EMR - Patient Treatment and Transport — Quick Review

An unresponsive adult patient is breathing but has noisy, gurgling respirations. Which airway maneuver should you perform FIRST?

Open the airway with a head-tilt chin-lift

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Insert an oropharyngeal airway

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Begin positive-pressure ventilation with a bag-valve-mask

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Apply a nonrebreather mask at 15 L/min

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You arrive to find an unresponsive patient lying on their back with vomit visible in the mouth. What is the correct immediate action?

Roll the patient to their side and suction the airway

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Insert an oropharyngeal airway immediately to prevent aspiration

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Begin rescue breathing with a pocket mask

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Perform abdominal thrusts to clear the obstruction

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When sizing an oropharyngeal airway (OPA) for an adult, which external landmark measurement gives the correct length?

From the corner of the mouth to the angle of the jaw or the earlobe

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From the tip of the nose to the earlobe

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From the center of the upper lip to the chin

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Choosing the size that matches the patient's approximate age

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You are about to insert an oropharyngeal airway in an adult patient. During insertion, the patient begins to gag. What is the most appropriate action?

Remove the OPA immediately and consider a nasopharyngeal airway instead

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Continue insertion because gagging confirms correct placement

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Push the OPA in quickly to pass through the gag reflex

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Hold the OPA in place until gagging subsides, then advance

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Which patient would be the BEST candidate for a nasopharyngeal airway (NPA)?

A semiconscious patient with an intact gag reflex who cannot maintain their own airway

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A fully conscious and alert patient complaining of shortness of breath

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A patient with a known skull-base fracture and clear fluid draining from the nose

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A deeply unresponsive patient with no gag reflex

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During suctioning of an adult patient’s oropharynx, how long should each suction pass last?

No longer than 15 seconds per pass

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No longer than 5 seconds per pass

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Up to 30 seconds if secretions are thick

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Until the airway is completely clear, regardless of time

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An unresponsive trauma patient with a suspected cervical spine injury has audible secretions in the airway. What is the correct approach?

Use a jaw-thrust without head-tilt to open the airway and suction the secretions

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Apply a cervical collar before doing anything to the airway

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Perform a head-tilt chin-lift because the airway takes priority over spine precautions

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Withhold airway intervention until the cervical spine is cleared by imaging

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A patient is breathing adequately at 16 breaths per minute and reports mild difficulty breathing after a minor asthma flare. Which oxygen delivery device is most appropriate?

Nasal cannula at 2 to 6 L/min

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Nonrebreather mask at 15 L/min

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Bag-valve-mask with reservoir at 15 L/min

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Simple face mask at 10 L/min

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What is the approximate oxygen concentration delivered by a nonrebreather mask running at 15 L/min?

Roughly 80 to 90 percent

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Approximately 44 percent

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Approximately 60 percent

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100 percent, because the reservoir bag contains pure oxygen

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Before placing a nonrebreather mask on a patient, what must you ensure?

The reservoir bag is fully inflated before the mask is placed on the patient's face

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The flow rate is set to 6 L/min to conserve oxygen

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The one-way valves between the mask and reservoir are removed to prevent CO2 buildup

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The patient is supine to reduce oxygen demand

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A patient with a history of chronic obstructive pulmonary disease (COPD) is in moderate respiratory distress with an SpO2 of 86 percent. What is the correct oxygen approach for the EMR?

Apply oxygen and titrate to maintain SpO2 at or above the target range, around 88 to 92 percent for COPD

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Withhold oxygen because high-flow oxygen is always contraindicated in COPD patients

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Apply a nasal cannula at 1 L/min only, because higher flows abolish their drive to breathe

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Administer no oxygen unless SpO2 drops below 80 percent

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A nasal cannula is running at 4 L/min on a patient who remains cyanotic around the lips. Your nonrebreather masks are unavailable. Which action is MOST appropriate?

Increase the nasal cannula flow toward 6 L/min and prepare to assist ventilation with a bag-valve-mask if the patient deteriorates

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Leave the flow at 4 L/min because higher flows through a nasal cannula cause oxygen toxicity

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Remove the nasal cannula and let the patient breathe room air until equipment arrives

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Cover the patient's mouth with the cannula tubing to increase delivered concentration

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When ventilating an adult with a bag-valve-mask (BVM), how much volume should each breath deliver and over what duration?

Enough volume to produce visible chest rise, delivered over about 1 second

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At least 1,200 mL per breath to ensure adequate oxygenation

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The full bag volume squeezed with each breath

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A rapid forceful squeeze over half a second to overcome airway resistance

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A lone EMR is performing rescue breathing on an adult who has a pulse but inadequate breathing, using a pocket mask. What is the correct ventilation rate per current guidelines?

One breath every 6 seconds, about 10 breaths per minute

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One breath every 5 seconds, about 12 breaths per minute

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One breath every 2 to 3 seconds, about 20 to 30 breaths per minute

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One breath every 10 seconds, about 6 breaths per minute

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Two EMRs are performing CPR on an adult cardiac arrest patient using a BVM, with no advanced airway in place. What is the correct compression-to-ventilation ratio?

30 compressions to 2 ventilations

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15 compressions to 2 ventilations

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Continuous compressions with one breath every 6 seconds

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50 compressions to 2 ventilations

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During BVM ventilation the patient’s abdomen rises with each squeeze but the chest does not. What is the most likely cause?

The airway is not adequately opened and air is entering the esophagus and stomach

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The oxygen flow rate is set too low

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The reservoir bag is not connected to oxygen

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The mask seal is poor and air is leaking around the face

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You are ventilating an adult in respiratory arrest with a BVM. After repositioning the airway and confirming a good mask seal, the chest still rises minimally, and an OPA is in place. What should you do next?

Suction the airway in case secretions are obstructing ventilation, then reattempt BVM

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Increase the squeeze force to push air past the obstruction

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Remove the OPA because it is likely causing the obstruction

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Switch to a nasal cannula at 15 L/min while reassessing

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When performing chest compressions on an adult, what is the correct compression depth?

At least 2 inches but no more than 2.4 inches

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At least 1 inch

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At least 3 inches to ensure adequate perfusion pressure

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One third the depth of the chest

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During single-rescuer infant CPR, where should compressions be delivered and with what technique?

On the lower half of the sternum using two fingers

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On the center of the sternum using the heel of one hand

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On the lower half of the sternum using both thumbs with the hands encircling the chest

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On the xiphoid process using two fingers

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You find a 4-year-old child who is unresponsive and pulseless. As a single rescuer, what compression-to-ventilation ratio and depth should you use?

30 compressions to 2 ventilations, compressing at least one third the depth of the chest, about 2 inches

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30 compressions to 2 ventilations, compressing at least 2.4 inches, the same as an adult

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15 compressions to 2 ventilations, compressing at least one third the depth of the chest

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15 compressions to 2 ventilations, compressing at least 1 inch

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During high-quality CPR on an adult, which action is MOST important for minimizing interruptions to chest compressions?

Keep pauses for pulse checks and rhythm analysis to less than 10 seconds each

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Rotate compressors every 5 minutes to prevent fatigue

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Pause compressions for 30 seconds after each defibrillation to assess the rhythm

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Deliver ventilations at the same time as compressions to avoid pausing

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You are performing two-rescuer CPR on a 6-month-old infant. After the AED is attached, it advises a shock. Immediately after the shock is delivered, what should you do?

Resume CPR immediately, starting with chest compressions, without pausing to check a pulse

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Check for a pulse for up to 30 seconds before resuming compressions

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Deliver two rescue breaths before resuming compressions to re-oxygenate the heart

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Wait 60 seconds to see whether the rhythm has converted before resuming CPR

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You are alone and find an unresponsive adult. After confirming no breathing and no pulse, you have an AED within immediate reach. What is the correct first action after confirming arrest?

Activate EMS if not already done, retrieve the nearby AED, and begin CPR

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Perform 5 cycles of CPR before leaving to retrieve the AED

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Perform rescue breathing first for 2 minutes, then retrieve the AED

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Apply pads and shock without ever performing chest compressions

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You arrive on scene and find an unresponsive adult who is not breathing normally. Your partner begins CPR while you retrieve the AED. After turning on the AED, what is your immediate next step?

Attach the electrode pads to the patient's bare chest as directed by the device

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Press the analyze control before attaching any pads

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Deliver a shock immediately before the rhythm is analyzed

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Check for a pulse before attaching the pads

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The AED analyzes the rhythm and announces that a shock is advised. Before pressing the shock control, what must the EMR do?

Confirm verbally and visually that no one is touching the patient before the shock is delivered

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Continue chest compressions while the shock is delivered to minimize interruptions

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Remove the pads and reposition them before shocking

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Give two rescue breaths immediately before the shock

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You are preparing to use an AED on a 60-year-old man in cardiac arrest. You notice a visible implanted device beneath the skin of his upper left chest. What is the correct pad placement?

Place the nearby pad at least one inch away from the implanted device

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Do not use the AED because the implanted device will interfere with defibrillation

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Place one pad directly over the device to ensure adequate current delivery

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Use only one pad and hold the other against the patient's back manually

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An AED is attached to an unresponsive adult in cardiac arrest. The AED announces that no shock is advised. What should the EMR do next?

Immediately resume CPR beginning with chest compressions

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Remove the pads and reassess the patient for signs of life

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Wait two minutes for the AED to re-analyze before taking any action

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Deliver a manual shock because the AED may have malfunctioned

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You are using an AED on a patient lying on a wet dock near a lake. The AED is attached and ready to analyze. What is the most important action to take before allowing the AED to analyze?

Move the patient to a dry surface or dry the chest thoroughly before analysis and shock delivery

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Proceed with analysis immediately because modern AEDs are waterproof

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Dry the pads and reattach them but leave the patient on the wet surface

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Withhold AED use entirely and focus only on CPR until a dry environment is available

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A child estimated to be 6 years old is in cardiac arrest. An AED with pediatric pads and a dose attenuator is available, as are standard adult pads. Which option describes correct pad selection and placement?

Use the pediatric pads with attenuator; if the child's chest is small, place one pad on the center of the chest and one on the center of the back to prevent overlap

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Use adult pads and place both on the anterior chest in the standard adult position

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Do not use the AED for any child under 8 years old regardless of available equipment

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Use the pediatric pads but always place them anterior to anterior even when they would overlap

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A conscious adult is clutching her throat and cannot speak, cough, or breathe. She is standing and appears panicked. What is the correct immediate intervention?

Deliver abdominal thrusts until the object is expelled or the patient becomes unresponsive

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Perform a blind finger sweep of the mouth to remove the object

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Encourage the patient to keep coughing forcefully and simply monitor her

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Lay her supine and begin chest compressions while she is still conscious

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You are performing abdominal thrusts on a conscious adult with a complete airway obstruction. The patient suddenly becomes unresponsive and slumps. What is your next action?

Lower the patient to the ground, call for additional resources if not already done, and begin CPR starting with chest compressions

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Continue abdominal thrusts on the floor before starting CPR

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Immediately give rescue breaths before performing any chest compressions

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Roll the patient prone and deliver back blows before starting CPR

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A 10-month-old infant is handed to you by a panicked parent. The infant is conscious, making high-pitched sounds, cannot cry effectively, and has a weak ineffective cough. What is the correct sequence of interventions?

Deliver five back blows followed by five chest thrusts, alternating until the obstruction clears or the infant becomes unresponsive

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Perform abdominal thrusts as for an adult, adjusting the force for the infant's size

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Place the infant supine and give five chest compressions only, without back blows

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Perform a finger sweep of the mouth first, then deliver back blows if no object is found

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During CPR on an unresponsive adult with a suspected airway obstruction, your first rescue breath does not make the chest rise. You reposition the head and the second breath also fails to make the chest rise. What should you do next?

Resume chest compressions, then look in the mouth for a visible object before reattempting breaths

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Insert a nasopharyngeal airway to bypass the obstruction

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Perform five abdominal thrusts before returning to chest compressions

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Attempt several more breaths with increasing force to push the object through

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A visibly pregnant patient in her third trimester shows signs of complete airway obstruction. She is conscious and standing. Which modification to the standard adult technique is most appropriate?

Deliver chest thrusts instead of abdominal thrusts, with hands on the lower half of the sternum

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Perform standard abdominal thrusts but use about half the usual force to protect the fetus

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Place her in the left lateral position and perform back blows only

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Withhold all thrusts and wait for ALS because manual thrusts are contraindicated in pregnancy

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A patient has a deep laceration to the forearm with bright red blood flowing steadily. There is no suspected fracture. What is the first and most appropriate intervention to control the bleeding?

Apply firm, continuous direct pressure over the wound with a clean dressing

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Elevate the arm and apply a loose bandage without first applying direct pressure

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Apply a tourniquet proximal to the wound as the very first step

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Pack the wound with hemostatic gauze before applying any external pressure

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You have applied direct pressure to a bleeding thigh wound for several minutes and the dressing is now soaked through. Bleeding is still not controlled. What is the most appropriate next step?

Apply a tourniquet proximal to the wound on the thigh

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Remove the soaked dressing, inspect the wound, and start over with a fresh dressing

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Pour cold water over the wound to slow the bleeding through vasoconstriction

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Elevate the leg above the level of the heart and wait for the bleeding to clot on its own

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A tourniquet has been applied to a patient’s arm for hemorrhage control. Which piece of information is most critical to document and report to the receiving facility?

The time the tourniquet was applied

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The brand and model of the tourniquet used

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The patient's last tetanus immunization date

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The number of times direct pressure was attempted before the tourniquet

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You are treating a patient with a deep penetrating wound to the groin where a tourniquet cannot be placed. Bleeding is severe. What is the most appropriate hemorrhage control technique?

