EMT PRACTICE

–EMT PRACTICE EXAM 9–

19. The first incident management system was 24. The areas for greatest concern of internal blood
known as the loss are the chest, abdomen, and
a. national incident management system. a. thighs.
b. incident command system. b. pelvis.
c. incident management system. c. brain.
d. none of the above. d. lower extremities.

20. Which of the following is considered a member 25. The condition characterized by the separation
of the incident management system’s command of the inner layers of the aorta, which allows
staff? blood to flow between theses layers, is called
a. operations officer a. aortic aneurysm.
b. incident commander b. arteriosclerosis.
c. section chief c. aortic dissection.
d. safety officer d. atherosclerosis.

21. A significant finding in head trauma that 26. Which of the following are the correct four
indicates a skull fracture is links in the chain of survival, which is
a. bruising to the sphenoid bone. recommended by the American Heart
b. the presence of cerebrospinal fluid. Association for successful care of prehospital
c. altered LOC. cardiac arrest victims?
d. a full thickness laceration with bone a. early access to emergency care, early
exposure. ventilations, early defibrillation, and early
advanced care
22. You are dispatched to a minor MVC. The b. early access to the hospital, early
patient, sitting on the curb side, tells you that ventilations, early defibrillation, and early
he was just bitten by ants and has severe evacuation
allergies to many insect bites. His skin is c. early access to emergency care, early cardiac
currently warm and dry, and he doesn’t monitoring, early defibrillation, and early
appear to be in distress. You should advanced care
a. administer benadryl. d. early access to emergency care, early CPR,
b. administer an EpiPen. early defibrillation, and early advanced care
c. apply high flow O2.
d. continue with your physical exam. 27. A condition that is caused by the heart’s
inability to pump and leads to an overload of
23. You are assessing a patient who was struck by a fluid in the tissues is
car. He has pain and swelling over his upper a. COPD.
right quadrant and appears to be developing b. CHF.
symptoms of shock. You suspect c. chronic bronchitis.
a. a lacerated liver. d. asthma.
b. splenetic rupture.
c. injuries to the right kidney.
d. traumatic injury to the large bowel.

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–EMT PRACTICE EXAM 9–

28. Which of the following is an indication of cardiac 33. When inserted, the CombiTube will enter the
compromise? trachea approximately _________ of the time.
a. increased pulse rate a. 90%
b. altered mental status b. 60% to 80%
c. agitation c. 10% to 20%
d. all of the above d. 50%

29. When assessing a patient with chest pain, 34. The laryngeal mask airway was initially
asking the patient to rate the pain on a scale designed
from one to ten would fall under what part of a. for the use of EMTs in the field.
the acronym OPQRST? b. for use in a controlled environment, such as
a. quality the operating room.
b. severity c. for use by the military.
c. provocation d. to allow the patient to step down from a
d. radiate more invasive device when healing.

30. In order to assist in the administration of 35. The mechanical device that uses negative
nitroglycerine to a patient, his or her systolic
blood pressure should be above pressure to differentiate tracheal from
a. 100 mmHg.
b. 90 mmHg. esophageal intubation is a(n)
c. 110 mmHg. a. capnographer.
d. 120 mmHg. b. capnometer.
c. end-tidal carbon dioxide (ETCO2) detector.
d. esophageal detector device (EDD).

31. The Sellick’s maneuver is performed by 36. The side or part of the body that is farthest
applying _____________ pressure on the from the midline is described as
cricoid cartilage. a. distal.
a. downward b. dorsal.
b. upward c. lateral.
c. backward d. medial.
d. frontward
37. The largest organ of the body is part of the
32. The CombiTube is a a. circulatory system.
a. single lumen device. b. integumentary system.
b. blind insertion device. c. endocrine system.
c. triple lumen device. d. respiratory system.
d. device to be used under direct laryngoscopy.

196

–EMT PRACTICE EXAM 9–

38. You respond to a patient who has a behavioral 43. You arrive on the scene to find a patient in the
emergency. The patient states that he hears beginning of the second stage of labor. You
voices talking to him, and the voices are telling should
him to kill. You should a. stay on the scene and deliver the baby.
a. believe him and be alert to possible violence. b. transport immediately.
b. try to talk sense into him. c. contact medical control for orders.
c. tell him that the voices are not real. d. all of the above.
d. restrain him until law enforcement arrives
for assistance. 44. The presence of meconium
a. is an indicator of fetal distress.
39. A common symptom seen with a diabetic b. is a normal finding.
patient is excessive drinking to satisfy extreme c. is only emergent if the baby is in respiratory
thirst. This is also called distress.
a. polyuria. d. occurs in 80% of births.
b. polydipsia.
c. polyphagia. 45. Preeclampsia typically develops after
d. dysphagia. the___________ week of pregnancy.
a. 20th
40. Patients who do not produce insulin at all b.30th
a. have type 2 diabetes. c. 28th
b. are hypoglycemic. d. 36th
c. have normal blood sugar levels.
d. have type 1 diabetes. 46. When resources and personnel are provided by
other jurisdictions, this is called
41. The leading cause of maternal death in the first a. an MCI.
trimester of pregnancy is b. a unity of command.
a. placenta abruption. c. mutual aid.
b. eclampsia. d. supporting material.
c. internal hemorrhage, secondary to an
ectopic pregnancy. 47. Prior to the establishment of National Incident
d. bleeding associated with a miscarriage. Management Sysstem, the incident command
system was developed and designed for
42. A multipara woman is one who a. the 9/11 terrorist attack.
a. is experiencing her first pregnancy. b. wildfires in California.
b. has had more than one baby born alive. c. flooding disasters.
c. has had one live birth. d. a chemical warfare attack.
d. None of the above.

197

–EMT PRACTICE EXAM 9–

48. Which of the following is a component of the 53. Using the rule of nines, the posterior trunk
MSDS? accounts for what percentage of body surface
a. reactivity data area on an adult?
b. health hazard data a. 18
c. the boiling point b. 9
d. all of the above c. 36
d. 14
49. A DOT Hazard Class 1 indicates
a. explosives. 54. Using the rule of nines, each lower extremity in
b. combustible liquids. a pediatric patient accounts for what
c. gases. percentage of body surface area?
d. infectious substances. a. 14
b. 7
50. Radioactive material can kill or injure by c. 9
a. Interrupting cardiac rhythms. d. 18
b. Disrupting cellular functions.
c. Increasing blood clot formation. 55. Which of the following is a high priority
d. Acting as a corrosive. (severe) burn injury?
a. full thickness burns affecting less than 2%
51. When applying a bandage or a dressing to a b. partial thickness burns affecting 12%
hand, you should put the hand in what c. burns complicated by an extremity fracture
position? d. superficial burns affecting 55%
a. position of function
b. slightly flexed 56. In which instance is the placement of an AED
c. slightly extended indicated?
d. flat a. a pulseless patient
b. an unresponsive patient
52. You are treating a 52-year-old female patient c. a choking patient who is losing
who has been complaining of substernal chest consciousness
pain radiating into her left arm. The pain began d. a patient with apnea
as she was playing tennis and has lasted
approximately ten minutes. You apply oxygen 57. Early advanced care is the ________ link in the
and medical control authorized you to assist chain of survival.
the patient with her nitroglycerin. The patient a. third
states she feels relief from the chest pain within b. first
five minutes of the nitroglycerin c. second
administration. You understand the reason the d. fourth
nitroglycerin may have relieved her pain is by
increasing oxygenation by 58. Besides ventricular fibrillation, the second
a. reducing the clot. rhythm that the AED considers shockable is
b. dilating bronchioles. a. rapid ventricular tachycardia.
c. preventing the clot from getting bigger. b. asystole.
d. dilating blood vessels. c. atrial fibrillation.
d. pulseless electrical activity.

198

–EMT PRACTICE EXAM 9–

59. Infarction means 65. Patients who have severe difficulty breathing
a. the death of tissue. are usually found in what position?
b. inadequate tissue perfusion. a. high-Fowler’s
c. decreased blood flow. b. Trendelenburg
d. none of the above. c. semi-Fowler’s
d. tripod
60. Another term for an abnormal cardiac rhythm
is 66. You are assessing a patient who has inhaled a
a. cardiomyopathy. poisonous substance and has no signs of
b. dysrhythmia. trauma. You should initially
c. asystole. a. apply high flow O2.
d. tachypnea. b. identify the substance.
c. call poison control.
61. Which of the following is an indicator of d. move the patient into the fresh air.
correct endotracheal tube placement?
a. abdominal rise and fall 67. Approximately 80% of all poisonings are by
b. gastric sounds a. ingestion.
c. positive waveform capnography b. inhalation.
d. your partner’s assurance that he saw the tube c. surface contact.
pass through the vocal cords d. injection.

62. What is the best indicator of correct tube 68. You are assessing a patient who has a history of
placement? behavioral emergencies and hostile tendencies.
a. direct visualization What should be a major clue for the possibility
b. chest rise and fall of danger?
c. O2 sat monitoring a. the patient’s violent history
d. ETCO2 monitoring b. the patient’s posture
c. the level of the patient’s distress
63. The most common complication from the use d. all of the above
of a flow-restricted, oxygen-powered
ventilation device is 69. The two categories in which the underlying
a. a tension pneumothorax. causes of behavioral emergencies fall under are
b. hyperventilation. a. psychogenic brain disorders and neural
c. decreased O2 sat. dysfunctions.
d. gastric distention. b. behavioral disorders and environmental
influences.
64. The medical term for shortness of breath is c. organic brain syndrome and functional
a. orthopnea. disorders.
b. orthodontalgia. d. none of the above.
c. dyspnea.
d. apnea.

