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UNCLE BRIAN’S

EXAM FROM HELL

600 QUESTIONS FOR THE EMR AND EMT

Remote Areas Emergency Medical Systems www.raems.com Remote Areas Emergency Medical Systems www.raems.com 1. The mechanism of injury is evaluated during the: a) scene size-up. b) initial assessment. c) focused history and physical exam. d) all of the above.

2. All of the following are considered significant mechanisms of injury EXCEPT: a) ejection from a vehicle. b) fall of more than 3 times the patient's height. c) roll-over of a vehicle. d) penetration of an extremity.

3. Reasons for performing a rapid trauma assessment in a patient with a significant mechanism of injury include all of the following EXCEPT: a) to assess the extent of injuries. b) to focus care on specific injuries. c) to detect injuries that may become life-threatening. d) to provide a basis for care en route to the hospital.

4. Your 40-year-old female patient is conscious and alert. She fell out of bed and is complaining of right hip pain. She should receive: a) a rapid trauma assessment. b) a focused physical exam. c) a head-to-toe "DCAP-BLS". d) all of the above.

5. You arrive on the scene of a motor vehicle crash. The driver is a conscious 18-year-old male patient complaining of neck pain. The passenger is obviously dead. After the initial assessment, you should: a) perform a focused physical exam. b) perform a rapid trauma assessment. c) focus your assessment on the patient's neck and spine. d) move the patient to the ambulance before beginning a full body assessment.

6. All of the following are significant mechanisms of injury for a child EXCEPT: a) a penetrating head wound. b) a bicycle-car collision. c) a vehicle in a medium speed collision. d) a fall from 5 feet.

Remote Areas Emergency Medical Systems www.raems.com 7. A 66-year-old male patient is unconscious following a vehicle roll-over. After completing the initial assessment, you reconsider the mechanism of injury and continue spinal stabilization. Your next step should be to: a) obtain a AMPLE history from bystanders. b) consider requesting advanced life support. c) assess the patient's vital signs. d) open the patient's airway.

8. "DCAP-BLS" is a memory aid to help you remember: a) the trauma patient's vital signs. b) what to look for while inspecting and palpating your patient. c) the patient's medications, allergies, and previous medical history. d) the order of assessing the patient during the detailed physical exam.

9. What does the "D" in "DCAP-BLS" stand for? a) dislocations. b) distal function. c) deformities. d) dyspnea.

10. During a rapid trauma assessment you should evaluate the patient's head, neck, chest, abdomen, pelvis, extremities, and: a) heart rhythm. b) blood sugar level. c) posterior. d) all of the above.

11. You perform a rapid assessment on an unresponsive 10-year-old female trauma patient. When evaluating her chest, you should assess for: a) paradoxical motion. b) jugular vein distention. c) softness. d) distention.

12. Your 40-year-old male patient crashed his motorcycle. He complains of pain to his right leg. While assessing his leg, you assess for: a) distal pulse. b) dorsal distention. c) bilateral crepitation. d) muscular rigidity.

13. A 16-year-old female patient received a gunshot wound to her abdomen. In addition to inspecting for an exit wound, you should examine her posterior body for: a) vein distention. b) paradoxical motion. c) tenderness to the spine. d) colostomy or ileostomy.

Remote Areas Emergency Medical Systems www.raems.com 14. While performing a focused physical exam, your trauma patient begins breathing very rapidly. You should: a) make a mental note and continue with your exam. b) stop your exam and provide appropriate care. c) re-assess beginning with the patient's head. d) re-evaluate the mechanism of injury.

15. A detailed physical exam is typically performed: a) before the focused history. b) en route to the hospital. c) immediately following the initial assessment. d) instead of a focused exam.

16. The purpose of the detailed physical exam is to: a) gather additional information about the patient's injuries and condition. b) take repeated vital signs measurements and note trends. c) find life-threatening problems. d) perform critical interventions.

17. A 30-year-old responsive male patient has a gunshot wound to the chest. Your detailed physical exam on this patient: a) will begin immediately after the initial assessment. b) will begin before the initial assessment. c) may never begin due to the seriousness of the chest injury. d) will be delayed until an ALS provider is on the scene.

18. A 25-year-old female patient fell off of a ski lift. She is responsive and complains of head pain. During the detailed physical exam, you should evaluate her face looking for: a) jugular vein distention. b) rashes and hives. c) softness or rigidity. d) deformities and contusions.

19. A responsive 24-year-old female patient tells you her horse kicked her. She complains of breathing difficulty. During your detailed exam you should assess for paradoxical motion of her: a) eyes. b) chest. c) jugular veins. d) abdomen.

20. A 63-year-old male patient complains of general weakness, nausea, and vomiting. The mechanism of injury is unknown. During the detailed exam you inspect and palpate for firmness and distention of the patient's: a) chest. b) abdomen. c) posterior. d) pelvis.

Remote Areas Emergency Medical Systems www.raems.com 21. A teenage male patient was run over by a tractor driven by his brother. He is unresponsive. During the detailed physical exam you should look for clear drainage from the patient's: a) ears. b) abdomen. c) chest. d) eyes.

22. You arrive to find an unconscious elderly female patient slumped over a steering wheel. There does not appear to be any vehicle damage. You are one hour from the nearest medical facility. You should: a) perform rapid trauma assessment. b) perform a detailed exam en route. c) obtain a history from any witnesses. d) all of the above.

23. A 30-year-old female patient fell off of her bicycle. She was not wearing a helmet. During your detailed exam you notice a bruise behind her left ear. This is most likely a sign of: a) possible hearing loss. b) a head injury. c) a mandible injury. d) a past injury to that area.

24. An 18-year-old male patient crashed his jet ski into a dock at high speed. He is responsive. You should evaluate his ears looking for: a) contusions. b) drainage. c) blood. d) all of the above.

25. Your patient complains of chest pain. He has no known prior history of this sort of pain. Which of the following questions should you ask? a) "Is your pain crushing and heavy?" b) "Is your pain dull?" c) "How would you describe your pain?" d) all of the above.

26. During patient assessment of a responsive patient you use the memory device "PQRST". What does the letter "P" stand for in this memory aid? a) provokes. b) pulse. c) present complaint. d) pain.

27. During patient assessment of a responsive medical patient you use the memory device "AMPLE" to obtain information. What does the letter "P" stand for in this memory aid? a) pulse. b) pain.

Remote Areas Emergency Medical Systems www.raems.com c) provokes. d) pertinent past history.

28. Your 36-year-old male patient tells you he is a diabetic. What is the first step of your focused history and physical exam? a) Conduct a rapid physical exam. b) Obtain baseline vital signs. c) Gather the history of the present illness. d) Question the patient about past medical problems. 29. Your patient is a 78-year-old male with a history of chest pain. You should find out which medications he takes during the: a) AMPLE history. b) PQRST exam. c) ongoing assessment. d) initial assessment.

30. A 23-year-old patient just had a seizure. Following the seizure, he is awake enough to tell you he is an epileptic. Why is this history important? a) It provides you information to give to the hospital staff. b) The history helps determine what interventions you may take. c) The history helps determine the nature of the illness. d) all of the above.

31. Which of the following medications is most likely to have been prescribed for a patient with chest pain? a) antidepressants. b) antibiotics. c) epinephrine auto-injector. d) nitroglycerin.

32. The rapid physical exam of an unresponsive medical patient is MOST similar to which of the following? a) initial assessment. b) focused physical exam. c) detailed physical exam. d) rapid trauma assessment.

33. A 25-year-old female patient is unresponsive. There is no apparent mechanism of injury. During the rapid physical exam of her neck you should look for: a) presence of breath sounds. b) a medical identification device. c) paradoxical respirations. d) motor function.

34. A 77-year-old male patient is unresponsive but breathing. You should obtain pertinent patient information from: a) bystanders or family members. b) the family physician. c) the responding advanced life support unit.

Remote Areas Emergency Medical Systems www.raems.com d) medical direction.

35. When caring for pediatric patients it is important to remember that an infant: a) does not like being separated from his parents. b) has a high degree of stranger anxiety. c) will resist being undressed. d) will not mind having an oxygen mask applied.

36. All of the following is true of the fontanelle, or "soft spot" in an infant's skull, EXCEPT: a) the fontanelle will be present until about 2 to 3 years of age. b) the fontanelle is likely to sink when the infant is dehydrated. c) the fontanelle is likely to bulge when the infant is crying. d) a bulging fontanelle may be a sign of increased intracranial pressure.

37. At an emergency scene, you can help keep your pediatric patient calm by: a) keeping him away from parents during your exam. b) maintaining a serious, authoritative attitude. c) positioning yourself above the patient. d) letting the child hold a favorite toy.

38. As you enter the room, you form a general impression of your 18-month-old patient. All of the following signs would indicate that the child is sick EXCEPT: a) the child pays no attention to you. b) the child is crying loudly and kicking. c) the child's nostrils are flaring as he breathes. d) the child's skin has a distinct red-pink appearance.

39. All of the following are acceptable ways to determine the level of responsiveness of an infant EXCEPT: a) shout at the infant. b) shake the infant. c) pinch the infant. d) tap the infant.

40. Which of the following should be done to maintain an open airway in an infant with a respiratory problem? a) Perform Sellick's maneuver by pressing on the patient's larynx. b) Press on the patient's forehead to tilt the head slightly backward. c) Have the child assume a sitting position and apply blow-by oxygen. d) Place a folded towel under the patient's shoulders to align the airway.

41. In elderly patients, increased deposits of cholesterol on arterial walls lead to increased risk of all of the following EXCEPT: a) diabetes. b) stroke. c) heart attack. d) hypertension.

Remote Areas Emergency Medical Systems www.raems.com 42. You are assessing an elderly patient who appears to have a diminished mental status. You should do all of the following EXCEPT: a) ask a family member if the diminished mental condition is normal for this patient. b) assume that a diminished mental status is normal for a patient of this age. c) consider what underlying condition might be causing the altered mental status. d) take your time, speak slowly and clearly, and give the patient extra time to respond.

43. Two-way radios that are at a fixed site such as a hospital are called: a) mobile radios. b) base stations. c) repeaters. d) cellular radios.

44. Hand-held, two-way radios are also called: a) portable radios. b) mobile radios. c) base radios. d) cellular phones.

45. To initiate a radio call from the ambulance, you should do all of the following EXCEPT: a) name your own unit, then the unit you are calling. b) press the "press to talk" button and wait one second before speaking. c) place your lips two to three inches from the microphone. d) keep the ambulance windows shut.

46. When you have finished a radio transmission, say: a) over. b) roger. c) 10-4. d) thank you.

47. You are calling the hospital with information about a patient. Which of the following items would you state first? a) The pulse is 120. b) Patient denies difficulty breathing. c) 73-year-old female. d) History of diabetes.

48. Which of the following is an effective method for improving how you communicate with your patient? a) Stand above the patient. b) Use eye contact. c) Use medical terms. d) Talk loudly.

49. The FCC (Federal Communication Commission) is responsible for all of the following EXCEPT: a) inspecting ambulance communication equipment. b) assigning radio frequencies to different agencies.

Remote Areas Emergency Medical Systems www.raems.com c) licensing radio frequencies. d) establishing rules regarding use of offensive language.

50. You are treating a patient who is blind. Which of the following will help in communicating with this patient? a) Speak loudly. b) Explain what you are doing. c) Spell out medical terms. d) Hold the patient's hand. 51. You are treating a 76-year-old man who tells you his name is Joseph Wicker. What should you call him? a) Use the name Joe to put him at ease. b) Use his formal first name and call him Joseph. c) Use a term like "dear" to make him feel at ease. d) Call him "Mr. Wicker" unless he tells you otherwise.

52. You are treating a 23-year-old woman who has a painful swollen deformity on her lower left leg. She is very nervous about what you are going to do. She asks you if the procedure will hurt. What should you tell her before you splint the leg? a) Not to worry, everything will be fine. b) Yes, it may hurt some. c) No, this shouldn't hurt at all. d) Yes, it might but it's no big deal.

53. You are treating a 32-year-old man who is deaf. You need to find out why he called for an ambulance. What is the best way to communicate with this man? a) Speak very loudly just in case he can hear something. b) Make sure the patient can see your mouth in case he can lip read. c) Find someone else to ask questions so you don't need to talk to him. d) Call for an interpreter to meet you at the hospital.

54. You are treating a 2-year-old girl. She is crying and won't look at you. All of the following are appropriate methods of communication EXCEPT: a) try to get the parents to help you talk to her. b) have the parents leave the room so the child is not distracted. c) be sure to tell the truth. d) get down on her eye level when you speak.

55. At the emergency scene, you discover that neither the patient nor his family speak English. All of the following are appropriate ways to aid communication with this family EXCEPT: a) find a bystander who can interpret. b) use a manual that provides translations. c) simply care for the patient without speaking. d) ask your dispatcher to locate an interpreter.

56. When you first arrive at the scene, you should: a) find the patient. b) advise dispatch that you are on the scene. c) start your initial assessment.

Remote Areas Emergency Medical Systems www.raems.com d) notify the hospital that you may have a patient.

57. When communicating with the hospital about a patient's condition, you should: a) speak quickly to avoid long air times. b) give the total medical history so they are prepared. c) talk slowly and clearly so the hospital understands. d) only call the hospital if your patient is not breathing.

58. You may receive an order from the on-line physician to help a patient with his/her medication. You should then: a) have the physician speak directly with the patient. b) write down the physician's order word for word. c) repeat the order back to the physician word for word. d) advise the physician that you understand and then give the medication.

59. You receive an order from the on-line physician that you do not understand. What should you do? a) Ask the physician to repeat the order. b) Do nothing and clarify with the physician at the hospital. c) Try to figure out what the physician meant. d) Call another hospital for clarification.

60. Which of the following is a medication carried on the unit? a) oral glucose. b) ibuprofen. c) acetylsalicylic acid. d) acetaminophene.

61. In most EMS systems, before you help a patient self-administer a prescribed inhaler, you will need permission from: a) the patient's personal physician. b) medical direction. c) the family. d) the ALS squad.

62. Oral glucose comes in what type of medication form? a) fine powder. b) gel. c) sublingual spray. d) liquid.

63. Why is oral glucose effective for patients suffering from an altered mental status and diabetes? a) Oral glucose raises low oxygen levels in the brain. b) Oral glucose raises low levels of sugar in the brain. c) Oral glucose enlarges constricted arteries in the brain. d) Oral glucose dilates the arteries in the brain.

Remote Areas Emergency Medical Systems www.raems.com 64. Why is oral glucose administered between the patient's cheek and gum? a) It makes it easier to swallow. b) This area has many blood vessels. c) It has an unpleasant taste. d) It prolongs the action of glucose.

65. Which medication is used to treat patients who are hypoxic? a) activated charcoal. b) nitroglycerin. c) oral glucose. d) oxygen.

66. Why is nitroglycerin effective for patients with recurrent chest pain? a) It enlarges bronchial tubes. b) It constricts the blood vessels. c) It dilates coronary blood vessels. d) All of the above.

67. The diaphragm is a: a) muscular structure that divides the chest cavity from the abdominal cavity. b) cartilage ring forming the lower portion of the larynx. c) leaf-shaped structure covering the trachea. d) branch of the trachea leading to the lungs.

68. The process when the chest expands causing air to flow into the lungs is called: a) exhalation. b) ventilation. c) expiration. d) inhalation.

69. Breathing that is not sufficient to support life is called: a) inadequate breathing. b) cyanotic breathing. c) irregular breathing. d) distressed breathing.

70. Very rapid breaths may: a) not provide enough air to the lungs. b) provide too much air to the lungs. c) provide too much air to the brain. d) provide too much oxygen throughout the body.

71. Which of the following signs is characteristic of adult respiratory distress? a) decreased pulse rate. b) respiratory rate of 12 breaths per minute.

Remote Areas Emergency Medical Systems www.raems.com c) use of the accessory muscles. d) bilateral chest expansion.

72. Agonal respirations are best defined as: a) shallow, rapid, and regular breaths. b) deep, rapid, and regular breaths. c) shallow, very slow, and irregular gasping breaths. d) deep, very slow, and regular breaths.

73. Agonal respirations are an imminent characteristic of breaths seen: a) in emotionally disturbed patients. b) in allergic reactions. c) in diabetic emergencies. d) just before respiratory arrest.

