EMT PRACTICE

–THE EMT PRACTICE EXAM 2–

89. An 11-month-old crying female has swallowed 93. A 5-year-old male is experiencing severe
a piece of a hot dog. She is coughing, and you respiratory distress. He is altered with poor skin
can hear high-pitched sounds coming from the signs. You should
throat. You should a. assist ventilations with a pediatric bag-valve
a. administer back blows and chest thrusts. mask and supplemental oxygen.
b. perform a blind finger sweep to attempt b. perform blind finger sweeps to attempt to
removal of the object. remove an obstruction.
c. provide high-concentration oxygen by blow- c. provide oxygen by pediatric nonrebreather
by mask. mask.
d. provide ventilations by bag-valve mask and d. provide oxygen by the blow-by method.
oxygen.
94. Fontanels are the
90. Your patient is a 26-year-old male who has a. strong contractions that signal the end
been in a motor vehicle accident. The patient’s of labor.
radial pulse is weak, while the carotid pulse is b. soft spots located on the infant’s head.
strong. You should c. blood vessels in the umbilical cord.
a. treat for signs and symptoms of shock. d. special forceps doctors use to assist the
b. recheck by taking the brachial pulse. delivery.
c. wait 15 minutes, then recheck vital signs.
d. check for low blood pressure on the 95. Where does blood travel when it leaves the
other arm. right ventricle of the heart?
a. to the pulmonary veins, then to the lungs
91. The sniffing position refers to the b. to the aorta, then out to the body
a. way children position themselves when c. to the vena cava, then to the left atrium
feeling respiratory distress. d. to the pulmonary arteries, then to the lungs
b. recovery position used for children in
respiratory distress. 96. The third stage of labor consists of the
c. position used to insert the oropharyngeal or a. delivery of the placenta.
nasopharyngeal airway. b. full dilation of the cervix.
d. position of the child's head for c-spine c. birth of the baby.
immobilization. d. onset uterine contractions.

92. Diastolic pressure is a measure of the 97. You have just assisted in the delivery of a
a. force exerted against the walls of the blood newborn who has good color, a strong pulse,
vessels when the heart contracts. and is not yet breathing. You should
b. force exerted against the walls of the blood a. suction the infant again.
vessels when the heart relaxes. b. slap the baby’s back vigorously.
c. rhythm and strength of the heart’s c. massage the baby’s back gently.
contractions during arterial circulation. d. provide artificial ventilation.
d. time it takes the capillary beds in the
extremities to refill after being blanched.

45

–THE EMT PRACTICE EXAM 2–

98. Amniotic fluid with a yellow or brownish color 102. Which of the following signs and symptoms
means a high likelihood of may indicate shock in children?
a. an alert mental state
a. miscarriage. b. increased urine output
b. infectious disease. c. excessive tear production
c. excessive bleeding. d. cool, clammy skin
d. fetal distress.

99. Your patient is a 68-year-old male who is 103. As an EMT, you are acting as a patient advocate
complaining of chest pain. Your focused when you
assessment findings include a pulse rate of 92, a a. document the care you provide.
BP of 140/90, and some difficulty breathing. b. treat patients with dignity and respect.
After administering oxygen, you should focus c. continue your education and training.
your questioning to determine if the patient has d. consult with medical direction in the field.

a history of 104. What are the earliest signs of shock?
a. asthma. a. fatigue and depression
b. diabetes mellitus. b. weak pulse and low blood pressure
c. cardiac problems. c. anxiety and tachycardia
d. strokes. d. cyanosis and shallow respirations

100. Your patient is a 24-year-old female who tells 105. The following are all effective techniques for
you that she is three months pregnant. She is stress reduction EXCEPT
experiencing profuse vaginal bleeding and a. getting more exercise.
severe cramping. After administering oxygen, b. seeking professional help.
you should c. working extra hours.
a. be alert for signs and symptoms of shock, d. eating a healthy diet.
and transport quickly.
b. prepare for an emergency on-scene delivery 106. It is necessary to wear a mask and eye
of a premature infant. protection when
c. attempt to stop the bleeding before a. transporting a patient.
transporting the patient. b. suctioning a patient.
d. place the patient on her left side and call for c. splinting a closed injury.
an ALS unit. d. administering oxygen.

101. Your patient is a 28-year-old pregnant female
who has just been in a minor car accident.
Which set of vital signs would be normal for
this patient?
a. pulse, 100; respirations, 14; BP, 108/72
b. pulse, 58; respirations, 24; BP, 118/78
c. pulse, 96; respirations, 8; BP, 124/86
d. pulse, 82; respirations, 22; BP, 140/96

46

–THE EMT PRACTICE EXAM 2–

107. Which statement about disposable gloves 111. Which of the following is NOT part of the
is correct? standard medical report you give to the
a. You should remove gloves by grasping the receiving facility?
ends of the fingers and pulling them off right a. mental status
side out. b. history of present illness
b. It is not necessary to wear gloves when c. medical diagnosis
suctioning or ventilating a patient with a d. vital signs
bag-valve-mask device.
c. Gloves protect both you and the patient 112. You are splinting the injured leg of a 5-year-old
from the transmission of infectious diseases. male. What should you say?
d. One pair of gloves is sufficient for any call, a. “If you don’t allow me to immobilize your
no matter how many patients there are. leg the pain will get much worse.”
b. “After I strap your leg to this board, it may
108. Which of the following situations illustrates help your leg feel better.”
implied consent? c. “Stop crying! I can’t work when you’re
a. You splint the broken arm and leg of a 6-year- making loud noises.”
old female with her mother’s permission. d. “Mom, if your child stops crying, I’ll explain
b. You care for a cardiac patient who asks you what I’m doing.”
to help him take a dose of nitroglycerin.
c. You arrive at the scene of a car crash, and the 113. Why is it important to maintain body heat in a
injured driver says,“Please help my child first.” patient with shock?
d. You provide life support to a man who was a. Shivering wastes vital oxygen and energy.
found unconscious by bystanders who b. Patients in shock often have fever as well.
called EMS. c. Blood congeals more easily when the body is
cold.
109. Placing a patient in the recovery position allows d. Hypothermia may increase the severity of
a. the patient to breathe more deeply. shock.
b. secretions to drain more easily.
c. the EMT to position the airway. 114. Which of the following is an example of a
d. the EMT to provide basic life support. subjective statement that could be included in a
prehospital-care report?
110. During the scene size-up, you should determine a. Bystander stated, “He was drunk as a skunk.”
whether the scene is safe to enter and whether b. Patient vomited two times during transport.
a. you need any additional help. c. Bystanders assisted EMTs in moving patient.
b. the patient’s ABCs are normal. d. Patient stated, "I think I have a fever."
c. you need to contact dispatch.
d. the patient is sick or a trauma victim.

47

–THE EMT PRACTICE EXAM 2–

115. Your patient has a wound on her anterior left 119. Your patient is a 6-year-old male who is having
lower leg that is spurting large amounts of a severe nosebleed. No trauma is suspected.
blood. Direct pressure alone is ineffective. What How should you treat this child?
is your next action to control the bleeding? a. Pinch his nostrils together and transport
a. Place a tourniquet proximal to the injury him sitting upright, leaning forward.
b. Apply indirect pressure to the left side of the b. Pack the nostrils with gauze and place the
groin patient in the recovery position.
c. Place a tourniquet distal to the injury c. Apply indirect pressure to the upper lip and
d. Apply indirect pressure to the popliteal have the patient lie supine.
artery d. Apply an occlusive dressing and place the
patient in the recovery position.
116. Your patient is an 84-year-old female who is
complaining of severe abdominal pain. The 120. How does cardiac pain differ from respir-
abdomen is rigid and tender. What should you atory pain?
suspect? a. Cardiac pain increases when the patient
a. cardiac disease breathes.
b. internal bleeding b. Cardiac pain is localized around the heart
c. pregnancy and arms.
d. thoracic aneurysm c. Cardiac pain does not change with
movement or palpation.
117. Which of the following is an example of care d. Cardiac pain generally occurs on the left side
that would be provided by the EMT performing of the chest.
triage at a mass-casualty incident?
a. covering the patient to prevent shock
b. opening the airway
c. starting CPR
d. applying PASGs

118. Which of the following describes an emergency
patient move?
a. The patient cannot be cared for adequately
in the present location.
b. Because of danger, there is no time to
immobilize the spine.
c. The patient is being moved to a more
comfortable location.
d. The patient is being moved against his or
her will.

48

–THE EMT PRACTICE EXAM 2–

Answers 8. b. Blood under the skin, appearing on the sur-
face as a bruise, is also known as ecchymosis.
1. a. Normal values for a newborn are: pulse,
120–160; respirations, 40–60; BP, 80/40. 9. c. Use palpation only when it is difficult to hear
the pulse, either because the setting is
2. c. Based on the information provided, the extremely noisy or because the patient’s
patient is breathing too quickly to provide his pulse is very weak.
own adequate ventilations. This patient can-
not be managed with a nonrebreather alone; 10. a. The other methods will provide an either too
artificial ventilations are needed to oxygenate large or too small measurement of an OPA.
the patient adequately.
11. c. You can omit the detailed physical exam if
3. d. Before transporting a patient without con- your patient shows no alterations in con-
sent, it is always best to seek medical direc- sciousness and if the mechanism of injury
tion. does not suggest high risk of trauma.

4. b. Based on the information provided, the 12. a. Ethics are the principles of conduct; con-
patient is ventilating adequately but has poor cerns for what are right or wrong, good or
skin signs, indicating inadequate perfusion. bad. Choice b describes morals, choice c is a
High-flow oxygen via a nonrebreather mask better description of bioethics, and choice d
should ensure that the patient is fully describes justice for the patient.
oxygenated.
13. c. The best way to monitor the patient’s mental
5. d. When assessing the carotid pulse, first locate status is to interact with the patient so that
the Adam’s apple and then slide two fingers you are immediately aware of any changes.
toward one side of the neck; never exert
strong pressure or assess the carotid pulse on 14. b. Assess the brachial pulse instead of the radial
both sides of the neck at the same time. or carotid in patients less than one year old.

6. a. Head injury, eye injury, or drug use may 15. a. Patient a, with elevated pulse and respiratory
cause the pupils to be nonreactive or rate and cool, clammy skin is showing early
unequally reactive. Shock, airway obstruc- signs of shock. Patients b and c have normal
tion, and cardiac arrest will cause both vital signs. Patient d has a normal pulse, low
pupils to dilate equally. blood pressure, and slow respiratory rate but
hot and dry skin, so shock is not clearly evi-
7. c. While it may be true that providing high lev- dent in this patient.
els of oxygen over prolonged time periods
may cause the hypoxic drive to fail, it is a 16. a. The most important sign of a diabetic emer-
rare occurrence in the prehospital field. With gency is altered mental status; patients may
the complaint of shortness of breath, it is appear intoxicated or act anxious or combat-
better to ensure that the patient is fully oxy- ive. Patients who present an altered level of
genated rather than taking a chance that she consciousness should have an evaluation for
is hypoxic. The EMT is prepared to ventilate diabetic emergency.
the patient if she goes into respiratory arrest
due to the high levels of oxygen. 17. a. While many EMS workers are understand-
ably concerned about HIV/AIDS, it presents
far less risk than hepatitis or TB because the
virus does not survive well outside the
human body.