Pack the wound tightly with hemostatic gauze and apply firm direct pressure over the packed wound

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Apply a tourniquet as high on the thigh as possible even though the wound is in the groin

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Cover the wound with an occlusive dressing and simply monitor during transport

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Apply ice packs to the wound to induce vasoconstriction and slow the blood loss

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A patient has a traumatic partial amputation of the lower leg with massive hemorrhage. You apply a tourniquet two inches above the wound and tighten it, but bleeding continues. What is the most likely explanation and correct action?

The tourniquet may be insufficiently tight or poorly seated; apply a second tourniquet just proximal to the first and tighten until bleeding stops

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The bleeding is venous and will self-limit, so maintain pressure and continue transport

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Remove the first tourniquet, pack the wound with hemostatic gauze, and reapply the tourniquet

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The tourniquet is fine; continued bleeding is expected and will stop once the patient's pressure drops

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You respond to a patient with a large neck wound and arterial bleeding. Which approach is most appropriate for an EMR?

Apply firm direct pressure with a gloved hand or dressing to the bleeding site without compressing both carotid arteries at once

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Wrap a bandage circumferentially around the neck and pull it tight over the wound

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Apply an occlusive dressing and seal all four sides as you would for a chest injury

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Apply a tourniquet around the neck, since other methods are ineffective there

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A trauma patient is pale, cool, and sweaty. Her pulse is rapid and weak, she is anxious, and she feels dizzy when she sits up. These findings are most consistent with which condition?

Hypovolemic shock from internal or external blood loss

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Neurogenic shock from spinal cord disruption

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Anaphylactic shock from an allergic reaction

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Cardiogenic shock from heart muscle failure

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You are treating a patient in shock after a motor vehicle collision. After ensuring a patent airway and controlling external bleeding, what is the most important EMR action to address the shock?

Keep the patient warm and arrange rapid transport to a definitive care facility

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Give oral fluids to replace the volume lost from internal bleeding

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Sit the patient upright in a chair to reduce the heart's workload

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Apply ice packs over the major vessels to slow the heart rate

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A trauma patient in shock has a systolic blood pressure of 88 mmHg. The ambient temperature is 50 degrees Fahrenheit and the patient’s clothes are wet. Beyond hemorrhage control, which intervention is most critical?

Remove the wet clothing, cover the patient with dry blankets, and protect against further heat loss

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Leave the wet clothing in place to avoid disturbing a possible spinal injury

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Cool the patient further to lower the heart's metabolic demand

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Apply chemical heat packs directly against the bare skin over major vessels to rewarm quickly

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A patient who was stabbed is conscious but shows signs of early shock. There is no obvious external bleeding. Which statement best explains the absence of visible bleeding and does NOT change your priority of care?

Internal hemorrhage into a body cavity such as the abdomen or chest can produce shock without visible external blood loss

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The lack of external bleeding confirms the blade did not reach any major vessel

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Shock without visible bleeding after a stabbing indicates neurogenic shock from the pain

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The patient is most likely having a fainting spell rather than true hemorrhagic shock

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You are treating a conscious patient with suspected neurogenic shock after a diving injury. The skin is warm, the pulse is 52 beats per minute, and the blood pressure is 82/50 mmHg. He cannot feel his body below the shoulders. How does this differ from hemorrhagic shock, and what is the priority?

Neurogenic shock shows warm skin and a slow pulse rather than cool skin and a fast pulse; the priority is spinal motion restriction, temperature maintenance, and rapid transport

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This is identical to hemorrhagic shock and should be managed with aggressive tourniquet use

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Warm skin and a slow pulse mean he is not in shock and the low pressure is a normal athletic finding

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It is best treated by placing the patient in a steep head-down position with the legs raised high

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A 72-year-old woman struck by a car has a suspected internal abdominal injury and signs of shock. Her mental status is declining and scene time is already four minutes. Which set of actions best reflects correct EMR priorities?

Control any external bleeding, keep her warm, position her supine, and begin immediate transport while continuing assessment en route

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Stay on scene up to ten more minutes to finish a full head-to-toe exam before moving her

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Place her in the recovery position and wait for ALS to arrive before transporting

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Give oxygen by nasal cannula at 4 liters per minute and watch her for five minutes before transport

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An unresponsive adult is found face-down after a fall from a ladder. Which action should the EMR take FIRST regarding spinal motion restriction?

Manually stabilize the head and neck before moving the patient

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Apply a rigid cervical collar before touching the patient

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Log-roll the patient immediately without waiting for additional rescuers

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Assess the patient's level of consciousness before addressing the spine

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When applying a rigid cervical collar to a seated patient with a suspected spinal injury, what is the correct sizing criterion?

The collar must fit the distance between the patient's chin and the top of the shoulder without tilting the head

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The collar should be one size larger than measured to allow for swelling

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Any available collar may be used as long as it covers the cervical vertebrae

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The collar is correctly sized when the patient can flex the chin to the chest

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A conscious adult victim of a motor vehicle collision is ambulatory at the scene and denies neck or back pain. Which of the following findings would MOST indicate the need for spinal motion restriction?

The patient reports bilateral hand numbness after striking the windshield

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The patient has a visible laceration on the forehead

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The patient is mildly anxious and emotionally upset

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The patient walked away from the vehicle without assistance

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During a log-roll of a trauma patient, which team member is responsible for directing the movement?

The rescuer maintaining inline stabilization of the head and neck

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The most experienced EMR at the scene

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The rescuer positioned at the patient's hips

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The rescuer responsible for placing the long backboard

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An EMR arrives at a scene where a bystander is already holding a trauma patient’s head. What is the MOST appropriate next action?

Place your hands to take over inline stabilization and instruct the bystander to carefully release once you have control

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Ask the bystander to continue holding while you complete the primary survey

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Apply a cervical collar immediately and release the bystander from holding

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Gently reposition the head to a neutral position before taking over stabilization

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A helmeted motorcyclist is unconscious after a crash. The patient’s airway is patent and breathing is adequate with the helmet in place. Which statement BEST describes helmet management?

Leave the helmet in place and maintain inline stabilization unless the helmet prevents airway management or adequate assessment

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Remove the helmet immediately because unconscious patients cannot protect their own airway

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Remove only the face shield and defer full helmet removal until arrival at the hospital

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Remove the helmet as a team using the two-person technique before assessing breathing

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A patient found in a confined space has a suspected cervical spine injury and is in a seated position. The patient is conscious and has adequate breathing. Which device is MOST appropriate for initial packaging before moving the patient through the confined space?

A short immobilization vest or short backboard to stabilize the torso and head before extrication

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A long backboard applied immediately in the seated position

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Manual inline stabilization alone until the patient can be placed supine outside the space

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A scoop stretcher applied laterally to avoid disturbing the seated position

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Before and after splinting a suspected forearm fracture, the EMR must assess which of the following?

Distal pulse, motor function, and sensation

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Blood pressure in both arms

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Grip strength and elbow range of motion

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Skin temperature and capillary refill only

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A patient has a closed angulated injury to the mid-shaft femur with no distal neurovascular compromise. What is the preferred immobilization device?

A traction splint applied along the long axis of the leg

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A rigid board splint secured from the hip to the ankle

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A soft padded splint applied directly over the deformity

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Bilateral long board splints taped together around the thigh

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While splinting a suspected ankle fracture, the EMR notes the foot is cold, pale, and pulseless. What is the MOST appropriate action?

Gently realign the extremity toward the anatomical position, reassess circulation, and arrange for rapid transport

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Splint the ankle in the position found and document the neurovascular deficit

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Apply a traction splint to the lower leg to restore circulation

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Elevate the foot above heart level before applying the splint

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An EMR is applying a rigid board splint to a suspected tibial fracture. The splint should be positioned so that it immobilizes which structures?

The joint above and the joint below the suspected fracture site

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Only the fracture site itself to allow joint mobility for comfort

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The fracture site and the joint above only, to reduce splint length

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The entire lower extremity from pelvis to foot regardless of fracture location

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A patient fell from a bicycle and has a suspected shoulder dislocation with the arm held across the chest. How should the EMR splint this injury?

Immobilize the arm in the position of comfort found, using a sling and swathe

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Straighten the arm to anatomical position before applying a rigid splint

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Apply a traction splint along the humerus to realign the shoulder joint

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Bind both arms to the torso with a long backboard strap to prevent movement

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A patient has an open femur fracture with bone visible through the wound and moderate external bleeding that has been controlled with a pressure dressing. Which additional step is correct BEFORE applying a traction splint?

Cover the wound and exposed bone with a moist sterile dressing before applying the splint

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Attempt to reinsert the protruding bone end before splinting to reduce infection risk

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Remove the pressure dressing to inspect the wound fully before applying the splint

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Apply the traction splint first to reduce the fracture, then address the wound

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A responsive adult with type 1 diabetes is found diaphoretic and confused with a blood glucose reading of 50 mg/dL and an intact gag reflex. Which medication is indicated per standard EMR protocol?

Oral glucose gel administered between the cheek and gum

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Sublingual nitroglycerin spray to improve perfusion

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Epinephrine auto-injector to reverse the hypoglycemic reaction

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Supplemental oxygen via non-rebreather mask at 15 L/min

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An adult is in respiratory distress with suspected hypoxia after smoke inhalation. Which oxygen delivery device and flow rate provide the highest concentration of oxygen for a spontaneously breathing patient?

Non-rebreather mask at 10 to 15 liters per minute

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Nasal cannula at 2 to 4 liters per minute

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Simple face mask at 6 to 8 liters per minute

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Venturi mask at 24 percent concentration

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An EMR responds to a patient with a known severe allergy who develops hives, wheezing, and low blood pressure after eating shellfish. The patient has a prescribed epinephrine auto-injector. Which site is correct for administration?

Anterolateral thigh, through clothing if necessary

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Deltoid muscle of the upper arm

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Subcutaneous tissue of the abdomen

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Medial thigh to avoid the femoral vessels

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An EMR finds an unresponsive adult with pinpoint pupils and slow, gurgling respirations. Bystanders report the patient used an opioid. The EMR has naloxone available. What is the correct action?

Open the airway, support ventilations, and administer naloxone per protocol

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Administer naloxone first, then reassess the airway

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Wait for ALS because naloxone is outside EMR scope in most systems

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Administer oral glucose to rule out low blood sugar before giving naloxone

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A conscious adult with chest pain consistent with possible cardiac ischemia has no known aspirin allergy. He states he already chewed one regular-strength aspirin (325 mg) 20 minutes ago at home. Per protocol the EMR considers giving 324 mg of aspirin (four 81 mg tablets). What is the MOST appropriate action?

Do not give additional aspirin because the patient has already taken a full antiplatelet dose within the past hour

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Administer the full 324 mg dose regardless of prior aspirin use

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Administer only two 81 mg tablets to supplement the earlier dose

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Withhold aspirin because the patient is already anticoagulated and at bleeding risk

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When assessing a 3-year-old child in respiratory distress, which finding is MOST consistent with early compensated respiratory distress rather than late decompensation?

Increased respiratory rate with nasal flaring and intercostal retractions

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Bradycardia with a slowing respiratory rate

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Central cyanosis of the lips and nail beds

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Decreased level of consciousness with hypotension

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An EMR is caring for a 75-year-old who fell from standing height and has a possible hip fracture. Which consideration is MOST important when packaging this patient for transport?

Pad bony prominences and voids to prevent pressure injury during transport, given reduced soft tissue and skin fragility

Correct Incorrect Correct answer

Apply a traction splint to the hip as you would for a mid-shaft femur fracture

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Avoid supplemental oxygen to prevent oxygen toxicity in elderly patients

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Place the patient in a high-Fowler position to reduce respiratory effort

Correct Incorrect Correct answer

An EMR is called to a patient who is 36 weeks pregnant and reports sudden, painless, bright red vaginal bleeding. What is the MOST appropriate treatment and positioning for transport?

Administer high-flow oxygen, position the patient on her left side, and arrange for rapid transport

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Place the patient supine and perform a vaginal examination to assess dilation

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Allow the patient to choose her own position of comfort and transport non-urgently

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Apply a pelvic binder to control the bleeding and transport in a seated position

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An EMR assists in the delivery of a full-term infant. After birth the baby is limp, apneic, and centrally cyanotic. Which action is the HIGHEST priority?

Warm, dry, and stimulate the infant, then open the airway and reassess breathing

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Begin chest compressions immediately at a rate of 100 to 120 per minute

Correct Incorrect Correct answer

Administer blow-by oxygen from a distance without warming, drying, or stimulating

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Clamp and cut the umbilical cord before initiating any resuscitation steps

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An EMR responds to a bariatric patient (estimated weight 400 pounds) who is unresponsive on the floor after a syncopal episode. The patient is breathing adequately. Which transport consideration is MOST critical?

Request additional personnel and bariatric-rated equipment before attempting to move the patient, to prevent rescuer injury and maintain patient safety

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Use a standard stretcher with extra straps because all stretchers support at least 500 pounds

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Move the patient immediately using a two-rescuer carry to minimize time on scene

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Leave the patient supine on the floor and wait for ALS before any movement

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During an emergency delivery, the EMR observes the baby’s head crowning. Which action should the EMR take first?

Apply gentle support to the baby's head to guide a controlled delivery

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Instruct the mother to push as hard as possible to speed delivery

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Insert a gloved hand into the vaginal canal to check for cord position

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Position the mother supine with her legs tightly together to delay delivery

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Immediately after delivering a newborn, what is the EMR’s first priority?