74. A 6-year-old female patient is complaining of breathing difficulty. Which of the following signs or symptoms would assist you in verifying this complaint? a) movement of the diaphragm. b) use of accessory muscles. c) respiratory rate of 16 breaths per minute. d) diaphragm and abdomen moving in the same direction.

75. Of the following, which is the leading cause of death in infants and children? a) severe allergic reactions. b) cardiac problems. c) nervous system problems. d) respiratory problems.

76. Children in respiratory distress may present with "seesaw breathing." "Seesaw breathing" occurs when: a) the child breathes through the nose and then the mouth. b) the chest and abdomen move in opposite directions. c) the muscles pull in between the ribs and then push out. d) the muscles above the clavicles pull in and then push out.

77. When infants or children experience breathing difficulties, their pulse may: a) decrease significantly, then return to normal. b) decrease early, then increase significantly. c) increase significantly, then return to normal. d) increase early, then decrease significantly.

78. PQRST are letters used to help you remember which questions to ask patients during your assessment. What does the "P" stand for? a) proximity. b) pulse. c) provocation. d) pain.

Remote Areas Emergency Medical Systems www.raems.com 79. What is the most important management for a patient experiencing breathing difficulty? a) Administer oxygen. b) Assist patient in taking a prescribed inhaler. c) Find the patient's position of comfort. d) Ask the patient to remain calm.

80. A 45-year-female patient is complaining of breathing difficulty. You determine she is breathing adequately but remains cyanotic. Your next action should be to: a) provide oxygen by nonrebreather mask at 15 liters per minute. b) assist respirations with artificial ventilation only. c) assist respirations with artificial ventilation and supplemental oxygen. d) provide oxygen by nasal cannula at 6 liters per minute.

81. A 63-year-old patient is unresponsive and breathing at a rate of 28 and very shallow. You would manage this patient by: a) seeing if the patient will tolerate a nasal cannula. b) providing artificial ventilation. c) seeing if the patient will tolerate a nonrebreather mask. d) using the pocket face mask without supplemental oxygen.

82. While providing artificial ventilation to a patient with inadequate breathing and a gag reflex, you should also use: a) chest compressions. b) supplemental oxygen. c) a suction catheter. d) an oral airway.

83. Artificial ventilation in an adult is adequate when: a) the ventilation rate is 10 per minute. b) the ventilation rate is 25 times per minute. c) the chest rises and falls. d) there is resistance felt when delivering ventilations.

84. You are providing artificial ventilation to a 60-year-old female. The patient's pulse continues to increase. This may signify: a) a normal response before pulse begins to decrease. b) an increase in patient oxygen levels. c) inadequate artificial ventilation. d) none of the above.

85. Of the following, what should you do when artificial ventilation with a pocket face mask is not effective? a) Switch to a nonrebreather mask with supplemental oxygen. b) Reposition the airway and ventilate again. c) Continue to ventilate the patient. d) Provide mouth-to-mouth ventilations.

Remote Areas Emergency Medical Systems www.raems.com 86. When using a nonrebreather mask you should administer oxygen at: a) 10 liters per minute. b) 3 liters per minute. c) 6 liters per minute. d) 15 liters per minute.

87. The normal rate of breathing for an infant is: a) 12 to 20 breaths per minute. b) 45 to 60 breaths per minute. c) 8 to 10 breaths per minute. d) 25 to 50 breaths per minute.

88. Normal or adequate breathing may be determined by observing for rate, rhythm, and: a) severity. b) provocation. c) quality. d) onset.

89. Which of the following is an early sign of inadequate breathing in children? a) blue-gray skin. b) barrel chest. c) nasal flaring. d) tremors.

90. Management for a child experiencing an upper airway obstruction due to blood and teeth includes: a) suctioning. b) refraining from placing anything in the mouth. c) applying nonrebreather mask, then suction. d) artificial ventilation, then suction.

91. Which of the following is a sign of a lower respiratory problem? a) a harsh, high pitched sound. b) rapid breathing. c) wheezing. d) breathing effort on inhalation.

92. A slow pulse in an infant or small child experiencing breathing difficulty is: a) a serious and abnormal sign. b) a good sign. c) normal and usually brief. d) also seen in adults.

93. Your patient tells you she has emphysema. You should: a) withhold oxygen, since these patients do not respond to oxygen.

Remote Areas Emergency Medical Systems www.raems.com b) withhold oxygen, because you could eliminate the hypoxic drive. c) administer oxygen, because in most cases the hypoxic drive will not be a problem. d) withhold oxygen because these patients become apneic if they receive high flow oxygen.

94. The cardiovascular system is made up of the: a) heart and lungs. b) heart and blood vessels. c) heart, lungs, and blood vessels. d) heart, lungs, and brain. 95. Cardiac compromise refers to: a) chest pain. b) cardiac arrest. c) a heart attack. d) any kind of problem with the heart.

96. Cardiac compromise commonly includes all of the following signs or symptoms EXCEPT: a) difficulty breathing. b) warm, dry skin. c) nausea or vomiting. d) epigastric pain.

97. Your 45-year-old male patient is experiencing chest discomfort. Your first action should be to: a) apply the defibrillation pads to the patient's chest. b) put the patient in a position of comfort. c) administer oxygen by the nasal cannula. d) ventilate the patient with a bag-valve mask.

98. Your adult chest-pain patient is breathing adequately. She is conscious and alert. You should: a) administer oxygen through a nasal cannula. b) administer oxygen through a nonrebreather mask. c) use the pocket face mask without supplemental oxygen. d) use the pocket face mask with a low concentration of oxygen.

99. The responsive patient experiencing cardiac compromise is positioned: a) supine. b) sitting up. c) on his side. d) in the position that feels most comfortable to the patient.

100. The cardiac conduction system disturbance that most commonly results in cardiac arrest is: a) pulseless electrical activity. b) ventricular fibrillation. c) ventricular tachycardia. d) asystole.

101. Which of the following is a shockable rythum? a) sinus rhythm. b) asystole.

Remote Areas Emergency Medical Systems www.raems.com c) ventricular fibrillation. d) pulseless electrical activity.

102. Which of the following is most effective in restoring a patient's pulse? a) oxygen. b) chest compressions. c) artificial ventilation. d) defibrillation.

103. The automated external defibrillator should give a "No Shock" message for all of the following conditions EXCEPT: a) the patient's rhythm is flatline. b) the patient has a pulse. c) the heart's normal electrical activity has returned. d) the patient's rhythm is ventricular fibrillation.

104. You are a lone rescuer responding to a patient in cardiac arrest, and you have an AED. You should: a) provide one-rescuer CPR before beginning defibrillation. b) instruct a bystander to provide CPR while you set up the defibrillator. c) choose a bystander to help you provide two-rescuer CPR before beginning defibrillation. d) defibrillate the patient as quickly as possible without first providing CPR.

105. You should deliver your first shock to a cardiac arrest patient: a) within one minute of arrival at the patient's side. b) after several minutes of CPR have failed to restart the heart. c) as soon as an ACLS team arrives. d) after obtaining the history from bystanders.

106. The EMT-A requests prehospital advanced cardiac life support for the care of the cardiac arrest patient because: a) early ACLS intervention provides for higher survival rates. b) ACLS personnel must be present when EMT-As perform defibrillation. c) only paramedics can transport cardiac arrest patients. d) the EMT-A is not adequately trained to manage cardiac arrest.

107. All of the following are types of defibrillators EXCEPT: a) manual defibrillators. b) magnetic imaging defibrillators. c) semiautomatic defibrillators. d) fully automatic defibrillators.

108. Which statement is CORRECT concerning semiautomatic defibrillators? a) They do not advise the operator to take any action. b) They advise the operator to press a button to deliver a shock. c) They deliver the shock automatically. d) They require the operator to analyze the cardiac rhythm.

Remote Areas Emergency Medical Systems www.raems.com 109. Touching the patient when the automated external defibrillator is analyzing the rhythm: a) is acceptable with modern defibrillators. b) is indicated to maintain cardiac compressions. c) is indicated to maintain artificial ventilation. d) can cause the AED to misinterpret a rhythm.

110. What should you do when you are about to defibrillate a patient who has a nitroglycerin patch? a) Leave the patch in place. b) Remove the patch. c) Defibrillate around the patch. d) Contact medical direction for guidance.

111. What should you do for the cardiac arrest patient found in the rain? a) Deliver one shock, then move the patient to a dry place. b) Deliver three shocks, then move patient to a dry place. c) Move patient inside and make sure he is dry before defibrillating. d) Perform CPR rather than attempting defibrillation.

112. You are providing artificial ventilation with a bag-valve mask. Your partner says, "Clear." What should you do next? a) Hold the bag-valve mask to the patient's face using leather gloves. b) Hold the bag-valve mask to the patient's face, but make sure you are not touching the patient. c) Remove the bag-valve mask from the patient's face and move away from the patient. d) Hold the bag-valve mask to the patient's face and squeeze the bag at the time of defibrillation.

113. Inappropriate delivery of shocks is usually the result of: a) electro-magnetic fields. b) mechanical error. c) human error. d) anatomical abnormalities.

114. When using an automated external defibrillator, you should defibrillate: a) after analysis of rhythm and shock is indicated. b) after hooking up oxygen. c) after on-line approval from medical direction. d) after hooking up oxygen and obtaining on-line medical approval.

115. You get a "No Shock" message after delivering four shocks. What should you do next? a) Check pulse and deliver a shock if pulse is absent. b) Check pulse and resume CPR for one minute if pulse is absent. c) Check pulse and transport if pulse is absent. d) Contact medical direction for further instructions.

Remote Areas Emergency Medical Systems www.raems.com 116. When applying defibrillation pads what should you do for the patient with a hairy chest? a) Press the pads firmly on the chest. b) Quickly shave some of the hair away. c) Apply pads to right and left shoulders. d) Apply pads to patient's back.

117. What constitutes a "set of stacked" shocks in automated defibrillation? a) Six shocks are delivered with no pause for a pulse check. b) One shock, CPR, then three more shocks are delivered. c) Three shocks are delivered with no pause for a pulse check. d) Three shocks are delivered with pulse checks after each shock.

118. You have administered six shocks to your cardiac arrest patient. She remains pulseless and is not breathing. No ACLS is on the scene. You should next: a) re-analyze rhythm and deliver six more shocks. b) contact medical direction for guidance. c) provide no further treatment until an ACLS unit arrives. d) immediately transport the patient.

119. You are transporting a 44-year-old male to the nearest facility, which is 30 minutes away. The patient was resuscitated at the scene but now goes back into cardiac arrest. You should immediately: a) contact medical direction for instructions. b) ask the driver to proceed with lights and siren to the hospital. c) stop the vehicle, perform CPR, and ready the defibrillator. d) defibrillate en route using a semi-automated defibrillator.

120. You are dispatched to a house where you find a 79-year-old female in cardiac arrest. You are alone but have an AED. After your initial assessment you should give two ventilations to assure an open airway, then: a) analyze the rhythm, and deliver a shock if indicated. b) provide chest compressions for one minute before defibrillating. c) analyze the rhythm, then begin chest compressions. d) call medical direction, then begin chest compressions.

121. If an ACLS team arrives at the scene before you have finished the first cycle of stacked shocks: a) they should take over care of the patient immediately. b) they should allow you to complete a cycle of six to nine shocks before taking over care of the patient. c) they should allow you to complete a cycle of three shocks before taking over care of the patient. d) they should allow you to complete a cycle of six shocks before taking over care of the patient.

122. A patient who has been resuscitated from cardiac arrest is: a) at a high risk of going back into arrest.

Remote Areas Emergency Medical Systems www.raems.com b) not likely to go into arrest again. c) less likely to arrest if shocked at least six times. d) less likely to arrest after three shocks.

123. An unconscious patient with a pulse who has been resuscitated from cardiac arrest requires: a) pulse checks repeated every 30 seconds. b) standard chest compressions. c) pulse checks repeated every 2 minutes. d) modified chest compressions. 124. Following a resuscitation from cardiac arrest, care should include all of the following EXCEPT: a) aggressively maintain an open airway. b) perform chest compressions and assisted ventilations. c) keep the defibrillator on the patient in case arrest reoccurs. d) perform a focused assessment based on the patient's complaints.

125. When using an automated external defibrillator (AED), which of the following is a good way to minimize inappropriate shocks? a) practicing with the AED frequently. b) always conducting CPR before defibrillating. c) using manual rather than automated defibrillation. d) always monitoring the rhythm on the AED screen.

126. According to the American Heart Association's "chain of survival", high survival rates from cardiac arrest depend on early access, early CPR, early defibrillation, and: a) early rehabilitation. b) early advanced care. c) early medical direction contact. d) early transport.

127. In the American Heart Association's "chain of survival", the term "early access" means that: a) EMS is called quickly. b) a first responder performs CPR quickly. c) an ACLS team is dispatched immediately . d) the medical director is contacted promptly.

128. Hypoglycemia is a term for a diabetic condition which means: a) high blood insulin level. b) high blood sugar. c) low blood insulin level. d) low blood sugar.

129. What appearance might a typical diabetic patient have when glucose in the bloodstream is low? a) energetic. b) alert and oriented. c) intoxicated. d) flushed, dry skin.

130. You perform a focused history and physical exam on a 13-year-old female patient. Witnesses

Remote Areas Emergency Medical Systems www.raems.com tell you her behavior changed suddenly. She has sweaty skin and complains of feeling hungry. Of the following, she is most likely to be suffering a/an: a) diabetic emergency. b) cardiac emergency. c) respiratory emergency. d) allergic reaction.

131. Which of the following questions is MOST relevant to ask of the suspected diabetic patient? a) "When was your last meal?" b) "Who is your physician?" c) "Do you have chest pain?" d) "Does it hurt when you breathe in?"

132. Children with diabetes: a) are less likely to need sugar than adults. b) respond just like adults during a diabetic emergency. c) are less likely to need insulin than adults. d) are more at risk for low blood sugar than adults.

133. Altered mental status may typically be caused by any of the following EXCEPT: a) drug overdose. b) low blood sugar. c) head trauma. d) chest pain.

134. All of the following are indications for giving oral glucose EXCEPT: a) the patient is unconscious. b) the patient's mental status is altered. c) the patient is awake enough to swallow. d) the patient has a history of low blood sugar.

135. Treatment of the conscious patient with diabetes may include: a) providing cardiac compressions. b) giving oral glucose. c) giving patient's prescribed insulin. d) giving low concentration oxygen by nasal cannula.

136. Your diabetic patient has lost consciousness after you administered oral glucose. You should next: a) assure an open airway. b) give a second dose of oral glucose. c) use a tongue depressor to inspect the airway. d) use a tongue depressor as a bite-block in case of seizures.

137. Your patient is unconscious. A medical identification bracelet tells you that she is a diabetic. What should you do first?

Remote Areas Emergency Medical Systems www.raems.com a) Administer oral glucose. b) Contact medical direction. c) Assure open airway. d) Check for a pulse.

138. Your diabetic patient is unconscious. Treatment may include all of the following EXCEPT: a) giving oral glucose. b) positioning patient on his/her side. c) preparing to perform CPR if necessary. d) performing artificial ventilation if necessary.

139. An appropriate action prior to administering oral glucose is to assure that the patient: a) does not have high blood sugar levels. b) is unconscious and breathing. c) is conscious and able to swallow. d) has an empty stomach.

140. Glucose is administered by placing the gel: a) under the patient's tongue. b) between the patient's cheek and gum. c) on the roof of the patient's mouth. d) on the patient's tongue.

141. The body's basic source of energy is: a) adrenalin. b) oxygen. c) glucose. d) insulin.

142. Oral glucose is given to the diabetic patient because it helps get: a) sugar into the bloodstream and to the brain. b) insulin into the pancreas. c) excess sugar out of the body. d) excess sugar out of the pancreas into the blood.

143. All of the following are commonly associated with seizures EXCEPT: a) epilepsy. b) alcohol withdrawal. c) cardiac arrest. d) head injury.

144. What should be done to care for the patient who is suffering or has just suffered a seizure? a) Restrain the patient. b) Position the patient on his side.

Remote Areas Emergency Medical Systems www.raems.com c) Place a bite block in the patient's mouth. d) Administer a sedative medication.

145. A stroke may result from any of the following EXCEPT: a) reduction of the sugar supply to an area of the brain. b) blockage of an artery that supplies an area of the brain. c) reduction of the oxygen supply to an area of the brain. d) rupture of an artery that supplies an area of the brain.

