Deck 15: Shock and Resuscitation

Question 1

A patient goes into cardiac arrest at 11:40 a.m. Which of the following treatment descriptions gives the patient the best chance for recovery?

A) CPR at 11:42 a.m. and advanced cardiac drugs at 11:48 a.m.
B) Defibrillation at 11:46 a.m. followed by ACLS at 11:51 a.m.
C) CPR at 11:41 a.m. and defibrillation at 11:43 a.m.
D) Defibrillation at 11:44 a.m. followed by CPR at 11:49 a.m.

Answer 1

C

Question 2

You have been asked to describe the American Heart Association's Chain of Survival to a group of Emergency Medical Responder students. What description is best?

A) A sequence of care that provides instructions on how to use an AED
B) A sequence of events that, if enacted quickly, gives the best chance for surviving cardiac arrest
C) A treatment plan that helps to prevent and treat cardiac arrest in the general population
D) A treatment plan, that if followed, guarantees the survival of cardiac arrest

Answer 2

B

Question 3

Resuscitation, started during what phase of cardiac arrest, provides the patient with his or her best chance of survival?

A) Circulatory
B) Metabolic
C) Electrical
D) Bradycardic

Answer 3

C

Question 4

Because of a shortage of paramedics at your ambulance service, it has been announced that there will be AEDs placed on every ambulance for use by EMT crews. Which of the following statements indicates an understanding of how this will affect the EMTs?

A) "Cardiopulmonary resuscitation will no longer be needed."
B) "The AED will let us know whether or not to shock the patient."
C) "EMTs will now be able to shock all patients in cardiac arrest."
D) "EMTs will have to learn how to interpret ECG tracings."

Question 5

A 47-year-old patient has been in cardiac arrest for 6 minutes. While you set up the AED, you would direct your partner to:

A) perform CPR at a ratio of 30 ventilations to two compressions.
B) assist you in making sure that the AED is ready for application.
C) perform a primary and secondary assessment.
D) start cardiopulmonary resuscitation until the AED is ready.

Question 6

Your service has a new AED. During the in-service on the new device, the instructor informs you that it is a semi-automated AED and uses a biphasic wave form, as opposed to the monophasic form used by the previous AED. As a knowledgeable EMT, you should recognize that:

A) the new AED will defibrillate with lower amounts of electrical energy.
B) the EMT will not need to press a "shock" button to shock the patient.
C) the new AED will defibrillate with higher amounts of electrical energy.
D) less energy but more shocks will be needed to treat cardiac arrest.

Question 7

Immediately following the onset of cardiac arrest, brain cells begin to die after:

A) 1 minute.
B) 5 minutes.
C) 10 minutes.
D) 15 minutes.

Question 8

The EMT should request advanced life support (ALS) backup for a patient in cardiac arrest because:

A) paramedics must be present in order for the EMT to use the AED.
B) cardiac arrest patients must be transported by ALS personnel.
C) ALS care is superior to basic life support care, even with the AED.
D) ALS treatment decreases the possibility of the patient going back into cardiac arrest once successful defibrillation has occurred.

Question 9

When presenting information on cardiac arrest and automated external defibrillation to a community group, a man asks why people should perform CPR prior to the arrival of EMS if they are going to provide a shock. Your response would be:

A) "Immediate CPR can prolong the period in which the heart can be shocked following cardiac arrest."
B) "In many cases, CPR can reverse the cardiac arrest, making a shock by the AED unnecessary."
C) "In the American Heart Association's Chain of Survival, CPR is the most important link in surviving cardiac arrest."
D) "CPR is needed to keep blood flowing through the body so the EMTs can give the patient IV medications when they arrive."

Question 10

A patient arrests at 1313. E-911 is activated and dispatches an ambulance at 1315. The ambulance arrives on scene at 1319 and the EMTs reach the patient's side and start care at 1321. After transporting the patient, the patient is transferred to the ED staff at 1346. Based on that information, which one of the following is true?

