicator of adequate ventilation? - Correct answer ) The chest rises and falls.
Which one of the following is a benefit of using a humidification system when administering oxygen? - Correct answer Oxygen therapy is less drying to the upper respiratory tract. A patient was eating dinner when he got a piece of food caught in his throat. Although coughing has failed to remove the food, he remains able to move an adequate amount of air into and out of his lungs. A nasal cannula has been applied and vital signs are stable. During transport, the patient suddenly begins to exhibit stridorous respirations. Your immediate action should be to - Correct answer perform abdominal thrusts. When providing an in-service on ventilating the geriatric patient, you should emphasize which one of the following in regards to a patient who has dentures? - Correct answer Loose appliances should be removed if they interfere with the airway or the seal between the mask and face. Which one of the following best describes the purpose of a Venturi mask? - Correct answer Precise concentrations of oxygen are able to be delivered You are starting to ventilate a patient with a laryngectomy and stoma. As you provide the first few ventilations, you note that the air passes easily into the patient, but does not cause the chest to rise. Your next action should be to: - Correct answer seal the patient's mouth and nose. A patient with a stoma and tracheostomy tube is responsive to painful stimuli and breathing shallowly at 6 times per minute. He has cyanosis of the fingertips and a weak, rapid radial pulse. Which one of the following is best in providing respiratory care to this patient? - Correct answer Attach the bag-valve device directly to the tracheostomy tube. A 21-year-old female has overdosed on an unknown drug. She has snoring respirations and an intact gag reflex. She has weak respiratory effort and is slightly cyanotic. Given these assessment findings, your care should include: - Correct answer insertion of a nasal airway. Which one of the following is obstructing the airway when snoring is heard?
- Correct answer The tongue A patient who inhaled superheated steam in an industrial fire is most likely to exhibit which one of the following airway noises? - Correct answer stridor
(CHF). As an EMT, you realize that this should benefit the patient by: - Correct answer forcing fluid in the lungs back into the bloodstream. The EMT would recognize that administering continuous positive airway pressure (CPAP) at too high of a pressure can cause: - Correct answer lung collapse When considering continuous positive airway pressure (CPAP), the patient must exhibit: - Correct answer ability to breathe on his own What disease process would continuous positive airway pressure (CPAP) be most beneficial to? - Correct answer CHF with moderate to severe dyspnea What statement made by another crew member would cause you to disregard the use of continuous positive airway pressure (CPAP) for a patient? - Correct answer "His respirations are agonal and slow. The EMT is properly applying continuous positive airway pressure (CPAP) when he: - Correct answer places the mask over the mouth and nose and tightens it to the face. After 2 minutes of continuous positive airway pressure (CPAP) at 4 cmH2O, you see no improvement in the respirations or SpO2 level. You would: - Correct answer continue CPAP as is and monitor the patient for another 2 minutes. Typically, the highest continuous positive airway pressure (CPAP) pressure used for therapy is: - Correct answer 10 cmH2O. When administering continuous positive airway pressure (CPAP) to a patient, you would recognize that the patient is benefiting from the treatment when the: - Correct answer patient states he is breathing easier. When administering continuous positive airway pressure (CPAP) to a patient in respiratory distress, what statement made by the patient would be most concerning? - Correct answer "I feel nauseated."
The difference between respiration and ventilation is best described as: - Correct answer Respiration describes the exchange of O2 and CO2 while ventilation describes the movement of air that carries them. The structure that lies between the trachea and bronchi is: - Correct answer carina. Which of the following is true regarding the form or function of the alveoli? - Correct answer The alveoli permit gas exchange between the lungs and bloodstream A young male patient has been stabbed in the right lateral chest. Regarding the respiratory system, which of the following represents the greatest danger to his well-being? - Correct answer Collection of air between the pleural and visceral membranes In a healthy patient, for air to be exhaled from the lungs, what must occur?
