Infectious disease
For at least how long should you rub your hands when washing with soap and water?
A. 45 seconds
B. 20 seconds
C. 30 seconds
D. 10 seconds
B. 20 seconds
When washing with soap and water, the hands should be rubbed together for at least 20 seconds to lather. A longer time may be necessary if the hands are excessively soiled.
Pg.41-43
What quality does a patient have to have to refuse treatment?
A. Street-smarts
B. Medical knowledge
C. Humor
D. Decision-making capacity
A patient must have decision-making capacity to be able to refuse treatment. To determine decision-making capacity, remember time, place, events, etc.
P.96
Which of the following are phases of a rescue operation?
Select the 3 answer options which are correct.
A. Decontamination
B. Disentanglement
C. Gaining access
D. Arrival and scene size-up
B. Disentanglement
C. Gaining access
D. Arrival and scene size-up
Rescue situations may take many forms, but the rescue will generally follow these phases:
Decontamination would be a phase of a hazmat operation.
p.1468-1475
The 5 major functional areas of the Incident Command System (ICS) include which of these?
Select the three answer options which are correct.
A. Finance/administration
B. Planning
C. Command
D. Medical
E. Triage
F. Safety
G. Staging
A. Finance/admin
B. Planning
C. Command
The Incident Command System (ICS) comprises five major functional areas: command, operations, planning, logistics, and finance/administration.
Medical or EMS would be a branch or division under the major function of operations.
P.1488-1490
A power line fell at the site of a car crash. You can hear a baby crying from inside the car. What should you do?
Select one:
a. Approach the car on the opposite side of the power line.
b. Establish a danger zone around the power line.
c. Push the power line away with a dry wooden stick.
d. Call the fire department.
b. Establish a danger zone around the power line.
If you have not already called the power company you should. Then you should establish a safety zone around the vehicle. This prevents other emergency crews from entering and endangering themselves.
What should an EMT do with blood-soaked clothing that was cut off a trauma patient?
A. Place the clothes in a red biohazard bag
B. Place the clothes in a trash bag and dispose of them in a biohazard container at the receiving hospital
C. Give the clothes back to the patient in a plastic personal bag
D. Place them in a yellow biohazard bag and dispose of them in a biohazard container at the receiving hospital
A. Place the clothes in a red biohazard bag
Any medical waste, including contaminated disposable equipment or clothing, should be placed in a red biohazard bag and disposed of at the hospital. Contaminated reusable equipment is placed in a red bag for transport and cleaning at the station.
If a patient wants to retain their clothes, the items should be placed in a red biohazard bag first. Contaminated materials should not be stored at the station.
Pg.50-51
An on-duty EMT refuses to initiate care for a patient who is rude but not verbally or physically abusive. The EMT stays on the scene until an alternate unit arrives. The patient dies as a result of the delay in care. Which of the following has occurred?
A. Negligence
B. Assault
C. Battery
D. Abandonment
a. Negligence
Negligence is the failure to provide the care that a person with similar training would provide in the same or a similar situation. Determination of negligence is based on the duty of the provider, the breach of said duty, the physiological or psychological harm/damage, and the causation of intervention or lack thereof in that damage. All four elements must be present for negligence to apply.
Assault is the unlawful placement of a person in fear of immediate bodily harm.
Battery is the unlawful touching of a person, including providing emergency care without consent.
Abandonment is the unilateral termination of care without the patient's consent and without making any provisions for continuing care by a medical professional who is competent to provide care for the patient. In this scenario, care was never initiated; therefore, the patient was not abandoned.
P.101
Which of the following is correct regarding air medical landing zones?
Select the three answer options which are correct.
A.Use flares to mark the corners of the landing zone.
B. Position emergency vehicles at the corners of the LZ with headlights facing inward.
C.The landing zone should be as close to the scene as possible.
D.A flat area of 100 × 100 feet is ideal.
E.50 × 50 landing zone is ideal
B. Position emergency vehicles at the corners of the LZ with headlights facing inward.
C.The landing zone should be as close to the scene as possible.
D.A flat area of 100 × 100 feet is ideal.
Considerations for EMS helicopter landing zones vary. Generally, a flat area of 100 × 100 feet is ideal. Marking the zone can be accomplished by placing emergency vehicles in the corners with headlights pointing into the center, forming an "X."
