EMT Module Review

Respiratory Emergencies

100

What is going on in this picture?

Tripod Position 

Pt is having trouble breathing 

200

An acute infectious disease caused by bacterium or a virus that affects the lower respiratory tract and causes lung inflammation resulting in dyspnea is?

A) Pneumonia
B) Emphysema
C) Chronic Bronchitis 

 A) Pneumonia

300

Medical direction has ordered you to assist a patient in taking his metered dose inhaler. After placing the patients lips on the mouthpiece which instruction would be most appropriate?

A) please inhale, then hold your breath, and I will give you the medication
B) please exhale, hold your breath, and I will administer the medication
C) please hold your breath and i will administer the medication
D) please inhale slowly and i will administer the medication, then hold your breath

D) please inhale slowly and i will administer the medication, then hold your breath

400

A patient with a history of COPD is breathing 32 times per minute. Her vital signs are pulse of 140, bp 168/102 and spo2 is 98% on room air. You would classify this patients condition as?

A) Dyspnea
B) Hypoxia
C) Bradypnea
D) Apnea 

A) Dyspnea 

500

Which of the following statements are true?

A) Both inspiration and expiration require the same amount of energy.

B) Inspiration is an active process that requires energy; expiration requires little to no energy. 

C) Inspiration requires little energy; expiration requires much energy. 

D) inspiration and expiration require no energy in a healthy person. 

B) Inspiration is an active process that requires energy; expiration requires little to no energy. 

600

A confused, lethargic and non-verbal 50 year old female pt has an altered mental status. You are told she has COPD, your primary assessment shows 6 bpm, cool clammy skin, cyanosis around her lips. What should be your priority it’s management?

A) Administer oxygen by non rebreather mask at 15 lpm

B) Administer oxygen by nasal cannula at 15 lpm 

C) Assist respirations with positive pressure ventilation 

D) Sit the patient up, assess lung sounds, and obtain a blood pressure. 

C) Assist respirations with positive pressure ventilation. 

700

Your medical directors written protocol instructs you to obtain on-line medical direction prior or assisting a patient with a metered - dose inhaler. Given this protocol, you must contact ;

A) No one; physician direction is not required when assisting with the MDI

B) An Emergency physician before assisting with the MDI

C) The pts family doctor before assisting with the MDI

D) the medical director after assisting with the MDI

B) An Emergency physician before assisting with the MDI

800

After administering a bronchodilator to a patient through a small-volume nebulizer, which of these statements made by the patient should be of most concern to the EMT? 

A) ”I suddenly feel nervous”
B) “I feel shaky”
C) “My chest feels heavy”
D) “My mouth is really dry”

C) My chest feels heavy 

900

Which audible respiratory sounds would make you suspicious of an upper airway problem?

A) Wheezing
B) Rhonchi
C) Crackles
D) Stridor

D) Stridor 

1000

What are the components of the Secondary Assessment ? 

History - OPQRST

Past medical history - SAMPLE

Secondary Assessment - assessed affected system

Vitals - diagnostics - field impression - treatment plan - transport and re-evaluation. 

AMS, Stroke, & Headache

100

Name the 3 components of the Cincinnati Prehospital Stroke Scale. 

1) Facial Droop

2) Arm Drift

3) Speech

200

When assessing a patient with stroke-like signs and symptoms, it is critical that the EMT also suspect and rule out which condition ?

A) Shock

B) Narcotic Overdose

C) Syncope

D) Hypoglycemia 

D) Hypoglycemia 

300

Which of these conditions places the patient at the greatest risk for acute neurologic deficit?

A) Acute myocardial infarction

B) New onset of type 2 diabetes 

C) Chronic Obstructive Pulmonary Disease

D) Transient ischemic attack 

D) Transient Ischemic Attack 

400

Which of these conditions would the EMT recognize as most likely signaling a neurological deficit ?

A) Hypoglycemia

B) Headache

C) Constricted Pupils

D) Paralysis 

D) Paralysis 

500

Which one of these describes the typical sign and symptoms of a transient ischemic attack ?

A) Mild, but permanent

B) Temporary, with many TIAs lasting less than 15 minutes 

C) Persistent, with most TIAs lasting more than 1 hour but less than 24

D) Severe and debilitating

B) Temporary, with many TIAs lasting less than 15 minutes. 

600

An elderly male patient with a history of COPD, hypertension, and diabetes presents as lethargic and confused. His airway is patent and breathing is adequate. His skin is hot and his radial pulse is strong regular and bounding. Heart rate is 112, respirations 20, bp 108/64, SPO2 of 94%. temperature is 102.8°F also noted as swelling in his right lower leg. Given these findings what do you suspect is responsible for his altered presentation?