Position and clear the airway, then dry and stimulate the infant while keeping it warm

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Clamp and cut the umbilical cord before assessing the infant

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Administer supplemental oxygen by mask at 15 liters per minute

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Place the infant on the mother's chest and wait for spontaneous breathing without stimulation

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A newborn remains limp and apneic after 30 seconds of drying and stimulation. What should the EMR do next?

Begin positive pressure ventilations with a properly sized bag-valve-mask at a rate of 40 to 60 breaths per minute

Correct Incorrect Correct answer

Begin chest compressions immediately at a rate of 100 per minute

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Suction the oropharynx continuously for 30 seconds before attempting ventilation

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Wrap the infant warmly and observe for spontaneous respiratory effort for another 60 seconds

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At delivery, the EMR notices the umbilical cord is wrapped once loosely around the newborn’s neck. What is the correct action?

Slip the cord over the infant's head and proceed with delivery

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Clamp and cut the cord immediately before delivering the body

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Push the infant's head back in to allow repositioning of the cord

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Apply traction to the cord to deliver the shoulders quickly

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An EMR delivers an infant and notes the placenta has not delivered 30 minutes after birth. Which action is most appropriate?

Transport without attempting to manually remove the placenta, and keep the mother and infant warm

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Gently pull on the umbilical cord to hasten placenta delivery

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Massage the uterus using a deep bimanual technique

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Clamp the cord as close to the vaginal opening as possible to apply traction

Correct Incorrect Correct answer

During delivery, the EMR observes a single limb presenting at the vaginal opening rather than the head or buttocks. What should the EMR do?

Position the mother with her hips elevated, cover the presenting part with a moist sterile dressing, and transport immediately

Correct Incorrect Correct answer

Instruct the mother to push with contractions to complete the delivery

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Attempt to gently reposition the limb back into the birth canal

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Place the mother in the left lateral recumbent position and await spontaneous resolution

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A construction worker is found confused, with hot skin, after working outdoors in extreme heat. Which condition does this presentation most suggest?

Heat stroke

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Heat exhaustion

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Heat cramps

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Severe dehydration without heat illness

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A patient found unresponsive in a cold environment has no palpable pulse after a careful 30 to 60 second pulse check. What should the EMR do?

Begin CPR and arrange for immediate transport

Correct Incorrect Correct answer

Withhold CPR because cold cardiac arrest has a poor prognosis

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Fully rewarm the patient before initiating CPR

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Continue checking for a pulse for several more minutes before starting compressions

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An EMR is caring for a patient with moderate hypothermia who is shivering. Which field intervention is most appropriate?

Remove wet clothing, insulate the patient from the environment, and handle the patient gently to avoid triggering a dysrhythmia

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Vigorously rub the patient's extremities to generate heat through friction

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Apply chemical heat packs directly against the bare skin of the axillae and groin

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Encourage the patient to perform mild exercise to raise core temperature

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A patient is retrieved from a pool after a witnessed submersion of roughly 3 minutes. The patient is unresponsive but has a pulse. What should the EMR prioritize?

Opening the airway and providing ventilatory support while preparing for transport

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Performing abdominal thrusts to clear water from the lungs before ventilating

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Withholding ventilation until the patient arrives at the hospital

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Placing the patient in the recovery position and monitoring without intervention

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A 68-year-old man is found seated outside on a hot day. He is alert and oriented, diaphoretic, and reports weakness and nausea. His skin is pale and cool despite the ambient temperature. Which statement best describes appropriate field treatment?

Move him to a cool environment, have him rest supine with legs elevated, and offer oral fluids only if he can swallow and is not vomiting

Correct Incorrect Correct answer

Immerse him in ice water immediately to prevent progression to heat stroke

Correct Incorrect Correct answer

Apply ice packs to the neck and groin and transport while withholding all fluids

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Administer high-flow oxygen by non-rebreather mask and restrict all fluid intake

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A teenager is unconscious after falling through ice into a frozen lake and was submerged for an estimated 8 minutes before bystanders pulled him out. He has no spontaneous breathing. Which statement best guides resuscitation decisions?

Begin CPR immediately; prolonged cold water submersion does not eliminate the possibility of survival, and resuscitation should continue until advanced care is available

Correct Incorrect Correct answer

Withhold CPR because submersion beyond 5 minutes in cold water is universally fatal

Correct Incorrect Correct answer

Provide only rescue breathing without compressions to avoid cardiac dysrhythmia from the cold

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Delay resuscitation until the patient is rewarmed to a core temperature above 30 degrees Celsius

Correct Incorrect Correct answer

An EMR is at the scene of a house fire and finds a responsive patient lying on the floor with smoke filling the room. Which type of move is most appropriate?

Emergency move, because the immediate environment poses a life threat to both the patient and rescuer

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Non-emergency move, because the patient is responsive and can assist

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Urgent move, because only patients with suspected spinal injuries require emergency moves

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No move yet, because the EMR should wait for additional personnel to perform a proper lift

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When preparing to lift a patient on a wheeled stretcher, what should the EMR do?

Keep the back straight, bend at the knees, and keep the load close to the body

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Bend at the waist and keep the legs straight to use the larger back muscles

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Twist the torso while lifting to redirect the stretcher toward the ambulance

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Keep the arms fully extended away from the body to maintain balance during the lift

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A patient with a suspected spinal injury must be moved from a vehicle in which he is seated upright. Which device is most appropriate for initial stabilization and extrication?

A vest-style short extrication device that stabilizes the spine before the patient is moved

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A long backboard placed behind the patient through the rear window

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A scoop stretcher slid under the patient from the front seat

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Immediate manual extraction followed by supine placement on a long board

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When carrying a patient down a staircase on a stair chair, what is the correct position for the EMR at the lower end of the chair?

Facing the patient and moving backward down the stairs while guiding the descent

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Facing away from the patient and walking forward to see the steps

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Standing beside the chair and supporting only the armrests

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Remaining at the top of the stairs while a single rescuer guides the chair from below

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A single EMR must perform an emergency drag of a heavy unresponsive supine patient from a burning structure. Which drag technique best protects the patient’s head while allowing the rescuer to pull from a position of leverage?

Shoulder drag, grasping the patient's clothing at the shoulders and cradling the head between the forearms

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Ankle drag, pulling the patient feet first while the arms trail above the head

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Firefighter carry over one shoulder to clear the structure faster

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Log roll the patient onto a backboard before dragging to maintain full spinal alignment

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An EMR is caring for an alert patient with a closed femur fracture and stable vital signs. A second crew is 10 minutes away. Which move strategy is most appropriate?

Splint the fracture in place and perform a non-emergency move when the additional crew arrives to assist with proper packaging

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Perform an immediate emergency drag to the ambulance to prevent blood loss from delay

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Have the patient bear weight and walk to the stretcher to reduce rescuer lift injury

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Use a single-rescuer carry immediately to avoid waiting for additional personnel

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When transferring care of a patient to an arriving ALS crew, which information should the EMR communicate first?

Chief complaint, mechanism of injury or nature of illness, and current mental status

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The patient's insurance information and contact details

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A detailed list of all bystanders who witnessed the event

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The names of all EMRs who were on scene

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An EMR has managed a 55-year-old man with chest pain for 8 minutes when an ALS unit arrives. He is diaphoretic and anxious, and the EMR has placed him in a position of comfort with oxygen applied. Which information is most critical to include in the verbal handoff?

The onset, quality, radiation, severity, and timing of the chest pain, along with baseline vital signs, interventions performed, and any change in condition

Correct Incorrect Correct answer

Only the current vital signs, because ALS providers will obtain a full history themselves

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The patient's weight and height for medication dosing purposes

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A description of the scene environment and bystander statements only

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Before loading a patient onto a stretcher for transport, the EMR should ensure all of the following EXCEPT:

That the patient has signed a written consent form for every intervention performed on scene

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That the patient is secured with at least two stretcher straps across the torso and legs

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That all identified injuries are splinted or bandaged before movement

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That any oxygen or airway adjuncts in use are transferred and functioning on the stretcher

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An EMR is the first responder on scene when a patient in respiratory distress deteriorates to unresponsiveness just as a transporting crew arrives. The crew needs about 2 minutes to set up equipment. What should the EMR do during that interval?

Continue airway management and ventilation with available tools while giving a concise real-time update so the transporting crew can prepare appropriately

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Stop all interventions and defer entirely to the arriving crew the moment they reach the patient

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Ask the transporting crew to stand by until the EMR has completed a full reassessment and written report

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Transfer the patient to the stretcher without communication so the crew can assess independently

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When transferring care of a patient to an incoming EMS crew, which piece of information is MOST important to communicate first?

Chief complaint and current mental status

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The patient's home address and insurance information

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The name of the patient's primary care physician

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The exact mileage from the scene to the hospital

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An EMR has cared for a 68-year-old man with chest pain for 8 minutes before the ambulance crew arrives. Which element should be included in the verbal report to the paramedics?

Vital signs obtained during the EMR's assessment

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The EMR's personal opinion of the likely diagnosis

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A request that the paramedics repeat all assessment steps from the beginning

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The patient's employer and occupational history

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An EMR is handing off a 45-year-old woman with a severe allergic reaction to an arriving ALS crew. The patient received no epinephrine because the EMR’s kit did not contain it. What is the BEST way to communicate this during transfer of care?

State clearly that no medications were administered and explain that epinephrine was unavailable at the scene

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Omit the medication information because no treatment was given

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Document the epinephrine as administered en route to avoid confusion

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Ask the ALS crew to decide for themselves whether medications were given based on the patient's appearance

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During transfer of care, the EMR reports that a trauma patient’s mental status changed from alert to confused approximately 3 minutes ago. Why is the timing of this change most significant to the receiving crew?

It suggests a deteriorating condition that may require rapid intervention

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It allows the receiving crew to document a more detailed social history

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It confirms the EMR's assessment was performed incorrectly

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It indicates the patient no longer requires spinal precautions

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An EMR at a community event transfers care of an unresponsive adult to paramedics. The patient’s companion tells the EMR the patient has a documented do-not-resuscitate order but the paperwork is at home. How should the EMR handle this in the verbal report?

Report the companion's statement about the order to the paramedics and note that no documentation is present at the scene

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Instruct the paramedics to honor the order immediately based on the companion's word alone

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Withhold the information because it cannot be verified

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Advise the companion to contact the hospital directly so the EMR can avoid liability

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An EMR cared for a pediatric patient and obtained a history from the child’s parent, who left the scene before the ALS crew arrived. The parent stated the child has a severe penicillin allergy. Which action BEST reflects proper transfer-of-care practice?

Report the allergy to the receiving crew verbally and document it on the patient care report

Correct Incorrect Correct answer

Omit the allergy because the parent is no longer present to confirm it

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Administer a test dose of penicillin to verify the allergy before transfer

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Delay transfer of care until the parent returns to confirm the history

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An unresponsive adult patient is breathing adequately and has no suspected spinal injury. Which position BEST protects the airway from aspiration?

Recovery position (lateral recumbent)

Correct Incorrect Correct answer

Supine with arms at the sides

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Sitting upright at 90 degrees

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Prone with the head turned to the side

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What is the correct method for sizing an oropharyngeal airway (OPA) before insertion?

Measure from the corner of the patient's mouth to the earlobe or angle of the jaw on the same side

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Measure from the tip of the nose to the earlobe on the opposite side

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Select the size based on the patient's estimated body weight

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Choose the largest size that will fit between the patient's teeth

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When suctioning an adult patient’s oropharynx, the EMR should limit each suction attempt to no longer than how many seconds?

15 seconds

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5 seconds

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30 seconds

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60 seconds

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A semiconscious patient has a gag reflex present and secretions pooling in the oropharynx. Which airway adjunct is MOST appropriate for this patient?

Nasopharyngeal airway (NPA)

Correct Incorrect Correct answer

Oropharyngeal airway (OPA)

Correct Incorrect Correct answer

Supraglottic airway device

Correct Incorrect Correct answer

Endotracheal tube

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An EMR inserts an OPA into an unresponsive adult and finds that, instead of holding the tongue forward, the device is pushing the tongue back toward the pharynx and worsening the obstruction. What is the MOST likely cause?

The OPA is too large for the patient

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The OPA is too small for the patient

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The patient has a cervical spine injury that is worsening

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The patient should not have any airway adjunct placed

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When inserting a nasopharyngeal airway in an adult, how should the device be oriented during insertion?

With the bevel facing the nasal septum (toward the midline)

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With the bevel facing the lateral wall of the nostril

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Rotated 180 degrees so the bevel faces superiorly

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At a 45-degree upward angle toward the forehead

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An EMR is suctioning a patient who begins to vomit during the procedure. After clearing the vomitus, the patient’s SpO2 drops to 88 percent and breathing remains present but labored. What is the PRIORITY next action?

Reposition the airway and provide supplemental oxygen or assisted ventilation as indicated by breathing adequacy

Correct Incorrect Correct answer

Insert an OPA immediately before reassessing breathing

Correct Incorrect Correct answer

Continue suctioning for up to 60 seconds to ensure the airway is fully clear

Correct Incorrect Correct answer

Place the patient supine and perform abdominal thrusts

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A nasal cannula delivering oxygen at 4 liters per minute provides an approximate fraction of inspired oxygen (FiO2) of what percentage?

Approximately 36 percent

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Approximately 21 percent

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Approximately 60 percent

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Approximately 90 percent

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Which oxygen delivery device is MOST appropriate for a patient who is breathing adequately but has mild respiratory distress with an SpO2 of 94 percent?