The landing zone should be as close to the scene as possible for ease of access and egress.
Marking the zone's corners with lights may be helpful, but the use of flares is not recommended, as they may become a hazard.
P.1455-1456
Using the START (simple triage and rapid transport) triage criteria, which of the following patients would be categorized as immediate or red?
Select the 2 answer options which are correct.
A. The patient follows commands, has a respiratory rate of 26, and a capillary refill of < 2 seconds
B. The patient follows commands, has a respiratory rate of 36, and a capillary refill of 3 seconds
C. The patient is unresponsive, is apneic, and has -no pulse
D. The patient is confused and lethargic with a respiratory rate of 20 and a capillary refill of < 2 seconds
B. The patient follows commands, has a respiratory rate of 36, and a capillary refill of 3 seconds
D. The patient is confused and lethargic with a respiratory rate of 20 and a capillary refill of < 2 seconds
The first component of START triage is to gather patients who can walk to a collection area on their own. They are categorized as minor (green). Those who are unable to walk but have normal respirations (breathing between 10 and 30 breaths per minute), show no signs of circulatory compromise (capillary refill below 2 seconds or pulse below 100), and can follow simple commands are categorized as delayed (yellow).
If any patient falls outside these parameters, they are tagged as immediate (red). Patients who have no pulse, are not breathing, and are unresponsive are tagged as unsalvageable/deceased (black).
P.1498-1500
Which of the following are antidote kits that may be used after exposure to a nerve agent?
Select the two answer options which are correct.
A. Pasadena
B. Anitdote Treatment Nerve Agent
Auto-Injector (ATNAA).
C. DuoDote
D. Evanokit
E. Narcan
B. Anitdote Treatment Nerve Agent
Auto-Injector (ATNAA).
C. DuoDote
The DuoDote and Mark 1 antidote kits both contain atropine and pralidoxime, which are nerve agent reversals. Mark 1 is older and has two separate injections, and the DuoDote consists of one injection. The military form of the combination injector is the Antidote Treatment Nerve Agent Auto-Injector (ATNAA).
The Pasadena and Cyanokit are used for cyanide, not nerve agent exposure.
P.1539-1540
Which of the following items is not commonly used as personal protective equipment (PPE) in a prehospital setting?
A. Respirator
B. Body armor
C. Face shield
D. Gown
B. Body armor
Gloves, masks, respirators, barrier devices, and gowns are all regularly used personal protective equipment (PPE) in a prehospital setting. Each scenario may dictate a varied level of required PPE.
Standard precautions should always be followed.
Body armor (i.e., a bulletproof vest) is generally not part of everyday PPE. Some areas may require body armor; however, most department policies direct EMS personnel to avoid situations in which gun violence will likely occur.
Pg. 45,47-48,63-64
A man gives you a Do Not Resuscitate (DNR) order for his 65 year old wife who has terminal cancer. Their adult children called 911 and tell you, "Dad wouldn't call for an ambulance and Mom stopped breathing 10 minutes ago." What should you do?
Select one:
a. Assess for signs of lividity and rigor mortis.
b. Contact medical control.
c. Disregard the DNR and begin CPR.
d. Verify that the DNR is properly completed.
D. Verify the validity of the DNR
You should first verify the validity of a DNR before withholding treatment. It is better to start treatments early and discontinue treatments when a valid DNR has been presented. BUT you should follow your local protocol because opinions vary depending on the local medical director.
Which of the following are hand tools that may be used in a vehicle rescue?
Select the 2 answer options which are correct.
A. Window punch
B. Pry bar
C. Jaws of life
D. Lifting bags
A. Window punch
B. Pry bar
Hand tools used in vehicle rescues include axes, pry bars, window punches, or striking tools such as sledgehammers.
Jaws of life and lifting bags are examples of powered tools that require special training to operate.
P.1470-1474
At a multiple casualty incident, a 21 year old male is crying out with severe arm pain. He has a 3 inch subdermal laceration with swelling behind his ear. Which START triage category should you assign to this patient?
Select one:
a. Critical
b. Immediate
c. Minor
d. Delayed
C. minor (green)
His airway is open and patent because he is able to "cry out" in pain. His injuries might seem severe but for an MCI his triage tag would be minor or green.
