• NUR 2755 MDC4 09/11/2026
Final Exam
Full TEST BANK 3 — Emergency Care and
Transportation of the Sick and Injured (12th
Edition, AAOS) — Complete EMT-Level
Instructor Question Bank With Correct Answers,
Deep Rationales & All 41 Chapters | Updated
2026 Version
Which of the following patients would be the LEAST likely to present with classic signs and symptoms of acute
myocardial infarction?
• A:55-year-old female with COPD and frequent infections.
• B:59 year-old male with alcoholism and angina pectoris.
P 1
, • NUR 2755 MDC4 09/11/2026
Final Exam
• C:72-year-old female with diabetes and hypertension.
• D:64-year-old male with renal disease and depression. - Correct Answer :The correct answer is C;
Reason:
Chest pain, pressure, or discomfort (usually lasting greater than 15 minutes) is present in the majority of patients
experiencing acute myocardial infarction (AMI). Other common signs and symptoms include shortness of
breath, nausea, and diaphoresis. However, elderly female patients—especially those with diabetes—are more
likely to present with atypical or unusual signs and symptoms than any other patient population. Diabetic
neuropathy—a degenerative nerve condition associated with diabetes—results in decreased sensitivity to pain;
therefore, the patient may present without any pain or discomfort. Sometimes, the only presenting signs and
symptoms of AMI are generalized weakness, fatigue, or fainting.
A patient who is experiencing an acute myocardial infarction:
• A:has chest pain or discomfort that does not change with each breath.
• B:often complains of a different type of pain than a patient with angina.
• C:most often describes his or her chest pain as being sharp or tearing.
• D:often experiences relief of his or her chest pain after taking nitroglycerin.
You selected A; This is correct! - Correct Answer :You selected A; This is correct!
Reason:
The type of chest pain or discomfort associated with acute myocardial infarction (AMI) is the same that is
experienced by patients with angina pectoris (eg, dull, crushing, pressure, heaviness); thus, you cannot
distinguish AMI from angina pectoris based solely on the type or quality of pain. Furthermore, the pain
associated with AMI, like that of angina, often radiates to the arm, jaw, back, or epigastrium. Relative to other
causes of chest pain or discomfort (eg, pleurisy, pneumothorax), the pain associated with AMI and angina does
not worsen or improve when the patient takes a breath. Rest and nitroglycerin often relieve the pain associated
with stable angina, but are less likely to relieve the pain associated with AMI.
Following a head injury, a young female is semiconscious and is bleeding from the nose and left ear. You should:
• A:place a pressure dressing over her ear to prevent blood loss.
• B:insert a nasal airway to keep her tongue from blocking the airway.
• C:cover her ear and nose with a loose gauze pad to collect the blood.
P 2
, • NUR 2755 MDC4 09/11/2026
Final Exam
• D:control the bleeding from her nose by pinching her nostrils closed - Correct Answer :You selected D; The
correct answer is C;
Reason:
Blood draining from the ears or nose following a head injury may contain cerebrospinal fluid (CSF) and indicates a
skull fracture. In these cases, do NOT attempt to stop the flow of blood. Applying excessive pressure may force
the blood leaking from the ears or nose to collect within the cranium, which could increase the pressure on the
brain and cause permanent damage. Loosely cover the ears or nose with a sterile gauze pad to collect the blood
and help keep contaminants out (patients with a skull fracture and CSF leakage are at risk for meningitis). The
nasopharyngeal (nasal) airway is contraindicated in patients with a possible skull fracture, especially if blood is
draining from the nose. The airway adjunct may inadvertently enter the cranial vault through the fracture.
Nitroglycerin is contraindicated in all of the following situations, EXCEPT:
• A:systolic BP of 80 mm Hg.
• B:recent use of Cialis.
• C:history of cardiac bypass surgery.
• D:the presence of a head injury. - Correct Answer :You selected C; This is correct!
Reason:
Nitroglycerin (NTG) is a vasodilator drug used to relieve chest pain in patients with cardiac compromise by
dilating the coronary arteries and improving blood flow to the heart. Because of its vasodilator effects, it should
not be given to patients who have a systolic BP less than 100 mm Hg or to patients who have recently (within
the past 24 to 48 hours) taken erectile dysfunction (ED) drugs (eg, sildenafil [Viagra], vardenafil [Levitra],
tadalafil [Cialis]). ED drugs also cause vasodilation and may cause significant hypotension if given together with
NTG. You should also avoid NTG in patients with a head injury; dilation of the cerebral blood vessels may worsen
intracranial pressure caused by the head injury. By itself, a history of cardiac bypass surgery does not
contraindicate the use of NTG.
