Quiz 5: Gynecology

The paramedic accurately describes the difference between endometritis and endometriosis when she states: A) "Endometriosis is an infection of the uterine lining, while endometritis occurs when endometrial tissue is found outside the uterus." B) "Endometriosis occurs in women under age 40, while endometriosis is more common in women who are older." C) "Endometritis is an infection of the uterine lining, while endometriosis occurs when endometrial tissue is found outside the uterus." D) "Endometritis patients can be transported code 2, while those with endometriosis should always go code 3."

Your patient tells you that she is being treated for cystitis. You recognize that she is being treated for: A) ovarian cysts. B) pelvic inflammatory disease. C) a urinary tract infection. D) an ectopic pregnancy.

Which of the following is TRUE of mittelschmerz? A) It is typically located unilaterally in one of the upper abdominal quadrants. B) It is usually accompanied by heavy vaginal bleeding. C) It is associated with ovulation. D) It is a sign of ectopic pregnancy.

Menorrhagia is: A) irregular cycles of menstruation. B) painful menstruation. C) absence of menstruation. D) excessive menstrual flow.

Mittelschmerz refers to which of the following? A) Purulent vaginal discharge B) False labor pains C) Midcycle abdominal pain D) Painful urination

Which of the following occurs during the proliferative phase of the menstrual cycle? A) Ovulation B) An increase in uterine vascularity C) Endometrial thickening D) A drop in estrogen levels

The innermost lining of the uterus is called the: A) myometrium. B) perimetrium. C) endometrium D) vasometrium.

A 22-year-old woman presents in moderate distress, complaining of diffuse lower abdominal pain. She states that the pain has become progressively worse for the past two weeks and she is now unable to walk without an increase in pain. Your physical exam reveals severe pain with palpation of the lower abdomen and the following vital signs: heart rate 102, blood pressure 118/74 mmHg, and respirations 20. Which of the following statements made by the patient would most indicate the presence of pelvic inflammatory disease? A) "My boyfriend was just diagnosed with chlamydia." B) "I just had an IUD inserted." C) "My last menstrual cycle was normal." D) "I have chronic urinary tract infections."

A 20-year-old sexually active woman presents with severe right-side abdominal pain that radiates to her back. She states that the pain came on sharply during intercourse about 15 minutes earlier, and she reports a small amount of vaginal bleeding. She states that her menstrual cycles have been irregular for the past 3 months. The most likely clinical diagnosis would be: A) ruptured ectopic pregnancy. B) ruptured ovarian cyst. C) spontaneous abortion. D) pelvic inflammatory disease.

A 33-year-old woman presents with a low-grade fever and abdominal pain. She reports that she noticed blood in her urine this morning. Which of the following questions would be most helpful when trying to identify the underlying cause of this patient's symptoms? A) "Have you noticed any foul-smelling discharge?" B) "Do you have any pain or burning with urination?" C) "Do you take birth control?" D) "Have you vomited today?"

A 19-year-old woman presents with severe lower abdominal pain, an oral temperature of 102.4°F, and skin that is pale and sweaty. She reports that she had an elective abortion 72 hours earlier and has had bloody vaginal discharge ever since. Appropriate treatment for this patient would include which of the following? A) IV fluids, oxygen, and transport B) Position of comfort, pain medication, and delayed transport C) Detailed secondary exam and 12-lead ECG D) Knee-chest position and rapid transport

A 22-year-old woman presents with severe abdominal pain and signs of shock. When asked whether she is pregnant, she states, "There's no way I'm pregnant, I have an IUD." Which of the following is the most likely cause of her signs and symptoms? A) Endometriosis B) Pelvis inflammatory disease C) Miscarriage D) Ectopic pregnancy

All of the following are associated with spontaneous abortion EXCEPT: A) nontraumatic vaginal bleeding. B) the passage of clots and tissue. C) hypotension and fever. D) cramping abdominal pain.

Your patient is a 42-year-old woman who is alert and upset, complaining of vaginal bleeding. She states that the bleeding began ten hours ago and is heavier than her normal menstrual flow. Her last menstrual period was three months ago, G3P3, and there is no other significant gynecologic history. Which of the following is the most likely cause of her signs and symptoms? A) Ectopic pregnancy B) Pelvic inflammatory disease C) Menopause-related dysfunctional uterine bleeding D) Spontaneous abortion

A 34-year-old woman presents with complaints of vaginal bleeding and pain during intercourse. Her last menstrual period was two weeks ago and was reportedly heavier than normal. She reports that she had saturated two menstrual pads in the past two hours. You should: A) assess vital signs and transport. B) apply oxygen and start a large-bore IV. C) advise her to insert a tampon to control the bleeding. D) ask her if she has a family history of uterine cancer.

A 16-year-old female patient presents with complaints of abdominal pain and dizziness. She is pale and clammy, and reluctant to answer your questions regarding her sexual activity. Vital signs are: blood pressure 92/62 mmHg, heart rate 102, and respirations 20. You should: A) make it clear that she must be honest about her sexual history. B) start a large-bore IV and transport emergently. C) ask the mother if the patient might be pregnant. D) transport in a position of comfort.

Your patient is a 35-year-old woman who is complaining of severe abdominal pain in both lower quadrants. She states that she had a tubal ligation two years ago. Which of the following questions is appropriate to ask during your care of this patient? A) "Have you ever had a sexually transmitted disease?" B) "Do you have more than one sexual partner?" C) "Have you ever had pelvic inflammatory disease (PID)?" D) "When was your last menstrual period?"

Risk factors for ectopic pregnancy include all of the following EXCEPT: A) use of an intrauterine device for birth control. B) pelvic inflammatory disease. C) previous ectopic pregnancies. D) IV drug usage.

You are called to the scene of a sexual assault. The patient is a 17-year-old female who is crying inconsolably and withdraws when you attempt to touch her. Which of the following is the most appropriate response? A) Explain to the patient that she must allow you to examine her for injuries. B) Ask the patient to describe how she was assaulted so you know where she is injured. C) Tell the patient that you cannot help her if she won't allow you to touch her. D) Explain to the patient that you will not touch her if she does not want you too.

A 35-year-old woman has been raped. She states repeatedly that she wants to change her clothes before going to the hospital, and becomes hysterical when you advise her that she should remain dressed to preserve evidence. You should: A) allow her to change and carefully bag each item of clothing. B) refuse to let her change her clothing, as it will destroy evidence. C) allow her to change only her shirt, not her pants or undergarments. D) promise to let her change as soon as you get to the hospital.

Which of the following is NOT an appropriate adaptation to make in the assessment and care of a sexual assault victim? A) Allow a friend to accompany the victim in the back of the ambulance. B) Ask simple, closed-ended questions about the nature of the assault. C) Keep the back of the ambulance well lit and warm. D) Do not touch the patient unless it is necessary to obtain vital signs or examine injuries.

A 35-year-old woman presents with abdominal pain that she describes as "cramping and dull." She reports having multiple sexual partners in the past six months, and states that she has an IUD. Vital signs are: blood pressure 118/76 mmHg, heart rate 88, and respirations 18. Appropriate care of this patient includes: A) cardiac monitoring and transport. B) examining the genitalia for hemorrhage. C) elevating the legs during transport. D) position of comfort and routine ALS care.

A 22-year-old woman presents with left-sided lower abdominal pain. She reports that her last menstrual cycle ended approximately 10 days ago. Her blood pressure is normal and she rates the pain as 6 on a scale of 10. You should: A) palpate the abdomen. B) administer oxygen. C) withhold pain medication. D) look for vaginal bleeding.

Your patient is an 18-year-old woman who is alert and in moderate distress, complaining of abdominal pain and light-headedness. She describes a four-week history of worsening unilateral lower quadrant abdominal pain with onset of malaise, nausea, and vomiting this week. Today, she is experiencing faintness and near-syncope with exertion. She denies pain or difficulty with urination. Her last menstrual period was two weeks ago. She is sexually active and uses oral contraceptives. Physical examination reveals marked tenderness and guarding with palpation of her abdomen. Her skin is cool and diaphoretic. Her vital signs are: heart rate 121, blood pressure 90/58 mmHg, respirations 18. The patient's presentation is most consistent with: A) ectopic pregnancy. B) pelvic inflammatory disease. C) spontaneous abortion. D) pyelonephritis.

A 30-year-old woman presents with a fever of 103.5°F, pale skin, and an altered mental status. She cries out and withdraws when you palpate her abdomen. Her husband reports that she had a cervical biopsy three days earlier, and has be "feeling sick" ever since. Vital signs are: blood pressure 88/60 mmHg, heart rate 110, and respirations 22. You suspect: A) sepsis secondary to endometritis. B) hypovolemia secondary to miscarriage. C) infection of fibroid tumors. D) shock due to pelvic inflammatory disease.

A 26-year-old woman is complaining of severe abdominal pain and heavy vaginal bleeding. She has used five sanitary napkins in the past hour. Her last menstrual period was six weeks ago, and she describes a history of irregular periods, but never to this extent. Management of this patient should include: A) IV dextrose. B) oral antiemetic. C) IM epinephrine. D) IV fluids.

Your patient is a 44-year-old woman who is alert and in mild distress. She states that she had an acute onset of sharp, right lower quadrant abdominal pain last evening while having intercourse and that the pain has not subsided. Physical examination reveals tenderness with palpation to the lower right abdominal quadrant. Vital signs are: heart rate 98, respirations 16, blood pressure 116/78 mmHg. She reports she had a tubal ligation ten years ago and that she has several small fibroid tumors. Which of the following is the most likely diagnosis for this patient? A) Ectopic pregnancy B) Pelvic inflammatory disease C) Mittelschmerz D) Ruptured ovarian cyst

Your patient is a transgender man complaining of severe lower abdominal pain. He states that he is in the process of transitioning from female to male, and that he takes hormone supplements. When evaluating this patient, which of the following questions is most appropriate? A) "Are you planning to have gender reassignment surgery?" B) "When was your last menstrual cycle?" C) "How often do you use illegal drugs?" D) "Are you usually sexually active with men, or with women?"

A 27-year-old woman reports significant vaginal bleeding. She states that she is 11 weeks pregnant and awoke this morning to heavy bleeding including the passage of clots. She is crying and very upset, stating, "I can't lose this baby-I can't live with that." When caring for this patient, you should: A) ask her if she has ever had a miscarriage. B) perform a vaginal exam to determine if she is still bleeding. C) transport the patient in a position of comfort and provide emotional support. D) inform the patient's husband that she may be having a miscarriage.

A 30-year-old woman has right-sided abdominal pain and is hypotensive. You suspect she may have a ruptured ectopic pregnancy. You recognize: A) life-threatening hemorrhagic shock and the need for fluid resuscitation. B) potentially dangerous obstructive shock that requires rapid transport. C) a common medical condition that affects many women each year. D) a very rare disease process that requires immediate surgery to save the pregnancy.

Which of the following is NOT an appropriate way to control vaginal bleeding in the prehospital setting? A) Placing sterile gauze over the opening of the vagina B) Using a tampon C) Using a sanitary napkin D) Placing an absorbent pad under the patient

Your patient is a 36-year-old woman who is alert and complaining of abdominal pain. She states that she is having her period and that this pain is "much different than the cramps I usually get." She describes the pain as achy throughout her pelvis and lower abdomen. She says that this has occurred the past three menstrual cycles and that she has experienced dyspareunia and spotting over the same period. She is G2P2 and has no other significant gynecologic history. Physical examination reveals pain with palpation over her entire abdomen; her skin is warm and dry. Vital signs are: heart rate 84, blood pressure 124/76 mmHg, respiration 12, SpO₂ = 99%. Which of the following is the most likely diagnosis for this patient? A) Uterine fibroids B) Endometriosis C) Primary dysmenorrhea D) Polycystic ovary disease

Just before an infant is delivered, the fetal scalp can be seen at the vaginal opening during each contraction. This is referred to as: A) effacement. B) crowning. C) dilation. D) presentation.

The blood-rich structure that serves as a lifeline for the developing fetus is called the: A) uterus. B) cervix. C) placenta. D) amniotic sac.

The medically appropriate term for the projected birth date of a baby is: A) probable date of delivery. B) expected date of labor. C) predicted delivery date. D) estimated date of confinement.

The term "puerperium" refers to: A) the delivery of the afterbirth. B) a specific fertility treatment. C) the time surrounding delivery. D) a technique used to delay contractions.

You are caring for a woman who is 32 weeks pregnant. While assessing her breathing, you notice that her rib cage expands visibly with each breath and that her tidal volume appears to be deep. You recognize: A) signs of a severe respiratory condition requiring immediate intervention. B) an increase in tidal volume that is normal during pregnancy. C) signs of obstructive shock. D) an increase in oxygen demand due to an obstetrical emergency.

A 27-year-old pregnant woman was the restrained driver of a vehicle that hit the guardrail at a high rate of speed. She sustained a large laceration to the upper thigh and has lost a significant amount of blood. Vital signs are: heart rate 102, blood pressure 118/78 mmHg, respirations 18, and her skin is pale and clammy. Which of the following BEST explains this patient's presentation? A) Maternal blood volume increases during pregnancy, allowing vital signs to remain normal despite significant blood loss. B) Fetal oxygen demand increases after trauma, causing maternal blood pressure and heart rate to increase immediately after injury. C) Maternal blood volume decreases during pregnancy, amplifying the effects of epinephrine and allowing for the maintenance of blood pressure. D) Maternal vital signs remain normal following trauma to ensure the survival of the developing fetus.

A 30-year-old woman complains of swelling in both of her legs. She is 32 weeks pregnant, and states that she has also developed varicose veins over the past few weeks. Which of the following BEST explains the cause of this patient's signs and symptoms? A) The gravid uterus compresses the superior vena cava, decreasing venous return to the heart. B) Changes in the endocrine system cause peripheral edema during the late stages of pregnancy. C) The gravid uterus compresses the pelvic and femoral vessels, decreasing venous return and causing venous stasis. D) Changes in kidney function alter the normal electrolyte balance, causing tissue edema in the legs and feet.

During which period of development is the fetus most susceptible to damage from maternal exposure to toxins, such as alcohol and tobacco? A) 1-8 weeks B) 16-20 weeks C) 8-12 weeks D) 20-40 weeks

Which structure allows oxygenated maternal blood to bypass the uninflated lungs of the developing fetus? A) Ductus venosus B) Foramen ovale C) Umbilical artery D) Ductus arteriosus

A 38-year-old pregnant woman called 911 after she developed a "splitting headache" unrelieved by over-the-counter analgesics. She states that she has a previous diagnosis of diabetes that is typically well controlled with insulin injections. This patient's history of diabetes makes her more likely to develop which of the following pregnancy-related conditions? A) Preeclampsia B) Cerebral aneurysm C) Congestive heart failure D) Stroke

A 29-year-old woman is 28 weeks pregnant. She complains of nausea, abdominal pain, and right shoulder pain. She states she vomited once, which caused temporary relief; however, the pain returned shortly afterward. She has no pertinent medical history or allergies, has stable vital signs, and states that she ate a cheeseburger about 20 minutes prior to the start of her pain. The most likely cause of this patient's presentation is: A) food poisoning. B) cholecystitis. C) hyperemesis gravidarum. D) appendicitis.

You are caring for a 42-year-old woman who is 32 weeks pregnant with twins. She is complaining of a severe headache and blurred vision, and lives in a rural area approximately 30 miles from the nearest ED. Your physical exam reveals significant peripheral edema and the following vital signs: heart rate 98, blood pressure 156/98 mmHg, respirations 18. The patient states she has a history of hypertension, but has not taken her prescribed medications because "they aren't safe for the babies." Appropriate treatment for this patient includes: A) administration of nitroglycerine and delayed transport. B) intravenous calcium chloride and 12-lead ECG. C) administration of aspirin and a prehospital stroke assessment. D) intravenous magnesium sulfate and rapid transport.

A 24-year-old pregnant woman is actively seizing. Her partner reports that she complained of abdominal pain approximately 10 minutes ago, and then began seizing. He reports that the seizure activity has been consistent for the past 10 minutes, and that she has no significant medical history. You should: A) apply a nasal cannula, assess blood glucose level, and transport in the left lateral position. B) insert a nasal airway, administer midazolam, and obtain vital signs. C) apply high-flow oxygen, administer magnesium sulfate, and transport emergently. D) suction the airway, obtain IV access, and assess blood pressure.

A 25-year-old woman presents complaining of heavy vaginal bleeding accompanied by cramping abdominal pain and backache. She can't stop crying and reports that she is 11 weeks pregnant with her first child. Your physical exam reveals what appears to be the fetus and umbilical cord passing through the vaginal opening; however, the placenta has not been passed. Appropriate care for this patient includes: A) clamping and cutting the umbilical cord, wrapping fetal material in linen, and providing emotional support for the patient. B) leaving the fetus untouched and transporting the patient in a position of comfort. C) oxygen, 1000 mL fluid bolus, and rapid transport. D) disposing of the fetal material in a biohazard bag, left lateral position, and providing emotional support for the patient.

You are caring for a patient who is 36 weeks pregnant. She states that she has been experiencing vaginal bleeding after intercourse, and denies any associated pain. Vital signs are: heart rate 84, respirations 18, blood pressure 102/72 mmHg, and warm, dry skin. The most likely cause of this patient's vaginal bleeding is: A) spontaneous abortion. B) placenta previa. C) abruptio placentae. D) false labor.

A 37-year-old, obviously pregnant woman complains of sharp, tearing abdominal pain. She reports that she is pregnant with her fifth child, but states she cannot remember the exact due date. The patient has a history of drug use and states that she last smoked crack cocaine approximately 30 minutes ago. You suspect: A) spontaneous abortion. B) placenta previa. C) abruptio placentae. D) false labor.

A pregnant woman is complaining of a severe headache and "feeling ill." Her vital signs are: heart rate 92, blood pressure 120/82 mmHg, and respiratory rate of 16. Which of the following questions would be most helpful in identifying a possible pregnancy-related emergency? A) "Do you have a history of migraine headaches?" B) "Have you been experiencing morning sickness or excessive vomiting today?" C) "When was the last time you saw your doctor?" D) "What has been a typical blood pressure for you during this pregnancy?"

Which of the following techniques is an appropriate method of estimating the gestational age? A) Measuring the circumference of the woman's abdomen; each inch corresponds to one week of pregnancy. B) Palpate the abdomen and estimate gestational age based on the size of the developing fetus. C) Measure the height of the fundus; each centimeter corresponds to one week of pregnancy. D) Palpate the abdomen; if fetal movement is felt then the pregnancy is at least 14 weeks.

When assessing the vital signs of a pregnant patient, it is generally most appropriate to have the patient in which position? A) Supine B) Left lateral recumbent C) Semi-Fowler's D) Standing

You are caring for a 19-year-old woman who states that she is 32 weeks pregnant. She is experiencing cramping abdominal pain every six to seven minutes and reports a brief period of fluid discharge from her vagina approximately 15 minutes ago. You should: A) provide routine BLS care and transport. B) begin a fluid bolus and transport code 3. C) administer ondansetron and reassess vital signs. D) apply oxygen and perform a physical exam.

The second stage of labor begins: A) with the complete dilation of the cervix. B) at the onset of contractions. C) when the baby is delivered. D) at the rupture of membranes.

You are caring for a woman in labor. She has had three previous deliveries and states that her contractions are approximately 3 minutes apart. Physical exam reveals a bulging of tissue at the vaginal opening with each contraction; however, the baby's head is not yet visible. You should: A) encourage the mother to breathe and ready her for transport. B) prepare for imminent delivery. C) place the mother in the knee-chest position. D) perform an internal exam to see how much the cervix is dilated.

What is the appropriate sequence of care for a newborn following a normal delivery? A) Suction the nose, dry the infant, and cut the cord. B) Dry the infant, cut the cord, and place infant on mother's stomach. C) Suction the mouth, deliver the placenta, and cut the cord. D) Apply oxygen, dry the infant, and give the infant to the mother.

A newborn has just been delivered. He is centrally pink with pale extremities, has a heart rate of 110, and is actively crying and moving. The appropriate APGAR score for this infant is: A) 6. B) 7. C) 8. D) 9.

A newborn is listless and has a heart rate of 50 beats per minute after 30 seconds of stimulation. You should FIRST: A) initiate positive pressure ventilation. B) begin chest compressions. C) obtain IV access. D) apply the AED.

A 42-year-old woman is 38 weeks pregnant and in active labor. While assessing for crowning, you notice that although the top of the baby's head is visible, a loop of the umbilical cord is protruding from the vagina. You should: A) gently attempt to reinsert the cord into the vaginal canal. B) encourage the mother to push while gently pulling traction. C) clamp and cut the presenting section of the umbilical cord. D) insert two fingers to raise the head of the baby off the cord.

You are assisting a mother with an out-of-hospital delivery. After the head delivers, it immediately retracts back into the perineum. You should: A) transport in the knee-chest position. B) instruct the mother to drop her buttocks off the end of the bed. C) gently pull downward on the infant's head. D) instruct the mother to avoid pushing if possible.

During delivery, you notice a yellowish-green fluid on the baby's head and face. You recognize: A) a normal side effect of delivery. B) that emergency transport is required. C) a sign of fetal hypoxia. D) that the infant will require resuscitation.

You have just delivered a healthy newborn to a 35-year-old woman. There is a steady flow of blood from the vagina and her uterus feels soft upon palpation. Her vital signs are: heart rate 122, respirations 20, blood pressure 90/60 mmHg. Appropriate management of this patient includes: A) sanitary pads placed over the vagina and continued monitoring. B) two large-bore IVs and oxytocin administration. C) Trendelenberg position and administration of magnesium sulfate. D) low-flow oxygen and position of comfort.

A 32-year-old woman was the restrained passenger of a vehicle that hit a tree at a high rate of speed. She is 34 weeks pregnant and complains of excruciating abdominal pain. She is cool and diaphoretic and has a faint and rapid radial pulse. You suspect: A) traumatic onset of labor. B) uterine inversion. C) uterine rupture. D) premature rupture of membranes.

A woman late in her pregnancy is in cardiac arrest. When resuscitating this patient, it is appropriate to: A) compress at a rate of at least 120 per minute. B) use a mechanical compression device. C) lift and push the gravid uterus to the left. D) assess for imminent delivery.

You have just delivered an infant at 33 weeks gestation. The infant is blue and limp and has a brachial pulse of 70 beats per minute. What is the appropriate sequence of care for this infant? A) Keep warm and dry, chest compressions, clamp and cut the cord. B) Keep warm and dry, clamp and cut the cord, positive pressure ventilations. C) Clamp and cut the cord, positive pressure ventilations, keep warm and dry. D) Clamp and cut the cord, chest compressions, positive pressure ventilations.

A 21-year-old woman is complaining of abdominal pain. She says she is 25 weeks pregnant and has been actively trying to stop using methamphetamines, but slipped and used earlier today. Her abdominal pain comes every 8 to 10 minutes and is described as sharp and cramping. You suspect: A) hypertensive disorder of pregnancy. B) abruptio placentae. C) toxic shock syndrome. D) preterm labor.

When is the ideal time to assess a neonate for the APGAR score? A) 2 to 3 minutes after delivery B) 1 minute and 5 minutes after delivery C) 5 to 10 minutes after delivery D) 2 minutes and 10 minutes after delivery

In some cases, the spinal cord and associated structures of a newborn may be exposed. This abnormality is called a: A) Tetralogy of Fallot. B) meningomyelocele. C) omphalocele. D) choanal atresia.

Which of the following best describes Pierre Robin syndrome? A) A congenital condition characterized by a small jaw and large tongue in conjunction with a cleft palate B) A condition in which the ductus arteriosis fails to close completely C) Repeat febrile seizures within the first 6 months of life D) Persistent pneumonia following meconium aspiration

Which of the following is TRUE regarding vaginal delivery? A) Infants delivered vaginally are at greater risk of post-delivery complications. B) The compression of the infant's chest during vaginal delivery aids in the removal of fluid from the fetal lungs. C) Vaginal delivery stimulates the production of insulin in the newborn. D) The foramen ovale close more successfully in newborns delivered vaginally.

Factors that stimulate the newborn to take the first breath include all of the following EXCEPT: A) hypothermia. B) hypoxia. C) hyperglycemia. D) acidosis.

You are caring for a newborn who had prolonged respiratory distress and hypoxia following birth. You recognize that continued hypoxia and subsequent severe acidosis can cause: A) refractory hypotension. B) rapid development of fetal alveoli to compensate for hypoxia. C) persistent fetal circulation. D) the formation of congenital heart defects.

You have been called to the residence of a five-day-old infant. His parents are concerned because he sleeps about 18 hours a day. They took a rectal temperature and got a reading of 100°F. Which of the following is the best course of action? A) Administer a 10 mL/kg fluid bolus. B) Undress the infant to his diaper and sponge him with tepid water. C) Reassure the parents that the infant's sleep patterns and temperature are normal. D) Contact medical control to order acetaminophen.

You have just assisted in the delivery of a full-term infant in the back of the ambulance. Ten minutes after delivery, you obtain vital signs on the newborn and find the following: heart rate 120, respirations 54, and SpO₂ of 90%. You recognize: A) the need for immediate supplemental oxygen. B) appropriate vital signs for this infant. C) tachycardia and the possibility of shock. D) tachypnea and possible respiratory distress.

Which of the following is NOT an option for prehospital vascular access in the newborn? A) Cannulation of a peripheral vein in an extremity B) Intraosseous needle placed in the proximal tibia C) Femoral vein cannulation D) Umbilical vein cannulation

Which of the following is NOT a recommended method for assessing the heart rate of a newborn? A) Palpating the carotid pulse B) Palpate the umbilical pulse C) Auscultate heart sounds D) Palpate a femoral pulse

Which of the following statements is TRUE regarding the cardiac output of a neonate? A) Cardiac output doubles within the first few hours of life. B) The cardiac output of a neonate is strongly influenced by body temperature. C) Neonates do not readily alter their pulse rate; cardiac output depends mainly on stroke volume. D) Newborns have a fixed stroke volume; cardiac output depends mostly on heart rate.

A newborn has just been delivered. You notice a greenish-brown substance on the infant, and observe a vigorous cry and active movement. What is the appropriate way to manage this patient? A) Prepare to suction the trachea with an endotracheal tube and meconium aspirator. B) Using a bulb syringe, suction the nose and then the mouth. C) Rub the infant with a dry towel and place on the mother's chest. D) Lay the infant supine and place padding behind the shoulders.

At 90 seconds after birth, based on the following findings, which newborn does NOT require resuscitative efforts beyond routine care? A) HR = 100, RR = 30, peripheral cyanosis, APGAR = 8 B) HR = 158, RR = 40, central cyanosis, APGAR = 6 C) HR = 75, RR = 25, central cyanosis, APGAR = 5 D) HR = 98, RR = 27, peripheral cyanosis, APGAR = 6

You have just assisted in the delivery of a 34-week-gestation infant in the office of a methadone clinic. After 30 seconds of drying and stimulation, the infant remains limp and cyanotic, with a pulse of 50. Which of the following is the most appropriate action to take at this point? A) Begin CPR at a rate of 3 compressions to 1 ventilation. B) Intubate the trachea, ventilate, reassess, and prepare to transport to a NICU. C) Begin bag-valve-mask ventilations and establish intravenous access. D) Continue to warm and dry the infant for an additional 30 seconds, while preparing to intubate.

Immediately after delivery, a neonate is crying and moving his arms and legs, but is centrally cyanotic. You recognize: A) the need for supplemental oxygen. B) signs of a normal, healthy infant. C) the need to prevent further heat loss. D) signs of a congenital heart abnormality.

All of the following are accurate methods for obtaining the heart rate of a newborn EXCEPT: A) a pulse oximeter. B) 3-lead ECG. C) palpating a brachial pulse. D) auscultating heart tones.

You are resuscitating a 15-day-old infant who was found pulseless and apneic in her crib. Which of the following questions would be most helpful when obtaining a history from the parents? A) "Does your daughter have any congenital heart abnormalities?" B) "Was your baby sleeping face up?" C) "Is there a family history of heart disease?" D) "Have any of your other children died from SIDS?"

You are called to the home of a 72-hour-old infant whose mother is concerned because the infant has been "vomiting after she eats." Based on this information, which of the following should you include in your history and physical assessment? A) End-tidal CO₂ monitoring B) Auscultation of gastric sounds C) Asking if the baby could have ingested any toxins D) Assessing the fontanels

You have just assisted in the delivery of an approximately 4 kg newborn whose mother is a rather petite primapara. On assessment, you note that there is no spontaneous movement of the infant's right arm at the shoulder, but he moves the elbow and wrist. He otherwise exhibits vigorous movement and has a 1-minute APGAR score of 9. Which of the following should you suspect? A) Neonatal abstinence syndrome B) Spinal cord damage C) Fractured clavicle D) Caput succedaneum

You are assessing a 1-minute APGAR score on a patient who has peripheral cyanosis and a heart rate of 98, who cried spontaneously after delivery, is actively moving his extremities, and has a strong cry. What is the APGAR score of this patient? A) 9 B) 7 C) 8 D) 10

A newborn was found pulseless and apneic in his crib. After lengthy attempts at resuscitation, medical control has advised you to stop resuscitation. When you inform the parents, they become hysterical and the mother cries, "Give me my baby! I don't want you touching him!" You should: A) gently tell the mother that, unfortunately, she cannot hold the baby until the coroner arrives. B) hand the child to the mother and allow the parents time alone with the child. C) request that a law enforcement officer remain with the mother. D) move the infant to the ambulance and transport.

You are called to a residence to care for a 3-hour-old infant in respiratory distress. Your physical exam reveals retractions, grunting, and tachypnea, along with rhonchi and crackles in the lungs. The midwife reports that the amniotic fluid had "thin meconium." Which of the following is the most likely cause of this infant's signs and symptoms? A) Tetralogy of Fallot B) Cardiac compromise C) Persistent fetal circulation D) Meconium aspiration

You respond to an apartment for a "sick child." You arrive to find a 2-week-old infant in her mother's arms, wrapped in a thick blanket. The mother reports that the baby has been coughing, and suddenly "went stiff" 10 minutes ago. The infant is listless and not rousable. You should FIRST: A) unwrap the child and assess skin temperature. B) apply oxygen and assess blood glucose. C) obtain a blood pressure and medical history. D) package the infant in a car seat and transport emergently.

Which of the following is NOT a consequence of respiratory insufficiency in the newborn? A) Hypoxia B) Hyperglycemia C) Bradycardia D) Acidosis

A first-time mother has called 911 because her 5-day-old son is "acting sick." Your assessment reveals a lethargic infant with a patent airway, adequate respirations, and a pulse rate of 100 beats per minute. His skin is cold to the touch and mottled. The mother reports she was giving the child a bath just prior to calling EMS. You suspect: A) hypoxia. B) hyperglycemia. C) hypothermia. D) hypercarbia.

A 4-hour-old infant is inconsolable with a weak cry. His hands and feet are trembling. The mother reports a history of gestational diabetes and hypertension, and states she delivered at home without complication. Which of the following is the most likely cause of this infant's signs and symptoms? A) Type 1 diabetes mellitus B) Meconium aspiration C) Hypoglycemia D) Febrile seizures

Which of the following is the correct dosage of epinephrine in neonatal resuscitation? A) 0.1 to 0.3 mg/kg, 1:1,000 B) 0.01 to 0.03 mg/kg, 1:1,000 C) 0.01 to 0.03 mg/kg, 1:10,000 D) 1 to 3 mg/kg, 1:10,000

Which of the following statements is TRUE of prehospital newborn care? A) It is impossible to anticipate which deliveries may result in the need for newborn resuscitation. B) Newborns weighing over 2,500 grams are at higher risk of respiratory compromise. C) Sixty percent of newborns delivered outside a hospital require some form of resuscitation. D) Low-birth-weight babies are much more likely to require immediate assistance after delivery.

Which of the following statements BEST describes the relationship between primary and secondary apnea in newborns? A) Primary apnea is due to respiratory failure, whereas secondary apnea is due to cardiac arrhythmia. B) Primary apnea occurs only at birth, whereas secondary apnea occurs anytime during the first month of life. C) Secondary apnea results from primary apnea. D) Secondary apnea is a less serious condition and responds well to tactile stimulation and an oxygen-enriched atmosphere.

The appearance of your newborn patient leads you to suspect that he has Pierre Robin syndrome. Which of the following should be your most immediate concern? A) Upper airway obstruction B) Lower airway obstruction C) Compression of the lungs by the abdominal contents D) Shunting of blood through a patent foramen ovale

You suspect that a newborn has choanal atresia. Which of the following signs would lead you to this diagnosis? A) The infant develops cyanosis when crying. B) The baby cannot nurse and breathe at the same time. C) The baby has unequal brachial pulses. D) The infant has a persistently low SpO₂.

Which of the following conditions may result in persistent fetal circulation? A) Failure to cut the umbilical cord B) Down syndrome C) Hypoxia D) Overaggressive administration of blow-by oxygen

Which of the following are likely to occur when suctioning a newborn's airway? A) Hypoxia, tachycardia B) Hypoxia, bradycardia C) Hypoxia, ventricular fibrillation D) Vagal stimulation, tachycardia

Which of the following describes the appropriate administration of intravenous fluids in a newborn? A) Normal saline or lactated Ringer's solution 40 mL/kg using a pressure infuser B) Normal saline, 10 mL/kg, slow IV push C) 10 percent dextrose in water, 20 mL/kg, slow IV push D) 5 percent dextrose in 0.45 percent saline solution, 30 mL/kg

Which of the following BEST describes why hypoglycemia after delivery is common in infants born to mothers with gestational diabetes? A) The fetus develops compensatory insulin production in utero due to maternal hyperglycemia, which causes hypoglycemia after delivery. B) The genetic nature of diabetes mellitus makes infants born to mothers with gestational diabetes more likely to have diabetes themselves. C) The fetus is no longer receiving insulin via the umbilical cord, and therefore becomes hypoglycemic after birth. D) Gestational diabetes may cause fetal pancreatic abnormalities that cause hypoglycemia after birth.

Which of the following is the appropriate way to document a premature infant's gestational age? A) "Infant was born 3 weeks early." B) "Infant's gestational age is 4 weeks premature." C) "Infant was born 3 weeks prior to due date." D) "Infant was born at 33 weeks and 4 days gestation."

In which of the congenital anomalies of the heart does the ductus arteriosus fail to close? A) transposition of the great vessels B) patent ductus arteriosus C) ventricular septal defect D) tetralogy of Fallot

In which of the congenital anomalies of the heart is there a narrowing in the arch of the aorta, obstructing blood flow? A) coarctation of the aorta B) hypoplastic left heart syndrome C) aortic stenosis D) mitral stenosis

Funding for a significant amount of prehospital pediatric education comes largely from a program known as: A) Emergency Medical Pediatric Association. B) Emergency Medical Services for Children. C) Pediatric Advanced Medical Care. D) Pediatric Emergency Care Program.

Which of the following statements regarding prehospital care of pediatric patients is TRUE? A) Up to 85 percent of children treated by EMS need nothing more than basic life support skills. B) The majority of pediatric calls are for allergic reactions. C) More than 50 percent of pediatric patients require advanced life support. D) Most pediatric patients seen by EMS personnel are from low-income families.

Your patient is a 16-year-old female cheerleader who fell while attempting a pyramid formation and struck her forehead on the back of another girl's head. She has a 2-cm laceration just above her right eyebrow. She is tearful and asks you if you think she is going to have a scar. Which of the following is the best response? A) "It's a small cut. The emergency department will do everything they can to minimize scarring." B) "I really can't say. You should probably see a plastic surgeon." C) "A doctor can provide a prognosis when the cut has healed." D) "It's likely, but it's not something to get upset about."

Your patient is an eight-year-old girl. As you approach her, you note that she is holding her right arm against her body, cradling it with the left arm. To find out what happened, which of the following is the best approach? A) Ask the parents to tell you what happened while you examine the child. B) Sit next to the patient and ask her what happened. C) Take the parents aside and ask them what happened. D) Ask the parents to leave the room so you can talk to the patient.

Your patient is a five-year-old boy who appears to be dehydrated after having the flu. Which of the following is the best way to communicate with the patient regarding the need for obtaining IV access? A) Just before placing the IV, tell him you must put a needle in his arm. Tell him it will hurt, but only for a second. B) Tell him you are going to "start an IV in his arm" but that it won't hurt a big boy like him. C) Tell him you need to give him fluids to help him feel better and that it might hurt a little when you start the IV. D) Have a parent distract him while you place the IV.

At which of the following ages does the risk of foreign body airway obstruction become a significant concern in the normally developing infant? A) 3 months B) 18 months C) 1 month D) 6 months

You are in the home of a 28-month-old boy whose mother called EMS because he fell while running and struck his forehead on the corner of a table. The patient has a hematoma on his forehead but seems to have forgotten about the injury and is entertaining himself with some building blocks. Which of the following is the best way to begin assessing the child? A) To avoid upsetting him, observe him from a distance and make no physical contact with him. B) Make him feel comfortable by calling him by a nickname. C) Sit next to him and ask if you can play with some of his toys. D) Ask his mother to pick him up and hold him on her lap.

You are in the home of a 17-year-old female patient who is complaining of abdominal pain. Her mother and father are hovering near her and answering most of the questions you ask her. You sense that the patient is uncomfortable answering questions in front of her parents. Which of the following is the best way to handle this situation? A) Tell the patient you know she might be embarrassed but that it is imperative that she give you the whole story so you know what to do for her. B) Defer the history to the triage nurse at the emergency department so as not to cause undue discomfort to the patient. C) Ask the parents to go to the kitchen with your partner so he can get some information for your paperwork. D) Tell the parents the daughter probably doesn't want to talk about her problems in front of them.

Your patient is a conscious eight-month-old infant who has a severe airway obstruction as a result of choking on a slice of canned peach. Which of the following is your FIRST intervention? A) A portable suction device, using a rigid tonsil tip and no more than 100 mmHg of vacuum B) The use of a manually triggered, flow-restricted, oxygen-powered ventilation device C) Abdominal thrusts interspersed with attempts to ventilate D) An alternating series of back blows and chest thrusts

Your patient is a 9-month-old boy who was a restrained passenger in a motor vehicle collision. Prior to your arrival, his mother took him out of the seat and is now holding him. Which of the following is the best way to transport this patient? A) Place him back in the car seat and transport with the car seat on the gurney. B) Allow the mother to hold the child during transport. C) Secure the child to your gurney as you would an adult. D) Place the child on a long backboard with a folded towel under his shoulders, then place the backboard on the gurney.

Your patient is a 13 year-old male drowning victim. He was initially in cardiac arrest with a pulseless, wide-complex bradycardia. He is intubated and being ventilated with supplemental oxygen. After CPR and intubation, the patient is now in ventricular tachycardia with a weak radial pulse. Which of the following would be an appropriate treatment for this patient? A) Amiodarone, 5 mg/kg IV push B) Lidocaine, 3 mg/kg IV bolus, followed by a 3 mg/minute drip C) Procainamide, 20 mg per minute, up to 800 mg D) Synchronized cardioversion starting at 0.5-1.0 joules/kg

Which of the following is NOT an acceptable estimate of the correct size of endotracheal tube for a pediatric patient? A) The patient's age in years plus 16, divided by 4 B) The diameter of the little finger C) A length-based resuscitation tape D) Twice the width of the naris

Your patient is a seven-month-old boy whose mother called because he suddenly became lethargic and pale. Your assessment reveals that he is in a supraventricular tachycardia at a rate of 244 per minute. The patient's extremities are mottled and his capillary refill time is 4 seconds. Which of the following is the best treatment plan for this patient? A) Adenosine, 0.1 mg/kg rapid IV push, repeated at 0.2 mg/kg if unsuccessful B) Verapamil, 0.3 mg/kg over 3 to 5 minutes C) Diltiazem, 0.25 mg/kg over 2 minutes D) Synchronized cardioversion beginning at 0.5-1.0 joules/kg

Your patient is a four-year-old boy with a history of asthma. He ran out of his inhaled bronchodilator while visiting his grandparents' farm. The patient has pale, cool, moist skin with cyanosis of his nail beds. He has audible wheezing with a respiratory rate of 18, accessory muscle use, and a heart rate of 130. He appears fatigued, he is unable to speak more than one or two words at a time, and his head bobs with each breath. Which of the following best describes this patient's respiratory status? A) Because of decreased respiratory, cardiovascular, and stored energy reserves, the child's muscles have fatigued and he is now in respiratory failure. B) The child is in the early stages of his asthma attack, and is showing signs of respiratory distress. C) The patient is having some respiratory difficulty; however, a nebulizer treatment will likely correct all issues. D) The child's asthma was exacerbated by exercise and he is therefore tired. Rest will ease his respiratory distress.

As the pediatric patient progresses from respiratory distress to respiratory failure, which of the following occurs? A) Hyperactivity B) Increased arterial carbon dioxide tension C) Peripheral cyanosis D) Muscular rigidity

Which of the following is NOT a sign of respiratory distress in the pediatric patient? A) Grunting B) Tachypnea C) Tachycardia D) Central cyanosis

Which of the following affects the lower airway? A) Epiglottitis B) Pneumonia C) Croup D) Pharyngitis

Your patient is a toddler who was burned when he accidentally pulled the cord of a deep fryer sitting on a countertop and spilled hot oil on his head and back. He has burns to the back half of his head, as well as his entire back. What percentage of total body surface area does this account for? A) 36 percent B) 40 percent C) 27 percent D) 18 percent

Your 12-month-old patient has burns covering the full length of both lower extremities circumferentially. Which of the following is the most accurate estimate of the percentage of total body surface area involved? A) 20 percent B) 36 percent C) 14 percent D) 28 percent

Your patient is a nine-month-old infant in respiratory distress with grunting respirations of 50 per minute, nasal flaring, and intercostal retractions. He is pale, and you note scattered bilateral wheezing on auscultation of the lungs. The mother states that the child is healthy and up to date on all his immunizations. Which of the following conditions is most likely, based on this information? A) New-onset asthma B) Bacterial tracheitis C) Bronchiolitis due to respiratory syncytial virus D) Epiglottitis due to Haemophilus influenzae type B

Which of the following is TRUE of asthma in the pediatric patient? A) Bronchodilators are more effective in pediatric patients than in adults, and steroids are rarely indicated. B) Oxygen and nebulized beta agonists are indicated in the initial phase of an asthma attack. C) Bronchodilators are effective primarily when treating the second phase of an asthma attack. D) The primary therapeutic goal in the initial phase of an asthma attack is to rehydrate the patient and administer mucolytic and anti-inflammatory agents.

Which of the following is the most common result of blunt chest trauma in children? A) Anterior flail segment B) Intrathoracic injury without external bruising of the thorax C) Associated spinal cord injury D) Fractured ribs with a high incidence of hemothorax

Your 15-year-old male patient has a stab wound along the right sternal border at the fourth intercostal space. The patient responds to painful stimuli and shows little evidence of external bleeding. His respirations are 30, his breath sounds are clear and equal, and his radial pulse is weak and disappears on inspiration. The patient has distended jugular veins and is dyspneic. This patient is most likely suffering from ________ shock due to ________. A) obstructive; cardiac tamponade B) hypovolemic; hemothorax C) distributive; loss of sympathetic nervous tone D) hypoxic; tension pneumothorax

Which of the following conditions does NOT cause an upper airway obstruction? A) Epiglottitis B) Croup C) Bacterial tracheitis D) Asthma

Your patient is a 12-year-old boy who was accidentally shot with a handgun by a playmate. You note one gunshot wound to the right upper quadrant of the abdomen, but no exit wound. The patient is pale, with cool, mottled extremities. He is lethargic, has a heart rate of 140, a respiratory rate of 30, and a blood pressure of 92/60 mmHg. Which of the following can be said for certain about this patient? A) He is in compensated shock. B) He is in irreversible shock. C) He is in decompensated shock. D) It is not possible to say anything for certain about this patient.

All of the following are associated with an increased incidence of SIDS, EXCEPT: A) female infant. B) age between two and four months. C) low birth weight. D) fall and winter months.

Which of the following best explains the cause of sudden infant death syndrome (SIDS)? A) Congenital absence of the Hering-Breuer reflex B) SIDS, by definition, has no identifiable cause. C) Diffuse axonal injury occurring due to "shaken baby syndrome" D) Aspiration of vomited formula or breast milk

Your four-year-old female patient has injuries suspicious of abuse. Statistically, who is most likely the abuser? A) Her mother, who is a stay-at-home mom B) Her father, who works in a local steel mill C) Her seven-year-old brother, with whom she shares a bedroom D) Her teenaged aunt, who babysits her two evenings a week

Your patient is an 11-year-old male quadriplegic who depends on a phrenic nerve stimulator to stimulate contraction of his diaphragm and allow him to breathe. You are called to the home during a thunderstorm that has caused a power outage. Which of the following is the best course of action? A) Advise dispatch that you will be on the scene indefinitely and ask them to notify the power company that restoring power to this residence is a priority. B) Teach the patient's family members how to use the bag-valve-mask device and tell them to contact the department with questions or difficulties. C) Request a generator from the fire department tactical support division. D) Assist his breathing with a bag-valve-mask device, and transport.

What is NOT one of the objectives of JumpSTART? A) To optimize the primary triage of injured children in the MCI setting B) To reduce the emotional burden on triage personnel who may have to make rapid life-or-death decisions about the injured C) To allow responders to "think with their hearts" when treating the injured children D) To enhance the effectiveness of resource allocation of all MCI victims

You arrive at an MCI. You see a non-ambulatory child who has been evaluated using the JumpSTART algorithm with a yellow tag. What does this represent? A) Provide immediate attention to this patient. B) Move on and look at other patients; this patient does not have a significant external injury. C) The patient is dead. D) Delayed response; check to see if there are significant external signs of injury.

You are at the scene of a collision involving a school bus carrying elementary school age children. You are concerned that some of the children may have spinal injuries. Which of the following is TRUE of cervical spine injuries in children? A) They are more often due to penetrating trauma than in adults. B) The heavier head of the child increases the incidence of cervical distraction injuries. C) Pediatric patients do not require cervical spine immobilization, as their bodies will self-splint the injury. D) The pediatric cervical spine should be immobilized in a position of moderate hyperextension.

Your patient is a three-year-old girl who has had vomiting and diarrhea for 24 hours. Which of the following is the best way to gain her cooperation when assessing her vital signs? A) Avoid explanations, and finish the assessment quickly. B) Ask if you can check her doll to "see how the doll is feeling" before repeating the same procedures on the child. C) Say, "I'm going to take your blood pressure." D) Explain that you want to give her arm a hug.

Your patient is a five-year-old girl who awoke with a harsh cough, sore throat, drooling, and high fever. She has shallow respirations of 40 and inspiratory stridor. She is completely focused on breathing, leaning forward on her outstretched arms. Which of the following is the best course of action? A) Start an IV for administration of succinylcholine and midazolam for RSI, intubate the trachea, and ventilate at a rate of 24 to 28 per minute. B) Provide high-concentration oxygen by nonrebreather mask, start an IV, and repeat a full set of vital signs every 5 minutes en route to the emergency department. C) Inspect the hypopharynx for edema and be prepared for immediate surgical cricothyrotomy if airway obstruction is imminent. D) Provide blow-by oxygen, humidified if possible; transport without delay and avoid procedures that might upset her.

Your patient is a 14 month-old girl who has been taking an antibiotic for three days for an ear infection. Her parents have called EMS because the patient has not been eating or drinking, is irritable, has a fever, and generally appears very sick. Which of the following should you most highly suspect? A) Herpes zoster B) Bacterial meningitis C) Fifth disease D) An allergic reaction to the antibiotic

You have just arrived on the scene where an infant stopped breathing. You find a three-month-old child being held tightly by his mother, who is sobbing uncontrollably. On examination, you find that the child is apneic and pulseless and has dependent lividity and early rigor mortis. There are no obvious signs of injury. Which of the following is the best course of action? A) Begin limited resuscitative measures, then contact medical control for orders to terminate resuscitation in the field. B) Gently tell the mother that the baby is dead and that there is nothing that can be done for him; allow her to hold him. C) Tell the mother that the baby is dead but that you cannot allow her to hold him until the police verify that no crime has been committed. D) Begin CPR and continue BLS measures until you are inside the ambulance; notify the hospital that you are transporting a deceased SIDS infant.

Your patient is a seven-year-old girl with a history of bee-sting anaphylaxis. She was stung by a bee and nearly immediately began having difficulty swallowing and breathing. Her father administered her prescribed 0.15 mg epinephrine auto-injector without result. On your arrival, the patient responds to painful stimuli; has labored, rapid, wheezing respirations; a heart rate of 60; and a blood pressure of 92/60 mmHg. Which of the following is the best sequence of treatment for this patient? A) Administer only epinephrine 1:1,000 IM B) Administer only diphenhydramine IM C) Administer diphenhydramine IM and epinephrine 1:1,000 IV D) Administer both epinephrine 1:10,000 and diphenhydramine intravenously

Your 15-year-old male patient was kicked in the scrotum while playing with some friends. He is complaining of excruciating pain in his testicles. Which of the following guidelines applies to the examination of this patient? A) Make sure the procedure takes place in a medical office. B) Make sure another paramedic is present during the exam. C) Make sure a paramedic of the same sex performs the exam. D) Make sure a paramedic of the opposite sex performs the exam.

You have been called for a 1-week-old infant who is sick. Assessment reveals him to have a fever and rhonchi in the left lower lobe. Which of the following assessment findings would be most concerning to you, given the age of this patient? A) Respiratory rate of 33 breaths per minute B) Skin that is pink and warm C) Continual moaning and crying D) Nasal passages occluded by mucus

You are delayed getting to a residence where a 16-month-old boy is actively seizing. The mother reports that he has had a fever for the past two days. A firefighter on scene informs you that the child has been seizing since their arrival approximately 15 minutes ago. You should: A) apply oxygen, administer intranasal midazolam, and transport. B) apply oxygen, administer fluids, and transport. C) actively cool the child with ice packs to the groin and axilla. D) actively warm the child with blankets.

A woman has called 911 after not being able to wake her eight-year-old son. Upon arrival, the mother tells you that her son is a diabetic, and that his diabetic alert dog awoke her in the night indicating the child's blood sugar was low. You perform a blood glucose check and find that your glucometer reads 28 mg/dL. You should: A) administer IV dextrose at 30% concentration. B) administer 1 mg of IV glucagon. C) administer 1 mg of IM glucagon. D) administer IV dextrose at 25% concentration.

A 16-year-old girl has been complaining of abdominal pain, nausea, polyuria, and polydipsia for the past 4 days. She has no significant medical history. You suspect she may be suffering from: A) ovarian cysts. B) diabetic ketoacidosis. C) meningitis. D) ectopic pregnancy.

You are caring for a seven-year-old in ventricular fibrillation. The child weighs 19 kg. You have just delivered your first shock, and another paramedic reports that she has obtained IO access. You should direct the paramedic to administer what dose of epinephrine? A) 1.019 mg of 1:10,000 B) 1.9 mg of 1:1,000 C) 0.19 mg of 1:10,000 D) 0.019 mg of 1:1,000

A nine-year-old weighing 28 kg is in supraventricular tachycardia. Which of the following is the appropriate dose of adenosine for this patient? A) 0.28 mg B) 2.8 mg C) 0.75 mg D) 6 mg

Which of these is not a component of the airway examination in the primary assssment? A) Is the airway patent? B) Is the airway maintainable with head positioning, suctioning, or airway adjuncts? C) Is the airway not maintainable? D) Is the airway a likely cause of cardiac arrest?

Which of these is not a typical condition to evaluate in assessment of the child's circulation? A) Heart rate B) Peripheral circulation C) Blood oxygenation D) End-organ perfusion

Your 78-year-old patient gives a history of congestive heart failure, renal insufficiency, and type 2 diabetes. Together, these conditions are called: A) comorbid conditions. B) confounding conditions. C) functional impairments. D) polypathophysiology.

The study of the effects of aging and age-related diseases in human beings is called: A) dementiology. B) geriatrics. C) gerontology. D) senescence.

The term elderly applies to a person beginning at age: A) 70. B) 55. C) 80. D) 65.

Elderly people who live alone are more likely to be: A) male, under age 80. B) female, age 85 or older. C) female, under age 80. D) male, age 85 or older.

You have been asked to deliver a talk about the geriatric population. Which of the following points would you emphasize in your presentation? A) Assessment can be difficult because most persons older than 70 have some degree of dementia. B) Many of the elderly have a combination of different diseases in various stages. C) Geriatric patients actually comprise a smaller number of EMS calls and transports than generally thought. D) Dementia and chronic disease are both an inevitable part of the aging process.

Which of the following statements regarding EMS consideration of psychosocial issues in elderly patients is TRUE? A) Successful medical treatment of elderly patients involves an understanding of the broader social situation in which they live. B) Most elderly patients are lonely and isolated, and may not be able to care for themselves. C) Elderly patients usually have limited income, and are likely to be unable to afford expensive medication. D) It is unlikely that an elderly patient in a nursing facility will be as well cared for as one who lives at home.

Which of the following is an appropriate question to ask of an elderly patient who lives alone? A) "Are you sure you are capable of taking care of yourself?" B) "Isn't there anyone who could move in with you to help you?" C) "Is there someone you can call if you have trouble with your medications tonight?" D) "Don't you know living alone is dangerous at your age?"

While you are off-duty, a friend, who knows you are a paramedic, expresses concern about her elderly parents. She knows that their health needs are changing, but does not know what to do to help. Which of the following would NOT be an appropriate resource for her to use? A) AARP B) Department of Health and Human Services C) The local community senior center D) OSHA

Which of the following is NOT a factor in altered pharmacokinetics in the elderly? A) Decreased hepatic function B) Slowed drug absorption from the gastrointestinal tract C) Increased total body water D) Decreased renal function

An 84-year-old man complains of generalized weakness and an ache in his left shoulder. He also reports mild shortness of breath and has clear lung sounds and an SpO₂ of 96%. When asked, he claims that the discomfort started after getting out of bed two hours ago. He denies any known injury to his shoulder or back. He has a history of coronary artery disease, hypertension, TIA, and dementia. Your differential diagnosis for this patient should include: A) aortic dissection, pulmonary embolism, and myocardial infarction. B) myocardial infarction, stroke, and musculoskeletal trauma. C) trauma, pulmonary embolism, and pneumonia. D) COPD, stroke, and medication overdose.

A 97-year-old man became dizzy and fell onto the floor. You find him sitting on the floor with his wife next to him. His wife states that he did not lose consciousness and that this has happened several times over the past two days. Currently, the patient is alert and oriented and complaining of dizziness and a headache. He has a history of coronary artery disease, emphysema, and hypertension, and states that he saw his doctor two days ago. Which one of the following questions would be most helpful in identifying the cause of this patient's signs and symptoms? A) "Have you ever had a stroke?" B) "Did the doctor prescribe any new medications?" C) "When was the last time you ate or drank anything?" D) "Why didn't you call 911 when he fell before?"

You are called to a residence for an unresponsive patient. The patient, an 86-year-old man, has reportedly been depressed recently. An empty bottle of Inderal is next to the patient, who is bradycardic and hypotensive. To best care for this patient, you should: A) apply pacer pads and pace at a rate of 80 per minute. B) administer 1 mg of epinephrine 1:10,000. C) administer glucagon. D) apply pads and perform synchronized cardioversion.

A 78-year-old woman complains of dizziness, visual disturbances, fatigue, and loss of appetite. Which of the following medications would be most likely to cause these symptoms? A) Coumadin B) Enalapril C) Pradaxa D) Digitalis

Which of the following statements regarding pharmacokinetics and the aging process is TRUE? A) Aging causes the kidneys to filter out more waste products, enhancing the absorption of many medications. B) Functional changes in the kidneys, liver, and gastrointestinal system slow the absorption and elimination of many medications. C) Cardiac cells become more sensitive to medication as they age, meaning that lower doses of cardiac medications are necessary. D) The GI tract of an elderly patient quickly processes medications, meaning that medications have a shorter half-life than in younger patients.

You are at the home of a 92-year-old male patient. He is alert and oriented and in good spirits and, although mildly hearing impaired, can hear you if you speak clearly and face him as you speak. He has no teeth and is not wearing dentures. His speech is indistinct and difficult to understand. Which of the following is the best course of action? A) See if he can write down what he wants to say. His speech may be impaired from a stroke rather than a lack of dentition. B) Tell him to respond to your questions with simple hand gestures. C) Ask him to put in his dentures if he has them. Locate them for him if necessary. D) Ask a family member to "translate," because the family is probably able to understand him better.

Which of the following statements is TRUE of falls in the elderly? A) Falls in the elderly are not preventable. B) Falls are the leading cause of accidental death in the elderly. C) The elderly have the highest incidence of falls. D) All of the above are true.

Your patient is a 75-year-old woman complaining of constipation and abdominal pain for two days. Your physical examination reveals a moderately distended abdomen. Which of the following is the best course of action? A) Advise the patient to use an enema. B) Suggest that the patient see her primary care physician. C) Transport the patient, because she has a potentially serious medical problem. D) Advise the patient to use a laxative.

Which of the following is NOT a complication caused by incontinence? A) Skin ulcer B) Urinary tract infection C) Diverticulosis D) Sepsis

You are caring for an elderly patient who lives alone. The patient is complaining of feeling unwell for a period of several days and seems to be unable to provide a detailed personal medical history. An appropriate assessment of this patient should include: A) an assessment of living conditions, nutrition, and social support. B) contacting adult protective services to report an unsafe living situation. C) contacting the patient's physician to obtain an accurate history. D) exposing the patient to look for signs of physical abuse.

An 85-year-old man has fallen down five stairs to the carpeted floor below. He hit his head and is complaining of a headache. When getting a history from this patient, what question should you ask first? A) "What caused you to fall?" B) "What medications are you taking?" C) "Do you have a history of medical problems?" D) "Have you ever been diagnosed with dementia?"

An 87-year-old woman fell while getting out of bed. She is on the floor with severe pain to her left hip. Family members tell you that she takes medication for high blood pressure, high cholesterol, and depression. When assessing the patient, what assessment finding is most concerning? A) Heart rate of 118 beats per minute B) External rotation of the hip C) Weak pedal pulse in the left foot D) Respiratory rate of 20 breaths per minute

Which of the following statements demonstrates an accurate understanding of vital signs in relation to the geriatric patient? A) The typical resting heart rate is less than 50 beats per minute. B) Blood pressure is typically higher in elderly women. C) The resting respiratory rate is typically higher in the elderly. D) The vital signs of an elderly patient are similar to those of an adolescent.

You have been called for a 72-year-old woman with chest pain. On scene, the patient denies ever having chest pain and requests to sign a refusal. Before having the refusal signed, the paramedic must consider that many geriatric patients may deny symptoms because of: A) fear of losing independence and dignity. B) apprehension about medical bills. C) confusion regarding their rights as a patient. D) acute onset of dementia and other neurological diseases.

Common mental health problems in the geriatric population include all of the following EXCEPT: A) affective disorders. B) post-traumatic stress disorder. C) depression. D) suicide.

Your patient is a 75-year-old woman who is complaining of generalized weakness and loss of appetite. Your physical exam reveals no remarkable findings, and the patient has no significant past medical history. You reassure the patient that these are common complaints among people in her age group. Which of the following should you do next? A) Advise the patient to make an appointment with her doctor. B) Transport the patient for evaluation of a potentially serious medical problem. C) Call a family member to come and stay with the patient. D) Reassure the patient that there is nothing to worry about, and that you don't believe she needs to go to the hospital.

You respond to a low-income apartment complex for a report of an unresponsive patient. The landlord reports that the patient, a 90-year-old man, is two months behind on his rent and has not paid his utility bills. The patient presents unresponsive on a tile floor with a slow carotid pulse and skin that is pale and cold. You should have a high index of suspicion for: A) a suicide attempt. B) head trauma. C) hypothermia. D) elder abuse.

Age-related changes in ________ make elderly patients more susceptible to ________. A) circulation; hyperglycemia. B) sweat glands; hyperthermia. C) lung tissue; hypokalemia. D) cardiac cells; ventricular fibrillation.

Police have called for EMS assistance at the home of a 78-year-old woman. The patient's daughter called 911 after her mother stated that she "didn't want to live anymore." The police officer tells you, "I don't think she'd actually hurt herself, since she's almost 80 years old." Which of the following is an appropriate response to this statement? A) "You're right, she probably wouldn't. Let me see if she wants to sign a refusal of care form." B) "Actually, elderly patients have a high rate of depression and suicide." C) "I don't think she needs a hospital evaluation; the daughter can take her to her primary physician." D) "She may be being abused; you should question the daughter about it."

The elderly patient in shock may be less likely to exhibit which of the following expected manifestations of shock? A) Altered mental status B) Cardiac dysrhythmias C) Hypothermia D) Tachycardia

When assessing a 90-year-old woman who fell, what assessment finding should concern the paramedic most? A) Skin tear that appears infected on her arm B) Heart rate of 90 beats per minute C) Sudden onset of confusion D) History of osteoporosis and leg pain

Which of the following statements regarding traumatic injuries and the elderly is TRUE? A) Hip fractures are responsible for 85% of traumatic deaths. B) Head injuries are easy to detect in the elderly. C) Bradycardia is an early sign of blood loss. D) Injuries are most commonly caused by falls.

Which of the following is an intrinsic factor in falls in the elderly? A) High shelving for storage B) Glaucoma C) Throw rugs in the living area D) Ice on a driveway or sidewalk

You have been called to a nursing home for an 86-year-old woman with pneumonia. The patient's airway is patent, respirations labored, and skin cool and pale, with an intact radial pulse. The vital signs are: pulse 124, respirations 20, blood pressure 104/58 mmHg, SpO₂ at 91%, and temperature 98.2^°F. The patient also complains of chest pain and has a cough. Given this situation, the focus of your care should be: A) transport to the hospital. B) adequate oxygenation. C) obtaining a 12-lead ECG. D) eliminating the chest pain.

The son of a 73-year-old woman has called 911. The patient is confused and exhibiting out-of-character behavior. The son informs you that she is a diabetic, and takes pills and not injectable insulin. Assessment reveals adequate breathing, skin that is cool, and a radial pulse that is rapid and weak. Based on this history, you should be suspicious of: A) hyperglycemia. B) urinary tract infection. C) sepsis. D) hypoglycemia.

You have been called for an elderly woman who fell and hit her head. The patient is confused and has a laceration on her forehead. When getting the history from family members, which statement would be most indicative of a stroke? A) "She has a history of progressive dementia." B) "She has been getting fatigued faster lately." C) "She suddenly could not remember her name yesterday." D) "She has been drinking more water than normal."

Your patient is an 82-year-old woman whose daughter called EMS because the patient became very short of breath as they walked from their parking spot to the front of their church. On your arrival, the patient states that she just needed a little rest and now feels much better. On questioning, she admits to several such episodes in the past month. She denies chest pain and she says, "I just got winded because I'm getting so old." The patient has a heart rate of 104, a respiratory rate of 20, and blood pressure of 172/90 mmHg. Your history and physical examination should focus on which of the following possibilities? A) Myocardial infarction B) Thyroid storm C) Cerebrovascular accident D) COPD

A 77-year-old woman is confused and combative. Her daughter states that she has been gradually "acting strange" since waking up this morning. The patient has a history of alcoholism, and reportedly fell two weeks ago. Given your knowledge of the changes associated with aging, you should maintain a high index of suspicion for: A) acute alcohol intoxication. B) internal hemorrhage. C) subdural hematoma. D) hypokalemia.

Which of the following actions of the paramedic may lead to decubitus ulcer development in the elderly patient? A) Failing to pad the backboard for a patient in need of spinal immobilization B) Allowing the patient to remain in the same position during an extended transport time C) Failing to remove wet or soiled clothing of the incontinent patient D) All of the above

You have been called for an 86-year-old man who fell. The patient is incontinent and has an ulcerative rash beneath his adult diaper. During your assessment, you also find many bruises to his body in various stages of healing. The son reports that the patient fell getting out of bed; however, the daughter-in-law states that the patient fell while getting dressed. Your best action would be to: A) contact the police and wait on scene until they arrive. B) ask the family members why their stories are different. C) document elder abuse in your PCR. D) provide care and transport, and inform the emergency department physician that you suspect abuse.

Which of the following conditions increases the likelihood that an elder may be abused or neglected? A) Incontinence B) Dementia C) Immobility D) All of the above

You have been called for an 86-year-old man who fell. The patient is incontinent and has an ulcerative rash beneath his adult diaper. During your assessment, you also find many bruises to his body in various stages of healing. The son reports that the patient fell getting out of bed; however, the daughter-in-law states that the patient fell while getting dressed. Which of the following is the BEST example of how to document the patient's history in your PCR? A) "Family members are unable to provide accurate history of event." B) "Son states that the patient fell while getting out of bed; daughter-in-law states that the patient fell while getting dressed." C) "The patient may have fallen while getting out of bed, or while getting dressed." D) "Family members are unable to agree upon history of event, causing suspicion for elder abuse."

Which of these factors does not typically decrease compliance in the elderly? A) Limited mobility B) Fear of toxicity C) Childproof containers D) Poor skin integrity

Which of these is the least important physical requirement for effective continence? A) Anatomically correct GI/GU tract B) Adequate tissue perfusion C) Competent sphincter mechanism D) Adequate cognition and mobility

Which of the following is NOT an example of human trafficking? A) A Vietnamese woman coerced into traveling to the United States to work off a debt owed to a relative B) A teenager forced into prostitution through threats of violence C) A man who crosses the U.S.-Mexico border illegally to obtain work D) A young woman from China who is forced by her parents to marry an American man

Which of the following would constitute child neglect? A) Spanking a 5-year-old as a form of punishment B) Denying a 9-year-old access to electronics as a form of punishment C) Buying a child clothing only from thrift stores D) Failing to properly bathe a child on a regular basis

Which is NOT a factor associated with elder abuse? A) Financial stress of caretaking B) Limited long-term care options C) Multiple prescription medications D) Increased life expectancy

What is the estimated percent range of sexual assaults that are NOT reported? A) 25-35 B) 63-74 C) 0-22 D) 52-63

What is the most common living situation of abused elders? A) They live with their children. B) They live in a nursing facility. C) They live alone. D) They are homeless.

Police have called you to the scene of a domestic disturbance. At the scene, you find a woman with a lacerated lip and a man in police custody. Both parties are denying that any abuse occurred; however, a neighbor reports hearing "angry screaming." After conferring with law enforcement, which of the following pieces of information would most raise your index of suspicion for partner abuse? A) The man is unemployed and did not graduate from high school. B) The woman appears not to have showered in several days. C) The couple lives in a middle-income neighborhood. D) The couple has no children.

Which of the following statements regarding child abusers is TRUE? A) They usually have a diagnosed mental health condition. B) They often have a history of incarceration. C) They were likely abused themselves. D) They are usually violent toward adults as well.

A 19-year-old college student cannot remember what happened to him the night before, and is concerned that he may have been raped. Which of the following factors most supports the suspicion that a predator drug may have been used on this patient? A) The fact that he is a male aged 18-21 B) The fact that he is a college student C) The fact that he has no physical injuries D) The fact that he thinks he was raped

You are transporting a 5-year-old child who you believe may have been abused. The child withdraws in fear whenever you attempt to touch him. Which of the following may help when trying to assess and care for this child? A) Giving the child a stuffed toy to hold B) Playing music in the back of the ambulance C) Avoiding eye contact and trying to not touch the child D) Talking to the child in neutral, age-appropriate language

Law enforcement has requested your presence at the scene of a human trafficking arrest. A 14-year-old girl presents with bruises to her face and abdomen, and reports that she thinks she may be pregnant. Police officers report that the girl's uncle, who is handcuffed at the scene, has confessed to prostituting the girl for the past several months. The patient states repeatedly that she is "fine" and does not want to go to the hospital. Which of the following is an appropriate response? A) "It's OK, you are safe now and don't have to lie anymore." B) "I can tell you are trying to not anger your uncle, but you need to tell us the truth." C) "Unfortunately, you are a minor and can't refuse to go with us." D) "You have bruises on your face and may be pregnant. You need to come with us to get checked out at the hospital."

When caring for a victim of partner abuse, which of the following statements is appropriate? A) "Here is the phone number of a women's shelter nearby; they help a lot of women in similar situations." B) "When you decide you are tired of this abuse, call the police and they will help you." C) "The best thing to do is get out as quickly as you can." D) "You need to get help quickly, before he hurts you seriously."

Why is it important to educate victims of partner abuse about the availability of support services in their community? A) So they will leave their abusers B) Because many victims of partner abuse are often not aware of the resources available to help them C) Victims need to know how to document evidence of their abuse in order to convict their abuser. D) Often victims think that they are unique and no one shares a similar experience.

Which of the following is TRUE of your responsibility to report child abuse? A) Consult your state EMS regulations regarding reporting child abuse; all states differ. B) It is better to let your immediate supervisor report the abuse. C) It is your responsibility to report all suspected abuse to the appropriate reporting agency. D) In most states, EMS providers are not required to report abuse; only doctors must report.

When is a paramedic legally required to report abuse? A) Whenever anything seems unusual in the care of a child, elder, or dependent adult B) Whenever there is physical or behavioral evidence that suggests abuse C) Only when there is clear evidence of abuse D) Only when another provider agrees with the suspicion of abuse

You have responded to a residence for an injured child. The mother presents you with a two-year-old boy who is crying loudly. She says he fell off the family playground equipment and won't stop crying. You ask the boy what happened, and he points to the jungle gym outside and cries more. You notice some seven- to ten-day-old bruises on his shins, and scrapes on his palms and elbows. What impression could you form using your knowledge of child abuse? A) The child indicates the same story as the mother, and children of that age tend to injure themselves playing. B) Continual crying is a sign of abuse, and so are the old bruises. C) The child was obviously unsupervised and may be neglected. D) There are some warning signs, and the police should be involved.

Which of the following common conditions may be mistaken for child abuse? A) Diaper rash B) Rug burns C) Mosquito bites D) Chickenpox

What is one of the most important indicators of child abuse? A) Child's behavior B) Family finances C) Attitude of the family members D) Absence of one parent

Which type of unique burn pattern would cause you to suspect that a young child may be being abused? A) Splash B) Dipping C) Circumferential D) Scald

You arrive on the scene of an alleged rape. A 25-year-old female has been physically assaulted quite badly and has numerous deep lacerations. You must remove her clothes in order to provide care. What is the best procedure when caring for this patient? A) Remove the patient's clothes quickly, and place them in a biohazard bag. B) Cut around the injury sites and leave the rest of the clothes on the patient. C) Carefully remove her clothing in a private area, cover her with blankets, and bag the clothes in a paper bag to give to the police as evidence. D) Cut off her clothes quickly; patient care takes priority over evidence.

A 30-year-old woman has been sexually assaulted. She is crying, and appears withdrawn and frightened. Which of the following strategies would be appropriate to use when caring for this patient? A) Give the patient clear direction by telling her where to sit and what to do. B) Calm the patient by providing information on sexual assault support groups. C) Allow the patient to control all aspects of the interaction, such as where she rides in the ambulance and what care is provided. D) Talk to the patient in a low and quiet voice, using simple words, so as not to frighten her.

Which of the following are common date rape drugs? A) Ketamine, THC, and tropine B) Rohypnol, GHB, and MDMA C) Sodium pentothal, thiamine, and HDT D) Phenobarbital, glucosamine, and ketamine

A 22-year-old woman called 911 after waking up in an unfamiliar room on her college campus. She has bruises to her wrists and complains of vaginal pain, but has no memory of any events from the previous evening. The last thing she remembers is entering a fraternity party with a group of friends. This patient's history is most consistent with: A) sexual assault involving head trauma. B) alcohol-induced sexual assault. C) date rape. D) predator drug use.

What group is NOT commonly affected by hate crimes? A) Racial minorities B) Religious groups C) Low-income individuals D) Disabled individuals

Regarding hate crimes, EMS providers should: A) not rush to the conclusion that a violent act is a hate crime, as hate crimes are rare and often only seen in very urban areas. B) be sure that a health care provider of the same minority group is available to care for a victim of a hate crime. C) document all possible hate crimes and report them to adult protective services. D) assume that any violent act toward a commonly victimized group is a hate crime until proven otherwise, and involve the police if necessary.

When providing a verbal handoff of a sexual assault victim, which of the following sets of information should be included in your report? A) Patient age, any injuries, approximate time of the assault, and any areas of the patient's body or clothes that have been cleaned B) Any injuries, name of assailant, location of the assault, and if drugs were involved C) Relationship of the assailant to the victim, how much alcohol the victim consumed, and if emergency contraception is needed D) Patient age, assailant age, and any injuries

Which of these is not a common sign of human trafficking? A) The person appears disconnected from family, friends, and community organizations. B) The person has a sudden or dramatic change in behavior. C) The person has bruises in various stages of healing. D) The person does need to be coached on what to say.

Which of the following describes deafness? A) The inability to hear B) A defect in the brain that does not allow sound to be processed C) A congenital defect involving the inner ear D) The inability to hear under 30 decibels

The inability of nerve impulses to reach the auditory center of the brain is called: A) audioneural deafness. B) conductive deafness. C) sensorineural deafness. D) cochlear imbalance.

What is enucleation? A) Removal and replacement of the patient's eyeball with a prosthetic eye B) Corrective laser surgery C) Loss of vision in one eye due to trauma D) Removal of the eyeball

Which of the following is NOT a common cause of vision loss? A) Multiple sclerosis B) Diabetes C) Premature birth D) Cytomegalovirus

An injury to which cervical vertebra(e) may prevent a person from breathing? A) C-5-C-7 B) C-1-C-3 C) C-1 only D) C-3-C-5

What is the cause of conductive deafness? A) Any condition that prevents voice or vibration from being transmitted to the brain from the outer ear due to nerve damage B) A condition that prevents sound from traveling from the inner to the outer ear C) A decrease in the sensory threshold voltage of the ear D) Any condition that prevents sound from being transmitted from the external ear to the middle or inner ear

Which of the following best describes the etiology of cerebral palsy? A) A genetic disorder related to the chromosomes B) German measles, cerebral hypoxia, head injury, or any number of diseases C) Drug and alcohol abuse by the mother D) Typhoid, head injury, or rubella

You arrive at the scene of a vehicle-versus-pedestrian accident. At the scene, you find a 32-year-old man with an apparent mid-shaft femur fracture. As you introduce yourself, the man tells you that he is blind, and that a police officer took his guide dog a few minutes ago. Regarding the service dog, you should: A) tell law enforcement to contact animal control, which will hold the dog until the patient is discharged from the hospital. B) locate the dog and transport it with the patient to the hospital. C) inform the patient that he should call a family member or friend to come pick up the dog from law enforcement. D) tell police to transport the dog to the ED, as animals are not allowed inside the ambulance.

You have arrived on the scene of an injured person. The person has been identified by the police as having a hearing impairment. What is the best way to communicate with this person? A) Use written words or pictures. B) Ask the patient to turn up their hearing aid. C) Speak loudly and make hand gestures. D) Call for an American Sign Language interpreter to meet you at the hospital.

You are about to transport a cancer patient who complains of dyspnea. She is hemodynamically stable and has a history of asthma. On assessment, you note that she has some diffuse wheezes. You are going to administer an albuterol treatment and your protocol states that you should start an IV when you give a breathing treatment. The patient says that she has very bad veins, but she has an implanted port under the skin of her left chest. What is the best course of action? A) Administer albuterol only, as there is no urgent need for an IV. B) Withhold all treatment, as albuterol may negatively interact with her chemotherapy. C) Contact medical control for orders to access the port before beginning the albuterol treatment. D) Some implanted ports require special catheters, so try for a peripheral line.

A 22-year-old man has fallen at a local park. He has Down syndrome, and is crying. Which of the following strategies may be helpful when caring for this patient? A) Speak to the patient as you would to a young child, as he has a cognitive age of 3 to 5 years old. B) Begin with simple questions to assess the developmental level of the patient. C) Direct all questions to the patient's caregiver. D) Treat the patient as you would any adult, so as not to offend him.

You are assisting with the transport of a bariatric patient who needs to be removed from her top-floor bedroom. Due to the patient's size and weight, multiple resources are being used to get the patient out through an upstairs window. Which of the following considerations should be a top priority in this scenario? A) Performing the action quickly, so as not to create a spectacle in the neighborhood B) Minimizing damage to the patient's house and property, even if it means extending the operation C) Protecting the patient's dignity throughout the process, ensuring her comfort and safety D) Using as few resources as possible, so as not to deplete the rest of the emergency response system

Which of the following statements is accurate regarding the care for a child with spina bifida? A) Most are able to live normal, healthy lives. B) There is a high chance of a latex allergy, so non-latex equipment should be used. C) Opiate pain medication is contraindicated. D) Patients will be quadriplegic, so their wheelchairs must be transported with them.

A 34-year-old man is having trouble breathing. As you introduce yourself, his 7-year-old daughter tells you that he is deaf and communicates via American Sign Language. Which of the following is an appropriate means of communicating with this patient? A) Write down all questions and give them to the patient. B) Use gestures speak slowly so the patient can lip read. C) Ask the daughter to serve as a translator. D) Use the patient's TTY phone as a virtual translator.

A 22-year-old woman is a quadriplegic and requires transport to the hospital for wound on her leg. She is on a portable home ventilator. Which of the following is the best way to transport this patient? A) Keep the patient on her home ventilator, transporting the equipment with the patient. B) Call dispatch and ask for a CCT unit that has a transport ventilator. C) Provide positive-pressure ventilation with a bag-valve device during transport. D) Disconnect the ventilator and passively oxygenate the patient with a nonrebreather mask.

You have responded to a report of an injured person. When you arrive, you find a 55-year-old woman who has fallen and sustained a small laceration to her forehead. She is holding a small dog and asks if she can bring it with her to the hospital. What is the most appropriate action to take regarding transport? A) Explain to the patient that the ambulance is a sterile area and that she will have to call a friend to come and get the dog. B) Ask the patient if it is a service dog, and what it is trained to do. C) Restrain and transport the dog in the front of the ambulance. D) Transport the dog, but only if she has a carrier for it to ride in.

A 5-year-old girl has a high fever and cough. The girl's mother informs you that her daughter has leukemia and finished her most recent round of chemotherapy two days ago. She states that the girl is neutropenic. You recognize that: A) neutropenia is a common side effect of chemotherapy, but is not a serious concern. B) neutropenic fevers are always due to pneumonia. C) neutropenia is a serious condition that often leads to sepsis. D) neutropenic cough is a side effect of chemotherapy and should be treated with albuterol.

A Muslim woman is ill and requires transport to the hospital. The patient's husband is refusing to allow the patient to be examined, as both members of the crew are male. The patient is quiet, but persistently agrees with her husband. How should you respond to this situation? A) Contact law enforcement, as this is likely partner abuse. B) Direct all questioning to the patient, encouraging her to come with you to the hospital. C) Transport the patient without examining her, allowing the husband to ride in the patient compartment with his wife if he wishes. D) Have the husband take his wife to the hospital, after signing a refusal of care form.

A school nurse has called EMS because an 8-year-old girl has a fever and is dehydrated. Just after your arrival, the girl's parents arrive. They calmly inform you that they do not believe in Western medicine, and that they will take the girl home to treat her. The child has an altered mental status and appears to be in serious condition. You should: A) advise the parents of the risks and allow them to sign a refusal of treatment form. B) provide treatment to the girl under the concept of implied consent. C) quietly contact law enforcement to assist you in convincing the parents. D) leave the scene and document that there was no patient contact.

You arrive at the scene to find a patient who has fallen. She appears to be homeless. After introducing yourself, you begin to assess her. However, she states that she does not want your help because she cannot afford it. What would be an appropriate response? A) "Don't worry, Medicare will cover it." B) "There is a public hospital that we can bring you to nearby." C) "I'm sorry to hear that. We'll need to call a lower-cost EMS provider." D) "You need medical attention; the hospital will work with you to help cover the cost."

You are caring for a male patient who has not spoken to answer any of your questions, but will nod or shake his head. He appears to have a developmental disability. Which of the following is the best way to document this information on your patient care report? A) "Patient refuses to answer questions." B) "Patient is non-verbal, but will nod his head yes and no." C) "Patient is developmentally disabled and unable to speak." D) "Patient is not responsive to questioning."

What is the term for the skin's ability to return to its normal appearance after being subjected to pressure? A) Turgor B) Elasticity C) Ductility D) Sepsis

What does PEEP stand for? A) Positive exhalation and excretion pressure B) Preliminary exhaustive expiratory plan C) Pulmonary expulsion/end perfusion D) Positive end-expiratory pressure

Which of the following best describes a tracheostomy? A) An opening from the esophagus to the trachea B) A temporary opening made from the posterior neck through the trachea C) A surgical opening from the anterior neck into the trachea D) An opening made by incision from the larynx through the neck

Your patient has Guillain-Barré syndrome. Which of the following sets of symptoms would you expect to find? A) Fever, followed by weakness and paralysis B) Headache, respiratory distress, and neuropathy C) Visual disturbances and motor deficits D) Rash, GI upset, and dizziness

Which of the following factors has contributed to the increase in individuals who receive health care at home? A) More families can afford home health care. B) Research shows that patients recover faster at home. C) Fewer people have insurance and therefore cannot afford hospital care. D) There are tax breaks for individuals who provide care for a loved one at home.

The majority of home health care patients fall into which demographic category? A) Males age 55+ B) Females between ages 70 and 82 C) Females age 65+ D) Males between ages 75 and 85

While assessing a chronically ill 85-year-old male patient who is cared for at home, you notice that his wife appears tired and unkempt. The patient is well cared for; however, he has multiple health problems and requires constant attention. Understanding the psychosocial needs of a family member who provides care, which of the following would be appropriate to say to the wife? A) "It is obviously difficult for you to care for him. It might be best to put him in a nursing facility." B) "It is very expensive to pay for a home health aide, but perhaps you could ask your children to help with the cost." C) "I can see that you provide excellent care for your husband. Would you like some information on a support group for spouses who provide care?" D) "You are compromising your well-being for your husband and may require medical attention."

Which of the following is NOT a common reason for ALS intervention with a chronic care patient? A) Equipment failure B) Desire for hospice care C) Absence of a caregiver D) Change in condition

You are called to the home of a 75-year-old patient with end-stage lung cancer. The patient's daughter states that she called because the patient is experiencing increasing dyspnea. The patient is on home oxygen at 4 liters per minute; however, the daughter states that the patient's SpO₂ is "way lower than normal." What would be the best course of action in this situation? A) Transport the patient to the ED. B) Ask the daughter if the patient has a DNR. C) Examine the patient's oxygen equipment to be sure it is working. D) Prepare to administer oxygen via CPAP.

A 13-day-old infant is suffering from bronchopulmonary dysplasia. His family, along with a home health nurse, called 911 after the child's oxygen saturation began to fluctuate. The home health nurse reports that although the baby is on a ventilator, the nurse has been weaning him to lower intermittent mandatory ventilation settings. The child has a heart rate of 160 bpm and is ventilator dependent with an SpO₂ of 86%. Lung sounds reveal crackles and rhonchi in the left lung; the child is hot to the touch and has cyanotic extremities and central mottling. You suspect: A) pneumothorax secondary to bronchopulmonary dysplasia. B) aspiration secondary to ventilator usage. C) sepsis secondary to lower respiratory infection. D) barotrauma secondary to high ventilator pressure settings.

Which of the following is NOT a common sign of sepsis? A) Nausea and vomiting B) Fever C) Altered mental status D) Hyperactivity

You are sent to a home for a cardiac arrest. You find a patient in cardiac arrest who has been under hospice care for end-stage AIDS. The palliative care nurse tells you that some family members who were present when the patient went into cardiac arrest became very upset and called 911. The patient has been pulseless and apneic for approximately 15 minutes without resuscitation. A relative interrupts and says she doesn't care what the nurse says; she wants you to help her brother. What should your next action(s) be? A) Have the nurse provide the DNR, ask the sister if she was aware of her brother's end-of-life wishes, and explain that you are ethically bound to honor the DNR. B) Provide all the interventions you can-immediate family are always able to override the DNR. C) Explain to the sister that because the family did not start CPR right away, the chances of resuscitation are extremely small. D) Start CPR and ACLS. Do a round of drugs, then call for orders for field termination of resuscitative efforts.

When you arrive on the scene of an incident in which a home health care provider is present, which of the following is the best way to deal with the situation? A) Tell the home care provider that your certification overrides theirs and that you are in charge now. B) Respect the home care provider's position, use the person's information accordingly, and request the person's help should the need arise. C) Let the person talk to a member of the crew not involved in patient care to keep the person busy and out of the way. D) Ascertain the person's certification level. If the person is not an RN, ask the person to stand back.

You are dispatched to an extended care facility for a "sick person." On arrival, you speak with the staff who tells you that Ms. Johnson "just started acting differently and is slow to respond." Your assessment reveals that she is febrile and has vomited. When you move her to the gurney, you notice a stage 3 ulcer on her lower back that has a foul smell. Which of the following statements is most likely to be TRUE? A) This is most probably due to neglect. Report the facility to the appropriate authorities. B) This is most likely a GI emergency, such as norovirus or C. diff. C) The signs could be masking a more serious issue, such as a cardiac event. D) The ulcer may be infected, causing sepsis and requiring immediate intervention.

You are caring for a child with muscular dystrophy who is on a home ventilator. The boy's father called 911 after noticing his son repeatedly attempting to cough-something that is atypical for this patient. The father states that he believes the child's tracheostomy tube may be dislodged, and he is unsure what to do. Your assessment reveals that the inner cannula appears to be dislodged. Which of the following is your best course of action? A) Detach the home ventilator, orally intubate the trachea, and reattach the ventilator to the ET tube. B) Deflate the cannula cuff and remove the cannula, then hyperventilate the patient. C) Transport, with an early alert that a respiratory therapist will be needed. D) Attempt to reposition the inner cannula with sterile Magill forceps.

What might you notice before entering a residence that would lead you to assume that a home health care situation might exist? A) A "No Smoking, Oxygen in Use" sign B) A wheelchair ramp C) A vehicle in the driveway that appears to be used for convalescent transport D) All of the above

You have arrived at the home of an elderly man who called 911 for pain in his penis. He has a Foley catheter in place. He is supposed to have a home health aide visiting him daily, but, although it is 1500 hours, she has not yet visited today. You visualize the catheter and bag and note that the Foley bag is full of urine, so much so that it appears to be pulling the tube taut. You should: A) call the home health care service and ask when the health aide is scheduled to arrive. B) access the drain, drain the urine into a container, and reassess the patient's discomfort. C) transport to the ED, as any procedure involving a Foley requires special training. D) remove the Foley catheter using aseptic technique and transport.

Many patients with neuromuscular degenerative diseases receive chronic respiratory support at home. Ultimately, what step may you, as a paramedic, have to take immediately, regardless of the type of respiratory support available in the patient's home? A) Alter dosages of medications already in use to achieve a better effect. B) Intubate and ventilate. C) Call the patient's physician and get orders not addressed by your protocols. D) Rapidly become familiar with the patient's medical equipment.

You are dispatched to a residence for a report of a "man down." Upon arrival, you find a well-kept home with the door open, and a van in the driveway with "palliative care specialist" printed on the side. As you enter the home, a woman meets you and says, "It's my mother. She has terminal cancer and we can't seem to wake her up." Which of the following questions would be most appropriate to ask at this time? A) "Did anyone check for a pulse?" B) "What type of cancer does your mother have?" C) "Is your mother receiving hospice care?" D) "What hospital does she normally go to?"

A wheelchair transport driver has called 911 after transporting a 68-year-old man from a dialysis center back to his residential care home. The patient has a blood-soaked bandage on his right forearm and states, "My fistula has been bleeding since I left dialysis. I can't get it to stop!" You should: A) lift the bandage to ascertain whether the bleeding is from the dialysis fistula or another source. B) immediately apply a tourniquet proximal to the fistula. C) apply firm, direct pressure over the fistula with your gloved hand. D) apply pressure to the brachial artery pressure point to slow the bleeding.

You are caring for a patient with a gastrostomy tube. The patient complains of pain around the tube, and states that the surrounding area has been sore for a few days. Your physical exam reveals red, swollen skin around the G tube that is warm to the touch. You suspect: A) an obstruction in the G tube. B) an infection at the insertion site. C) that the tube has been dislodged. D) that the patient is not properly caring for the device.