A) Hypoxia
B) Tachycardia 
C) Peripheral Edema
D) Infection 

D) Infection 

700

On scene, a confused 68-year-old female patient with possible stroke has an SPO2 of 91% on room air. Regarding oxygen therapy and the adjunct by which to provide it which of these represents the most desirable target SPO2 reading for the amount of oxygen delivered?

A) SPO2 100% 6 L per minute 02 via nasal cannula
B) SPO to 100% with 15 L per minute 02 via nonrebreather mask
C) SPO2 95% with 2 L per minute 02 via nasal cannula
D) SPO2 98% with 12 L per minute 02 via non-rebreather

C) SPO2 95% with 2 L per minute O2 via nasal cannula

800

A 49 year old male patient is unable to speak. You would document this finding as; 

A) Dysarthria
B) Apnea
C) Aphasia 
D) Dysplegia

C) Aphasia 

900

Which of these statements made by a patient suggests that he is suffering from a tension headache?

A) The pain seems to get worse as the days goes on
B) The light really seems to bother my eyes when I get headaches
C) The pain starts at the top of my head and spreads down my back
D) I get so nauseated with the pain

A) The pain seems to get worse as the day goes on 

1000

Name at least 3 critical fails for the NIEMT assessments ?

Initiate or call for transport in 15 minutes 

PPE - SCENE SAFE -  Appropriate oxygen therapy - assess or provide adequate ventilation/problems with ABC - Fail to transport and stay on scene - 

secondary before primary - dangerous interventions - incompetent EMT - unacceptable affect with the pt - uses or orders dangerous interventions  

Shock & Resuscitation

100

A 34 year old female goes into cardiac arrest at 09:40 - which of these gives her the best chance for recovery?

A) CPR at 09:45 & advanced cardiac drugs at 09:51

B) CPR at 09:41 & defibrillation at 09:43

C) Defibrillation at 09:48 and ALS at 09:55

B ) CPR at 09:41 & defibrillation at 09:43

200

Your cardiac arrest patient has regained a pulse. Your paramedic unit is 20 minutes east and your closest hospital is 15 minutes west - what do you do?

A) Wait on scene for the paramedic to arrive. 

B) Start transport to the hospital and let dispatch know. 

C) Load up your patient and meet the paramedic. 

D)

B) Start transport to the hospital and let dispatch know. 

300

Place the following events in order - 

A) Check A/B/C 

B) Check Responsiveness   

C) Start CPR

D) Scene Safe

D- Scene Safe

B - Check Responsiveness 

A - Check ABCs

C - Start CPR

400

Your patient that is in early shock tells you that he has had severe diarrhea and vomiting over the past four days. Given this information, you recognize the pathophysiology of the shock as?

A) Leakage of the capillaries

B) Loss of red blood cells

C) Loss of plasma volume

D) Decrease formed elements in the blood 

C) Loss of plasma volume 

500

What cardiac rhythm is the AED designed to shock?

A) Asystole

B) Ventricular Fibrillation 

C) Pulseless Electrical Activity

D) Bradycardia 

B) Ventricular Fibrillation

600

You are treating a 4 year old who sustained trauma after being ejected from a motor vehicle roll over. Your assessment revealed a blood pressure of 72/52, a heart rate of 118, and respirations of 28, unlabored. The pulse ox reading is 92%. How would you describe these findings?

A) Elevation of all vitals signs
B) Acceptable Vitals for this age
C) Normal with an abnormally low blood pressure
D) Shock findings for this age

D) Shock findings for this age. 

700

You have been called to transport a patient in septic shock from the ED to another hospital with two nurses accompanying you. As a knowledgeable EMT you recognize this shock has been caused by what?

A) Fluid volume loss
B) Infection
C) Blood loss
D) Failing heart 

B) Infection

800

If a cardiac arrest patient were in asystole, which message would the AED provide?

A) “Press Analyze”
B) ”Check Electrodes”
C) ”No Shock Advised”
D) ”Shock Advised”

C) No Shock Advised

900

You are assessing a Yang female who sustained blunt trauma to the chest in a MVC. Which assessment findings best indicates that she is deteriorating and in the decompensatory phase of shock ?

A) Heart rate of 100 BPM
B) Restless and confused mental status
C) Blood continuing to ooze from an abdominal laceration
D) Blood pressure of 88/50

D) Blood pressure of 88/50

1000

What does OPQRST stand for?

O - onset of event

P - provocation or palliative (what makes better or worse)

Q - quality 

R - region or radiation 

S - severity 

T - time (how long, has it changed, happened before, stopped)

Cardiovascular Emergencies

100

Which of these identifies the major elements of the pathway that blood takes through the heart in the correct order?

A) Right atrium - left atrium - left ventricle - right ventricle 

B) Vena cava - right ventricle - pulmonary artery - left ventricle - aorta 

C) Aorta - left atrium - left ventricle - pulmonary capillary 

D) Pulmonary vein - pulmonary capillary - pulmonary artery - right ventricle 

B) Vena cava - right ventricle - pulmonary artery - left ventricle - aorta

200

Which of the following patients is most likely to suffer a silent MI?

