1:  Which of the following is NOT a sign of internal bleeding?

A: Vomiting bileB: BruisingC: Painful, swollen, or deformed extremitiesD: A tender, rigid abdomen

Reason: Vomiting bile is usually not a sign of internal bleeding. However, the most common signs are bruising, a tender, rigid abdomen, and painful, swollen, or deformed extremities.

2:  How many vertebrae are in the lumbar spine?

A: 2B: 3C: 5D: 7

Reason: The lumbar spine has five vertebrae, the cervical spine has seven, and the coccyx has three bones that are fused together in adulthood.

3:  You are called to the scene where a 6-year-old child has fallen from the back of a pickup truck and is complaining of right arm pain. There is an obvious deformity of the right arm. The arm needs to be immobilized prior to transport. You should:

A: have a parent distract the child, and quickly splint his or her arm.

B: tell the child the treatment you perform will not hurt him or her.

C: not splint the arm if it is going to hurt the child at all.D: be honest, telling the child it might hurt when you

splint the arm, but he or she can be honest about his/her fear, concerns, and pain.

Reason: Always be honest. Help patients understand the reasons behind your actions, regardless of the age of the patient. If you lie, the patient will likely not believe anything else you say. Responses to pain such as crying or yelling are normal, and you should not withhold necessary treatment because it will cause discomfort.

4:  Which of the following is true of a patient with a brain injury?

A: Decreased blood pressure, increased pulseB: Decreased blood pressure, decreased pulseC: Increased blood pressure, increased pulseD: Increased blood pressure, decreased pulse

Reason: A patient with a brain injury most often has increased blood pressure and a decreased pulse.

5:  If you are splinting a severely deformed extremity, or distal circulation is compromised or absent, you should:

A: align to anatomic position using gentle traction.B: push protruding bones back into place.C: immobilize in the position you found it in.D: not immobilize at all and transport immediately.

Reason: The best thing to do if the extremity is severely deformed or distal circulation is compromised is to gently align to anatomic position. NEVER try to push protruding bones back into place. Not immobilizing the extremity at all is not a good idea because it can be bumped or moved while en route to the hospital.

6:  A patient is not sure he wants to be treated. After you explain the possible consequences of refusing treatment, the patient agrees to be treated and transported. When you arrive at the hospital, the emergency department is very busy, and no one can locate someone to take over care of your patient. The department clerk says you can leave the patient by the trauma room and she will make sure the next available nurse takes over care of your patient. This option:

A: is acceptable because the patient has been safely delivered to the emergency department.

B: is acceptable only if the patient is in critical condition.

C: is acceptable because the department clerk is a hospital employee and has basic medical knowledge.

D: is not acceptable because it would be considered abandonment.

Reason: Although the patient is in the emergency department, if you do not turn the patient over to someone with equal or more medical training than yourself (such as the department clerk), you have committed abandonment. You must turn over care to an equally qualified or more qualified health professional than yourself.

7:  When treating an open abdominal injury with evisceration, you should:

A: gently push the protruding organ back into the abdomen and cover with an occlusive dressing.

B: gently push the protruding organ back into the abdomen and cover with a bulky dressing.

C: not push the organ back into place, but cover with an occlusive dressing.

D: not push the organ back into place, but cover with a moist, bulky dressing.

Reason: NEVER try to replace the organ into the abdominal cavity. Leave it as is, and cover it with a moist, sterile, bulky dressing, and transport immediately.

8:  What layer(s) does a partial-thickness burn involve?

A: EpidermisB: Epidermis and dermisC: Epidermis, dermis, and subcutaneous layersD: Epidermis, dermis, subcutaneous layers, and

muscle

Reason: A partial-thickness burn (second-degree burn) involves the epidermis and dermis. A full-thickness burn (third degree) would involve the epidermis, dermis, subcutaneous layers, and possibly the underlying muscle.

9:  You are dispatched to a nursing home for a 78-year-old man who was found not breathing, with no pulse. CPR has not been started. The nurse on scene says the patient is a "no code" because she knows for sure he has a DNR. However, the papers have not been found. Without these papers, your best option for action would be to:

A: begin CPR.B: transport the patient without treatment.C: allow the staff as much time as they need to find

the DNR.D: call the coroner.

Reason: If an advance directive is not at-hand, cannot be found, or looks suspicious or incomplete, the best decision is to begin care until medical direction can be contacted for other instructions. Rely on local protocols regarding advance directives.

10:  The FIRST thing an EMT-B should do when arriving at the scene of a vehicle collision is:

A: check to see whether the vehicles involved have deployed air bags.

B: determine whether there is patient entrapment and how you will extricate.

C: determine whether patients are low or high priority.D: evaluate hazards and calculate the need for

additional support.

Reason: The first thing the EMT-B should do when arriving on

the scene of a vehicle collision would be to evaluate the hazards and calculate the need for additional support. After calling for extra support if necessary, you would see if patients are low or high priority, how you would extricate them, and determine treatment options.

11:  In what order should these phases of the rescue process occur? 1. Stabilizing the vehicle 2. Gaining access 3. Sizing up the situation 4. Untangling the patient

A: 3,1,2,4B: 1,3,2,4C: 4,2,1,3D: 2,1,4,3

Reason: The correct order for the phases of the rescue process are sizing up the situation, stabilizing the vehicle, gaining access to the patient, and then untangling the patient.

12:  You and your crew are called to the home of an older woman who has fallen. She is complaining of severe wrist pain. During the physical exam, you gently palpate the affected arm and wrist. Which of the following correctly lists the order of the bones in the arm from proximal to distal?

A: Humerus, radius and ulna, carpals, metacarpals, phalanges

B: Femur, patella, tibia and fibula, tarsals, metatarsal, phalanges

C: Phalanges, metacarpals, carpals, ulna and radius, humerus

D: Frontal, parietal, temporal, occipital, sphenoid

Reason: Proximal to distal examining would mean starting at the point closest to the body and moving out on a given extremity. The humerus is the bone of the upper arm. The radius and ulna make up the lower arm, or forearm. The carpals and metacarpals make up the hand. The phalanges are the bones of the fingers.

13:  If a patient goes into cardiac arrest during transport, the driver should:

A: drive faster.B: contact the hospital emergency department.C: stop the ambulance and assist with CPR.D: stop the ambulance, contact the hospital, and wait

for someone to tell you what to do.

Reason: The driver should stop the ambulance and assist in

CPR if needed. CPR may not be effectively performed in a moving ambulance.

14:  In the case of sudden infant death syndrome, the EMT-B should always:

A: declare the infant dead.B: transport the body without care.C: make sure there is no evidence of child abuse.D: attempt resuscitation and transport to the hospital.

Reason: In SIDS cases, the EMT-B should always attempt resuscitation and transport, even if the infant is beyond resuscitation. This extra step in compassion will greatly help the family cope, knowing that someone tried to revive the infant.

15:  You are called to the scene of a 76-year-old man in severe respiratory distress. He has a medical history of emphysema and is currently a three-pack-a-day cigarette smoker. He is distressed and fatigued, and has a difficult time speaking with you. You can see frothy sputum in his mouth. He is breathing approximately 30 breaths/min. In what order should you administer treatment?

A: Suction, insert nasopharyngeal airway, and give supplemental oxygen via a nonrebreathing mask at 15 L/min

B: Suction, insert an oropharyngeal airway, and give supplemental oxygen via a nasal cannula at 6 L/min

C: Immediately insert a nasopharyngeal airway and give supplemental oxygen via a bag-valve-mask device every 5 seconds

D: Suction, insert an oropharyngeal airway, and give supplemental oxygen via a bag-valve-mask device every 3 seconds

Reason: The frothy sputum in the patient's mouth could be inhaled, creating more problems. The first step would be to suction. He is still conscious and responsive, so he would have a gag reflex, making the oropharyngeal airway inappropriate. You would use the nasopharyngeal airway. The patient has tachypnea (fast breathing), but is still breathing on his own. Therefore, he would need supplemental oxygen via a nonrebreathing mask, and 15 L/min gives an oxygen concentration of approximately 90%. A bag-valve-mask device would not be necessary unless the patient wasn't breathing adequately (for example, 8 breaths/min).

16:  If you suspect a conscious toddler of being in respiratory

distress, you should do all of the following EXCEPT:

A: open the airway.B: administer high-concentration oxygen.C: allow the child to sit up.D: insert something into the child's mouth.

Reason: Opening the airway, administering oxygen, and allowing the child to sit up are all necessary treatments of a toddler in respiratory distress. NEVER insert anything into the child's mouth. That action could set off spasms in the upper airway that could completely obstruct the airway.

17:  A common occurrence in a child with a very high or rapidly rising temperature is:

A: vomiting.B: unresponsiveness.C: seizure.D: dehydration.

Reason: A febrile seizure is a common occurrence in a child with a very high fever. Vomiting can occur, but isn't a common occurrence. Listlessness is common, but unresponsiveness would indicate a serious problem. Dehydration would take some time to set in.

18:  Your crew is called to the home of a 78-year-old man complaining of severe, nonradiating chest pain. His skin is cool and clammy, and he is pale. His pulse is weak and irregular. You are unable to obtain a blood pressure. He has nitroglycerin tablets. After consulting medical direction, you are ordered to assist the patient in taking his nitroglycerin tablets. What should your main concern with administering nitroglycerin be in this situation?

A: He may have taken Viagra and not been honest about it with you.

B: His nitroglycerin may not be effective because he has had them for several months.

C: You are unable to obtain a blood pressure, therefore you cannot be sure it is adequate for administration of nitroglycerin.

D: You are not sure he remembers whether he has previously taken any of the nitroglycerin tablets.

Reason: A male patient needs to be discreetly asked if he is on any medications for erectile dysfunction (Viagra, Cialis, or Levitra). If you are honest about the risks of taking nitroglycerin in addition to any of these medications, most patients will be honest with you about whether or not they are taking them. His

nitroglycerin may not be effective after several months, but it will not hurt him to take it, and still may offer some relief. However, if you cannot obtain a blood pressure, you cannot rule out the contraindication of a systolic blood pressure lower than 100 mm Hg in order to give nitroglycerin.

19:  At a scene where hazardous materials are present, the "safe zone" should be located where?

A: Upwind and downhillB: Downwind and at the same levelC: Downwind and downhillD: Upwind and at the same level

Reason: The safe zone at a scene where there are hazardous materials present would be upwind, but at the same level, rather than uphill or downhill from the scene.

20:  The type of consent based on the idea that an unconscious patient would consent to life-saving treatment if he or she were conscious is:

A: expressed consent.B: implied consent.C: informed consent. D: indirect consent.

Reason: Implied consent is the idea that if a patient were conscious he or she would agree to treatment. Expressed consent is when a patient verbally gives permission to be treated. Informed consent is permission for treatment given by a competent patient. Indirect consent is not a form of consent.

21:  You are called to the residence of a 34-year-old woman who is "not acting right," according to her husband. She has a history of diabetes. She is conscious, but has slurred speech and is not making sense when answering questions. Medical direction advises that you give the patient glucose in the cheek. However, by the time you prepare the medication, the patient is unconscious. What should you do?

A: Follow the advice of medical direction and administer the oral glucose, then transport.

B: Consider calling ALS for some other way to administer her medication.

C: Transport the patient immediately, and do not administer any medication at all.

D: Transport the patient immediately, calling medical control en route to ask for direction because the patient's condition has changed.

Reason: If the patient's condition changes significantly, medical direction should be contacted. In this situation, you were advised to administer a medication orally to a conscious patient, but the patient was unconscious before it could be administered, so medical direction should be consulted before administering the medication. However, because the patient's condition is declining, she should be transported immediately, and medical direction should be called en route.

22:  Forcing a competent adult patient to receive care and/or go to the hospital can result in ________ charges against the EMT-B.

A: negligenceB: assault and batteryC: abandonmentD: kidnapping

Reason: It is considered assault and battery to treat a competent patient who has refused treatment. The EMT-B could also be charged with kidnapping if the patient is unwillingly transported. Negligence is not treating a patient at all, or not treating the patient appropriately. Abandonment is leaving the patient after care has begun, without leaving them under the care of someone equally or more qualified than the EMT-B.

23:  When treating a critically injured patient with an organ donor card, you should:

A: withhold any lifesaving measures that would potentially damage the organs.

B: assume the patient has a DNR.C: treat the patient as you would any other patient, but

inform the emergency physician that the patient is an organ donor when you turn over care.

D: concentrate only on giving the patient oxygen to make sure the organs stay perfused.

Reason: Organ donors should not be treated differently in any way. Do your best to save the patient's life, and inform the emergency department physician that the patient is an organ donor in the event he or she does not survive.

24:  Your ambulance responds to a call for a 23-year-old female with extreme difficulty breathing. You are told by a family member that she is allergic to peanuts, and she just finished a meal at a local restaurant. She is pale, sitting in a tripod position, and is beginning to panic. She has an EpiPen, but it is not with her. A bystander happens to be allergic to bees, and is

carrying her EpiPen. What should you do?

A: Contact medical control for permission to administer the bystander's EpiPen because it is a respiratory emergency.

B: Call for ALS and try to meet them en route to the hospital.

C: Give the patient oxygen via a nonrebreathing mask at 15 L/min and transport.

D: Help the patient administer the bystander's EpiPen in order to alleviate her respiratory distress, then transport.

Reason: The rules for an EMT-B to help administer a patient's medication is that it belong to the patient, that it have an expiration date that has not passed, that it is one of the medications EMT-Bs are allowed to help administer, and that the EMT-B has permission from medical control to help administer the medication. In this case, the patient did not have her own medication with her, and the EMT-B is not permitted to help her use someone else's prescription. Administering the patient oxygen and transporting is not enough because the patient is having an anaphylactic response. The EMT-B must also call for ALS backup, because ALS personnel can administer epinephrine and other medications before the patient arrives at the hospital.

25:  The right atrium of the heart:

A: pumps blood to the body.B: pumps blood to the lungs.C: receives blood from the pulmonary veins.D: receives blood from the venae cavae.

Reason: The right atrium of the heart receives blood from the venae cavae.

26:  In what order does oxygen travel from the environment to the lungs?

A: Nose, bronchi, larynx, trachea, lungB: Epiglottis, trachea, bronchi, alveoliC: Mouth, pharynx, trachea, bronchi, alveoliD: Larynx, esophagus, trachea, bronchi, alveoli

Reason: The order in which oxygen gets from the environment into the lungs is the mouth, pharynx, trachea, bronchi, and alveoli.

27:  You are called to a scene in which a child has ingested a

cleaning product containing lye. You call poison control and are advised to immediately transport the child. You also call medical direction and are advised to administer activated charcoal en route to the hospital. You know that lye is a caustic substance and that administering activated charcoal is contraindicated. What should you do?

A: Administer the charcoal anyway, following the directions of medical control.

B: Argue with medical control, telling them that poison control advised you to transport only.

C: Follow the advice of poison control only, and do not inform medical control of your decision.

D: Repeat the orders of poison control to medical control, and question the contraindication that you know exists.

Reason: The EMT-B should always repeat back the orders of medical control, and always question orders they are unsure of. Questioning should not be done in an argumentative manner, however.

28:  The pressure on the walls of an artery when the left ventricle contracts is:

A: diastolic. B: systolic.C: venous.D: arterial.

Reason: Systolic blood pressure is the pressure on the walls of an artery when the left ventricle contracts. Diastolic pressure is the pressure remaining in the arteries when the left ventricle of the heart relaxes and refills.

29:  Inadequate breathing can be defined as:

A: breathing too fast.B: breathing too slowly.C: breathing too fast or too slowly.D: breathing too deeply.

Reason: Inadequate breathing can be breathing too fast or too slow, because neither provides the correct exchange of oxygen and carbon dioxide that the body needs to keep adequate perfusion.

30:  Your crew responds to a call for a 33-year-old man complaining of severe chest pain and difficulty breathing. When you arrive, you find the patient sitting in a tripod position and

breathing 35 breaths/min. He is pale, and his skin is cool and sweaty. He tells you the chest pain was sudden, and is sharp and nonradiating. He also tells you he has no history or chest pain or any other pertinent medical history. He did have a water skiing accident 12 days ago. How would you appropriately treat this patient?

A: Perform a detailed physical exam, give patient oxygen via a nasal cannula at 4 L/min, and transport.

B: Give the patient oxygen via a nonrebreathing mask at 15 L/min and rapidly transport.

C: Give the patient oxygen via a nasal cannula at 4 L/min and call medical control to ask if you should administer nitroglycerin.

D: Tell patient to take two baby aspirin and call his family physician.

Reason: You do not need to perform a detailed physical exam because his pain is limited to his chest. Nitroglycerin is inappropriate because he has no cardiac history and would not have a nitroglycerin prescription of his own. Baby aspirin would not work for the same reason. A nasal cannula at 4 L/min will not help slow his breathing rate, and is not adequate. The correct answer would be to give him oxygen via a nonrebreathing at 15 L/min and transport him immediately.

31:  What is most likely the problem for the patient in question 30?

A: Pulmonary embolismB: Impending heart attackC: AnginaD: Indigestion

Reason: This patient is probably dealing with a pulmonary embolism. The clues are that he has no cardiac or other pertinent history of chest pain or cardiac problems, he had a skiing accident 12 days ago that could have created a blood clot or dislodged some other material that is causing the embolism. The most common signs of pulmonary embolism are sudden onset of sharp, stabbing chest pain and difficulty breathing, increased respiratory and heart rate, and possible hypotension.

32:  How should an oropharyngeal airway be inserted in an adult patient?

A: Anatomically correct.B: Upside down, then turned 180 degrees over the

tongue.C: Into the left side of the mouth, and turned to hold

the tongue out of the airway.D: Into the right side of the mouth and turned to hold

the tongue out of the airway.

Reason: In an adult patient, the oropharyngeal airway in inserted upside down, with the tip towards the roof of the mouth, and then turned 180 degrees so that it is anatomically correct, holding the tongue out of the airway. It would be inserted anatomically correct in an infant.

33:  If a choking patient refuses care and then becomes unconscious, the EMT-B should:

A: treat the patient, because being unconscious means implied consent.

B: ask family members for permission to treat the patient.

C: call medical direction.D: refuse to treat or transport the patient.

Reason: Once a patient is unconscious, implied consent is assumed, and you may treat the patient. If you are unsure, it can never hurt to call medical direction and ask advice.

34:  If you are called to treat an unconscious child whose parents are not present, you should:

A: assume expressed consent and treat the child.B: assume implied consent and treat the child.C: call medical direction for permission to treat the

child.D: refuse to treat the child until you obtain permission

from a parent or guardian.

Reason: Implied consent is assumed for minors whose parent or guardian is not present in a medical emergency. Expressed consent is actual spoken consent to treat the child. If you refuse to treat the child in a true medical emergency, you may face charges.

35:  What was founded in 1970 to establish professional standards for EMS personnel?

A: US Department of TransportationB: National Highway Traffic Safety AdministrationC: American Medical AssociationD: National Registry of Emergency Medical

Technicians

Reason: The National Registry of Emergency Medical Technicians was founded in 1970 to establish professional

standards for EMS personnel.

36:  Your crew is called to an office complex for a 51-year-old female complaining of dizziness. When you arrive, the patient is lying on the floor. She is breathing and conscious. Her co-workers inform you that a few minutes ago she had fallen to the floor and "shook violently" for about a minute and a half. After establishing scene safety, how would you treat this patient?

A: Check airway, breathing and circulation, perform a rapid physical exam, and transport.

B: Insert an oropharyngeal airway, provide oxygen via a nonrebreathing mask at 15 L/min, and transport.

C: Perform a detailed physical exam, take care of any life-threatening injuries, and transport.

D: Check airway, breathing, and circulation, insert an oropharyngeal airway, provide oxygen via a bag-valve-mask device at 15 L/min, and transport.

Reason: Immediately after scene size-up, the initial assessment should be performed. This includes ABCs, assessment of patient's mental status, and identification and treatment of any life-threatening injuries. A nonrebreathing mask at 15 L/min would be appropriate oxygen therapy, unless the patient is not breathing adequately. An oropharyngeal airway can only be inserted if patient remains unconscious.

37:  A continuous self-review with the purpose of identifying and correcting parts of the EMS system that need improvement is called:

A: protocols.B: standing orders.C: CISM.D: quality improvement.

Reason: Quality improvement is a continuous self review with the purpose of identifying and correcting parts of the EMS system that need improvement. Protocols are described in a comprehensive guide explaining the EMT's scope of practice. Standing orders are part of protocols, and designate what the EMT is required to do for a specific condition.

38:  The legal limits of the EMT-B's job duties are formally defined by the:

A: medical director.B: scope of practice.C: Department of Transportation.D: state in which the EMT-B works.

Reason: The scope of practice formally defines the legal limits of all EMS personnel.

39:  You respond to a call for a 42-year-old man with an altered mental status. He lives alone and is unable to coherently answer your questions. You examine him and find that he has a dry mouth and his breath has a faint odor, somewhat like alcohol. His pulse is weak and regular. His blood pressure is 96/94 mm Hg. His respirations are 24 breaths/min. His skin is warm, dry, and pink. He complains of nausea. How would you treat this patient from this point?

A: Tell dispatch you believe he is simply intoxicated and leave.

B: Assume the patient has diabetes and give him oral glucose.

C: Check the patient's blood glucose level with a glucometer, and if it is too low, ask medical direction if you can give him oral glucose. Follow medical direction's advice, and then transport.

D: Tell medical control you believe the patient has diabetes, obtain permission to give him oral glucose, and if his vital signs and mental status return to normal, leave.

Reason: You cannot assume intoxication, because too often symptoms of diabetes mimic alcohol consumption. You can assume by the patient's vital signs and altered mental status, as well as your physical findings, that he is diabetic. You must obtain permission from medical control to give him oral glucose. Because low blood glucose levels may not be the problem, or may not be the only problem, you should still transport the patient. Even if the oral glucose returns his mental status and vital signs to normal, you should not leave the patient at the scene.

40:  What important act established a path in which emergency response workers can find out if they have been exposed to life-threatening infectious diseases?

A: Ryan White CARE ActB: Highway Safety Act of 1966C: AIDS Protection ActD: Emergency Medical Act of 1973

Reason: The Ryan White CARE Act was established so that emergency response workers can find out if they have been exposed to any life-threatening infectious diseases.

41:  _______ are described in a comprehensive guide explaining the EMT's scope of practice, while __________ are part of protocols, and designate what the EMT is required to do for a specific condition.

A: Offline medical direction; on-line medical directionB: On-line medical direction; offline medical directionC: Protocols; standing ordersD: Standing orders; protocols

Reason: Protocols are described in a comprehensive guide explaining the EMT-B's scope of practice, while standing orders are part of protocols and designate what the EMT-B is required to do for a specific condition.

42:  You are called to the scene of a one-vehicle collision where a car has hit a pole holding power lines. There is only one person in the vehicle. He seems to be unconscious. Damage to the vehicle is minimal. Which of the following is the BEST answer for what you might look for in your scene size-up before you treat the patient?

A: Downed power lines, any fluids leaking from the vehicle, any smoke rising from the vehicle, oncoming traffic

B: Broken glass from the vehicle, signs that another vehicle was involved and fled the scene, hazardous materials, whether or not the police have secured the scene

C: Whether the car is too damaged for easy access to the patient, whether an airbag has deployed or may threaten your safety upon extrication of the patient

D: Whether the pole the car hit is stable or unstable, whether the patient's injuries may require more than just minimal body substance isolation precautions

Reason: Although all of the answers have valid concerns for EMS personnel, the most dangerous things to look for are listed in answer A. The most threatening situation would be downed power lines, possible hazardous or flammable materials leaking from the vehicle, smoke coming from anywhere in the vehicle, and the location of the vehicle with regard to oncoming traffic.

43:  Medical direction has to be given and transferred to the EMT-B by the physician himself. True or False?

A: TRUEB: FALSE

Reason: Medical direction can be transferred by the physician to another person (such as a nurse or other emergency

department worker) and then to the EMT-B.

44:  What would be the LAST choice for ventilating a patient?

A: Mouth-to-mask with high-flow supplemental oxygenB: Flow-restricted oxygen-powered ventilation deviceC: One-rescuer bag-valve-mask ventilationD: Two-rescuer bag-valve-mask ventilation

Reason: The least effective method for ventilating a patient, and therefore the last choice, would be one-rescuer bag-valve-mask ventilation.

45:  You are called to the apartment of a college student with an "unknown" medical issue. When you arrive, you find a woman lying in bed. Prescription medication bottles and beer cans are on the nightstand. The patient is conscious, but crying, and will not answer any of your questions but does not appear to have an altered mental status. As she's crying, you can see that there are some pill fragments in her mouth. What should you do?

A: Tell the patient you are going to remove the fragments that you can see in her mouth, and then slowly and calmly remove the fragments you can easily see.

B: Ask the patient to spit out the fragments. If she does not comply, tell her you will have to use a suction device to remove them.

C: Leave the fragments of pills in her mouth, they will probably do no more harm than the pills she has already taken.

D: Give the patient water or some other way to wash the fragments down so that they do not compromise her airway.

Reason: The best answer is B. You should never put your fingers in the mouth of someone who could have an altered mental status-the problem stated that she only appeared to not have an altered mental status. If you leave the pill fragments in her mouth they will dissolve, putting more of the drug into her system. Washing them down with water or any other liquid will do the same thing. Your best option is to ask her to spit out the fragments. If she does not comply after repeated attempts, try using suction to remove them.

46:  An EMT-B must switch oxygen cylinders before the pressure gauge reads ______ psi.

A: 200B: 400

C: 600D: 800

Reason: If the psi reads 200, the oxygen cylinder must be changed so that adequate oxygen is available for the next patient who may need it.

47:  Which ventilation device is contraindicated for use on infants or children?

A: Nonrebreathing maskB: Bag-valve-mask deviceC: Pediatric pocket maskD: Flow-restricted, oxygen-powered ventilation device

Reason: A flow-restricted, oxygen-powered ventilation device is contraindicated for use in infants and children because of its power and the delicate lung tissue of infants and children.

48:  In scenario number 15, which of the following would you do first?

A: Initial assessmentB: Baseline vital signsC: SAMPLE historyD: Detailed physical exam

Reason: The initial assessment should always come first in this kind of situation. You must assess the patient's mental status, airway, breathing, circulation and any life-threatening conditions before taking any history. If the patient is unconscious, a detailed physical exam should follow initial assessment.

49:  When arriving on scene where there are already police, fire vehicles, and other ambulances present, you should conduct your own scene size-up. True or False?

A: TRUEB: FALSE

Reason: No matter who is already on scene, you should ALWAYS conduct your own scene size-up upon arrival.

50:  What is the key element of body substance isolation (BSI) equipment?

A: Determine what BSI is needed after you have done your initial assessment of the patient.

B: Always have all personal protective equipment readily available.

C: Always wear all personal protective equipment, and take off what you don't need once you have done your

initial assessment of the patient.D: Put personal protective equipment on the patient as

well as yourself.

Reason: The minimum BSI equipment you should have on for all calls is gloves. Other equipment is appropriate based on the call you are responding to. Always have any personal protective equipment you may need within reach, just in case.

51:  You respond to a call for a 44-year-old man working in a chemical manufacturing plant. You are told on arrival by his coworkers that he was burned when a container of lye powder broke open as he was moving it, covering most of his body. The Hazmat team has been called, but their estimated arrival time is nearly 30 minutes. What should you do?

A: Put on gloves, a face shield, a breathing mask and a gown, and then attempt to help the patient remove his clothing. Then provide constant irrigation with water until HazMat arrives.

B: Do nothing until HazMat arrives, and then follow their instructions.

C: Instruct the patient to dust himself off the best that he can, move to an area away from the dry powder, and wait for the HazMat team to arrive.

D: Stand far enough away to not compromise your own safety and monitor his breathing and mental status until HazMat arrives.

Reason: Despite extensive body substance isolation precautions, as an EMT-B you are not trained in handling hazardous materials. Doing nothing at all may compromise the patient's breathing, sight, mental status, or other functions. The best thing to do is to instruct the patient to dust off as much of the powder as he could, then walk somewhat away from the area of the spill. If breathing or other problems develop, instruct him to remove all clothing and jewelry, and continuously irrigate his skin with water only until HazMat arrives.

52:  While treating a patient for headache, nausea, and weakness, your eyes begin to water and you begin to feel nauseous. Your partner is feeling the same. What should you do?

A: Call the police and fire departments.B: Call for additional ambulances.C: Evacuate all people from the area/building.D: Call medical direction for advice.

Reason: If more than one person is experiencing the same

signs and symptoms, you can safely assume something at the scene is causing it, and the best thing to do would be to immediately remove all people from that area or building.

53:  How would you accurately evaluate the skin color of a dark-skinned patient?

A: Look at the color of the bottom of the patient's feet.B: Look at the color of the lips and nail beds.C: Look at the color of the palms of the hands.D: All of the above.

Reason: The best way to accurately evaluate the skin color of a dark-skinned patient would be to look at the color of the inside of the lips and the nail beds.

54:  If you are called to respond to a scene in which a patient was found floating in a frozen lake, and you are told that the patient was underwater approximately 3 to 5 minutes, the patient is cold to the touch and cyanotic, how long should you assess for pulselessness before starting CPR?

A: 5 secondsB: 15 secondsC: 25 secondsD: 45 seconds

Reason: Severely hypothermic patients will have a very slow heart rate, so the pulse should be checked for a longer period of time. As a rule, heart rates are generally assessed from 15 to 30 seconds and then multiplied, so in this case, 45 seconds would be the best choice.

55:  When considering the pulse of an adult patient, which of the following means that something may be seriously wrong with the patient?

A: A sustained pulse below 50 beats/minB: A sustained pulse above 120 beats/minC: A sustained irregular and weak pulseD: All of the above

Reason: A sustained pulse below 50 beats/min, above 120 beats/min, or irregular and weak are ALL signs that something could be seriously wrong with the patient.

56:  The skin of a patient with serious liver problems will appear:

A: jaundiced (yellow).B: red and blotchy.C: pale.

D: cyanotic.

Reason: Jaundice appears as yellow in the skin and eyes of patients with liver problems.

57:  If you are instructed by medical control to provide active, rapid rewarming of areas of a patient's body affected by deep cold injury, this would be best accomplished by:

A: covering the areas with a room temperature blanket.

B: applying warm, but not hot, circulating water to the affected areas.

C: massaging affected areas to restore circulation.D: immersing affected areas in hot water.

Reason: Covering the affected areas with a blanket is passive rewarming, not active. Massaging any area with a deep cold injury is not suggested because it could cause severe tissue damage. Hot water is not recommended because it can further harm the skin already damaged by the extreme cold. The best idea is to apply warm, circulating water to affected areas and transport immediately.

58:  A patient's pupils may become _________ due to blood loss, drug use, use of eye drops, or extreme fright.

A: unequalB: unreactiveC: dilatedD: constricted

Reason: Pupils often dilate (expand) due to blood loss, drug use, use of eye medications and extreme fright.

59:  A pulse oximeter will produce falsely high readings in patients with:

A: drug overdose.B: hypoxia.C: carbon monoxide poisoning.D: COPD.

Reason: A pulse oximeter will produce falsely high readings in patients with carbon monoxide poisoning.

60:  You and your crew respond to a call for a 23-year-old man complaining of weakness, nausea, fatigue, and joint pain. He believes he is coming down with a cold or flu, but you are told he felt fine when he went on a scuba diving trip early that morning. He denies medical conditions or any pertinent medical

history. On the way to the hospital, the patient has a full body seizure and does not regain consciousness. What is the probable diagnosis for this patient?

A: Hypoglycemia brought on by the patient's nauseaB: Decompression sicknessC: BarotraumaD: Undiagnosed epilepsy

Reason: Given that the patient denied having any medical conditions or pertinent medical history but mentioned his scuba diving trip that morning, he is most likely experiencing decompression sickness. He has common signs of decompression sickness, and additional signs would be shortness of breath, dizziness, headache, paralysis, and unconsciousness. Epilepsy is usually diagnosed at an early age and controlled with medication. Hypoglycemia would not normally result in a seizure that rapidly, followed by unconsciousness.

61:  With a severe head injury, clear fluid draining from the ears and nose would be:

A: cerebrospinal fluid.B: lymphatic fluid.C: synovial fluid.D: tears.

Reason: Clear fluid draining from the ears and nose after a head injury would be cerebrospinal fluid.

62:  Stable patients should be reassessed every _____ minutes, while unstable patients should be reassessed every ______ minutes.

A: 10; 3B: 15; 5C: 20; 10D: 30; 15

Reason: Stable patients should be assessed every 15 minutes; unstable patients should be assessed every 5 minutes.

63:  In a behavioral emergency, if a patient denies treatment, who is the best person(s) to give you advice on providing care against that patient's will if you believe he may harm himself or others?

A: Law enforcement personnelB: The patient's family doctorC: The patient's family members

D: Your medical director

Reason: The best source of information for any area that is uncertain for EMT-Bs is their medical director. If the behavioral emergency involved any sort of crime or damage to property or another person, law enforcement would also be involved, but would have little or no say in whether or not you could treat the patient against his will.

64:  Blind finger sweeps are NEVER performed on an infant or child. True or False?

A: TRUEB: FALSE

Reason: Blind finger sweeps are NEVER performed on an infant or child because they could further lodge an obstruction into the airway.

65:  A situation in which a drug should not be used because it may cause harm to the patient or offer little effect in improving their condition is called a(n):

A: adverse reaction.B: side effect.C: contraindication.D: indication.

Reason: A contraindication is a situation in which a drug should not be used because it may cause harm to the patient, or offer little effect for improving the patient's condition.

66:  When responding to a call for a patient who is 7 months' pregnant with her first child, she tells you she has been ill with flu-like symptoms for the last 3 days. She asks that you transport her to the emergency department. How should she be transported?

A: On her left sideB: Flat on her back with her legs elevatedC: Flat on her back with her head lower than her feetD: The position makes no difference.

Reason: The preferred position for pregnant patient's after 20 weeks' gestation is on the left side to prevent the baby from compressing any of the major blood vessels of the mother's abdomen. If the patient were in shock or some other medical emergency, you may have to consider another position, but this patient is stable.

67:  Why is nitroglycerin given to a patient having chest pain?

A: It constricts blood vessels and raises blood pressure.

B: It dilates blood vessels and decreases the workload of the heart.

C: It increases blood flow to the brain.D: It is a painkiller.

Reason: Nitroglycerin dilates blood vessels, decreasing the workload of the heart, thereby decreasing chest pain.

68:  Which one of the following is NOT a shockable rhythm?

A: Asystole and pulseless electrical activityB: Ventricular tachycardiaC: Ventricular fibrillationD: Pulseless ventricular tachycardia

Reason: Asystole and PEA (pulseless electrical activity) are nonshockable rhythms. Ventricular tachycardia, ventricular fibrillation, and pulseless ventricular tachycardia are all shockable rhythms.

69:  You are called to the home of a woman in labor with her fourth child. She is full term, and her water has broken. When you examine her, you see a loop of umbilical cord protruding from the vaginal opening. How do you treat her?

A: Prepare the area and the patient for a home delivery.

B: Gently push the umbilical cord back into the birth canal, put the patient on her left side, and transport rapidly.

C: Leave the umbilical cord where it is, and rapidly transport.

D: Put the patient in a position with her knees to her chest, gently push the fetus away from the cord, and keep the cord moist while rapidly transporting.

Reason: The care the patient needs for this condition, a prolapsed umbilical cord, can only be received at the hospital. Your job is to make sure adequate blood flow continues through the umbilical cord to the infant until you get the mother to the hospital. The best way to do this is to put the patient in a knee chest position to keep the infant's head away from the birth canal, give the mother oxygen, and keep the cord moist while rapidly transporting.

70:  If a patient has a pacemaker and needs to be defibrillated, you should:

A: not worry about the pacemaker and perform defibrillation as you would with any other patient.

B: increase the joules on the AED.C: remove the pacemaker.D: place the defibrillator pad several inches away from

the pacemaker.

Reason: A patient who has a pacemaker and needs to be defibrillated should be treated by placing the defibrillator pad several inches away from the pacemaker, usually visible under the skin.

71:  A patient who has continuous seizures, one after another, is experiencing:

A: convulsions.B: repeating seizure disorder.C: brain damage.D: status epilepticus.

Reason: Status epilepticus is a condition in which a patient has back-to-back seizures without regaining consciousness. It is a serious condition that must be treated immediately.

72:  While transporting a woman 8 months' pregnant with her first child, she says she feels the need to push. Upon examining her, you see one of the infant's arms hanging from the vaginal opening. What should you do?

A: Go ahead and deliver the infant in the ambulance.B: Gently push the infant's arm back into the birth

canal and rapidly transport the mother to the emergency department.

C: Adjust the stretcher so that the mother's pelvis is higher than her head, tell her to do her best not to push, and rapidly transport.

D: Leave the mother as is, tell her not to push, and rapidly transport.

Reason: It is best not to try this potentially difficult delivery in the field. You would not try to push the infant's arm back into the birth canal, or leave it dangling out and tell the mother not to push. If you put the mother in a position where the pelvis is elevated, it decreases pressure on the infant and decreases the strong urge the mother has to push. Transport rapidly.

73:  If a patient has signs and symptoms of a stroke, but all signs and symptoms disappear in less than 24 hours, the patient experienced a(n):

A: cerebrovascular accident (CVA).B: transient ischemic attack (TIA).C: altered mental status (AMS).D: acute myocardial infarction (AMI).

Reason: If a patient shows signs and symptoms of a stroke that disappear completely within 24 hours, he or she has experienced a TIA (transient ischemic attack).

74:  In what order would the following bleeding control measures be used to stop serious bleeding? 1. Tourniquet 2. Firm pressure on the wound 3. Pressure on a pressure point 4. Elevation of the wound in addition to pressure

A: 1,2,3,4B: 2,4,3,1C: 3,1,2,4D: 4,3,1,2

Reason: The first step in stopping serious bleeding is firm pressure on the wound. If this does not stop it, the second step is to keep firm pressure while elevating the wound site. If this still does not work, putting pressure on a pressure point such as the closest major artery, is suggested. A tourniquet is only suggested as a very last result, and only if the bleeding may otherwise result in life-threatening blood loss.

75:  You respond to the scene of a sexual assault of a 31-year-old woman. Police have secured the scene. Your patient states she was hit in the head with a bat, fell to the ground, and was then raped. What are necessary interventions?

A: Spinal immobilization, focused history and physical exam, and rapid transport

B: Letting law enforcement transport the patient after you address any bleeding or other injuries

C: Focused physical exam of all injuries, an exam to determine whether or not the patient was actually raped, then transport

D: Using a c-collar for immobilization, focused physical exam, allowing her to clean up, and completion of the police report before transport

Reason: Spinal immobilization is a necessary precaution because the patient was hit in the head with a bat and then fell to the ground. Focused history and physical exam will then treat any other injuries she may have experienced. Being gentle and understanding are important. It is not your job to try to determine whether or not she has been raped, but it is important that the patient not clean up in any way that may destroy evidence that

will be obtained in a rape kit at the hospital.

You got 23 out of 75 correct.

You got 31% out of the total questions correct.