Nasal cannula at 2 to 6 liters per minute

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Nonrebreather mask at 15 liters per minute

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Bag-valve-mask with 100 percent oxygen

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Simple face mask at 15 liters per minute

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Before placing a nonrebreather mask on a patient, the EMR should flush the reservoir bag with oxygen first. What is the PRIMARY reason for this step?

To ensure the reservoir contains a sufficient volume of high-concentration oxygen for the first breath

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To test whether the mask seal is airtight before application

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To warm the oxygen so the patient does not feel discomfort

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To verify the one-way valves are functioning by observing the bag deflate

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A nonrebreather mask is set at 10 liters per minute. During inspiration the EMR notices the reservoir bag collapses completely before the patient finishes inhaling. What is the correct response?

Increase the flow rate to prevent the bag from fully collapsing

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Decrease the flow rate because the bag collapse indicates too much oxygen

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Switch immediately to a nasal cannula at 6 liters per minute

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Remove the mask and reassess the patient for a tension pneumothorax

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An EMR is caring for a patient with a known history of severe chronic obstructive pulmonary disease who is in mild respiratory distress with an SpO2 of 90 percent. The patient is breathing adequately at 16 breaths per minute. Which approach to oxygen administration is MOST appropriate?

Apply low-flow oxygen by nasal cannula and reassess SpO2 frequently, titrating to maintain saturation around 88 to 92 percent

Correct Incorrect Correct answer

Apply a nonrebreather mask at 15 liters per minute to rapidly drive the saturation to 100 percent

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Withhold all supplemental oxygen because patients with COPD should never receive oxygen

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Begin positive-pressure ventilation immediately

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When using a bag-valve-mask (BVM) alone as a single rescuer, what is the MOST critical challenge?

Maintaining an adequate mask seal while keeping the airway open with one hand

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Determining the correct tidal volume from the bag size

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Preventing the pressure relief valve from activating during ventilation

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Ensuring the oxygen reservoir bag remains attached to the BVM

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When providing ventilations with a BVM to an adult patient who is not breathing, the EMR should deliver each breath over approximately how long?

About 1 second, enough to produce visible chest rise

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3 to 4 seconds to ensure complete lung filling

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Less than 0.5 seconds to maximize the ventilation rate

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Until the reservoir bag is fully compressed on every breath

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An EMR is ventilating an apneic adult with a BVM and notices the abdomen rising with each breath while the chest barely moves. What is the MOST likely cause?

The airway is not adequately open and ventilations are inflating the stomach

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The BVM oxygen flow rate is too high, creating excess pressure

Correct Incorrect Correct answer

The patient has a tension pneumothorax preventing chest expansion

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The mask size is too large for the patient's face

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A pocket mask with a one-way valve and supplemental oxygen port is being used to ventilate an apneic adult. Oxygen is connected to the side port at 10 liters per minute. What approximate FiO2 can be expected with this setup?

Approximately 50 percent

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Approximately 21 percent because the rescuer's exhaled air dilutes the oxygen

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Approximately 100 percent because oxygen is flowing continuously

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Approximately 16 percent because the rescuer's exhaled air contains less oxygen than room air

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During BVM ventilation of a cardiac arrest patient, the EMR notices increasing resistance when squeezing the bag and the chest is no longer rising, despite a good mask seal and an open airway. CPR has been ongoing for 4 minutes. What is the MOST appropriate next action?

Reassess airway position, suction if secretions or vomitus are present, and continue ventilation while preparing for ALS handoff

Correct Incorrect Correct answer

Increase the squeeze force to overcome the resistance and ensure adequate tidal volume

Correct Incorrect Correct answer

Stop ventilations and perform only chest compressions until ALS arrives

Correct Incorrect Correct answer

Switch to mouth-to-mouth ventilation to determine whether the resistance is device-related

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When performing CPR on an adult, what is the recommended chest compression depth?

At least 2 inches but no more than 2.4 inches

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At least 1.5 inches but no more than 2 inches

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At least 2.5 inches but no more than 3 inches

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At least 1 inch but no more than 1.5 inches

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A lone rescuer is performing CPR on an infant. What compression-to-ventilation ratio should be used?

30:2

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15:2

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30:1

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15:1

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You find an unresponsive adult who is not breathing normally and you have no AED available. What is the correct way to begin resuscitation?

Activate the emergency response system, then begin chest compressions immediately

Correct Incorrect Correct answer

Open the airway and give two rescue breaths before starting compressions

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Check for a pulse for up to 30 seconds before starting compressions

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Apply supplemental oxygen before initiating compressions

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Two trained rescuers are performing CPR on a 6-year-old child who has not been intubated. Which compression-to-ventilation ratio is most appropriate?

15:2

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30:2

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30:1

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5:1

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A lone rescuer is performing infant CPR using the two-finger technique. Where on the body should the compressions be delivered?

On the center of the chest, just below the nipple line

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On the upper half of the sternum, at the level of the clavicles

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Over the left side of the chest directly above the heart

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On the lower tip of the sternum at the xiphoid process

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At what rate should chest compressions be delivered during CPR for a patient of any age?

100 to 120 compressions per minute

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60 to 80 compressions per minute

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80 to 100 compressions per minute

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120 to 140 compressions per minute

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During two-rescuer CPR, your partner takes over chest compressions. Which action is most important to optimize cardiac output during this transition?

Keep the interruption in compressions to less than 10 seconds

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Increase the compression rate to 130 per minute after the switch to compensate

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Deliver two rescue breaths immediately when the new rescuer takes position

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Recheck the pulse for up to 15 seconds before the new rescuer begins

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While performing CPR on an adult, an EMR notices the chest is not fully recoiling between compressions. What is the most likely consequence?

Reduced venous return to the heart, which lowers coronary perfusion pressure

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Increased air trapping in the lungs from inadequate exhalation

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Greater risk of rib fractures due to sustained sternal pressure

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A slower compression rate as the rescuer compensates for the poor recoil

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An AED advises a shock for an adult in cardiac arrest. What must the rescuer do immediately before pressing the shock button?

Confirm that no one is touching the patient and announce 'clear'

Correct Incorrect Correct answer

Deliver one rescue breath while the AED charges to save time

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Continue chest compressions until the shock button is pressed

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Remove and re-apply the pads to confirm proper placement before shocking

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Using standard anterolateral placement, where should adult AED pads be positioned?

One pad below the right clavicle and one on the left lateral chest below the armpit

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Both pads on the left side of the chest, separated by at least 4 inches

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One pad over the left chest and one on the upper back between the shoulder blades

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One pad on the upper sternum and one on the lower left abdomen

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You must use an AED on an 8-year-old child, but only standard adult pads are available. What is the correct approach?

Use the adult pads in an anteroposterior position, one on the chest and one on the back, so they do not overlap

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Do not use the AED, because adult energy levels are always contraindicated in children under 12

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Cut the adult pads in half to reduce their size before applying them

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Apply the adult pads in the standard anterolateral position and proceed without any change

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Immediately after an AED delivers a shock to a cardiac arrest patient, what should the EMR do?

Resume chest compressions right away without pausing to recheck the pulse

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Check for a pulse for up to 10 seconds to see whether the shock worked

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Wait 30 seconds for the AED to reanalyze the rhythm before touching the patient

Correct Incorrect Correct answer

Deliver two rescue breaths before restarting compressions

Correct Incorrect Correct answer

A bystander has been doing CPR for about 4 minutes on an unwitnessed adult cardiac arrest. The AED is now ready. What is the best immediate action?

Attach the AED and follow its prompts without delay

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Perform 2 more minutes of CPR before attaching the AED to reperfuse the heart first

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Gather a brief history from the bystander before attaching the AED

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Deliver rescue breaths for 30 seconds before allowing the AED to analyze

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A conscious adult is clutching his throat and cannot speak, cough, or breathe. What is the appropriate first action?

Deliver abdominal thrusts until the object is expelled or the patient becomes unresponsive

Correct Incorrect Correct answer

Perform a blind finger sweep of the mouth to remove any visible obstruction

Correct Incorrect Correct answer

Lay the patient supine and perform back blows in that position

Correct Incorrect Correct answer

Begin rescue breathing to force air past the obstruction

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A conscious infant is showing signs of a severe airway obstruction. Which technique should be used to relieve it?

Alternate 5 back slaps with 5 chest thrusts, supporting the infant face-down then face-up

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Deliver abdominal thrusts using two fingers placed just above the navel

Correct Incorrect Correct answer

Perform 5 back blows followed by 5 abdominal thrusts as used for adults

Correct Incorrect Correct answer

Lay the infant supine and attempt repeated mouth-to-mouth rescue breathing

Correct Incorrect Correct answer

A conscious adult with severe obesity becomes unresponsive after abdominal thrusts fail to relieve her airway obstruction. She is now on the ground. What is the correct next step?

Begin CPR and look in the mouth for a visible object before each set of rescue breaths

Correct Incorrect Correct answer

Continue abdominal thrusts in the supine position using twice the normal force

Correct Incorrect Correct answer

Perform chest thrusts with the patient supine but search the mouth only if the object becomes visible on its own

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Perform finger sweeps of the throat whether or not an object is visible

Correct Incorrect Correct answer

While giving rescue breaths to an unresponsive choking patient, the EMR finds the first breath does not make the chest rise. What is the most appropriate next step?

Reposition the head and attempt a second breath before proceeding to compressions

Correct Incorrect Correct answer

Immediately begin abdominal thrusts before attempting any additional breaths

Correct Incorrect Correct answer

Skip ventilations entirely and proceed directly to chest compressions

Correct Incorrect Correct answer

Use a bag-valve mask with supplemental oxygen to force air past the obstruction

Correct Incorrect Correct answer

A conscious 3-year-old has a mild airway obstruction. She is coughing forcefully and still making some sounds. What is the most appropriate initial management?

Encourage the child to keep coughing and do not intervene with back slaps or thrusts

Correct Incorrect Correct answer

Begin alternating back slaps and abdominal thrusts immediately to prevent deterioration

Correct Incorrect Correct answer

Perform a blind finger sweep to try to clear the airway

Correct Incorrect Correct answer

Lay the child prone and deliver 5 firm back blows between the shoulder blades

Correct Incorrect Correct answer

An EMR applies direct pressure to a large thigh laceration. After a few minutes, blood has soaked through the first dressing. What is the correct next action?

Apply additional dressings on top of the original dressing and continue direct pressure

Correct Incorrect Correct answer

Remove the soaked dressing and apply a fresh one to better assess the wound

Correct Incorrect Correct answer

Immediately apply a tourniquet because direct pressure has failed

Correct Incorrect Correct answer

Elevate the extremity and stop applying direct pressure while you reassess

Correct Incorrect Correct answer

An EMR applies a commercial tourniquet to a patient’s forearm for life-threatening bleeding. What information must be documented and handed off to incoming EMS?

The time the tourniquet was applied

Correct Incorrect Correct answer

The patient's blood pressure at the time the tourniquet was applied

Correct Incorrect Correct answer

The estimated blood loss in milliliters before the tourniquet was applied

Correct Incorrect Correct answer

The brand and lot number of the tourniquet used

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A patient has a deep penetrating wound to the right armpit with spurting arterial bleeding, and direct pressure is hard to maintain because of the wound’s location. Which hemorrhage-control technique is most appropriate?

Pack the wound with hemostatic gauze and apply sustained direct pressure over the packing

Correct Incorrect Correct answer

Apply a tourniquet as high as possible on the right arm

Correct Incorrect Correct answer

Apply a pressure bandage loosely over the wound to allow drainage

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Leave the wound open and position the patient for gravity drainage during transport

Correct Incorrect Correct answer

An EMR applies a tourniquet to a patient’s leg for arterial bleeding. After fully tightening it, bright red blood is still flowing from the wound. What is the most appropriate next action?

Apply a second tourniquet just proximal to the first and tighten until bleeding stops

Correct Incorrect Correct answer

Loosen the first tourniquet slightly and reapply it over padding to improve effectiveness

Correct Incorrect Correct answer

Switch to wound packing alone because the tourniquet has failed

Correct Incorrect Correct answer

Leave the tourniquet as is and document it as adequate since some bleeding is expected

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A 34-year-old man has significant bleeding from a leg laceration and is showing early signs of shock. After you control the hemorrhage, which body position is generally most appropriate for him?

Lying flat on his back (supine)

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Sitting fully upright to ease breathing

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Lateral recumbent (recovery position)

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Prone with the head turned to the side

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You are caring for a patient in shock on a cold day. Why is maintaining body temperature a priority in this patient?

Hypothermia worsens the blood's ability to clot and impairs cardiovascular function, accelerating shock progression

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Cold temperatures cause peripheral vasodilation, lowering blood pressure further

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Shivering increases oxygen consumption but has no effect on clotting

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Body temperature does not significantly affect shock outcomes in the prehospital setting

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A teenage patient involved in a motor vehicle crash has pale, cool, diaphoretic skin and a rapid, weak radial pulse. She is conscious and anxious. Which set of interventions is the highest priority at this time?

Control visible hemorrhage, apply oxygen, cover with a blanket, and arrange immediate transport

Correct Incorrect Correct answer

Obtain a detailed past medical history and full medication list before beginning any treatment

Correct Incorrect Correct answer

Place the patient in a seated position and give oral fluids to restore intravascular volume

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Obtain intravenous access first and withhold oxygen until SpO2 is confirmed below 94 percent

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During a prolonged wait for an ambulance in winter, a shock patient’s mental status begins to decline. His skin is mottled and his breathing has slowed. What does this change most likely indicate?

Decompensated shock, in which the body can no longer maintain adequate perfusion

Correct Incorrect Correct answer

The patient is improving because his heart rate is decreasing toward normal

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These signs indicate neurogenic shock caused by a spinal cord injury

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Slowed breathing is a normal response to cold exposure and does not indicate deterioration

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A patient with an isolated open femur fracture has significant external bleeding that has been controlled with a tourniquet. He is now showing signs of shock. You have one blanket available. How should you use it to best preserve core temperature while still being able to monitor the injury?

Cover the patient's torso, keeping the tourniquet site exposed for ongoing reassessment

Correct Incorrect Correct answer

Wrap the blanket tightly around the injured leg over the tourniquet to insulate the extremity

Correct Incorrect Correct answer

Place it beneath the patient on the ground to prevent conductive heat loss to the surface

Correct Incorrect Correct answer

Fold it and place it under the patient's head only, because the head loses the most body heat

Correct Incorrect Correct answer

A 68-year-old woman is found unresponsive in her cold apartment. She has a pulse of 42 beats per minute and is breathing 8 times per minute. Her skin is cold and waxy. Which action is most important to avoid during initial management?

Rough handling or unnecessary movement, which can trigger ventricular fibrillation in a severely hypothermic heart

Correct Incorrect Correct answer

Applying supplemental oxygen via nonrebreather mask

Correct Incorrect Correct answer

Covering the patient with blankets to prevent further heat loss

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Opening the airway and providing assisted ventilations

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You arrive at the scene of a fall from a ladder. The patient is conscious and complaining of neck pain. What is your first spinal-related action?

Manually stabilize the head and neck in a neutral, inline position

Correct Incorrect Correct answer

Apply a cervical collar before touching the patient

Correct Incorrect Correct answer

Tell the patient to hold still while you finish assessing the scene

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Log-roll the patient immediately to assess the back

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A cervical collar has been applied to a trauma patient. When should manual stabilization of the head be released?

Only after the patient is fully secured to an approved immobilization device with all straps in place

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Immediately after the cervical collar is applied and confirmed to be the correct size

Correct Incorrect Correct answer

Once the patient confirms he can no longer feel pain in his neck

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As soon as the stretcher is loaded into the ambulance

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During assessment of a conscious, alert trauma patient, which finding would most strongly indicate the need for spinal motion restriction?

Midline cervical spine tenderness on palpation combined with a high-speed impact mechanism

Correct Incorrect Correct answer

Bruising to the front of the chest with no complaint of neck or back pain

Correct Incorrect Correct answer

An abrasion to the forehead with full, pain-free neck range of motion and no distracting injuries

Correct Incorrect Correct answer

Tachycardia and diaphoresis with no musculoskeletal complaints

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A restrained driver is unconscious after a high-speed collision. You have one EMR partner. Fuel is leaking and you must move the patient out of the vehicle urgently. What is the best approach?

Perform a rapid extrication with manual inline stabilization, accepting some spinal movement to remove the patient from immediate danger

Correct Incorrect Correct answer

Wait for additional resources to set up full long-board immobilization before moving the patient

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Apply a short immobilization device before moving the patient, regardless of the fuel hazard

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Have the patient walk to safety since the mechanism was not severe

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A 7-year-old unrestrained child was ejected from a vehicle. She is unresponsive with agonal respirations. You need to open the airway. Which technique is preferred given the concern for spinal injury?

Jaw thrust without head tilt

Correct Incorrect Correct answer

Head-tilt chin-lift, because cervical collars cannot be fitted to children under 8

Correct Incorrect Correct answer

Hyperextend the neck to maximize airway diameter in pediatric patients

Correct Incorrect Correct answer

Insert a nasopharyngeal airway without any manual maneuver first

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While applying a cervical collar, you find the only available collar is too large: the patient’s chin does not rest in the chin cup and the collar forces the head into mild hyperextension. What should you do?

Maintain manual inline stabilization and use rolled towels or padding to hold neutral alignment while awaiting a properly sized collar

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Apply the oversized collar anyway because any collar is better than none

Correct Incorrect Correct answer

Flex the neck slightly to compensate for the hyperextension the collar causes

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Apply the collar, document that sizing was suboptimal, and release manual stabilization

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Before splinting a closed mid-shaft forearm fracture, which assessment must be performed and documented?

Distal pulse, motor function, and sensation

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Blood glucose level and pupillary response

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Skin temperature of the uninjured arm only

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Lung sounds and oxygen saturation

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When splinting an angulated fracture of the lower leg, when is it appropriate to attempt to straighten the limb before applying the splint?

When pulses are absent distal to the injury and gentle traction in line with the bone may restore circulation

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Whenever the patient requests it to reduce pain

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Only when the bone is visibly protruding through the skin

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Never; angulated fractures must always be splinted in the position found

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A patient has a suspected fracture of the humerus (upper arm). Which splinting approach is most appropriate?

Immobilize the shoulder and the elbow, then use a sling and swathe to secure the arm against the torso

Correct Incorrect Correct answer

Splint only the fracture site and leave both the shoulder and elbow free to move

Correct Incorrect Correct answer

Apply a rigid posterior splint and leave the arm extended straight at the side

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Apply a traction splint, the preferred device for humeral fractures

Correct Incorrect Correct answer

After you apply a rigid splint to a tibial fracture, the patient reports that her toes have become numb and she can no longer wiggle them. What is the most appropriate immediate action?

Loosen or remove the splint, reassess distal circulation and sensation, and reapply less tightly

Correct Incorrect Correct answer

Document the findings and reassess in 10 minutes to see if sensation returns

Correct Incorrect Correct answer

Elevate the limb above heart level and apply ice to reduce swelling

Correct Incorrect Correct answer

Recognize this as an expected finding after splinting that needs no immediate action

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A patient has an open femur fracture with bone visible through the wound. Bleeding has been controlled. How should you manage the open wound and fracture together?

Cover the wound with a moist sterile dressing, do not push the bone back into the wound, and immobilize the femur with a traction splint if indicated by protocol

Correct Incorrect Correct answer

Manually reduce the fracture to close the wound before splinting

Correct Incorrect Correct answer

Apply a dry occlusive dressing tightly over the exposed bone to prevent contamination

Correct Incorrect Correct answer

Withhold all splinting until surgical debridement is completed at the hospital

Correct Incorrect Correct answer

A traction splint is being considered for a patient with a suspected mid-shaft femur fracture. Which finding would be a contraindication to using a traction splint?

A suspected pelvic fracture on the same side as the femur fracture

Correct Incorrect Correct answer

The patient is conscious and cooperative

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The fracture is closed with intact distal pulses

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The patient weighs more than 150 pounds

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A conscious adult is having chest discomfort, denies any aspirin allergy or recent gastrointestinal bleeding, and has taken no aspirin today. Per a typical protocol for a suspected cardiac event, how should aspirin be given?

Have the patient chew non-enteric-coated aspirin rather than swallow it whole

Correct Incorrect Correct answer

Give a single 650 mg dose swallowed whole with a full glass of water

Correct Incorrect Correct answer

Give 81 mg swallowed whole to minimize gastric irritation

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Crush a 500 mg tablet and dissolve it in juice to drink

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A 55-year-old man with diabetes is unresponsive. His blood glucose reads 38 mg/dL. Why is oral glucose not appropriate for this patient at this time?

An unresponsive patient cannot protect his airway, so oral glucose creates a risk of aspiration

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Oral glucose is contraindicated in all diabetic patients over age 50

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Oral glucose is only indicated when blood glucose is below 20 mg/dL

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Oral glucose raises blood sugar too slowly to help any patient with altered mental status

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You respond to a 22-year-old woman with a known bee sting allergy. She has been stung and has hives, wheezing, and low blood pressure. She has her own epinephrine auto-injector. Which action should you take first?

Assist her in using her epinephrine auto-injector into the outer mid-thigh as quickly as possible

Correct Incorrect Correct answer

Give oxygen first and reassess before using the auto-injector

Correct Incorrect Correct answer

Contact medical direction to confirm an order before giving any medication

Correct Incorrect Correct answer

Lay her supine and wait to see whether the reaction stabilizes on its own

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You have given intranasal naloxone to an unresponsive patient with a suspected opioid overdose. After several minutes the patient remains unresponsive with respirations of 4 per minute. What is the most appropriate next step?

Continue assisted ventilations and give another dose of naloxone per protocol

Correct Incorrect Correct answer

Wait at least 10 minutes before any repeat dose to avoid precipitating withdrawal

Correct Incorrect Correct answer

Stop naloxone because the lack of response proves it is not an opioid overdose

Correct Incorrect Correct answer

Stop assisted ventilations because naloxone will restore breathing within seconds

Correct Incorrect Correct answer

A 6-year-old child (about 20 kg) is in severe respiratory distress with stridor, hives, and vomiting after eating at a birthday party. The caregiver has an adult epinephrine auto-injector (0.3 mg). No pediatric auto-injector is available. What should you do?

Use the adult auto-injector per protocol, since the benefit of epinephrine in anaphylaxis outweighs the risk of a slightly higher dose

Correct Incorrect Correct answer

Withhold epinephrine because the adult dose will cause a lethal arrhythmia in a child this size

Correct Incorrect Correct answer

Give oral diphenhydramine from the first aid kit and transport without epinephrine

Correct Incorrect Correct answer

Use only half the dose by pulling the device away after partly depressing the trigger

Correct Incorrect Correct answer

An EMR arrives on scene to find a 4-year-old child who is unresponsive and not breathing. What compression-to-ventilation ratio is correct when a single rescuer performs CPR on this child?

30 compressions to 2 ventilations

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15 compressions to 2 ventilations

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30 compressions to 1 ventilation

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15 compressions to 1 ventilation

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When assessing an older adult after a ground-level fall, which finding should raise the EMR’s suspicion for a significant injury even though the patient reports only mild discomfort?

Point tenderness over the hip with external rotation of the affected leg

Correct Incorrect Correct answer

Mild bruising on the forearm with no deformity

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Slight swelling of the ankle with full weight-bearing ability

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An abrasion on the palm with no underlying bony tenderness

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An EMR is caring for a patient who is 36 weeks pregnant and lying supine on a stretcher. Her blood pressure drops and she becomes pale and dizzy. After confirming the airway is open, what is the most appropriate next action?

Manually displace the uterus to the left or tilt the patient onto her left side

Correct Incorrect Correct answer

Place the patient in the Trendelenburg position to improve venous return

Correct Incorrect Correct answer

Administer high-flow oxygen and prepare for immediate delivery

Correct Incorrect Correct answer

Apply a pneumatic anti-shock garment to increase peripheral resistance

Correct Incorrect Correct answer

A patient weighing approximately 400 pounds requires transport after a fainting episode. She is now awake and alert. Which consideration is most important when moving this patient?

Use a bariatric-rated stretcher and request additional personnel before any lift

Correct Incorrect Correct answer

Use a standard stretcher and place a backboard underneath for extra support

Correct Incorrect Correct answer

Allow the patient to walk to the stretcher to avoid equipment damage

Correct Incorrect Correct answer

Apply a scoop stretcher and transfer immediately to limit scene time

Correct Incorrect Correct answer

An EMR is evaluating a 2-year-old who is alert, crying, and breathing at 30 breaths per minute after a minor fall. The child’s skin is pink and warm. How does this respiratory rate compare with normal values for this age group?

It is within the normal range for a toddler

Correct Incorrect Correct answer

It is significantly elevated and indicates respiratory distress

Correct Incorrect Correct answer

It is below normal and indicates early hypoventilation

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It is borderline low and warrants supplemental oxygen

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An older adult with known dementia is found on the floor by a home care aide. The patient cannot report pain or describe how the injury happened. Which approach best guides the EMR’s physical examination?

Perform a systematic head-to-toe assessment, watching for guarding, deformity, and behavioral cues such as moaning or grimacing during palpation

Correct Incorrect Correct answer

Limit the examination to areas the aide identifies as injured to avoid agitating the patient

Correct Incorrect Correct answer

Skip palpation of non-deformed extremities because the patient would vocalize if they were fractured

Correct Incorrect Correct answer

Rely primarily on vital signs to determine injury severity because the history is unavailable

Correct Incorrect Correct answer

During an imminent delivery, the EMR sees the infant’s head crowning. What is the correct action at this moment?

Apply gentle counterpressure to the head to guide a slow, controlled delivery

Correct Incorrect Correct answer

Instruct the mother to push hard with the next contraction to speed delivery

Correct Incorrect Correct answer

Grasp the head firmly and pull downward to complete the delivery

Correct Incorrect Correct answer

Ask the mother to cross her legs and delay delivery until advanced help arrives

Correct Incorrect Correct answer

Immediately after an emergency field delivery, what is the EMR’s first priority for the newborn?

Dry and stimulate the newborn while keeping it warm

Correct Incorrect Correct answer

Clamp and cut the umbilical cord before assessing breathing

Correct Incorrect Correct answer

Suction the newborn's airway with a bulb syringe before drying

Correct Incorrect Correct answer

Count the heart rate before performing any other intervention

Correct Incorrect Correct answer

An EMR delivers a newborn whose umbilical cord is wrapped loosely around the neck. What is the appropriate management?

Slip the cord gently over the infant's head and proceed with the delivery

Correct Incorrect Correct answer

Immediately clamp and cut the cord before delivering the body

Correct Incorrect Correct answer

Apply traction to the body to rapidly deliver the infant before the cord tightens

Correct Incorrect Correct answer

Have the mother stop pushing and transport immediately without further intervention

Correct Incorrect Correct answer

After delivery, a newborn remains apneic and limp despite 30 seconds of drying and stimulation. The heart rate is 80 beats per minute. What is the next appropriate action?

Begin positive pressure ventilations at a rate of 40 to 60 breaths per minute

Correct Incorrect Correct answer

Begin chest compressions at a rate of 120 per minute

Correct Incorrect Correct answer

Continue stimulation for another 60 seconds before intervening

Correct Incorrect Correct answer

Place the newborn in a sniffing position and apply blow-by oxygen

Correct Incorrect Correct answer

During an imminent delivery, the EMR sees that the presenting part is not the head but a single foot. Which action is most appropriate?

Position the mother with her hips elevated, administer high-flow oxygen, and transport emergently without attempting delivery

Correct Incorrect Correct answer

Guide the delivery by grasping the foot and applying gentle downward traction

Correct Incorrect Correct answer

Instruct the mother to push forcefully to complete the delivery before transport

Correct Incorrect Correct answer

Place the mother in a left lateral position only and withhold oxygen until the fetal heart rate is confirmed

Correct Incorrect Correct answer

After delivery of the infant, significant bright red vaginal bleeding occurs and the placenta has not yet delivered. What should the EMR do?

Apply firm fundal massage and transport emergently while monitoring for signs of shock

Correct Incorrect Correct answer

Clamp and cut the cord, then pull on it firmly to speed placental delivery

Correct Incorrect Correct answer

Pack the vaginal canal with sterile dressings to control the hemorrhage

Correct Incorrect Correct answer

Withhold fundal massage until the placenta delivers spontaneously within 30 minutes

Correct Incorrect Correct answer

A 22-year-old runner collapses during a road race on a hot day. He is confused, his skin is hot and dry, and his body temperature is estimated to be extremely elevated. Which condition does this presentation most suggest?

Heat stroke

Correct Incorrect Correct answer

Heat exhaustion

Correct Incorrect Correct answer

Heat cramps

Correct Incorrect Correct answer

Low blood sodium from overhydration

Correct Incorrect Correct answer

An EMR finds a patient unconscious in a snowbank. The patient is unresponsive, breathing very slowly, and has a weak, slow pulse. What is the priority intervention?

Move the patient to a warm environment, remove wet clothing, and apply passive rewarming while preparing for transport

Correct Incorrect Correct answer

Begin rapid active rewarming by immersing the extremities in hot water on scene

Correct Incorrect Correct answer

Withhold all movement until the patient regains consciousness to avoid arrhythmias

Correct Incorrect Correct answer

Apply vigorous external stimulation to raise the heart rate before moving

Correct Incorrect Correct answer

A hiker presents with pale, waxy, hard skin on the toes and pain that has progressed to numbness after prolonged exposure to freezing temperatures. Pulses are present in the foot. How should the EMR manage the affected toes?

Protect the area from further trauma and cold, cover it loosely with dry dressings, and avoid rubbing or rewarming in the field

Correct Incorrect Correct answer

Rub the toes briskly to restore circulation before applying dressings

Correct Incorrect Correct answer

Immerse the toes in water just below body temperature to gradually rewarm them

Correct Incorrect Correct answer

Open any blisters present and apply antibiotic ointment to prevent infection

Correct Incorrect Correct answer

An EMR responds to a person pulled from a pond who is unresponsive and not breathing. Bystanders state the patient was submerged for about 4 minutes in cold water. What takes priority in resuscitation?

Open the airway and begin rescue breathing immediately, followed by CPR if there is no pulse

Correct Incorrect Correct answer

Perform abdominal thrusts to clear aspirated water before beginning ventilations

Correct Incorrect Correct answer

Delay ventilations and start chest compressions first to circulate any residual oxygen

Correct Incorrect Correct answer

Withhold resuscitation because prolonged submersion is always non-survivable

Correct Incorrect Correct answer

A 68-year-old man is found confused and weak at an outdoor summer festival. His skin is pale and moist, he is sweating heavily, his breathing is rapid, and his temperature is 38.2 degrees Celsius. Which condition best fits this presentation, and what is the appropriate initial treatment?

Heat exhaustion; move him to a cool area, remove excess clothing, apply cool wet cloths, and offer oral fluids if he can swallow safely

Correct Incorrect Correct answer

Heat stroke; begin immediate ice water immersion to prevent brain injury

Correct Incorrect Correct answer

Heat cramps; provide sports drinks and gentle stretching of the affected muscles

Correct Incorrect Correct answer

Low blood sodium from overhydration; restrict all fluid intake until sodium levels are confirmed

Correct Incorrect Correct answer

When using proper body mechanics to lift a patient on a stretcher, which technique best protects the EMR from back injury?

Keep the back straight, bend at the knees and hips, and hold the load close to the body

Correct Incorrect Correct answer

Bend at the waist with the knees locked to maximize leverage on the stretcher

Correct Incorrect Correct answer

Twist the torso toward the direction of movement to generate lifting momentum

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Extend the arms fully outward to spread the weight across the shoulders

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An EMR is on scene with a patient who has an isolated ankle injury. She is alert, has normal vital signs, and there is no threat on the scene. Which type of move is most appropriate?

A non-emergency move using a stair chair or stretcher, with spinal precautions if indicated

Correct Incorrect Correct answer

An emergency move dragging the patient by her arms to the ambulance right away

Correct Incorrect Correct answer

Rapid extrication with a long backboard regardless of mechanism

Correct Incorrect Correct answer

An extremity lift performed as quickly as possible to minimize scene time

Correct Incorrect Correct answer

An EMR arrives at a house fire and finds a patient unresponsive in a smoke-filled room while the structure is still burning. Which move is most appropriate, and why?

Perform an emergency drag to remove the patient from immediate danger before beginning assessment

Correct Incorrect Correct answer

Perform a full spinal assessment and apply a cervical collar before moving the patient

Correct Incorrect Correct answer

Wait for fire suppression crews to clear the room before making patient contact

Correct Incorrect Correct answer

Use a scoop stretcher to maintain spinal alignment during removal

Correct Incorrect Correct answer

A patient is found sitting in a chair after a fall from standing. She is alert, complains of hip pain, and has no mechanism suggesting spinal injury. Which device is most appropriate to move her to the stretcher?

A scoop stretcher or transfer sheet that fits her position and minimizes painful movement

Correct Incorrect Correct answer

A long backboard with full spinal immobilization applied before any movement

Correct Incorrect Correct answer

A stair chair, because seated patients must always be moved in a seated position

Correct Incorrect Correct answer

A vest-style extrication device, which is designed for seated patients with possible spinal injury

Correct Incorrect Correct answer

Two EMRs are carrying a 220-pound alert patient down a flight of stairs in a stair chair. What is the safest configuration for the descent?

The EMR at the foot end faces uphill and controls the descent, bearing most of the load with the patient tilted slightly back

Correct Incorrect Correct answer

Both EMRs face downhill so they can see where they are stepping

Correct Incorrect Correct answer

The EMR at the head end bears most of the weight and controls the pace

Correct Incorrect Correct answer

The patient is tilted forward at the waist to shift weight toward the stairs

Correct Incorrect Correct answer

A patient is breathing adequately but has mild respiratory distress following a minor motor vehicle collision. She has no history of COPD. Which oxygen delivery device and flow rate is most appropriate?

Nasal cannula at 2 to 4 liters per minute

Correct Incorrect Correct answer

Nonrebreather mask at 15 liters per minute

Correct Incorrect Correct answer

Bag-valve mask at 15 liters per minute with reservoir

Correct Incorrect Correct answer

Simple face mask at 10 liters per minute

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You are treating an unresponsive adult who is breathing shallowly at a rate of 6 breaths per minute. Which oxygen delivery method is most appropriate?

Bag-valve mask with supplemental oxygen and reservoir

Correct Incorrect Correct answer

Nonrebreather mask at 15 liters per minute

Correct Incorrect Correct answer

Nasal cannula at 6 liters per minute

Correct Incorrect Correct answer

Simple face mask at 8 liters per minute

Correct Incorrect Correct answer

A nonrebreather mask is applied to a patient with suspected carbon monoxide exposure. The EMR sets the flow rate at 6 liters per minute. What is the primary problem with this flow rate?

It is insufficient to keep the reservoir bag inflated, allowing the patient to re-inhale exhaled gases and lowering the delivered oxygen concentration

Correct Incorrect Correct answer

It delivers too high a concentration of oxygen and may suppress the patient's hypoxic drive

Correct Incorrect Correct answer

It exceeds the capacity of the one-way valves on the mask, causing pressure buildup

Correct Incorrect Correct answer

It is the correct flow rate for a nonrebreather mask used in carbon monoxide exposure

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Which patient presentation is the best indication for applying a nonrebreather mask rather than a nasal cannula?

A conscious adult with an oxygen saturation of 88 percent and labored breathing after a near-drowning event

Correct Incorrect Correct answer

A conscious adult with mild anxiety and an oxygen saturation of 97 percent after a minor collision

Correct Incorrect Correct answer

A patient who refuses to wear a face mask but is breathing at 16 breaths per minute with adequate depth

Correct Incorrect Correct answer

An older adult with known COPD whose oxygen saturation is at baseline and who feels well

Correct Incorrect Correct answer

During transport you notice the reservoir bag on a nonrebreather mask is completely deflating with each breath the patient takes. What is the most likely cause and the correct correction?

The oxygen flow rate is too low; increase flow so the bag remains at least one-third full during inhalation

Correct Incorrect Correct answer

The patient is hyperventilating; slow the rate by coaching the patient to breathe through the nose only

Correct Incorrect Correct answer

The one-way inhalation valves are obstructed; remove and replace the mask with a simple face mask

Correct Incorrect Correct answer

The reservoir bag has a leak; seal the bag port with tape and continue transport

Correct Incorrect Correct answer

An unresponsive adult patient has no suspected spinal injury. What is the most appropriate initial manual airway maneuver?

Head-tilt chin-lift

Correct Incorrect Correct answer

Jaw thrust without any head movement

Correct Incorrect Correct answer

Insertion of a nasopharyngeal airway before any positioning

Correct Incorrect Correct answer

Immediate orotracheal intubation

Correct Incorrect Correct answer

You are sizing an oropharyngeal airway for an adult patient. Which measurement technique is correct?

Measure from the corner of the mouth to the earlobe on the same side of the face

Correct Incorrect Correct answer

Measure from the tip of the nose to the earlobe

Correct Incorrect Correct answer

Measure from the chin to the suprasternal notch

Correct Incorrect Correct answer

Select the largest size that will insert without resistance

Correct Incorrect Correct answer

A patient with an intact gag reflex needs airway support but cannot tolerate an oropharyngeal airway. Which adjunct is most appropriate?

Nasopharyngeal airway lubricated and inserted through the larger nostril

Correct Incorrect Correct answer

Oropharyngeal airway inserted sideways and rotated as tolerated

Correct Incorrect Correct answer

Endotracheal tube placed while the patient is conscious to secure the airway

Correct Incorrect Correct answer

Suction catheter left in place in the oropharynx to hold the airway open

Correct Incorrect Correct answer

During suctioning of an adult patient, the EMR applies continuous suction for 25 seconds. What is the primary risk of this technique?

Hypoxia from prolonged removal of oxygen along with secretions

Correct Incorrect Correct answer

Accidental removal of a previously placed oropharyngeal airway

Correct Incorrect Correct answer

Stimulation of the vagus nerve causing tachycardia

Correct Incorrect Correct answer

Creation of a vacuum seal that fuses the catheter to the tracheal wall

Correct Incorrect Correct answer

You are about to insert a nasopharyngeal airway. The patient has suspected facial trauma and a clear fluid discharge from the nose. What should you do?

Avoid inserting the nasopharyngeal airway and use an alternative airway management strategy

Correct Incorrect Correct answer

Insert the airway into the unaffected nostril angled toward the eye

Correct Incorrect Correct answer

Insert the airway and pack the nostril with gauze to control the leakage

Correct Incorrect Correct answer

Proceed with insertion because the airway does not reach the cranial vault

Correct Incorrect Correct answer

An unresponsive trauma patient with suspected cervical spine injury has blood and vomit pooling in the oropharynx. What is the correct sequence of airway management?

Suction the oropharynx, maintain manual in-line stabilization, perform a jaw thrust, then insert an appropriate airway adjunct

Correct Incorrect Correct answer

Perform a head-tilt chin-lift to open the airway, then suction and insert an oropharyngeal airway

Correct Incorrect Correct answer

Insert an oropharyngeal airway first to maintain patency, then suction around it

Correct Incorrect Correct answer

Log-roll the patient to clear secretions, apply a cervical collar, and begin transport without further airway intervention

Correct Incorrect Correct answer

A semiconscious patient begins vomiting while you have an oropharyngeal airway in place. What is the most important immediate action?

Remove the airway and turn the patient to the lateral recovery position while suctioning the oropharynx

Correct Incorrect Correct answer

Leave the airway in place and suction through it with a flexible catheter

Correct Incorrect Correct answer

Hold the airway in place and hyperextend the neck so gravity can clear the vomit

Correct Incorrect Correct answer

Remove the airway only after suctioning is complete to avoid losing airway access

Correct Incorrect Correct answer

Before lifting and loading a patient onto the stretcher for transport, which action should the EMR perform first?

Ensure all life-threatening conditions have been identified and interventions initiated

Correct Incorrect Correct answer

Complete the written patient care report in full before moving the patient

Correct Incorrect Correct answer

Obtain a detailed past medical history from the patient's family

Correct Incorrect Correct answer

Confirm insurance information with the receiving facility

Correct Incorrect Correct answer

Which position is most appropriate when transporting a conscious patient who is having difficulty breathing?

Position of comfort, typically sitting upright or semi-reclined

Correct Incorrect Correct answer

Supine with the legs elevated 6 to 12 inches

Correct Incorrect Correct answer

Prone to promote postural drainage

Correct Incorrect Correct answer

Left lateral recumbent to reduce cardiac workload

Correct Incorrect Correct answer

You are preparing to transfer care of a patient to an arriving advanced life support unit. The patient has a splinted femur fracture, oxygen at 15 liters per minute via nonrebreather mask, and an altered level of consciousness. Which action regarding equipment is most important before the handoff?

Ensure all interventions remain intact and functioning, and verbally confirm device status with the receiving crew

Correct Incorrect Correct answer

Remove the splint so the advanced crew can reassess the fracture without your equipment

Correct Incorrect Correct answer

Switch the oxygen to a nasal cannula to preserve onboard oxygen for the advanced unit

Correct Incorrect Correct answer

Hand over all written documentation before providing any verbal report

Correct Incorrect Correct answer

A patient you are transporting deteriorates during transport. When should the EMR alert the receiving facility about the change in patient condition?

As soon as the change is identified, using radio or phone communication

Correct Incorrect Correct answer

After arriving at the facility so the staff can assess the patient directly

Correct Incorrect Correct answer

Only if the change is severe enough to require a different transport destination

Correct Incorrect Correct answer

At the same time the written report is completed upon arrival

Correct Incorrect Correct answer

You are with a patient in cardiac arrest. After several minutes of CPR and two AED shocks, the patient regains a pulse and begins breathing spontaneously. An advanced life support unit is about 12 minutes away. What is the most appropriate transport decision?

Begin transport toward the appropriate receiving facility and plan to intercept the advanced unit en route

Correct Incorrect Correct answer

Remain on scene until the advanced unit arrives so they can assume care before any movement

Correct Incorrect Correct answer

Cancel the advanced unit and transport directly, since the patient now has a pulse

Correct Incorrect Correct answer

Stop active interventions and wait for the advanced unit to make all further decisions

Correct Incorrect Correct answer

When giving a verbal report to the receiving emergency department nurse, which information should the EMR provide first?

Patient age, sex, chief complaint, and level of consciousness

Correct Incorrect Correct answer

The patient's insurance carrier and primary care physician

Correct Incorrect Correct answer

A complete list of all medications found at the scene

Correct Incorrect Correct answer

The estimated scene time and mileage from the incident location

Correct Incorrect Correct answer

During a transfer of care report, the EMR states that the patient is a 67-year-old male found unresponsive with a Glasgow Coma Scale of 8, blood pressure 88 over 60, heart rate 112, oxygen saturation 91 percent on 15 liters via nonrebreather, a history of hypertension and diabetes, no known drug allergies, and home medications of metformin and lisinopril. Which critical element is missing from this report?

The nature of the illness or mechanism of injury and the interventions performed by the EMR

Correct Incorrect Correct answer

The patient's next-of-kin contact information

Correct Incorrect Correct answer

The name and unit number of the responding crew

Correct Incorrect Correct answer

The patient's vaccination history

Correct Incorrect Correct answer

An EMR is handing off care of a 45-year-old female with chest pain to an advanced life support crew at the scene. The paramedic interrupts the report to begin her assessment. What should the EMR do?

Pause and allow the paramedic to assess, then complete the verbal report at an appropriate opportunity

Correct Incorrect Correct answer

Insist on completing the full report before the paramedic touches the patient

Correct Incorrect Correct answer

Leave the scene and submit only a written report since the verbal handoff was interrupted

Correct Incorrect Correct answer

Restart the report from the beginning once the paramedic finishes assessing

Correct Incorrect Correct answer

You respond to a residential fall and find a confused 80-year-old male on the floor who cannot provide a history. His daughter reports he takes an anticoagulant and has a pacemaker. On assessment you find a scalp laceration, equal pupils, and a Glasgow Coma Scale of 13. Which elements are most important to emphasize during your transfer of care report?

Anticoagulant use, the pacemaker, the mechanism of the fall, neurological findings, and the baseline mental status reported by the daughter

Correct Incorrect Correct answer

Scene address, time of arrival, and crew names only, deferring clinical details to the written report

Correct Incorrect Correct answer

Vital signs and oxygen saturation only, treating the neurological exam as unremarkable

Correct Incorrect Correct answer

The scalp laceration and estimated blood loss only, deferring medication history to the family

Correct Incorrect Correct answer

An EMR crew transports a pediatric patient in respiratory distress to the emergency department. On arrival the receiving nurse says she was not notified of the incoming patient, and the child’s oxygen saturation has dropped to 84 percent during transport. What is the most important immediate action?

Clearly announce the patient's critical condition to the receiving team and begin assisted ventilation while requesting immediate physician evaluation

Correct Incorrect Correct answer

Complete the written patient care report before announcing the patient to avoid confusion

Correct Incorrect Correct answer

Return to the ambulance to radio medical control and await further instructions

Correct Incorrect Correct answer

Report the notification failure to the charge nurse and document the breakdown before treating the patient

Correct Incorrect Correct answer

When using a bag-valve-mask (BVM) to ventilate an unresponsive adult who is not breathing, how long should each breath be delivered?

Over approximately 1 second, until visible chest rise occurs

Correct Incorrect Correct answer

Over 3 seconds, to ensure full lung expansion

Correct Incorrect Correct answer

As fast as possible, to maximize oxygen delivery

Correct Incorrect Correct answer

Over 2 to 3 seconds, with firm pressure on the bag

Correct Incorrect Correct answer

A single EMR is attempting BVM ventilation on an apneic adult. The patient’s chest is not rising with each breath. Which action should the EMR take first?

Reposition the airway with a head-tilt chin-lift and recheck the mask seal

Correct Incorrect Correct answer

Increase the squeeze force on the bag to push more air through

Correct Incorrect Correct answer

Switch immediately to mouth-to-mouth ventilation

Correct Incorrect Correct answer

Insert a nasopharyngeal airway before attempting another breath

Correct Incorrect Correct answer

An EMR is performing single-rescuer BVM ventilation on an apneic adult with no suspected spinal injury. Which technique best maintains an open airway and an effective mask seal simultaneously?

EC clamp technique: fingers form a C around the mask while the remaining fingers form an E along the jaw to lift it into the mask

Correct Incorrect Correct answer

Placing both thumbs on top of the mask and using all fingers to compress the bag

Correct Incorrect Correct answer

Cupping both palms over the mask dome while a partner squeezes the bag

Correct Incorrect Correct answer

Pressing the mask firmly downward onto the face while extending the neck maximally

Correct Incorrect Correct answer

During pocket mask ventilation of an unresponsive adult, the EMR notices the patient’s abdomen rising instead of the chest. What does this finding most likely indicate?

Air is inflating the stomach, suggesting inadequate airway positioning or excessive ventilation volume

Correct Incorrect Correct answer

The patient is beginning to breathe spontaneously

Correct Incorrect Correct answer

The pocket mask has been placed over the abdomen rather than the face

Correct Incorrect Correct answer

The patient has a tension pneumothorax preventing chest wall movement

Correct Incorrect Correct answer

An EMR is ventilating an apneic 8-month-old infant with a BVM. Compared with an adult, which adjustment is most important when ventilating an infant?

Use only enough volume to produce visible chest rise, because infant lungs require much smaller tidal volumes

Correct Incorrect Correct answer

Deliver breaths faster, targeting 30 ventilations per minute

Correct Incorrect Correct answer

Tilt the head back as far as possible to fully extend the neck

Correct Incorrect Correct answer

Use the same bag squeeze pressure as for an adult to ensure adequate depth

Correct Incorrect Correct answer

An EMR and a partner are providing two-rescuer BVM ventilation on an adult in cardiac arrest. CPR is in progress. The ventilator notices that each breath requires increasing bag pressure and produces only minimal chest rise, even with a good mask seal and correct head position. Which complication is most likely developing?

Gastric distension from previous overventilation is elevating the diaphragm and reducing lung compliance

Correct Incorrect Correct answer

The patient is regaining consciousness and actively resisting ventilation

Correct Incorrect Correct answer

The BVM one-way valve has failed, recirculating exhaled air back into the lungs

Correct Incorrect Correct answer

Hyperoxia from supplemental oxygen is causing bronchospasm

Correct Incorrect Correct answer

An EMR is alone with an unresponsive, apneic adult. A BVM is available but no supplemental oxygen source is present. Which statement about providing ventilations in this scenario is correct?

BVM ventilation without supplemental oxygen still delivers approximately 21% oxygen and is preferable to no ventilation

Correct Incorrect Correct answer

BVM ventilation without oxygen is contraindicated because it delivers less oxygen than mouth-to-mouth rescue breathing

Correct Incorrect Correct answer

The rescuer should withhold ventilations until oxygen is available to avoid hypercarbia

Correct Incorrect Correct answer

Supplemental oxygen is required for BVM ventilation to function properly; the valve will not open without it

Correct Incorrect Correct answer

When performing chest compressions on an adult in cardiac arrest, what is the correct compression depth?

At least 2 inches (5 cm), but no more than 2.4 inches (6 cm)

Correct Incorrect Correct answer

At least 1 inch (2.5 cm)

Correct Incorrect Correct answer

At least 3 inches (7.5 cm) for maximum cardiac output

Correct Incorrect Correct answer

Exactly 1.5 inches (3.8 cm)

Correct Incorrect Correct answer

What compression-to-ventilation ratio should a single EMR use when performing CPR on a 3-year-old child?

30 compressions to 2 ventilations

Correct Incorrect Correct answer

15 compressions to 2 ventilations

Correct Incorrect Correct answer

30 compressions to 1 ventilation

Correct Incorrect Correct answer

15 compressions to 1 ventilation

Correct Incorrect Correct answer

At what rate should chest compressions be delivered during CPR for an adult in cardiac arrest?

100 to 120 compressions per minute

Correct Incorrect Correct answer

60 to 80 compressions per minute

Correct Incorrect Correct answer

80 to 100 compressions per minute

Correct Incorrect Correct answer

120 to 140 compressions per minute

Correct Incorrect Correct answer

An EMR is performing infant CPR alone. Which technique and compression depth are correct for a single rescuer performing infant chest compressions?

Two-finger technique on the lower half of the sternum, compressing approximately 1.5 inches (4 cm)

Correct Incorrect Correct answer

Heel of one hand on the center of the chest, compressing at least 2 inches (5 cm)

Correct Incorrect Correct answer

Two thumbs encircling the chest, compressing approximately 1.5 inches (4 cm)

Correct Incorrect Correct answer

Two-finger technique on the upper sternum, compressing approximately 1 inch (2.5 cm)

Correct Incorrect Correct answer

A bystander has been performing single-rescuer CPR on an adult for 3 minutes before an EMR arrives. The EMR has a BVM and a partner. Which action should the team take to minimize interruptions to chest compressions?

Switch to two-rescuer CPR with one person compressing and the other ventilating, limiting all pauses in compressions to less than 10 seconds

Correct Incorrect Correct answer

Stop compressions for up to 30 seconds to place an oral airway and attach the BVM before restarting

Correct Incorrect Correct answer

Continue single-rescuer CPR without ventilations until the AED is attached and analyzed

Correct Incorrect Correct answer

Have both rescuers take turns compressing simultaneously to increase chest pressure

Correct Incorrect Correct answer

During CPR, why is full chest recoil between compressions critically important?

Full recoil allows the heart chambers to refill with blood, maximizing the blood ejected with each compression

Correct Incorrect Correct answer

Full recoil prevents rib fractures by allowing the sternum to return to its neutral position

Correct Incorrect Correct answer

Full recoil activates the patient's natural pacemaker by reducing intrathoracic pressure to zero

Correct Incorrect Correct answer

Full recoil is required only when compressions exceed 120 per minute

Correct Incorrect Correct answer

An EMR alone finds a 6-year-old child who is unresponsive, not breathing, and pulseless, with no witnessed collapse and no AED immediately available. After activating EMS, which sequence of actions is correct?

Begin CPR immediately with 30 compressions followed by 2 ventilations; after about 2 minutes of CPR, retrieve a nearby AED

Correct Incorrect Correct answer

Leave the child to retrieve the AED first, then return and begin CPR

Correct Incorrect Correct answer

Provide 2 minutes of ventilations only before starting compressions, because pediatric arrest is usually respiratory in origin

Correct Incorrect Correct answer

Begin CPR at a 15:2 ratio as a single rescuer, because children always require the two-rescuer pediatric ratio

Correct Incorrect Correct answer

An EMR is performing CPR on an adult who begins to show signs of return of spontaneous circulation: a definite pulse is palpable and the patient takes an occasional breath. What is the correct immediate action?

Stop compressions, support ventilations if breathing is inadequate, and monitor the patient closely for deterioration

Correct Incorrect Correct answer

Continue compressions at a reduced rate of 60 per minute to maintain perfusion pressure

Correct Incorrect Correct answer

Continue compressions for one additional 2-minute cycle to ensure the rhythm is stable

Correct Incorrect Correct answer

Administer two rapid rescue breaths to clear carbon dioxide before checking the pulse again

Correct Incorrect Correct answer

After an AED delivers a shock to an adult in cardiac arrest, what should the EMR do immediately?

Resume chest compressions immediately without pausing to check for a pulse

Correct Incorrect Correct answer

Wait 30 seconds for the heart to stabilize before checking the pulse

Correct Incorrect Correct answer

Deliver a second shock before restarting compressions

Correct Incorrect Correct answer

Check the pulse and breathing for up to 1 minute before resuming CPR

Correct Incorrect Correct answer

An EMR is preparing to use an AED on an adult who collapsed in a swimming pool area. The patient is lying in a puddle of water. What should the EMR do before attaching the AED pads?