146. Of the following, which is critical to the care of a suspected stroke patient? a) immobilizing the patient. b) administering oral glucose. c) conducting a detailed physical exam. d) quickly transporting the patient to the hospital.

147. A severe allergic reaction is sometimes called: a) psychogenic shock. b) cardiogenic shock. c) respiratory shock. d) anaphylactic shock.

148. Typical causes of allergic reactions include all of the following EXCEPT: a) wasps, hornets, and yellow jackets. b) metals and plastics. c) nuts and shellfish. d) dust, soaps, and chemicals.

149. How rapidly do signs and symptoms of a severe allergic reaction MOST OFTEN appear? a) immediately. b) within one to two minutes. c) within four to six minutes. d) within ten to twenty minutes.

150. A patient suffering from an allergic reaction may tell you his skin feels: a) cool and dry. b) warm and tingling. c) hot and dry. d) none of the above.

151. Which of the following might a patient suffering from an allergic reaction say? a) "My heart is beating too slow." b) "My chest feels tight." c) "My skin feels cold." d) "My muscles ache."

152. You may see all of the following in an allergic reaction patient EXCEPT: a) itchy, watery eyes. b) slow pulse.

Remote Areas Emergency Medical Systems www.raems.com c) headache. d) runny nose.

153. A 14-year-old male patient complains of an itchy feeling in his throat and difficulty breathing. He tells you he was just stung by an insect. You suspect he is suffering from: a) high blood sugar. b) low blood sugar. c) an allergic reaction. d) an impending seizure. 154. An important clue that your patient may be suffering an allergic reaction would be: a) breath that smells like acetone. b) a slow pulse. c) chest pain. d) a prior allergic reaction.

155. Infants rarely experience anaphylactic reactions because: a) they have limited exposure to allergens. b) they have not yet developed antibodies. c) they have too many antibodies. d) they have too many antigens.

156. What care should you provide the allergic-reaction patient during the INITIAL assessment? a) blood pressure check. b) airway management. c) head-to-toe exam. d) AMPLE history.

157. Your patient is experiencing an allergic reaction to a wasp sting. She is breathing adequately. What is your next step? a) Administer high concentration oxygen by nonrebreather mask. b) Take the patient's blood pressure. c) Contact medical direction. d) Administer high concentration oxygen by nasal cannula.

158. After eating peanuts at a baseball game, your patient has lost consciousness. He is breathing at a rate of 32 per minute and very shallow. After assuring an open airway, your next action should be to: a) provide artificial ventilation. b) administer prescribed epinephrine auto-injector. c) provide high concentration oxygen through a nonrebreather mask. d) contact medical direction.

159. Your patient is suffering an anaphylactic reaction and does not have a prescribed epinephrine auto-injector. You should: a) request an ALS (paramedic) intercept. b) advise the patient to see his personal physician. c) ask his physician to phone a prescription to the nearest pharmacy. d) request an epinephrine injection for the patient when you arrive at the hospital.

Remote Areas Emergency Medical Systems www.raems.com 160. Your patient is suffering from an allergic reaction to shrimp. Earlier he was breathing adequately; now he is not. What should you suspect? a) The patient's airway is at risk. b) An emotional reaction. c) Low blood sugar. d) The patient is about to have a seizure.

161. In an allergic reaction, exposure to an allergen will cause: a) blood vessels to slowly constrict. b) blood vessels to spasm. c) blood vessels to close completely. d) blood vessels to dilate rapidly.

162. Why do patients suffering from allergic reactions have difficulty breathing? a) Allergens use up oxygen molecules. b) Allergens destroy the respiratory drive in the brain. c) Tissues swell in the respiratory system. d) The cardiac rhythm is disturbed.

163. Which of the following would qualify an allergic reaction as anaphylactic? a) severe breathing difficulty and no hives. b) normal breathing and hives. c) increased blood pressure and a complaint of itchy, watery eyes. d) a normal blood pressure and a complaint of itchy, watery eyes.

164. Your patient was stung by a bee. He complains of itchy palms. He denies breathing difficulty. At this time he is probably suffering: a) an anaphylactic reaction. b) a mild allergic reaction. c) an epinephrine reaction. d) mild dermatitis.

165. Your patient just ate a lobster. She complains of itchy, watery eyes. She denies breathing difficulty. Her blood pressure is falling. You should assume that she is suffering: a) a minor allergic reaction to the lobster. b) a heart attack. c) indigestion. d) an anaphylactic reaction.

166. The definition of absorbed poisons is those that are: a) swallowed. b) inhaled. c) taken into the body through unbroken skin. d) all of the above.

167. Carbon monoxide is a poison that may enter the body by: a) inhalation.

Remote Areas Emergency Medical Systems www.raems.com b) ingestion. c) absorption. d) all of the above.

168. The most frequent victims of accidental poisonings are: a) children. b) the elderly. c) the seriously ill. d) teenagers. 169. The body's responses to poisonous substances are far more serious in: a) the middle aged. b) young adults. c) teenagers. d) the elderly.

170. Your patient is a conscious 2-year-old male. He has ingested a small quantity of bleach. You may see which of the following signs? a) dilated pupils. b) hot, dry skin. c) bright red skin on child's extremities. d) chemical burns around the mouth.

171. All of the following are common signs of carbon monoxide poisoning EXCEPT: a) cherry red lips. b) nausea. c) headache. d) breathing difficulty.

172. When you treat a child for a suspected poison ingestion, you should: a) assume children will not swallow most poisons. b) treat for the worst. c) assume the child has not ingested a lethal amount. d) treat the least potential life threat first.

173. You are en route to a possible poisoning by inhalation. Upon arrival you should immediately: a) perform a scene size-up. b) manage the patient's airway. c) perform an initial assessment. d) perform a focused history and exam.

174. The single most important treatment for an inhaled poisoning, after airway management, is to: a) transport. b) contact medical direction. c) administer high concentration oxygen. d) administer activated charcoal.

175. Treatment for your patient suffering from carbon monoxide poisoning includes: a) asking the patient to breathe into a paper bag.

Remote Areas Emergency Medical Systems www.raems.com b) administering oxygen. c) administering activated charcoal. d) administering oral glucose.

176. The pilot of a crop duster has crashed into a corn field. You believe the aircraft is carrying pesticides. As you respond to this emergency, you should first: a) perform rapid extrication. b) stabilize the cervical spine. c) manage the patient's airway. d) approach the scene with care.

177. The most important part of the treatment for an absorbed poison is to: a) neutralize the poison with vinegar. b) remove the poison from the skin. c) neutralize the poison with baking soda in water. d) administer activated charcoal.

178. Your patient has splashed liquid ammonia into his eyes. What treatment should you provide first? a) Irrigate eyes with clean water. b) Cover eyes with sterile gauze. c) Dilute ammonia with vinegar and water. d) Irrigate eyes with a weak acid solution.

179. You suspect that your nearly unconscious male patient has ingested sleeping pills and alcohol. He is breathing inadequately. You should immediately: a) give oxygen by nasal canula. b) administer activated charcoal. c) administer syrup of ipecac. d) manage the airway.

180. Your patient is a known chronic abuser of alcohol. She is found unconscious on a sidewalk. She is breathing adequately. You should suspect and assess for: a) a heart attack. b) a head injury. c) blood sugar problems. d) all of the above.

181. A 53-year-old, whom you know to be a chronic alcohol abuser, tells you he has had "only two beers." He is sweating, trembling, anxious, and hallucinating. He begins to seize. You should suspect: a) marijuana. b) sleeping pills. c) narcotics.

Remote Areas Emergency Medical Systems www.raems.com d) alcohol withdrawal.

182. A typical sign of narcotics abuse would be: a) increased pulse rate. b) constricted pupils. c) increased rate and depth of breathing. d) dilated pupils.

183. Which of the following is one way the body loses heat? a) conversion. b) induction. c) conduction. d) inspiration.

184. Most radiant heat loss occurs from: a) the head or neck. b) perspiration. c) exhalation. d) the feet and legs.

185. Cooling that affects the entire body is called: a) hyperthermia. b) frostnip. c) hypothermia. d) frostbite.

186. The weather is cold and your patient is trapped in a wrecked auto. He appears to have a head injury. You should also prepare to treat the patient for: a) hyperventilation. b) hypothermia. c) anaphylaxis. d) hypoglycemia.

187. A 2-year-old patient is suffering from severe hypothermia. You would expect to see all of the following signs or symptoms EXCEPT: a) cool abdominal skin. b) shivering. c) drowsiness. d) numbness.

188. The severity of hypothermia can BEST be determined by noting the patient's decreasing motor function and: a) skin moisture. b) degree of chest pain. c) level of nausea. d) decreasing mental status.

Remote Areas Emergency Medical Systems www.raems.com 189. All of the following are typical signs or symptoms of hypothermia EXCEPT: a) rapid breathing in early stages. b) stiff or rigid posture in late stages. c) anxiety and a sense of doom in early stages. d) reddened skin becoming pale in late stages.

190. Which of the following signs or symptoms might you expect to see in a patient suffering from severe hypothermia? a) irrational behavior. b) excessive mucous production. c) blood tinged sputum. d) burning or itching in the underarms.

191. You should suspect severe hypothermia when the patient: a) complains of chest pain. b) shivers intensely. c) is no longer shivering. d) complains of numbness and tingling.

192. Signs of a deep local cold injury may include all of the following EXCEPT: a) white, waxy skin. b) grayish-blue skin. c) reddened skin. d) blotchy skin.

193. Which of the following patients would you be most concerned about during a hypothermia emergency? a) a 30-year-old. b) a 77-year-old. c) a 15-year-old. d) a 44-year-old.

194. Passive rewarming of a hypothermic patient involves: a) applying external heat sources. b) allowing the body to rewarm itself. c) giving the patient warm liquids. d) gently massaging patient's extremities.

195. Rough handling of a patient suffering from severe hypothermia may cause: a) ventricular fibrillation. b) nausea and vomiting. c) increased shivering. d) decreased shivering.

196. Your hypothermic patient is alert and responding appropriately. All of the following are acceptable emergency care steps EXCEPT: a) removing the patient's wet clothing. b) transporting the patient to the hospital.

Remote Areas Emergency Medical Systems www.raems.com c) covering the patient with warm blankets. d) rewarming the patient's limbs.

197. During core rewarming of a hypothermic patient you apply heat to all the following areas EXCEPT: a) head. b) soles of the feet. c) armpits. d) lower back. 198. You should suspect a heat-related emergency if the patient, on a hot day: a) has constricted pupils. b) complains of leg cramps after working outdoors. c) has breath that smells like nail polish remover. d) complains of "itchy" skin.

199. Your patient is a 76-year-old male. He lives in a trailer without air conditioning. His skin is cool, pale, and moist. He complains of weakness and cramps in his legs and abdomen. Emergency care may include all of the following EXCEPT: a) giving the patient oxygen by nonrebreather mask. b) placing the patient in a bathtub with cool water. c) applying moist towels over cramped muscles. d) putting the patient in supine position with legs elevated.

200. The muscular abdominal organ where the fetus develops is called: a) the placenta. b) the uterus. c) the birth canal. d) the ovarian chamber.

201. The organ responsible for the exchange of oxygen, food, and waste between a mother and fetus is called the: a) uterus. b) ovary. c) placenta. d) vagina.

202. The fetal structure containing vessels that carry blood to and from the placenta is called the: a) uterus. b) birth canal. c) umbilical cord. d) cervix.

203. The "bag of waters" that surrounds the developing fetus is also called the: a) uterus. b) meconium. c) perineum. d) amniotic sac.

Remote Areas Emergency Medical Systems www.raems.com 204. The purpose of the rubber bulb syringe in an obstetric kit is to suction: a) the baby's mouth and nostrils. b) blood from the cut umbilical cord. c) any postpartum vaginal bleeding. d) all of the above.

205. The plastic bag contained in the obstetric kit is intended to be used to carry: a) sanitary napkins. b) the placenta after it is delivered. c) oxygen tubing. d) cord clamps and hemostats.

206. New shoelaces or twine contained in the obstetric kit is used to: a) tie the umbilical cord. b) secure the blanket around the baby. c) secure the oxygen mask on the baby's face. d) tie a delivery tag to the baby's wrist for identification.

207. Which of the following represents a predelivery emergency? a) breech presentation. b) abruptio placentae. c) crowning. d) cephalic presentation.

208. Which of the following is a common sign or symptom of a predelivery emergency? a) mother's skin is red and dry. b) profuse vaginal bleeding. c) "bloody show." d) itchy skin.

209. Seizures in pregnancy commonly occur: a) during the first 6 weeks past conception. b) in the first three months of the pregnancy. c) in mid-pregnancy. d) late in the pregnancy.

210. Signs and symptoms of a miscarriage include: a) cramping abdominal pains. b) bleeding. c) delivery of fetus before the 28th week of pregnancy. d) all of the above.

211. Management of the patient who has suffered a miscarriage includes: a) placing a sanitary napkin in the vagina. b) discarding any expelled tissues.

Remote Areas Emergency Medical Systems www.raems.com c) treating for shock. d) removing any tissues from the vagina.

212. Crowning occurs when the: a) placenta separates from the uterine wall. b) umbilical cord presents at the vaginal opening. c) baby's head is visible at the vaginal opening. d) placenta is formed in an abnormal location.

213. Your patient is a 23-year-old experiencing labor pains. You need to decide if you should transport or prepare for the baby's delivery. Which of the following should you ask the patient? a) How long have you had labor pains? b) Has your "bag of waters" broken? c) How often are the contractions occurring? d) all of the above.

214. Your patient is experiencing labor pains. She feels like she needs to move her bowels. This is significant because it may indicate that: a) birth will occur soon. b) birth is still some time away. c) she is going into shock. d) the baby is still very high in the birth canal.

215. During assessment of the mother in labor, uterine contractions are evaluated to determine if: a) a cephalic delivery will occur. b) there is any intra-abdominal bleeding. c) a breech delivery will occur. d) birth is imminent.

216. As delivery of the baby nears, the uterus will begin to: a) spasm. b) feel soft. c) feel more rigid. d) distend the abdomen.

217. All of the following are appropriate treatment measures for a predelivery emergency EXCEPT: a) providing high concentration oxygen. b) placing a sanitary napkin in the vagina. c) replacing pads as they become soaked. d) rapid transport to the hospital.

218. How should the expectant mother be positioned when birth is imminent? a) on her right side with legs apart. b) supine with knees drawn up and spread apart. c) in a sitting position on the stretcher. d) in the knee-chest position.

219. When preparing the mother for delivery, you should put on a gown, cap, face mask, and eye protection for all of the following reasons EXCEPT: a) this is considered appropriate for body substance isolation.

Remote Areas Emergency Medical Systems www.raems.com b) there is a high probability of splashing fluids during delivery. c) there is a high probability of exposure to bodily fluids after the delivery. d) this helps you to give a professional appearance during delivery.

220. During delivery of the baby you should encourage the mother to do all the following EXCEPT: a) breathe deeply through her mouth. b) try not to strain. c) relax between contractions. d) push as contractions begin to lessen.

221. When delivering a baby you should perform all of the following EXCEPT: a) pulling on the baby's head to assist delivery of the shoulders. b) positioning your gloved hands at the vaginal opening. c) spreading your fingers around the baby's head. d) assuring someone is at the mother's head for support.

222. As the baby's head is delivered, you see that the umbilical cord is wrapped around the baby's neck. You should immediately: a) transport, since no basic life-support care can be provided. b) gently attempt to remove the cord from around the baby's neck. c) delay delivery by gently pushing on the baby's head. d) cut the cord and quickly deliver the baby.

223. As the baby's head delivers, you notice the amniotic sac has not broken. You should immediately: a) gently push on the baby's head to delay delivery. b) use your gloved finger to puncture the membrane. c) cover and protect the membrane from laceration. d) continue with the delivery since the bag will rupture as the baby is delivered.

224. Which of the following is the correct way to use the rubber bulb syringe when managing the newborn's airway? a) Compress the syringe after placing it in baby's nostrils, then mouth. b) Compress the syringe before placing it in baby's mouth, then nostrils. c) Compress the syringe and suction only the nostrils. d) Compress the syringe and suction only the mouth.