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–EMT PRACTICE EXAM 9–

70. The topographic anatomical term for the front 75. A combustible liquid is considered a DOT
side of the body is Hazard Class
a. anterior. a. 2.
b. dorsal. b. 3.
c. inferior. c. 9.
d. medial. d. 6.

71. Bleeding after labor should NOT be managed 76. When at a landing zone, how should the
by aircraft be approached?
a. administering high flow O2 via an NRB a. from the rear
mask. b. from the side
b. applying a sanitary napkin into the vagina. c. depends on the make and model of the
c. placing the mother left laterally recumbent. aircraft
d. placing the infant on the mother’s chest and d. only when accompanied by a flight crew
allowing him or her to nurse. member

72. Which of the following is NOT a sign of 77. The optimal landing zone should be established
respiratory distress in children? on level ground, free of debris, and measure
a. crying a. 60 feet by 60 feet.
b. head bobbing b. 100 feet by 100 feet.
c. retractions c. 50 feet by 50 feet.
d. grunting d. None of the above.

73. A carcinogenic effect is 78. You are conducting primary triage during an
a. an increase in the risk of an individual MCI. Which of the following patients would be
developing cancer. tagged yellow?
b. an increase in the risk of a developing a. A patient breathing 24 times per minute
embryo having physical effects. without a radial pulse
c. a permanent change in the individual’s b. A patient breathing 14 times per minute,
DNA. without a radial pulse present, who obeys
d. none of the above. simple commands and has an arterial bleed
controlled by a tourniquet
74. Secondary decontamination is performed c. A patient who begins spontaneous
a. in the cold zone. respirations after you open the airway, has a
b. in the warm zone. radial pulse, and is unresponsive
c. in a shower area. d. A patient walking to the treatment area with
d. at the hospital. an amputated right arm

200

–EMT PRACTICE EXAM 9–

79. You have been dispatched to a patient with an 83. The electrode that is placed either on the right
altered mental status. Upon your arrival you arm or just below the right clavicle is what
color?
find a male patient who is speaking with slurred a. red
b. black
speech and confused words. His skin is c. yellow
d. white
diaphoretic and bystanders state the patient was
84. Common signs and symptoms of myocardial
fine a few moments ago and then suddenly infarction include
a. chest discomfort lasting less than 20
began acting disoriented. The patient has no minutes, dyspnea, and pain relieved by rest.
b. sharp tearing chest pain lasting more than
facial droop and equal hand grips. He has a 30 minutes, dyspnea, and pain unrelieved by
rest or nitroglycerin.
medic alert tag that indicates he has a history of c. chest pressure lasting more than 30 minutes,
nausea, dyspnea, and pain unrelieved by rest
diabetes. Your treatment should include or nitroglycerin.
a. oxygen and requesting ALS for a normal d. chest tightness, dyspnea, wheezing breath
sounds, and pain unrelieved by rest.
saline IV bolus.
b. placing the patient in soft restraints and 85. You are assessing a hypertensive patient with
epistaxis. After scene safety and BSI precautions
request law enforcement assistance. have been taken, you should first
c. oral glucose, but only if the patient can a. apply direct pressure, squeezing both
nostrils.
follow commands. b. lay the patient flat.
d. assisting the patient with his insulin and c. apply supplemental O2.
d. attempt to calm and reassure the patient.
request ALS.
86. There are ________ cranial nerves.
80. What is the term that identifies the three signs a. 7
that are indicative of increased intracranial b. 12
pressure? c. 9
a. Cullen’s sign d. 10
b. Beck’s triad
c. Battle’s sign 87. The term describing structures that are located
d. Cushing’s triad closer to the trunk is
a. superficial.
81. Bleeding from a subdural hematoma is b. proximal.
a. arterial. c. lateral.
b. venous. d. distal.
c. a collection of blood between the dura mater
and the skull.
d. more rare than epidural hematomas.

82. Which of the following is NOT a component of
the Glasgow Coma Scale?
a. motor response
b. respirations
c. eye opening
d. verbal response

201

–EMT PRACTICE EXAM 9–

88. A normal pupil reaction to shining a bright 93. Cirrhosis of the liver develops in
light into an eye would be the _____________ ____________ of patients with chronic
of the pupil. Hepatitis C.
a. constriction a. 100%
b. dilation b. 20%
c. unequal reaction c. 50%
d. unresponsiveness d. 30%

89. Which of the following is a method of indirect 94. Tuberculosis is a _______________ organism.
disease transmission? a. viral
a. mosquito b. bacterial
b. water c. dormant
c. coughing d. genetic
d. sexual contact
95. The term power lift refers to using muscle
90. A ____________ is a microorganism that is groups in your
capable of causing a disease in a host. a. back.
a. vector b. legs.
b. spore c. arms.
c. droplet d. abdomen.
d. pathogen
96. Rapid extrication should be used for which of
91. Which of the following statements is true? the following?
a. Only some infectious diseases are a. A patient who is bleeding profusely from the
contagious, but all contagious diseases are back of the head
infectious. b. A patient who is screaming and stating that
b. All infectious diseases are contagious. she is unable to breathe
c. Some contagious diseases are infectious. c. An accident where the airbag was not
d. None of the above. deployed
d. None of the above
92. What is the incubation period for Hepatitis B?
a. 1–2 weeks 97. Included in the treatment of a child suspected
b. 2–10 weeks of increased intracranial pressure (ICP), the
c. 4–12 weeks EMT should be especially vigilant to avoid
d. 2–6 weeks a. hyperventilation
b. hypoventilation
c. hypoxia
d. hypocapnia

202

–EMT PRACTICE EXAM 9–

98. Injuries to the spine that cause the individual 103. Which of the following is true regarding
vertebrae to pull apart and separate from one laryngeal mask airways?
another are called a. They can be used in morbidly obese
a. distraction injuries. patients.
b. extension injuries. b. They are a single lumen, blind insertion
c. compression injuries. airway device.
d. displaced injuries. c. They are classified as a high-pressure airway
device.
99. Aniscoria is d. They decrease the risk of aspiration in
a. explosive diarrhea. patients who have a full stomach.
b. posturing.
c. unequal pupils. 104. What does the P stand for in SAMPLE?
d. dilation of the blood vessels. a. pain
b. provocation
100. The best way to treat a patient who has a large, c. past medical history
spurting laceration on the head is to d. past meal eaten
a. apply pressure to the carotid artery.
b. place a gloved hand over gauze while 105. You are evaluating a patient who you believe is
holding constant, firm pressure. having a stroke. You decide to use the
c. apply a bandage and dressing to the head. Cincinnati Prehospital Stroke scale as part of
d. all of the above. your patient assessment. The three components
of the Cincinnati Stroke Scale are
101. You are assessing a child who has sustained a. facial droop, arm drift, and abnormal speech.
burns to his entire anterior legs bilaterally and b. facial grimace, arm strength, and abnormal
to his anterior right arm. He has a burned body speech.
surface area of __________. c. facial droop, arm drift, and altered mental
a. 22.5%. status.
b. 27%. d. facial droop, arm strength, and altered
c. 23%. mental status.
d. 18.5%.
106. Which of the following is the medical term for
102. Which of the following is a curved forcep that double vision?
can be used to remove a foreign body from a a. dysplopia
patient’s mouth? b. diplopia
a. McWhirter prongs c. photophobia
b. Magill forceps d. conjunctival vision
c. Miller blades
d. Magoo prongs 107. What is another name for the mitral valve in
the heart?
a. biscuspid valve
b. aortic knob
c. tricuspid valve
d. pulmonic valve

203

–EMT PRACTICE EXAM 9–

108. You are treating a 58-year-old male patient for 111.What does the S stand for in the charting
a possible AMI. During your assessment you mnemonic SOAP?
noted the patient is extremely diaphoretic with a. signs and symptoms
sweat soaking through his shirt. You have the b. subjective
patient on oxygen and have administered 324 c. scene description
mg ASA and .12 mg nitroglycerin per medical d. skin color
control. The patient suddenly collapses and is
unresponsive, pulseless, and apneic. As you 112. The AED will prompt you to defibrillate which
expose his chest you notice a medication patch two cardiac rhythms?
at midclavicular line and distal to the right a. pulseless electrical activity and ventricular
clavicle. How do you proceed? fibrillation
a. Immediately place the AED pads and b. premature ventricular beats and ventricular
defibrillate if indicated tachycardia
b. Quickly dry the chest, place the pads c. sinus bradycardia and supraventricular
anterior/posterior, and defibrillate if tachycardia
indicated d. ventricular tachycardia and ventricular
c. Quickly remove the medication patch, wipe fibrillation
off the excess medication, dry the chest,
apply pads in the standard position, and 113. An explosion has occurred, and your patient
defibrillate if indicated sustained injuries when they were thrown into a
d. Begin CPR and contact medical control for brick wall. This type of injury is classified as a
instructions a. primary blast injury
b. secondary blast injury
109. During your assessment of a patient, you note c. tertiary blast injury
that her skin is very pale. Which of the d. quaternary blast injury
following would be the most likely cause?
a. fever 114. What is the medical term for the passage of
b. hypertension dark, tarry stools that is indicative of lower
c. carbon monoxide poisoning gastrointestinal bleeding?
d. blood loss a. Melena
b. Hematochezia
110. Which of the following is NOT one of the c. Epistaxis
classic signs seen in Cushing’s triad? d. Hemoptysis
a. rise in blood pressure
b. slowing pulse 115. Which of the following would cause
c. irregular pupils obstructive shock?
d. erratic respirations a. tension pneumothorax
b. massive myocardial infarction
c. severe blood loss
d. anaphylactic shock

