NREMT 2023 CORRECT ANSWER

NREMT 2023 CORRECT ANSWER In trauma a low pulse pressure suggests? - CORRECT ANSWER-Significant blood loss Blood pressure has a direct effect on? - CORRECT ANSWER-The perfusion of the bodys tissues Cells that die during a stroke are called? - CORRECT ANSWER-Infarcted cells You are called to a home where a 91 year old man has had a syncopal episode and is vomiting. The caregiver who called 911 stated that the patient's bowel movements have been bright red since yesterday. The patient has not complained of any pain, but is nauseated. What is most likely wrong with this man and which choice includes appropriate treatment steps? Choices: A. He has an upper GI bleed and should be transported sitting up with high flow O2 administered via a non rebreather mask at 15 LPM. B. He has had a TIA and should be given high flow oxygen via NRB and transported on his effected side to the nearest hospital. C. He has pancreatitis and should be given high flow O2 via NRB at 15 LPM. Rapid transport in a left lateral recumbent position while keeping him warm will help avoid shock. D. He has a lower GI bleed and should be given O2 via nasal cannula at 4LPM and transported in a position of comfort while treating for shock - CORRECT ANSWER-D. He has a lower GI bleed and should be given O2 via nasal cannula at 4LPM and transported in a position of comfort while treating for shock Rationale: The bright red blood in the bowel movements is indicative of a lower GI bleed. Answer 1,2, and 3 all utilize an NRB to deliver high flow O2. Given that the patient is vomiting and nauseated, it would be advisable to use a nasal cannula, rather than an NRB, to help avoid potential airway compromise if the patient continues to vomit. If a patient was feeling nauseated this would likely be a_______________response. If a person was tachycardic it would likely be a___________________ response. - CORRECT ANSWER-Parasympathetic/Sympathetic You are assessing an 84 year old man. Upon auscultation of the lungs you discover crackles or rale sounds. He is complaining of chest pain and congestion. These signs and symptoms can indicate? Choices: A. An embolism B. Collapse of the vena cava C. Left ventricular failure D. Right ventricular failure - CORRECT ANSWER-C. Left ventricle failure Rationale: These are signs and symptoms of a possible failure of the left ventricle. The pump portion of the heart is unable to pump efficiently and fluid begins to back up into the lungs. A child between 3-5 would have normal vitals if they were? Choices: A. 35 breaths a minute, pulse of 88, and Systolic BP of 100 B. 24 breaths a minute, pulse of 76, and Systolic BP of 98 C. 20 breaths a minute, pulse of 100, and Systolic BP of 110 D. 20 breaths a minute, pulse of 120, and Systolic BP of 120 - CORRECT ANSWER-20 breaths a minute, pulse of 100, and Systolic BP of 110 Rationale: A child between 3 and 5 (preschool-age) should have respirations between 20-30, a pulse of 80-120, and a systolic BP of 80 - 110. (Toddler 12 to 36 months) The pediatric assessment triangle is composed of three elements: Choices: A. Muscle Tone, Respiratory depth and rate, Perfusion B. Circulation, Appearance, Work of Breathing C. Level of Consciousness, Quality of Respirations, General Appearance D. Blood pressure, Pulse rate, Respiratory Rate - CORRECT ANSWER-B. Circulation, Appearance, Work of Breathing Rationale: PAT is Work of Breathing, Skin Circulation, Appearance. The pediatric assessment triangle is used to form a rapid general impression of a child without making physical contact. Look at the child's appearance and muscle tone. Look at the work of breathing for signs of respiratory distress. Tachypnea or retractions of sternum and or intercostal muscles is a sign of respiratory difficulty. Look at the skin as a quick reference for circulation. Pallor can be a sign of poor circulation. The patient is a 6 year old girl whose mother says has been sick for a few days and then started having breathing problems this morning. Upon assessment, you notice the child is flaring her nostrils and has a hoarse voice when talking. What is she most likely suffering from and what should you do? Choices: A. She could have croup and needs to be transported with a nasal cannula at 4 lpm B. She could have tonsillitis and will require transport to the hospital in a position of comfort C. She could have SARS and should be transported wearing a HEPA mask D. She could have epiglottitis and needs to be transported with high flow O2 on an NRB - CORRECT ANSWER-D. She could have epiglottitis and needs to be transported with high flow O2 on an NRB Rationale: Epiglottitis is known to strike children in this age group. Croup is usually in younger children. Transporting with airway support is the best answer. What is pulse pressure? - CORRECT ANSWER-The difference between the systolic and diastolic measurements of the blood pressure A 57 year old woman is complaining of chest pain. Her blood pressure is 109/88 and her respirations are at 22 per minute. What condition does the patient's blood pressure indicate? A. Paradoxical Pressure B. Low pulse pressure C.Systolic transcardiac eschemia D. Martiners Rule - CORRECT ANSWER-B. Low pulse pressure Rationale: A pulse pressure is considered abnormally low if it is less than 25% of the systolic value. In this question it is about 20% of the systolic value. The pulse pressure is the difference between the systolic and diastolic measurements of the blood pressure. 109 systolic - 88 diastolic = 21 mmHg. In trauma a low pulse pressure suggests significant blood loss. If the pulse pressure is extremely low, i.e. 25 mmHg or less, the cause may be low stroke volume, as in Congestive Heart Failure and/or shock. A low pulse pressure can also be caused by aortic valve stenosis and cardiac tamponade