225. In order to assist in controlling the airway, once the baby has been delivered you should: a) keep baby above the level of the mother's vagina. b) lay the baby on its side with the head lower than the body. c) keep the baby below the level of the mother's vagina. d) lay the baby on its back with the head higher than the body.

226. You are unable to loosen or slip the umbilical cord from around the baby's neck. Your next action should be to: a) delay delivery by gently pushing on the baby's head. b) clamp the cord in two places and transport. c) clamp the cord in two places and cut the cord between the clamps. d) cut the cord and then apply direct pressure to the ends of the cord.

Remote Areas Emergency Medical Systems www.raems.com 227. Which of the following signs or symptoms indicates delivery of the placenta? a) shortening of the umbilical cord. b) "bloody" show. c) brief return of labor pains. d) sudden gush of blood.

228. Which of the following can you expect to occur after delivery of the placenta? a) vaginal bleeding. b) supine hypotensive syndrome. c) brief period of unconsciousness. d) sudden drop in the patient's blood pressure.

229. All of the following are appropriate methods for controlling bleeding following delivery of the baby and the placenta EXCEPT: a) massaging the uterus. b) placing a sanitary napkin over the vaginal opening. c) elevating the mother's feet. d) telling the mother to squeeze her legs together.

230. A newborn should begin breathing within: a) 10 seconds. b) 30 seconds. c) 45 seconds. d) 1 minute.

231. If your newborn patient does not breathe within the appropriate period of time, you should gently but vigorously: a) hold the baby up by its feet. b) rub the baby's chest. c) slap the baby's bottom. d) rub the baby's back.

232. Your newborn patient is breathing 48 times per minute and her pulse rate is 110. You notice facial cyanosis. You should deliver oxygen: a) with a pediatric nasal cannula at 10 to 15 liters per minute. b) at 10 to 15 liters per minute using oxygen tubing close to the infant's face. c) with a pediatric mask at 10 to 15 liters per minute. d) at 60 breaths per minute using a bag-valve-mask device.

233. The most common abnormal delivery is a: a) limb presentation. b) prolapsed umbilical cord. c) breech delivery. d) cephalic delivery.

234. When you check for crowning, you see an arm at the vaginal opening. You should immediately:

Remote Areas Emergency Medical Systems www.raems.com a) place the mother in a sitting position to delay delivery. b) gently pull on the arm to assist with delivery. c) transport the mother to a medical facility. d) gently push the arm back into the vagina.

235. Meconium staining, a sign of fetal or maternal distress, is a result of: a) fetal defecation. b) vaginal bleeding. c) mucus from the fetus's mouth and nose. d) abruptio placentae.

236. One of the most important steps you can take in caring for the premature baby is to: a) give the baby high concentration oxygen by nonrebreather mask. b) keep the baby warm. c) suction fluids only from the nose. d) encourage family members to hold the baby.

237. In what position should you place the expectant mother who suffers from supine hypotensive syndrome? a) on her left side. b) on her right side. c) in sitting position. d) with legs elevated.

238. When assisting at the birth of a baby, you should consider that your patient(s) is/are: a) only the mother. b) only the baby. c) the mother and the baby. d) the mother, the baby, and the family.

239. Which of the following is not a part of the circulatory system? a) heart. b) lungs. c) blood. d) blood vessels.

240. The circulatory system is responsible for: a) taking in oxygen and getting rid of wastes. b) electrolyte balance. c) distribution of blood to the body. d) breaking down foods into usable energy.

241. A blood vessel with thick, muscular walls that carries blood away from the heart is a(an): a) artery. b) capillary. c) vein. d) venule.

242. External bleeding that is a steady flow of dark red blood is from a(n): a) artery.

Remote Areas Emergency Medical Systems www.raems.com b) vein. c) capillary. d) all of the above.

243. External bleeding that is rapid, spurting with each heartbeat, and profuse is from a(n): a) artery. b) vein. c) capillary. d) all of the above.

244. Of the following, your first choice for controlling external bleeding from an extremity should be: a) use of pressure points. b) the use of a tourniquet. c) elevation of the extremity. d) direct pressure.

245. The pressure point you should use to control bleeding from the lower extremities is at the: a) brachial artery. b) femoral artery. c) temporal artery. d) carotid artery.

246. You should use the pressure point at the brachial artery to control bleeding from: a) an upper extremity. b) a lower extremity. c) the face. d) a foot.

247. Body substance isolation (BSI) precautions taken when there is a high probability of blood splatter should include all of the following EXCEPT: a) gloves. b) protective eyewear. c) masks. d) oral airway adjunct.

248. Of the following, your first step in the care of a trauma patient is: a) control of external hemorrhage. b) opening and maintaining the airway. c) assessment of the carotid pulse. d) assessment of respirations.

249. The chief assessment element that tells you whether to suspect internal hemorrhage is: a) mechanism of injury. b) medical history. c) initial blood pressure. d) level of consciousness.

250. Signs of internal bleeding include all the following EXCEPT: a) a blood pressure of 120/80. b) bruising over vital organs.

Remote Areas Emergency Medical Systems www.raems.com c) bleeding from the mouth or other body orifice. d) a tender, rigid abdomen.

251. A late sign of internal bleeding is: a) bruising. b) painful, swollen extremities. c) signs of shock. d) bright red vomitus.

252. The patient with suspected internal bleeding should be given oxygen by: a) nonrebreather mask at 15 liters per minute. b) nasal cannula at 6 liters per minute. c) nasal cannula at 2 liters per minute. d) nonrebreather mask at 8 liters per minute.

253. Your care for the patient with internal bleeding should include all the following EXCEPT: a) maintaining ABCs. b) fluids by mouth. c) control of any external bleeding. d) immediate transport to the appropriate facility.

254. Early signs and symptoms of hypoperfusion include: a) a decrease in the pulse rate. b) elevated blood pressure. c) cool, clammy skin. d) constricted pupils.

255. An altered mental status as an EARLY sign of shock may present as any of the following EXCEPT: a) anxiety. b) restlessness. c) combativeness. d) lethargy.

256. As you monitor the patient who you believe is going into shock, one of the last signs you would expect to see is: a) increased pulse. b) decreased blood pressure. c) increased respirations. d) cool, clammy, pale skin.

257. When approved by your medical direction, use of the pneumatic anti-shock garment is usually indicated for: a) open chest injuries. b) head trauma. c) pelvic injuries. d) cardiac arrest.

Remote Areas Emergency Medical Systems www.raems.com 258. Which statement BEST describes why prompt transport of the trauma patient is necessary? a) Extremity injuries should be splinted at the emergency department. b) External bleeding can be properly controlled only at a hospital. c) There is nothing that can be done for the patient at the scene. d) Survival rates are significantly improved with rapid transport to and surgery at a hospital.

259. Protection, temperature regulation, and excretion are major functions of the: a) muscles. b) skin. c) membranes. d) blood vessels.

260. The outer layer of the skin is called the: a) dermis. b) subcutaneous layer. c) epidermis. d) dura.

261. Shock absorption and insulation are the major functions of which layer of the skin? a) dermis. b) subcutaneous layer. c) epidermis. d) dura.

262. When managing the patient with soft tissue injuries it is important to always: a) completely disinfect the wound site. b) apply the PASG to your patient. c) take BSI precautions. d) seal the wound with an occlusive dressing.

263. An injury in which the epidermis remains intact, but cells and blood vessels in the dermis may be damaged, is called a(n): a) avulsion. b) concussion. c) contusion. d) evisceration.

264. When force is transmitted to the body's internal structures causing internal organs to rupture or bleed internally, the injury is called a(n): a) crush injury. b) concussion. c) contusion. d) avulsion.

265. A bruise may be an indication of internal injuries and internal bleeding. It is important for you

Remote Areas Emergency Medical Systems www.raems.com to monitor your patient for any signs and symptoms of: a) low blood sugar. b) shock. c) infection. d) hypothermia.

266. An open wound caused by a sharp, pointed object passing through the skin or other tissue is called a(n): a) laceration. b) abrasion. c) avulsion. d) puncture.

267. An injury in which flaps of skin and tissues are torn loose or pulled off completely is called a(n): a) laceration. b) abrasion. c) avulsion. d) puncture.

268. Bleeding from a laceration should USUALLY be controlled by: a) a pressure point. b) a tourniquet. c) a cold pack. d) direct pressure.

269. A 17-year-old male patient has been involved in a fight. You find a pencil impaled in his upper arm. Your management would include: a) removal of the pencil to bandage the wound. b) stabilizing the pencil with a bulky dressing. c) applying a tourniquet to control bleeding. d) cutting the exposed portion of the pencil off to ease bandaging and transport.

270. A 32-year-old female patient has amputated her index finger in a table saw accident. You have bandaged her hand. The best way to transport the amputated finger is by: a) placing the finger directly in ice. b) wrapping the finger well in an occlusive dressing. c) placing the finger directly in sterile saline. d) wrapping the finger in gauze, placing it in a plastic bag, and keeping it cool.

271. Your patient has received an open chest wound from a knife. Management should include all of the following EXCEPT: a) high concentration oxygen. b) sealing the wound with an occlusive dressing. c) care for shock.

Remote Areas Emergency Medical Systems www.raems.com d) cleaning the wound with saline.

272. A 23-year-old male patient has been involved in a motor vehicle crash and has an open abdominal injury with protruding bowel. Your treatment of the injury should include: a) replacing the exposed bowel. b) application of the PASG for the abdominal injury. c) covering the exposed bowel with a sterile dressing moistened with saline, then an occlusive dressing. d) covering the bowel with dry sterile gauze prior to transport.

273. Regarding an occlusive dressing for an open chest wound or an occlusive dressing for an open abdominal wound: a) the occlusive dressing for an open abdominal wound is sealed on all four sides; the occlusive dressing for an open chest wound is left open at one corner or side. b) the occlusive dressing for an open chest wound is sealed on all four sides; the occlusive dressing for an open abdominal wound is left open at one corner or side. c) all occlusive dressings are left open at one corner or side. d) all occlusive dressings are sealed on all four sides.

274. In an adult, a full thickness burn that involves 2%-10% of the body surface is classified as a: a) minor burn. b) moderate burn. c) critical burn. d) circumferential burn.

275. A superficial burn is characterized by: a) charred black areas. b) blisters. c) reddening of the skin. d) lack of pain.

276. You are called to assist a 34-year-old male patient who opened the radiator of his car resulting in the hot liquid being sprayed on his chest. The skin is red and painful, but no other signs or symptoms are present. Your patient's burn would be classified as: a) critical. b) severe. c) superficial. d) full thickness.

277. You are caring for a 24-year-old female patient who accidentally spilled an alkaline drain cleaner on her forearm. The cleaner has been washed off but the arm is still painful, red, and blistered. This burn would be classified as: a) partial thickness. b) severe. c) superficial. d) full thickness.

278. A burn characterized by intense pain, reddening, and blisters is called a: a) superficial burn. b) partial thickness burn. c) full thickness burn.

Remote Areas Emergency Medical Systems www.raems.com d) critical burn.

279. Your 42-year-old male patient was involved in a house fire. His lower legs have been burned. The area is charred black but your patient states he has little pain. This burn would be classified as: a) partial thickness. b) full thickness. c) superficial. d) minor. 280. A burn in which all layers of the skin are damaged is sometimes called a) first degree burn. b) second degree burn. c) third degree burn. d) fourth degree burn.

281. Acceptable care for a superficial burn may include all of the following EXCEPT: a) cool the burn with water. b) apply a burn ointment. c) keep the burn site clean. d) keep the patient warm.

282. A 34-year-old female patient has suffered a partial thickness burn to her forearm. Your treatment should include: a) applying a burn ointment. b) applying ice. c) puncturing blisters. d) applying a dressing.

283. You respond to a burn patient at a house fire. Upon your arrival, one of the firefighters assists a 34-year-old male patient to your ambulance. The patient is conscious and alert. He has full thickness burns to both hands and forearms. He also has partial thickness burns to his chest. Your treatment should include: a) soaking the burned areas in saline and wrapping with a sterile dressing. b) carefully wrapping the burned areas with a dry sterile dressing. c) applying an antiseptic ointment to the burns to prevent infection. d) applying ice to the burned areas to cool them.

284. As an EMT-A you should be familiar with the various types of dressings and bandages. As a rule, dressings should: a) be sterile. b) provide an air tight seal. c) be placed over all bandages. d) all of the above.

285. Because it can become a constricting band, one type of bandage you should NOT use to hold dressings in place is: a) self-adherent roller gauze. b) strips of adhesive tape. c) an elastic bandage. d) a triangular bandage.

Remote Areas Emergency Medical Systems www.raems.com 286. To properly apply a pressure dressing and bandage to an open wound it is important that you: a) apply a tourniquet to control bleeding. b) replace any dressings that become blood-soaked. c) apply an antiseptic solution to the wound. d) expose the entire wound, cutting away clothing as needed.

287. A 23-year-old male patient was the driver of a car that struck a telephone pole. You notice bruising to the chest from impact with the steering wheel. This sign suggests a possible: a) abdominal injury. b) head injury. c) lung injury. d) pelvic injury.

288. Besides stopping the burning process, your first concern in treating a conscious patient who has received partial thickness burns to the face is treating: a) for shock. b) airway problems. c) the burned area by applying a dressing. d) for hyperthermia.

289. Problems with Improper bandaging can include all of the following EXCEPT: a) bandage is too tight, restricts blood supply. b) bandage is too loose, may slip off wound. c) bandage covers all edges of dressing, prevents air circulation. d) bandage has loose ends, can get caught on objects.

290. In which of the following situations might you remove an impaled object? a) A knife has punctured a lung. b) A piece of metal has punctured the bowel. c) A steel rod has punctured the skull. d) A thin piece of wire has punctured the cheek.

291. You respond to a farm accident in which an 18-year-old man has had his right leg amputated below the knee. After your patient has been appropriately managed, the amputated leg should be: a) transported wrapped in a sterile dressing, and kept as cool as possible. b) transported wrapped in a sterile dressing, and immersed in cold water. c) left at the scene for the medical examiner. d) transported packed directly in ice.

292. Your patient has been exposed to an unknown chemical which has soaked his clothing. You should immediately flush the patient with: a) water. b) a neutralizing solution. c) vinegar. d) a baking soda solution.

Remote Areas Emergency Medical Systems www.raems.com 293. The major problem caused by electrical shock is often not the burn itself. The most serious problem to consider is: a) shock. b) hypothermia. c) respiratory or cardiac arrest. d) brain damage.

294. Tendons, ligaments, and cartilages are all components of the: a) cardiovascular system. b) musculoskeletal system. c) nervous system. d) sensory system.

295. Clavicles and scapulae are components of the: a) musculoskeletal system. b) cardiovascular system. c) digestive system. d) nervous system.

296. The collarbones, shoulder blades, arms, wrists, and hands are components of the: a) thorax. b) lower extremities. c) upper extremities. d) spinal column.

297. Your patient has fallen from a horse and has a fractured lower leg. Since the broken bone has torn through the skin, this fracture is called: a) closed. b) open. c) simple. d) spiraled.

298. An important reason to splint a closed painful, swollen, deformed injury is to: a) cover any external injuries. b) prevent it from becoming an open injury. c) allow the patient to move the injured extremity without pain. d) make transporting the patient easier and more comfortable.

299. General rules of splinting include: a) attempting to push protruding bones back into place. b) splinting of all injuries individually prior to transport. c) not using extra padding, as this may decrease the effectiveness of the splint. d) checking for pulse, motor function, and sensation before and after splinting.

300. If you have applied a splint properly, it will immobilize the: a) injury site, only. b) adjacent joints and bone ends.

Remote Areas Emergency Medical Systems www.raems.com c) entire extremity. d) injury site and one joint below.

301. If your patient is a high priority for "load and go" transport, the fastest method of splinting would be securing: a) the injured limb to the torso. b) the injured limb to an uninjured limb. c) the entire body to a spine board. d) each site individually to a rigid splint. 302. Your first priority in treating a patient with a painful, swollen, deformed extremity is: a) opening and maintaining the airway. b) splinting closed pain, swollen, deformed extremities. c) applying direct pressure to open injuries. d) assessing circulation in injured extremities.

303. If you apply a splint too loosely, some of the complications may include all of the following EXCEPT: a) further soft tissue injury. b) causing an open fracture to occur. c) compression of injured nerves and blood vessels. d) allowance of too much movement.