- Correct answer The diaphragm must relax. In a healthy person, the primary stimulus to breathe is - Correct answer carbon dioxide. What condition would the EMT associate with a hypoxic respiratory drive? - Correct answer Chronic obstructive pulmonary disease A patient with a heavy smoking history and chronic obstructive pulmonary disease (emphysema) presents in marked respiratory distress with cyanosis noted to her fingertips. When administering oxygen to this patient, the EMT would remember that: - Correct answer high-concentration oxygen must be provided if the patient's condition warrants Hypoxia occurs when which of the following occurs? - Correct answer Inadequate amounts of O2 are available to the cells. What body system or structure is responsible for the control and regulation of a person's breathing? - Correct answer Brain When administering oxygen to a hypoxic patient, what signs would seemingly indicate that the patient is improving? - Correct answer The heart rate drops from 120 to 80 beats per minute.
A person has been diagnosed with high blood pressure. A medication that can effectively serve to lower his blood pressure is one that: - Correct answer dilates the arteries When treating a patient with chest pain, the primary goal of the EMT is to: - Correct answer recognize the possibility of cardiac compromise and provide proper care A TV reporter has been assigned to your ambulance for a ride-along. He is doing a segment on the local EMS services for EMS week. In your down time, he tells you that his wife was diagnosed with atherosclerosis. He is unsure what the condition is and asks you to explain it to him. Your response would be: - Correct answer "The coronary arteries become narrowed by fat deposits." You are interviewing a patient you suspect to be suffering from acute coronary syndrome. Which of the following questions is most appropriate? - Correct answer "Are you having any chest discomfort or pain?" You have arrived at a residence to help another crew with a 62-year-old woman who is complaining of fatigue, chest discomfort, and diaphoresis. The EMTs on scene report that she has a history of hypertension for which she takes a blood pressure pill and is prescribed nitroglycerin because she has atherosclerosis. She also reports an allergy to aspirin. Vitals are pulse 64, respirations 16, blood pressure 128/86, and SpO2 97% on room air. Which of the following statements made by the EMTs would require immediate intervention on your part? - Correct answer "I am going to put her on high-concentration oxygen because she had chest pain." After being dispatched for a male patient experiencing shortness of breath, you arrive to find the confused 67-year-old man sitting upright at his kitchen table in severe respiratory distress. You also note remarkable swelling to his lower legs and feet. He has an open airway, but cannot speak more than two to three words without attempting to breathe. His breathing is extremely labored and his skin is cool, diaphoretic, and dusky in color. Family states a history of hypertension, congestive heart failure, and angina, for which he takes nitroglycerin. Your immediate action in caring for this patient is to: - Correct answer apply continuous positive airway pressure (CPAP).
You have been called to an office building for a 47-year-old male complaining of chest pain. He is alert, oriented, and complaining of pain in his chest that came on suddenly about 15 minutes ago. His skin is diaphoretic and cool. Which one of the following should you do first? - Correct answer Obtain a heart rate, respiratory rate, blood pressure, and SpO2 reading. You are caring for a 62-year-old female with chest pain and shortness of breath. She is alert and oriented with an open airway. Her breathing is adequate and radial pulse strong. Her skin is warm and dry. Which one of the following should you do next? - Correct answer Obtain her heart rate and blood pressure. Which one of the following statements made by another EMT, regarding chest pain and acute coronary syndrome, should you agree with? - Correct answer "Many patients experiencing acute coronary syndrome do not have actual chest pain; rather, they experience a sensation of discomfort or pressure." You are assisting a paramedic in the transport of a patient from a community hospital emergency department to a large medical center. The patient was diagnosed with an acute myocardial infarction (heart attack) and received fibrinolytic therapy in the ED. Currently, you are transporting the patient with the fibrinolytic medication infusing through an IV. In regards to the fibrinolytic therapy, you know that during this transport, you will need to closely monitor the patient for what complication? - Correct answer Internal bleeding Which one of the following statements should the EMT recognize as an absolute contraindication to the use of fibrinolytic medications in the emergency department? - Correct answer Two months ago I had a stroke on the left side of my brain A patient with chest pain and shortness of breath informs you that the last time he had a heart attack, he went into heart failure. When performing your secondary assessment, which one of the following signs or symptoms is most indicative that the patient is in heart failure again? - Correct answer Crackles in the lungs