204

–EMT PRACTICE EXAM 9–

116. What type of burn involves the epidermis and Answers
varying layers of the dermis?
a. superficial burn 1. a. The assessment of the airway should be done
b. partial thickness burn rapidly and completed within 15 seconds.
c. full thickness burn
d. combination burn 2. b. Agonal respirations are considered dying
gasps and are characterized by irregular,
117. Your patient has had battery acid splashed in occasional gasps for air.
his eyes and now has no vision. Which of the
following treatments would be most 3. d. Normal breathing will have a regular rise
appropriate? and fall of the chest, movement of the abdo-
a. Immediately neutralize the acid with a base, men, and a normal rate and rhythm.
such as baking soda.
b. Cover both his eyes with a sterile dressing. 4. b. During compensated shock, respirations will
c. Flush the affected eye with normal saline for increase to compensate for the decrease in
ten minutes. perfusion.
d. Flush both eyes with eyewash or normal
saline for ten minutes. 5. a. The glottis opening is the narrowest portion
of the adult airway.
118. Which one of the following is a
contraindication for the administration of 6. d. If the ATV goes into alarm or you notice a
nitroglycerin? sudden change in the adequacy of the chest
a. Cardiac related chest pain rise and fall, it is best to begin bag-valve mask
b. Diastolic blood pressure < 100 mmHg ventilations to ensure adequate ventilations as
c. Headache you troubleshoot the issue with the ATV..
d. Systolic blood pressure < 100 mmHg
7. a. Aspirin makes the platelets in the blood less
119. Which one of the meninges is closest to the likely to stick together and, therefore, pre-
skull? vents clots from getting any bigger. Aspirin
a. pia mater cannot break up clots and nitroglycerin
b. dura mater causes vasodilation of the coronary arteries..
c. arachnoid membrane
d. corpus callosum 8. b. Automaticity is the unique characteristic
possessed by cardiac muscle. Contractility is
120. What part of the spinal cord innervates the the ability of the muscle to contract when
diaphragm? stimulated by an electrical impulse. Conduc-
a. cervical spine tivity is the ability of the muscle to rapidly
b. thoracic spine conduct electrical impulses to other parts of
c. lumbar spine the muscle.
d. all the spine innervates the diaphragm
9. b. The thyroid cartilage makes up what is
known as the Adam’s apple.

10. a. Cocaine overdoses will present with dilated
pupils, unless other drugs have been taken
along with cocaine.

11. a. A child who is not crying and has poor muscle
tone and pale skin is presenting in an emer-
gent condition. The child should immediately
be evaluated for life-threatening problems.

205

–EMT PRACTICE EXAM 9–

12. c. Infants lose the majority of their body heat separated and blood, many times under high
pressure, flows in between those layers an
through their heads. aortic dissection or dissecting aneurysm has
13. b. Secondary drowning syndrome can occur occurred. These are many times character-
ized by a sharp or tearing pain. An aneurysm
within 24 hours after a drowning incident. is a weakening in the vessel wall that allows it
14. c. A ventriculoperitoneal shunt is placed in the to balloon out.

brain to help drain excess CSF and would be 26. b. Congestive heart failure (CHF) is a condi-
nized four links in the chain of survival,
common in a child with hydrocephalus. including early access to emergency care,
15. c. The birth of an infant occurs in the end of early CPR, early defibrillation, and early
advanced care.
the second stage of labor.
16. a. In order to prove negligence, a plaintiff 27. b. Congestive heart failure (CHF) is a condi-
tion in which the heart loses the ability to
must show the EMT had a duty to act, adequately pump, allowing fluid to overload
they breached that duty, and the breach in the tissues.
resulted in measurable damages. Neglect
and abandonment refer to the obvious 28. d. Cardiac compromise will present signs of
subversion to perform a duty and can also shock, including increased pulse rate, altered
lead to negligence, but neither is a mental status, and agitation.
requirement to prove negligence. Battery
refers to the actual act of causing harm. 29. b. When asking a patient to rate their pain on a
17. c. At the scene of a hazardous material call, one to ten scale, you are attempting to quan-
tify the severity of the pain.
park the ambulance uphill and upwind in
30. a. The systolic blood pressure should be above
order to lessen the exposure to toxic fumes. 100 mmHg in order to give nitroglycerin.
18. b. A competent adult gives permission to treat
31. a. The Sellick’s maneuver is performed by
with expressed consent. applying downward pressure on the cricoid
19. b. The first incident management system was cartilage.

originally known as the incident command 32. b. The CombiTube is a dual lumen, blind inser-
tion airway device.
system (ICS).
20. d. The safety officer reports directly to the inci- 33. c. When inserted, the CombiTube will go into
the esophagus approximately 80% to 90% of
dent commander and is considered a mem- the time and into the trachea 10% to 20% of
the time.
ber of the command staff.
21. b. The presence of cerebrospinal fluid should 34. b. The laryngeal mask airway (LMA) was origi-
nally designed to be used in the operating
always raise suspicion for a skull fracture. room.
22. d. At present, the patient is not currently dis-
35. d. The esophageal detector device (EDD) uses
playing any signs or symptoms of a severe negative pressure to differentiate from intuba-
tions in the trachea versus in the esophagus.
allergic reaction, so you should continue
36. c. The part of the body farthest from the mid-
with your physical exam.
23. a. Blunt trauma with pain and swelling over line is said to be lateral.

the upper right quadrant should raise a high

index of suspicion for a lacerated liver.
24. b. A patient can lose all his or her blood vol-

ume through an open pelvic fracture.
25. c. When the inner layers of the aorta become

206

–EMT PRACTICE EXAM 9–

37. b. The integumentary system (skin) is the 54. a. Using the rule of nines, each lower extremity
largest organ in the body. in a pediatric patient accounts for 14% of
body surface area.
38. a. Always be alert for the potential of violence
on behavioral emergency calls. 55. c. Any burn that is complicated by an extremity
ity fracture is classified as a severe burn.
39. b. Polydipsia is the medical term for excessive
thirst and is frequently seen in patients with 56. a. The AED should only be applied to patients
high blood sugar. who are pulseless. All other patients listed
may still have a pulse, which is a contraindi-
40. d. Patients who do not produce insulin have cation for applying the AED.
type 1 diabetes.
57. d. Early advanced care is the fourth link in the
41. c. The leading cause of maternal death in the chain of survival.
first trimester of pregnancy is internal bleed-
ing, secondary to an ectopic pregnancy. 58. a. An AED will shock ventricular fibrillation
and rapid ventricular tachycardia.
42. b. Multipara means that the patient has had
more than one baby born alive. 59. a. Infarction means tissue death.
60. b. A dysrhythmia is an abnormal cardiac rhythm.
43. a. If the patient is beginning the second stage 61. c. Positive waveform capnography is an indicator
of labor, birth is imminent. If there are no
complications suspected, you should of correct endotracheal tube placement.
remain on the scene and deliver the baby. 62. d. End-tidal CO2 monitoring is optimal for

44. a. Meconium is an indicator of fetal distress. indicating correct tube placement.
45. a. Preeclampsia typically develops after the 63. d. Gastric distention is the most common

twentieth week of pregnancy. complication when using flow-restricted,
46. c. Mutual aid occurs when resources and per- oxygen-powered ventilation devices.
64. c. Dyspnea is the medical term for shortness
sonnel are provided by other jurisdictions. of breath.
47. b. The incident command system was 65. d. Patients who have severe shortness of breath
are usually in the tripod position because this
originally developed for California wildfires. helps to maximize air exchange in the lungs.
48. d. Reactivity data, health hazard data, and the 66. d. Any patient who has inhaled a toxic substance
should be immediately moved to fresh air.
product boiling point are all MSDS components. 67. a. About 80% of poisonings are by ingestion.
68. d. The patient’s history, posture, and level of
49. a. A DOT Hazard Class 1 is an explosive. distress are all indicators of the possibility
50. b. Radioactive material can cause injury and of danger to the EMTs.
69. c. The two classifications of behavioral emer-
death through the disruption of cellular gencies are organic brain syndrome and
function (i.e., depleting the immune system functional disorders.
or instigating cancers). Radioactive material 70. a. The anatomical term for the front of the
can also cause severe burns. body is anterior.
51. a. When applying a bandage or dressing to a 71. b. Never place anything inside the vagina in an
hand, place it in the position of function. attempt to control vaginal bleeding.
52. d. Nitroglycerin improves blood flow and,
therefore, improves perfusion of the myocar- 207
dium by dilating the blood vessels.
53. a. Using the rule of nines, the posterior trunk
accounts for 18% of adult body surface area.

–EMT PRACTICE EXAM 9–

72. a. Crying is not a sign of respiratory distress in 84. c. These are all common signs and symptoms
children; it is usually a good indicator of air- of a myocardial infarction. The others could
way patency. be angina, dissecting aorta, or asthma.

73. a. A carcinogenic effect is one that will increase 85. a. Control of an epistaxis includes applying
an individual’s risk of developing cancer. direct pressure and squeezing both nostrils.