304. Your 35-year-old male patient has fallen while rock climbing. During your assessment you find a deformed right lower leg. The distal extremity is pulseless and the skin is cool and cyanotic. Your emergency treatment for this injury should include: a) splinting the extremity as it is. b) attempting to realign the injured extremity. c) applying a traction splint. d) moving the patient to your ambulance before splinting.

305. Traction splints are specifically designed to splint injuries to the: a) upper arm. b) lower arm. c) upper leg. d) lower leg.

306. Use of a traction splint is contraindicated if your patient: a) has a knee injury. b) has a back injury. c) has a femur fracture. d) has no distal pulse in the injured extremity.

307. Which of the following splinting devices would NOT be appropriate for the management of a fractured tibia? a) air inflated splint. b) two rigid board splints. c) traction splint. d) single rigid splint with ankle hitch.

Remote Areas Emergency Medical Systems www.raems.com 308. Your treatment for a patient with a shoulder girdle injury should include: a) using a traction splint. b) attempting to reduce a dislocation. c) applying a rigid arm splint. d) using a sling and swathe to splint the injury.

309. Your 64-year-old female patient has slipped on the ice and you suspect a pelvic fracture. This type of injury is very serious, because: a) a pelvic injury is very painful. b) internal organs, blood vessels, and nerves may be injured. c) a pelvic injury is difficult to stabilize. d) the patient cannot be log rolled.

310. You may consider using the PASG for splinting injuries to the: a) knee. b) ankle. c) pelvis. d) all of the above.

311. "Splinting someone to death" means: a) splinting too tightly, compressing blood vessels and nerves. b) splinting too loosely, permitting movement and further tissue damage. c) splinting without first applying traction or realignment, causing further tissue damage. d) spending too much time splinting, neglecting care for life-threatening conditions, and unnecessarily delaying transport.

312. What is the rationale for splinting a painful, swollen, or deformed extremity even when you cannot be sure there is a fracture? a) A painful, swollen, or deformed extremity is almost always a fracture, and so it should be treated as a fracture. b) Any injury to an extremity, however minor, will result in further tissue damage and permanent injury unless splinted. c) Since the exact nature of the injury cannot be determined without an x-ray, you should assume and treat for the worst. d) Although splinting will have no effect on the eventual outcome of the injury, it will increase the patient's comfort during transport.

313. The components of the central nervous system are the: a) cranium and vertebrae. b) muscles and tendons. c) brain and spinal cord. d) arteries and veins.

314. The component of the central nervous system that decides how to respond to changing conditions inside and outside of the body is the: a) spinal cord.

Remote Areas Emergency Medical Systems www.raems.com b) peripheral nerves. c) sensory nerves. d) brain.

315. Most messages sent from the brain first travel along the: a) spinal cord. b) peripheral nerves. c) sensory nerves. d) autonomic nerves. 316. The brain is protected by the: a) mandible. b) cranium. c) spinous process. d) orbits.

317. The spinal cord is protected by the: a) skull. b) thorax. c) vertebrae. d) pelvis.

318. The sections of the spine that are most susceptible to injury are the: a) cervical and sacral. b) cervical and thoracic. c) cervical and lumbar. d) cervical and coxygeal.

319. You are caring for a 36-year-old, conscious, male patient. He was the driver of an automobile struck on the driver's side by another automobile at approximately 45 mph. He has an open soft tissue injury to the left side of his face. You should assume from this injury that the patient also has a: a) low back injury. b) cervical spine injury. c) pelvic injury. d) abdominal injury.

320. If you miss a head or spine injury during the assessment of your patient, or if the injury is not treated appropriately, the result to the patient may be: a) permanent disability. b) death. c) paralysis. d) all of the above.

321. Tenderness anywhere along the vertebrae may be a sign of possible: a) spine injury. b) abdominal injury. c) kidney injury. d) head injury.

Remote Areas Emergency Medical Systems www.raems.com 322. One sign of spine injury is priapism, which is: a) lack of sensation to the distal extremities. b) persistent erection of the penis. c) cramping of the fingers and toes. d) loss of bladder control.

323. The most reliable sign of spinal injury in a conscious patient is: a) pain with movement. b) pain without movement. c) paralysis of the extremities. d) unequal pupils.

324. You are caring for a conscious 26-year-old female patient who was hit by a car while riding her motorcycle. She was wearing a helmet. Your assessment should include: a) asking her to try to stand and walk. b) asking her if she can feel you stab the bottom of her foot with your name tag pin. c) asking her to move her head from side to side. d) asking her if she can feel you lightly touch her fingers and toes.

325. You should open the airway of a trauma patient by using the: a) head-tilt, chin-lift method. b) head-tilt, neck-lift method. c) jaw-thrust, head-tilt method. d) jaw-thrust method.

326. Equipment necessary to properly stabilize your patient's cervical spine includes: a) sandbags. b) soft cervical collars. c) rigid cervical collars. d) all of the above.

327. When caring for a patient involved in a motor vehicle crash, you may release manual stabilization of your patient's head and neck after the patient: a) has a rigid cervical collar applied. b) is secured to a long spine board. c) has been removed from the vehicle. d) has arrived at the hospital emergency department.

328. A properly applied cervical collar should assist you in maintaining the head and neck in: a) a hyperextended position for airway maintenance. b) a slightly flexed position for airway maintenance. c) a neutral in-line position. d) the "sniffing" position.

329. Which of the following is a potential cause of an airway obstruction?

Remote Areas Emergency Medical Systems www.raems.com a) bone fragments. b) blood clots. c) broken teeth. d) all of the above.

330. What may result from applying an improperly sized rigid cervical collar? a) A too-large collar will hyperextend the neck. b) A too-small collar will hyperextend the neck. c) A too-large collar will hyperflex the neck. d) all of the above. 331. When log-rolling a patient onto a long spine board, the EMT-A in charge of the move is the person at the: a) head. b) chest. c) pelvis. d) feet.

332. Which of the following is the correct sequence for securing a patient to a long spine board? a) head, torso, legs. b) legs, torso, head. c) torso, legs, head. d) head, legs, torso.

333. You are caring for a 52-year-old unconscious male patient who is the passenger in a vehicle struck by a semi-truck. He has an open head wound, and bruising to the chest and abdomen. His respirations are 28 per minute and his pulse is 140 per minute. His skin is very cool and clammy. Your choice for extricating this patient is: a) full immobilization with a short spine board. b) full immobilization with a vest-type extrication device. c) rapid extrication. d) using only the chest straps on the short spine board.

334. When using a rapid extrication procedure for a high priority patient: a) a long spine board is slid between the patient and the vehicle seat. b) a cervical collar is not used. c) the patient is secured to a short spine board prior to extrication from the vehicle. d) the roof of the vehicle must be removed.

335. You respond to a 16-year-old football player who has been injured on the field. He is lying on his back, complaining of neck pain, head pain, and dizziness. His helmet is still on. A valid reason for leaving the helmet in place as you immobilize him is: a) the helmet is loose enough for you to examine the patient's face and head. b) the helmet is a snug fit and provides no movement of the patient's head. c) the patient may develop airway problems. d) the patient is dizzy.

336. In caring for a patient involved in a motorcycle crash you decide to remove the patient's helmet. To do so, which of the following methods will be correct? a) The EMT-A at the head removes the chin strap while the other EMT-A manually stabilizes the patient's head.

Remote Areas Emergency Medical Systems www.raems.com b) The EMT-A at the head maintains manual stabilization while the other EMT-A removes the chin strap. c) The EMT-A at the head holds the helmet stable while the other EMT-A places his hands behind the patient's neck to stabilize the head. d) The EMT-A at the head places his hands behind the patient's neck to stabilize the head while the other EMT-A removes the chin strap.

337. Your patient was riding a bicycle when she was struck by a car. To clear her ears while removing her bicycle helmet, one EMT-A should stabilize her head and neck while the other: a) cuts the helmet into two halves. b) cuts away the ear pieces. c) reaches inside the helmet to flatten the ears. d) pulls the helmet outward on both sides to clear the ears.

338. Your patient is the driver of a car that was involved in a crash. He is still sitting behind the wheel of the car. You quickly assess the patient and determine that his condition is stable. Which of the following would be the best way to remove the patient from the vehicle? a) Manually stabilize the patient's head, neck, and torso while rapidly transferring the patient to a long spine board. b) Manually stabilize the patient's head, neck, and torso while transferring the patient to a wheeled stretcher. c) Apply a rigid cervical collar, then a short spine board or vest-type extrication device, then transfer the patient to a long spine board. d) Apply a rigid cervical collar, then a vest-type extrication device or a short spine board, then transfer the patient to a stair chair.

339. Which of the following is the correct method to remove a patient from a vehicle when the patient is a high priority for rapid transport? a) normal extrication procedure. b) rapid extrication procedure. c) rapid take-down. d) extremity lift.

340. An important anatomical difference of infants and children compared to adults is that: a) they have a slower respiratory rate. b) they have a smaller surface area relative to body mass. c) their brain tissues are thinner and softer. d) their spleen and liver are more protected.

341. An infant or young child is more likely to suffer airway blockage than an adult for all of the following reasons EXCEPT: a) the ribs are more flexible. b) the deciduous (baby) teeth are easily dislodged. c) the larger, heavier head will tip forward when child is supine. d) secretions in the mouth, nose, and airway are more abundant.

342. Because many children fear pain, when you are about to perform a painful procedure it is

Remote Areas Emergency Medical Systems www.raems.com important to: a) tell the child it won't hurt. b) tell the child to look away. c) tell jokes while doing the procedure. d) tell the child it will hurt but be reassuring.

343. Your 2-year-old female patient is suffering respiratory distress. The cause is likely to be any of the following EXCEPT: a) airway obstruction. b) a cold. c) epiglottitis. d) indigestion.

344. It is important to recognize signs of EARLY respiratory distress in a child. Signs of early respiratory distress include: a) audible wheezing. b) decreased heart rate. c) breathing rate of 22. d) altered mental status.

345. You are caring for a 10-month-old, crying female patient. She has swallowed a piece of a hot dog which is causing a partial airway obstruction. Your treatment should include: a) back blows and chest thrusts. b) blind finger sweep to attempt removal of the object. c) high concentration oxygen by blow-by or nonrebreather. d) ventilations by bag-valve mask and oxygen.

346. Your 4-year-old male patient has swallowed a marble which is causing a complete airway obstruction. Your immediate care should include: a) CPR. b) oxygen by pediatric nonrebreather. c) back blows and chest thrusts. d) abdominal thrusts.

347. Your treatment for a 3-year-old male patient suffering severe respiratory distress should include: a) oxygen by the blow-by method. b) assisted ventilations with supplemental oxygen. c) blind finger sweeps to attempt removal of an obstruction. d) oxygen by pediatric nonrebreather mask.

348. The signs and symptoms of shock (hypoperfusion) in children include: a) slow respiratory rate. b) increased urine output. c) excessive tear production. d) cool, clammy skin.

Remote Areas Emergency Medical Systems www.raems.com 349. An important concept to understand about shock in infants and children is that: a) their bodies cannot compensate for blood loss for very long. b) decompensating shock develops very gradually. c) they compensate for a long time, then decompensate rapidly. d) it takes a higher percentage of blood loss to cause shock in a child.

350. A sign of decreased perfusion in your 2-year-old patient is: a) strong, rapid peripheral pulse. b) flushed skin. c) delayed capillary refill. d) over-activity.

351. In infants and children, the primary cause of cardiac arrest is: a) shock (hypoperfusion). b) respiratory failure. c) hypothermia. d) febrile seizures.

352. Which of the following is the most common cause of seizures in infants? a) epilepsy. b) head injury. c) poisoning. d) fever.

353. You are caring for a 2-year-old with fever. She experiences a seizure. Your treatment should include all EXCEPT: a) obtaining a good history of previous seizure activity. b) applying rubbing alcohol to lower the fever. c) providing oxygen by the blow-by method. d) positioning the patient on her side after the seizure ends.

354. You arrive at the scene of a bicycle crash involving a car. Your 10-year-old male patient was riding the bike. He is unconscious and has a great deal of bleeding from an open leg wound. Your first action should be to: a) control the bleeding. b) assure an open airway. c) apply a pediatric PASG. d) administer oxygen.

355. You are caring for a 6-year-old female patient who has reportedly fallen off her bed. During your exam you note small, round burns to the girl's back and several bruises of different colors on her legs and arms. Her parents state that she falls a lot. Your most likely suspicion should be that: a) the child is mentally impaired. b) the house may have several hazards for the child. c) the child has been abused.

Remote Areas Emergency Medical Systems www.raems.com d) the child may be very uncoordinated.

356. Indications that your 8-year-old male trauma patient may be abused would include: a) the child readily telling you how his injury occurred. b) the parents being willing to leave you alone with the child. c) scars, bumps, and knots at the sites of past injuries. d) the parents showing reasonable concern about the child.

357. If you suspect that your pediatric patient has been physically abused you should: a) report your suspicions to the emergency department staff. b) call for law enforcement response to the scene. c) ask the child if he has been abused. d) make your suspicions known to the parents.

358. Experiencing a strong emotional response after caring for a critically ill or injured pediatric patient is a normal reaction. If this occurs, you should consider all the following EXCEPT: a) talking to other EMTs about your feelings. b) talking with a professional counselor. c) contacting your area CISD team. d) working through the stress alone.

359. The equipment carried on an EMS unit used to obtain vital signs includes a: a) penlight. b) stethoscope. c) sphygmomanometer. d) all of the above.

360. Which is an optional item to be carried on an ambulance? a) a set of rigid cervical collars. b) a folding stair chair. c) a child safety seat. d) a hypothermia thermometer.

361. A typical fixed ambulance oxygen delivery system consists of all of the following EXCEPT: a) 8,000 liter replacement cylinder. b) two stage regulator. c) reducing valve and yoke. d) 3,000 liter reservoir.

362. Chemical cold packs should be carried on an EMS unit for: a) musculoskeletal injuries. b) abdominal injures. c) respiratory illness. d) cardiac illness.

363. Why would an EMS unit carry sterilized aluminum foil? a) to wrap body parts in. b) to keep a newborn warm. c) to make a cup over an avulsed eye.

Remote Areas Emergency Medical Systems www.raems.com d) all of the above.

364. The supplies for childbirth include all of the following EXCEPT: a) a rubber bulb syringe. b) sanitary napkins. c) large safety pins. d) sterile surgical gloves.

365. The phases of an ambulance call include all of the following EXCEPT: a) preparation. b) billing and collections. c) transporting to the hospital. d) receiving and responding.

366. When using the siren the EMT-A should: a) use it sparingly. b) never assume that all motorists will hear it. c) be prepared for erratic movements of motorists. d) all of the above.

367. One factor contributing to unsafe driving conditions that the driver can control is: a) the day of the week. b) weather conditions. c) the speed of the vehicle. d) time of day.

368. Use of escort vehicles during an emergency response is often a: a) very quick way to respond. b) more dangerous means of response. c) means of decreasing the chance of collision. d) way to make the ambulance driver's job easier.

369. Operators of emergency vehicles must drive with the safety of others in mind. This concept is known, briefly, as driving: a) within the law. b) with due regard. c) in the emergency mode. d) within intent.

370. The responsibilities of the emergency dispatcher include all of the following EXCEPT: a) dispatching and coordinating EMS resources. b) interrogating the caller and prioritizing the call. c) coordinating with other public safety agencies. d) providing medical direction to the responding unit.

371. When an emergency dispatcher questions a patient or caller which of the following is NOT routinely asked?

Remote Areas Emergency Medical Systems www.raems.com a) What is the exact location of the patient? b) What's the problem? c) Has the patient been in the hospital recently? d) How old is the patient?

372. When you are on the scene of a collision and have determined that the patient's status is stable, the call is considered: a) a true emergency. b) due regard. c) no longer a true emergency. d) a priority one response.

373. Factors that can increase an EMS unit response time include all the following EXCEPT: a) time of day. b) weather. c) number of certified drivers in the unit. d) road maintenance and construction.

374. Full immobilization of a trauma patient should take place: a) prior to moving the patient to the ambulance. b) en route to the hospital in the ambulance. c) just prior to arrival at the hospital. d) before your initial assessment is performed.

375. You should complete your prehospital care report: a) at the emergency scene. b) en route to the hospital. c) immediately upon arrival at the hospital. d) as soon as you are free from patient care duties.