49

–THE EMT PRACTICE EXAM 2–

18. a. A tort is a civil wrong committed by one sniffing position. For infants, the correct
individual against another. Improper or neg- position is the neutral position with padding
ligent patient care would be considered a placed below the shoulders and upper back.
tort. You should never flex the airway forward as
this will close off the airway. The recovery
19. a. The zygomatic bones are found in the face. position is used for spontaneously breathing
They are also known as cheekbones. patients to protect their airway.
29. b. Since most children have healthy hearts, they
20. c. Although all the choices can cause airway are most likely to suffer life-threatening
obstruction, the tongue is the most common respiratory emergencies prior to sudden car-
cause, especially in unconscious patients. diac death. It is recommended to perform
two minutes of CPR to see if that will revive
21. a. Infants and children are prone to breathing the patient prior to going for help or locating
difficulties because they have small air pas- an AED. Since the patient is suffering a life-
sages that are easily occluded; they also rely threatening condition, you would treat the
heavily on their diaphragms and suffer fre- patient under implied consent.
quent respiratory infections. 30. b. The patient should inhale deeply and hold
her breath to absorb the medicine.
22. a. The normal respiratory rate for an infant is 31. a. Agonal respirations are a sign that the
40–60/min. patient is nearing death. Because he is also
pulseless, begin CPR immediately.
23. b. Snoring indicates that the tongue has relaxed 32. c. Document all side effects of medication
into the upper airway, partially obstructing it. administration and report them to the
receiving facility; besides increased pulse rate
24. a. There are 33 vertebrae in the human spinal and nausea, other common side effects are
column. tremors and nervousness.
33. c. Because dentures can make it easier to
25. b. Gurgling is a sign that fluid is present in the obtain a good mask seal, you should remove
airway; the correct procedure is to immedi- them only if they become dislodged.
ately open and suction the airway. An airway 34. a. While b may seem correct, an AED cannot
adjunct may be used to assist in maintaining detect a pulse. It can only detect an orga-
airway patency once it is cleared. nized rhythm that may produce a pulse.
35. d. The normal respiratory rate for an adult is
26. a. According to the American Heart Associa- 12–20 breaths per minute, and chest-wall
tion, at least 800 mL of air should be deliv- motion should be regular and neither shal-
ered to the patient when using an adult low nor very deep. Patient a is breathing too
bag-valve mask. quickly for a 3-month-old (it should be
around 40 at this age), and the use of acces-
27. c. ATVs can allow EMTs to perform other sory muscles in the neck shows some level of
tasks, but the EMT must continually moni-
tor the patient to ensure that the rate and
tidal volume are adequate to ventilate the
patient, the ATV is not causing barotrauma,
especially in patients with poor lung compli-
ance, and that there is enough oxygen to
keep the ATV working.

28. b. A child’s head should be slightly hyperex-
tended for ventilation in a position called the

50

–THE EMT PRACTICE EXAM 2–

distress is present. Patient b has a slower The others have similar signs and symptoms,
than normal rate (it should be around 20), but the sudden onset, hypertensive emer-
and the irregularity and diaphragmatic gency, and the differing blood pressure in
nature suggest a spinal cord injury may be each arm points to the aneurysm.
present. Patient c is breathing much too fast 40. b. The white blood cells, which make up a part
(rate 12–20 for adults), and the shallow chest of the body’s immune system, fight
motions suggests insufficiency or distress. infections.
36. a. Patients experiencing a myocardial infarc- 41. d. In angina, unlike a heart attack, the reduced
tion, death of the myocardium, complain of blood flow to the heart does not result in
crushing chest pain lasting longer than 20 permanent damage.
minutes. This is one of the signs that help to 42. a. Do not administer nitroglycerin if the
differentiate between stable angina, chest patient’s systolic blood pressure is below 100
pain lasting less than 20 minutes or relieved mm Hg.
with rest, or an infarction. Polydipsia is 43. d. Before assisting a patient to administer
increased thirst and is found predominantly nitroglycerin, check for the right patient, the
in diabetic emergencies and hemiparesis is right route of administration, the right dose,
one-sided weakness predominantly found in and the expiration date.
stroke patients. 44. c. After verifying that there is no pulse and
37. b. A nonrebreather mask will not be adequate opening the airway, your first priority is to
to provide ventilations. Additional electrical attach the AED and determine if defibrilla-
shocks may actually send the patient back tion is required.
into a pulseless rhythm. 45. b. “Coffee-grounds” vomit is digested blood
38. a. When using a rigid catheter to suction and indicates the presence of internal bleed-
infants and small children, take care not to ing, as do abdominal tenderness and signs
touch the back of the throat, since stimula- and symptoms of shock. A ruptured appen-
tion here can cause bradycardia due to stim- dix and fractured pelvis will not cause bleed-
ulation of the vagus nerve. Touching the ing into the gastrointestinal (GI) tract.
back of the throat or around the base of the Ingested poisoning may or may not result in
tongue in any patient can trigger a gag, GI bleeding, but inhaled poisoning will
which could lead to vomiting, but the result in respiratory problems.
chance of this is not any greater in pediatric 46. c. This woman shows classic signs of cardiac
patients. The tongue cannot “fall into the compromise: dull chest pain, sudden onset
airway”; however, in the absence of proper of sweating, and difficulty breathing.
positioning, a flaccid tongue can relax into a 47. a. The vena cava carries oxygen-poor blood
position that could lead to obstruction of from the body to the right atrium, so it can
the airway. be transported to the right ventricle and
39. d. The signs and symptoms are indicative of a from there to the lungs.
dissecting aortic aneurysm, which requires 48. c. Central pulses may be palpated at the carotid
immediate rapid transport to the hospital. artery in the neck and at the femoral artery

51

–THE EMT PRACTICE EXAM 2–

in the groin. The brachial and radial pulses 57. d. You auscultate (listen with a stethoscope)
are peripheral pulses. through the chest wall to determine if breath
49. b. The diastolic blood pressure represents the sounds are present and equal on both sides
pressure in the brachial artery when the ven- of the chest. As you are listening, you may
tricles are at rest (diastole). also note the relative rate and quality of
50. c. Stridor, a harsh sound usually heard during breathing, but those are secondary reasons
inspiration, is a sign of upper-airway for listening to the chest wall. If you are hav-
obstruction. ing trouble determining the respiratory rate
51. c. Assess onset by asking when the pain began when you are performing vital signs, you can
and how long it took to reach its greatest listen to one side of the chest wall to deter-
severity. mine the respiratory rate.
52. b. A patient may take up to three doses of nitro-
glycerin, each dose three to five minutes 58. d. Bleeding control with spurting blood carries
apart. The blood pressure should be greater maximum danger of contamination; there-
than 100, and the pulse rate should be greater fore, maximum protection is required. Air-
than 60. Nitroglycerine use is contraindicated way suctioning or intubation does not
in children. generally require a gown. Cleaning of con-
53. a. Pelvic fractures carry danger of severe inter- taminated instruments does not generally
nal bleeding. require eye/facial protection.
54. b. The back of an infant’s head (occiput) is rel-
atively larger compared with an adult’s. Plac- 59. b. An EMT may help a patient in respiratory
ing the infant on his or her back, without difficulty to administer an inhaler if the
shoulder padding, may cause the head to tilt inhaler was prescribed for that patient and
forward excessively, closing the airway. medical direction is obtained. In some juris-
55. c. A barrel chest is associated with a long his- dictions, you may have standing orders to
tory of respiratory disease, such as bronchi- assist the patient, which means medical
tis, emphysema, or COPD. Because the direction is provided ahead of time in the
alveoli are not functioning properly, air trap- standing order. It is important for you to
ping occurs in the lungs. The increased effort determine how many doses she has already
it takes to move air in and out of the lungs taken (choice a), but you must first deter-
results in an overdevelopment of the chest mine if the medication she took was pre-
muscles and in time, leads to the barrel- scribed to her before you can assist her
shaped appearance. further. The standard dosing regimen for an
56. d. You should apply the AED as if there were EMT assisting with a prescribed inhaler is to
pediatric pads and defibrillate when indi- provide a total of two doses, one every three
cated. The child is too small to place both minutes.
pads on the anterior chest and new biphasic
AEDs read the impedance of the patient and 60. d. After helping a patient take prescribed nitro-
deliver and appropriate level of energy. glycerin, reassess vital signs and chest pains;
a second dose may be given three to five
minutes later.

52

–THE EMT PRACTICE EXAM 2–

61. b. The AED can detect only the electrical activ- bility of a diabetic emergency as it is a more
ity within the patient’s heart. It does not common occurrence. An allergic reaction
assess rate, mechanical activity (pumping will not cause the sudden onset of altered
action), or the degree of cardiac mental status.
compromise. 69. c. This patient is most likely suffering from
congestive heart failure and his treatment
62. d. If life-threatening conditions are present, should include positioning him in Fowler’s
you should focus on those injuries or begin position (sitting up), high-flow oxygen via
to package the patient for rapid transport if NRB at 10–15 lpm, and, if allowed by medi-
you cannot manage her life-threatening cal control, the use of CPAP may prevent
problems. other more invasive airway management.
Elevating the patient’s legs will exacerbate his
63. d. COPD is unlikely to occur in pediatric respiratory compromise. His MDI is not
patients. The other three choices may cause indicated and 2–4 lpm oxygen is too low for
some level of respiratory distress in the pedi- his condition.
atric patient. 70. b. Talk quietly with the patient to help her
remain calm and persuade her to seek medi-
64. a. A seesaw pattern is a sign of breathing diffi- cal help. Be on guard for a violent outburst.
culty in infants. Restraints and police backup are not neces-
sary to manage this patient. Asking too many
65. b. The best treatment for cardiac arrest in the personal questions may agitate her.
pediatric patient is to prevent it all together. 71. a. This patient may be experiencing internal
This can occur through aggressive public bleeding and possible signs of shock. High-
education and prevention programs or flow oxygen is warranted.
aggressive treatment of respiratory illnesses 72. b. In shock, the body attempts to preserve per-
that could deteriorate into cardiac arrest. fusion by shunting blood away from the skin,
increasing heart rate and increasing respira-
66. b. As the body tries to compensate for a decrease tory rate.
in oxygen levels in the blood stream, the heart 73. a. The central nervous system consists of the
will try to beat more quickly to circulate brain and the spinal cord.
blood to the cells more quickly. The skin will 74. b. Even if the patient has extricated himself
also turn pale and cool as the body shifts from the car, immobilize him to a long spine
blood flow back to the critical organs. The board if the mechanisms of injury lead you
patient will also breathe more quickly to to suspect spine damage. A standing take-
draw in more oxygen and expel more carbon down will allow you to immobilize the
dioxide. patient from the standing position.
75. d. The patient’s condition has become unstable;
67. d. If a patient is immobilized to a long board, you should treat her for shock and reassess
you can tilt the entire board to clear the every five minutes. She should already be on
airway.

68. c. Sudden onset of altered mental status
strongly suggests diabetic emergency. Alco-
hol intoxication will have a slower onset.
Poisoning may also cause altered mental sta-
tus, but you should first rule out the possi-

53

–THE EMT PRACTICE EXAM 2–

oxygen. Alert medical control of your find- signs of labored breathing, such as supracla-
ings, but permission is not needed to treat vicular and intercostal retractions.
this patient for shock. Because she is unsta-
ble, 15 minutes is too long a time period to 83. b. Water or air in the stomach caused by invol-
go between vital signs assessments. untary swallowing during a drowning epi-
76. a. The other choices do not make sense as sode may cause the stomach to expand and
potential signs or symptoms of hypothermia. press against the diaphragm, making it diffi-
As blood flow to the brain diminishes, cult to ventilate the lungs.
altered mental status may occur, causing
confusion and eventually unconsciousness. 84. c. The correct rate of providing artificial venti-
77. c. Indications for use of epinephrine are signs lations to children is 20 breaths per minute,
and symptoms of respiratory distress or or one breath every three seconds.
hypoperfusion (shock). Glucose is indicated
for diabetic patients. There are no medica- 85. d. In an unresponsive choking infant, you switch
tions (other than oxygen) indicated for use from chest compressions and back blows, to
by EMTs in the treatment of cardiac arrest doing CPR, which includes 30 chest compress-
patients. ions, looking into the mouth and only sweeping
78. c. Patients with early hypothermia have a rapid if you see object, and then attempting two
pulse and respiratory rate and red skin; patient breaths. You then go back to chest compress-
a has the signs of late hypothermia. Patient d ions. Chest compressions w./ back blows are
has hyperthermia. Patient b has normal vital only used on an infant who is still unresponsive.
signs.
79. b. This patient is in late stages of respiratory 86. d. Ventricular fibrillation (V-Fib) is a disorga-
distress. Simply providing oxygen without nized and ineffective pumping of the ventri-
ventilation will be inadequate for this child’s cles wherein the electrical activity originates
needs. in multiple places throughout the ventricles.
80. d. The most important principle of care for Choice a is tachycardia, b is ventricular
patients with severe hypothermia is to pre- tachycardia, and c is bradycardia.
vent further heat loss by removing the
patient from the cold environment; active 87. b. Seizures, seen as body stiffness and/or shak-
rewarming should be done in the hospital.
81. c. The National Incident Management System ing, are a common side effect of high fevers
is a coordinated system of procedures that in infants and small children.
provides standardization and flexibility, 88. a. A dry diaper and absence of tears when the
which allows for orderly communications infant cries are signs of dehydration, a cause
and decision making among varied agencies of hypovolemic shock.
in response to a disaster. 89. c. The patient is not experiencing a complete
82. d. In infants and children, who rely heavily on foreign-body airway obstruction, and she
the diaphragm for breathing, abdominal appears to be ventilating adequately. There-
breathing is normal in the absence of other fore, oxygen provided with a blow-by mask will
help ensure adequate oxygenation.
54
90. a. Suspect shock (decreased tissue perfusion)
whenever the distal pulse is weaker than the
central pulse. Low blood pressure is a late sign
of shock; do not wait to treat the patient for
shock until the blood pressure drops.

–THE EMT PRACTICE EXAM 2–

91. a. The sniffing position refers to one of the ways history of cardiac disease and if the patient
that children naturally position themselves has a prescription for nitroglycerin.
when they are struggling to breathe. The 100. a. The patient is likely to be experiencing a
position aligns their airway in such a way miscarriage; shock is possible. If she delivers,
that they can move more volume in and out. the child will be too small to survive. There
is no method to stop the bleeding in the pre-
92. b. Diastolic pressure is a measure of the force hospital setting. There is no need to place
exerted against the walls of the blood vessels her in the left lateral recumbent position.
when the heart muscle relaxes; it is thus the 101. a. It is normal for a pregnant woman to have a
lower of the two numbers that make up a slightly increased pulse and decreased blood
blood pressure reading. Choice d describes pressure. The respiratory rate of patient b is
the capillary refill test. The force of arterial too fast. Patient c has a too slow respiratory
circulation is not assessed in the prehospital rate, and patient d is hypertensive and has a
setting as it requires very invasive respiratory rate that is too high.
procedures. 102. d. Blood is shunted away from the skin early in
children with shock, causing it to pale,
93. a. With the patient being altered in his mental become cool, and sweat.
status, it appears that he is not ventilating 103. b. Acting as a patient advocate means treating
adequately. A nonrebreather mask will not all patients as you would like to be treated
be able to ventilate the child appropriately. yourself.
There is no information to indicate a 104. c. The earliest signs of shock are subtle changes
foreign-body obstruction. in mental status, such as anxiety and restless-
ness, and tachycardia. Fatigue and depression
94. b. The fontanels are the soft spots on the baby’s are not common signs of shock. Cyanosis is
head where the bony parts of the skull have not one of the earliest signs, and shallow res-
not yet grown together, allowing the head to pirations can occur any time during the
contract somewhat during delivery. shock process. Low blood pressure is a late
sign of shock.
95. d. Oxygen-poor blood arrives in the right 105. c. Effective stress-reduction techniques include
atrium and is pumped out through the right balancing work and recreation, getting
ventricle via the pulmonary arteries to the enough rest, eating a healthy diet, getting
lungs. regular exercise, and seeking help if
necessary.
96. a. The third stage of labor consists of the deliv- 106. b. Wear a mask and eye protection when there
ery of the placenta after the baby is delivered. is a high probability of splattering, such as
when suctioning a patient.
97. c. To stimulate a healthy newborn to breathe, 107. c. Because gloves protect both you and your
rub his or her back, or flick the soles of his or patients, most protocols now call for EMTs
her feet. to wear gloves for any patient contact.
Remove gloves by pulling them off inside
98. d. Meconium, or fetal stool, appears as yellow,
brown, or green material in the amniotic
fluid. When present, it is associated with an
increased risk of fetal distress.

99. c. For a patient such as this one who is display-
ing signs and symptoms of cardiac compro-
mise, use the SAMPLE survey to focus your
questioning to determine if there is any past

55

–THE EMT PRACTICE EXAM 2–

out, so you do not touch the soiled outer among elderly patients; symptoms are
surface; change gloves for each new patient abdominal pain, tenderness, and rigidity.
contact. This patient is too old to be pregnant. A tho-
108. d. Implied consent means that, because your racic aneurysm will not cause abdominal
adult patient cannot give consent to treat- distension.
ment, you act without it. 117. b. Only the most critical care, such as opening
109. b. The recovery position, with the patient on the airway to assess respirations, is provided
the left side with the left arm under the head, during triage. Unfortunately, CPR cannot be
allows secretions to drain more easily from started by the individuals performing triage.
the airway. 118. b. An emergency move is one required to
110. a. During scene size-up, determine whether the remove the patient from imminent danger,
scene is safe for you to enter, the number of such as a fire, or when you must move a
patients, if you have the appropriate BSI patient to gain access to other critically
equipment and precautions, and whether wounded patients. You should stabilize the
you will need backup from additional EMS head and neck with your hands, and if possi-
units or other services. ble, apply a cervical collar before moving the
111. c. The EMT’s report should not include a diag- patient.
nosis, but rather a complete description of 119. a. For a nosebleed, when no trauma is sus-
the patient’s condition. pected, have the patient sit up and lean for-
112. b. Always speak directly to the patient, and ward to prevent blood from entering the
explain what you are doing in words he or airway and gently pinch the nostrils together.
she can understand. If the parent is present, 120. c. Cardiac pain, unlike respiratory pain, usually
explain your treatment to him or her as well. is not increased by movement or palpation;
113. a. Blood carries heat, and a loss of blood will it is more diffuse than respiratory pain and
result in a drop in body temperature. Shiver- may be felt in the shoulder, neck, and jaw, as
ing, the body’s response to cold, increases well as in the chest.
metabolism by wasting oxygen and energy
that would be better spent in fueling hypoxic
cells.
114. d. This is a subjective statement. Statement a is
inappropriate and unnecessary. Statements b
and c are objective statements.
115. a. A tourniquet is now the next step in hemor-
rhage control for arterial bleeding. The tour-
niquet should be placed proximal to the
injury and in accordance with your local
protocol.
116. b. Internal bleeding caused by the rupture of an
abdominal artery is an occasional emergency

56

CHAPTER 4 EMT
PRACTICE EXAM 3

CHAPTER SUMMARY

This is the third of ten practice exams in this book based on the
National Registry’s EMT cognitive exam. Use this test to identify
which types of questions continue to give you problems.

You should now be familiar with the format of the National Registry’s EMT exam. Your practice test-
taking experience will help you most, however, if you have created a situation as close as possible to
the real one.
For this third exam, simulate a real test. Complete the test in one sitting, setting a timer or a stopwatch.
You should have plenty of time to answer all of the questions when you take the real exam, but be sure to
practice maintaining your concentration and maintaining a steady pace.

Following the exam is an answer key, with all the answers explained. These explanations will help you
see where you need to concentrate further study. When you’ve finished the exam and scored it, note your
weaknesses so that you’ll know which parts of your textbook to concentrate on before you take the remaining
exams.

57

Blank Page

–EMT PRACTICE EXAM 3–

EMT Practice Exam 3 5. While evaluating your 56-year-old male patient
with chest discomfort, he suddenly collapses
1. Which set of vital signs is within normal limits? and becomes unconscious. He is apneic and
a. newborn: pulse, 100; respirations, 36/min; pulseless. Which of the following will most
BP, 60/30 likely reverse this condition?
b. 3-year-old male: pulse, 98; respirations, a. Provide high-flow oxygen with a
27/min; BP, 84/48 nonrebreather mask.
c. 9-year-old female: pulse, 118; respirations, b. Begin chest compressions at a rate of 80
24/min; BP, 120/80 beats per minute.
d. 24-year-old male: pulse, 92; respirations, c. Begin the process of defibrillating the patient
26/min; BP, 112/70 with an AED.
d. Ventilate the patient with a pocket mask and
2. Use of accessory muscles, grunting, and stridor supplemental oxygen.
are all signs of
a. labored respirations. 6. Your patient is a 67-year-old female whom you
b. noisy respirations. found in cardiac arrest. You have resuscitated
c. shallow respirations. her by using an AED and are now transporting
d. agonal respirations. her. If she again becomes pulseless, you should
a. request online medical direction.
3. You assess the color, temperature, and b. stop the ambulance and use the AED.
condition of a patient’s skin to gather c. begin CPR and continue en route.
information about his or her d. defibrillate quickly while en route.
a. capillary refill.
b. heart rate. 7. Which trauma patient is at greatest risk for
c. perfusion. serious injury?
d. respiration. a. 43-year-old male, who fell seven feet from a
stepladder
4. Which statement about assessing blood b. 24-year-old female, involved in a moderate-
pressure is correct? speed vehicle collision
a. If you obtain one normal reading, it is not c. 17-year-old male, who fell off a bicycle onto
necessary to reassess blood pressure. concrete
b. A single reading is not as useful as multiple d. 5-year-old female, involved in a moderate-
readings used to look for a trend. speed vehicle collision
c. Variations of more than 5 mm Hg from
normal is considered very significant.
d. Assess blood pressure by palpation only
when the patient is in a quiet place.

59

–EMT PRACTICE EXAM 3–

8. A bystander is doing CPR on a patient in 12. You are treating a 39-year-old female who has
cardiac arrest. You size up the scene, practice been in a motor vehicle accident. She has a
body substance isolation, and begin your initial suspected broken arm and leg, moderate
assessment by having the bystander bleeding from the leg wound, and signs and
a. verify pulselessness. symptoms of early shock. Vital signs are pulse,
b. continue CPR. 96 and thready; respirations, 28 and shallow;
c. stop CPR. BP, 110/78. Your treatment should focus on
d. provide a history of cardiac arrest. a. stabilizing the patient and transporting her
to the hospital.
9. Your patient, a trauma victim, has flat jugular b. carefully splinting and bandaging all the
veins while she is lying down. What is this a patient’s injuries.
sign of? c. performing a detailed trauma assessment in
a. increased intracranial pressure the field.
b. respiratory distress d. opening the airway and monitoring vital
c. spinal injury signs every 15 minutes.
d. severe blood loss
13. You are en route to the receiving facility with a
10. The myocardium generates its own impulse to 71-year-old male patient with a history of heart
cause coordinated contractions so the heart can disease. The patient’s distress has been relieved
pump blood throughout the body. The normal with nitroglycerin, and his vital signs are stable.
electrical pathway is How often should you reassess the patient’s
a. AV Node, Bundle of His, SA Node, and vital signs?
Purkinje Fibers. a. every five minutes or more often
b. SA Node, AV Node, Bundle of His, and b. every 15 minutes
Purkinje Fibers. c. every 30 minutes
c. SA Node, Bundle of His, AV Node, and d. There is no need to reassess a stable patient.
Purkinje Fibers.
d. SA Node, Purkinje Fibers, Bundle of His, 14. The major purpose of the EMT’s interactions
and AV Node. with a patient during transport is to
continuously evaluate the patient’s
11. The valve between the right atrium and the a. mental status and airway.
right ventricle is the b. pulse and respirations.
a. tricuspid valve. c. anxiety and restlessness.
b. pulmonary valve. d. skin color and pupils.
c. mitral valve.
d. aortic valve.

60

–EMT PRACTICE EXAM 3–

15. Your trauma patient has an amputated foot. 19. The proper hand position for providing chest
How should you care for an amputated foot? compressions for a child is
a. Wrap it in a sterile dressing, then in plastic, a. two hands on the sternum two fingers below
and keep it cool. the sternal notch.
b. Immerse it in a tub of ice water and b. the heel of one hand on the sternum just
transport it with the patient. above the nipple line.
c. Put it inside the PASG and inflate the other c. the heel of one hand on the middle of the
leg of the garment. sternum in between the nipples.
d. Put the foot back on the leg and then splint d. the heel of one hand on the lower half of the
it in place. sternum over the xyphoid process.

16. If a patient’s respiratory rate is irregular, you 20. The main purpose of the detailed physical
should count the respirations for how long? examination is to
a. 15 seconds and multiply by four a. reveal hidden or less obvious injuries.
b. 30 seconds and multiply by two b. detect changes in the patient’s condition.
c. one full minute c. obtain a complete medical history.
d. two full minutes d. check vital signs and breath sounds.

17. Which patient’s vital signs are abnormal? 21. While performing a rapid trauma assessment
a. 67-year-old male: pulse, 68; respirations, 15; of a patient who was injured in a motor vehicle
BP, 130/88 accident, you note paradoxical motion. This
b. 44-year-old female: pulse, 92; respirations, indicates the presence of
22; BP, 120/80 a. pelvic fracture.
c. 14-year-old male: pulse, 88; respirations, 18; b. internal bleeding.
BP, 110/70 c. chest injury.
d. 7-year-old female: pulse, 100; respirations, d. head injury.
23; BP, 96/50
22. The glottis is the
18. Which statement about the assessment of a a. soft tissue at the base of the tongue.
patient with cardiac compromise is correct? b. nasopharynx and oropharynx.
a. You cannot determine the degree of cardiac c. midaxillary intercostal muscles.
damage in the field. d. opening between the pharynx and the
b. You should not ask patients about trachea.
nitroglycerin or other drug use.
c. The purpose of the focused history is to
determine whether to use the AED.
d. Patients usually describe cardiac pain as
localized and moderately severe.

61

–EMT PRACTICE EXAM 3–

23. Your patient is a 19-year-old male who has 27. While suctioning, if you cannot clear a patient’s
been in a motorcycle crash. Vital signs are mouth in 15 seconds, you should
pulse, 92 and weak; respirations, 24 and a. immediately suction the airway again.
shallow; BP 116/80. He has a suspected spinal b. suction the nose along with the mouth.
injury, as well as a painful, deformed, swollen c. suction for 15 more seconds and reassess.
right foot. Blood loss is not significant. What d. logroll the patient to clear the mouth.
should your treatment plan focus on?
a. immobilizing the injured foot in position of 28. A 65-year-old female is complaining of chest
function pressure, difficulty breathing, and is pale. She
b. immobilizing the patient and transporting presents supine in bed. What should you do
him rapidly before sitting her up?
c. opening the airway and ventilating the a. Check her blood pressure to make sure it is
patient adequate.
d. applying the PASG and inflating all b. Do nothing; sit her up right away.
compartments c. Help the patient administer her own
nitroglycerin tablets.
24. What is the general rule for administration of d. Check her pupils to make sure they are reac-
oxygen in the field? tive.
a. Administer high-flow oxygen only under
specific online medical direction. 29. Your patient is a 20-year-old male who has been
b. Do not administer high-flow oxygen to in a motorcycle accident. Because of clues from
children, elderly, or pregnant patients. the mechanism of injury on the scene, spinal and
c. Do not administer high-flow oxygen to head injuries are suspected. After your initial
patients with obvious signs of shock. assessment, how often should you reassess vital
d. Administer oxygen to all patients who are in signs?
respiratory distress. a. after every intervention
b. every 15 minutes
25. The use of reasonable force when dealing with c. continuously during transport
a patient with a behavioral disorder refers to d. every 30 seconds
a. the force necessary to incapacitate the
patient.
b. calling in police backup in a reasonable way.
c. using soft restraints rather than handcuffs.
d. the force necessary to restrain the patient.

26. Rapid onset of altered mental status in a
diabetic patient often results when the patient
a. decreases their insulin dose.
b. gets too little exercise.
c. skips a meal.
d. drinks alcohol.

62

–3EMT PRACTICE EXAM 3–

30. A 70-year-old male is complaining of chest 33. Your patient, a 45-year-old female, is still
pain and shortness of breath. He is alert with seated in her car after a crash. She does not
pale, cool, sweaty skin. His pulse is 100; BP, appear to be in a life-threatening situation.
136/64; and respirations, 24. Upon However, she does complain of significant
auscultation, you can hear crackles in the lung neck and back pain with movement. What
fields. Which of the following actions would be technique should you use to immobilize her
appropriate?
a. Have the patient lie flat because he could be spine?
in shock. a. Logroll her directly onto the ground; then
b. Provide oxygen at 2 L/min using a nasal
cannula. apply a long spine board.
c. Administer nitroglycerin that is prescribed b. Have her get out of the car; then
to the patient’s wife.
d. Have the patient sit up to assist with his immobilize her while standing.
breathing effort. c. Apply a cervical collar before assisting her

31. Your patient is a 23-year-old male who has out of the car.
suffered possible spinal trauma while playing d. Apply a short spine board and then transfer
football. He is still wearing his sports helmet as
you begin your initial assessment. When should her to a long spine board.
you remove his helmet?
a. when it is time to apply a cervical collar 34. Your patient is a 68-year-old female with
b. if it prevents you from assessing the airway chronic respiratory disease. She is exper-
c. before you position him on the long board iencing difficulty breathing in spite of home
d. when you assess his level of consciousness oxygen delivery. You should

32. You would assess a patient’s breath sounds by a. increase the flow rate of her oxygen supply.
placing your stethoscope over the midaxillary b. replace her nasal cannula with a face mask.
line and the c. consult medical direction for instructions.
a. midclavicular line. d. treat the patient for the signs of shock.
b. sternum.
c. cricoid notch. 35. In which situation should you assist a patient
d. xiphoid process. with using a prescribed inhaler?
a. 47-year-old male: history of severe asthma;
respirations, 28/min; wheezing, unresponsive
b. 6-year-old female: history of upper-
respiratory infection; respiratory rate,
24/min; coughing up blood.
c. 69-year-old male: history of emphysema;
difficulty breathing; inhaler was prescribed
for his son

d. 14-year-old female: history of asthma;
respirations, 24/min; alert; used the inhaler
one time yesterday

63

–EMT PRACTICE EXAM 3–

36. Your patient is showing signs of possible 41. All of the following are signs of inadequate
carbon monoxide poisoning. What should be breathing EXCEPT
your first concern on this call? a. slow rate of breathing.
a. Secure the safety of yourself, other people, b. cool, clammy skin.
and the patient. c. respiratory rate of 12–20.
b. Open the airway and administer supplemen- d. shallow breathing.
tal oxygen.
c. Transport the patient rapidly to the closest 42. Which of the following lists the correct order
facility. for cardiopulmonary circulation?
d. Obtain medical direction to administer a. vena cava, left atrium, left ventricle,
activated charcoal. pulmonary veins, lungs, pulmonary arteries,
right atrium, right ventricle, aorta
37. Which patient’s respiratory rate is normal? b. aorta, right ventricle, right atrium,
a. 4-year-old male: respirations, 38/min pulmonary arteries, lungs, pulmonary veins,
b. 11-year-old female: respirations, 12/min left ventricle, left atrium, vena cava
c. 27-year-old male: respirations, 14/min c. aorta, right atrium, right ventricle,
d. 82-year-old female: respirations, 10/min pulmonary veins, lungs, pulmonary arteries,
left atrium, left ventricle, vena cava
38. In order to control the flow rate of oxygen to d. vena cava, right atrium, right ventricle,
the patient, you must pulmonary arteries, lungs, pulmonary veins,
a. select the right size tank. left atrium, left ventricle, aorta
b. select the right size tubing.
c. open the valve on the tank. 43. If a clinical problem is identified in the EMS
d. adjust the regulator setting. service, a plan is developed and implemented
to reduce further occurrences of the same
39. The airway of a child can become easily problem. This is called
obstructed because, in comparison with an adult, a. quality improvement.
a child has a b. call-sheet review.
a. shorter airway and more secretions. c. ongoing system redesign.
b. narrower airway and larger tongue. d. quality assurance.
c. smaller nose and mouth.
d. faster breathing rate.

40. The major hazard associated with using and
transporting oxygen tanks is that they can
a. fail to function properly if chilled.
b. leak and emit poisonous fumes.
c. explode if dropped or handled roughly.
d. run out of battery power at any time.

64

–EMT PRACTICE EXAM 3–

44. You have been called for an infant who is 48. Your patient is a 67-year-old female with chest
choking. Upon your arrival, you notice the pains and a history of heart disease. After
infant is cyanotic, unresponsive, and apneic. helping her take a dose of prescribed
Where will you check for a pulse on your nitroglycerin, you find that her blood pressure
patient? is 96/68 and she is still in severe pain. Medical
a. At the carotid artery closest to you direction tells you to administer a second dose
b. At the brachial artery of nitroglycerin and transport. You should
c. At the carotid artery opposite to you a. administer the medication and document
d. At the femoral artery the vital signs and the order.
b. repeat the blood pressure reading and the
45. Perfusion is defined as order to medical direction.
a. the amount of blood pumped through the c. ask to speak to a senior physician.
body in one minute. d. request advanced cardiac life support
b. the exchange of gases, nutrients, and waste (ACLS) backup immediately.
between the alveoli and the capillaries.
c. the amount of blood pumped into the 49. In the case of children, airway adjuncts are
system with each beat. used when the
d. the exchange of gases, nutrients, and waste a. child is in respiratory distress and needs
between the cells and the capillaries. supplemental oxygen.
b. usual means of opening and maintaining the
46. You would evaluate the severity of a patient’s airway are ineffective.
hyperthermia by assessing the c. child is frightened of the oxygen mask and
a. temperature of the skin. nasal cannula.
b. color of the skin. d. respiratory rate is less than 20/min or greater
c. blood pressure and heart rate. than 60/min.
d. presence of muscle cramps.
50. You should select the correct size
47. Your patient is a 79-year-old male who is oropharyngeal airway for a child by measuring
experiencing chest pain. Which question would from the
you ask to investigate the O part of the a. angle of the jaw to the corner of the mouth.
OPQRST acronym? b. central incisor to the angle of the jaw.
a. Have you ever felt this kind of pain before? c. central incisor to the tragus of the ear.
b. Where were you when the pain started? d. corner of the mouth to the cricoid cartilage.
c. How long ago did the pain begin?
d. What does the pain feel like? 51. Cool, clammy skin that is a sign of shock
results from
a. a rise in the patient’s temperature.
b. the body’s attempt to increase the vascular
space.
c. decreased heart rate and blood pressure.
d. diversion of blood flow to the vital organs.

65

–EMT PRACTICE EXAM 3–

52. Delayed capillary refill is a reliable test of 56. The formation of plaque, through the buildup
peripheral circulation in of calcium and fatty deposits, in the arteries
a. elderly patients. which may lead to the formation of
b. infants and children. thromboemboli is called which of the
c. patients in early shock. following?
d. pregnant women. a. Angina
b. Arterial dissection
53. Your medical patient is experiencing clinical c. Aortic aneurysm
signs of shock. You should d. Atherosclerosis
a. lay the patient flat on his stomach.
b. lay the patient flat on his back. 57. You are treating a patient who is conscious,
c. sit the patient up. alert, and oriented times four. The patient is
d. lay the patient flat on his back with legs complaining of crushing chest pain that
elevated. radiates to the left jaw that has lasted more
than 30 minutes and is unrelieved by rest. The
54. You are treating a patient who is anxious, has an patient’s skin is diaphoretic. You have placed
altered mental status, complains of shortness of the patient on oxygen and medical control has
breath, and is sitting up in bed. You assess vital ordered the administration of aspirin. What are
signs and obtain a pulse of 112 and weak, blood the actions of aspirin in the treatment of
pressure is 88/60, respirations are 28, shallow, cardiac related chest pain?
and labored, skin is pale, cool, and clammy, and a. Fever reduction
breath sounds reveal crackles in all lobes. What b. Decreases the ability of platelets to clot
type of shock is this patient exhibiting? c. Inhibits the release of thrombin and breaks
a. Obstructive up the clot
b. Anaphylactic d. Inhibits the action of fibrin and decreases
c. Cardiogenic the ability of clots to form
d. Distributive
58. A 14-year-old female is unconscious after a
55. Bleeding caused by a wound to one large artery 15-foot fall off a ladder. When evaluating her
or vein can usually be controlled by chest during a rapid trauma assessment, you
a. concentrated direct pressure. should assess for
b. diffuse direct pressure. a. paradoxical motion.
c. pressure points. b. jugular vein distention.
d. extremity elevations. c. softness.
d. distention.

66

–EMT PRACTICE EXAM 3–

59. Your patient is a 62-year-old male who has 62. The outer layer of the heart is called the
survived a serious car crash. He is unconscious, a. parietal pleura.
cyanotic, and bleeding profusely from a thigh b. peritoneum.
wound. Breathing is rapid and shallow. Other c. myocardium.
injuries are suspected. In which order should d. pericardium.
you provide care?
a. open the airway and provide oxygen, control 63. Your patient has a painful deformity of the
bleeding, immobilize, transport right lower leg. The pulse in the right posterior
b. immobilize, control bleeding, transport, tibial artery is missing. Before splinting the
open the airway and provide oxygen injured leg, you should
c. open the airway and provide oxygen, a. use gentle traction to attempt to align the
immobilize, control bleeding, transport limb.
d. control bleeding, open the airway and b. apply a tourniquet to stop internal bleeding.
provide oxygen, immobilize, transport c. check the right brachial pulse as well.
d. place the right foot in the position of
60. For which type of wound should you use an function.
occlusive dressing that is taped on only three
sides? 64. Which symptoms are signs of a partial
a. an impaled object upper-airway obstruction due to the presence
b. a sucking chest wound of a foreign body?
c. an abdominal evisceration a. increased work of breathing during
d. an amputation expiration with a wheezy cough
b. gasping respiratory efforts, and the patient is
61. When treating a patient who has suffered an unable to cough or speak
electrical burn, you should be alert for the c. no effort of breathing, absent chest-wall
possibility of movement, unable to cough or speak
a. cardiac arrest. d. stridor during inspiration, inability to speak,
b. internal bleeding. and dyspnea
c. heat shock.
d. allergic reaction. 65. A 23-year-old male has suffered a penetrating
head wound that is bleeding profusely and a
cervical spine injury. During your rapid trauma
assessment, you should
a. treat the head wound and continue your
rapid assessment.
b. stop your exam and provide appropriate
care for both injuries.
c. manage the cervical spine injury and
continue your rapid assessment.
d. make a mental note of both injuries and
continue the assessment.

67

–EMT PRACTICE EXAM 3–

66. What should you do if you do not have the 70. A 20-year-old female complains of leg and hip
right size cervical collar to fit a patient with a pain after falling off a 20-foot ladder. You
suspected spinal injury? should conduct a
a. Use the next larger or smaller size collar. a. focused physical exam.
b. Use rolled towels secured with tape. b. rapid trauma assessment.
c. Leave the neck unsecured and tape the head. c. an OPQRST on the pain only.
d. Place the patient on a backboard without d. detailed physical exam.
a collar.
71. Which of the following patients is showing
67. A 12-year-old female fell while skating. She did signs and symptoms of imminent respiratory
not strike her head and is alert, complaining of arrest?
pain to the left wrist. How should you assess a. 2-year-old male: respirations, 60/min; severe
this patient? retractions; cyanosis
a. Assess just the areas that the patient tells you b. 3-year-old female: respirations, 50/min;
are painful. nasal flaring; wheezing
b. Assess every body part from head to toe. c. 4-year-old male; respirations, 8/min;
c. Focus on just the patient’s airway and unresponsive; limp muscle tone
cervical spine. d. 3-year-old female: respirations, 10/min;
d. Complete only the initial and ongoing cyanosis; decreased muscle tone
assessment.
72. When caring for a patient whose baby is
68. Which statement by a patient is most likely to delivering in a breech presentation, you should
suggest that the patient’s thinking is psychotic? do all of the following EXCEPT
a. “I’ve never felt this bad before.” a. position the mother with her knees flexed,
b. “I know you can’t help me.” drawn up, and widely separated.
c. “Am I going to die now?” b. administer high-flow oxygen to the mother
d. “They sent you to lock me up.” and begin transport quickly.
c. pull gently on the infant’s trunk or legs if
69. Your patient is agitated and confused and delivery of the head is delayed.
seems to be displaying symptoms of drug use. d. allow the delivery to occur spontaneously
The best way to prevent the situation from until the trunk is delivered.
becoming dangerous to the patient, yourself, or
others is to
a. restrain the patient as soon as possible.
b. speak calmly and quietly to the patient.
c. refuse to treat the patient until he
calms down.
d. inform the patient of your self-defense
techniques.

68

–EMT PRACTICE EXAM 3–

73. You are assessing an awake, alert patient 77. Baseline vital signs in the unresponsive medical
complaining of abdominal pain. He denies any patient include the patient’s
trauma. When conducting a focused history a. past medical history.
and physical exam, what should you do first? b. signs and symptoms.
a. Conduct a rapid physical exam. c. blood pressure.
b. Reassess vital signs. d. allergies.
c. Gather the history of the present illness.
d. Question the patient about past medical 78. Your patient has accidentally sprayed
problems. insecticide in his eye. What should immediate
first aid involve?
74. The correct way to stimulate a newborn to a. placing an airtight dressing over the eye
breathe is to b. administering activated charcoal to the patient
a. rub his or her back or flick the soles of his or c. irrigating the eye with clean water for
her feet. 20 minutes
b. position him or her with the head higher d. placing 10 cc of sterile saline solution in
than the body. the eye
c. suction his or her nose and then the mouth.
d. smack him or her gently on the buttocks. 79. You just completed a rapid physical exam on an
unresponsive 65-year-old female. Your next
75. During your focused history and physical exam action should be to
of an unresponsive patient, you should first a. take a history of the present illness.
a. obtain vital signs and then gather OPQRST b. gather a SAMPLE history.
from the patient. c. perform a focused physical exam.
b. obtain vital signs and then gather OPQRST d. obtain baseline vital signs.
from the family.
c. gather a SAMPLE history and OPQRST 80. Your patient is a 14-year-old male who struck
from the family. his head on a diving board. Your first reaction
d. request ALS and begin a detailed head-to- should be to
toe exam. a. remove the patient from the water and
warm him.
76. To help determine what poison a patient has b. release gastric distention and provide
ingested, you should be alert for chemical burns artificial ventilation.
around the mouth as well as c. administer oxygen and provide artificial
a. burns on the hands. ventilation.
b. red-colored vomitus. d. immobilize the patient while still in the
c. moist or dry skin. water.
d. unusual breath odors.

69

–EMT PRACTICE EXAM 3–

81. Your patient is a 2-year-old female who has 85. The correct procedure for inserting an oral
injured her leg. The best way to calm her while airway in an infant or child is to
you are examining her is to a. use the tongue depressor to move the tongue
a. explain what you are doing in technical forward, and insert the airway right side up.
language. b. tip the head back and open the mouth wide,
b. tell her that if she doesn’t cooperate, she and then rotate the airway on insertion.
won’t get better. c. lubricate the tip of the airway with sterile
c. examine her while she is sitting on her saline, and insert it until you feel resistance.
parent’s lap. d. insert the airway with the bevel toward the
d. do any painful procedures first so she can base of the throat, pushing gently if you feel
calm down. resistance.

82. Which statement about suctioning infants and 86. When caring for a rape victim, it is important
children is correct? to discourage the patient from
a. Insert the suction catheter until it touches a. bathing or douching.
the back of the throat. b. reporting the crime.
b. Administer oxygen immediately before and c. talking about feelings.
after suctioning. d. naming the assailant.
c. Never suction for longer than 30 seconds at
a time. 87. In order to care for a child who has a partial
d. The vacuum pump should be set no higher upper-airway obstruction, you should
than 200 mm Hg. a. use a combination of back blows and
chest thrusts.
83. You are caring for a victim of a motor vehicle b. open the airway and attempt to ventilate
accident who is approximately seven months the child.
pregnant. The mechanism of injury strongly c. provide oxygen, position the child, and
suggests spinal trauma. How should you transport rapidly.
position the patient during transport? d. use back blows and finger sweeps to remove
a. immobilized on a long backboard that is the obstruction.
then tilted to the left
b. immobilized and transported supine on a 88. In which of the following circumstances should
long backboard you suspect the possibility of child abuse?
c. immobilized in whatever position she is a. A parent tells you the 4-month-old infant’s
most comfortable injuries were caused by rolling off the bed.
d. seated upright with her torso immobilized in b. A distraught parent promptly reports and
a short spine device requests treatment for a seriously injured
child.
84. In order to determine whether an infant is c. A parent tells you that the child walked into
responsive to verbal stimuli, you would a door at school, but the teacher disagrees.
a. say the child’s name. d. The child and parent both give you an
b. ask the child to say his or her name. identical account of how an injury occurred.
c. make a sudden loud noise.
d. have a parent speak to the child.

70

–EMT PRACTICE EXAM 3–

89. You should suspect the possibility of shock in a 93. When is it normal for the baby’s head to rotate
child who has a recent history of from the facedown position to the side?
a. vomiting and diarrhea. a. during crowning
b. cardiac arrest. b. right before the head delivers
c. epileptic seizures. c. right after the head delivers
d. upper-respiratory disease. d. as the body delivers

90. Your patient, a 27-year-old-female who is 94. You are assessing a newborn who has a pink
pregnant with her second child, tells you, “My body but blue extremities, a pulse rate of
water broke an hour ago.” This should alert you 98/min, no response to suctioning, moderate
that the patient flexion of the extremities, and a respiratory
a. has signs and symptoms of shock. rate of 38/min. What is the APGAR score for
b. is pregnant with twins. this infant?
c. will have her baby fairly soon. a. 2
d. is having a miscarriage. b. 4
c. 6
91. You should place your hand on a pregnant d. 8
woman’s abdomen during contractions to
determine the 95. When should you expect an infant to start to
a. strength of the contractions. breathe spontaneously?
b. duration of the contractions. a. one to five seconds after birth
c. size of the fetus. b. 10–15 seconds after birth
d. fetal heart rate. c. 20–30 seconds after birth
d. one minute after birth
92. You are assisting with a delivery in the field. As
the baby’s head is born, you find that the cord is 96. Which of these situations is a true emergency
wrapped tightly around the infant’s neck and that cannot be managed in the field?
cannot be dislodged. You should a. breech presentation
a. transport the mother immediately in the b. meconium in the amniotic fluid
knee/chest position. c. multiple births
b. clamp the cord in two places and cut it d. limb presentation
between the clamps.
c. pull hard on the cord to force the placenta to 97. Your patient is a 19-year-old female with severe
deliver immediately. vaginal bleeding. As part of the SAMPLE
d. exert gentle pressure on the baby’s head to history, it is particularly important to ask the
slow the delivery. patient if she
a. feels dizzy.
b. has vomited.
c. may be pregnant.
d. has ingested poison.

71

–EMT PRACTICE EXAM 3–

98. All of the following are examples of indirect 102. A standard of care is the
medical direction EXCEPT a. highest level of care an EMT can legally
a. continuing education classes taught by provide.
physicians. b. list of skills EMTs are required to perform in
b. contact between physicians and EMTs in your state.
the field. c. national description of all procedures the
c. design of EMS systems by physicians. EMTs may perform.
d. quality-improvement efforts by physicians. d. minimum level of care that is normally
provided in your locality.
99. You should allow family members to remain
with a patient EXCEPT when 103. Which situation might constitute legal
a. the patient is in the process of dying. abandonment of a patient?
b. the patient has gruesome injuries. a. You leave your patient because the fire in an
c. they want to reassure the patient. adjacent building reaches the room you are
d. they interfere with patient care. in.
b. You begin CPR on a patient and ask a
100. If a newborn infant’s respiratory effort is bystander to continue while you assess
inadequate, your first intervention should be to another patient.
a. provide artificial ventilations at a rate of c. Your patient states that he or she does not
60-120/min. want treatment and signs a statement to that
b. provide positive pressure ventilations at a effect.
rate of 40-60/min. d. You transport a patient to the hospital and
c. administer high-flow oxygen via the blow-by leave him or her in the care of a nurse who
method. signed your patient-care report.
d. transport immediately to a hospital with a
newborn intensive care unit. 104. When using an ATV the EMT should adjust
which settings to achieve proper ventilations?
101. In which situation would you be treating a. Rate and oxygen percentage
a patient under an assumption of implied b. Peak inspiratory pressure and tidal volume
consent? c. Rate and ventilator effort
a. 4-year-old male, with broken leg, parent d. Tidal volume and rate
gives permission for treatment
b. 19-year-old female, with seizure, who refuses
treatment or transport
c. 47-year-old male, with chest pain, requests
transport to the hospital
d. 80-year-old female, unconscious, no friends
or family members present

72

–EMT PRACTICE EXAM 3–

105. Your patient is a 25-year-old male who has had 108. Whenever it is necessary to carry out an
two seizures within the last hour. He shows no emergency move of a patient, it is important to
signs of drug or alcohol use. He now states that a. pull the patient along the line of the body’s
he feels fine and refuses both transport and long axis.
further treatment. You should b. immobilize the patient to a long spine board
a. carefully document every attempt you make before the move.
to provide care. c. complete the detailed assessment before
b. obtain an order for tranquilizers from the the move.
medical direction physician. d. have at least two EMTs lift the patient off
c. call for police backup to help you restrain the ground.
the patient.
d. leave the patient immediately to avoid being 109. The first step in a rapid extrication of a patient
sued for battery. from a car is to
a. apply a cervical immobilization collar.
106. In which of the following situations might you b. place the end of the long backboard on
be found to have committed assault against the seat.
your patient? c. rotate the patient until his or her back is in
a. You leave your patient at the scene of an the open doorway.
accident before additional help arrives. d. move all of the extremities into a neutral
b. You tell the patient, “If you don’t let me position.
splint your leg, I’ll have to tie you up.”
c. You tell the patient, “You’re over 18 and you 110. Which patient should be placed in the recovery
have the right to refuse treatment.” position?
d. You transfer care of your patient to a first a. A pregnant woman who has been in a car
responder who has just arrived on the scene. crash
b. A conscious cardiac patient complaining of
107. An indication for the insertion of a shortness of breath
nasopharyngeal airway would be c. A unresponsive patient who does not have a
a. a patient who will not tolerate an suspected spine injury
oropharyngeal airway. d. A child in respiratory distress with a rate of
b. severe head injury with blood draining from 6/min
the nose.
c. a deviated septum. 111. The increased pressure on arterial walls
d. basilar skull fracture. produced when the left ventricle contracts
is the
a. systolic pressure.
b. arterial pressure.
c. diastolic pressure.
d. residual pressure.

73

–EMT PRACTICE EXAM 3–

112. The nervous system regulates the frequency and Questions 116–120 refer to the following scenario:
strength of contractions through several
receptors located in the heart and blood vessels. You respond to a dispatch of an “unknown
When the beta 1-adrenergic receptors are medical event.” As you arrive on the scene, an
stimulated the elderly gentleman greets you at the door and
a. heart rate and strength of contractions motions you to step inside. You are directed to
decrease. the rear of the house, where an elderly woman
b. heart rate increases and strength of presents to you sitting on the bed. She appears
contractions decrease. to be in severe respiratory distress.
c. strength of contractions and heart rate
increase. 116. After assessing the scene for hazards, what
d. blood vessels constrict and heart rate should you do next?
decreases. a. Establish the patient’s baseline vital signs.
b. Establish a SAMPLE history.
113. Which of the following is an example of an c. Perform an initial assessment.
effective way to communicate with an elderly d. Perform a focused assessment.
patient?
a. “Sir, I’m going to try to make you 117. When should you place the patient on oxygen?
comfortable until we get to the hospital.” a. after the focused assessment
b. “You just sit down here on this nice, b. during the initial assessment
comfortable chair and don’t worry.” c. after taking baseline vital signs
c. “I will try to talk very slowly so you can d. after medical command gives you
understand me.” permission
d. “Sir, I’ll make sure I explain everything I’m
doing to your son.” 118. Which of the following signs would you assess
for first?
114. When assessing our patient you note the pulse a. lung sounds
rate is elevated and the pulse feels adequate and b. abdominal tenderness
equal. If the heart rate is elevated and the stroke c. presence of pedal pulses
volume remains the same, then the cardiac d. swelling in her fingers
output will
a. remain the same. 119. Which of the following questions would you
b. increase. NOT ask during your OPQRST of the present
c. decrease. illness?
d. None of the above a. When did you begin having trouble
breathing?
115. The myocardium is perfused by the b. Does anything else cause you pain or
a. coronary arteries. discomfort?
b. carotid arteries. c. Does anything make the breathing easier or
c. aorta. worse?
d. vena cava. d. Do you have any respiratory problems?

74

–EMT PRACTICE EXAM 3–

120. After a few minutes of supplemental oxygen 6. b. For a pulseless patient, defibrillation takes
therapy, the patient states that she feels much precedence over either administering oxygen
better. What would you do now? or performing CPR, but always stop the
a. Discontinue the oxygen since she feels better. ambulance before using the AED. Do not
b. Perform a reassessment of her vital signs. analyze a heart rhythm in a moving vehicle.
c. Have her sign a refusal-of-care form.
d. Contact her private physician. 7. d. Children are likely to suffer serious injury in
lower-speed collisions than adults; none of
Answers the other choices represents a serious mecha-
nism of injury.
1. b. This patient’s vital signs are all within the
normal range for his age. 8. c. In order to accurately assess the patient’s air-
way, breathing, and circulation status, all
2. a. Signs of labored respirations, or increased external compressions or ventilations must
effort of breathing, include use of accessory be stopped.
muscles to breathe, grunting, and stridor.
Stridor is a loud, high-pitched sound heard 9. d. The jugular veins are normally somewhat
on respirations that usually indicates an distended while a patient is lying down; flat
upper-airway obstruction. Agonal respira- veins signify blood loss.
tions are gasping slow respirations that hap-
pen for some patients as they are dying. 10. b. The normal electrical pathway through the
heart begins at the SA Node, pauses at the
3. c. The color, temperature, and condition of the AV Node to allow blood to fill the ventricles,
skin allows you to form an indirect assess- continues through the Bundle of His, and
ment of the patient’s perfusion, or circula- then surrounds the ventricles through the
tory status. Purkinje Fibers.

4. b. A single blood pressure reading, unless it is 11. a. The tricuspid valve separates the right
extremely high or extremely low, is not in atrium from the right ventricle. The pulmo-
itself significant. Blood pressure readings are nary valve is between the right ventricle and
most useful in establishing a trend that can the pulmonary arteries. The mitral valve sep-
signal changes in the patient status. Blood arates the left atrium from the left ventricle
pressure varies constantly during the day by and the aortic valve separates the left ventri-
20 mm Hg or more during sleep, work, and cle from the aorta.
relaxation activities. Assessment of BP by
palpation is useful when the patient is in a 12. a. Although you should quickly splint the
very noisy environment, making ausculta- patient’s wounds and stop major bleeding,
tion difficult. treatment of a patient in shock should focus
on rapidly transporting her to the hospital.
5. c. Chances are, this patient is experiencing sud- You can continue to stabilize and treat her
den ventricular fibrillation that may be most injuries while you are transporting her. Per-
likely reversed with a defibrillation attempt. form any other examinations while en route
to the hospital. Monitor and assess her vital
signs every five minutes.

13. b. Reassess a stable patient every 15 minutes
while en route to the receiving facility.

75

–EMT PRACTICE EXAM 3–

14. a. Although interacting with the patient con- 21. c. Paradoxical motion, the movement of one
tinuously will keep you informed about his portion of the chest wall in the opposite
or her level of anxiety and allow you to direction from the rest of the chest during
observe skin color and pupils, the main pur- respirations, indicates serious injury to the
pose is to assess changes in mental status and chest wall.
patency of airway.
22. d. The glottis is the opening between the phar-
15. a. Always transport an amputated part along ynx and the trachea.
with the patient, wrapped in sterile dressings
and then in plastic. Keep the amputated part 23. b. For a patient who is showing signs of shock
cool, but do not put the foot directly in con- as well as possible spinal injury, care focuses
tact with ice or ice water because the ice can on immobilization and rapid transport,
cause further tissue damage, which may result rather than on caring for isolated extremity
in the inability to reimplant the amputated injuries. This patient already has an open
part. airway, and ventilation is not necessary,
although oxygen should be administered by
16. c. If a patient’s respiratory rate is irregular, a nonrebreather mask and his respiratory
count for one full minute; otherwise, count status should be closely monitored as his
for 30 seconds and multiply by two to obtain respiratory rate is a little fast and his effort is
the respiratory rate. shallow.

17. b. This patient’s pulse and respiratory rate are 24. d. EMTs should administer oxygen to all
both elevated. patients who show signs and symptoms of
respiratory distress.
18. a. It is impossible to determine the actual degree
of tissue damage in the field, so the purpose 25. d. Reasonable force refers to the amount of force
of the focused assessment is to gather infor- necessary to prevent injury to the patient or
mation for the receiving facility. You should anyone else, including the rescuers. It is
always ask about medications; it is the M of sometimes necessary to use force to restrain
SAMPLE. The focused history has nothing to a patient with a behavioral disorder. Reason-
do with AED use. Cardiac pain has all sorts of able force does not define the type of
presentations, making it difficult to differenti- restraints needed.
ate from other conditions.
26. c. Rapid onset of altered mental status in dia-
19. c. The proper hand placement for compressing betic patients is associated with hypoglyce-
a child’s chest is to place the heel of one or mia, or low blood sugar. This most
two hands in the middle of the sternum commonly occurs when patients take their
between the patient’s nipples and avoid the normal dose of insulin but skip a meal.
xyphoid process. Excessive exercise can also bring on a hypo-
glycemic state.
20. a. The purpose of the detailed physical exami-
nation, which is performed while en route to 27. d. If you cannot clear the patient’s mouth of
the hospital on all trauma patients as well as secretions, logroll the patient so the secre-
unresponsive medical patients, is to reveal tions can drain out. Never suction for longer
hidden injuries. than 15 seconds at a time, and oxygenate the
patient between suction attempts.
76

–3EMT PRACTICE EXAM 3–

28. a. The position of comfort for most people 34. b. The EMT should address the difficulty
having trouble breathing is sitting; however, breathing with more O2 prior to contacting
this patient may have low blood pressure, medical control. That would take preced-
possibly due to a cardiac emergency. In this ence.
case, it would be important to ensure that
her blood pressure is adequate to support a 35. d. You can help a patient to use a prescribed
sudden change in body position. inhaler if the patient has signs and symp-
toms of respiratory emergency, if the inhaler
29. a. Because patients with spinal injuries are at was prescribed for that patient, and if the
risk of paralysis and breathing difficulties, patient is responsive. Be sure and determine
reassess vital signs after every intervention, if the patient has used the inhaler already
such as cervical immobilization or whole- and if it helped lessen the distress.
body immobilizations. Once the patient is a
little more stable, you would continue to 36. a. In cases of inhalation poisoning when the
reassess vital signs every five minutes toxin may still be present, your first concern
because he would still be a critical patient. should be to ensure your own safety and that
of other people in the area. Move the patient
30. d. This patient’s blood pressure is adequate to to your ambulance, then begin your assess-
support a sitting patient. This patient also ment and treatment. Activated charcoal is
requires high-flow oxygen via nonrebreather administered in the case of ingested (swal-
as part of the treatment plan. lowed) poisons, not inhaled poisons.

31. b. Leave a helmet in place if it fits well, does not 37. c. The normal breathing rate for an adult is
interfere with assessment or administration between 12–20 breaths per minute.
of oxygen, and the patient is not in cardiac
arrest. Leave the shoulder pads in place along 38. d. You control the flow of oxygen to the patient
with the helmet. You do not need to apply a by adjusting the regulator on the oxygen
cervical collar to this patient, but you should tank. The size of the tank has no bearing on
immobilize his body and head to a long the flow rate. Oxygen tubing size is standard-
spine board. You can assess his level of con- ized. The valve must be in the open position
sciousness without moving the helmet. to deliver any oxygen, but it does not change
the rate of flow.
32. a. Assess breath sounds bilaterally over the
midaxillary and midclavicular lines. 39. b. In comparison with an adult, a child has a
larger tongue, which can obstruct the airway,
33. d. Immobilize the patient to a short spine and a narrow airway, which can more easily
board like the Kendrick Extrication Device be blocked by secretions.
or other commercial device while she is still
seated; then transfer her to a long spine 40. c. Because oxygen tanks contain gas at very
board. If you suspected she was in shock or high pressure, they can explode if they are
was unstable, you would perform a rapid dropped or otherwise roughly handled.
extrication by applying a cervical collar and
quickly removing her from the vehicle with 41. c. A respiratory rate of 12–20 breaths per min-
the assistance of several rescuers while trying ute is normal; signs of inadequate breathing
to maintain a neutral alignment to her spine. include cyanosis, increased or decreased
breathing rate, shortness of breath, and
irregular rhythm.

77

–EMT PRACTICE EXAM 3–

42. d. The correct order for cardiopulmonary 51. d. In early shock, the body diverts blood flow
circulation starts in the vena cava and ends away from the skin and toward the body’s
with the aorta. vital organs, resulting in decreased periph-
eral circulation and cool, clammy skin.
43. a. Quality assurance is the process that identi-
fies the problem and focuses on the individ- 52. b. Capillary refill time is used to determine
ual to make corrections. Quality peripheral perfusion in infants and children
improvement focuses on the system to iden- only.
tify an issue or process that is prone to fail-
ure and concentrates on making system 53. d. If no traumatic injury mechanism is sus-
corrections to solve the problem. pected, keeping the patient flat with legs ele-
vated will promote blood circulation back to
44. b. A pulse check in an infant is performed at the critical organs.
the brachial artery on the medial aspect of
the upper arm. The carotid artery is hard to 54. c. This patient is suffering from congestive heart
palpate in an infant, as is the femoral artery. failure, which has resulted in their deteriora-
tion to cardiogenic shock. The crackles in the
45. d. Perfusion is the transfer of oxygen and car- lungs rules out anaphylactic shock. The
bon dioxide, glucose and other nutrients, crackles and lack of a narrowing pulse pres-
and waste products from the cells to the cap- sure rules out obstructive shock. The cool
illaries. Choice a is cardiac output, b is respi- clammy skin and lack of a fever rules out dis-
ration, and c is stroke volume. tributive shock.

46. a. Patients with hyperthermia with cool skin 55. a. Bleeding from a single site can usually be
still retain their ability to eliminate heat; controlled by concentrated direct applied
their condition is therefore not as serious as pressure to that site. Diffuse pressure is
that of patients with hot skin, who have lost reserved for circumstances when concen-
this ability. You should also closely monitor trated direct pressure is unadvisable, like
the patient’s mental status. when controlling bleeding from an open
skull fracture. Tourniquets and elevation are
47. c. O stands for onset, or when the pain began. steps to take if direct pressure is ineffective.
48. b. Nitroglycerin is not administered to a patient
56. d. This is a definition of atherosclerosis. An
whose systolic blood pressure is lower than aneurysm is a weakening of the arterial wall
100. Repeat the blood pressure reading and and a dissection occurs when the aneurysm
the order and request that the physician con- ruptures.
firm it.
49. b. Airway adjuncts, such as nasopharyngeal and 57. b. Aspirin has an antiplatelet action that
oropharyngeal airways, are used only when decreases the ability of platelets to form
the jaw thrust and head-tilt/chin-lift are inef- clots. This will prevent existing clots from
fective in opening the airway. getting bigger, but will not reduce or break
50. a. Select the correct size oral airway for a child up existing clots.
by measuring from the angle of the jaw to
the corner of the mouth. 58. a. Paradoxical motion of the chest may indicate
broken ribs or flail chest. Softness and dis-
78 tention during assessment generally refers to
the abdomen.

–EMT PRACTICE EXAM 3–

59. d. Airway and breathing comes first in a patient Use rolled-up towels if you do not have a
with a pulse; the stem states that the patient is cervical collar that fits properly.
breathing. Therefore, breathing has been 67. a. Without a serious mechanism of injury
assessed and it's been determined that the airway being reported, a focused physical assess-
is open. It's more likely that the patient is ment of the patient’s injuries is appropriate.
breathing rapid and shallow because they are 68. d. This statement reflects paranoia, a psychotic
losing so much blood. Given this, bleeding state in which people imagine that other
control takes precedence. people are conspiring to harm them.
69. b. You can frequently prevent situations from
60. b. For a sucking chest wound, apply an occlusive becoming dangerous by maintaining a calm,
dressing that is taped on only three sides. This professional manner and speaking quietly to
a distraught patient.
will allow air to escape from the chest cavity. 70. b. The mechanism of injury suggests that you
61. a. Electrical burns are often more serious than should look through the kill zone areas to
make sure there are no other underlying
they appear from the entrance and exit wounds; injuries.
71. c. Signs of imminent respiratory arrest are a
you should be alert for the possibility of cardiac breathing rate of less than 10/min, limp
muscle tone, slow or absent heart rate, and
arrest and be prepared to use the AED. weak or absent distal pulses; the patient will
62. d. The outer layer of the heart is called the peri- also be unresponsive. These patients need
artificial ventilation and chest compression.
cardium. This thin layer of tissue encases the Patients a, b, and d are in respiratory insuffi-
heart and holds a small amount of lubricant, to ciency and the early stages of respiratory fail-
allow the heart to contract and relax with-out ure, which, if uncorrected, will lead to
increased friction. respiratory arrest.
72. c. Do not pull on the infant’s trunk or legs to
63. a. When a pulse is missing distal to an injury, assist delivery. If the baby’s head is not deliv-
attempt to align the limb with gentle trac-tion. ered spontaneously, place your hand inside
Bringing the limb into alignment may relieve the birth canal to hold the cord and walls of
the vagina away from the baby’s face, and
pressure on the blood vessels and restore transport immediately.
73. c. Conducting an OPQRST on the pain and
circulation. finding out the SAMPLE history will gather
a lot of information about the patient’s com-
64. d. Partial upper-airway obstruction due to a plaint.
foreign body is differentiated from complete 74. a. If necessary, stimulate a newborn to breathe
obstruction by the patient’s ability to breathe or by gently rubbing his or her back or flicking
speak. Stridor indicates upper-airway the soles of his or her feet. You should always
obstruction. A wheezing sound (patient a) suction the mouth first and then the nose
indicates a lower-airway obstruction. Patients b
and c have a total airway obstruction.

65. b. Both life-threatening injuries to the patient
must be treated as quickly as possible.

66. b. If the mechanism of injury of the patient’s
signs and symptoms suggest spinal injury, you
must immobilize the neck and spine.

79

–EMT PRACTICE EXAM 3–

because infants are obligate nasal breathers, while still in the water; the second step is to
and if you suction the nose first, it may stim- attend to the airway.
ulate them to take a breath, inhaling any 81. c. Calm the toddler by allowing her to remain
amniotic fluid remaining in the oropharynx with her parent and by explaining what you
into the lungs. are doing in simple language. Warn her if
75. b. Since the patient is unresponsive, the most something will hurt, and if possible, perform
effective method of obtaining information painful procedures (sometimes blood pres-
about the patient’s condition is by looking sure assessment is painful) at the end of
for clues to the MOI/NOI and speaking with your assessment. Also, keep all your equip-
family and other witnesses to the event. ment out of sight until you are ready to use it
76. d. Some poisons can be identified by the so she can’t get all worked up about it. Kids
unusual breath odors they cause; for exam- have incredible imaginations and will invent
ple, cyanide causes an odor of bitter all sorts of painful scenarios as they look at
almonds. Choice a is incorrect because some your equipment and supplies. Sometimes you
substances may burn mucous membranes of can let the child briefly examine a piece of
the mouth but may not burn the skin. equipment before you use it or pretend to use
Choice b is incorrect because, depending it on the parent to help calm her down.
upon the substance ingested, vomit may or 82. b. When suctioning infants and children, be
may not be discolored or bloody. Choice c is sure not to stimulate the back of the throat,
incorrect because the toxin may or may not which can lead to bradycardia. Administer
cause changes in skin temperature or color; oxygen before and after suctioning, suction
it will depend upon the action of the poison for no more than 10–15 seconds at a time,
and if it causes shock. and set the vacuum pump at 80–120 mm
77. c. The other three choices are part of the SAM- Hg.
PLE history. Vital signs include pulse, blood 83. a. The patient should be immobilized on a long
pressure, respirations, skin signs, and pupil backboard, but the entire board should be
reactivity to light. tilted to the left side with padding to reduce
78. c. When toxins come in contact with the eye, the pressure of the fetus on her circulatory
irrigate the eye with clean water for 20 min- systems. This condition is called supine
utes, preferably while en route to the hypotension syndrome.
hospital. 84. d. An infant who is responsive to voice, or to
79. d. Since the patient is unresponsive, it will not verbal stimuli, would turn in the direction of
be possible to elicit a medical history the parent’s voice.
directly. An early set of vital signs may help 85. a. When inserting an airway in an infant or
determine the underlying cause of the child, use a tongue depressor and avoid rotat-
patient’s condition. ing the airway.
80. d. Because of the great risk of spinal injury 86. a. The rape victim should be discouraged from
with this type of trauma, the EMT’s first bathing, douching, urinating, or cleaning
action should be to immobilize the patient

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–EMT PRACTICE EXAM 3–

any wounds, since these activities may 95. c. An infant normally starts breathing indepen-
destroy evidence. dently within about 20–30 seconds after
87. c. Back blows, chest thrusts, and ventilation are birth; if it does not, provide tactile
performed on infants with complete airway stimulations.
obstructions; care for a child with partial
obstruction consists of placing the child in 96. d. A limb presentation, in which an arm or leg
a position of comfort and transporting is the presenting part, is a true emergency
rapidly. situation that cannot be managed in the
88. c. In cases of child abuse, different people fre- field. Place the mother with her pelvis ele-
quently give different accounts of the same vated, exert gentle pressure on the baby’s
accident, or parents may appear uncon- body, and transport the mother in this posi-
cerned. tion. Breech, meconium, and multiple births
89. a. Shock in children is most frequently associ- can all be handled in the field. Call for ALS
ated with fluid loss due to vomiting and assistance for each of these emergencies and
diarrhea or to blood loss. expect fetal distress in the newborn(s).
90. c. It is normal for the amniotic sac to rupture
and the fluid it contains to drain out of the 97. c. Determine if the patient may be pregnant,
woman’s vagina before delivery. and if so, treat her like a pregnant woman—
91. b. You place your hand on the pregnant wom- administer oxygen and transport her on her
en’s abdomen to measure the duration of the left side.
contractions. To measure the length of a
contraction you begin the time from the 98. b. Indirect medical direction includes all
beginning of the first contraction to the involvement by physicians with EMS systems
beginning of the next contraction. except direct supervision of EMTs in the
92. b. If the cord is wrapped around the infant’s field.
neck and it cannot be placed back over the
head, the infant is in danger of suffocation. 99. d. Always allow family members to stay with a
Immediately clamp the cord in two places patient except if their presence interferes
and carefully cut between the clamps. Never with necessary care.
pull on the umbilical cord as this can cause
uterine inversion, which is a life-threatening 100. b. If, on initial assessment, the newborn’s respi-
emergency. rations are slow, shallow, or absent, you
93. c. The baby’s head is usually born facedown in should provide positive pressure ventilations
the vertex position, and the head rotates just with a bag-valve mask at the rate of 40-60/min.
after it emerges from the birth canal. After about 30 seconds of this intervention,
94. b. This infant would receive one point for skin you should reassess the patient to determine
color (appearance), one point for pulse rate, if you need to continue with the bag-valve-
zero for grimace, one point for activity, and mask ventilation.
one point for respirations.
101. d. Implied consent is applicable in cases where
the patient is unable to consent; you provide
treatment under the assumption that any
rational person would want to receive treat-
ment under the circumstances.

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–EMT PRACTICE EXAM 3–

102. d. A standard of care for any locality is the 108. a. An emergency move is carried out when the
minimum acceptable level of care normally patient is in immediate danger. Because
provided there. All care providers, including there is no time to protect the spine before
EMTs, are legally held to this standard. an emergency move, you should try to pro-
tect the spine by dragging the patient in a
103. b. Abandonment may occur if you stop caring straight line, either by pulling on his or her
for a patient without his or her consent, and clothing or by placing the patient on a blan-
without transferring care to personnel of the ket and dragging the blanket.
same or higher level. For patient a, personal
safety takes priority over patient care. If a 109. a. Before beginning the actual extrication, the
conscious capable adult patient has signed a first step is to check and open the airway if
refusal (and he or she heard about risks/ben- necessary. You need to attempt to apply a
efits first), you have not committed aban- cervical collar before performing the move.
donment, ruling out case c. To avoid If it is a true emergency (scene is very unsta-
abandonment when dealing with hospitals, ble and dangerous) and you cannot do this,
hospital personnel must assume care of make every effort to keep the head and neck
patient before you can leave, and this in a neutral alignment while you move the
occurred in case d. patient. If you can slide the patient onto a
longboard, it will make moving him or her
104. d. The EMT should adjust the rate of respira- easier because you can keep him or her in
tions and the tidal volume on the Automatic alignment more easily.
Transport Ventilator (ATV) to achieve ade-
quate ventilations. Adequate ventilations 110. c. Use the recovery position for a patient who
should be evaluated by the rise and fall of the is breathing spontaneously but who is unre-
chest. Some models may allow adjustment to sponsive or likely to vomit and aspirate
the peak inspiratory pressure, but that is an material into the airway. You should not use
alarm to indicate poor compliance or it for a spinal injured patient until he or she
increased airway pressures, not adequate is properly immobilized. Patient a should be
ventilations. placed in the left lateral recumbent position
once she is immobilized. Patient b should be
105. a. Refusal of treatment requires that the patient assisted into the position of comfort with the
be fully aware of the consequences of refusing recovery position used if the mental status
care. Document all attempts made to change decreases (and he or she is still breathing
the patient’s mind by you and other caregiv- adequately). Patient d needs bag-valve mask
ers. ventilation.

106. b. Threatening the patient may be held to con- 111. a. The systolic pressure is the increased pres-
stitute assault; options a and d both consti- sure in the artery when the left ventricle is
tute abandonment of a patient. contracted.

107. a. One of the indications for the insertion of a 112. c. When the Beta 1 receptors are stimulated the
nasopharyngeal airway is a patient who is heart rate and strength of contractions
unable to tolerate an oropharyngeal airway.

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increase. Alpha stimulation causes the vessels 115. a. The coronary arteries provide circulation
to constrict and Beta 2 receptors cause the and therefore perfusion to the myocardium.
bronchioles to dilate.
113. a. Speak to elderly patients respectfully, 116. c. An initial assessment will determine the ini-
directly, and clearly, and do not assume that tial, most serious life threats first.
they can’t understand the situation.
114. b. Cardiac output is a function of the heart rate 117. b. If the patient is having respiratory distress,
and stroke volume. If the heart rate increases provide oxygen immediately after assessing
and the stroke volume remains the same, her respiratory effort.
then cardiac output will increase. You noted
the pulse rate was elevated and the quality of 118. a. Since her chief complaint appears to be
the pulse remained normal; therefore, the respiratory distress, listening to lung sounds
heart rate had increased and stroke volume early would provide some information about
remained the same. A pulse that is bounding her respiratory system.
would tend to indicate an increase in stroke
volume, while a weak pulse would tend to 119. d. This is a good question to ask during the
indicate a reduced stroke volume. SAMPLE history taking.

120. b. An ongoing assessment is important to per-
form so that you can spot trends in the
patient’s condition.

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CHAPTER 5 EMT
PRACTICE EXAM 4

CHAPTER SUMMARY

This is the fourth of ten practice exams in this book based on
the National Registry’s EMT cognitive exam. Using all the
experience and strategies you gained from the other three so
far, take this exam to see how far you have come since taking
the first test.

Multiple-choice exams are efficient and have become a common method of testing. It has been
argued that fill-in or free-response testing is more challenging and provides a superior evaluation
of a person’s knowledge. Why not take advantage of both methods? The questions in this exam
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.

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–EMT PRACTICE EXAM 4–

EMT Practice Exam 4 4. An EMT should speak up for a patient and
make sure the patient’s needs are addressed.
1. What is the minimum training level for This is called
ambulance personnel?

2. True or false: The safety of your patient and 5. The government department responsible for
bystanders is your primary responsibility on an creating the EMT curriculum is
EMS scene.

3. Leaving your patient with another qualified 6. The process consisting of continuous self-
individual is called review with the purpose of identifying aspects
that require improvement is called

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–EMT PRACTICE EXAM 4–

7. The person who assumes ultimate 10. Organisms that cause infection such as viruses
responsibility for the oversight of patient care and bacteria are called
is called

8. An EMT or other person authorized by the 11. The processes and procedures designed to
medical director to give medications or protect you from infection are known as
perform emergency care is called

9. A policy or protocol issued by a medical 12. The equipment used to protect you from all
director that authorizes EMTs and others to possible routes of contamination are
perform certain skills is called collectively known as

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–EMT PRACTICE EXAM 4–

13. A patient has a productive cough. What 16. EMTs and other EMS workers are routinely
potentially fatal lung disease should an EMT be given a test called a PPD test. What does PPD
concerned about with respect to personal safety mean, and what can the test detect?
and that of his or her crew?

14. What does the acronym HIV stand for? 17. What is the difference between eustress and
distress?

15. The U.S. Congress act that establishes 18. When a patient finds out he or she is dying, it is
procedures by which emergency response common to go through various emotional
workers may find out if they have been exposed stages including denial. Name some others.
to life-threatening infectious diseases is called

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–EMT PRACTICE EXAM 4–

19. What are the three Rs of reacting to a 23. Name two of the most significant causes of
dangerous situation? lawsuits against EMTs.

20. Explain the difference between expressed 24. A finding of negligence against an EMT
consent and implied consent. requires that a number of circumstances be
proved. List these circumstances.

21. In order for a patient to refuse care or 25. Leaving a patient after care has been initiated
transport, several conditions must be fulfilled. and before proper transfer to someone with
List as many of these conditions as possible. equal or greater medical training is known as

22. Provide an example of an advance directive.

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–EMT PRACTICE EXAM 4–

26. The anatomical term for the front of the body is 30. The anatomical term for an imaginary line
drawn down the center of the body passing
between the eyes and past the umbilicus is

27. The anatomical term for the rear of the body is 31. Provide the positional term for the following
patients (e.g., a patient lying on his or her back
28. The anatomical term to describe a position is in the supine position):
closer to the torso is ■ A patient lying on his or her abdomen
■ A patient sitting
■ A patient lying with the head slightly lower
than the feet

32. What is the name of the bone of the lower jaw?

29. The anatomical term to describe a position
farther from the torso is

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–EMT PRACTICE EXAM 4–

33. What is the name of the bone found at the base 37. The bone that sits anterior to the knee joint is
of the sternum? known as

34. The spinal column is made up of individual 38. Describe the difference between voluntary and
bones called vertebrae. How many vertebrae are involuntary muscles. Give at least one example
there in the human spine? of each.

35. Name the five divisions of the spine and state 39. A leaf-shaped structure that closes to prevent
the number of vertebrae in each division. food and other objects from entering the
trachea is known as

36. Tarsals and metatarsals are found where?

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–EMT PRACTICE EXAM 4–

40. Small sacs within the lungs where gas exchange 44. The division of the nervous system that
takes place with the bloodstream are called controls involuntary motor function and affects
such things as digestion and heart rate is the

41. The component of blood primarily 45. Epinephrine is sometimes called
instrumental in the formation of blood clots is
called

42. What is a key function of the white blood cells? 46. During the initial assessment, how do you
determine signs of adequate breathing?

43. What is perfusion? 47. Your patient presents with skin that appears
blue or gray. This condition is called
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–EMT PRACTICE EXAM 4–

48. What is respiratory failure? 52. The technique used to open the airway of a
patient with a head, neck, or spine injury is

49. List as many signs of inadequate breathing as 53. What is the best method to evaluate adequate
you can. ventilation of a patient when using a bag-valve
mask?

50. What is the normal breathing rate for an adult?

54. What percentage of oxygen will a bag-valve
mask with a reservoir deliver?

51. The technique used to provide the maximum
opening of a patient’s airway is

93

–EMT PRACTICE EXAM 4–

55. Based on American Heart Association 59. To be effective, how much air intake (measured
guidelines, how much air should be delivered to in mm Hg) should a suction unit be able to
a patient using an adult bag-valve mask? maintain?

56. What is the best method to size an 60. Never suction a patient for more than _________
oropharyngeal airway (OPA)? seconds at a time.

57. What does the term contraindication mean? 61. The atmosphere contains approximately
_________% oxygen.

62. A portable oxygen cylinder, when filled, is
pressurized to approximately _________ pounds
per square inch (psi).

63. Oxygen should not be allowed to empty below
a safe residual pressure. The safe residual
pressure for a portable cylinder is

58. What is the best method to size a 64. An oxygen cylinder should be hydrostatically
nasopharyngeal airway (NPA)? tested every _________years. Cylinders with a star
after the date may be hydrostatically tested
every _________years.

94