You are completing the prehospital care report and are documenting the fact that you assisted a patient in taking his nitroglycerin pill. How will you document the route of administration? - Correct answer Sublingual Which one of the following instructions given by an EMT indicates the proper administration of nitroglycerin? - Correct answer "Let this pill dissolve under your tongue." Prior to administering nitroglycerin to a patient with chest pain, the EMT must ensure that the: - Correct answer nitroglycerin is prescribed for the patient Which statement made by the EMT indicates a safe understanding of the administration of nitroglycerin in the prehospital setting? - Correct answer "A total of three nitroglycerin tablets may be administered in the prehospital setting, and this includes what the patient takes prior to EMS arrival." A 44-year-old male is experiencing chest pain. He has a history of angina and is prescribed nitroglycerin, which he has not taken yet. He is also taking another medication. Which of the following contraindicates the administration of nitroglycerin? - Correct answer Levitra Your patient is a 67-year-old male who has chest pain. After assisting with his nitroglycerin, his chest pain remains 7 out of 10 and he is still diaphoretic. His vital signs are: pulse 72 beats per minute, respirations 18 per minute and adequate, blood pressure 82/60 mmHg, and SpO2 at 97% on 2 liters per minute of oxygen. To the present, the patient has taken two nitroglycerin tablets. You should: - Correct answer transfer him to the stretcher and transport You have been called for a 56-year-old female complaining of chest pain. She informs you that she takes nitroglycerin and asks you to get it off of the top of her refrigerator. You find it is a clear glass jar hand labeled "nitroglycerin." Which of the following is the most appropriate response? - Correct answer "It is best to keep the nitro in a dark container since light will inactivate it." Which one of the following actions is it essential that the EMT take prior to assisting the patient in taking his nitroglycerin tablet? - Correct answer Evaluate the patient's blood pressure
Your patient has chest pain, and you have just assisted him in taking his nitroglycerin tablet. Which of the following patient statements is the cause for greatest concern? - Correct answer "The chest pain does not feel any different." When obtaining a medical history, which of the following patient statements seemingly indicates that he is suffering from classic angina? - Correct answer "When I stopped cutting the grass, the pain went away." You have been called for a patient with angina. On scene the 67-year-old man reports that he has a history of angina and the pain started when he was moving firewood from the garage into his house. Unfortunately, the pain has yet to go away, despite three nitroglycerin tablets and 20 minutes of rest. Your next action should be to: - Correct answer check the patient's vital signs. Which statement would the EMT expect from a patient with unstable angina? - Correct answer "The chest pain awakens me from my nighttime sleep." The EMT shows that she understands the difference between classic angina and an acute myocardial infarction (MI) when she states: - Correct answer "An acute myocardial infarction results in the death of cardiac tissue; classic angina does not." A patient with a past medical history of angina is complaining of chest discomfort. When assessing the patient, which sign or symptom should alert the EMT that the patient is probably suffering an acute myocardial infarction and not an anginal attack? - Correct answer Chest discomfort is not relieved by nitroglycerin You are assessing a patient in heart failure. Which of the following signs or symptoms seemingly indicates that the left ventricle is the cause of the heart failure? - Correct answer Crackles in the bases of both lungs You are caring for a 69-year-old male who is short of breath and in congestive heart failure. He is alert, anxious, and panicked with an open airway and rapid shallow respirations. His heart rate is tachycardic, and his skin is cool and diaphoretic with cyanosis noted to the lips and fingers.