376. Of the following items on an ambulance which is checked with the engine off? a) dash mounted gauges. b) battery. c) windshield wiper operation. d) vehicle's warning lights.

377. Which of the following items on the ambulance is inspected with the engine on? a) vehicle's emergency lights. b) level of the oil. c) operation of the doors and latches. d) horn.

378. When delivering the patient to the hospital you should never: a) write the patient care report in the emergency department.

Remote Areas Emergency Medical Systems www.raems.com b) just move a patient onto the hospital stretcher and leave. c) transfer the patient's personal effects. d) obtain a release from the hospital.

379. After each call, prior to putting the ambulance back in service, you should always: a) clean up blood, vomitus, and other body fluids. b) dispose of trash in the ambulance garbage can. c) red bag linens and blankets used on the call. d) fill the gas tank to full capacity. 380. In quarters, after a call, you and your partner should do all of the following EXCEPT: a) clean and sanitize patient care equipment. b) use a germicide on ambulance surfaces that were in contact with blood or body fluids. c) discard all respiratory equipment. d) wash your hands and change soiled clothing.

381. The condition of a patient is normally reported in all of the following ways EXCEPT: a) by telephone upon returning to base. b) as an oral report upon arrival at the hospital. c) in a written report on the PCR. d) by radio en route to the hospital.

382. In quarters, after a call, you and your partner should: a) place badly contaminated linens into a biohazard container. b) replace expendable items that have been used. c) carry out post-operation vehicle maintenance. d) all of the above.

383. At a hazardous material incident, a "safe zone" should be established that is in what position? a) downwind/downhill. b) upwind/uphill. c) downwind/same level. d) upwind/same level.

384. After a the hot, warm, and cold zones have been established at a hazardous material incident, and while specialized hazmat personnel are on the way, the EMT-A should: a) begin extinguishing any fires. b) begin leading patients out of the hot zone. c) assist any firefighters that have arrived on the scene. d) remain stationed in the cold zone.

385. Resources that EMT-As should use to obtain information about a toxic substance at a hazardous material incident include all of the following EXCEPT: a) CHEMTREC. b) the regional poison control center. c) the North American Emergency Response Guidebook. d) the Emergency Medical Dispatcher.

386. Upon your arrival at a scene of a hazardous material spill, you should: a) establish a safe zone.

Remote Areas Emergency Medical Systems www.raems.com b) not walk in any spilled materials. c) not assume the scene is safe. d) all of the above.

387. What should be your highest priority at a hazardous material incident? a) your safety and that of your patients and the public. b) stabilizing the incident as fast as possible. c) rapidly removing all exposed patients from the scene. d) estimating the extent of damage. 388. When observing placard information at the scene of a hazmat, the EMT-A should: a) use binoculars from a safe distance. b) get close enough to read accurately without binoculars. c) get close enough to recognize colors. d) disregard the placard since placards are frequently incorrect.

389. Upon your arrival at the scene of a hazardous material spill, you will need to: a) encourage contaminated patients to exit the area. b) call for appropriate backup assistance. c) place yourself in a high position for visibility. d) begin decontaminating patients.

390. The most widely applicable definition of a multiple-casualty incident is a(n): a) disaster. b) event that places a great demand on EMS personnel and resources. c) event that involves 10 or more patients. d) event that involves 100 or more patients.

391. When an EMS unit is the first to arrive at a multiple-casualty scene, the crew leader should do all of the following EXCEPT: a) assume EMS Command. b) assume Incident Command. c) call for backup resources. d) transport the most seriously injured.

392. The officer at a multiple casuality incident responsible for sorting and prioritizing patients is the: a) triage officer. b) treatment officer. c) transportation officer. d) staging officer.

393. The officer at a multiple casualty incident responsible for coordinating ambulances and dispatching them to the scene is the: a) extrication officer. b) transportation officer. c) staging officer. d) triage officer.

Remote Areas Emergency Medical Systems www.raems.com 394. The officer at a multiple casualty incident responsible for logging patient destinations and communicating with the area hospitals is the: a) triage officer. b) treatment officer. c) transportation officer. d) staging officer.

395. At the scene of a multiple-casualty incident, EMT-As who become emotionally incapacitated should: a) be treated as patients. b) be removed by the police. c) receive immediate counseling. d) be treated ahead of other patients.

396. At an MCI, a patient with an altered mental status and no other obvious trauma should be considered: a) priority 1. b) priority 2. c) priority 3. d) priority 4.

397. Patients with signs of shock at an MCI are considered: a) priority 1. b) priority 2. c) priority 3. d) priority 0.

398. As an EMT-A, the first step you should to take to prevent contamination of yourself, your equipment, and others at the scene of a hazardous material incident is to: a) wear hazmat-protective clothing. b) remain and keep others in the safe area. c) use a self-contained breathing apparatus. d) shower and launder contaminated clothing.

399. The leaf-shaped structure that covers the opening of the trachea is called the: a) esophagus. b) epiglottis. c) vallecula. d) d) larynx.All of the following are necessary components of an effective EMS system EXCEPT: e) public access, such as 911. f) dispatchers. g) hospital emergency departments. h) rehabilitation facilities.

400. Which of the following would NOT be considered part of the EMT-A's responsibility as a patient advocate?

Remote Areas Emergency Medical Systems www.raems.com a) getting an extra blanket for the patient who complains of feeling cold. b) reporting drugs found in the patient's home to the hospital staff. c) complying with a request not to report abuse as a cause of injuries. d) arranging for a neighbor to care for the patient's pet.

401. Finding out enough about what's wrong with your patient to be able to provide emergency care is called: a) accounting. b) assessment. c) access. d) advocacy.

402. Your first responsibility as an EMT-A is to: a) open the patient's airway. b) keep yourself safe. c) gain access to the patient. d) provide for the patient's safety.

403. Choose the BEST completion for this sentence: On-scene safety is the responsibility of: a) each crew member. b) the senior responder. c) the scene commander. d) the police.

404. The program for evaluating and improving the effectiveness of the EMS system is called: a) quality assessment. b) quality improvement. c) quality evaluation. d) quality review.

405. The EMS physician's oversight of the patient care aspects of the EMS system is referred to as: a) trauma system. b) medical direction. c) evaluation. d) standing orders.

406. Which of the following is NOT a responsibility of the EMS Medical Director? a) overseeing training of EMS personnel. b) writing EMS treatment protocols. c) being present at the emergency scene. d) consulting with EMS personnel by phone.

407. Orders given to the EMT-A by telephone or radio are called: a) off-line medical direction.

Remote Areas Emergency Medical Systems www.raems.com b) standing orders. c) on-line medical direction. d) protocols.

408. Resourcefulness, emotional stability, and ability to lead are considered necessary: a) educational traits of the EMT-A. b) personality traits of the EMT-A. c) attitudinal traits of the EMT-A. d) physical traits of the EMT-A. 409. Courses intended to renew and update information already studied in an original course are called: a) continuation classes. b) refresher courses. c) supplemental training. d) adjunct education.

410. Attending conferences, watching EMS videos, or listening to lectures for the purpose of supplementing, or adding to, knowledge received in an original course is known as: a) graduate school. b) refresher training. c) continuing education. d) recertification qualification.

411. A communications system that has the capability of automatically identifying the caller's phone number and location is called: a) emergency medical dispatch. b) auto call-back. c) enhanced 911. d) priority dispatch.

412. The role of the emergency medical dispatcher includes all of the following EXCEPT: a) obtaining appropriate information from callers. b) giving instructions to callers for emergency care. c) dispatching appropriate agencies to the emergency scene. d) providing on-line medical direction to EMS personnel.

413. Ways to safeguard your well-being include understanding and dealing with: a) the stress that normally accompanies critical incidents. b) ensuring scene safety. c) taking body substance precautions. d) all of the above.

414. Emergencies that seem to have a higher potential for causing excess stress on EMS providers include all of the following EXCEPT: a) multiple casualty incidents. b) calls involving infants and children. c) death of a coworker. d) calls involving medical emergencies.

Remote Areas Emergency Medical Systems www.raems.com 415. The inability to share your feelings with a friend or significant other who is interested in EMS is likely to lead to any of the following feelings EXCEPT: a) frustration. b) accomplishment. c) separation. d) rejection.

416. The emotional stages that patients or their families go through when confronted with death or dying include all of the following EXCEPT: a) denial. b) bargaining. c) acceptance. d) gratitude.

417. A reaction to death or dying where the patient says, "Not me" is referred to as: a) anger. b) denial. c) bargaining. d) depression.

418. A reaction to death or dying where the patient questions, "Why me?" is referred to as: a) anger. b) denial. c) bargaining. d) depression.

419. A reaction to death or dying where the patient says, "Okay, I'm not afraid" is referred to as: a) bargaining. b) acceptance. c) depression. d) denial.

420. A reaction to death or dying where the patient says, "Okay, but first let me..." is referred to as: a) bargaining. b) acceptance. c) depression. d) denial.

421. Understanding the reactions to death, the EMT-A should: a) be tolerant of angry reactions. b) not falsely reassure. c) offer as much comfort as one realistically can. d) all of the above.

Remote Areas Emergency Medical Systems www.raems.com 422. Families of EMTs may have negative reactions to the job, frequently for any of the following common causes EXCEPT: a) the EMT's unavailability to participate in certain social activities. b) the EMT's requirement to work some holidays and weekends. c) the family member's inability to understand emotional reactions to calls. d) the family member's own frequent involvement in EMS activities.

423. Common signs and symptoms of stress include all of the following EXCEPT: a) irritability with family, friends, and coworkers. b) increased interest in sexual activity. c) loss of appetite. d) inability to concentrate.

424. Your partner has worked many shifts in a row and has recently handled a number of serious trauma calls. She has recently become irritable at home and work and complains of the inability to sleep and concentrate. Which of the following is a likely cause of her signs and symptoms? a) infectious mononucleosis. b) a cumulative stress reaction. c) high blood pressure. d) all of the above.

425. Each of the following is a common sign of stress EXCEPT: a) loss of interest in work. b) indecisiveness. c) chronic low-grade fever. d) loss of interest in sexual activity.

426. Positive ways of dealing with stress include all of the following EXCEPT: a) requesting a busier work shift. b) exercising. c) reducing consumption of alcohol and caffeine. d) devoting time to relaxing.

427. Foods that should be avoided or limited to help control stress include: a) fruits and vegetables. b) alcohol and coffee. c) salads and breads. d) all of the above.

428. A process where a team of trained peer counselors and mental health professionals meet with EMT-As who have been involved in a major incident is called a CISD, which stands for: a) critique and interview on scene deportment. b) catastrophic incident service defusing. c) critical incident stress debriefing. d) counseling interview for situational depression.

Remote Areas Emergency Medical Systems www.raems.com 429. The purpose of the CISD process is to: a) investigate the events of a call. b) help diffuse the psychological trauma. c) create a chain of events for documentation. d) critique the call.

430. The CISD team should do all of the following EXCEPT: a) offer suggestions on how to deal with and overcome stress. b) explain that the discussions are confidential. c) encourage the participants to discuss their feelings about the call. d) take plenty of notes about the discussions.

431. After a stressful incident, EMS providers should: a) go home and have a big meal. b) speak openly with the press. c) vent feelings by talking with each other. d) all of the above.

432. Scene safety should be verified before entering: a) hazardous materials scenes. b) potentially violent scenes. c) rescue operation scenes. d) all of the above.

433. Organisms that cause infection, such as viruses and bacteria, are called: a) pathogens. b) toxins. c) antigens. d) antibodies.

434. Disposable gloves, eye shields, masks, and gowns are known as: a) airborne pathogen precautions. b) bloodborne disease precautions. c) disease prevention equipment. d) personal protective equipment.

435. Which of the following would provide the greatest personal safety for the EMT working at night or in traffic? a) EMS insignia. b) reflective clothing. c) flares. d) emergency spotlights.

436. At the scene of a crime, violence, or potential violence, all of the following may be acceptable

Remote Areas Emergency Medical Systems www.raems.com clothing or equipment for personal protection EXCEPT a: a) bullet-proof vest. b) concealed hand-gun. c) pair of slip-proof shoes. d) light-weight kit.

437. The EMT-A's ethical responsibilities and legal duties are called: a) duty to act. b) scope of practice. c) advanced directives. d) medical direction.

438. DNR is an abbreviation for a type of: a) organ donation procedure. b) implied consent. c) genetic material. d) advance directive.

439. Expressed consent is: a) assumed to exist when the patient is unconscious. b) defined by local protocol for certain types of emergencies. c) assumed to exist when care is urgently needed. d) obtained from a conscious, competent, adult patient.

440. When informing an adult of a treatment that is needed and the associated risks, the EMT-A is asking for: a) expressed consent. b) mutual consent. c) implied consent. d) emancipated consent.

441. Consent based on the theory that the unconscious patient would approve of life saving treatments is called: a) expressed consent. b) mutual consent. c) implied consent. d) assumed consent.

442. Summer camps and schools often require: a) the parents to be present when treatment is rendered. b) written consent forms from parents to allow treatment. c) children to give oral consent to any treatment. d) all of the above.

443. A properly handled patient's refusal of medical aid or transport should include all of the

Remote Areas Emergency Medical Systems www.raems.com following EXCEPT: a) informing the patient of the risks and consequences of a refusal. b) complete and accurate documentation on the patient care report. c) a credible witness to the patient's signature. d) a family member's signature as well as the patient's signature.

444. Unlawful touching of another person without consent is: a) waiver of consent. b) negligence. c) implied consent. d) assault or battery.

445. In order to prove negligence, the attorney must show all of the following EXCEPT: a) a duty to act was breached. b) an injury was inflicted. c) the injury was life-threatening. d) the action(s) caused injury.

446. Stopping the treatment of a patient without assuring the continuation of treatment at the same level or higher is referred to as: a) negligence. b) assault. c) abandonment. d) breach of duty.

447. The only time(s) when you can release confidential patient information is/are to: a) inform other health care professionals who need information in order to continue care. b) report incidents required by state law such as rape or abuse. c) comply with a legal subpoena. d) all of the above.

448. At a crime scene you should: a) proceed with care, disturbing the scene only as needed. b) delay care until police have photographed the scene. c) use the phone at the scene rather than your radio to contact police. d) protect the scene by closing all open doors and windows.

449. Regarding DNR orders, the EMT-A should go ahead and provide resuscitation when: a) a patient with no legal DNR order refuses care before losing consciousness. b) a family member tells you that the patient did not want resuscitation. c) the family shows you a handwritten DNR statement they attest was written by the patient. d) all of the above.

Remote Areas Emergency Medical Systems www.raems.com 450. Advantages of advance directives for medical care include: a) having the doctor's recommendations on record. b) having the family's consent on record. c) having the patient's wishes on record. d) all of the above.

451. Varying degrees of hospital advance directives may commonly include any of the following EXCEPT: a) an order to provide a life-ending lethal injection. b) allowing for CPR only if the arrest is witnessed. c) allowing only comfort care. d) not allowing the use of long-term life support measures.

452. The normal anatomical position is best described as: a) lying in the supine position, with the palms facing downward. b) standing, facing forward, with the palms facing forward. c) lying in the prone position, with the palms facing upward. d) standing, facing forward, with the palms facing backward.

453. If the patient is standing with palms facing forward, the thumb is on which side of the hand? a) superior. b) inferior. c) medial. d) lateral.

454. Which of the following is correct? a) The hand is distal to the elbow. b) The elbow is proximal to the shoulder. c) The spine can be felt on the anterior body. d) The breastbone lies posterior to the heart.

455. Slicing through the imaginary body down the center, passing between the eyes and extending down past the umbilicus, creates a plane called the: a) mid-axillary line. b) anterior axillary line. c) midline. d) mid-clavicular line.

456. All of the following are body systems EXCEPT: a) respiratory. b) cardiovascular. c) abdominal. d) musculoskeletal.

457. The musculoskeletal system: a) gives the body shape.

Remote Areas Emergency Medical Systems www.raems.com b) protects vital internal organs. c) provides for body movement. d) all of the above.

458. The upper jaw is also called the: a) mandible. b) zygomatic. c) maxilla. d) mastoid. 459. The segment of the spinal column that forms the posterior pelvis is the: a) thoracic. b) cervical. c) lumbar. d) sacral.

