On-Line Practice Exam 6 - This exam is from another publisher other than the one used in class.  Therefore some questions may require some research to answer.  Furthermore this exam includes questions that should have been obtained in an EMT-Basic program.  It is recommended that you take the exam by placing your answers on a sheet of paper then Click here for "Answer Key Exam 6".

1.       A paramedic should use ________ to recognize potential hazards at the scene of an emergency.

          a.   sight and smell

          b.   taste

          c.   touch and hearing

          d.   all senses

2.       Scenario: You are responding to a collision between a car and a truck. Prior to arrival, you consider ________ as a potential hazard at this scene.

          a.   fire and traffic only

          b.   broken glass and chemical spills

          c.   leaking gas and downed electrical wires

          d.   all of the above

3.       Always use a properly fitted HEPA mask when managing a patient you suspect has:

          a.   influenza.

          b.   TB.

          c.   COPD.

          d.   asthma.

4.       Scenario: You respond to "shots fired, man down." You should enter the scene when:

          a.   you observe the gunman fleeing the scene.

          b.   you get to the location.

          c.   dispatch informs you the scene is safe.

          d.   police officers arrive and secure the scene.

5.       Scenario: You and your partner are treating a 27-year-old asthmatic patient outside a bar when a growing crowd becomes hostile and unruly. To protect yourself, your partner, and the patient, you should:

          a.   remove yourselves and the patient from the scene.

          b.   exit the scene leaving the patient behind.

          c.   move the patient into the bar.

          d.   use your vehicle to disburse the crowd.

6.       The proper procedure for gaining access to a patient at the scene of a domestic violence incident would be to:

          a.   have your partner distract the assailant.

          b.   wait for law enforcement personnel to arrive.

          c.   have your dispatcher tell the patient to come outside.

          d.   leave the scene and become available for the next assignment.

 7.       Who or what is usually the best source of information about the nature of your patient's illness if he is alert and oriented?

          a.   visual cues.

          b.   diagnostic tests.

          c.   the patient himself.

          d.   family members and bystanders. 

8.       The mechanism of injury that injured your patient is based on all of the following EXCEPT:

          a.   strength of the forces.

          b.   direction of the forces.

          c.   nature of the forces.

          d.   timing of the forces.

9.       Scenario: You find a patient awake and alert with stable vital signs, lying supine on the sidewalk after being struck by a motor vehicle traveling at 10 mph. As you assess the patient, you consider ________ because of a high index of suspicion.

          a.   severe internal injuries

          b.   lower extremity fractures

          c.   pneumothorax

          d.   closed head injury

10.     In most calls to scenes of two-car accidents, you should be prepared to expect and look for:

          a.   multiple patients.

          b.   severe lower extremity injuries.

          c.   flail chest.

          d.   altered mental status patients.

11.     As the first unit on the scene of a mass casualty incident, you and your partner should:

          a.   split up, with one assuming a command role, the other a triage role.

          b.   split up, with both initiating triage of patients.

          c.   stay together, both locating and treating the most serious patients.

          d.   stay together, both initiating triage of patients.

12.     One of the main reasons you should call for additional assistance when dealing with multiple patients is that:

          a.   you should share the risks of an unstable scene.

          b.   interesting and exciting calls should be experienced by many.

          c.   you cannot safely and effectively treat them all.

          d.   you are only responsible for command and triage.

 13.     Forming a general impression as part of your initial assessment helps you to:

          a.   administer proper medications.

          b.   determine baseline mental status.

          c.   stabilize the cervical spine.

          d.   determine general clinical status and priority.

14.     Scenario: You are assessing a 34-year-old male who is not awake. After determining that he does not respond to verbal stimuli, your next action would be to:

          a.   open his airway.

          b.   start cardiopulmonary resuscitation.

          c.   pinch his fingernails.

          d.   place him on a backboard.