A) Down time is 8 minutes.
B) Total down time is 31 minutes.
C) Down time is 25 minutes.
D) Total down time is 6 minutes.

Question 11

Why is defibrillation in the first few minutes of cardiac arrest so critical?

A) If cardiac arrest is not treated within the first few minutes, ventricular fibrillation will convert to asystole, a non-shockable heart rhythm.
B) Research has shown that a heart in cardiac arrest will continue to pump blood for a few minutes before cardiac output drops to zero.
C) In the first few minutes of cardiac arrest, the blood pressure is still normal, but will drop quickly, making successful defibrillation less likely.
D) In the first few minutes of cardiac arrest the heart is still warm, but begins to cool rapidly making it less receptive to a defibrillatory shock.

Question 12

What cardiac arrest rhythm is the AED designed to shock?

A) Asystole
B) Pulseless electrical activity
C) Ventricular fibrillation
D) Bradycardia

Question 13

The AED should never be applied to a patient who is not in cardiac arrest because some patients in:

A) ventricular tachycardia may have a pulse.
B) ventricular fibrillation may be conscious and alert.
C) ventricular fibrillation may have a pulse.
D) asystole may still have a pulse.

Question 14

Which one of the following links in the American Heart Association's Chain of Survival must occur first, if a patient is to survive cardiac arrest?

A) Early CPR
B) Early defibrillation
C) Early access
D) Early advanced life support

Question 15

Within two minutes of going into cardiac arrest, an AED is applied, the patient is shocked, and a pulse is restored. The EMT should recognize that the heart was in:

A) ventricular fibrillation and now is in cardiac arrest.
B) asystole and now is in an organized rhythm.
C) ventricular fibrillation and now is in an organized rhythm.
D) ventricular fibrillation and now is in asystole.

Question 16

Which one of the following statements about the AED and its use in the treatment of cardiac arrest is true?

A) "AEDs have simplified the treatment of cardiac arrest to the point where the EMT does not have to be worried about inappropriately shocking a patient."
B) "Research has shown that the first shock delivered by an AED is often faster than the first shock delivered by a manual defibrillator."
C) "To use an AED, the EMT must be able to identify some basic cardiac arrest heart rhythms so that he or she can tell the AED to shock or not shock the patient."
D) "The AED is advantageous in that it will determine if a patient is in cardiac arrest and whether or not to shock."

Question 17

A patient has just gone into cardiac arrest. His heart is most likely in what rhythm?

A) Ventricular fibrillation
B) Asystole
C) Ventricular tachycardia
D) Pulseless electrical activity

Question 18

Which one of the following statements about the heart rhythm of ventricular fibrillation is true?

A) "Ventricular fibrillation occurs when the heart rate is so slow and weak that a pulse cannot be felt."
B) "When a patient's heart is in ventricular fibrillation, it is unable to pump blood throughout the body."
C) "The most effective treatment for converting ventricular fibrillation to a healthy heart rhythm is CPR."
D) "The AED is designed to identify ventricular fibrillation and give a 'No Shock Advised' message when it is present."

Question 19

Which one of the following is a benefit of the automated external defibrillator?

A) The ease and speed by which it can be used
B) Elimination of the need for a primary assessment
C) Its ability to identify and confirm cardiac arrest
D) The need for little-to-no training

Question 20

As you arrive at a metal scrap yard for an unknown medical emergency, you observe a male supine on the ground with AED electrodes on his chest. The AED operator has just ordered coworkers to clear the patient because the AED is going to shock. Within seconds, the AED delivers a shock without the operator pressing a "shock" button. The EMT should recognize what type of AED?

A) Semi-automated
B) Manual
C) Fully automated
D) Biphasic

Question 21

You have arrived at a residence where a 4-month-old baby was found in his crib in cardiac arrest. Emergency Medical Responders have been on scene for 5 minutes prior to arrival. They began CPR immediately on reaching the patient's side. You have an AED with adult pads with you, but not pediatric pads. After rechecking and confirming that the patient is in cardiac arrest, you would:

A) continue CPR and transfer to the stretcher for transport.
B) place the AED on the patient and follow all prompts.
C) continue CPR for 2 more minutes before placing the AED.
D) discuss with the parents if they want to proceed with use of the AED.

