L e a r n i n g E x p r e s s® COMPLETE TEST PREPARATION

L e a r n i n g E x p r e s s® COMPLETE TEST PREPARATION EMT-BASIC EXAM The Most EMT Practice Tests Available! • TWELVE complete practice tests based on the official national registry exam • Updated review lessons covering current U.S. DOT/NHTSA curriculum • Written by an expert team of EMS educators and practitioners • Proven test-taking strategies to help reduce anxiety Boost Your Score! FREE ACCESS to an Instantly Scored Online Practice Exam IT’S LIKE HAVING THE TEST IN ADVANCE! EMT-BASIC EXAM Fifth Edition ® Copyright © 2011 LearningExpress, LLC. All rights reserved under International and Pan-American Copyright Conventions. Published in the United States by LearningExpress, LLC, New York. Library of Congress Cataloging-in-Publication Data: EMT-basic exam.—5th ed. p. ; cm. ISBN-13: 978-1-57685-790-8 ISBN-10: 1-57685-790-5 1. Emergency medicine—Examinations, questions, etc. 2. Emergency medical technicians—Examinations, questions, etc. I. LearningExpress (Organization) [DNLM: 1. Emergency Medical Services—Examination Questions. 2. Emergencies—Examination Questions. 3. Emergency Medical Technicians— Examination Questions. WX 18.2] RC86.7.E5915 2011 616.02'5076—dc22 Printed in the United States of America 5 4 3 2 1 Fifth Edition ISBN 978-1-57685-790-8 For more information or to place an order, contact LearningExpress at: 2 Rector Street 26th Floor New York, NY 10006 Or visit us at: CONTENTS CONTRIBUTORS v CHAPTER 1 The EMT-Basic Exam 1 CHAPTER 2 The LearningExpress Test Preparation System 5 CHAPTER 3 EMT-Basic Practice Exam 1 23 CHAPTER 4 EMT-Basic Practice Exam 2 53 CHAPTER 5 EMT-Basic Practice Exam 3 81 CHAPTER 6 EMT-Basic Practice Exam 4 111 CHAPTER 7 EMT-Basic Practice Exam 5 139 CHAPTER 8 EMT-Basic Practice Exam 6 159 CHAPTER 9 EMT-Basic Practice Exam 7 179 CHAPTER 10 EMT-Basic Practice Exam 8 201 CHAPTER 11 EMT-Basic Practice Exam 9 223 CHAPTER 12 EMT-Basic Practice Exam 10 243 iii CONTENTS CHAPTER 13 EMT-Basic Practical Skills Exam 273 CHAPTER 14 State Certification Requirements 309 ADDITIONAL ONLINE PRACTICE 313 iv CONTRIBUTORS Mike Clumpner is a co-founder and senior partner with Nimshi International, a Charlotte, North Carolina consulting firm. Mike is also a full-time fire captain/paramedic for the Charlotte Fire Department where he is currently assigned to the Special Operations Division. Mike is a decorated 18-year veteran of the fire service, with 16 years of experience as a firefighter/paramedic serving on busy inner-city fire companies. He is a FEMA Medical Task Force Leader assigned to North Carolina Urban Search and Rescue Task Force 3 (NCTF-3) and has worked since 2004 as a helicopter flight paramedic with Regional One Air Medical Service in Spartanburg, South Carolina. Mike is also clinical faculty at the University of Maryland at Baltimore County where he teaches a variety of classes and assists with program development. Mike is also a sworn civilian law enforcement officer with a large metropolitan law enforcement agency where he is currently assigned to the Special Response Team as a SWAT officer and tactical paramedic. Mike has three undergraduate degrees, an MBA, and is now completing a doctoral degree (PhD) in home- land security policy. Mike has published numerous articles in peer-reviewed journals and has authored and co- authored multiple books on a variety of subjects. Mike has lectured extensively throughout North America, Latin America, Europe, Australia, New Zealand, and the Caribbean presenting at more than 250 major congresses and symposiums on a variety of subjects. Meredith C. White, CCEMT-P, EMT-P, CCT has been working in health care and EMS for 12 years, including working as a helicopter flight paramedic for the last four years. She obtained her paramedic certificate in 1998 and received her critical care training at the Medical College of Georgia in Augusta, Georgia. In addition to her EMS career, she has also been employed with Southeastern Tissue Alliance as a tissue procurement technician and is also a certified cardiographic technician (CCT) with a nuclear medicine lab in Atlanta, Georgia. Meredith lives in New Orleans, Louisiana and is employed as a consultant at Nimshi International, where she is actively involved in the development of various critical care education programs. CONTRIBUTORS Malcolm D. Devine, NREMT-Paramedic worked as a paramedic in the New York City 911 system following graduation from the State of New York Stony Brook University Paramedic Program. Devine currently holds the position of clinical coordinator–paramedic instructor at SUNY Stony Brook and is an active paramedic with the Setauket fire district in Setauket, NY. vi