EMT STATE EXAM NC QUESTIONS AND ANSWERS GRADED A+

EMT STATE EXAM NC QUESTIONS AND ANSWERS GRADED A+ FIRST STAGE OF LABOR - The first stage occurs from onset of true labor contractions till dilation and effacement of the uterus. 2nd stage of labor - The hallmark finding in the second stage of labor is the complete delivery of the baby. 3rd stage of labor - The third stage occurs when the placenta delivers. Ligaments connect.... - Bone to Bone Tendons connect - Bone to Muscle START Triage 1st Step - START triage begins by asking patients to get up and walk to a collection point START Triage 2nd step - respirations are assessed START Triage 3rd Step - if the patient is not breathing, the airway is opened. START Triage 4th Step - Pulse is then assessed START Triage 5th Step - Check mental status. Rule of 9's:Child:BACK - child's back represents 18% of his body surface area Rule of 9's:Child: Both Legs (Front & Back) - the front and back of both legs each represent 7% Rule of 9's:Child:Torso (Front & Back) - child's anterior and posterior torso would represent 36% Primary blast stage - also known as the pressure wave), damages hollow, gas containing organs of the body such as the lungs, GI system, inner ears, and sinuses. Secondary blast - The secondary phase causes cause blunt and penetration injuries from flying debris. Tertiary phase of blast - tertiary phase are injuries sustained from the patient being thrown back and impacting something (wall, ground, etc.). A 71-year-old female has fallen and complains of left hip pain. On examination you note her left foot is rotated laterally. This finding most likely indicates a - femur fracture "5 Rights" of medication administration. - right patient, right medication, right route, right dose, and right time. If you are responsible for establishing the landing zone for the helicopter, what is the minimum size of the LZ you should prepare assuming the rescue efforts are occurring at night? - The minimum size of the landing zone at night is 100' by 100'. During daylight, the minimum LZ zone is 60' by 60'. In either situation the LZ should be square, with a marker indicating the direction of wind travel Which one of the following is a sign of Cushing's triad (Cushing's reflex) that occurs with traumatic brain injury? - The vital signs are an increased blood pressure, slowing pulse rate, and irregular respirations (classically seen as Cheyne-Stokes). Classes of hemorrhage - A Class III hemorrhage is said to occur when the patient has lost 30-40% of their circulating blood volume. This is a significant bleed due to the fact that the body's compensatory mechanisms are maximized, and any additional blood loss will now create significant disturbances in hemodynamic stability. In Class I and II hemorrhage, blood pressure remains acceptable, in Class IV hemorrhage the blood pressure drops dangerously low. APGAR SCORE - Appearance: 0=blue/pale; 1=blue & pink; 2=no cyanosis-all pink Pulse Rate: 0=Absent; 1=<100; 2=>100 Reflex: 0=no response to stimuli; 1=grimace; 2=cry or pull away Activity: 0=None; 1=some flexion,2=flexed arms/legs resisting extension Respiratory: 0=Absent; 1=weak, irregular; 2=strong, lusty cry Organs in Upper Right Quadrant of Abs - The liver is found primarily within the boundaries of the upper right quadrant. Organs in Upper Left Quadrant of Abs - The stomach and spleen are typically found in the upper left quadrant. Bladder location - The bladder is found on the midline between the lower two quadrants. Communication "Reflection" - Reflection is a technique where you paraphrase the patient's words to encourage more information and to build trust Minimum safe residual pressure in oxygen tank is? - The minimum safe residual pressure in an oxygen tank is 200 psi. Nasal cannula oxygen flow rate - 1 to 6L/min Nasal cannula oxygen concentration - 24% to 44% NRB Flow rate - 12 to 15L/min NRB oxygen delivered - 90% to 100% Venturi mask oxygen delivery - 24, 28, 35, 40 percent BVM flow rate and oxygen delivery - 15L /min and nearly 100% Cheyne-Stokes Respirations - Shows irregular respirations followed by a period of apnea Ataxic Respirations - irregular, ineffective respirations that may or may not have an identifiable pattern. ICP (intracranial Pressure) Signs/symptoms - decreased pulse (Bradycardia), increased B/P (Hypertension), irregular respirations. ICP Defined - Accumulations of blood within the skull or swelling of the brain. Triad of signs (Cushing's Reflex) are: (Usually seen with ICP) - 1. Increased systolic B/P 2. Decreased pulse rate 3. Irregular respirations. Glascow Comas Scale (GCS) Components; - Eye opening, Verbal Response Motor Response GCS (Eye Opening) Ratings - Spontaneous-4 Verbal response-3 Response to pain-2 None-1 GCS (Verbal Response) Ratings - Oriented Conversation-5 Confused Conversation-4 Inappropriate Words-3 Incomprehensible sounds-2 None-1 GCS (Best Motor Response) - Obeys Commands-6 Localizes Pain-5 Withdraws Pain-4 Abnormal Flexion-3 Abnormal Extension-2 None-1 GCS Scores Total Ratings: - 13-15: mild dysfunction; 15 is considered a person with no neurologic disabilities A oxygen tank which holds 350 liters - D Cylinder (portable) D Tank (PSI): - 2000 psi Severe allergic reaction signs: - urticaria, bronchosphasm, swelling of lips Order of assessing a patient after scene size up: - 1. Initial assessment 2. Focused Assessment 3. Complete assessment 4. Ongoing Assessment Ethics: - Philosophy of right and wrong, of moral duties, CQI - Circular System of continuous internal and external reviews and audits of all aspects of an ems system General Adaptation Syndrome (stress) - 1. Alarm Response 2. Reaction and Resistance 3. Recovery or exhaustion Fight or Flight Response - The physiologic response involves the interaction of the endocrine and nervous systems. Pulse rate:adult - 60-100 Pulse rate : newborn - 140-160 Pulse rate: child(6-12) - 65-110 PERL: dilated signs - Cerebral hypoxia, cocaine, Epi, amphetamine PERL: small eye signs - Narcotic, organophosphate PERL: Unequal eyes - Brain injury, can be normal Distended neck veins causes - Tension pneumo, cardiac tamponade , right heart failure Define Ascites: - Fluid in abdominal cavity Shock formula - HR (beta-1) X Stroke Volume (beta-2)= CO or BP Unstable scenes - 1. Safety always first 2. Injury 3. Index of suspicion 4. Observe before leaving Neonatal resuscitation: assess and support - Temperature: warm and dry Airway: position and suction Breathing: stimulate to cry Circulation: HR and color Neonatal Frequent needs: - Dry, warmth, position, suction, stimulate. Oxygen Neonatal moderate needs: - Establish effective ventilation. BVM or endotracheal intubation. Neonatal infrequent needs: - Chest compressions and medications Shock symptoms (opposite of ICP) - Hypotension, tachycardia, tachypnea Uterus location - Lower quadrants if over 3 months pregnant Uterus location (over 6 months pregnant)? - Upper quadrants Large and small intestine locations? - Each quadrant Kidney location? - Upper and lower quadrant: retro peritoneal Adrenal glands location? - On superior portion of upper quadrant Amenorrhea - Without period. Sign of pregnancy Anisocoria - Unequal pupils Aura - Sensation primo to seizure Cephalgia - Headache Dsyconjugate gaze - Unequal eye movement Embolus emboli - Clot or particle that travels in the blood stream Emesis - Vomit Exacerbate - Increase in symptoms or severity of disease Hematuria - Blood in urine Hemoptysis - Coughing up blood