Question 22

While using the AED to treat a patient in cardiac arrest, your partner informs you that he can feel a carotid pulse. Which of the following should you do immediately?

A) Obtain a blood pressure.
B) Reanalyze the patient's heart rhythm.
C) Insert an oropharyngeal airway.
D) Assess the patient's breathing.

Question 23

After receiving a "No Shock Advised" message from the AED, it is determined that the patient has a weak pulse and slow and shallow respirations. You would immediately:

A) transfer to the stretcher for transport.
B) provide 2 minutes of CPR.
C) start positive pressure ventilation.
D) obtain a blood pressure.

Question 24

When should the EMT transport the cardiac arrest patient?

A) After three "No Shock Advised" messages are received
B) Immediately upon determining that the patient is in cardiac arrest
C) After one shock has been delivered and the patient remains in cardiac arrest
D) Before delivering the first shock when a "Shock Advised" message is received

Question 25

The AED has just been applied to a female cardiac arrest patient. After analyzing the heart rhythm, it provides a "No Shock Advised" message. The EMT should immediately:

A) reanalyze the patient's heart rhythm.
B) resume cardiopulmonary resuscitation.
C) check the electrodes for proper placement.
D) check the patient for a pulse and blood pressure.

Question 26

After you apply the AED to a cardiac arrest patient, it delivered a shock. Immediately after the shock, the EMT should do which one of the following?

A) Check the patient for a pulse and reanalyze the rhythm if no pulse is present.
B) Provide 2 minutes of CPR, and then check the patient for a pulse.
C) Check the patient for a pulse and start CPR if no pulse can be located.
D) Provide five cycles of single-rescuer CPR with a ratio of 15 compressions to two ventilations.

Question 27

You have been dispatched to a residence for a male patient with a cardiac history who is complaining of chest pain. On scene you find a 52-year-old male patient sitting in a chair. He is alert and oriented and states that his chest pain feels like the last time he had a heart attack. He also states that in the hospital his heart stopped and they had to shock him twice before it restarted. He is breathing adequately and has a strong radial pulse. Which one of the following would be appropriate in the care of this patient?

A) Apply the AED to the patient but do not turn it on.
B) Provide positive pressure ventilation with high-concentration oxygen.
C) Open the airway using the head-tilt, chin-lift maneuver.
D) Obtain the heart rate, respiratory rate, and blood pressure.

Question 28

You have been called for a 57-year-old female who has choked on a large pill. On arrival you find the patient collapsed on the floor with family by her side. Your assessment reveals her to be unresponsive, not breathing, and pulseless. Which one of the following should you do immediately?

A) Start chest compressions.
B) Perform five abdominal thrusts.
C) Apply the AED and hit the "analyze" button.
D) Open the airway and attempt ventilation.

Question 29

A 52-year-old male has collapsed on his front porch and his family dialed 911. When you arrive, the daughter informs you that the patient has been down for approximately 8 minutes. Assessment reveals him to be in cardiac arrest. Which one of the following should you do immediately?

A) Contact medical direction for permission to use the AED given the downtime.
B) Perform five cycles of CPR at a ratio of 15 compressions to two ventilations (single rescuer CPR).
C) Hold CPR so that the AED can be checked and applied for use.
D) Start CPR while the AED is readied for use.

Question 30

If a cardiac arrest patient were in asystole ("flat line"), which of the following messages would the AED provide?

A) "Shock advised"
B) "Check electrodes"
C) "No shock advised"
D) "Press analyze"

Question 31

You have been called for an elderly male patient who suddenly collapsed. On scene you find an 82-year-old man lying on the garage floor. Assessment reveals him to be unresponsive and not breathing. Which one of the following should you do immediately?

A) Determine the "down time."
B) Apply the AED.
C) Start cardiopulmonary resuscitation.
D) Check for a carotid pulse.

Question 32

What statement regarding care for the adult patient in cardiac arrest is true?

A) "It is important to always check for a pulse immediately after the AED has delivered a shock."
B) "When using an AED, the machine should be turned on before applying the electrodes."
C) "When checking for a patient's pulse, the EMT should take no more than 5 seconds."
D) "If two EMTs are performing CPR, a ratio of 30 compressions to two ventilations can be used."

Question 33

After analyzing a cardiac arrest patient's heart rhythm, the AED provides a "Deliver Shock" message. After clearing the patient, the EMT's next step should be to:

A) press the shock button, and then check for the return of a pulse.
B) press the shock button, and then allow the AED to analyze the heart rhythm.
C) press the shock button, and then perform CPR for 2 minutes.
D) check for a pulse, and then press the shock button if a pulse is not present.

Question 34

You have just applied the AED to a female patient in cardiac arrest and the machine is ready to analyze the heart rhythm. Which of the following instructions is appropriate at this time?

A) "Stop CPR and clear the patient."
B) "Stop chest compressions but continue ventilation."
C) "Continue CPR until we see if a shock is advised."
D) "Stop CPR but continue to check for a pulse."

Question 35

Which one of the following unresponsive patients would the EMT recognize as in cardiac arrest?

A) Female who has an occasional gasp for a breath but no palpable carotid pulse
B) Male patient with a heart rate of 16 beats per minute and agonal respirations
C) Female who is not breathing and has a heart rate of 24 beats per minute
D) Male with an absent radial pulse but breathing 20 times a minute

Question 36

It is critical that the EMT never apply the AED to a person who is not in cardiac arrest because an accidental shock could:

A) cause the patient extreme pain.
B) cause the beating heart to go into cardiac arrest.
C) cause the patient to lose his eyesight.
D) produce full thickness burns and lead to a deadly infection.

Question 37

You have arrived at a residence for a 66-year-old female who is in cardiac arrest. In the living room, you find Emergency Medical Responders performing CPR on the patient. They quickly report that they found the patient in cardiac arrest and have been doing CPR for 5 minutes. Which one of the following statements should you make at this time?

A) "Let's stop CPR so I can check the airway, breathing, and circulation."
B) "Let's stop CPR so I can put the electrodes of the AED on her chest."
C) "Let's continue CPR for another 2 minutes, and then I will put the AED on."
D) "Let's continue CPR while I talk with the family to see if they want us to continue."

Question 38

A "No Shock Advised" message is provided by the AED. The EMT understands that this could mean:

A) the patient is in ventricular fibrillation.
B) the electrodes may be loose.
C) the patient has regained a pulse.
D) CPR is no longer needed.

Question 39

An unrestrained 37-year-old female is in cardiac arrest after striking a tree head-on at a high rate of speed. Assessment reveals her to have suffered massive blunt trauma to the chest and abdomen. The patient is quickly extricated from the vehicle and placed on a long board for immobilization. It is estimated that the patient has been in cardiac arrest for approximately 10 minutes, during which CPR was not performed. At this time, the EMT would:

A) withhold CPR and perform a focused trauma assessment.
B) perform CPR and contact medical command for permission to use the AED.
C) administer CPR for 2 minutes prior to applying the AED.
D) apply electrodes to the patient's chest and follow the AED's instructions.

Question 40

A 7-year-old boy choked on a grape at school. By the time the obstruction was removed, assessment revealed him to be in cardiac arrest. When you arrive, teachers are performing CPR. The school nurse informs you that CPR has been in progress for 6 minutes. You have an AED, but do not have a pediatric conversion device that reduces the energy of defibrillation from that of an adult to that of a child. Which one of the following should you do immediately?

A) Perform five abdominal thrusts and then 1 minute of CPR before using the AED.
B) Continue CPR and transfer the boy to the stretcher for immediate transport.
C) Place the electrodes on the boy's chest and follow the AED's prompts.
D) Instruct the teachers to continue CPR for 2 additional minutes before applying the AED.

Question 41

You have been called to a public pool for an unresponsive patient. On arrival you find lifeguards performing CPR with a pocket mask and oxygen on a 67-year-old male. They report that the patient was in the water and was seen clutching his chest seconds before going unresponsive. He was immediately pulled from the water and CPR was initiated. They estimate that CPR has been performed for 5 minutes. Assessment shows the man to be unresponsive, apneic, and pulseless. Which one of the following is your first response?

A) "Stop CPR and let's apply the AED."
B) "We need to quickly dry him from head to toe before applying the AED."
C) "Let's start ventilation with a bag-valve mask and oxygen."
D) "Let's take a towel and dry off his chest."

Question 42

The EMT realizes that the best means of preventing failure of the AED is to:

A) always make sure that the AED is kept clean and free of damage.
B) check the AED and its supplies at the beginning of each shift.
C) check the electrodes monthly and replace when expired.
D) obtain a second set of batteries when the original set is no longer functional.

Question 43

An EMT has just received a "Shock Advised" message from the AED. Just before delivering the shock, the EMT must:

A) press the analyze button once more.
B) hold the patient's head to avoid injury when shocking.
C) ensure that all rescuers are clear of the patient.
D) remove the oral airway to prevent possible choking.

Question 44

You have been assigned to a football game to provide standby coverage. While taking a break, you decide to walk to a nearby concession stand for a soft drink. On the way, you come across a group of people standing around a male patient who collapsed and is on the ground. Your assessment reveals him to be unresponsive, not breathing, and pulseless. A bystander states that the patient collapsed less than a minute earlier. An AED is located less than a minute from your location. The nearest EMT is 5 minutes from your location. Which one of the following should you do immediately?

A) Start CPR and wait for the AED.
B) Run to retrieve the nearby AED.
C) Call for assistance and start CPR.
D) Take manual in-line spinal stabilization.

Question 45

The owner of a day care center for adults with Alzheimer's disease calls you to ask about an AED at her facility. Specifically, she asks if she will need a physician to oversee the AED program. Your reply should be:

A) "If you intend to use the AED on anyone under the age of 50 years, a medical director will be needed."
B) "A medical director is only needed if you are going to bill insurance companies for the provision of care; if you are not, a medical director is not needed."
C) "You will need to have a physician medical director since the AED can only be used with his or her permission under his or her license."
D) "If you get a semi-automated AED, you will need a physician medical director. Since fully automated AEDs are easier to use, a medical director is not needed."

Question 46

The EMT would recognize which of the following as the most probable case of cardiogenic shock?

A) Myocardial infarction
B) Severe vomiting and diarrhea
C) Gastrointestinal bleed
D) Systemic infection

Question 47

A patient with a severe gastrointestinal bleed is in shock. Which of the following would best correct the patient's underlying problem?

A) Intravenous fluids
B) Blood replacement
C) High-concentration oxygen
D) Replace lost electrolytes

Question 48

After two cardiac arrests, a large home improvement center has purchased a fully automated AED. You have been asked to provide education on its use. During an instructional session, a student asks you what will happen when the AED indicates that a shock is indicated. Your response should be:

A) "The AED will prompt you to recheck the pulse."
B) "You will need to reanalyze the heart rhythm."
C) "The AED will automatically shock the patient."
D) "You will need to press the shock button."

Question 49

You are transporting a patient in cardiac arrest. The AED is being used and a shock has been advised. Prior to administering the shock, what should you do?

A) Ensure that no rescuer is touching the stretcher.
B) Move the patient from the metal stretcher to a nonmetal surface.
C) Withhold all shocks because metal will conduct the shock into the ambulance.
D) Stop the ambulance and have all rescuers exit prior to shocking with the AED.

Question 50

Your cardiac arrest patient has regained a pulse after two shocks. Which of the following actions would be appropriate?

A) Transporting the patient supine and secured to a back board
B) Removing the AED once it is determined that a pulse has returned
C) Reanalyzing the patient's heart rhythm with the AED every 5 minutes
D) Canceling the ALS assistance and proceeding directly to the hospital

Question 51

You are transporting an unresponsive 31-year-old female patient who suffered cardiac arrest. On scene Emergency Medical Responders (EMRs) shocked her once with the AED and she regained a pulse. She remains unresponsive and is breathing shallowly. Ventilations are being provided with a bag-valve mask. An EMR has agreed to ride to the hospital with you to provide assistance in caring for the patient. Which one of the following instructions given to the EMR is most appropriate?

A) "Place her in the semi-Fowler's position so her airway is clear if she vomits."
B) "Leave the AED on her, even though she is breathing and has a pulse."
C) "Please check her breathing and pulse every 5 minutes."
D) "Place her on a nonrebreather with 15 liters per minute of oxygen."

Question 52

Your ambulance service director has given you the go ahead to replace an old AED with a new AED produced by a different manufacturer. Before making the purchase, you must receive authorization to do so by the:

A) shift supervisor.
B) old manufacturer.
C) American Heart Association.
D) AED medical director.

Question 53

You have applied the AED's electrodes to an obese male patient in cardiac arrest. When you press the analyze button, the AED gives you a "check electrode" message. In looking at the patient, which one of the following would most likely be responsible for this message?

A) Obese chest and abdomen
B) History of asthma
C) Hairy chest
D) AED pads placed too far to the left

Question 54

A patient in early shock informs the EMT that that he has had severe diarrhea and vomiting over the past four days. Given this history, the EMT should recognize the pathophysiology of the shock as:

A) loss of red blood cells.
B) decreased formed elements in the blood.
C) leakage of the capillaries.
D) loss of plasma volume.

Question 55

Which one of the following activities related to the use of an AED would a medical director carry out?

A) Overseeing repairs to AEDs that are in need of service or repair
B) Responding to calls in which the EMT is using the AED
C) Obtaining funding for supplies like batteries, razors, and electrodes
D) Reviewing cases in which an AED was used but no shock was advised

Question 56

A 51-year-old male who suffered cardiac arrest has regained a pulse after one shock from the AED. The dispatcher informs you that the paramedic unit you have requested for assistance is coming from the eastern end of the county and has a 20-minute ETA. The hospital is 15 minutes west of your location. Which one of the following would be most appropriate?

A) Load the patient and meet the paramedic unit at a halfway point.
B) Wait on scene for the paramedic unit to arrive.
C) Load the patient in the ambulance and wait on scene for the paramedic unit.
D) Start transport to the hospital and inform ALS of your intent.

Question 57

The EMT understands that when paramedics administer IV fluids as treatment for hemorrhagic shock, the fluids will:

A) stabilize the shock by restoring needed electrolytes.
B) enable the lungs to better oxygenate the blood.
C) do nothing to get more oxygen to the cells.
D) reverse the shock by increasing the blood pressure.

Question 58

You are instructing a first-aid class at a local chemical plant. The course includes instruction regarding an AED that is to be placed in the plant. What point would you emphasize about the most common cause of AED failure?

A) "The batteries must be checked regularly."
B) "An extra set of electrodes should be kept in the AED."
C) "The AED should be kept clean and undamaged."
D) "Always check the electrode wires for cracks."

Question 59

Which one of the following actions performed by the EMT indicates appropriate care with the AED when treating a patient in cardiac arrest?

A) He places the AED pads two inches away from a transdermal medication patch on the patient's chest.
B) He intentionally withholds a shock on a patient in cardiac arrest who has an implantable defibrillator.
C) He places, then quickly removes, a set of electrodes in an attempt to remove hair from a patient's chest.
D) He applies one electrode over the top of the power source for a pacemaker located on the patient's chest.

Question 60

You are transporting a 57-year-old male who went into cardiac arrest at home. After two shocks and CPR, he regained a pulse, but remains unresponsive and in respiratory arrest. During transport, your reassessment reveals the absence of a carotid pulse. Which one of the following should you do first?

A) Reapply the AED and analyze the heart rhythm.
B) Provide five cycles of CPR prior to using the AED.
C) Start CPR and continue emergency transport.
D) Stop the ambulance and analyze the heart rhythm with the AED.

Question 61

Which one of the following statements made by a patient's family member would cause the EMT to suspect that a patient is suffering from hypovolemic shock?

A) "He has had a rash for the past three days."
B) "He cannot stop throwing up."
C) "He has been taking an antibiotic for a chest cold."
D) "He got up this morning and was having a hard time breathing."

Question 62

The EMT knows that the cause underlying distributive shock is:

A) poor fluid intake.
B) loss of blood volume.
C) damaged heart with poor contractility.
D) dilation of the blood vessels.

Question 63

Which of the following patient remarks best reinforces your suspicion that he is in the early stages of hypovolemic shock?

A) "I have had diarrhea for the past four days."
B) "I fell last night and think I hurt my belly; see the bruise?"
C) "I must have fallen and hit my head. I am very confused and restless."
D) "I have been coughing up green mucus and feel weak."

Question 64

A 28-year-old male was cutting limbs from a tree when he lost his footing and fell approximately 20 feet. He is unresponsive and breathing shallowly at 28 times per minute. His radial pulse is weak and thready, and his skin is cool to the touch. Emergency Medical Responders (EMRs) have placed him on a nonrebreather face mask and are holding manual in-line cervical spine stabilization. His respirations are snoring. Based on these assessment findings, which one of the following instructions would you provide to the EMRs?

A) "He has snoring respirations, so let's go ahead and open the airway with the head-tilt, chin-lift."
B) "Do not cover him with a blanket because that will cause his blood vessels to dilate and drop his BP."
C) "Let's go ahead and elevate his legs 8 to 12 inches so more blood gets to his vital organs."
D) "Let's take off the oxygen mask and start positive pressure ventilation to assist his breathing."

Question 65

You believe that a young male patient, who has been shot in the lower abdomen, is bleeding internally and is in the early stage of shock. Which item indicates the appropriate prehospital care of this patient?

A) Semi-Fowler's position and direct pressure over the injury site
B) "Shock" position and administration of water by mouth
C) Oxygen therapy and rapid transport to the hospital
D) Oxygen therapy and warm packs to the abdomen

Question 66

A patient in shock with abdominal pain indicates he noticed a lot of blood in the toilet after having a bowel movement this morning. The EMT should suspect what type of shock?

A) Septic hypovolemic
B) Hemorrhagic hypovolemic
C) Hypoxic hypovolemic
D) Nonhemorrhagic hypovolemic

Question 67

A driver was ejected from his vehicle in a rollover-type collision. Assessment findings reveal the patient to be unresponsive with bruising to the abdominal and pelvic areas along with an open femur fracture. The patient has an open airway and is breathing 32 times per minute. His skin is cool and clammy and the radial pulses weak. Manual in-line spinal stabilization is being maintained. The EMT's next intervention would be to:

A) obtain a blood pressure.
B) assist respirations.
C) examine the fracture site.
D) apply a cervical collar.

Question 68

A patient has fallen down a flight of stairs and is restless and confused. The airway is open, and he is adequately breathing 22 times per minute. He has a radial pulse of 92 beats per minute and is moderate in strength. Emergency Medical Responders are maintaining manual in-line spinal stabilization. Your next action would be to:

A) check the blood pressure and assess for injuries causing blood loss.
B) apply oxygen at 15 liters per minute via nonrebreather face mask.
C) insert an oral airway and start positive pressure ventilation with oxygen.
D) immobilize the patient with a cervical collar and long spine board.

Question 69

A confused and anxious patient fell 20 feet from a ladder. What sign suggests that the patient is in shock?

A) Heart rate of 110
B) Deformity to the left arm
C) Contusion to his head
D) Constricted pupils

Question 70

You are treating a patient with severe chest pain and believe she is in cardiogenic shock. As such, which of the following is most appropriate?