460. The bones of the lower extremities include: a) acetabulum, calcaneous, and carpals. b) femur, tibia, and fibula. c) orbit, lumbar, and shin. d) radius, ulna, and humerus.

461. The upper extremities include the: a) scapula and radius. b) humerus and calcaneous. c) tarsals and tibia. d) all of the above.

462. The type of muscle tissue that controls the flow of materials through the gastrointestinal system is: a) voluntary. b) involuntary. c) cardiac. d) skeletal.

463. Involuntary or smooth muscles are found in the: a) arms and legs. b) blood vessels. c) forehead. d) heart.

464. The type of muscle controlling movement as you walk is called: a) voluntary. b) involuntary. c) cardiac. d) smooth.

465. Which of the following represents the correct sequence of passage of oxygen from room air to the lungs? a) nose, bronchi, larynx, trachea, lung.

Remote Areas Emergency Medical Systems www.raems.com b) larynx, esophagus, trachea, bronchi, alveoli. c) mouth, pharynx, trachea, bronchi, alveoli. d) epiglottis, trachea, cricoid, bronchi, alveoli.

466. A leaf-shaped valve that prevents food from entering the trachea is the: a) pharynx. b) epiglottis. c) larynx. d) bronchi. 467. The structure containing the voice box is the: a) larynx. b) pharynx. c) trachea. d) sternum.

468. As the diaphragm and intercostal muscles relax, the chest cavity: a) increases in size, causing inhalation. b) increases in size, causing exhalation. c) decreases in size, causing exhalation. d) decreases in size, causing inhalation.

469. Pediatric airways differ from adult airways in that: a) the child's tongue takes up proportionately less space. b) the trachea is more rigid. c) all structures are smaller and more easily obstructed. d) all of the above.

470. The left atrium: a) receives blood from the veins of the body. b) receives blood from the pulmonary veins. c) pumps blood to the lungs. d) pumps blood to the body.

471. The major artery in the thigh is called the: a) carotid. b) femoral. c) radial. d) brachial.

472. The vessel that carries oxygen-poor blood to the right atrium is the: a) posterior tibia. b) internal jugular. c) vena cava. d) aorta.

473. The fluid that carries blood cells and nutrients is: a) platelets. b) hemoglobin.

Remote Areas Emergency Medical Systems www.raems.com c) lymph. d) plasma.

474. The blood component that is essential for the formation of blood clots is called: a) plasma. b) platelets. c) white blood cells. d) red blood cells.

475. The pressure on the walls of the artery when the left ventricle contracts is the: a) systolic pressure. b) arterial pressure. c) diastolic pressure. d) residual pressure.

476. The nervous system is subdivided into: a) central and peripheral systems. b) bones and muscles. c) brain and skin. d) spine and vertebral column.

477. All of the following are part of the endocrine system EXCEPT: a) thyroid. b) thymus. c) malleolus. d) pancreas.

478. When lifting a patient, you should assure your own safety by: a) always wearing a back brace. b) keeping the weight as far away from your body as possible. c) using your legs, not back, to lift. d) never lifting a patient over your own weight.

479. When lifting, always try to: a) communicate clearly and frequently with your partner. b) lift without twisting. c) know your physical ability and limitations. d) all of the above.

480. When you lift a cot or stretcher, always try to: a) use an even number of people so that balance is maintained. b) keep both of your feet together and flat on the ground. c) use a third person positioned on the heavier side. d) all of the above.

481. When placing all fingers and the palm in contact with the object being lifted, you are using a: a) power grip.

Remote Areas Emergency Medical Systems www.raems.com b) power lift. c) lock grip. d) all of the above.

482. When lifting a patient or equipment, all the following statements are true EXCEPT: a) know the weight of what you are lifting. b) position your feet shoulder-width apart. c) keep the weight as far from your body as possible. d) use your legs, not your back, to lift. 483. When carrying equipment with one hand, you should: a) keep your back straight and locked. b) lean to the opposite side for balance. c) lean forward for balance. d) lean slightly back for balance.

484. Whenever possible, if carrying a patient down stairs, you should: a) flex at the waist. b) position the patient with head and torso on the lower end. c) use one hand on the railing. d) use a stair chair instead of a stretcher.

485. When reaching for a patient or equipment, you should avoid reaching more than: a) 15 to 20 inches in front of your body. b) 10 to 12 inches in front of your body. c) one arm's length in front of your body. d) 24 to 30 inches in front of your body.

486. When reaching over to perform a log roll: a) keep your back straight. b) lean from your hips. c) use your shoulder muscles to help with the roll. d) all of the above.

487. When you must push an object: a) push from the area between the waist and shoulder. b) push from an overhead position. c) keep your elbows straight. d) push at a level below the waist.

488. If the patient is on the ground and you have decided that an emergency move is appropriate, the patient can be moved by: a) using one rescuer on each extremity. b) using a spine board and strapping him/her down. c) pulling on his/her clothing at the neck and shoulder area. d) all of the above.

489. If a patient has an altered mental status you should consider a(n): a) emergency move.

Remote Areas Emergency Medical Systems www.raems.com b) urgent move. c) non-urgent move. d) immediate move.

490. An urgent move for the patient found in the sitting position in an automobile is called: a) rapid takedown. b) rapid extrication. c) emergency rescue. d) blanket roll technique. 491. A method of lifting and carrying a patient in which one EMT-A slips his/her hands under the patient's armpits and grasps the wrists, while another EMT-A grasps the patient's knees is called the: a) slide transfer method. b) direct carry method. c) extremity lift. d) direct ground lift.

492. A method for transferring a bed-level patient to a wheeled ambulance stretcher is the: a) extremity transfer. b) side carry method. c) drawsheet method. d) log roll technique.

493. The direct ground lift is an example of a(n) ______move for a patient with no suspected spinal injury. a) emergency b) urgent c) immediate d) non-urgent

494. A method of transferring a patient from a bed to a stretcher in which two or more EMT-As curl the patient to their chests is called the: a) slide transfer method. b) direct carry method. c) drawsheet method. d) extremity transfer.

495. Which of the following specific moves is correctly paired with its type? a) drawsheet method: non-urgent move. b) blanket drag: emergency move. c) rapid extrication from a vehicle: urgent move. d) all of the above.

496. A position of comfort for a patient with difficulty breathing is likely to be: a) lying flat on his stomach. b) lying flat on his back. c) sitting up. d) lying flat on his back with his legs elevated.

Remote Areas Emergency Medical Systems www.raems.com 497. When treating a patient with signs of shock, the EMT-A may elevate the foot end of the backboard 8 to 12 inches. This is called the: a) Fowler's position. b) Supine position. c) Trendelenburg position. d) Prone position.

498. Examples of situations for an emergency move include: a) fire or danger of fire. b) explosives or other hazardous chemicals. c) inability to protect the patient from other hazards at the scene. d) all of the above.

499. The device called a wheeled stretcher is also referred to as a: a) portable stretcher. b) cot. c) orthopedic stretcher. d) all of the above.

500. The best patient carrying device to use to avoid trauma to an injured spine would be a(n): a) long spine board. b) wheeled ambulance stretcher. c) basket stretcher. d) orthopedic stretcher.

501. Lifting and moving patients should be done in a manner that meets which of the following goals? a) speed. b) safety for the patient. c) safety for the EMT-A. d) all of the above.

502. Which of the following structures is NOT part of the respiratory system? a) mouth. b) trachea. c) esophagus. d) larynx.

503. The structures that branch off from the trachea, leading to the lungs, are called right and left mainstem: a) alveoli. b) bronchi. c) cricoids. d) arterioles.

504. Which of the following is a sign of adequate breathing? a) bilateral chest expansion.

Remote Areas Emergency Medical Systems www.raems.com b) abdominal breathing. c) rapid rate. d) all of the above.

505. Which of the following signs would indicate your patient has inadequate breathing? a) breathing rate of 20 per minute. b) equal expansion of both sides of the chest. c) cyanosis of the lips. d) all of the above. 506. When using the head-tilt, chin-lift maneuver to open an unconscious patient's airway, your hand(s) should be placed: a) on the forehead and under the neck. b) on the nose, with the fingertips pinching it closed, and under the neck. c) on the forehead and on the nose, with the fingertips pinching it closed. d) on the forehead with the fingertips of the other hand under the lower jaw.

507. Your patient is found lying on the ground after falling off a roof. Due to the mechanism of injury you would open the patient's airway by what method? a) head-tilt, chin-lift. b) jaw-thrust. c) head-tilt, only. d) head-tilt, neck-lift.

508. Which of the following steps is NOT correct when using the jaw-thrust maneuver to open your patient's airway? a) Rest your elbows on the same surface as the patient. b) Stabilize the patient's head with your forearms. c) Tilt the head by applying gentle pressure to the forehead. d) Use your index fingers to push the angles of the lower jaw forward.

509. If your patient's airway contains blood, vomitus, or secretions: a) use suction to immediately clear the airway. b) your patient will still be able to breathe adequately. c) use artificial ventilations to clear the airway. d) perform a finger sweep to remove the blockage.

510. You should not suction an adult patient's airway for longer than: a) 10 seconds. b) 5 seconds. c) 15 seconds. d) 12 seconds.

511. Proper technique in suctioning your patient's airway includes: a) suctioning all the way down the airway. b) hyperventilating the patient before and after suctioning. c) applying suction as the catheter is being moved into place. d) applying suction for 20-30 seconds continuously.

Remote Areas Emergency Medical Systems www.raems.com 512. Which of the following would be considered an advantage in using a pocket mask to ventilate a non-breathing patient? a) There is no direct contact with the patient's mouth. b) Oxygen may be connected to the mask. c) A one-way valve prevents exhaled air from contacting you. d) all of the above.

513. You are the rescuer who is applying the mask to a trauma patient, using a bag-valve mask and the jaw-thrust maneuver. In this situation: a) head or neck tilt is unavoidable. b) you should kneel at the patient's side. c) you should use your ring and little fingers to bring the jaw upward. d) use of airway adjuncts is not necessary.

514. Adding a reservoir to a bag-valve-mask system increases the oxygen delivered to your patient from 50% to nearly: a) 70%. b) 90%. c) 80%. d) 100%.

515. When two rescuers are ventilating a patient with a bag-valve mask: a) one squeezes the bag while the other maintains a mask seal. b) one squeezes the bag while the other listens for breath sounds with each ventilation. c) one squeezes the bag while the other applies cricoid pressure. d) both squeeze the bag to maximize the oxygen delivery.

516. The most reliable sign that your patient is being adequately ventilated by a bag-valve mask is: a) the patient begins breathing on his own. b) the patient's chest rises. c) the patient's pupils react. d) the patient regains consciousness.

517. Signs that your patient is not being adequately ventilated by a bag-valve mask include: a) patient remains unconscious. b) heart rate remains abnormal. c) lung expansion remains equal. d) pupils remain unequal.

518. When administering mouth-to-stoma ventilations to a nonbreathing patient, the proper position of the head is: a) the same position as when performing mouth-to-mouth, using the head-tilt, chin-lift method. b) in a neutral position, as it is not necessary to position the airway. c) the same position as when performing mouth-to-mouth using only the jaw-thrust method.

Remote Areas Emergency Medical Systems www.raems.com d) the extended position, using the neck-lift method.

519. To select the proper size oropharyngeal airway, you should measure from the patient's: a) corner of the mouth to tip of the earlobe. b) center of the mouth to tip of the earlobe. c) corner of the mouth to tip of the nose. d) tip of the chin to angle of the jaw.

520. As you insert an oropharyngeal airway into your patient, she/he begins to gag. You should: a) attempt to reinsert the airway. b) remove the airway. c) restrain your patient and hold the airway in. d) contact medical control for direction.

521. A full oxygen cylinder has a pressure equal to: a) 2,000 to 2,200 psi. b) 1,000 to 1,200 psi. c) 1,500 to 1,700 psi. d) 3,000 to 3,200 psi.

522. The yoke of an oxygen pressure regulator for a size E cylinder or smaller can only fit an oxygen tank. It cannot fit on a tank containing another type of gas. The system used to assure this is called: a) hydrostatic testing. b) the pin index safety system. c) threading. d) U.S.P.

523. You are treating a patient with inadequate breathing. To administer the highest concentration of oxygen, you would use: a) a nasal cannula at 6 liters/minute flow. b) a nasal cannula at 15 liters/minute flow. c) a nonrebreather mask at 6 liters/minute flow. d) a nonrebreather mask at 15 liters/minute flow.

524. A nonrebreather mask at the proper liter flow of oxygen can deliver a maximum oxygen concentration of: a) 20 to 30%. b) 40 to 50%. c) 60 to 70%. d) 80 to 90%.

525. You should use a nasal cannula to deliver oxygen to your patient only if: a) your patient requires a high concentration of oxygen. b) your patient cannot tolerate a mask. c) your patient is suffering from chest pain. d) your patient is unconscious.

Remote Areas Emergency Medical Systems www.raems.com 526. Airway management and ventilation take precedence over other life-support skills because: a) the body's cells must have oxygen to survive. b) these skills are the quickest to perform. c) oxygen is the most readily available drug. d) all of the above.

527. A patient suffering COPD may have developed a "hypoxic drive" in which low oxygen levels stimulate the body to breathe. In the prehospital setting, for a COPD patient who is suffering chest pain or breathing difficulty: a) oxygen should be administered as to any other patient, regardless of the possible presence of a hypoxic drive. b) oxygen should be withheld because administering it could wipe out the patient's drive to breathe. c) oxygen should be administered, but at a lower-than-normal flow rate. d) oxygen should be administered, but for no longer than 30 seconds at a time.

528. You arrive at the scene of a building fire. A very excited bystander is screaming at you that a young woman has been hurt. You see her lying on the ground under a large piece of wood. The wood is still partially on fire. What should you do first? a) Immediately remove her from under the wood. b) Assess the patient for life-threatening injuries. c) Size up the scene before acting. d) Try to put out the fire.

529. When should you assess the scene of an accident or injury? a) only at the beginning of the call. b) at the beginning and throughout the entire call. c) only when needed. d) after the patient has been treated for life threatening injuries.

530. Downed electrical wires, an unknown liquid leaking from an overturned tank car, a vehicle on fire;all are examples of: a) crime scenes. b) scene hazards. c) hazardous materials. d) fire hazards.

531. At the scene of a collision, when there are no apparent hazards, you should extend the safety zone to at least: a) 50 feet in all directions. b) 100 feet in all directions. c) 100 feet in both directions along the roadway. d) 100 feet around the ambulance.

Remote Areas Emergency Medical Systems www.raems.com 532. You arrive at the scene of a bar fight. A 25-year-old man has been stabbed and is bleeding severely. The assailant is still on the scene and is holding a knife. What should you do first? a) Try to keep the assailant calm while you treat the patient. b) Rake the knife away from the assailant. c) Retreat to a place of safety and call for help. d) Stay where you are but tell the assailant to go away.

533. Knowing the mechanism of injury may help you predict injury patterns. If you have a patient who has a head injury from a blow to the head, what other injuries might you suspect? a) chest injuries. b) spinal injuries. c) leg injuries. d) arm injuries.

534. You arrive on the scene of a motor vehicle collision. The mechanism of injury suggests a rear end collision. Which of the following injury patterns should you most likely suspect? a) neck injury. b) chest injury. c) leg injury. d) arm injury.

535. Any time the patient has fallen more than ______, the fall should be considered severe. a) twice the patient's height. b) 5 feet. c) 3 times the patient's height. d) 10 feet.

536. During your scene size-up of a vehicle crash, it is important to determine the number of patients because: a) if there are more patients than you and your crew can handle, additional resources must be called. b) you will need to write a prehospital care report for each patient. c) you must notify the police of the number of patients. d) all of the above

537. All of the following resources might be called to an emergency scene to provide additional assistance EXCEPT: a) additional ambulances. b) the fire department. c) the power company. d) legal advisors.

538. It is important to evaluate scene safety prior to entering the scene because you need to determine: a) what personal protective equipment you will need. b) the likely mechanism of injury.

Remote Areas Emergency Medical Systems www.raems.com c) what additional resources may be needed. d) all of the above.

539. Which part of the initial assessment should be done first? a) Form a general impression. b) Open the airway. c) Assess breathing. d) Assess mental status.