Which of the following would not be appropriate management of bystanders and unprotected workers at the scene of a suspected toxic gas leak?
Select the three answer options which are correct.
A. Have them move downwind to reduce their exposure risk.
B. Have them move to a building with no windows.
C. Contact poison control to see what isolation distances are recommended.
D. Have them move to an area officially identified as the cold zone.
E. Utilize the Emergency Response Guidebook
F. Chemtree
A. Have them move downwind to reduce their exposure risk.
B. Have them move to a building with no windows.
C. Contact poison control to see what isolation distances are recommended.
In a hazmat situation involving a gas, the safe areas will be upwind, not downwind.
It would not be safe to move bystanders to a building with no windows, as it may not be ventilated and the gas could be trapped. You would not contact poison control for isolation distances; instead, you would most likely consult the Emergency Response Guidebook (ERG) or Chem Trec.
The cold zone is an area identified by the hazmat team as safe and is the best location for bystanders and unprotected workers.
P.1504-1514
Which of the following statements is true regarding gloves and/or glove use?
A. Gloves should be removed by gripping the fingers and pulling
B. Gloves only need to be changed when exposed to bodily fluids
C. Gloves are part of a minimum standard for all patient care if there is a possibility of exposure to blood or bodily fluids
D. Gloves are required for all patient care activities
C. Gloves are part of a minimum standard for all patient care if there is a possibility of exposure to blood or bodily fluids.
Gloves are part of a minimum standard for all patient care if there is a possibility of exposure to blood or bodily fluids
Gloves and eye protection are the minimum standard for all patient care if there is any possibility of exposure to blood or bodily fluids. Gloves are not required for all patient care activities, only if there is a risk of exposure to blood or body fluids. Gloves should be changed if they have been exposed to blood/bodily fluid, motor oil, gasoline, petroleum-based products, or other patients.
Gloves should be removed by pinching the wrist and pulling the glove inside out.
pg. 43-45
Which of the following scenarios illustrates implied consent?
A. CPR is given to an unconscious patient
B. A patient with an active, valid DNR is unresponsive
C. At the site of a motor vehicle accident, the driver asks for an unconscious child in the back seat to receive care first
D. A school nurse takes care of a student with minor injuries
A. CPR on an unconscious patient
Implied consent applies when surrounding circumstances would lead a reasonable person to believe that this consent would have been given, although no direct, expressed, or explicit words of agreement were uttered. This includes patients who are intoxicated by drugs or alcohol, mentally impaired, or suffering from certain conditions (e.g., head injury) that would preclude them from making a rational, informed decision.
A DR is a form of advanced directive, not consent.
Expressed consent is given when a patient (or parent/guardian of a minor) verbally or otherwise acknowledges that they are requesting care/transport. For consent to be valid, the patient must be informed of the risks, benefits, and alternatives to treatment and the consequences of refusal. In many cases, a school nurse has been given express consent to treat a patient and determine if EMS transport is required.
P.86-88 113-114
Which patient would require a rapid extrication from a car crash?
Select one:
a. A 72 year old male with neck and back pain
b. A 5 year old with a fractured leg
c. A 44 year old female who is apneic
d. A 17 year old female who is crying and bleeding
C. A 44 year old female who is apneic
The 44 year old female is apneic (not breathing). She needs immediate airway interventions that cannot be delayed. The apneic will cause her to become pulseless if left untreated.
Which of the following is considered a tertiary blast injury?
A.Injuries due to flying debris
B.Injuries due to the blast
C.Injuries from being hurled into a stationary object
D.Injuries due to fires started by the blast
C. Injuries from being hurled into a stationary object
Mechanisms of a blast injury are divided into five types.
Primary-type injuries are caused by the impact of a supersonic blast wave on the body, preferentially affecting hollow or gas-filled structures. Typical injuries include pulmonary barotrauma (blast lung), tympanic membrane rupture and middle ear damage, abdominal hemorrhage, and intestinal perforation.
Eyeball rupture and mild traumatic brain injury (concussion) are also included in this category.
Secondary-type injuries result from the impact of blast debris striking the body, such as penetrating or blunt injuries and eye penetration (evident or occult).