Which of the following describes pulseless electrical activity (PEA)?
• A:A rapid cardiac rhythm that does not produce a pulse, but responds to defibrillation
• B:Any organized cardiac rhythm, slow or fast, that does not produce a palpable pulse
• C:The presence of a palpable pulse in the absence of any electrical activity in the heart
P 3
, • NUR 2755 MDC4 09/11/2026
Final Exam
• D:A disorganized, chaotic quivering of the heart muscle that does not generate a pulse - Correct Answer :The
correct answer is B;
Reason:
Pulseless electrical activity (PEA) is a condition in which the heart produces organized electrical activity (slow or
fast), despite the absence of a palpable pulse. A disorganized, chaotic quivering of the heart muscle that does
not generate a pulse is called ventricular fibrillation (V-Fib), and is treated with defibrillation. Defibrillation is not
indicated for patients with PEA; it is only indicated for patients with V-Fib or pulseless ventricular tachycardia (V-
Tach). If the AED gives a no shock message, and the patient is still pulseless, he or she is either in asystole or PEA,
neither of which are shockable rhythms.
Which of the following questions would be the MOST effective in determining if a patient's chest pain radiates
away from his or her chest?
• A:Do you also have pain in your arm, jaw, or back?
• B:Is there any other part of your body where you have pain?
• C:Does the pain stay in your chest or move anywhere else?
• D:Is there anything that makes the pain better or worse? - Correct Answer :You selected C; This is correct!
Reason:
When assessing a patient with any type of pain, you should avoid asking leading questions; instead, ask open-
ended questions whenever possible. For example, instead of asking the patient if his or her pain is dull, crushing,
or sharp, ask him or her to describe the pain using his or her own words. Patients with radiating pain often state
that the pain moves or travels away from its point of origin, with pain in between point A and point B. Patients
with referred pain complain of pain in more than one location, without a trail of pain in between. You should also
ask the patient if anything makes the pain worse (provokes) or better (palliates).
Occasional, irregular breaths that may be observed in a cardiac arrest patient are called:
• A:Biot respirations.
• B:Cheyne-Stokes respirations.
• C:ataxic respirations.
• D:agonal gasps. - Correct Answer :You selected D; This is correct!
P 4
Final Exam
Full TEST BANK 3 — Emergency Care and
Transportation of the Sick and Injured (12th
Edition, AAOS) — Complete EMT-Level
Instructor Question Bank With Correct Answers,
Deep Rationales & All 41 Chapters | Updated
2026 Version
Which of the following patients would be the LEAST likely to present with classic signs and symptoms of acute
myocardial infarction?
• A:55-year-old female with COPD and frequent infections.
• B:59 year-old male with alcoholism and angina pectoris.
P 1
, • NUR 2755 MDC4 09/11/2026
Final Exam
• C:72-year-old female with diabetes and hypertension.
• D:64-year-old male with renal disease and depression. - Correct Answer :The correct answer is C;
Reason:
Chest pain, pressure, or discomfort (usually lasting greater than 15 minutes) is present in the majority of patients
experiencing acute myocardial infarction (AMI). Other common signs and symptoms include shortness of
breath, nausea, and diaphoresis. However, elderly female patients—especially those with diabetes—are more
likely to present with atypical or unusual signs and symptoms than any other patient population. Diabetic
neuropathy—a degenerative nerve condition associated with diabetes—results in decreased sensitivity to pain;
therefore, the patient may present without any pain or discomfort. Sometimes, the only presenting signs and
symptoms of AMI are generalized weakness, fatigue, or fainting.
A patient who is experiencing an acute myocardial infarction:
• A:has chest pain or discomfort that does not change with each breath.
• B:often complains of a different type of pain than a patient with angina.
• C:most often describes his or her chest pain as being sharp or tearing.
• D:often experiences relief of his or her chest pain after taking nitroglycerin.
You selected A; This is correct! - Correct Answer :You selected A; This is correct!
Reason:
The type of chest pain or discomfort associated with acute myocardial infarction (AMI) is the same that is
experienced by patients with angina pectoris (eg, dull, crushing, pressure, heaviness); thus, you cannot
distinguish AMI from angina pectoris based solely on the type or quality of pain. Furthermore, the pain
associated with AMI, like that of angina, often radiates to the arm, jaw, back, or epigastrium. Relative to other
causes of chest pain or discomfort (eg, pleurisy, pneumothorax), the pain associated with AMI and angina does
not worsen or improve when the patient takes a breath. Rest and nitroglycerin often relieve the pain associated
with stable angina, but are less likely to relieve the pain associated with AMI.