A) A 72 year old male with a syncopal episode

B) A 55 year old female with diabetes 

C) A 48 year old male with undiagnosed hypertension

D) A 60 year old female with colon cancer 

B) A 55 year old female with diabetes 

300

Why do we administer aspirin to patients with chest pain?

- in case of clot - makes the platelets less sticky - allowing blood to get around clots and not make the clots bigger. 

400

You have just arrived by the side of a 68 year old male with chest pain. After determining his airway is patent and breathing is adequate, it is imperative that you do what next?

A) Obtain full set of vitals 

B) Auscultate his breath sounds 

C) Determine whether he takes nitroglycerin 

D) Check his radial pulse

D) Check his radial pulse 

500

What are the protein strands that strengthen a clot called?

A) Plaque
B) Fibrin
C) Thrombin
D) Platelets 

B) Fibrin 

600

You are approached by an EMR whose informs you that last week he was on a call in which a patient had chest pains and a known coronary artery disease and was not given oxygen by the EMTS. You would reply;

A) Since extra oxygen slows the respiratory rate, it also causes the body to retain CO2, which is not beneficial for heart patients.
B) If the patient also had a history of COPD, oxygen was most likely withheld since it would be contraindicated.
C) It has been shown that oxygen given to patients with an acceptable pulse oximetry reading can be harmful.
D) That may have been an oversight, given that chest pain is caused by a lack of oxygen-rich blood delivery through the coronary arteries. 

C) It has been shown that oxygen given to patients with an acceptable pulse oximetry reading can be harmful. 

700

The three primary components of the cardiovascular system are best described as?

A) heart, blood vessels, brainstem

B) heart, lungs, blood vessels

C) heart, blood vessels, blood

D) arteries, veins, and capillaries 

C) heart, blood vessels, blood 

800

Regarding women and cardiac compromise, with which of these statements would you agree?

A) Most women, unless they are diabetic, will suffer from chest discomfort as opposed to pain when having an MI.

B) Although the risk of MI decreases with age, women should take daily aspirin as they get older.

C) Most women have right sided chest pain without dyspnea or palpitations when having an MI.

D) The death rate for women suffering a heart attack is higher than that for men.

D) The death rate for women suffering a heart attack is higher than that for men.

900

When treating chest pain, we often given Aspirin and Nitro together. What is the purpose/significance with giving these together ? What role does each play?

ASA - less sticky - decrease chance for clot to get Bigger.

Nitro - opens the vessels for blood to travel around the clot 

1000

What does SAMPLE stand for?

S - signs and symptoms 

A - allergies 

M - medications 

P - pertinent past history 

L - last intake and output 

E - events leading up to ?

Pharmacology

100

What is pictured here?

MDI (metered dose inhaler)

200

Upon reviewing a patients medications, you see “Levalbuterol”. You would recognize this as what?

A) The trade name for Glutose

B) The chemical name for Narcan

C) The generic name for Xopenex

C) The generic name for Xopenex

300

You have just administered albuterol to a patient, using a small-volume nebulizer. You then notify medical direction that you have administered it.  This is an example of which type of medical control?

A) Retrospective

B) On-line

C) Direct

D) Off-line

D) Off-line 

400

You just received an order to give Nitroglycerin to a patient sublingual.

What are 2 contraindications of this medication?

How would you administer this medication?

1.) BP lower than 90 systolic & Allergic Reaction to the medication & Phosphodiesterase inhibitors

2.) Sublingual is under the tongue. 

500

What are the 5 “medication rights” ?

1) Right Dose
2) Right Patient
3) Right Drug
4) Right Route
5) Right Time

600

You have just assisted a patient with her EpiPen. She is feeling better, however, her heart rate is now up to 120 from 90. What has happened?

A) Therapeutic Effect
B) Allergy
C) Side Effect

C) Side Effect 

700

Your female patient is have ‘the worst chest pain‘ she has ever felt. She has prescribed nitro but it is outside in the car. Her husband hands you his bottle that is his and says give her this. As the responding EMT - What do you do?

A) Use his, but get her bottle later to confirm its the same dose and belongs to her.
B) Make her go get her own bottle
C) Administer husbands Nitro.
D) Ask the husband to get hers from outside. 

D) Ask the husband to get hers from outside. 

800

Name a contraindication of administering oral glucose?

Unresponsive/Altered Mental Status & Unable to swallow 

900

The EMT should consider aspirin for a patient with ?

A) Fever

B) Chest Discomfort

C) Headache

D) Shortness of Breath

 B) Chest Discomfort 

1000

What are the components of the Primary Assessment  

General impression - Chief Complaint 

Level of Consciousness

Airway - Breathing - Circulation 

Transport Decision