15.     What does the "U" in A-V-P-U stand for?

          a.   Uncooperative.

          b.   Unresponsive.

          c.   Unaccessible.

          d.   Unconscious.

16.     Scenario: Your three-year-old patient opens his eyes when you speak to him and is able to mumble a response. This patient's mental status is best described as:

          a.   responsive to verbal stimuli.

          b.   responsive to tactile stimuli.

          c.   stuporous.

          d.   lethargic.

17.     The best method for determining responsiveness to painful stimuli in an infant patient is to:

          a.   flick the soles of her feet.

          b.   rub her sternum.

          c.   pinch her fingernails.

          d.   pinch her cheeks.

18.     The sound of gurgling usually indicates:

          a.   foreign body airway obstruction.

          b.   fluid in the upper airway.

          c.   constricted bronchioles.

          d.   fluid in the lower airway.

19.     The purpose of manual stabilization of the cervical spine during the initial assessment of a trauma patient is to:

          a.   allow for easier airway manipulation.

          b.   prevent the patient from moving his neck.

          c.   allow you to effectively control the patient.

          d.   assist you in determining transport priority.

20.     Scenario: You are called to the scene of a 55-year-old female lying supine on the side of the road. There are no bystanders around. You determine she is unresponsive. You should next:

          a.   start CPR.

          b.   intubate her airway.

          c.   manually stabilize her cervical spine.

          d.   provide high-concentration oxygen.

21.     To determine if a patient is breathing, a paramedic should:

          a.   palpate the patient's trachea.

          b.   hold a mirror to the patient's mouth and nose.

          c.   ausculate at the 5th and 6th intercostal space.

          d.   look, listen, and feel.

22.     All of the following are signs of inadequate breathing in an infant EXCEPT:

          a.   accessory muscle use.

          b.   altered mental status.

          c.   respiratory rate of 30 per minute.

          d.   cyanosis.

23.     In infants and young children, a paramedic must constantly ________ to maximize patency.

          a.   provide high-flow oxygen

          b.   readjust the airway

          c.   ventilate with a manual resuscitation device

          d.   observe chest rise and fall

24.     Devices for maintaining airway patency in a five-year-old patient include all of the following EXCEPT:

          a.   the pharyngotracheal lumen (PL) airway.

          b.   the endotracheal (ET) tube.

          c.   an oropharyngeal airway (OPA).

          d.   a suction unit.

25.     Scenario: You are assessing an adult patient and you palpate her wrist to locate a pulse but do not feel one. You should immediately:

          a.   palpate for an ulnar pulse.

          b.   palpate for a popliteal pulse.

          c.   palpate for a carotid pulse.

          d.   palpate the opposite wrist for a radial pulse.

26.     In an infant patient, the pulse is best detected by either palpating the brachial artery or:

          a.   auscultating the carotid pulse.

          b.   auscultating the apical pulse.

          c.   palpating the femoral pulse.

          d.   palpating the carotid pulse.

27.     Life-threatening blood loss can result from: (1) a nosebleed, (2) vaginal bleeding, (3) rectal bleeding, (4) trauma.

          a.   4 only.

          b.   3 and 4 only.

          c.   2, 3, and 4 only.

          d.   all of the above.

28.     Mottled, cyanotic, pale, or ashen skin color is often a sign of:

          a.   a total loss of blood supply to the extremities.

          b.   food poisoning.

          c.   warm, circulating blood being shunted to the core of the body.

          d.   inadequate respiratory effort.

29.     Scenario: You are assessing a 28-year-old male with multiple gunshot wounds to his abdomen. You would expect his skin to be:

          a.   cool and moist.

          b.   cold and dry.

          c.   warm and dry.

          d.   hot and moist.

30.     A patient with skin described as "clammy" has ________ skin.

          a.   cool and moist

          b.   warm and dry

          c.   mottled

          d.   ashen

31.     Why should patients with serious illness or injury be transported immediately?

          a.   in order for paramedics to return and treat additional patients.

          b.   because a physician is required to perform a complete assessment.

          c.   because it reduces the liability of the paramedics.

          d.   to get the patient to a facility that can deliver definitive care.