Following a head injury, a young female is semiconscious and is bleeding from the nose and left ear. You should:
• A:place a pressure dressing over her ear to prevent blood loss.
• B:insert a nasal airway to keep her tongue from blocking the airway.
• C:cover her ear and nose with a loose gauze pad to collect the blood.
P 2
, • NUR 2755 MDC4 09/11/2026
Final Exam
• D:control the bleeding from her nose by pinching her nostrils closed - Correct Answer :You selected D; The
correct answer is C;
Reason:
Blood draining from the ears or nose following a head injury may contain cerebrospinal fluid (CSF) and indicates a
skull fracture. In these cases, do NOT attempt to stop the flow of blood. Applying excessive pressure may force
the blood leaking from the ears or nose to collect within the cranium, which could increase the pressure on the
brain and cause permanent damage. Loosely cover the ears or nose with a sterile gauze pad to collect the blood
and help keep contaminants out (patients with a skull fracture and CSF leakage are at risk for meningitis). The
nasopharyngeal (nasal) airway is contraindicated in patients with a possible skull fracture, especially if blood is
draining from the nose. The airway adjunct may inadvertently enter the cranial vault through the fracture.
Nitroglycerin is contraindicated in all of the following situations, EXCEPT:
• A:systolic BP of 80 mm Hg.
• B:recent use of Cialis.
• C:history of cardiac bypass surgery.
• D:the presence of a head injury. - Correct Answer :You selected C; This is correct!
Reason:
Nitroglycerin (NTG) is a vasodilator drug used to relieve chest pain in patients with cardiac compromise by
dilating the coronary arteries and improving blood flow to the heart. Because of its vasodilator effects, it should
not be given to patients who have a systolic BP less than 100 mm Hg or to patients who have recently (within
the past 24 to 48 hours) taken erectile dysfunction (ED) drugs (eg, sildenafil [Viagra], vardenafil [Levitra],
tadalafil [Cialis]). ED drugs also cause vasodilation and may cause significant hypotension if given together with
NTG. You should also avoid NTG in patients with a head injury; dilation of the cerebral blood vessels may worsen
intracranial pressure caused by the head injury. By itself, a history of cardiac bypass surgery does not
contraindicate the use of NTG.
Which of the following describes pulseless electrical activity (PEA)?
• A:A rapid cardiac rhythm that does not produce a pulse, but responds to defibrillation
• B:Any organized cardiac rhythm, slow or fast, that does not produce a palpable pulse
• C:The presence of a palpable pulse in the absence of any electrical activity in the heart
P 3
, • NUR 2755 MDC4 09/11/2026
Final Exam
• D:A disorganized, chaotic quivering of the heart muscle that does not generate a pulse - Correct Answer :The
correct answer is B;
Reason:
Pulseless electrical activity (PEA) is a condition in which the heart produces organized electrical activity (slow or
fast), despite the absence of a palpable pulse. A disorganized, chaotic quivering of the heart muscle that does
not generate a pulse is called ventricular fibrillation (V-Fib), and is treated with defibrillation. Defibrillation is not
indicated for patients with PEA; it is only indicated for patients with V-Fib or pulseless ventricular tachycardia (V-
Tach). If the AED gives a no shock message, and the patient is still pulseless, he or she is either in asystole or PEA,
neither of which are shockable rhythms.
Which of the following questions would be the MOST effective in determining if a patient's chest pain radiates
away from his or her chest?
• A:Do you also have pain in your arm, jaw, or back?
• B:Is there any other part of your body where you have pain?
• C:Does the pain stay in your chest or move anywhere else?
• D:Is there anything that makes the pain better or worse? - Correct Answer :You selected C; This is correct!
Reason:
When assessing a patient with any type of pain, you should avoid asking leading questions; instead, ask open-
ended questions whenever possible. For example, instead of asking the patient if his or her pain is dull, crushing,
or sharp, ask him or her to describe the pain using his or her own words. Patients with radiating pain often state
that the pain moves or travels away from its point of origin, with pain in between point A and point B. Patients
with referred pain complain of pain in more than one location, without a trail of pain in between. You should also
ask the patient if anything makes the pain worse (provokes) or better (palliates).
Occasional, irregular breaths that may be observed in a cardiac arrest patient are called:
• A:Biot respirations.
• B:Cheyne-Stokes respirations.
• C:ataxic respirations.
• D:agonal gasps. - Correct Answer :You selected D; This is correct!
P 4