74. d. Secondary decontamination is typically per- 86. d. There are 10 cranial nerves.
formed at the hospital. 87. b. The term proximal describes a structure that

75. b. A combustible liquid is a DOT Hazard Class 3. is located closer to the trunk.
76. d. An aircraft should never be approached 88. a. A normal pupil reaction is to constrict when

unless you are accompanied by a member of exposed to a bright light.
the flight team. 89. b. Water is an example of an indirect vehicle-
77. b. The optimal landing zone measures 100 feet
by 100 feet and is free of obstacles and borne method for disease transmission.
debris. 90. d. A pathogen is a microorganism that is capa-
78. b. The patient breathing less than 30 times per
minute, having a radial pulse, and having the ble of causing a disease in a host.
ability to obey simple commands, but can- 91. a. Only some infectious diseases are conta-
not walk is categorized as yellow regardless
of other injuries. Patients breathing faster gious, but all contagious diseases are
than 30 times per minute or who were not infectious.
breathing before you opened their airways 92. c. The normal incubation period for Hepatitis
are tagged red, as are patients without a B is 4 to 12 weeks.
radial pulse or who cannot obey simple 93. c. Cirrhosis of the liver will develop in about
commands. Any patient who can walk to the one-half of patients with chronic Hepatitis C.
treatment area is initially tagged green until 94. b. Tuberculosis is a bacterial organism.
further assessed in the treatment area. 95. b. The term power lift refers to lifting while
79. c. This patient is exhibiting signs and symp- using muscles in your legs.
toms of hypoglycemia and can protect his 96. d. None of the answer choices is an emergency
airway. life threatening situation and, therefore, does
80. d. Cushing’s triad consists of increased blood not warrant the risk to the spine and neck
pressure, decreased heart rate, and irregular that rapid extrication presents. Many head
respirations. In addition, it is a sign of injuries bleed profusely due to the large
increased intracranial pressure. amount of capillaries in the head, but the
81. b. Bleeding from a subdural hematoma is bleeding is rarely uncontrollable or life
venous in nature. threatening. A patient screaming she can’t
82. b. Respirations are not included in the Glasgow breathe generally can breathe and clearly has
Coma Scale. a patent airway. An undeployed airbag is a
83. d. The white electrode is placed either on the risk to the patient and EMT, but can be min-
right arm or just below the right clavicle. imized by moving the seat back or using a
commercial airbag restraint device and cut-
ting power to the vehicle..

208

–EMT PRACTICE EXAM 9–

97. c. Proper ventilatory management with 106. b. Diplopia is the term for double vision.
suspected ICP is controversial. However, 107. a. The bicuspid valve is also called the mitral
all agree that hypoxia should be avoided.
An episode of hypoxia in patients with valve.
increased ICP increases risk of death or 108. c. You should remove the medication patch
permanent disability significantly.
Ventilatory rate should be based on and wipe the chest dry and free of excess
patient needs while SpO2 is maintained medication. You should then apply the AED
above 90%. It's also advisable to use as normal and follow the prompts.
EtCO2 when available to ensure proper 109. d. Blood loss would cause pale skin. Fever,
metabolism on a cellular level. hypertension, and carbon monoxide poison-
ing would typically present with red skin.
98. a. Distraction injuries are injuries to the spine 110. c. Pupillary response is not one of the three
classic signs seen with Cushing’s response.
in which the individual vertebrae pull apart 111. b. The S in SOAP stands for subjective.
112. d. The two rhythms an AED will prompt the
and separate from each other. EMT to shock are ventricular tachycardia
99. c. The term aniscoria means unequal pupils. and ventricular fibrillation.
100. b. The best way to treat a patient who has a 113. c. Tertiary blast injuries occur when a person is
thrown into an object from an explosion.
large, spurting laceration on the head is to 114. a. Melena is the medical term for the passage of
dark, tarry stools and is indicative of lower
place a gloved hand over gauze while holding gastrointestinal bleeding.
115. a. A tension pneumothorax would cause
constant, firm pressure. obstructive shock.
116. b. A partial thickness burn (second degree)
101. d. Burns to a child’s anterior legs bilaterally and involves the epidermis and varying layers of
the dermis.
his anterior right arm cover a body surface 117. d. If a patient has any chemical in his or her
eyes, immediately flush both eyes with eye-
area of 18.5%. wash or normal saline for at least ten minutes.
102. b. Magill forceps are used to remove foreign Never attempt to neutralize a chemical burn.

objects from a patient’s mouth. 118. d. Systolic blood pressure < 100 mmHg is a
103. b. Laryngeal mask airways are single lumen, contraindication. Cardiac chest pain is an
indication. Headache is a side effect of nitro-
blind insertion airway devices. They're not glycerin. Diastolic blood pressure has no
to be used in obese patients. These patients relation to the administration of nitroglycerin.

cannot tolerate high airway pressures, and 119. b. The dura mater is the layer of the meninges
that is closest to the skull.
using this device on them can increase the
120. a. The cervical spine innervates the diaphragm.
risk of aspiration of gastric contents.

104. c. P in SAMPLE stands for past medical history.
105. a. The Cincinnati Prehospital Stroke Scale

involves an assessment of the symmetry of

“facial droop” by having the patient smile.

Arm drift can be assessed by asking the

patient to hold her arms out with eyes closed
and see if one drifts downwards; abnormal
speech can be assessed to see if the patient
slurs her words or uses the wrong words.

209

Blank Page

CHAPTER11 EMT
PRACTICE EXAM 10

CHAPTER SUMMARY

This is the final practice exam in this book based on the
National Registry’s EMT cognitive exam. Use this test to con-
tinue your study and practice.

Like Chapter 5, this chapter contains questions in free-response format. The questions represent each
of the modules found in the U.S. Department of Transportation’s Emergency Medical Technician
National Education Standards. The results can be used to guide your study. If necessary, use the open-
book technique and refer to your EMT training text as you go. Take your time—there is more to this exam
than simply getting the answer correct; you must also understand the concept.

211

–EMT PRACTICE EXAM 10–

EMT Practice Exam 10 5. Describe automaticity.

1. Which lung has three lobes?

2. What are the five stages of the grieving process? 6. You were called to the residence of an adult
female in labor. After delivery, you assess that
the newborn has a pink body and blue hands.
He has a pulse of 110 beats per minute, resists
your attempts to straighten his hips and knees,
cries when his foot is flicked, and has slow
respirations. What is the APGAR score of
the infant?

3. Name six physiologic signs of stress.

7. Explain the electrical conduction system of a
normal functioning heart and state the normal
electrical current pathway.

4. Explain how the hypoxic drive works.

212

–EMT PRACTICE EXAM 10–

8. Explain what the SAMPLE history is used for 12. Describe what happens in the heart during
and state what each letter in the acronym diastole.
stands for.

13. What is peristalsis?

9. How would you recognize labored breathing in
a pediatric patient? Explain.

14. Why is good nutrition important to the
performance of an EMT?

10. Name a situation in which a healthy patient
may have a delayed capillary refill.

15. What is the definition of a vector-borne disease?

11. Name the components of blood.

213

–EMT PRACTICE EXAM 10–

16. What is diabetic ketoacidosis? 20. What method should be used to carry a patient
on a backboard or cot? How many rescuers are
used in this method, and where are the rescuers
positioned?

17. What is the APGAR score used for, and what
does each letter in the acronym stand for?

21. Name three contraindications for the
application of a traction splint.

18. Name two instances in which the pulse
oximeter may provide a false reading.

22. Define shock.

19. Why is it important to select the proper-sized
blood pressure cuff for your patient?

214

–EMT PRACTICE EXAM 10–

23. How should you treat a patient who presents a 27. What are the three elements of the Pediatric
flail chest? Assessment Triangle (PAT)?

24. List the steps in applying a tourniquet. 28. What should raise your index of suspicion for
child abuse when you are treating a pediatric
patient?

25. Why should you closely monitor glucose levels
after a diabetic patient has a seizure?

29. Besides urinary output, how else would you
determine that your infant patient may be
dehydrated?

26. What is the difference between ventilation and
respiration?

215

–EMT PRACTICE EXAM 10–

30. What should you suspect when you discover 34. What is blood pressure?
ecchymosis behind your patient’s ear over the
mastoid process? What is this ecchymosis called?

31. Name four situations in which it is appropriate 35. What other devices can be used to immobilize a
to remove a patient’s helmet. pediatric patient other than the long spine
board?

32. Define retrograde amnesia. 36. What are the blood vessels that carry blood to
the heart?

33. Why are head injuries more common in 37. List the types of shock.
children?

216

–EMT PRACTICE EXAM 10–

38. What are the three layers of the skin? 42. Where is the popliteal region?

39. What is a low angle rescue? 43. You have arrived at a hospital and waited
several minutes for a nurse to arrive in order to
give your report. A call comes through dispatch
for a traffic accident with injuries, and you
know that you are the closest unit. How should
you handle this situation?

40. What is the difference between a sprain and a
strain?

44. List the steps taken for attaching a regulator to
an oxygen cylinder.

41. In an incident command system, what does the
span of control refer to?

217

–EMT PRACTICE EXAM 10–

45. When should you suspect that delivery of an 49. What is an ectopic pregnancy?
infant is imminent?

50. What is meconium?

46. What is the purpose of a liter flow device on
oxygen?

51. What is supine hypotensive syndrome?

47. How is the Sellick’s maneuver performed?

52. Why is suction an immediate priority when
there is presence of meconium?

48. Why are the elderly more at risk for c-spine
injuries?

218

–EMT PRACTICE EXAM 10–

53. Why is it important to place gentle pressure on 57. List the signs and symptoms of a severe allergic
the baby’s head as soon as crowning occurs? reaction (anaphylaxis).