A 24-year-old man has called 911 after experiencing heart palpitations and dizziness. You direct your partner to apply a 4-lead ECG and see a narrow complex tachycardia on the monitor at a rate of 196 bpm. The patient is wearing a halter monitor and states, "My doctor is making me wear this because I keep having these episodes." How should you handle the presence of the halter monitor? A) Leave it in place and alter your treatment so as not to disturb the monitor. B) Remove the monitor and treat the patient per protocol. C) Leave the monitor on and delay treatment until you arrive at the ED. D) Contact the hospital for medical direction.

Which of the following most accurately describes why it is best to avoid taking a blood pressure on an arm with an AV graft in place? A) The blood pressure cuff will compress the graft, causing damage. B) The pressure created by the cuff is guaranteed to rupture the AV graft. C) Restricting circulation through the graft is likely to cause clot formation, a common problem with AV grafts. D) It is uncomfortable for a patient with an AV graft to have blood pressure taken on that arm.

Which of the following best describes "peak load"? A) The maximum amount of energy draw an ambulance's electrical system can handle B) The highest volume of calls at a given time C) The maximum amount of responses an agency can handle D) The maximum weight a stretcher can carry

Which of the following documents details the regulations regarding ambulance design? A) OHSA KKK specs B) SSS 1288D specs C) DOT KKK 1822E specs D) The DOT standards

Which of the following best describes the concept of due regard? A) The higher standard of safety that guides the operation of emergency vehicles B) The set of laws that allow emergency vehicles to exceed the speed limit C) Slowing down as much as possible before going through a red light or stop sign D) The standards that guide the use of lights and sirens when driving an emergency vehicle

Which government agency is responsible for creating guidelines that mandate the use of disinfecting agents, sharps containers, red bags, HEPA masks, and personal protective equipment? A) NHTSA B) DOT C) OSHA D) State EMSA

Ambulances are required to carry certain medications and supplies in order to provide a minimum standard of care. This equipment is referred to as: A) essential equipment. B) required stock. C) equipment protocol. D) general equipment.

Which of the following best describes a type III ambulance? A) Conventional truck cab-chassis with a modular ambulance body B) Specialty van, forward control integral cab-body ambulance C) A standard van, forward control integral cab-body ambulance system D) A medium-duty ambulance rescue vehicle

The Commission on Accreditation of Ambulance Services (CAAS) provides which of the following? A) Mandatory regulations for ambulance operations B) A legally enforceable standard for ambulance equipment C) Voluntary guidelines for ambulance equipment and supplies D) Detailed protocols for ambulance maintenance

How often should a thorough check of equipment on the ambulance be made? A) Beginning of every shift B) Monthly C) Daily D) Weekly

Which of the following tasks would NOT typically be included in a daily vehicle/equipment checklist? A) Washing the ambulance B) Checking the fuel level C) Siren function evaluation D) Oxygen pressure level assessment

Some EMS agencies use a system for ambulance deployment that involves placing ambulances in strategic locations to best meet the demands of call volume and ensure response times. This system is called: A) minimum deployment plan. B) system status management. C) assisted computerized deployment. D) system response protocol.

Most collisions involving ambulances occur: A) when exiting the station. B) in residential areas. C) on the highway. D) at intersections.

You are leaving the scene of a medical call and realize that a civilian has parked in front of you, blocking your egress. Which of the following is an appropriate response? A) Send law enforcement to find the owner of the vehicle. B) Using side- and rear-view mirrors, back up a few feet until you can clear the vehicle. C) Using a spotter, back up the ambulance until you are able to safely exit the area. D) Wait until the owner of the vehicle returns and ask the owner to pull forward.

Which of the following is TRUE regarding the use of lights and sirens during ambulance operations? A) It greatly reduces transport time to the hospital. B) It poses significant risks to you, the patient, and other drivers. C) Sirens should not be used during inclement weather. D) Lights and sirens can be used whenever it is convenient.

Which of the following describes a system that uses a number of agencies, responder levels, and delivery vehicles? A) A multiple agency system B) A tiered system C) An alarm system D) A multijurisdictional response system

You are driving with lights and siren to an emergency call. As you approach a busy intersection, you see that the light is red and there are cars stopped in all lanes of traffic. You should: A) sound the horn as you approach, wait for the light to turn, and then proceed with lights and siren. B) change the tone of the siren as you approach, sound the horn, and wait for motorists to move. C) move into the oncoming lane, proceed without stopping in the intersection. D) announce over your loudspeaker that motorists should exit the intersection to allow you to pass.

At the scene of a potential hazmat incident, where should the ambulance be parked? A) Downhill and downwind B) Near the warm zone for patient transport C) Uphill and upwind D) At least 500 yards away from the incident

You are the first on scene at a vehicle accident on a busy highway. You should: A) park the ambulance on the far side of the accident, leaving emergency lights on. B) park the ambulance on the near side of the accident, leaving emergency light on. C) park directly to the side of the accident, leaving only the side floodlights on. D) park past the accident, turning off emergency lights to avoid confusing motorists.

Which of the following was identified by data from New York State as the most common type of crash involving an ambulance? A) Lateral impact at an uncontrolled intersection with low visibility B) Rollover due to high speed on a wet roadway C) Rear-end collision at low speed with no weather issues D) Lateral impact at a controlled intersection with no weather issues

Which of these is a computerized personnel and ambulance deployment system designed to meet service demands with fewer resources and to ensure appropriate response times and vehicle locations? A) tiered response system B) reserve capacity C) system status management D) PAR

The ability to muster additional crews when all ambulances are on call or when a system's resources are taxed by a multiple-casualty incident is: A) reserve capacity. B) deployment. C) peak load. D) congestion.

What type of flight rules can be characterized by the pilot(s) relying almost exclusively on line of sight? A) Traditional flight rules B) Visual flight rules C) Emergency flight rules D) Instrument flight rules

Which of the following patients would NOT be a candidate for transport via fixed-wing aircraft? A) 3-hour-old neonate requiring transport from a community hospital to a higher-level NICU B) 42-year-old man who is sedated and intubated, being transported from a rural area to a university hospital C) 32-year-old man requiring prolonged extrication following a vehicle accident D) 12-year-old burn victim who has been stabilized at a local ED and now needs transport to a burn center

Which one of the following is NOT a typical use for a rotor-wing aircraft? A) Scene response for patient transport B) Search and rescue C) Organ procurement D) Transport over very long distances

During which conflict did helicopter evacuation of wounded U.S. soldiers become standard practice? A) World War I B) Korean War C) World War II D) Vietnam War

During which conflict did helicopter transport of U.S. soldiers evolve from strict evacuation to in-flight medical care? A) World War I B) Korean War C) World War II D) Vietnam War

Which piece of legislation authorized the U.S. military to use simultaneous helicopter evacuation and medical care to augment existing U.S. civilian EMS? A) Military Assistance to Safety and Traffic B) Army Combat and Civilian Cooperation C) Civilian Air Medical Program D) Military Cooperative Evacuation Protocol

Which of the following is a benefit of fixed-wing aircraft over rotor-wing aircraft? A) Fixed-wing aircraft offer greater flexibility in landing area. B) Fixed-wing aircraft can transport over longer distances. C) Fixed-wing aircraft can carry nurses while helicopters cannot. D) Fixed-wing aircraft can fly in heavy rain.

You are on the scene of a motor vehicle collision on a rural roadway. It is 0130 and there is significant low cloud cover. The patient is a 45-year-old man who weighs 91 kg and is unresponsive. The patient has been intubated and has two large-bore IVs established. Which of the following would be a limiting factor when considering air medical transport of this patient? A) Rural area B) Cloud cover C) Patient size D) Time of day

Which of the following is TRUE if the ground transport time is equal to air medical transport time? A) The patient should be transported by air, as all helicopters have a nurse onboard. B) The patient should be transported by ground, as it is safer for the patient and crew. C) Medical direction should be obtained to determine the preferred method of transport. D) Air transport should be used only if an IV is already established.

In most instances, modern medical helicopters are staffed by: A) a four-person crew including two paramedics, a pilot, and copilot. B) a three-person crew including a paramedic, nurse, and pilot. C) a two-person crew including a pilot and nurse. D) a three-person crew including 2 paramedics and a pilot.

Responsibilities of a landing zone officer include all of the following EXCEPT: A) selection of site. B) site preparation. C) determining safe flying conditions. D) air-to-ground communication.

Which of the following is the ideal size of a helicopter landing zone during daytime conditions? A) 100 square ft B) 100 square yd C) 200 square ft D) 200 square yd

You are preparing a landing zone for an incoming air medical helicopter. The chosen landing zone is dirt and it is a hot and dry day. You should: A) inform the incoming helicopter that there may be dust upon landing. B) choose a different landing zone. C) ask the fire department to wet down the area. D) widen the landing zone by 50 feet.

When is it appropriate to approach a landed helicopter? A) After the rotors stop spinning B) After a 5-minute "cooling off" period C) When the flight crew signals you to approach D) When the landing zone officer indicates it is safe

An air medical transport crew has just arrived at the scene where you are providing care for a patient with a suspected AMI. You should: A) move the patient to the door of the helicopter and prepare to load the patient. B) wait for the flight crew to make contact with you and give them a report. C) ask over the radio if the crew is ready to receive the patient. D) send a BLS provider to make contact with the flight crew.

When training a new provider in air medical operations, which of the following statements would be appropriate? A) "Never approach an aircraft from the rear." B) "Only patients under 90 kg can be transported in a helicopter." C) "Fixed-wing aircraft are only used by critical care transport teams." D) "It is your responsibility to determine safe flying conditions after receiving a call."

Which of the following is a responsibility of the paramedic during helicopter take-off? A) Determining wind direction and speed B) Continuous communication with the pilot and flight crew C) Visually assessing for straps left hanging out of aircraft doors D) Notifying the receiving hospital that the flight crew is departing

If necessary to provide guidance to the approaching aircraft, use clock-based directional terms. Always consider the point of reference for the pilot (the nose of the aircraft) to be the: A) 3 o'clock position. B) 12 o'clock position. C) 6 o'clock position. D) 9 o'clock position.

Which of the following patients would most likely benefit from air ambulance transport? A) Term infant born in a rural area B) 19-year-old male multisystem trauma patient C) 42-year-old female with 10/10 abdominal pain D) 2-year-old boy with febrile seizures

Which of these is not a way in which helicopters and airplanes have proved to be vital assets in the emergent transport of the ill or injured patients? A) Ongoing education B) Organ procurement C) Specialty care D) Scene responses

Which of the following incidents would be classified as a "closed incident"? A) A two-vehicle collision B) A building fire C) A grain storage bin collapse D) Persons sprayed with mace at a club

Which of the following incidents would be classified as an "open incident"? A) A collapse of a grocery store roof in a heavy rain B) People shot by a coworker at a factory C) A three-vehicle collision on a highway D) A gas pipeline explosion along a stretch of rural road

Which of the following is the best definition of a multiple-casualty incident? A) Any incident with more than one patient B) A situation in which more than one ambulance is needed C) Any incident in which situational demands overwhelm resources D) A situation in which there are more than three patients

Which of the following scenarios would benefit from pre-incident planning in anticipation of a possible MCI? A) Outdoor music festival with expected attendance of 10,000 B) Major road closure due to construction C) Increasing incidence of national terrorist activity D) The first winter storm of the season

The Incident Command System was initially developed as a management tool for: A) natural disasters. B) large-scale fires. C) urban violent crimes. D) rural EMS agencies.

The major functional areas of the National Incident Management System include all of the following EXCEPT: A) command. B) logistics. C) planning. D) execution.

Which of the following is TRUE regarding incident commanders? A) They make decisions in conjunction with the medical director. B) They hold full legal authority for decision making. C) They must clear all decisions with the logistics coordinator. D) They are not liable for decisions made during an MCI.

Span of control refers to: A) the number of individuals a supervisor can safely manage. B) the geographical area an incident covers. C) how many incident commanders are needed for a given MCI. D) how many division leaders an incident commander appoints.

You and your EMT partner arrive at the scene of a vehicle collision and find that the collision involved a large van and a school bus full of children. Your first action should be to: A) begin triaging patients. B) declare an MCI and establish yourself as incident commander. C) call for an air ambulance. D) inform dispatch that you may need additional resources.

Which of the following BEST describes the National Incident Management System? A) A uniform, yet flexible, system B) A rigid set of protocols C) The minimum acceptable standard for MCI operations D) A recommended list of job tasks for MCIs

The site from which civil government officials exercise direction and control in an emergency or disaster is called the: A) mutual aid coordination center (MACC). B) emergency aid and operations center (EAOC). C) incident command center (ICC). D) mobile dispatch coordination center (MDCC).