Move the patient to a dry surface and quickly dry the chest before placing the pads

Correct Incorrect Correct answer

Attach the pads while the patient is in the water; modern AEDs are waterproof

Correct Incorrect Correct answer

Place the pads over the patient's wet shirt to insulate against the water

Correct Incorrect Correct answer

Skip the AED and perform CPR only, because water makes defibrillation impossible

Correct Incorrect Correct answer

An EMR arrives to find a 4-year-old child in cardiac arrest. An AED is available but only standard adult pads are in the case; pediatric pads are not present. What should the EMR do?

Use the adult pads, ensuring the pads do not touch each other, applying them front and back if needed so they fit

Correct Incorrect Correct answer

Do not use the AED; defibrillation is contraindicated in children under 8 years of age

Correct Incorrect Correct answer

Cut the adult pads in half to reduce the delivered energy to a pediatric dose

Correct Incorrect Correct answer

Use the adult pads in the standard position and double the shock energy on the device

Correct Incorrect Correct answer

While preparing to attach AED pads to an unresponsive adult, the EMR notices an implanted pacemaker visible as a small bulge under the left clavicle. What should the EMR do?

Place the AED pad at least 1 inch away from the implanted device and proceed with defibrillation as indicated

Correct Incorrect Correct answer

Do not use the AED because the implanted pacemaker will be damaged by the shock

Correct Incorrect Correct answer

Place the pad directly over the device to ensure current passes through the pacemaker leads

Correct Incorrect Correct answer

Contact medical direction before using the AED, because implanted devices are a contraindication

Correct Incorrect Correct answer

An EMR is using an AED on an adult who collapsed. The AED analyzes the rhythm and announces ‘No shock advised.’ The patient remains pulseless and apneic. Which action is correct?

Resume CPR immediately; a non-shockable rhythm such as asystole or pulseless electrical activity requires continued high-quality CPR

Correct Incorrect Correct answer

Turn off the AED and wait for ALS units because nothing further can be done

Correct Incorrect Correct answer

Reattach the pads in a different position and re-analyze, because pad placement may have caused an incorrect reading

Correct Incorrect Correct answer

Deliver a manual shock using the AED override function to confirm the rhythm is truly non-shockable

Correct Incorrect Correct answer

An adult is clutching his throat, cannot speak, and is turning cyanotic after eating. Which intervention should the EMR perform first?

Deliver abdominal thrusts repeatedly until the object is expelled or the patient becomes unconscious

Correct Incorrect Correct answer

Perform a blind finger sweep of the mouth to remove the obstruction

Correct Incorrect Correct answer

Lay the patient supine and begin chest compressions

Correct Incorrect Correct answer

Deliver five back blows followed by five chest thrusts

Correct Incorrect Correct answer

A 7-month-old infant is found unresponsive and not breathing. The parent reports the infant was playing with small objects moments before. After activating EMS, the EMR opens the airway and attempts a ventilation but the chest does not rise. What should the EMR do next?

Reposition the airway and attempt one more ventilation; if still unsuccessful, begin CPR, looking in the mouth and removing any visible object before each ventilation attempt

Correct Incorrect Correct answer

Perform abdominal thrusts immediately, because this technique applies to all ages

Correct Incorrect Correct answer

Perform a blind finger sweep to remove the suspected object before attempting further ventilations

Correct Incorrect Correct answer

Skip ventilations and perform chest compressions only until the object is dislodged

Correct Incorrect Correct answer

An EMR responds to a pregnant woman in her third trimester who is conscious but cannot speak or cough after eating. Which technique should be used to relieve the obstruction?

Deliver chest thrusts to the center of the chest rather than abdominal thrusts

Correct Incorrect Correct answer

Perform standard abdominal thrusts, positioning hands just below the ribcage to avoid the uterus

Correct Incorrect Correct answer

Place the patient in a left lateral decubitus position and deliver back blows

Correct Incorrect Correct answer

Perform a finger sweep of the oropharynx to locate and remove the obstruction

Correct Incorrect Correct answer

You apply direct pressure to a deep laceration on a patient’s forearm. After 3 minutes, the dressing is soaked through with blood. What is the correct next step?

Apply additional dressings on top of the soaked ones and continue pressing firmly

Correct Incorrect Correct answer

Remove the soaked dressing and apply a fresh one directly to the wound

Correct Incorrect Correct answer

Release pressure for 30 seconds to assess whether clotting has begun

Correct Incorrect Correct answer

Immediately apply a tourniquet proximal to the wound

Correct Incorrect Correct answer

When applying a commercial tourniquet to a patient’s upper extremity, how far above the wound should the device be placed?

2 to 3 inches proximal to the wound

Correct Incorrect Correct answer

Directly over the wound site

Correct Incorrect Correct answer

At the axilla regardless of wound location

Correct Incorrect Correct answer

At least 6 inches proximal to the wound

Correct Incorrect Correct answer

A patient has a deep, narrow wound to the lateral thigh from a piece of metal. Direct pressure is not controlling the hemorrhage. You have a hemostatic dressing available. What technique is most appropriate?

Pack the wound cavity tightly with the hemostatic dressing and hold firm pressure for the manufacturer-recommended time

Correct Incorrect Correct answer

Lay the hemostatic dressing loosely over the wound surface and secure with a bandage

Correct Incorrect Correct answer

Apply the hemostatic dressing and immediately transport without holding pressure

Correct Incorrect Correct answer

Use the hemostatic dressing only after placing a tourniquet, regardless of wound location

Correct Incorrect Correct answer

After applying a tourniquet to a patient’s lower leg, you note that bleeding has not stopped and distal pulses are still present. What does this finding indicate?

The tourniquet is not tight enough to occlude arterial flow and must be tightened further

Correct Incorrect Correct answer

The tourniquet is correctly applied; venous bleeding can continue despite arterial occlusion

Correct Incorrect Correct answer

A second tourniquet should be placed distal to the first one

Correct Incorrect Correct answer

The wound requires a hemostatic dressing instead and the tourniquet should be removed

Correct Incorrect Correct answer

You are treating a patient with a penetrating wound to the right groin that is bleeding severely, and direct pressure is not controlling it. Which intervention is most appropriate given the anatomical location?

Pack the wound with a hemostatic dressing and apply firm sustained pressure

Correct Incorrect Correct answer

Apply a standard limb tourniquet at the proximal thigh

Correct Incorrect Correct answer

Apply a tourniquet around the waist

Correct Incorrect Correct answer

Elevate the right leg above the level of the heart and rely on elevation alone

Correct Incorrect Correct answer

Which of the following is the earliest sign of compensated hemorrhagic shock in an adult patient?

Increased heart rate with a normal blood pressure

Correct Incorrect Correct answer

Decreased blood pressure with a weak, thready pulse

Correct Incorrect Correct answer

Altered mental status and confusion

Correct Incorrect Correct answer

Bilaterally absent radial pulses

Correct Incorrect Correct answer

A patient in shock is shivering and has cool, pale, moist skin. Which action best addresses the risk of hypothermia worsening the patient’s condition?

Cover the patient with blankets, including under the patient if possible, and protect from wind and moisture

Correct Incorrect Correct answer

Apply warm, moist compresses directly to the skin to rapidly transfer heat

Correct Incorrect Correct answer

Remove wet clothing but leave the patient uncovered to allow natural rewarming

Correct Incorrect Correct answer

Have the patient drink warm fluids to raise the core temperature

Correct Incorrect Correct answer

A young adult sustained blunt abdominal trauma in a motor vehicle collision. The patient is anxious, diaphoretic, and has a heart rate of 118 and a blood pressure of 96/60 mmHg. Which position and action are most appropriate while awaiting ALS?

Position supine, keep the patient warm, give oxygen, and expedite transport

Correct Incorrect Correct answer

Place the patient in a high Fowler position to ease abdominal pain

Correct Incorrect Correct answer

Position in Trendelenburg with the legs elevated to shift blood to the core

Correct Incorrect Correct answer

Have the patient sit upright and walk to the ambulance to prevent leg hypoperfusion

Correct Incorrect Correct answer

You arrive at an outdoor summer event where a patient collapsed. The skin is hot and dry, and bystanders report the patient was confused before becoming unresponsive. Which type of shock is most consistent with this presentation?

Distributive shock secondary to heat stroke

Correct Incorrect Correct answer

Cardiogenic shock from heat-related myocardial depression

Correct Incorrect Correct answer

Obstructive shock from a pulmonary embolism

Correct Incorrect Correct answer

Hypovolemic shock from fluid loss alone

Correct Incorrect Correct answer

A patient who was trapped in a collapsed structure for 45 minutes shows signs of shock. The ambient temperature is near freezing, the patient’s skin is cold to the touch, and the heart rate is 50. Which management consideration is most critical during transport?

Handle the patient extremely gently and avoid rough movement, because the cold myocardium is prone to ventricular fibrillation

Correct Incorrect Correct answer

Vigorously rub the patient's limbs to generate friction heat and improve circulation

Correct Incorrect Correct answer

Remove all clothing immediately on scene to accurately assess skin temperature

Correct Incorrect Correct answer

Have the patient perform light physical activity to generate endogenous heat

Correct Incorrect Correct answer

When should you apply manual in-line spinal stabilization to a trauma patient?

As soon as a potential spinal injury is identified and before moving the patient

Correct Incorrect Correct answer

Only after the patient has been assessed for neurological deficits

Correct Incorrect Correct answer

Only after the cervical collar has been applied and secured

Correct Incorrect Correct answer

Only when the patient is unconscious and cannot report neck pain

Correct Incorrect Correct answer

A patient found lying face down at a trauma scene requires spinal motion restriction. Which method should the EMR use to move the patient to a supine position?

Logroll the patient as a unit with one rescuer maintaining in-line stabilization of the head

Correct Incorrect Correct answer

Have the patient roll over independently if they are able to follow commands

Correct Incorrect Correct answer

Lift the patient under the arms and rotate them to supine quickly

Correct Incorrect Correct answer

Apply a cervical collar first and then allow the patient to roll over on their own

Correct Incorrect Correct answer

You are assessing an alert, sober, unrestrained passenger from a low-speed rear-end collision. The patient denies neck or back pain, has full pain-free range of motion, no distracting injuries, and no neurological complaints. Which approach to spinal motion restriction is most appropriate?

Apply evidence-based low-risk criteria and withhold spinal motion restriction because no reliable indicators are present

Correct Incorrect Correct answer

Apply full spinal motion restriction regardless of findings because a motor vehicle was involved

Correct Incorrect Correct answer

Apply a cervical collar only and document refusal of a long backboard

Correct Incorrect Correct answer

Restrict spinal motion until a physician evaluates the patient, since field assessment is never permitted

Correct Incorrect Correct answer

During a logroll of a trauma patient, you are maintaining manual in-line stabilization of the head while the lead rescuer gives the command to roll. Which action should you take?

Move the head simultaneously with the torso so the head, neck, and spine stay aligned throughout the roll

Correct Incorrect Correct answer

Keep the head stationary while the body is rolled, then reposition the head afterward

Correct Incorrect Correct answer

Release stabilization briefly to allow a clear view of the back

Correct Incorrect Correct answer

Allow the patient to turn their head toward the direction of the roll for comfort

Correct Incorrect Correct answer

A patient with a known history of ankylosing spondylitis was involved in a ground-level fall and reports neck pain. During assessment you notice the spine has a fixed forward curvature. When applying spinal motion restriction, which adaptation is most important?

Immobilize the patient in the position found and pad the voids to support the existing curve rather than forcing the spine flat

Correct Incorrect Correct answer

Apply axial traction to straighten the spine before securing the patient

Correct Incorrect Correct answer

Skip cervical collar application because the rigid curvature makes it unnecessary

Correct Incorrect Correct answer

Position the patient flat and supine with a single towel under the head

Correct Incorrect Correct answer

Before and after applying a splint to a suspected forearm fracture, which assessment is essential?

Assess and document distal pulse, motor function, and sensation

Correct Incorrect Correct answer

Obtain a blood pressure reading in the injured extremity

Correct Incorrect Correct answer

Assess grip strength only, because a strong grip confirms full nerve function

Correct Incorrect Correct answer

Check skin color at the fracture site only, without assessing distal circulation

Correct Incorrect Correct answer

You apply a traction splint to a suspected closed femur fracture in an adult. Afterward the patient’s foot is cold and pale compared to the uninjured side. What is the most appropriate response?

Reassess the traction tension and alignment, and adjust the splint if it is causing neurovascular compromise

Correct Incorrect Correct answer

Accept the finding because femur fractures routinely cause temporary distal vascular changes

Correct Incorrect Correct answer

Increase traction force, because more traction will pull bone fragments away from the vessel

Correct Incorrect Correct answer

Remove the traction splint and apply a board splint without reassessing

Correct Incorrect Correct answer

A patient has an open tibia fracture with bone visible through the skin and moderate bleeding from the wound. Which sequence of interventions is correct?

Control bleeding with a sterile dressing, cover the exposed bone with a dry sterile dressing, then splint the extremity

Correct Incorrect Correct answer

Push the exposed bone back beneath the skin to reduce the fracture before splinting

Correct Incorrect Correct answer

Apply a tourniquet proximal to the fracture before any other intervention

Correct Incorrect Correct answer

Splint the extremity first to stabilize the bone ends, then address the wound

Correct Incorrect Correct answer

EMR – Patient Treatment and Transport — Quick Review

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