540. When assessing the mental status of a patient, the letters AVPU are used. If you are treating a patient who does not respond until you shout at him, which letter would best indicate the level of responsiveness? a) P b) U c) A d) V

541. You are treating a 27-year-old man who does not respond to you until you briskly rub his sternum. How would you summarize his level of responsiveness? a) Patient responds to verbal stimuli. b) Patient responds to painful stimuli. c) Patient responds to no stimuli. d) Patient does not respond to painful stimuli.

542. You are treating an 8-month-old infant who is not alert. What would be an appropriate way to check the level of responsiveness? a) Tap the infant on top of the head. b) Shake the infant by the shoulders. c) Pick the infant up by its feet. d) Flick the bottom of the infant's feet.

543. During the initial assessment of your patient, which of the following signs would indicate the patient's airway is open? a) Your patient is talking. b) Your patient is crying. c) The patient's respirations are normal. d) all of the above.

544. A reliable way to assess breathing in an unconscious patient is to: a) check skin color. b) check the pupils. c) watch for chest rise. d) check capillary refill.

545. Your patient is a 32-year-old female complaining of lower leg pain. She is alert and oriented and her respirations are 16. There are no obvious injuries you can see at first glance. What should you do next? a) Request additional resources.

Remote Areas Emergency Medical Systems www.raems.com b) Start positive pressure ventilations. c) Splint her lower leg. d) Continue the initial assessment.

546. An adult patient who is breathing at a rate of 6 breaths per minute needs to be cared for by: a) providing positive pressure ventilations with 100% oxygen. b) providing high concentration oxygen by a nonrebreather mask. c) beginning chest compressions. d) monitoring respirations only. 547. You are treating a 74-year-old male patient who collapsed at home. He is unresponsive. His respirations are 6 per minute. What should you do first? a) Start high concentration oxygen and assess his circulation. b) Give him two ventilations and assess his mental status. c) Move him to the ambulance and start high concentration oxygen. d) Provide positive pressure ventilations with 100% oxygen.

548. You arrive on the scene of a one-car accident. Your patient is a 47-year-old man who was the driver. He has no immediately observable injuries. He is answering all of your questions appropriately. His respirations are 26 and pulse is 100. Your next action should be to: a) start high concentration oxygen by nonrebreather mask. b) assess his blood pressure and skin color and condition. c) do a complete physical exam to discover any injuries. d) take vital signs, package, and transport immediately.

549. When assessing the respirations of a pediatric patient, it is important to remember that the respiratory rate of an infant or child: a) is basically the same as that of the adult. b) is usually slower than that of an adult. c) is usually faster than that of an adult. d) does not tell you much about the patient's condition.

550. You are treating a 27-year-old male who is unconscious. He is not breathing and you have determined that the airway is blocked. What should you do first? a) Begin positive pressure ventilations. b) Administer high concentration oxygen. c) Perform the Heimlich maneuver. d) Insert a nasal airway.

551. You are treating a 28-year-old female who fell 20 feet while roofing a house. After determining that she is unresponsive, you would immediately: a) open her airway using a head-tilt chin-lift maneuver. b) open her airway using a jaw-thrust maneuver. c) start high concentration oxygen using a nonrebreather mask. d) log-roll her onto a long spine board.

552. When you open an infant's airway you should: a) tilt the head back. b) tilt the head forward.

Remote Areas Emergency Medical Systems www.raems.com c) not move the head at all. d) move the head to a neutral position.

553. When performing the initial assessment of a responsive adult patient, you should assess the ______pulse. a) carotid. b) femoral. c) radial. d) brachial.

554. When performing your initial assessment on an infant, you should take the patient's ______pulse. a) carotid. b) radial. c) femoral. d) brachial.

555. During your initial assessment you discover a severe leg wound that is bleeding heavily. After assuring the adequacy of the airway and breathing, you should a) continue your assessment to find any other injuries. b) prepare the patient for immediate transport. c) start the patient on high concentration oxygen. d) stop and control the bleeding right away.

556. During your initial assessment, you find your patient's skin to be warm, pink, and dry. This indicates: a) possible shock. b) possible high fever. c) normal circulation. d) lack of oxygen to cells.

557. If a patient is in shock, you would expect the skin to be: a) cool and clammy. b) warm and dry. c) hot and dry. d) warm and moist.

558. A patient is entrapped in a vehicle at the scene of a car crash. Through the windshield, you observe that the patient's skin is growing pale and sweaty. You immediately suspect the patient is suffering from: a) a heart attack. b) exposure to cold. c) shock. d) stroke.

559. When evaluating the circulation in an infant, what sign can you assess that would not be considered reliable in an adult? a) capillary refill. b) pulse.

Remote Areas Emergency Medical Systems www.raems.com c) bleeding. d) skin color.

560. Which of the following capillary refill times is considered normal? a) 3 seconds. b) 2 seconds. c) 6 seconds. d) 4 seconds.

561. What external factor might prolong capillary refill time? a) warm weather. b) cold weather. c) high humidity. d) all of the above.

562. Which of the following patients would NOT be considered a high priority patient? a) 32-year-old woman who is unresponsive. b) 72-year-old man complaining of general leg ache. c) 7-year-old boy with severe abdominal pain for two hours. d) 55-year-old woman with difficulty breathing.

563. The purpose of the initial assessment is to identify: a) and immediately treat life-threatening conditions. b) life-threatening conditions for treatment later. c) all the injuries in an organized fashion. d) and treat all the injuries found.

564. Which of the following is NOT considered a vital sign? a) respirations. b) digestion. c) pulse. d) skin color.

565. A normal respiratory rate for an adult at rest is: a) between 6 and 8 per minute. b) between 8 and 10 per minute. c) between 20 and 24 per minute. d) between 12 and 20 per minute.

566. You are assessing a patient's respirations. You find that the respirations are 18, normal, and regular. The word "normal" is used to reflect: a) the quality of the respirations. b) the rate of the respirations. c) the rhythm of the respirations. d) the time of the respirations.

567. The use of accessory muscles and nasal flaring are all signs of: a) normal breathing. b) labored breathing.

Remote Areas Emergency Medical Systems www.raems.com c) shallow breathing. d) noisy breathing.

568. There are several different pulses that you can assess. In an adult patient, which pulse should you try to take first? a) brachial. b) femoral. c) carotid. d) radial. 569. Where is the radial pulse located? a) in the elbow. b) at the wrist. c) in the neck. d) in the groin.

570. Where is the carotid pulse located? a) behind the knee. b) at the wrist. c) in the neck. d) in the groin.

571. In order to measure a pulse, you should use: a) your fingers with moderate pressure. b) your fingers with firm pressure. c) your thumb with firm pressure. d) your fingers with very light pressure.

572. In the adult patient, a pulse rate above 100 is called: a) bradycardia. b) irregular. c) tachycardia. d) normal.

573. In the adult patient, a pulse rate below 60 is called: a) bradycardia. b) irregular. c) tachycardia. d) normal.

574. When taking the pulse, what two factors are you assessing? a) rate and quality. b) rate and location. c) quality and force. d) regularity and rhythm.

575. Lack of oxygen in blood cells and tissues resulting from inadequate breathing or heart function will cause the skin to be: a) green.

Remote Areas Emergency Medical Systems www.raems.com b) cyanotic. c) red. d) jaundiced.

576. The term "cyanotic" is used to describe skin color that is: a) yellow. b) red. c) blue-gray. d) pink. 577. Normal skin is usually: a) warm and dry. b) warm and moist. c) cool and moist. d) cool and dry.

578. Hot, dry skin is often the result of: a) shock. b) the body losing heat. c) fever. d) anxiety.

579. Cool, clammy skin is usually a sign of: a) fever. b) heat exposure. c) fear. d) shock.

580. To evaluate the capillary refill in a pediatric patient, press on the child's nail. The normal pink color to the nail bed should return in no more than: a) 1 second. b) 2 seconds. c) 3 seconds. d) 4 seconds.

581. During vital signs assessment, pupils are checked by: a) having the patient look up and down. b) having the patient open and close the eyes. c) shining a light into the patient's pupils. d) all of the above.

582. Normally, pupils are midpoint in size. When you shine your penlight into a patient's eye, the pupil will normally: a) dilate. b) become larger. c) constrict. d) remain about the same size.

583. Light entering the pupil of the eye can cause it to change size. When the environment gets

Remote Areas Emergency Medical Systems www.raems.com darker, the pupil will: a) constrict to allow more light in. b) constrict to allow less light in. c) dilate to allow more light in. d) dilate to allow less light in.

584. Nonreactive pupils are pupils that: a) constrict in response to a bright light. b) do not constrict in response to a bright light. c) dilate in response to a bright light. d) do not dilate in response to a bright light.

585. When taking a blood pressure on a patient, the bladder in the cuff should be centered over the: a) radial artery. b) carotid artery. c) brachial artery. d) femoral artery.

586. The pressure created when the heart contracts and forces blood into the arteries is called: a) regular blood pressure. b) diastolic blood pressure. c) systolic blood pressure. d) pulse pressure.

587. In the blood pressure reading 120 over 70, "120" represents the: a) systolic pressure. b) resting pressure. c) diastolic pressure. d) pulse pressure.

588. Low blood pressure is generally considered to exist when: a) the diastolic falls below 120 mmHg. b) the diastolic falls below 90 mmHg. c) the systolic falls below 120 mmHg. d) the systolic falls below 90 mmHg.

589. High blood pressure (hypertension) exists when the: a) systolic is above 150 or the diastolic is above 70. b) systolic is above 150 or the diastolic is above 90. c) systolic is above 130 or the diastolic is above 100. d) systolic is above 90 and the diastolic is above 150.

590. In the blood pressure reading 120 over 70, "70" represents the: a) systolic pressure. b) active pressure.

Remote Areas Emergency Medical Systems www.raems.com c) diastolic pressure. d) pulse pressure.

591. When the lower left chamber of the heart is relaxed and filling, the pressure remaining in the arteries is called: a) regular blood pressure. b) diastolic blood pressure. c) systolic blood pressure. d) resting blood pressure. 592. The one piece of equipment required to auscultate your patient's blood pressure that is not necessary when you palpate the pressure is: a) a stethoscope. b) a sphygmomanometer. c) a blood pressure cuff. d) a watch with a second hand.

593. Two kinds of information that you gather about your patient are signs and symptoms. Which of the following is NOT considered a sign? a) dizziness. b) vomiting. c) pale skin. d) bruise.

594. Signs and symptoms are two different kinds of information that you can gather about your patient. Which of the following is NOT considered a symptom? a) chest pain. b) headache. c) nausea. d) flushed skin.

595. Recording and reporting baseline vital signs of your patient is very important because, when combined with the ongoing assessments, you can: a) more accurately diagnose your patient's illness. b) see trends or changes in your patient's condition. c) more completely fill out your run report. d) determine what the patient's normal vitals usually are.

597. A "Medic Alert" or similar medical information tag can tell you vital information about your patient's: a) allergies. b) medications. c) current medical conditions. d) all of the above.

598. The mechanism of injury is evaluated during the: a) scene size-up. b) initial assessment c) focused history and physical exam. d) all of the above

599. When treating the patient with large, wet abscesses, the Responder should: a) Report the wound to the Laboratory Centres for Disease Control. b) Use a rigid splint. c) Cover the injury with an occlusive dressing and administer epinephrine.

Remote Areas Emergency Medical Systems www.raems.com d) Use proper protective equipment.

600. Treatment for your patient who was bitten by a venomous snake includes all of the following EXCEPT: a) keeping the patient calm. b) removing any rings or bracelets. c) applying light constricting bands above and below the wound. d) applying ice packs to the wound site.

…ANSWERS ON NEXT PAGE…

Remote Areas Emergency Medical Systems www.raems.com Remote Areas Emergency Medical Systems www.raems.com 1. a 31. d 61. b

2. d 32. d 62. b

3. b 33. b 63. b

4. b 34. a 64. b

5. b 35. a 65. d

6. d 36. a 66. c

7. b 37. d 67. a

8. b 38. b 68. d

9. c 39. b 69. a

10. c 40. d 70. a

11. a 41. a 71. c

12. a 42. b 72. c

13. c 43. b 73. d

14. b 44. a 74. b

15. b 45. a 75. d

16. a 46. a 76. b

17. c 47. c 77. d

18. d 48. b 78. c

19. b 49. a 79. a

20. b 50. b 80. a

21. a 51. d 81. b

22. d 52. b 82. b

23. b 53. b 83. c

24. d 54. b 84. c

25. c 55. c 85. b

26. a 56. b 86. d

27. d 57. c 87. d

28. c 58. c 88. c

29. a 59. a 89. c

30. d 60. a 90. a

Remote Areas Emergency Medical Systems www.raems.com 91. c 121. c 151. b

92. a 122. a 152. b

93. c 123. a 153. c

94. b 124. b 154. d

95. d 125. a 155. b

96. b 126. b 156. b

97. b 127. a 157. a

98. b 128. d 158. a

99. d 129. c 159. a

100. b 130. a 160. a

101. c 131. a 161. d

102. d 132. d 162. c

103. d 133. d 163. a

104. d 134. a 164. b

105. a 135. b 165. d

106. a 136. a 166. c

107. b 137. c 167. a

108. b 138. a 168. a

109. d 139. c 169. d

110. b 140. b 170. d

111. c 141. c 171. a

112. c 142. a 172. b

113. c 143. c 173. a

114. a 144. b 174. c

115. b 145. a 175. b

116. b 146. d 176. d

117. c 147. d 177. b

118. d 148. b 178. a

119. c 149. a 179. d

120. a 150. b 180. d

Remote Areas Emergency Medical Systems www.raems.com 181. d 211. c 241. a

182. d 212. c 242. b

183. b 213. d 243. a

184. c 214. a 244. d

185. a 215. d 245. b

186. c 216. c 246. a

187. b 217. b 247. d

188. b 218. b 248. b

189. d 219. d 249. a

190. c 220. d 250. a

191. a 221. a 251. c

192. c 222. b 252. a

193. c 223. b 253. b

194. b 224. b 254. c

195. b 225. b 255. d

196. a 226. c 256. b

197. d 227. c 257. c

198. b 228. a 258. d

199. b 229. d 259. b

200. b 230. b 260. c

201. c 231. d 261. b

202. c 232. b 262. c

203. d 233. c 263. c

204. a 234. c 264. a

205. b 235. a 265. b

206. a 236. b 266. d

207. b 237. a 267. c

208. b 238. c 268. d

209. d 239. b 269. b

210. d 240. c 270. d

Remote Areas Emergency Medical Systems www.raems.com 271. d 301. c 331. a

272. c 302. a 332. c

273. a 303. c 333. c

274. b 304. b 334. a

275. c 305. c 335. b

276. c 306. a 336. b

277. a 307. c 337. d

278. b 308. d 338. c

279. b 309. b 339. b

280. c 310. c 340. c

281. b 311. d 341. a

282. d 312. c 342. d

283. b 313. c 343. d

284. a 314. d 344. a

285. c 315. a 345. c

286. d 316. b 346. d

287. c 317. c 347. b

288. b 318. c 348. d

289. c 319. b 349. c

290. d 320. d 350. c

291. a 321. a 351. b

292. a 322. b 352. d

293. c 323. c 353. b

294. b 324. d 354. b

295. a 325. d 355. c

296. c 326. c 356. c

297. b 327. b 357. a

298. b 328. c 358. d

299. d 329. d 359. d

300. b 330. a 360. c

Remote Areas Emergency Medical Systems www.raems.com 361. a 391. d 421. a

362. a 392. a 422. d

363. b 393. c 423. d

364. c 394. c 424. b

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366. d 396. a 426. c

367. c 397. a 427. a

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371. c 401. c 431. d

372. c 402. b 432. c

373. c 403. b 433. d

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378. b 408. c 438. b

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380. c 410. b 440. d

381. a 411. c 441. a

382. d 412. c 442. c

383. d 413. d 443. b

384. d 414. d 444. d

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386. d 416. b 446. c

387. a 417. d 447. c

388. a 418. b 448. d

389. b 419. a 449. a

390. b 420. b 450. d

Remote Areas Emergency Medical Systems www.raems.com 451. c 481. a 511. c

452. a 482. a 512. b

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478. c 508. b 538. d

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480. d 510. a 540. a

Remote Areas Emergency Medical Systems www.raems.com 541. d 571. c

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550. c 580. d

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559. c 589. d

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565. b 595. d

566. d 596. b

567. a 597. d

568. b 598. a

569. d 599. d

570. b 600. d

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