32.     A patient ________ is an example of one requiring expeditious transport.

          a.   with an isolated wrist fracture

          b.   with neck and back pain secondary to a motor vehicle collision

          c.   suffering narcotic overdose

          d.   who is unresponsive to stimuli

33.     ________ is (are) a reliable indicator of circulatory function in infants and children.

          a.   Blood pressure

          b.   Capillary refill

          c.   Electrocardiogram findings

          d.   Skin temperature

34.     A common finding in patients suspected of hypovolemia is orthostatic vital sign changes. A positive finding would show the following when going from supine to seated positions:

          a.   BP increasing 10-20 mmHg, HR decreasing 10-20 bpm.

          b.   BP staying the same, HR increasing 40-50 bpm.

          c.   BP decreasing 10-20 mmHg, HR increasing 10-20 bpm.

          d.   BP decreasing 10-20 mmHg, HR decreasing 10-20 bpm.

35.     Scenario: You are assessing a patient with a suspected myocardial infarction. During your focused exam you should examine:

          a.   deep tendon reflexes.

          b.   peripheral perfusion status.

          c.   extraocular movements.

          d.   range of motion in joints.

36.     Medical patients with altered mentation or who are unresponsive are assessed:

          a.   similarly to a critical trauma patient.

          b.   like any other medical patient.

          c.   similarly to a patient with isolated trauma.

          d.   similarly to a patient complaining of chest pain.

37.     Scenario: You are assessing a trauma patient with bilateral tibia and fibula fractures as a result of being struck by a motor vehicle. Why should this patient be rapidly transported?

          a.   The potential for loss of limb is extreme.

          b.   The pain from fractures causes a great deal of stress.

          c.   This patient is a low priority and can wait to be transported.

          d.   The mechanism of injury gives a high index of suspicion for serious injury.

38.     All of the following mechanisms of injury yield a high index of suspicion for serious injury EXCEPT:

          a.   falling off the top of a 30-foot extension ladder.

          b.   a collision between a motorcycle and a pedestrian.

          c.   patient ejection after an automobile crash.

          d.   a gunshot wound to the distal lower leg.

39.     A fast, systematic assessment designed to identify other life-threatening injuries after the initial assessment is the:

          a.   detailed physical exam.

          b.   rapid trauma assessment.

          c.   focused physical exam.

          d.   one-minute exam.

40.     Examples of potentially life-threatening problems that might not be found in an initial assessment are:

          a.   scalp laceration and pelvic fracture.

          b.   foreign body airway obstruction and ruptured spleen.

          c.   ankle fracture and subcutaneous emphysema.

          d.   basilar skull fracture and respiratory distress.

41.     ________ may indicate cardiac tamponade or tension pneumothorax.

          a.   Distended neck veins

          b.   Non-distended neck veins

          c.   Cullen's sign

          d.   Turner's sign

42.     When assessing the chest, any open wounds that are located should be:

          a.   covered with a gauze bandage.

          b.   sealed with an occlusive dressing.

          c.   probed for depth.

          d.   drained using a catheter.

43.     Rebound tenderness in the abdomen is a sign of potential:

          a.   liver perforation.

          b.   spleen rupture.

          c.   peritoneal irritation.

          d.   pelvic fracture.

44.     Evaluation of the pelvis in the rapid trauma assessment includes pressing ________ on the symphysis pubis.

          a.   posteriorly

          b.   laterally

          c.   anteriorly

          d.   medially

45.     Scenario: You are treating a patient who fell off a second-story roof. When assessing the chest during the rapid trauma assessment, you discover absent lung sounds on the right side. You should next:

          a.   move to the abdomen and continue the rapid trauma assessment.

          b.   search for other signs of tension pneumothorax.

          c.   decompress the patient's chest.

          d.   intubate the patient's airway.

46.     Why is a focused history important in the majority of responsive medical patients?

          a.   It identifies signs of medical complications.

          b.   It supports diagnostic impression.

          c.   It helps to formulate a field diagnosis.

          d.   It allows treatments to be initiated immediately.

47.     The careful, thorough process of eliciting a patient's history and conducting a physical examination that is a luxury only performed en route to the hospital in emergency situations is known as the:

          a.   rapid trauma assessment.

          b.   detailed physical exam.

          c.   ongoing assessment.

          d.   rapid medical assessment.

48.     Special emphasis should be placed on ________ during your detailed physical exam.

          a.   mental status

          b.   cardiovascular and respiratory systems

          c.   cranial nerve function

          d.   areas suggested by the chief complaint

 49.     Scenario: During the detailed physical exam of a trauma patient you discover periorbital ecchymosis. This is a sign of a:

          a.   nasal bone fracture.

          b.   basilar skull fracture.

          c.   maxillary fracture.

          d.   zygomatic bone fracture.

50.     A detailed physical examination can be an anxiety-provoking experience. One of the best ways to minimize this anxiety is to:

          a.   keep the patient's clothes on.

          b.   warm your hands and instruments prior to their use.

          c.   drive slowly to the hospital.

          d.   use a calm, professional demeanor.

51.     Scenario: You have a 60-year-old male with an altered mental status. There is no evidence of trauma. One way to aid your assessment of this patient is to perform:

          a.   pulse oximetry.

          b.   blood glucose determination.

          c.   cardiac monitoring.

          d.   end-tidal CO2 monitoring.

52.     Scenario: A patient is complaining of abdominal pain, nausea, and vomiting. The medical assessment should include inspection for:

          a.   coffee ground emesis.

          b.   asymmetric uvula movement.

          c.   cerebrospinal fluid drainage from the nose.

          d.   Battle's sign.

53.     Why is a detailed physical exam rarely performed on critical trauma patients?

          a.   The rapid trauma assessment performs the same function.

          b.   It is only used on medical patients.

          c.   It produces too much patient anxiety.

          d.   It usually yields little relevant information.

54.     Scenario: You are en route to the hospital with a patient who is seemingly stable following a motor vehicle collision. The ________ should be repeated since patient condition can change suddenly.

          a.   initial assessment

          b.   reflex tests

          c.   chest and lung assessment

          d.   pulse rate and quality check

55.     An important aspect of the ongoing assessment is to monitor and evaluate all of the following EXCEPT:

          a.   the transport priority.

          b.   the patient's vital signs.

          c.   the effects of interventions.

          d.   the estimated remaining transport time.

56.     Reassessment of a critical patient's vital signs should be performed at least every ____ minutes.

          a.   5

          b.   10

          c.   15

          d.   20

57.     Multiple sets of vital signs should be taken to identify ________ in improvement or deterioration of the patient's condition.

          a.   pathologies

          b.   etiologies

          c.   levels of consciousness

          d.   trends

58.     Patterns of improvement or deterioration in patient condition include:

          a.   rising or falling pulse rate.

          b.   increasing or decreasing respiratory rate.

          c.   changing skin temperature and changing pupillary equality.

          d.   all of the above.

 59.     When assessing patients, paramedics should look for ________, which can identify conditions that may complicate the injury or illness.

          a.   insurance identification cards

          b.   Medic Alert tags

          c.   personal physician contact numbers

          d.   wallet information cards

60.     Paramedics are able to treat patients with the same techniques as other clinicians with the exception that they:

          a.   are far less trained than other practitioners.

          b.   perform these procedures in uncontrollable and unpredictable environments.

          c.   treat life-threatening emergencies only.

          d.   are not allowed to make independent decisions.

 61.     The term acuity refers to:

          a.   the severity of the patient's condition.

          b.   the use of standing orders for care.

          c.   the use of an algorithm.

          d.   critical thinking and decision-making skills.