54. Why should you wear gloves when 58. What is a behavioral emergency?
administering nitroglycerine?

55. In what ways can poisons or medications enter 59. What are some conditions that can mimic the
the body? signs and symptoms of a heart attack?

56. How will you know if the application of the 60. What are some changes that take place in the
PASG has worked? mother during pregnancy that may affect your
assessment and care?

219

–EMT PRACTICE EXAM 10–

61. What are the two methods for performing chest 64. List some strategies that will help you manage
compressions on an infant? and decrease stress in your life.

62. You have been dispatched to the scene of a 65. What are some signs that can help you
possible shooting. When is it okay to leave the determine when a patient may become violent
staging area and enter the scene? with you or others on scene?

63. You have been requested to enter a crime scene 66. List some scene hazards that may be dangerous
for an injured patient. How do you handle this to you and your partner.
situation?

67. What are some common hazards in a fire?

220

–EMT PRACTICE EXAM 10–

68. What is meant by duty to act? 72. What is meant by the term retroperitoneal?

69. When does a patient have the right to refuse 73. How is the respiratory system in a pediatric
medical care? patient different from that in an adult patient?

70. What does the acronym HIPAA stand for, what 74. What are the three main functions of the skin?
is its purpose, and how does it apply to you?

75. What is preeclampsia?

71. Your patient has sustained a superficial injury
to the arm. What does this mean?

221

–EMT PRACTICE EXAM 10–

76. How does eclampsia differ from preeclampsia? 80. Retractions may be present in a patient with an
increased work of breathing. Where would you
see this accessory muscle use?

77. How do you treat eclampsia?

81. What is the function of the pancreas?

78. What are the characteristics of an increased
work of breathing in pediatric patients?

82. When is it appropriate to use a Reeves
stretcher?

79. Why might blood pressure determination and
interpretation be difficult in pediatric patients?

83. When oral suctioning, how far should the tip of
the catheter be placed?

222

–EMT PRACTICE EXAM 10–

84. A compressed gas cylinder that is color-coded 88. What are some common factors to take into
yellow contains what type of gas? consideration when assessing for significant
mechanism of injury in a motor vehicle crash?

85. In a head-on collision, what injuries could you 89. List the steps that are taken when palpating a
expect to see in an unrestrained driver? blood pressure.

86. There are two pathways that the body can travel 90. Where can skin color be assessed to determine
along in a frontal collision when not restrained. good perfusion in your patient?
What are these two pathways?

87. What is cavitation?

223

–EMT PRACTICE EXAM 10–

91. Without a thermometer, how would you check 95. When assessing pulses, what should you assess?
the skin temperature of your patient?

92. In the acronym PERRL, what do the two Rs 96. A person who is A&O !4 is oriented to what
stand for? four things?

93. What is the condition suspected when 97. What factors may have you place a patient into
orthostatic vital signs are positive? a high-priority category?

98. What is a multi-system trauma?

94. In the acronym OPQRST, what does the P
stand for and what does it mean?

224

–EMT PRACTICE EXAM 10–

99. When assessing the abdomen of a patient who 102. When giving a report to the hospital staff via
has a traumatic injury, besides DCAP-BTLS, radio, what is pertinent information that
what are you looking for? should be included in the report?

100. What is crepitus? 103. Why is aspirin given to a patient complaining
of chest pain?

101. During a detailed physical exam of a trauma 104. What items should your OB kit contain?
patient, what are you checking the ears for?

105. What is the rule of palm?

225

–EMT PRACTICE EXAM 10–

106. What are signs and symptoms that you may see 110. What are some medications that should make
associated with rib fractures? you suspect that your patient is a diabetic?

107. What are some advantages of an AED? 111. At what point should compressions be
interrupted when using an AED?

108. What is dead space in the lung?

112. What is a TIA?

109. What are some common causes for seizures?

113. What is status epilepticus?

226

–EMT PRACTICE EXAM 10–

114. Why are elderly patients more susceptible to 118. What should be placed directly over an open
heat loss than non-elderly patients? wound to control bleeding and protect from
infection?

115. If able to do so, what position should you place 119. Why is a prolapsed cord dangerous to the baby?
a patient with an evisceration? Why?

116. What is a prolapsed cord? 120. In addition to early defibrillation, what
should be considered to increase the
chances of ROSC in a cardiac arrest
patient?

117. What are the criteria for the use of an AED?

227

–EMT PRACTICE EXAM 10–

121. What is the difference between stable and 124. What is another term that a pregnant female
unstable angina? may use instead of amniotic sac?

122. What is positional asphyxia? 125. Your patient has suffered a penetrating wound
to his chest wall. What is another term for this
wound? What type of dressing should be
applied?

123. What are some important questions that you
should ask a pregnant patient that will help you
to determine if birth is imminent?

126. If signs and symptoms of a tension
pneumothorax occur after you have sealed the
open chest wound, what should you do?

228

–EMT PRACTICE EXAM 10–

127. Who establishes command on scene? 130. On a conscious, pregnant female with a foreign
body obstruction, where should you place your
hands to provide thrusts to expel the object?

128. What do end-tidal carbon dioxide detectors do?
131. What does the anatomical term medial refer to?

129. The paramedic on scene has established an IV. 132. What does the term proper body mechanics
The solution is not flowing properly. What can refer to?
you do to troubleshoot this problem?

229

–EMT PRACTICE EXAM 10–

133. What are the types of suction units that you 137. In a dark-skinned patient, how would you be
may need to know how to use? able to see if the patient is pale?

134. Why is the insertion of a nasopharyngeal 138. In a patient with a hip fracture, what might you
airway contraindicated in patients with notice in the lower extremity?
significant facial trauma?

135. Where should you auscultate breath sounds? 139. When assessing the neck after a traumatic
injury, what are you looking for besides DCAP-
BTLS?

136. When assessing the skin, what do you assess?

140. What is subcutaneous emphysema?

230

–EMT PRACTICE EXAM 10–

141. Why should ongoing assessments be performed 145. What is the phase that immediately follows a
on all patients? seizure where the patient may remain
unresponsive, have an altered level of
consciousness, become agitated, or appear
sleepy?

142. What are the contraindications for oral
glucose?

146. What are some symptoms associated with an
envenomation?

143. What is a febrile seizure?

147. What are the six things that you must know
when considering what medication to
administer to a patient?

144. How should you care for a patient who is
having an active seizure?

231

–EMT PRACTICE EXAM 10–

148. What are some medications that an EMT may 4. Considered the backup plan to control
be called upon to assist administering? respiration, the hypoxic drive will stimulate

149. What are some common causes of shock in a breathing when the body cannot rely on the
pediatric patient?
carbon dioxide receptors. When the carbon
150. What is an epistaxis?
dioxide receptors fail, the oxygen receptors in
Answers
the brain, carotid arteries, and the walls of the
1. The right lung has three lobes: upper, middle, and
lower lobes. aorta will sense when oxygen levels are low, thus

2. The five stages of the grieving process include stimulating breathing.
denial, anger and hostility, bargaining, 5. Automaticity is defined as the ability of heart
depression, and acceptance.
cells to spontaneously depolarize and generate
3. Physiologic signs of stress include increased blood an action potential independently of influence
pressure, dilated pupils, increased heart rate, from the nervous system or hormones. This
perspiration, tense muscles, dilated blood vessels, action potential initiates the electrical impulse
decreased blood flow to the GI tract, increased that then causes physical contraction of the
respirations, and increased blood glucose levels. heart.

232 6. The APGAR score of this newborn is 8:
A = 1, P = 2, G = 2, A = 2, R = 1.

7. The electrical conduction system is a network of
specialized cardiac tissue that carries the

electrical impulses throughout the heart. In a

normal functioning heart, the electrical impulse

begins in the right atria at the sinoatrial (SA)

node. It then travels to the atrioventricular (AV)
node located in the interatrial septum, then
moves into the left and right bundle branches,
then moves along the Purkinje fibers located

along the walls of the ventricles.

8. The SAMPLE history is an acronym that is used
for guidance when performing further

assessment and obtaining a portion of the

patient’s history after immediate life threats

have been stabilized. S = signs and symptoms; A

= allergies to medications, food, or
othersubstances; M = medications (what
medications the patient is currently taking,
including prescribed, over-the-counter, and
herbal medications); P = pertinent past history;
L = last oral intake; and E = events leading up to
the injury or illness.

–EMT PRACTICE EXAM 10–

9. You can recognize labored breathing in a 19. A blood pressure cuff that fits too loosely on
pediatric patient by intercostal retractions, the patient may result in a falsely low blood
nasal flaring, gasping, and/or grunting. pressure reading. A cuff that fits too tightly may
result in a blood pressure reading that is falsely
10. A healthy patient may have a delayed capillary high.
refill in a few situations. Certain medications,
positions, body temperatures, and ages 20. The diamond-carry method should be used if a
(elderly) can all affect the capillary refill time. patient needs to be carried on a backboard or
cot. This method uses four rescue personnel.
11. The components of blood include plasma, red One rescuer stands at the head, another at the
blood cells, white blood cells, and platelets. feet, and one at each side of the patient.

12. During diastole, the ventricles relax and fill 21. Contraindications for applying a traction splint
with blood. are injuries occurring close to or involving the
knee, additional fractures in the affected limb,
13. Peristalsis is the wave-like contractions that injuries of the pelvis, and partial amputations
propel the contents of tubular organs. or avulsions with bone separation.