Tertiary-type injuries result from being hurled by the blast onto environmental surfaces or other debris, causing fractures, traumatic amputations, and closed or open brain injury.
Quaternary-type injuries do not overlap with primary, secondary, or tertiary blast injuries and result in burns, crush injuries
with rhabdomyolysis and compartment syndrome, respiratory tract injury from inhaled toxicants, asthma, angina, or MI (Myocardial Infarction) triggered by the event.
Quinary-type injuries result from toxic materials absorbed by the body from the blast. These materials can affect the immune system and autonomic nervous system, leading to an immediate hyperinflammatory state. A fever, diaphoresis, low central venous pressure, and tissue edema are typical of this category.
P.915-917
Which of the following statements describe the correct location of key elements of a HAZMAT scene?
Select the 2 answer options which are correct.
A. The incident command post is in the warm zone.
B. The command post is in the cold zone.
C. The decontamination corridor is in the warm zone.
D. Triage occurs in the hot zone.
B. The command post is in the cold zone.
C. The decontamination corridor is in the warm zone.
HAZMAT scenes are divided into safety zones based on the hazard, amount spilled, and other factors. These zones are established to help ensure the safety of responders.
The hot zone is the contaminated zone in which only trained responders with proper
PPE are allowed. The warm zone surrounds the hot zone and is where the decontamination corridor is established.
Responders working in the warm zone must be properly trained and have proper
PPE. The cold zone is established to provide a buffer from the hazards and requires no special training or PPE.
The command post is established in the cold zone. Triage is generally completed in the cold zone after decontamination.
P.1514-1516
A 53 year old male with a possible closed ankle fracture tells you that he has Hepatitis C. What type of personal protective equipment should you don?
Select one:
a. Gloves and a mask
b. Two pairs of gloves
c. Gloves
d. Refrain from touching him
C. Gloves
Hepatitis C is a blood borne pathogen. If the integrity of the skin has not been compromised, and there is no active bleeding, a single pair of gloves should be sufficient
Which of the following is not a function of a patient care report?
A. Evaluate calls for continuous quality improvement
B. Prevent lawsuits
C. Ensure adequate continuity of care
D. Provide information for training
b. Prevent lawsuits
A patient care report (PCR) describes the nature of the patient's condition and the treatment provided in the prehospital setting. The report serves the following functions:
• continuity of care
legal documentation education
Common pieces of information found on a
PC consist of:
initial assessment interventions provided
A PC is not designed to prevent lawsuits.
It can be used as legal documentation for a hearing or case; therefore, the information should be accurate.
p.134-138
A 56 year old male complains of abdominal pain. He was the restrained driver involved in a car crash at highway speeds. Your assessment reveals no obvious injury. What should you do?
Select one:
a. Transport him to the closest hospital.
b. Transport him to the hospital of his choice.
c. Call your supervisor for direction.
d. Transport him to a trauma center.
d. Transport him to a trauma center.
He should be transported to a trauma center because the abdomen has the ability to disguise internal bleeding for an extended period of time. He has a significant mechanism of injury and he complains of abdominal pain. He needs to be transported to a hospital that has a surgeon on site, and this is a requirement for a level 1 trauma center.
The Glasgow Coma Scale assigns a numerical score to three individual parameters based on a patient's overall level of consciousness following an injury. Which one of the following is not evaluated as part of the Glasgow Coma Scale?
A. Eye-opening response
B. Motor response
C. Verbal response
D. Visual acuity
D. Visual Acuity
The Glasgow Coma Scale (GCS) is an evaluation tool that can determine a patient's level of consciousness. It evaluates eye opening, verbal response, and motor response. A lower score suggests a more severe extent of brain injury. Survivability is not assessed with GCS but is assessed via the Revised Trauma Score.
Eye-opening scoring:
Verbal response scoring:
There are nine DOT classes of chemical waste recognized in the ERG. Which of the follow match class and chemical? Pick 3
A. DOT Class 8: Corrosives
B. DOT Class 5: Oxidizers and organic peroxides
C. DOT Class 1: Explosives
D. DOT Class 4: Radioactive-materials
A. DOT Class 8: Corrosives
B. DOT Class 5: Oxidizers and organic peroxides
C. DOT Class 1: Explosives
Here are the nine DOT classes of chemical waste recognized in the ERG: