Archive for October 2018

The most serious concern of a bladder rupture is:

The most serious concern of a bladder rupture is:



A) d. Shock and/or peritonitis
B) c. Urine and blood leakage
C) b. Massive hemorrhage
D) a. Loss of the body's ability to eliminate urine


Answer: A

You are managing an unresponsive 50-year-old female patient who was in a car-versus-tree motor vehicle crash. She is in the driver's seat wearing a chest strap but no waist belt. Her pulse rate is 134 beats/min, her respiratory rate is 36 breaths/min, and her blood pressure is 76/52 mm Hg. The imprint of her seat belt is clearly defined across her chest and abdomen, and her abdomen is rigid and bruising. You suspect that your patient may have:

You are managing an unresponsive 50-year-old female patient who was in a car-versus-tree motor vehicle crash. She is in the driver's seat wearing a chest strap but no waist belt. Her pulse rate is 134 beats/min, her respiratory rate is 36 breaths/min, and her blood pressure is 76/52 mm Hg. The imprint of her seat belt is clearly defined across her chest and abdomen, and her abdomen is rigid and bruising. You suspect that your patient may have:




A) c. A tension pneumothorax
B) d. Ruptured a blood vessel
C) a. A cardiac tamponade
D) b. A ruptured spleen


Answer: B

You are called to the ski patrol headquarters of a ski resort because there has been a skiing accident. When you arrive, you find a 23-year-old male patient immobilized and in obvious pain. He reportedly lost control on the mogul run and tumbled down the side, eventually striking a tree. During your assessment, his abdomen is slightly rigid with rebound tenderness. There is no abdominal bruising; it just appears slightly red. His pulse rate is 82 beats/min, his respiratory rate is 18 breaths/min, his blood pressure is 136/72 mm Hg, his skin is normal, and he rates his pain as a 10 out of 10. Based on these findings, you suspect:

You are called to the ski patrol headquarters of a ski resort because there has been a skiing accident. When you arrive, you find a 23-year-old male patient immobilized and in obvious pain. He reportedly lost control on the mogul run and tumbled down the side, eventually striking a tree. During your assessment, his abdomen is slightly rigid with rebound tenderness. There is no abdominal bruising; it just appears slightly red. His pulse rate is 82 beats/min, his respiratory rate is 18 breaths/min, his blood pressure is 136/72 mm Hg, his skin is normal, and he rates his pain as a 10 out of 10. Based on these findings, you suspect:



A) b. Pelvis fracture
B) c. Potential intestinal rupture
C) a. Massive internal hemorrhage
D) d. Spleen rupture


Answer: B

You are evaluating a 28-year-old female patient who was the belted driver in a car-versus-tree motor vehicle crash. She is also 30 weeks' pregnant. She is complaining of severe abdominal pain with cramping, and you can see blood soaking into her shorts and onto the driver's seat. As you prepare for a rapid extrication, you are worried that she may have experienced:

You are evaluating a 28-year-old female patient who was the belted driver in a car-versus-tree motor vehicle crash. She is also 30 weeks' pregnant. She is complaining of severe abdominal pain with cramping, and you can see blood soaking into her shorts and onto the driver's seat. As you prepare for a rapid extrication, you are worried that she may have experienced:



A) b. Femoral artery laceration
B) a. Abruptio placentae
C) c. Liver laceration
D) d. Premature labor


Answer: B

Paramedics play a vital role in early abdominal trauma management by:

Paramedics play a vital role in early abdominal trauma management by:



A) b. Identifying for the surgeons which organ is bleeding
B) a. Controlling internal bleeding
C) d. Triaging with patients who may or may not have suffered internal injuries following abdominal trauma
D) c. Providing rapid response and rapid transport to a trauma center


Answer: D

You are evaluating a 33-year-old female patient who was ejected from a motorcycle when her husband lost control on a corner. After exposing her body, you observe abrasions across her right flank and abdomen and note that bruising is developing along the posterior aspect of her right flank. Based on this information, you suspect that your patient:

You are evaluating a 33-year-old female patient who was ejected from a motorcycle when her husband lost control on a corner. After exposing her body, you observe abrasions across her right flank and abdomen and note that bruising is developing along the posterior aspect of her right flank. Based on this information, you suspect that your patient:



A) a. Has fatal injuries
B) c. Likely has superficial abdominal injuries only
C) d. May have internal abdominal injuries
D) b. Is in decompensated hemorrhagic shock


Answer: C

Based on your knowledge of anatomy, you would suspect a patient with a stab wound in the upper right quadrant to be at risk for:

Based on your knowledge of anatomy, you would suspect a patient with a stab wound in the upper right quadrant to be at risk for:



A) d. A perforated stomach, causing infection
B) c. A perforated bladder, causing infection
C) b. A lacerated spleen, causing internal hemorrhage
D) a. A lacerated liver, causing internal hemorrhage


Answer: D

You are evaluating a 14-year-old female patient who fell off a top bunk and onto a binder. You expose her abdomen and can see a line of demarcation from the edge of the binder across both lower quadrants. When you palpate the abdomen, it is soft and nontender in all quadrants, and she rates her pain at 3 out of 10. Her heart rate is 86 beats/min, her respiratory rate is 20 breaths/min, her blood pressure is 114/60 mm Hg, and her skin is normal. You suspect that your patient:

You are evaluating a 14-year-old female patient who fell off a top bunk and onto a binder. You expose her abdomen and can see a line of demarcation from the edge of the binder across both lower quadrants. When you palpate the abdomen, it is soft and nontender in all quadrants, and she rates her pain at 3 out of 10. Her heart rate is 86 beats/min, her respiratory rate is 20 breaths/min, her blood pressure is 114/60 mm Hg, and her skin is normal. You suspect that your patient:




A) d. Will likely have liver swelling
B) c. May have perforated her stomach
C) a. Appears to only have superficial injuries but should still be evaluated by a physician
D) b. Likely has massive internal bleeding


Answer: C

Following a traumatic pancreatic injury, the major concern becomes:

Following a traumatic pancreatic injury, the major concern becomes:



A) a. Hypersecretion of insulin
B) d. Massive hemorrhage
C) b. Hyposecretion of insulin
D) c. Leakage of digestive enzymes into the peritoneal space


Answer: D

You are treating a 40-year-old female patient who was stabbed in the right upper quadrant with a steak knife. Oxygen has been administered, and the entry wound has been covered with a sterile dressing. Appropriate care for this patient includes:

You are treating a 40-year-old female patient who was stabbed in the right upper quadrant with a steak knife. Oxygen has been administered, and the entry wound has been covered with a sterile dressing. Appropriate care for this patient includes:



A) c. Transport to the closest emergency department for a blood transfusion
B) a. Administration of IV epinephrine to help the patient compensate
C) d. Transport to the closest trauma center
D) b. IV fluids infusing at a KVO rate


Answer: C

You are treating a 44-year-old female patient who was struck by a car while crossing the street and was thrown 25 feet. She is responding to verbal stimuli, does not move appropriately, and has a pulse rate of 132 beats/min, a respiratory rate of 32 breaths/min, a blood pressure of 88/68 mm Hg, and pale and clammy skin. When you remove her clothing, her upper abdominal quadrants are bruised, rigid, and tender. Appropriate care for this patient includes:

You are treating a 44-year-old female patient who was struck by a car while crossing the street and was thrown 25 feet. She is responding to verbal stimuli, does not move appropriately, and has a pulse rate of 132 beats/min, a respiratory rate of 32 breaths/min, a blood pressure of 88/68 mm Hg, and pale and clammy skin. When you remove her clothing, her upper abdominal quadrants are bruised, rigid, and tender. Appropriate care for this patient includes:



A) b. Establishing a large-bore IV
B) d. Providing oxygen via nasal cannula
C) c. Positioning her in the left lateral recumbent position to protect her airway
D) a. Administering fentanyl for pain


Answer: A

Upon examining your patient, you suspect she may be developing a compartment syndrome of the lower leg. What is your best course of action when treating this patient in the field?

Upon examining your patient, you suspect she may be developing a compartment syndrome of the lower leg. What is your best course of action when treating this patient in the field?



A) A. Apply a PASG to decrease swelling and control internal bleeding.
B) B. Administer RICE.
C) C. Splint it with a padded splint in the position found.
D) D. Transport the patient to the closest, most appropriate facility


Answer: D

Why are fractures in the area of the epiphyseal plate of pediatric patients considered serious?

Why are fractures in the area of the epiphyseal plate of pediatric patients considered serious?



A) A. Because of their location, epiphyseal plate fractures are inherently difficult to immobilize properly.
B) B. The epiphyseal plate is a very vascular area. A fracture here may result in a great deal of blood loss, especially dangerous in the pediatric population because of their smaller amount of circulating blood volume.
C) C. The epiphyseal plate is located near a joint and therefore may involve nerve and vascular structures. These plates must be handled carefully to avoid permanent damage to the extremity.
D) D. The epiphyseal plate is the area of the bone responsible for the growth of the bone. A fracture here may prevent proper growth of the bone and cause unusual deformity to joints or an unnatural bending.


Answer: D

Your 33-year-old male patient is conscious and alert after falling to the ground while exiting his vehicle. He is complaining of an isolated injury to his left leg. There is tension in his muscles during relaxation, loss of distal sensation, and extreme pain on extension that seems to be out of proportion to his injury. What has most likely occurred to your patient?

Your 33-year-old male patient is conscious and alert after falling to the ground while exiting his vehicle. He is complaining of an isolated injury to his left leg. There is tension in his muscles during relaxation, loss of distal sensation, and extreme pain on extension that seems to be out of proportion to his injury. What has most likely occurred to your patient?



A) A. Compartment syndrome
B) B. Dislocation of his hip
C) C. Dislocation of his patella
D) D. Oblique fracture


Answer: A

What measurement should you use to adjust the Hare traction splint before applying it to a femur fracture?

What measurement should you use to adjust the Hare traction splint before applying it to a femur fracture?



A) A. Estimate the patient's height divided by 2 and add 6 to 8 inches past the end of the extremity.
B) B. Measure it against the injured leg from the ischium and add 6 to 8 inches past the end of the extremity.
C) C. Measure it against the uninjured leg from the ischium and add 6 to 8 inches past the end of the extremity.
D) D. Start with the traction splint fully extended and apply, tightening until the patient voices relief of pain.


Answer: C

When should you assess circulation when splinting an elbow?

When should you assess circulation when splinting an elbow?



A) A. After the splint
B) B. Before and after the splint
C) C. Before the splint
D) D. Only check if there is cardiovascular compromise


Answer: B

An abdominal evisceration is managed in the field by:

An abdominal evisceration is managed in the field by:



A) A. Replacing the contents into the abdominal cavity and keeping the patient warm
B) B. Covering the abdominal contents with moist dressing
C) C. Cooling the patient to reduce metabolism
D) D. Administering oral fluids and pain medication


Answer: B

Which of the following is true about mechanism of abdominal injury?

Which of the following is true about mechanism of abdominal injury?



A) A. Shootings and stabbings are the primary cause of abdominal injury.
B) B. Motor vehicle trauma is involved in as much as 75% of blunt abdominal trauma.
C) C. Penetrating abdominal trauma has a higher mortality rate than blunt abdominal trauma.
D) D. More than 75% of patients with penetrating abdominal trauma exsanguinate on scene.


Answer: B

Death due to abdominal trauma is usually a result of:

Death due to abdominal trauma is usually a result of:



A) A. Continuing hemorrhage and delayed surgical repair
B) B. Unpreventable infection
C) C. Exsanguination occurring within 30 minutes of the injury
D) D. Rupture of hollow organs and resulting nutritional deficiencies


Answer: A

Your patient is a 34-year-old female who just rear-ended another vehicle at a high rate of speed. Your patient is 23 weeks pregnant and is complaining of intense cramping, uterine pain and tenderness, occasional contractions, and an increase in vaginal bleeding. What is your patient most likely suffering from?

Your patient is a 34-year-old female who just rear-ended another vehicle at a high rate of speed. Your patient is 23 weeks pregnant and is complaining of intense cramping, uterine pain and tenderness, occasional contractions, and an increase in vaginal bleeding. What is your patient most likely suffering from?



A) A. Abruptio placentae
B) B. Imminent childbirth
C) C. Placental previa
D) D. Preeclampsia


Answer: A

Your patient was hit in the back with a baseball bat. Shortly after the incident, he began to experience lightheadedness and blurry vision. You notice bruising around his umbilicus. What does this indicate?

Your patient was hit in the back with a baseball bat. Shortly after the incident, he began to experience lightheadedness and blurry vision. You notice bruising around his umbilicus. What does this indicate?



A) A. Cullen's sign
B) B. Kehr's sign
C) C. Stop sign
D) D. Turner's sign


Answer: A

What borders the abdomen superiorly?

What borders the abdomen superiorly?



A) A. Abdominal wall
B) B. Diaphragm
C) C. Skeletal structures
D) D. Vertebral column


Answer: B

In gunshot wounds, the _______ of the projectile is the most important factor in determining the amount of kinetic energy transferred to the body and therefore the amount of damage sustained by the patient.

In gunshot wounds, the _______ of the projectile is the most important factor in determining the amount of kinetic energy transferred to the body and therefore the amount of damage sustained by the patient.



A) A. Mass
B) B. Shape
C) C. Tumble
D) D. Velocity


Answer: D

You arrive at the scene of a motor vehicle accident. Your patient, who is obviously late in her pregnancy, is still in the driver's seat. She states that she was wearing her seat belt although it is not currently in place. As you expose your patient, you find she has abrasions from the seat belt in the area of her shoulder and across her abdomen approximately 1 inch below her umbilicus. What can you infer from these markings?

You arrive at the scene of a motor vehicle accident. Your patient, who is obviously late in her pregnancy, is still in the driver's seat. She states that she was wearing her seat belt although it is not currently in place. As you expose your patient, you find she has abrasions from the seat belt in the area of her shoulder and across her abdomen approximately 1 inch below her umbilicus. What can you infer from these markings?



A) A. The lap belt portion of the seat belt was placed too high. This potential trauma places your patient at a high risk for preterm labor and delivery.
B) B. The lap belt portion of the seat belt was placed too high. This potential trauma places your patient at risk of abruptio placenta and uterine rupture.
C) C. Your patient was indeed wearing her seat belt and was appropriately secured.
D) D. Your patient was wearing her seat belt, and although the placement was not appropriate, the large amount of abdominal fat protected her and her fetus from damage.



Answer: B

Which statement best describes training needed for wilderness EMS?

Which statement best describes training needed for wilderness EMS?




A) a. Traditional providers are better trained in clinical skills and can therefore be inserted with minimal training.
B) c. Traditional providers cannot be inserted without additional training and extensive logistical support.
C) b. Traditional providers can be inserted without additional training and extensive logistical support.
D) d. Traditional providers need some training but can accomplish the same tasks without the additional logistical support.


Answer: B) c. Traditional providers cannot be inserted without additional training and extensive logistical support.

In addressing extrication in wilderness EMS, it differs from traditional EMS by:

In addressing extrication in wilderness EMS, it differs from traditional EMS by:




A) c. Requiring more personnel only if needed for traversing difficult terrain
B) a. Not requiring more personnel but more equipment
C) d. Requiring significantly more personnel than traditional EMS
D) b. Not requiring more personnel than traditional EMS activities


Answer: A) c. Requiring more personnel only if needed for traversing difficult terrain

Wilderness EMS is best defined as a system that is:

Wilderness EMS is best defined as a system that is:




A) d. Intertwined with more deliberate and dedicated EMS systems but with a separate medical skills set and objectives
B) b. Integrated into a particular region or activity, which is distinct and separate from a traditional EMS system
C) c. Integrated into or part of the standard EMS system, to provide wilderness care to a particular region
D) a. Distinctively different from other EMS systems and operates with the structure and hindrances of traditional EMS


Answer: C) c. Integrated into or part of the standard EMS system, to provide wilderness care to a particular region

Wilderness EMS teams should expect to interact with a variety of different groups and that can best be described as:

Wilderness EMS teams should expect to interact with a variety of different groups and that can best be described as:




A) b. Law enforcement, federal officials, and state officials
B) d. Travel agents, clergy, and federal officials
C) a. Aeromedical, military, and professional trip leaders/guides
D) c. State officials, military police, and wilderness firefighters


Answer: C) a. Aeromedical, military, and professional trip leaders/guides

In planning for a wilderness EMS system, it is necessary to define mechanisms and missions because of:

In planning for a wilderness EMS system, it is necessary to define mechanisms and missions because of:




A) c. Differences in medicolegal protocols and outcome consequences
B) d. Differences in protocols and clinical objectives
C) b. Differences in medicolegal consequences and protocols
D) a. Differences in mechanism of injury and clinical consequences


Answer: D) a. Differences in mechanism of injury and clinical consequences

In addressing wilderness EMS, which of the following best represents aspects of the 10 essentials for rescuer safety?

In addressing wilderness EMS, which of the following best represents aspects of the 10 essentials for rescuer safety?




A) b. Navigation aids and IV fluids
B) d. Weather awareness, signaling and helicopter training, and Combitubes
C) a. Attitude, clothing, and weather awareness
D) c. Shelter, IV fluids, and ET kit


Answer: C) a. Attitude, clothing, and weather awareness

The most robust wilderness EMS systems attain preparation by:

The most robust wilderness EMS systems attain preparation by:




A) b. Atypical basic skills with little flexibility built in
B) d. Fully designed protocols with little variance to ensure clinical standards
C) c. Flexible protocols but with rigid online medical direction
D) a. Atypical and advanced skills with some flexibility built in


Answer: D) a. Atypical and advanced skills with some flexibility built in

Regarding a wilderness EMS and an incident command system (ICS), which statement best describes the relationship?

Regarding a wilderness EMS and an incident command system (ICS), which statement best describes the relationship?




A) c. ICS terms are irrelevant to wilderness EMS, as teams are not trained to that level of sophisticated communication.
B) a. ICS terminology and roles should be implemented to avoid confusion.
C) d. ICS terms should be used unless there is a local term that is more appropriate, as the rescuers are all local.
D) b. ICS terms and definitions should not be used, as they may cause confusion with other non-EMS agencies.


Answer: B) a. ICS terminology and roles should be implemented to avoid confusion.

In consideration of wilderness EMS, providers need to have knowledge not only of EMS but also of:

In consideration of wilderness EMS, providers need to have knowledge not only of EMS but also of:




A) b. The techniques of remote wilderness clinical or field medicine
B) a. The techniques of practicing in solitude because of the solitary nature of wilderness EMS
C) d. The techniques to care for themselves and their team
D) c. The techniques of specialized skills such as field amputation and chest tubes


Answer: C) d. The techniques to care for themselves and their team

Wilderness EMS requires familiarity with fire and rescue equipment such as:

Wilderness EMS requires familiarity with fire and rescue equipment such as:




A) d. Technical ropes, swift water transfer, and principles of hydraulics
B) c. Technical ropes, swift water rescue, and hiking equipment
C) a. Litter wheels, rescue sleds, and stokes baskets
D) b. Swift water rescue and transfer, basics of height hydraulics, and hiking equipment


Answer: C) a. Litter wheels, rescue sleds, and stokes baskets

Which of the following best describes a significant challenge to wilderness EMS in the United States?

Which of the following best describes a significant challenge to wilderness EMS in the United States?




A) b. The dependence of paid personnel to provide rescue operations
B) d. The undue intervention of federal government agencies such as FEMA
C) a. The absence of a coordinating or certifying body
D) c. The intransigence of the states in regard to reimbursement


Answer: C) a. The absence of a coordinating or certifying body

Many organizations are involved in wilderness EMS, and one contribution of the U.S. Department of Defense is:

Many organizations are involved in wilderness EMS, and one contribution of the U.S. Department of Defense is:




A) d. Providing physician support of all operations
B) b. Integration of out-of-state resources
C) c. Integration of former military members into wilderness teams
D) a. As the sole provider of aircraft for rescue operations


Answer: C) c. Integration of former military members into wilderness teams

Which of the following statements best describes the issue of cervical immobilization?

Which of the following statements best describes the issue of cervical immobilization?




A) b. In wilderness EMS, many organizations do not allow teams to 'clear' c-spine unless extrication is over flat terrain.
B) a. In wilderness EMS, many organizations allow teams to 'clear' c-spine to simplify extrication.
C) d. In wilderness EMS, many providers still mandate full c-spine because of the terrain needed to traverse.
D) c. In wilderness EMS, many providers allow teams to 'clear' c-spine only if there is an advanced level provider present.


Answer: B) a. In wilderness EMS, many organizations allow teams to 'clear' c-spine to simplify extrication.

One of the most recognized wilderness systems is:

One of the most recognized wilderness systems is:




A) a. The divers alarm network
B) d. Search and recovery resulting from the high number of drownings
C) c. Search and rescue
D) b. The national wilderness medicine foundation


Answer: C) c. Search and rescue

One expected landmark in the evolution of wilderness EMS as a field is:

One expected landmark in the evolution of wilderness EMS as a field is:




A) a. National standardization of curricula
B) d. State standardization of certification
C) b. National standardization of position titles
D) c. State recognition of wilderness educational programs


Answer: A) a. National standardization of curricula

When responding to a farm for a report of an overturned tractor, the paramedic must consider several possible challenges including:

When responding to a farm for a report of an overturned tractor, the paramedic must consider several possible challenges including:




A) a. Air bag deployment pinning the tractor operator
B) c. That the patient has been trapped for several hours
C) d. Vehicle fluids being drained away from the scene
D) b. Electrical shock from a hybrid tractor engine


Answer: B) c. That the patient has been trapped for several hours

Toxic gasses that may be present in stored manure include:

Toxic gasses that may be present in stored manure include:



A) d. Methane, nitrous dioxide
B) a. Ammonia, carbon monoxide
C) b. Ammonia, hydrogen sulfide
D) c. Carbon monoxide, methane


Answer: C) b. Ammonia, hydrogen sulfide

A young girl is having difficulty breathing after playing outside in the barnyard next to the animals and silo. She is coughing, gasping for air, and dizzy, and she has started to wheeze. Which of the following is the most appropriate treatment?

A young girl is having difficulty breathing after playing outside in the barnyard next to the animals and silo. She is coughing, gasping for air, and dizzy, and she has started to wheeze. Which of the following is the most appropriate treatment?




A) c. Low-flow oxygen, bronchodilator, intravenous access, atropine
B) a. High-flow oxygen, bronchodilator, prompt transport
C) d. Oxygen therapy, atropine, bronchodilator, prompt transport
D) b. High-flow oxygen, IV fluid challenge, atropine, 2-PAM


Answer: B) a. High-flow oxygen, bronchodilator, prompt transport

Which of the following best describes a confined space?

Which of the following best describes a confined space?



A) b. A space large enough for a person to enter but not turn around
B) c. A space large enough to enter but not for continuous occupancy
C) a. A space large enough for a person to enter but not exit
D) d. A space too small to enter or permit occupancy by a person


Answer: B) c. A space large enough to enter but not for continuous occupancy

Which of the following best describes medications that may be used in the treatment of crush injury?

Which of the following best describes medications that may be used in the treatment of crush injury?




A) b. Sodium bicarbonate, calcium, propranolol, albuterol
B) a. Albuterol, insulin, glucose, sodium bicarbonate, morphine
b. Insulin, glucose, naloxone, sodium bicarbonate, albuterol
C) c. Sodium bicarbonate, insulin, glucose, calcium, naloxone


Answer: B) a. Albuterol, insulin, glucose, sodium bicarbonate, morphine

Which is the best explanation for the following set of symptoms: dizziness, drooling, eyes are watering, incontinent of urine, pupils are pinpoint in room light and nonreactive, and vital signs indicate hypotension and bradycardia?

Which is the best explanation for the following set of symptoms: dizziness, drooling, eyes are watering, incontinent of urine, pupils are pinpoint in room light and nonreactive, and vital signs indicate hypotension and bradycardia?




A) b. Heat stroke
B) d. Silo filler's disease
C) c. Pesticide poisoning
D) a. Heat exhaustion


Answer: C) c. Pesticide poisoning

When approaching an incident involving a patient trapped in a silo, the paramedic must consider:

When approaching an incident involving a patient trapped in a silo, the paramedic must consider:




A) b. Collapsing walls of the silo that may interfere with rescue efforts
B) a. Animal manure around the silo that may pose bacterial contamination
C) d. Toxic gasses in the silo as a result of the fermentation of stored materials
D) c. Higher than normal concentration of oxygen that may be flammable


Answer: C) d. Toxic gasses in the silo as a result of the fermentation of stored materials

The patient is a 28-year-old male cleaning a manure pit. The paramedic is called because the man is complaining of difficulty breathing accompanied by a runny nose and cough. Lung sounds indicate pulmonary edema in the lung bases. The patient states he cannot smell anything and wonders whether that is unusual. Treatment for the patient includes:

The patient is a 28-year-old male cleaning a manure pit. The paramedic is called because the man is complaining of difficulty breathing accompanied by a runny nose and cough. Lung sounds indicate pulmonary edema in the lung bases. The patient states he cannot smell anything and wonders whether that is unusual. Treatment for the patient includes:




A) c. Prompt evacuation from the area, high-flow oxygen, and IV atropine
B) d. Removal from the area, oxygen and airway support, and treatment for pulmonary edema
C) b. Having the patient sniff more manure to ensure the sense of smell is intact
D) a. Extrication from the environment, oxygenation, and airway support if needed


Answer: B) d. Removal from the area, oxygen and airway support, and treatment for pulmonary edema

Which statement best describes considerations of extricating a patient who has been trapped under an overturned tractor for approximately 3 hours?

Which statement best describes considerations of extricating a patient who has been trapped under an overturned tractor for approximately 3 hours?




A) a. Avoid lifting the tractor off the farmer too quickly.
B) b. Lift the tractor off the farmer as quickly as possible.
C) d. Transport the patient and tractor as one unit.
D) c. Replenish spilled hydraulic fluids before lifting the tractor.


Answer: A) a. Avoid lifting the tractor off the farmer too quickly.

Problems associated with an accidental injection of hydraulic fluid would include:

Problems associated with an accidental injection of hydraulic fluid would include:




A) a. Bacterial meningitis and respiratory compromise if sufficient fluid was injected
B) c. Subcutaneous emphysema and pulmonary edema secondary to histamine release
C) d. Vascular compression and ischemic necrosis to the point of amputation
D) b. Severe generalized anaphylaxis and neurogenic hypoperfusion


Answer: C) d. Vascular compression and ischemic necrosis to the point of amputation

The most likely cause of pulmonary edema in the base of the lungs of someone who had experienced difficulty breathing while working with a conventional silo is:

The most likely cause of pulmonary edema in the base of the lungs of someone who had experienced difficulty breathing while working with a conventional silo is:




A) d. Inhalation of nitrogen oxides
B) b. Exposure to low levels of oxygen
C) a. Congestive heart failure
D) c. Ingestion of organophosphates


Answer: A) d. Inhalation of nitrogen oxides

Which is the best statement regarding stabilizing an overturned tractor?

Which is the best statement regarding stabilizing an overturned tractor?




A) c. Most overturned tractors do not need cribbing because of the unique shape of the tractor.
B) d. Standard cribbing is usually sufficient to stabilize a tractor and attachment.
C) a. Cribbing resources may be limited, which could hinder vehicle stabilization.
D) b. It is important to standardize stabilization techniques to protect patients


Answer: C) a. Cribbing resources may be limited, which could hinder vehicle stabilization.

Which is the best statement regarding farm injuries and written treatment protocols?

Which is the best statement regarding farm injuries and written treatment protocols?




A) a. Protocols can be ignored because they do not pertain to farm accidents.
B) d. Protocols should always be exceeded when treating a patient in a farm accident.
C) b. Protocols may be too limiting for farm accident victims who may need more care.
D) c. Protocols must always be followed strictly to provide optimum care for the patient.


Answer: C) b. Protocols may be too limiting for farm accident victims who may need more care.

A patient has been trapped under a heavy piece of farm equipment that covered his upper abdomen, pelvis, and both legs for almost 90 minutes. The patient is complaining of severe respiratory distress. What is the paramedic's best response?

A patient has been trapped under a heavy piece of farm equipment that covered his upper abdomen, pelvis, and both legs for almost 90 minutes. The patient is complaining of severe respiratory distress. What is the paramedic's best response?




A) c. Provide oxygen by nonrebreather mask at 15 L/min.
B) b. Partially lift the equipment to allow chest expansion.
C) d. Rapidly extricate and transport the patient.
D) a. Immediately intubate and ventilate the patient.


Answer: B) b. Partially lift the equipment to allow chest expansion.

Which of the following best describes hazards related to farm machinery?

Which of the following best describes hazards related to farm machinery?




A) c. Pull in points, pinch points, crush points, shear points
B) a. Crush points, wrap points, cinch points, crush points
C) d. Shear points, pinch points, cinch points, crush points
D) b. Pinch points, pull out points, cinch points, crush points


Answer: A) c. Pull in points, pinch points, crush points, shear points

The less toxic families of pesticides are known as:

The less toxic families of pesticides are known as:




A) d. Cholinesterase inhibitors
B) c. Cholinesterase agonists
C) b. Catecholamine inhibitors
D) a. Acetylcholinesterase agonists


Answer: A) d. Cholinesterase inhibitors

Which of the following best describes what the paramedic needs to know when rescuing someone from a silo?

Which of the following best describes what the paramedic needs to know when rescuing someone from a silo?




A) a. Enter the silo wearing a level-A hazardous materials suit to avoid contamination.
B) b. Enter the silo from the bottom to avoid toxic gasses.
C) c. Use nonsparking tools to cut into the silo near the worker.
D) d. Use breathing protection


Answer: D) d. Use breathing protection

Which is the correct statement regarding IV access and fluid replacement for a patient who has been trapped under heavy equipment for over 1 hour?

Which is the correct statement regarding IV access and fluid replacement for a patient who has been trapped under heavy equipment for over 1 hour?




A) d. Start two or more large-bore IVs and run at KVO rates while extricating.
B) c. Start one large-bore IV and monitor for fluid overload after extrication.
C) a. Start at least one large-bore IV as soon as the patient is safely accessible.
D) b. Start one IV after the patient has been extricated


Answer: C) a. Start at least one large-bore IV as soon as the patient is safely accessible.

Which of the following best describes a potential mechanism of injury for an incident involving a conventional silo?

Which of the following best describes a potential mechanism of injury for an incident involving a conventional silo?




A) b. External wall collapse, falling off the outside ladder, high oxygen levels inside the silo
B) c. Falls inside the silo, falling off the outside ladder, entrapment by the unloader
C) a. Entrapment by the silo unloader, falls inside the silo, oxygen toxicity
D) d. Hypothermic oxygen load, falling off the outside latter, entrapment in the silo chute


Answer: B) c. Falls inside the silo, falling off the outside ladder, entrapment by the unloader

For which of the following incidents should crush injury be suspected?

For which of the following incidents should crush injury be suspected?




A) b. Entrapment under a tractor with extrication in 15 minutes of the accident
B) c. Overturned tractor under which the victim was trapped for 2 hours---
C) d. Rollover tractor in which the patient sustained a 4-inch scalp laceration
D) a. Entrapment in a conventional silo in which grain was stored


Answer: B) c. Overturned tractor under which the victim was trapped for 2 hours

What are the most correct reasons why paramedics should expect a serious situation if they are called to a farm machinery incident?

What are the most correct reasons why paramedics should expect a serious situation if they are called to a farm machinery incident?




A) b. The machinery is usually in remote areas where there is little support.
B) a. The equipment is large, and maintenance crews may have to be called to assist.
C) d. The rural community has multiple weapons, and they may not know the EMS crew.
D) c. The mechanism of injury has probably been severe


Answer: D) c. The mechanism of injury has probably been severe

The acronym SLUDGE-BBM represents signs and symptoms including:

The acronym SLUDGE-BBM represents signs and symptoms including:




A) c. Miosis, urination, mitosis, bronchospasm, emesis, lacrimation
B) a. Bradycardia, urination, miosis, bronchospasm, enuresis, lacrimation
C) d. Salivation, urination, miosis, bronchoconstriction, emesis, lacrimation
D) b. Diarrhea, urination, miosis, bronchospasm, emesis, lacrimation


Answer: C) d. Salivation, urination, miosis, bronchoconstriction, emesis, lacrimation

Which set of gasses poses the most significant hazards on a farm?

Which set of gasses poses the most significant hazards on a farm?




A) b. Methane, carbon tetrachloride, nitrogen dioxide
B) d. Nitrogen dioxide, ethane, carbon tetrachloride
C) a. Carbon monoxide, methane, ethane, nitric oxide
D) c. Nitric oxide, carbon monoxide, nitrogen dioxide


Answer: D) c. Nitric oxide, carbon monoxide, nitrogen dioxide

Which of the following best represents the symptom of a stinging sensation followed by pain and swelling 1 to 3 hours later, while working on farm machinery?

Which of the following best represents the symptom of a stinging sensation followed by pain and swelling 1 to 3 hours later, while working on farm machinery?




A) b. Crush injury
B) a. Allergic reaction to a bee sting
C) c. Hydraulic fluid injection
D) d. Silo filler's disease


Answer: C) c. Hydraulic fluid injection

When responding to an incident on a farm, the paramedic must be aware of a number of hazards including:

When responding to an incident on a farm, the paramedic must be aware of a number of hazards including:




A) b. Chemicals, toxins, confined spaces, animal diseases, and hand tools
B) a. Chemicals, toxic environments, confined spaces, animal diseases, and machinery
C) d. Chemicals, toxins, unconfined spaces, animal diseases, and machinery
D) c. Chemicals, toxins, confined spaces, animal husbandry, and machinery


Answer: B) a. Chemicals, toxic environments, confined spaces, animal diseases, and machinery

While performing a scene size-up for a silo rescue, the paramedic is told that the fermentation of the silage ended 2 months earlier. What does this information tell the paramedic?

While performing a scene size-up for a silo rescue, the paramedic is told that the fermentation of the silage ended 2 months earlier. What does this information tell the paramedic?



A) c. Toxic gasses have ceased accumulating and may have dissipated.
B) d. Toxic gasses have reached their maximum concentration.
C) b. Toxic gasses are still present but at less than flash point levels.
D) a. Nothing, as toxic gasses are continually produced and are still accumulating.


Answer: A) c. Toxic gasses have ceased accumulating and may have dissipated.

Which of the following describes the best method of extricating a victim from a silo?

Which of the following describes the best method of extricating a victim from a silo?




A) a. Chute of the silo, bottom of the silo, or side of the silo
B) d. Top of the silo, ventilation duct of the silo, or chute of the silo
C) b. Top of the silo, bottom of the silo, or side of the silo
D) c. Top of the silo, chute of the silo, or side of the silo


Answer: D) c. Top of the silo, chute of the silo, or side of the silo

Crush injury syndrome is caused by:

Crush injury syndrome is caused by:



A) c. The inability to breathe because of extreme weight on the chest
B) d. Toxins that accumulate from damaged or dead cells
C) a. Bone fragments entering the circulation
D) b. Fat emboli caused by damaged subcutaneous tissues


Answer: B) d. Toxins that accumulate from damaged or dead cells

A patient complains that his forearm is 'burning,' his muscles feel painful to extend, and his fingers feel cold to the touch. He states that he was trapped for a short time while operating his tractor and thinks he pulled the muscle when freeing himself. What would be the most appropriate cause for his symptoms?

A patient complains that his forearm is 'burning,' his muscles feel painful to extend, and his fingers feel cold to the touch. He states that he was trapped for a short time while operating his tractor and thinks he pulled the muscle when freeing himself. What would be the most appropriate cause for his symptoms?




A) b. Bruised muscle in the left forearm
B) c. Compartment syndrome
C) a. Acute tendonitis of the arm and hand
D) d. Overextension of the left forearm


Answer: B) c. Compartment syndrome

Farm machinery is powered by any one of three mechanisms including:

Farm machinery is powered by any one of three mechanisms including:




A) c. Power take off, hydraulics, manual power
B) a. Cascading electronics, hydraulics, motor
C) d. Power take off, motor, hydraulics
D) b. Power assist, motor, hydraulics


Answer: C) d. Power take off, motor, hydraulics

How does the management for classic heat stroke and exertional heat stroke differ?

How does the management for classic heat stroke and exertional heat stroke differ?




A) b. After rapid cooling, classic heat stroke also requires aggressive fluid resuscitation.
B) a. Classic heat stroke requires rapid cooling, whereas exertional heat stroke requires aggressive fluid.
C) d. After rapid cooling, there is no difference in care.
D) c. After rapid cooling, exertional heat stroke requires aggressive fluid resuscitation


Answer: C) d. After rapid cooling, there is no difference in care.

Heat stroke can be present with or without:

Heat stroke can be present with or without:




A) b. Dehydration
B) c. Increased body temperature
C) d. Mental status changes
D) a. A very hot environment


Answer: A) b. Dehydration

You have immobilized a patient who was ejected from a car in a motor vehicle crash and landed in the river running beside the road. You can help prevent hypothermia in this patient by:

You have immobilized a patient who was ejected from a car in a motor vehicle crash and landed in the river running beside the road. You can help prevent hypothermia in this patient by:




A) c. Placing the patient in a well-heated ambulance
B) b. Infusing IV fluids warmed to 104° F
C) a. Covering the patient with several wool blankets
D) d. Removing all of the patient's wet clothing and covering the patient with blankets


Answer: D) d. Removing all of the patient's wet clothing and covering the patient with blankets

You have been called to the home of a 37-year-old male patient in respiratory distress. He has no previous medical conditions and takes no medications. However, you can see the patient is in obvious severe distress; he is in the tripod position, and you hear rales as you walk into his house. While obtaining his history, you learn that he was the victim of a near-drowning event the day before and had required a brief period of positive-pressure ventilations. You suspect that this patient is now experiencing:

You have been called to the home of a 37-year-old male patient in respiratory distress. He has no previous medical conditions and takes no medications. However, you can see the patient is in obvious severe distress; he is in the tripod position, and you hear rales as you walk into his house. While obtaining his history, you learn that he was the victim of a near-drowning event the day before and had required a brief period of positive-pressure ventilations. You suspect that this patient is now experiencing:




A) a. Adult respiratory distress syndrome
B) d. Pneumonia
C) c. Congestive heart failure
D) b. Chronic obstructive pulmonary disorder


Answer: A) a. Adult respiratory distress syndrome

Heat stroke occurs at:

Heat stroke occurs at:




A) d. 110° F
B) c. 105° F
C) a. 100° F
D) b. 102° F


Answer: B) c. 105° F

A hyperbaric chamber:

A hyperbaric chamber:



A) d. Can create an artificially low pressure to improve healing
B) a. Can be used to practice breathing at extremely high altitudes
C) b. Can be used to practice scuba diving
D) c. Can create an artificially high pressure to improve healing and dissolve nitrogen bubbles in the body back into the bloodstream


Answer: D) c. Can create an artificially high pressure to improve healing and dissolve nitrogen bubbles in the body back into the bloodstream

How does fever differ from heat stroke?

How does fever differ from heat stroke?




A) a. Fever is caused by exercising the body too hard, whereas heat stroke is caused by the introduction of heat from the environment.
B) d. Heat stroke resets the hypothalamus; fever does not.
C) b. Fever is caused by pyrogens attempting to create an inhospitable environment in the body for some infection source, whereas heat stroke is caused by the introduction of heat from the environment.
D) c. Heat stroke is the result of a failure of the circulatory system.


Answer: C) b. Fever is caused by pyrogens attempting to create an inhospitable environment in the body for some infection source, whereas heat stroke is caused by the introduction of heat from the environment.

Your ambulance is providing first-response coverage at a high school track meet. You are summoned to a 17-year-old female patient lying down by a bench. Her coach is concerned because she keeps vomiting the water she is trying to 'chug' down. You immediately notice she seems pale for such a hot day and she is sweating, and when you take her pulse it feels weak and rapid, approximately 120 beats/min. Your patient also complains she feels nauseated, is lightheaded, and has no energy. However, she can answer all questions appropriately. You suspect that this patient has:

Your ambulance is providing first-response coverage at a high school track meet. You are summoned to a 17-year-old female patient lying down by a bench. Her coach is concerned because she keeps vomiting the water she is trying to 'chug' down. You immediately notice she seems pale for such a hot day and she is sweating, and when you take her pulse it feels weak and rapid, approximately 120 beats/min. Your patient also complains she feels nauseated, is lightheaded, and has no energy. However, she can answer all questions appropriately. You suspect that this patient has:




A) a. Classic heat stroke
B) b. Exertional heat stroke
C) d. Heat exhaustion
D) c. Heat cramps


Answer: C) d. Heat exhaustion

What is the mammalian diving reflex?

What is the mammalian diving reflex?



A) a. A complex cardiovascular reflex that constricts blood flow everywhere but the brain
B) c. The ability of mammals to over time train their bodies to maintain more dissolved oxygen in the bloodstream so that they can hold their breath for ever longer periods of time
C) b. An inherent instinct that signals the mammal when to surface for oxygen
D) d. A mammal's ability to consciously hold one's breath while submerged


Answer: A) a. A complex cardiovascular reflex that constricts blood flow everywhere but the brain

You are the paramedic on a search and rescue team that is preparing to carry a 21-year-old male patient who fell 18 feet from his tree stand, injuring his back and sustaining obvious bilateral lower leg fractures. Which of the following environmental conditions could most easily affect the patient's condition during the half-mile litter carry to the closest helicopter landing zone?

You are the paramedic on a search and rescue team that is preparing to carry a 21-year-old male patient who fell 18 feet from his tree stand, injuring his back and sustaining obvious bilateral lower leg fractures. Which of the following environmental conditions could most easily affect the patient's condition during the half-mile litter carry to the closest helicopter landing zone?




A) c. Uneven rocky terrain on the trail to the landing zone
B) a. Approximately 1 foot of snow covering the ground
C) b. Snow falling at 2 inches per hour
D) d. Winds of 30 mph with a wind chill of -10° F


Answer: D) d. Winds of 30 mph with a wind chill of -10° F

You are managing a 36-year-old female patient who has developed a severe headache and mental status changes, and has begun vomiting regularly while attempting to climb Mount McKinley. You are awaiting her arrival at the 8000-foot base camp. What problem do you suspect this patient has, and how do you want to treat it?

You are managing a 36-year-old female patient who has developed a severe headache and mental status changes, and has begun vomiting regularly while attempting to climb Mount McKinley. You are awaiting her arrival at the 8000-foot base camp. What problem do you suspect this patient has, and how do you want to treat it?



A) d. High-altitude cerebral edema; oxygen, diuretics, and a nasogastric tube
B) c. High-altitude cerebral edema; oxygen and airway protection with intubation
C) b. Acute mountain sickness; oxygen and dexamethasone
D) a. Acute mountain sickness; oxygen and continue descent


Answer: B) c. High-altitude cerebral edema; oxygen and airway protection with intubation

A 28-year-old patient was being evacuated for acute mountain sickness. When he is brought to your ambulance at the 5500-foot (altitude) trail head, he tells you that he feels fine now and wishes to return to his group and continue his ascent to the 11,000-foot peak. What do you advise him?

A 28-year-old patient was being evacuated for acute mountain sickness. When he is brought to your ambulance at the 5500-foot (altitude) trail head, he tells you that he feels fine now and wishes to return to his group and continue his ascent to the 11,000-foot peak. What do you advise him?




A) a. Advise him that he can continue on his trip at the same pace he maintained before.
B) c. Advise him that he needs to be seen in the emergency department.
C) b. Advise him that he can continue on his trip if he follows behind the group by 1000 feet.
D) d. Advise him that his symptoms could easily return if he returned to that altitude.


Answer: D) d. Advise him that his symptoms could easily return if he returned to that altitude.

You are receiving a 26-year-old male patient with altered mental status on an incoming airplane from Florida. When you receive the patient, his friends tell you that he began having a headache and joint pain midflight, and his condition progressively worsened. The patient looks extremely uncomfortable, is constantly wincing, and responds only to painful stimuli. He is diaphoretic, breathing rapidly, and has no obvious signs of injury. All his friends can tell you is that he went scuba diving several times during their trip. You suspect that this patient may have:

You are receiving a 26-year-old male patient with altered mental status on an incoming airplane from Florida. When you receive the patient, his friends tell you that he began having a headache and joint pain midflight, and his condition progressively worsened. The patient looks extremely uncomfortable, is constantly wincing, and responds only to painful stimuli. He is diaphoretic, breathing rapidly, and has no obvious signs of injury. All his friends can tell you is that he went scuba diving several times during their trip. You suspect that this patient may have:




A) a. A myocardial infarction
B) d. The bends
C) c. A septic infection from a saltwater drowning
D) b. A neurotoxin exposure from a snake


Answer: B) d. The bends

As scuba divers proceed to increasing depths, the amount of oxygen and nitrogen that becomes dissolved in the blood increases. When they begin to surface, they must do so slowly because the dissolved nitrogen will return into its gaseous form. This principle refers to:

As scuba divers proceed to increasing depths, the amount of oxygen and nitrogen that becomes dissolved in the blood increases. When they begin to surface, they must do so slowly because the dissolved nitrogen will return into its gaseous form. This principle refers to:




A) d. Newton's law
B) b. Dalton's law
C) a. Boyle's law
D) c. Henry's law


Answer: D) c. Henry's law

What is shallow water blackout?

What is shallow water blackout?




A) a. Drowning that occurs in less than 1 foot of water
B) b. Loss of consciousness from diving into a shallow body of water and striking one's head on the bottom
C) d. Loss of consciousness that occurs from trying to swim too far underwater and ignoring the need to take a breath
D) c. Loss of consciousness that occurs after hyperventilating before swimming (to hold one's breath longer)


Answer: D) c. Loss of consciousness that occurs after hyperventilating before swimming (to hold one's breath longer)

How is traditional 'street' EMS different from wilderness EMS?

How is traditional 'street' EMS different from wilderness EMS?




A) b. Injuries seen in 'street' EMS tend to be more severe.
B) d. Wilderness EMS presupposes much longer periods of EMS care and does not assume all patients will be transported to definitive care.
C) c. Wilderness EMS focuses on natural and herbal remedies for conditions that arise in the woods.
D) a. All injuries and illness need to be managed in the exact same manner; the setting is simply different.


Answer: B) d. Wilderness EMS presupposes much longer periods of EMS care and does not assume all patients will be transported to definitive care

A patient is being brought to shore after becoming unresponsive while scuba diving. Which of the following treatments is least likely to benefit the patient?

A patient is being brought to shore after becoming unresponsive while scuba diving. Which of the following treatments is least likely to benefit the patient?




A) b. Cardiac monitoring
B) d. Spinal immobilization
C) c. Hyperbaric chamber therapy
D) a. 100% oxygen


Answer: B) d. Spinal immobilization

What is occurring during decompression illness?

What is occurring during decompression illness?




A) a. Nitrogen bubbles are developing in the bloodstream and body tissues.
B) b. Not enough oxygen is available to the patient.
C) d. Too much pressure is being exerted on the bloodstream.
D) c. The body is swelling rapidly.


Answer: A) a. Nitrogen bubbles are developing in the bloodstream and body tissues.

You are waiting for a mountain climber to be brought down from an altitude of 10,000 feet after he had an acute decline in his level of consciousness. A report from a wilderness first responder tells you that the patient had been experiencing worsening shortness of breath, had been coughing heavily, and said that he felt like he had no energy. According to the wilderness first responder, the patient's respiratory rate declined from 36 to 10 breaths/min when the patient's level of consciousness decreased from awake to responsive to painful stimuli. The first responder is treating the patient for high-altitude pulmonary edema. You suspect that this condition has resulted in:

You are waiting for a mountain climber to be brought down from an altitude of 10,000 feet after he had an acute decline in his level of consciousness. A report from a wilderness first responder tells you that the patient had been experiencing worsening shortness of breath, had been coughing heavily, and said that he felt like he had no energy. According to the wilderness first responder, the patient's respiratory rate declined from 36 to 10 breaths/min when the patient's level of consciousness decreased from awake to responsive to painful stimuli. The first responder is treating the patient for high-altitude pulmonary edema. You suspect that this condition has resulted in:




A) c. Respiratory failure
B) b. Respiratory arrest
C) a. High-altitude cerebral edema
D) d. Severe respiratory distress


Answer: C) a. High-altitude cerebral edema

You are working in the first aid station of a ski resort. Your base is at 7500 feet, and the peak of the mountain is 9200 feet. A 23-year-old female patient comes into the clinic appearing weak and pale. She tells you that she arrived yesterday and did not sleep well last night, and today she has a mild headache, is nauseated, feels like she has no energy, coughs continuously regardless of what she does to relieve it, and feels short of breath. When you take her vital signs, you notice her SpO2 is 85%. You suspect that she has:

You are working in the first aid station of a ski resort. Your base is at 7500 feet, and the peak of the mountain is 9200 feet. A 23-year-old female patient comes into the clinic appearing weak and pale. She tells you that she arrived yesterday and did not sleep well last night, and today she has a mild headache, is nauseated, feels like she has no energy, coughs continuously regardless of what she does to relieve it, and feels short of breath. When you take her vital signs, you notice her SpO2 is 85%. You suspect that she has:




A) c. High-altitude pulmonary edema
B) a. Acute mountain sickness
C) b. Altitude cerebral edema
D) d. Pneumonia high


Answer: A) c. High-altitude pulmonary edema

You are evaluating a middle-age male patient who was found walking aimlessly down the street at 3 AM on a wintry night. Witnesses called you to evaluate him because he 'does not seem right.' During your evaluation, you find the patient is stumbling, shivering uncontrollably, fumbling with his zipper, and mumbling words that you cannot comprehend. You determine that this patient has:

You are evaluating a middle-age male patient who was found walking aimlessly down the street at 3 AM on a wintry night. Witnesses called you to evaluate him because he 'does not seem right.' During your evaluation, you find the patient is stumbling, shivering uncontrollably, fumbling with his zipper, and mumbling words that you cannot comprehend. You determine that this patient has:




A) c. Moderate hypothermia
B) b. Mild hypothermia
C) a. Hypoglycemia
D) d. Severe hypothermia


Answer: A) c. Moderate hypothermia

The most important aspect of drowning victim management is to:

The most important aspect of drowning victim management is to:




A) d. Not become a victim yourself
B) c. Get the patient out of the water
C) b. Get the patient dry
D) a. Get the airway open


Answer: A) d. Not become a victim yourself

A person has drowned whenever he or she:

A person has drowned whenever he or she:




A) b. Breathes water into the lungs
B) d. Experiences respiratory impairment as a result of being in or under a liquid
C) a. Experiences a blackout while swimming
D) c. Experiences death from submersion


Answer: B) d. Experiences respiratory impairment as a result of being in or under a liquid

It is late fall and you are assisting with the rescue of two men missing in northern Minnesota. They had gone out for an afternoon hunting trip and never returned. After 4 days, they have been located in a swamp, awake, with their clothes soaking wet. The two were huddled together beneath a tree in the snow shivering uncontrollably; they were confused and looked exhausted. During an examination of the 52-year-old male, you note that his core body temperature is 92° F but his other vital signs are within normal limits. What type of hypothermia does this patient have?

It is late fall and you are assisting with the rescue of two men missing in northern Minnesota. They had gone out for an afternoon hunting trip and never returned. After 4 days, they have been located in a swamp, awake, with their clothes soaking wet. The two were huddled together beneath a tree in the snow shivering uncontrollably; they were confused and looked exhausted. During an examination of the 52-year-old male, you note that his core body temperature is 92° F but his other vital signs are within normal limits. What type of hypothermia does this patient have?




A) d. Submersion
B) c. Immersion
C) a. Acute
D) b. Moderate


Answer: D) b. Moderate

You have been called to the home of a 37-year-old male patient in respiratory distress. He has no previous medical conditions and takes no medications. However, you can see the patient is in obvious severe distress; he is awake and anxious, in the tripod position, feels warm to the touch, and is coughing. While obtaining his history, you learn that he was the victim of a near-drowning event 4 days earlier and had required a brief period of positive-pressure ventilations. What do you suspect this patient has developed?

You have been called to the home of a 37-year-old male patient in respiratory distress. He has no previous medical conditions and takes no medications. However, you can see the patient is in obvious severe distress; he is awake and anxious, in the tripod position, feels warm to the touch, and is coughing. While obtaining his history, you learn that he was the victim of a near-drowning event 4 days earlier and had required a brief period of positive-pressure ventilations. What do you suspect this patient has developed?




A) d. Respiratory system failure
B) b. Adult respiratory distress syndrome
C) a. Acute asthma
D) c. Congestive heart failure


Answer: B) b. Adult respiratory distress syndrome

While standing by at the scene of a fire, you are called over to treat a firefighter being dragged out of the fire. His turnout gear is intact and his face mask is on. However, he is responding to verbal stimuli with only incomprehensible verbal mumbling. After moving him into the ambulance, his colleagues assist you in removing his turnout gear and you find his skin hot and flushed with excessive sweating. He is breathing 40 breaths/min, and his exhaled air is noticeably hot. There is no evidence of trauma. You suspect he has:

While standing by at the scene of a fire, you are called over to treat a firefighter being dragged out of the fire. His turnout gear is intact and his face mask is on. However, he is responding to verbal stimuli with only incomprehensible verbal mumbling. After moving him into the ambulance, his colleagues assist you in removing his turnout gear and you find his skin hot and flushed with excessive sweating. He is breathing 40 breaths/min, and his exhaled air is noticeably hot. There is no evidence of trauma. You suspect he has:




A) b. Hypoglycemia
B) c. Evidence of a seizure
C) d. Exertional heat stroke
D) a. Classic heat stroke


Answer: C) d. Exertional heat stroke

You and your partner have been running back-to-back calls since you walked in at 7 AM. By 2 PM you have already completed six emergency calls and a scheduled transport. The day is flying by, and to make matters worse, it is one of the hottest days of the year. Your partner has begun to complain of spasms and cramps in his legs and that he also feels nauseated. When you ask him what he had to drink today, he tells you, 'A couple of cans of Diet Coke.' You suspect that he may be experiencing:

You and your partner have been running back-to-back calls since you walked in at 7 AM. By 2 PM you have already completed six emergency calls and a scheduled transport. The day is flying by, and to make matters worse, it is one of the hottest days of the year. Your partner has begun to complain of spasms and cramps in his legs and that he also feels nauseated. When you ask him what he had to drink today, he tells you, 'A couple of cans of Diet Coke.' You suspect that he may be experiencing:




A) b. Exertional heat stroke
B) d. Heat exhaustion
C) a. Classic heat stroke
D) c. Heat cramps


Answer: D) c. Heat cramps

The most important consideration when rewarming frostbite is to:

The most important consideration when rewarming frostbite is to:




A) c. Provide consistent, regular rubbing
B) a. Avoid refreezing
C) b. Keep water used for immersion rewarming at a constant temperature
D) d. Rewarm as quickly as possible


Answer: B) a. Avoid refreezing

The best way to prevent frostbite is to:

The best way to prevent frostbite is to:




A) a. Avoid high mountain passes
B) b. Place a lubricant on any exposed skin in a cold climate
C) d. Wear proper clothing to protect the skin
D) c. Stay well hydrate


Answer: C) d. Wear proper clothing to protect the skin

What is an appropriate treatment for a venomous snakebite?

What is an appropriate treatment for a venomous snakebite?




A) c. Removing constricting clothes and immobilizing the limb bitten
B) a. Applying a lymphatic tourniquet
C) d. Suctioning the venom out with a snakebite kit
D) b. Applying ice to the bite site


Answer: A) c. Removing constricting clothes and immobilizing the limb bitten

Pit vipers have what form of venom?

Pit vipers have what form of venom?




A) d. Tissue toxins
B) a. Local toxins
C) c. Local and systemic toxins
D) b. Neurotoxins


Answer: C) c. Local and systemic toxins

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