A) Supplemental oxygen
B) Application of the AED
C) Administration of nitroglycerin
D) Rapid transport with the patient supine

Question 71

As you approach a patient, you observe a 1-inch circle of dark blood on his shirt. He appears confused, pale, and diaphoretic. Which one of the following should you do first?

A) Apply oxygen.
B) Cut his shirt.
C) Assess his airway.
D) Treat for shock.

Question 72

A 66-year-old female patient has been struck by a car. Your assessment reveals gurgling respirations, rapid breathing, and cool, diaphoretic skin. You also note bruising to her chest and abdomen. Which one of the following should you do immediately?

A) Determine the blood pressure.
B) Administer high-concentration oxygen.
C) Evaluate for shock.
D) Suction the airway.

Question 73

While cleaning a gun, a 44-year-old patient accidentally shot himself in the abdomen. On arrival, you observe the patient on the floor lying on his side with his legs drawn to his chest. Blood is evident on his shirt and pants. Which one of the following indicates the correct sequence of events when caring for this patient?

A) Perform primary and secondary assessments, move to the stretcher for immediate transport, start positive pressure ventilation en route to the hospital
B) Perform the primary assessment, administer high-concentration oxygen, perform a rapid secondary assessment, transfer to the stretcher, rapid transport
C) Transfer to the ambulance, rapid transport, primary assessment and oxygen therapy performed en route to the hospital
D) Transfer to the ambulance, perform the primary assessment and rapid secondary assessment, provide oxygen therapy, rapid transport

Question 74

Which one of the following conditions could be responsible for causing obstructive shock?

A) Infection throughout the body
B) Loss of blood in the urine
C) Blood clots in the lungs
D) Poor transfer of oxygen at the capillary level

Question 75

When a person is in shock, what is occurring in the body?

A) The cells are getting glucose and other nutrients, but not oxygen.
B) The amount of oxygen to the cells is adequate, but CO₂ is not being eliminated.
C) The blood has an adequate amount of oxygen, but not enough nutrients for cell survival.
D) The cells are not getting enough oxygen and waste products are accumulating.

Question 76

You are assessing an elderly patient with a decreased level of consciousness. Your assessment reveals the patient to have a patent airway, labored respirations, and weak, rapid pulses. The skin is pale, cool, and cyanotic in the extremities. You also observe diaphoresis and a delayed capillary refill. Vital signs for this patient are: HR 136 bpm, BP 66/40 mmHg, and respirations 40 and shallow. Auscultation of the lungs reveals profound rales located throughout each lung. His temperature is 99∘F and there is obvious JVD and pedal edema. Additionally, family states that the patient has an extensive cardiac and diabetic history. Based on this information you should suspect what kind of shock?

A) Cardiogenic
B) Hypovolemic
C) Hypotensive
D) Distributive

Question 77

The major categories of shock include:

A) hemorrhagic, distributive, hypoxic, and obstructive.
B) burn, hypovolemic, distributive, and hypoxic.
C) hypoglycemic, obstructive, distributive, and hypovolemic.
D) hypovolemic, cardiogenic, obstructive, and distributive.

Question 78

When performing the primary assessment, what sign or symptom best indicates that the patient is in hypovolemic shock?

A) Skin that is cool and diaphoretic
B) Radial pulse of 72 beats per minute
C) Crackles heard in both lungs
D) Constricted pupils

Question 79

You suspect that a patient involved in a motor vehicle collision is in shock. What sign or symptom of shock would you expect to see last?

A) Tachycardia
B) Increased respirations
C) Decreased blood pressure
D) Pale and diaphoretic skin

Question 80

Which one of the following statements best indicates an understanding of the prehospital role in caring for the patient in shock?

A) "The job of the EMT is to recognize that a person is in shock and get him or her to the hospital so treatment can be started."
B) "Because shock is a life-threatening condition, it is important that the EMT identify the exact cause so the proper care can be given."
C) "If shock is in the compensatory or early stage, it is not yet life-threatening and the EMT can take his time in assessing and treating the patient."
D) "Since shock is best treated in the hospital, the EMT should provide care to maintain perfusion to the vital organs and transport."