62.     An example of a potentially life-threatening patient complaint is:

          a.   severe shortness of breath secondary to asthma.

          b.   fractures of the tibia and radius.

          c.   end-stage renal failure with unconsciousness.

          d.   chest pain and a history of diabetes.

63.     Scenario: You are evaluating a patient who was in a motor vehicle collision. You determine that the patient is responsive to pain only and has a partially amputated arm at the elbow, a possible pelvic fracture, and a flail chest. You classify this patient's condition as:

          a.   critically life-threatening.

          b.   potentially life-threatening.

          c.   non-life-threatening.

          d.   expectant.

64.     Treatments that can be performed before contacting the medical direction physician are known as:

          a.   algorithms.

          b.   protocols.

          c.   standing orders.

          d.   management plans.

65.     Why is it NOT possible for paramedics to use a wholly algorithm-based system of patient care?

          a.   Paramedics function under the license of a medical director.

          b.   Patients frequently present with complaints that do not fit a specific algorithm.

          c.   Procedures contained in algorithms are not specific to most problems.

          d.   Algorithms address only first-line procedures.

66.     Critical thinking is a thought process used to:

          a.   focus on a situation's most important aspect.

          b.   act instinctively.

          c.   analyze and evaluate.

          d.   establish credibility with an emergency physician.

67.     The first step in critical thinking is to:

          a.   conduct a focused exam.

          b.   ascertain the chief complaint.

          c.   determine statistically significant conditions.

          d.   form a concept.

68.     Scenario: After a call, you discuss the patient with the emergency department physician, comparing diagnoses and care plans. This is an example of:

          a.   evaluating.

          b.   reflecting.

          c.   applying principles.

          d.   putting it all together. 

69.     Scenario: Your 23-year-old female patient presents with relatively normal vital signs and is fully alert and oriented. Her only complaint is lower abdominal pain. If you assume she is pregnant, you are:

          a.   applying the principles.

          b.   evaluating.

          c.   overgeneralizing.

          d.   interpreting the data.

70.     During the ongoing assessment of a stable patient, you should recheck vital signs every 15 minutes. This is an example of:

          a.   applying the principles.

          b.   reflecting.

          c.   reviewing.

          d.   evaluating.

71.     The ________ nervous system controls the "fight or flight" response.

          a.   parasympathetic

          b.   autonomic

          c.   peripheral

          d.   somatic

72.     The "fight or flight" response can lead to:

          a.   enhanced critical thinking ability.

          b.   diminished reflexes.

          c.   enhanced visual acuity.

          d.   diminished muscle strength.

 73.     While a person is thinking under pressure, hormones can diminish his or her:

          a.   concentration abilities.

          b.   muscle strength.

          c.   sensory acuity.

          d.   natural reflexes.

74.     Changing or stopping interventions that are not working is an example of:

          a.   reading the patient.

          b.   reviewing your performance.

          c.   reevaluating.

          d.   revising the management plan.

75.     Scenario: You arrive on location and begin to read the scene. You do this by:

          a.   addressing life threats.

          b.   conducting a focused exam.

          c.   observing the immediate surroundings.

          d.   auscultating the patient's lungs.

76.     In critical decision making, addressing life threats as they are found is an example of:

          a.   reading.

          b.   reacting.

          c.   reevaluating.

          d.   reviewing.

77.     One of the "six Rs" is to ________, being honest and critical, looking for ways to improve your patient management.

          a.   review the scene

          b.   review your performance

          c.   review the patient

          d.   review the patient care form

78.     What is one of the ways to read the patient?

          a.   Observe the level of consciousness.

          b.   Observe the mechanism of injury.

          c.   Conduct a focused exam.

          d.   Address life threats.

79.     The portion of critical thinking dedicated to assessing initial response to treatment and locating less-than-obvious problems is:

          a.   revising.

          b.   reacting.

          c.   reviewing.