THE EMT-BASIC EXAM CHAPTER SUMMARY This chapter tells you how to become certified as an Emergency Medical Technician-Basic (EMT-B). It outlines the certification requirements of the National Registry of Emergency Medical Technicians and tells you how to use this book to study for the written exam. he National Registry of Emergency Medical Technicians (NREMT) was established in 1970 in response to a suggestion of the U.S. Committee on Highway Safety. Today, the NREMT is an independent, not- for-profit agency whose job is to certify that EMTs have the knowledge and skills to do their job—to save lives and preserve health. By setting uniform national standards for training, testing, and continuing educa- tion, the NREMT helps ensure patient safety throughout the United States. In some states, the NREMT certification process is the only licensure process for EMTs. Other states have their own testing procedures. (A list of specific certification requirements for all 50 states, Washington, D.C., Puerto Rico, and the U.S. Virgin Islands appears in Chapter 14.) Nearly all states and U.S. territories base their curriculum and tests on the U.S. Department of Transportation’s National Standard Curriculum for EMT-Basics. The NREMT exam uses the same curriculum to guide the construction of exam questions. Therefore, whether you will be taking a state test or the NREMT test, you will be learning and studying similar material. This book is based on the NREMT cognitive examination. THE EMT- BASIC EXAM Minimum Requirements To apply for national registration as an EMT-Basic with the NREMT, you must meet the following requirements: ◦ You must be at least 18 years old. ◦ You must have successfully completed a state- approved National Standard EMT-Basic training program within the last two years. ◦ If your state does not require national EMT-Basic registration, you must obtain official documenta- tion of your current state EMT-Basic certification. ◦ You must have successfully completed all sections of a state-approved EMT-Basic practical exam within the past 12 months. This exam must equal or exceed all the criteria established by the National Registry. ◦ You must complete the felony statement on the application and submit the required documentation. ◦ You must submit current cardiopulmonary resuscitation (CPR) credentials from either the American Heart Association or the American Red Cross. ◦ You must submit an acceptable application attesting to the satisfaction of the previous requirements. ◦ You must send a $70 nonrefundable/ nontransferable application fee (money order only). All fees must be made payable to the National Registry of Emergency Medical Techni- cians and submitted with the application to cover processing of the application. ◦ You must successfully complete the National Reg- istry EMT-Basic cognitive and state-approved psychomotor examinations. How to Apply When you have met all the requirements and are ready to take the exam, visit the NREMT website at . From there, you will click on the link Apply for your NREMT Exam to create an account, fill out your application, pay your $70 fee, and ensure you are approved to take the exam. After you finish these introductory steps, you will be able to apply for this computerized exam by calling your state testing center. The EMT-Basic Cognitive Exam The National Registry’s EMT-Basic cognitive exami- nation ranges from 70 to 120 items, and the maxi- mum time allotted to take the exam is two hours from the time it begins. The exam is administered using a computer adaptive test (CAT). With the CAT method, each question is modified to fit your abili- ties. For example, if you answer a question correctly, the following question will be somewhat more chal- lenging. If you answer a question incorrectly, the following question will be a bit easier. The more questions you answer correctly, the more likely you are to end the exam early. Once you complete each section of questions, the CAT will reevaluate your ability, and as the exam continues, the program will adapt to match your skill level. The purpose of the CAT-administered cogni- tive exam is to find your highest ability level. The exam is pass/fail, and in order to pass, you must meet entry-level competency. Entry-level competency is the NREMT’s criteria for an EMT-Basic candidate, which includes being able to practice carefully and capably. THE EMT- BASIC EXAM The exam consists of six content areas: The National Registry EMT-Basic application also requires proof that you have successfully completed PERCENT OF CATEGORY OVERALL TEST Airway and Breathing 18.0% Cardiology 17.3% Trauma 16.7% Operations 16.7% Pediatrics and Obstetrics/Gynecology 16.0% Medical 15.3% TOTAL 100% For more information on the EMT-Basic cognitive exam, visit . The EMT-Basic Practical Exam When you apply for National Registry EMT-Basic reg- istration, you will fill out an application that consists of several sections. The application requires verification of your credentials. The verification may be in the form of your program director’s electronic signature attest- ing to competency in the following skills: 1. Patient Assessment/Management—Trauma 2. Patient Assessment/Management—Medical 3. Cardiac Arrest Management/AED 4. Spinal Immobilization (Seated Patient) 5. Spinal Immobilization (Supine Patient) 6. Bag-Valve-Mask Apneic Patient with a Pulse 7. Long Bone Fracture Immobilization 8. Joint Dislocation Immobilization 9. Traction Splinting 10. Bleeding Control/Shock Management 11. Upper Airway Adjuncts and Suction 12. Mouth-to-Mask with Supplemental Oxygen 13. Supplemental Oxygen Administration a state-approved practical examination within a 12-month period. At a minimum, the exam must evalu- ate your performance in the following skills. To pass the practical exam, you must meet or exceed the NREMT’s criteria in the following six areas: • Station #1: Patient Assessment/Management— Trauma • Station #2: Patient Assessment/Management— Medical • Station #3: Cardiac Arrest Management/AED • Station #4: Spinal Immobilization (seated or supine patient) • Station #5: Bag-Valve-Mask Apneic Patient with a Pulse • Station #6: Random Skill Station. This will con- sist of one of the following skills: ◦ Long bone fracture immobilization ◦ Joint dislocation immobilization ◦ Traction splinting ◦ Bleeding control/shock management ◦ Upper airway adjuncts and suction ◦ Mouth-to-mask with supplemental oxygen ◦ Supplemental oxygen administration Chapter 13 contains more detailed information about the NREMT practical exam. Using This Book to Prepare The bulk of this book consists of 10 practice tests, each containing 120–150 questions similar to those on the National Registry EMT-Basic cognitive examination. All practice tests represent content from the NREMT- Basic examination. The first step in using this book to prepare for the EMT-Basic cognitive examination is to read Chap- ter 2, which presents the nine-step LearningExpress Test Preparation System. Chapter 2 introduces essen- tial test-taking strategies that you can practice as you take the exams in this book. THE EMT- BASIC EXAM Next, take one complete practice test and score your answers using the answer key. Complete explana- tions for the answers are included. Even though the EMT-Basic cognitive exam is pass/fail, LearningExpress recommends scoring at least a 70% on the practice tests in order to achieve the best results on your final EMT-Basic exam. If you score over 70% on your first practice exam, congratulations! However, even if you do very well on the practice test, don’t become overconfident and sim- ply assume that you’ll pass the actual test easily—the items on that test will be different from those on the practice test. You’ll still need to do some test prepara- tion. No matter what your initial score, follow the suggestions in the next paragraphs. If you score below 70% on your first practice test, don’t panic, but do put in some concentrated study time. Begin your studying by determinining your major areas of weakness. For example, perhaps you answered 40 items on the practice test incorrectly, giving you a score of 80, or approximately 67%. Upon rereading the questions you missed, try to determine the content area in which they belong: Cardiology; Airway and Breathing; Trauma; Medical; Pediatrics and Obstetrics/Gynecology; or Opera- tions, for example. This analysis tells you where you need to concen- trate your studying. Try putting in one or two con- centrated evenings of study on each area. Review all the material on these topics in the textbook and printed materials from your EMS course. Then take a second practice test and check your total score and content area breakdown again. Chances are that your total will have improved. In the time leading up to the EMT-Basic cogni- tive exam, use the remaining practice tests to further pinpoint areas of weakness and to find areas to review. For example, suppose that after additional study ses- sions, you take the third practice test. You now do well on all the questions about circulation except the ones that ask you to recognize signs and symptoms of shock. This information tells you which specific pages of your textbook you should review. Once you have worked on and improved your areas of weakness, use the final days before the test to do some general reviewing. Devote a short period of time each day to reviewing