14. The physical exertion and stress that are part of 22. Shock is defined as inadequate tissue perfusion.
the EMT’s job require an extremely high 23. A patient with a flail chest should be treated by
output of energy. Certain foods can affect
energy levels and knowing which foods provide maintaining his or her airway, providing
the highest amount of fuel is paramount. respiratory support as needed, administering
supplemental oxygen, performing ongoing
15. A vector-borne disease is a disease that is assessments, and possible splinting/
caused by an infectious microbe and is immobilizing the flail segment.
transmitted to people through a blood-sucking 24. Have someone continue to hold direct pressure
arthropod (either an insect or arachnid). and elevation to the extremity. Apply a
commercial tourniquet per the manufacturer’s
16. Diabetic ketoacidosis is a condition in which specification proximal to the wound. If you do
there is an abnormally high accumulation of not have a commercial tourniquet a blood
acids in the bloodstream, resulting from pressure cuff may be used. Place the cuff
prolonged and very high hyperglycemia. proximal to the wound and inflate the cuff until
Insulin is not available in the body to lower the the bleeding stops. Continuously reassess the
sugar concentration. cuff to ensure it does not become deflated and
allows bleeding to begin again. If you have
17. The APGAR score is a scoring system used to neither a commercial tourniquet nor a blood
assess the status of a newborn. A = Appearance, pressure cuff you can make a tourniquet out of
P = Pulse, G = Grimace, A = Activity, and R = cloth/triangular bandage and a stick. Make a 4”
Respirations. wide strip out of the cloth and wrap the cloth
twice around the extremity proximal to the
18. Sickle cell disease, anemia, carbon monoxide wound. Tie a knot and place a stick or similar
poisoning, COPD, bright light, nail polish, and object on top of the knot. Tie a square knot over
hypovolemia may all cause a false reading on the stick. Start twisting the stick until the
the pulse oximeter. bleeding stops and then secure the stick so it will
not unwind. Once a tourniquet is placed you

233

–EMT PRACTICE EXAM 10–

need to clearly mark, either on a piece of tape 33. Head injuries are more common in children
placed on the forehead or directly on the because of the size of their heads in proportion
forehead, the fact that a tourniquet has been to their bodies.
applied, where, and at what time. You also must
document the same information in your run 34. Blood pressure is the pressure that is exerted on
report and you must notify those assuming care the walls of an artery.
of your patient that the tourniquet is in place.
25. You should closely monitor the glucose levels 35. A child may also be immobilized by using a
of a diabetic post-seizure because the glucose short spine board or Kendrick Extrication
levels may drop significantly due to the Device.
excessive muscular contractions that take place
during seizure activity. 36. Veins are blood vessels that carry blood to the
26. Ventilation is the body’s ability to move air in heart.
and out of the lungs, and respiration is the
exchange of gasses in the alveoli of the lung 37. The types of shock that the body may suffer are
tissue. anaphylactic shock, neurogenic shock,
27. The three elements of the Pediatric Assessment hemorrhagic shock, cardiogenic shock,
Triangle (PAT) are work of breathing, hypovolemic shock, septic shock, and
circulation to skin, and appearance. psychogenic shock.
28. Injuries that are not consistent with the
mechanism of injury given, conflicting stories 38. The three layers of the skin are the epidermis,
from the parents or caregivers, and abnormal the dermis, and the subcutaneous layer.
reaction from the child toward the parents or
caregivers should all raise your index of 39. A low angle rescue is a rope rescue that involves
suspicion for child abuse. terrain at a less than 40-degree angle.
29. An infant who is dehydrated may have flat or
sunken fontanels, dry oral mucosa, or may not 40. A sprain is caused by the stretching and/or
produce tears while crying. tearing of tendons and ligaments. A strain is
30. When ecchymosis is found behind a patient’s when a muscle is pulled or torn.
ear, you should immediately suspect that they
may have a skull fracture. Typically, the type of 41. The span of control refers to the amount of
skull fracture with this sign is a basilar skull people or elements that can be directly
fracture. This sign is called Battle’s sign. managed by another person.
31. You may remove a patient’s helmet if you are
unable to assess a patient’s airway, you are 42. The popliteal region refers to the area that is
unable to immobilize the patient’s spine posterior (behind) to the knee.
properly, the helmet causes excessive movement
of the head, or if the patient is in cardiac arrest. 43. A medical call is not completed until a formal
32. Retrograde amnesia is a type of amnesia where transfer of care has taken place. Leaving the
the patient is unable to recall the events that patient prior to proper transfer is
occurred just prior to the traumatic event or abandonment. Prior to taking another call,
brain injury. regardless of the location, the patient must be
transferred properly.

44. To attach a regulator to an oxygen cylinder, first
remove the seal. Then, inspect the valve for
cleanliness and any defects. Purge the valve to
express debris or dust particles that may have
gotten into the valve. Confirm the presence of an
O ring and inspect it for damage. Replace the O
ring, if needed. Slip the yoke of the regulator
over the cylinder valve. Line up the pins with the
holes on the valve and tighten the thumb screw.

234

–EMT PRACTICE EXAM 10–

Turning the pressure gauge away from you, open 55. Medications and poisons can enter the body
the valve one full turn. Confirm the pressure in through ingestion, injection, absorption, and
the cylinder by reading the gauge. inhalation.
45. You should suspect that delivery of the infant is
imminent when the baby is crowning, the 56. The PASG are generally limited to use as a
mother feels a strong urge to move her bowels, splint. You can tell when the PASG are
and the mother’s contractions become less than successful when they have immobilized the
two minutes apart. injury and there is still a pulse, sensation, and
46. Liter flow devices increase the amount of motor function distal to the injury. If your local
oxygen available to the patient. protocol allows the use of PASG to treat for
47. The Sellick’s maneuver is performed by hypoperfusion, then you know the PASG are
compressing the patient’s neck just below the successful if there is an increase in the patient’s
thyroid cartilage (Adam’s apple), placing the blood pressure.
thumb and forefinger on each side of the
cricoid cartilage. 57. Signs and symptoms of a severe allergic reaction
48. The elderly are at increased risk for cervical include tightness in the chest, severe wheezing,
spine injuries because they may have decreased rapid and labored breathing, stridorous
vision, be arthritic, or be on medications that respirations, hypotension, altered level of
make them dizzy or weak. consciousness, and an increased heart rate.
49. An ectopic pregnancy occurs when a fertilized
egg implants itself and begins to develop in an 58. A behavioral emergency occurs when a
area outside of the uterus. patient’s behavior is dangerous, abnormal, or
50. Meconium is fecal matter that is excreted by intolerable and causes concern for family,
the baby while it is still in the uterus. bystanders, caregivers, or the patient.
51. Supine hypotensive syndrome is a condition
that occurs when the fetus compresses the 59. There are many conditions that can mimic the
mother’s vena cava as the mother is lying signs and symptoms of a heart attack. Some of
supine. The compression of the vena cava these conditions include a panic attack, angina,
reduces blood return to the heart, causing pericarditis, anxiety, and a pulmonary
significantly low blood pressure. embolism.
52. If suctioning is delayed, the infant can aspirate
the meconium. Aspiration of meconium can 60. Some changes that occur in a mother during
cause serious damage to the newborn’s lungs pregnancy that may affect your assessment and
and even death. care are an increase in cardiac output, 50%
53. Placing pressure on the baby’s scalp when it increase in blood volume, and blood pressure
becomes visible is done to prevent an explosive decrease by as much as 10 mmHg. Her pulse
birth. This pressure helps to prevent injury to rate may also increase, and her respirations
both the mother and the baby. may be shallow and difficult.
54. Gloves should be worn when administering
nitroglycerin because it can be absorbed 61. The two methods for performing chest
through the skin and enter the bloodstream. compressions on an infant are the two-finger
technique and the two-thumb encircling hands
technique.

62. Regardless of the chief complaint, you must
only enter the scene when law enforcement has
requested you to do so and stated that the scene
is safe for you to enter.

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63. After ensuring the scene is safe, enter the scene 72. Structures that lie retroperitoneal are those that
carefully, as to not disturb possible evidence. lie behind the abdominal cavity.
The patient is your top priority; however, try
not to disturb anything around you unless 73. The respiratory system of a pediatric patient is
things must be moved in order to properly treat smaller proportionally and is less rigid than the
the patient. If you do move objects, be sure to respiratory system in an adult.
let law enforcement know what you did. Never
take anything from a scene of a crime. Enter 74. The three main functions of the skin are
and exit the scene in the same manner. temperature regulation of the body, protection,
and the transmission of information from the
64. It is important to be able to manage the amount environment to the brain.
of stress in your life.You can do this by
reducing the amount of hours that you work, 75. Preeclampsia, also known as pregnancy-
changing your attitude, changing work partners induced hypertension, is a condition that is
to avoid negativity, implementing a workout or characterized by swelling in the hands and feet,
exercise program, maintaining friendships high blood pressure, headache, and visual
outside of the work environment, and focusing disturbances.
on the quality of care that you provide.
76. Eclampsia has the same signs and symptoms as
65. Always pay attention to certain behaviors of preeclampsia; however, in the eclamptic
individuals on scene. Their behavior may signal mother there will be seizure activity.
that they may become violent. Pay attention to
their past history, vocal activity, physical 77. To treat eclampsia, lay the mother left lateral
activity, substance abuse, and posture. recumbent and apply oxygen. Maintain the
patient’s airway and suction vomitus as needed. As
66. Some scene hazards that can be harmful to you with every other call, perform scene size-up and
and your partner are fires, electricity, hazardous BSI, do initial assessments, obtain history, and
materials, unstable vehicles, and bystanders. perform a physical exam. Obtain baseline vital
signs and treat the patient as needed. Transport
67. Toxic gases, structural collapse, elevated the patient rapidly and do ongoing assessments.
temperatures, smoke, and oxygen deficiencies
are all common hazards associated with fires. 78. Characteristics of an increased work of
breathing in pediatric patients are nasal flaring,
68. Duty to act is the individual’s responsibility to abnormal positioning, abnormal airway
provide patient care when that individual is sounds, head bobbing, and accessory muscle
working in the capacity of a clinician or public use (retractions).
safety official.
79. Obtaining blood pressures in pediatric patients
69. A patient who is a competent adult and has may be difficult due to an EMT having
been advised of all the risks, alternative difficulty remembering the normal values for
treatments, and benefits may refuse treatment the patient’s age, lack of cooperation from the
at any time. patient, loud crying, and confusion as to the
proper blood pressure cuff size.
70. The acronym HIPAA stands for the Health
Insurance Portability and Accountability Act. 80. Retractions (accessory muscle use) may be seen
HIPAA not only aims to combat fraud in health above the clavicles, under the sternum, and
insurance, but one of its main purposes is to between the ribs.
also safeguard a patient’s confidentiality.
81. The pancreas produces and secretes insulin and
71. A superficial injury is an injury that is close to also produces and secretes fluids that aid in
or directly on the skin. digestion.