one or two chapters of your textbook. Then use the fourth and tenth practice tests to rehearse free-response testing. Although this method is not included on the official exam, it pro- vides an alternative form of evaluation, and the chal- lenge will help you achieve greater understanding of the concepts. After reading and studying this book, you’ll be well on your way to obtaining certification as an EMT- Basic. Good luck as you enter this rewarding and worthwhile career! THE LEARNINGEXPRESS TEST PREPARATION SYSTEM CHAPTER SUMMARY Taking the EMT-Basic exam can be tough. It demands a lot of preparation if you want to achieve a top score. Your career in emergency medical services depends on your passing the exam. The LearningExpress Test Preparation System, developed exclu- sively for LearningExpress by leading test experts, gives you the discipline and attitude you need to be a winner. irst, the bad news: Taking the EMT-Basic exam is no picnic, and neither is getting ready for it. Your future career as an EMT depends on passing, but there are all sorts of pitfalls that can keep you from doing your best on this all-important exam. Here are some of the obstacles that can stand in the way of your success: ▪ being unfamiliar with the format of the exam ▪ being paralyzed by test anxiety ▪ leaving your preparation to the last minute ▪ not preparing at all! ▪ not knowing vital test-taking skills: how to pace yourself through the exam, how to use the process of elim- ination, and when to guess ▪ not being in tip-top mental and physical shape ▪ arriving late at the test site, working on an empty stomach, or shivering through the exam because the room is cold THE LEARNINGEXPRESS TEST PREPARATION SYSTEM What’s the common denominator in all these test-taking pitfalls? One thing: control. Who’s in con- trol, you or the exam? Now the good news: The LearningExpress Test Preparation System puts you in control. In just nine easy-to-follow steps, you will learn everything you need to know to ensure that you are in charge of your preparation and your performance on the exam. Other test takers may let the test get the better of them; other test takers may be unprepared or out of shape, but not you. You will have taken all the steps you need to get a high score on the EMT-Basic exam. Here’s how the LearningExpress Test Preparation System works: Nine easy steps lead you through every- thing you need to know and do to get ready to master your exam. Each of the following steps includes both reading about the step and one or more activities. It’s important that you do the activities along with the reading, or you won’t get the full benefits of the sys- tem. Each step tells you approximately how much time that step will take you to complete. Step 1. Get Information 50 minutes Step 2. Conquer Test Anxiety 20 minutes Step 3. Make a Plan 30 minutes Step 4. Learn to Manage Your Time 10 minutes Step 5. Learn to Use the Process 20 minutes of Elimination Step 6. Know When to Guess 20 minutes Step 7. Reach Your Peak 10 minutes Performance Zone Step 8. Get Your Act Together 10 minutes Step 9. Do It! 10 minutes Total 3 hours We estimate that working through the entire system will take you approximately three hours, though it’s perfectly okay if you work more quickly or slowly than the time estimates assume. If you have a whole afternoon or evening free, you can work through the whole LearningExpress Test Preparation System in one sitting. Otherwise, you can break it up and do just one or two steps a day for the next several days. It’s up to you—remember, you’re in control. Step 1: Get Information Time to complete: 50 minutes Activities: Read Chapter 1, “The EMT-Basic Exam” and Chapter 14, “State Certification Requirements” Knowledge is power. The first step in the Learning- Express Test Preparation System is finding out every- thing you can about the EMT-Basic exam. Once you have your information, the next steps in the Learning- Express Test Preparation System will show you what to do about it. Part A: Straight Talk about the EMT-Basic Exam Why do you have to take this exam anyway? Simply put, because lives depend on your performance in the field. The EMT-Basic cognitive exam is just one part of a whole series of evaluations you have to go through to show that you can be trusted with the health and safety of the people you serve. The cognitive exam attempts to measure your knowledge of your trade. The practical skills exam attempts to measure your ability to apply what you know. It’s important for you to remember that your score on the EMT-Basic cognitive exam does not determine how smart you are or even whether you will make a good EMT. There are all kinds of things an