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82. A Reeves stretcher is used for supine patients number will be the systolic blood pressure.
that need to be carried through tight spaces or Document the pressure.
down stairs. 90. Skin color can be assessed for adequate
perfusion in the face, oral mucosa, conjunctiva,
83. When oral suctioning, the tip of the catheter and nail beds.
should be placed into the mouth only as far as 91. The back of an ungloved hand can be used to
you can see. assess a patient’s skin temperature.
92. The two Rs in PERRL stand for round and
84. A compressed gas cylinder that is color-coded reactive.
yellow indicates that the contents are medical 93. When orthostatic vital signs are positive,
grade air. hypovolemia should be suspected.
94. The P in OPQRST stands for provocation/
85. During a head-on collision, the rescuer may see palliation. When assessing a patient,
injuries to the head, neck, chest, abdomen, hip, provocation/palliation should lead you to ask
knee, leg, and internal organs. questions about what makes the patient’s
symptoms or pain better or worse.
86. When not restrained, the body can travel in 95. When assessing pulses, rhythm, strength, and
two pathways: down-and-under or up-and- rate should be assessed.
over. 96. A person who is A&O !4 is oriented to person,
place, time, and event.
87. When a medium- to high-velocity projectile 97. Factors that may indicate that a patient should
enters the body, the energy of the projectile can be placed into a high-priority category include
cause the surrounding tissues to expand greater unresponsiveness, difficulty breathing, signs
than the actual size of the projectile. This and symptoms of shock, chest pain, altered
expansion is called cavitation. level of consciousness, poor general appearance
or impression, complicated childbirth, and
88. Some common factors to take into uncontrolled breathing.
consideration when determining whether there 98. A multi-system trauma is a traumatic injury
has been a significant mechanism of injury in a that involves more than one organ system.
motor vehicle crash are intrusion into the 99. After assessing DCAP-BTLS on the abdomen of
passenger compartment, airbag deployment, a patient who sustained a traumatic injury,
bent steering wheel, usage of restraints, palpate and look for distention, rigidity, or
windshield starring, death of an occupant guarding.
inside the vehicle, and the speed of the vehicles 100. Crepitus is a grinding sound or feeling when
involved. broken bones rub together.
101. When checking the ears of a trauma patient
89. Assessing a blood pressure by palpation is done during a detailed physical exam, the ears are
by first taking proper BSI precautions. Then, checked for DCAP-BTLS and drainage of blood
choose an appropriately sized cuff and place it and cerebrospinal fluid.
on the upper arm, ensuring that the gauge is 102. When giving a report to a hospital via the
visible. Locate and palpate the radial pulse in radio, the information that should be included
the arm on which you placed the blood in the transmission is your unit ID number, the
pressure cuff. With the valve closed, inflate the
cuff at least 30 mmHg above where you last felt
the radial pulse. Gently and slowly open the
valve and deflate the cuff slowly, waiting for the
return of the radial pulse. Note where the
needle on the gauge is located when you felt the
first beat return to the radial artery. This

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–EMT PRACTICE EXAM 10–

patient’s age and gender, chief complaint, a 114. Elderly patients are more susceptible to heat loss
because of their reduced circulation and
brief history of present illness or complaint,
compensatory mechanisms.
relevant medical history, vital signs, results of
115. If possible, a patient with an evisceration should
your examination, care that was provided to be placed supine with his or her knees bent to

the patient, any changes in the patient’s reduce pressure on the abdominal muscles.

condition, and your ETA to the hospital. 116. A prolapsed cord is when the umbilical cord
103. Aspirin is given to patients with chest pain due to enters the birth canal before the baby’s head.

its prevention of blood clotting. 117. To use an AED on a patient, the patient must be
104. An OB kit should contain a bulb syringe, unconscious, unresponsive, apneic, have a clear

umbilical clamps, surgical scissors or scalpel, 4x4 airway, and be at least one year old.
gauze, towel drapes, baby blanket or foil baby
bunting, sanitary napkins, infant cap, and 118. A bandage should be placed directly over an
open wound to control bleeding and protect
biohazard bags.
105. The rule of palm is a method for assessing the from infection.

total body surface area of a burn patient using his 119. With a prolapsed cord, the blood flow may
or her own palm. The patient’s own palmar become occluded, depriving the baby of oxygen
surface is equal to approximately 1% of his or
and nutrients.
her total body surface area. 120. Continuing with chest compressions while the
106. Signs and symptoms associated with rib fractures
AED is charging ensures that the heart remains
are painful respirations, crepitus, and deformity. primed and at the best possible threshold for
successful conversion to a pulse producing
107. Speed of operation, continuous monitoring, and rhythm. Compressors should be switched out
ease of operation are advantages of an AED. every two minutes to avoid fatigue and to
maintain effective compression depth.
108. Dead space in the lung refers to area outside of 121. Stable angina is characterized by chest pain that
the alveoli where gas exchange doesn't take place. is of coronary origin that is usually relieved by

109. Common causes for seizures are hypoxia, head sitting down, resting, and administering
injuries, intracranial bleeding, brain tumors,
alcohol withdrawal, metabolic changes, and nitroglycerine. Unstable angina is characterized

infections. by similar chest pain of coronary origin that is
110. Some of the medications found at a patient’s
produced by fewer stimuli than that of stable
residence that should make you suspect that your
patient is a diabetic are insulin, glucophage, angina. The pain is not relieved by rest,
Avandia™, Amaryl™, Actos™, and glucagon.
111. When using an AED, compressions should only nitroglycerine, etc.
be interrupted when the AED is in either analyze 122. Positional asphyxia is suffocation that occurs

or shock mode. when a patient is restrained improperly,
112. TIA stands for transient ischemic attack.
restricting the neck, chest wall, or diaphragm.
Although it has similar signs and symptoms of a 123. When interviewing a pregnant patient, it is
stroke, it typically resolves within 24 hours.
113. Status epilepticus can be a seizure that lasts important to ask the patient’s previous birth
approximately ten minutes or longer, or several
seizures that occur back-to-back with no period history, including the number of live births.
of consciousness in between seizures.
Typically, the more live births, the faster the

labor process will occur. Other questions

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–EMT PRACTICE EXAM 10–

should include (1) time between contractions, receive compressions to the abdomen.
(2) length of contractions, (3) presence of a 131. The anatomical term medial refers to
mucous or watery discharge, and (4) if the
patient has an urge to bear down or feels like placement toward the midline of the body.
they need to make a bowel movement. 132. Proper body mechanics refers to the proper use
124. Lay people frequently refer to the amniotic sac
as the “bag of waters.” of your body when lifting or moving objects so
125. Penetrating trauma to the chest wall is that injury will not occur.
frequently referred to as an “open 133. Three types of suction units that may be used
pneumothorax.” This should be treated with in the field are electric, manually operated, and
an occlusive dressing to prevent air from oxygen powered.
entering the chest cavity. If there is evidence 134. Nasopharyngeal airways are contraindicated in
that it is a sucking chest wound, then a three- patients with significant facial trauma because
side dressing should be applied. the airway may pass into the cranium or a sinus
126. If signs and symptoms of a tension cavity if fractures are present.
pneumothorax develop after you have sealed 135. Breath sounds should be auscultated on the
the open chest, ensure that a three-sided upper and lower chest and back and at the
dressing is in place to assist with relieving the midaxillary line.
pressure. One can also lift up a side of the 136. When assessing skin, assess moisture,
dressing in a process known as “burping the temperature, and color.
dressing.” 137. In a dark-skinned patient, the oral mucosa and
127. The first emergency person to arrive on scene nail bed are good places to assess normal skin
should establish command. If needed, color.
command can then be passed to more qualified 138. When a patient presents a hip fracture, you
responders as they arrive on scene. may notice shortening and rotation of the
128. End-tidal carbon dioxide detectors measure the lower extremity of the affected hip.
amount of exhaled carbon dioxide from a 139. When assessing the neck of a patient who has
patient. sustained a traumatic injury, inspection should
129. If an IV is not flowing properly, perform the include looking for tracheal deviation, jugular
following steps: (1) Ensure that there are no vein distension, and crepitus.
signs of infiltration at the site of the IV; 140. Subcutaneous emphysema is a crackling sound
(2) Check to make sure that all clamps are or sensation that is caused by air trapped
open; (3) Check to see if any of the IV underneath the skin.
tubing is kinked; (4) Check to see if the IV is 141. Ongoing assessments should be performed on
positional; (5) Drop the IV bag below the site all patients to determine if the treatments have
of the IV and assess for blood return in the been effective, find any changes that may occur
tubing; and (6) If there are any doubts as to the in the patients’ conditions, and identify any
functionality of the IV, turn off the fluid and other injuries or illnesses that may have been
remove the IV. overlooked during the initial assessments.
130. If a conscious pregnant patient is choking, 142. If a patient is unconscious or unable to
place two hands in the center of the chest and swallow, oral glucose must not be administered.
compress inward. The patient should not 143. A febrile seizure is a seizure caused by a rapid
increase in body temperature. It is usually
associated with an infection.

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–EMT PRACTICE EXAM 10–

144. When a patient is experiencing a seizure, 147. When considering what medication to
perform a scene size-up, take body substance administer to a patient, the six things that you
isolation precautions, protect the patient from must know include the correct patient, the
injuring him- or herself by moving objects that actions, the dose, the indications, the
he or she may strike or objects that pose a contraindications, and the route of the drug.
threat to his or her safety, and place something
soft beneath the patient’s head, if able to do so. 148. Some medications that an EMT may assist
Apply oxygen via non-rebreather mask, have administering include aspirin, albuterol inhaler
suction readily available, and prepare to or nebulizer, epinephrine auto injector,
transport. nitroglycerine, oral glucose, and oxygen.

145. The phase that immediately follows a seizure in 149. Common causes of shock in a pediatric patient
which the patient may continue to be are vomiting, trauma, diarrhea, blood loss, and
unresponsive or have an altered level of infection.
consciousness is called the postictal phase.
150. Epistaxis is a nosebleed.
146. Signs and symptoms of an envenomation
include swelling, pain, bite marks, chills,
weakness, nausea, vomiting, fever, dizziness,
tightness in the chest, and shortness of breath.

240

CHAPTER12 EMT
PRACTICAL
SKILLS EXAM

CHAPTER SUMMARY

This chapter presents the National Registry’s EMT practical
skills examination, which is used by many states and forms the
basis for the practical exam in many other states. Being famil-
iar with what will be expected of you—and knowing how the
practical exam is scored—will help your self-confidence when
you take the practical exam.

During your EMT training, you practiced various techniques and skills under a variety of conditions.
But during a practical examination for certification, conditions have to be standardized as much as
possible. The procedural guidelines that your examiners will be following will be sequential and often
stringent. You have to do things in a particular order, just as you are told. This means that testing can be stressful.
Proper preparation can help you overcome this stress.

The National Registry of Emergency Medical Technicians (NREMT) requires successful completion of a
state-approved practical examination that meets the NREMT’s minimum standards. The following ten skills are
tested because they are directly related to the potential loss of life or limb.

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–EMT PRACTICAL SKILLS EXAM–

• Patient Assessment/Management—Trauma The National Registry developed a sample prac-
• Patient Assessment/Management—Medical
• Bag-Valve-Mask Ventilation of an Apneic Adult tical examination to help states develop their EMT

Patient practical exam. Many states have adopted this sample
• Oxygen Administration by Non-rebreather
exam as their skills certification examination. Whether
Mask
your state uses the NREMT exam or has developed its
• Cardiac Arrest Management/AED
• Bleeding Control/Shock Management own EMT skills exam, the NREMT exam that follows
• Long Bone Immobilization
• Joint Immobilization will help you prepare for your practical examination.
• Note: Spinal immobilization is no longer
However, you should become familiar with your state’s
required by the NREMT but may still be a
required skill of the respective states. examination, local scope of practice, and treatment pro-

tocols before you take the exam.
The skills examination consists of seven

stations. Five of these stations are mandatory
stations, and one is a random skill station. The
stations and time limits are listed in the table on this
page.

STATION NREMT PRACTICAL SKILLS EXAM TIME
Station 1 SKILLS TESTED 10 minutes
Station 2 Patient Assessment/Management—Trauma 15 minutes
Station 3 Patient Assessment/Management—Medical
Station 4 Bag-Valve-Mask Ventilation of an Apneic Adult Patient 5 minutes
Station 5 Oxygen Administration by Non-rebreather Mask 5 minutes
Station 6 Cardiac Arrest Management/AED 10 minutes
Station 7 Spinal Immobilization – Supine Patient 10 minutes
Random Skill: 10 minutes

Spinal Immobilization – Seated Patient 10 minutes
Bleeding Control/Shock Management 10 minutes
Long Bone Immobilization 5 minutes
Joint Immobilization 5 minutes

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–EMT PRACTICAL SKILLS EXAM–

You will not be told which random skill you In addition, failure to perform critical criteria, listed
will be tested on before the examination. Many at the bottom of each skill-assessment sheet,
examiners will have you blindly select from skills constitutes failure of that station. All the necessary
listed on sepa-rate cards, or the coordinator may equipment will be provided for you at each station.
select one skill to administer to all candidates. You must follow proper body substance isolation
procedures for every skill.
This chapter contains the NREMT sample
practical examination and the instruction to the To access and download the actual NREMT
candidates. Generally, you can fail up to three skills Skill Sheets for the purposes of administering or
and retest those skills on the same day. Retests are practicing an NREMT equivalent psychomotor
proctored by a different examiner. Please refer to exam, visit www. nremt.org/nremt/about/
the Candidate General Instructions section for more psychomotor_exam_emt.asp.
detailed information.
Before you begin each station, ask any
It may be helpful to the examiner during the questions that you have; you will not be permitted to
examination process if you talk aloud while perform- ask questions during the assessment. Remember,
ing each skill. The examiner can then not only see good communication and critical-thinking skills are
what you are doing, but he or she can also hear what vital to successfully completing any practical
you are thinking as you go through the process. This examination.
might also help you stay on track during the skills
exam, as it might jog your memory of a missing or Remember this: “Practice makes perfect”
out-of-sequence step. Instructions for each station applies perfectly to the skills exam portion of any
are listed, along with the minimum score for each EMT testing process. The more times you can
station. rehearse these skills, the more comfortable you will
be when performing them in front of an examiner.
This translates directly to the field setting, where you
can be confident that your skills will be competent
when the patient needs them the most!

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–EMT PRACTICAL SKILLS EXAM–

EMT will offer to repeat the instructions and will ask you
Practical Examination if the instructions were understood. Do not ask for
additional information. Candidates sometimes com-
Candidate General Instructions plain that skill station examiners are abrupt, cold, or
Welcome to the EMT practical examination. I’m name appear unfriendly. No one is here to add to the stress
and title. By successfully completing this examination and anxiety you may already feel. It is important to
process and receiving subsequent certification, you will understand that the examiners have been told they
have proven to yourself and the medical community must avoid casual conversation with candidates. This
that you have achieved the level of competency assuring is necessary to assure fair and equal treatment of all
the public receives quality prehospital care. candidates throughout the examination. We have
instructed the skill station examiners not to indicate
I will now read the roster, for attendance pur- to you, in any way, a judgment regarding your per-
poses, before we begin the orientation. Please identify formance in the skill station. Do not interpret any of
yourself when your name is called. the examiner’s remarks as an indication of your
overall performance. Please recognize the skill sta-
The skill station examiners utilized today were tion examiner’s attitude as professional and objec-
selected because of their expertise in the particular tive, and simply perform the skills to the best of your
skill station. Skill station examiners observe and ability.
record your expected appropriate actions. They record
your performance in relationship to the criteria listed Each skill station is supplied with several types
on the evaluation instrument. of equipment for your selection. You will be given
time at the beginning of the skill station to survey and
The skill station examiner will call you into the select the equipment necessary for the appropriate
station when it is prepared for testing. No candidate, management of the patient. Do not feel obligated to
at any time, is permitted to remain in the testing area use all the equipment. If you brought any of your own
while waiting for his or her next station. You must wait equipment, I must inspect and approve it before you
outside the testing area until the station is open and can enter the skill station.
you are called. You are not permitted to take any
books, pamphlets, brochures, or other study materials As you progress through the practical examina-
into the station. You are not permitted to make any tion, each skill station examiner will be observing and
copies or recordings of any station. The skill station recording your performance. Do not let his or her
examiner will greet you as you enter the skill station. documentation practices influence your performance
The examiner will ask your name. Please assist him or in the station.
her in spelling your name so that your results may be
reported accurately. Each skill station examiner will If the station has an overall time limit, the exam-
then read aloud “Instructions to the Candidate” iner will inform you of this when reading the instruc-
exactly as printed on the instruction provided to him tions. When you reach the time limit, the skill station
or her by the examination coordinator. The informa- examiner will instruct you to stop your performance.
tion is read to each candidate in the same manner to However, if you complete the station before the allot-
ensure consistency and fairness. ted time, inform the examiner that you are finished.
You may be asked to remove equipment from the
Please pay close attention to the instructions, as patient before leaving the skill station.
they correspond to dispatch information you might
receive on a similar emergency call and give you You are not permitted to discuss any specific
valuable information on what will be expected of you details of any station with each other at any time.
during the skill station. The skill station examiner Please be courteous to the candidates who are testing
by keeping all excess noise to a minimum. Be prompt
244