EMT- JBL Final Exam with accurate solution 2024

EMT- JBL Final Exam with accurate solution 2024 According to the USDOT, minimum staffing for BLS ambulance includes: - At least one EMT in the patient compartment. The driver does not need to be an EMT Which of the following statements regarding heatstroke is correct? - Heatsrtoke occurs when the body is exposed to more heat than it can eliminate and normal mechanisms such as sweating are overwhelmed. The temp can rise to appoint where tissues are destroyed. It can develop during prolonged vigorous physical activity or in closed, poorly ventilated, hot and humid space. High humidity impairs heat elimination via sweating. Patients will have hot, dry, flushed skin, become agitated, and LOC will decrease If a vehicle strikes a tree at 60 mph, the unrestrained driver would likely experience the MOST severe injuries during the: - Motor-vehicle crashes typically consist of three separate collisions. Understanding the events that occur during each collision will help you remain alert for certain types of injury patterns. During the first collision, the vehicle strikes another object. Damage to the car is perhaps the most dramatic part of the collision, but it does not directly affect patient care. It does, however, provide information about the severity of the collision; thus, it has an indirect effect on patient care. During the second collision, the passenger collides with the interior of the vehicle. Just like the obvious damage to the exterior of the car, the injuries that result are often dramatic and usually apparent during your primary assessment. During the third collision, the occupant's internal organs collide with the solid structures of the body. Although the injuries that occur during the third collision may not be as obvious as those that occur during the second collision, they are often the most life-threatening. A 22-year-old man had a strong acid chemical splashed into both of his eyes. He is conscious and alert, is experiencing intense pain, and states that he is wearing contact lenses. Treatment should include: - As a general rule, contact lenses should be left in place. Chemical eye burns are an exception to this rule. If left in place, the chemical could get behind the contact lens and continue to cause injury. Therefore, you should remove the contact lenses and immediately irrigate the eyes with sterile saline or water. If needed, continue to irrigate the eyes throughout transport. A 22-year-old male has a shard of glass impaled in his cheek. You look inside his mouth and see minor bleeding. The patient is conscious and alert with adequate breathing. You should: - It remains true that you should remove an impaled object if it compromises the airway or impedes your ability to manage the airway. However, neither is the case with this patient because he has an adequate airway. He is conscious and alert and has only minor bleeding in his mouth. The safest approach, and most practical given the situation, would be to carefully stabilize the shard of glass in place; consider wrapping the exposed glass with gauze to protect yourself from getting cut. Since the patient is conscious and alert and has only minor oral bleeding, it would not be unreasonable to hand him the suction catheter and allow him to use it as needed. Be sure to instruct the patient to use the suction and not to swallow any blood. Keep in mind that if you attempt to remove the shard of glass, you risk cutting yourself and causing further injury to the patient. When an error occurs while using the AED, it is MOST often the result of: - AEDs are highly sensitive and specific in recognizing shockable rhythms (eg, V-Fib, pulseless V-Tach); this means that they are highly reliable. It would be extremely rare for the AED to recommend a shock when one is not indicated or fail to recommend a shock when one is indicated. When an error does occur, it is usually the operator's fault. The most common error is not having a charged battery. To avoid this problem, many AEDs are equipped with an alarm that warns the operator if the battery is not fully charged. Some of the older AEDs, however, are not equipped with this feature. Therefore, it is important to check the AED daily, exercise the battery as often as the manufacturer recommends, and always have a spare, fully charged battery on hand. Prior to your arrival, a woman experiencing an asthma attack took two puffs from her prescribed inhaler without relief. After administering supplemental oxygen, you should: - Before assisting a patient with any medication other than oxygen, the EMT must ensure that the medication is prescribed to the patient and then obtain authorization from medical control. In this case, the physician probably will allow you to help the patient take one more puff from her inhaler. Generally, up to three puffs from an inhaler are delivered in the field. It is important for you to ask the patient how many puffs were taken from the inhaler before you arrived. The EMT must correct any airway and/or breathing problems as quickly as possible. After doing so, a secondary assessment can be performed. Upon discovering an open chest wound, you should: - Upon discovering an open chest wound (ie, sucking chest wound), you must take immediate action to prevent air from entering the wound. This is most effectively accomplished by applying an occlusive dressing or similar material to the wound. A porous (non-occlusive) trauma dressing will not prevent air from entering the wound. Tape three sides of the occlusive dressing and closely monitor the patient. If worsened respiratory distress and signs of shock are noted, a tension pneumothorax is probably developing, and you must release pressure from the pleural space by lifting up the unsecured portion of the occlusive dressing. Which of the following signs and symptoms are MOST characteristic of hyperglycemic ketoacidosis? - Hyperglycemic ketoacidosis (diabetic coma) is characterized by a dangerously high blood glucose level (hyperglycemia); slow onset; warm, dry skin (from dehydration); Kussmaul's respirations, which are deep and rapid; and breath with a fruity or acetone odor. Insulin shock results from a low blood glucose level (hypoglycemia) and is characterized by a rapid onset; altered mental status; and cool, clammy skin. You are assessing an elderly man with respiratory distress. He is coughing up bloody sputum and has an oxygen saturation of 85%. You auscultate his breath sounds and hear coarse crackles in all lung fields. This patient MOST likely has: - This patient's signs and symptoms are classic for left-sided congestive heart failure and pulmonary edema. As the left side of the heart weakens, so that it can no longer effectively pump blood, blood backs up into the lungs, resulting in pulmonary edema. As pulmonary edema gets worse, the patient begins coughing up pink, frothy sputum (hemoptysis). The presence of fluid in the lungs impairs the exchange of oxygen and carbon dioxide, resulting in hypoxemia and a low oxygen saturation (SpO2). Auscultation of the patient's lungs often reveals coarse crackles, which indicates the presence of fluid. Emphysema is a chronic respiratory disease, not an acute one. Furthermore, hemoptysis is not a common finding with emphysema. Likewise, patients with decompensated asthma often have markedly diminished lung sounds owing to severe bronchospasm; hemoptysis and crackles are not common. Bacterial pneumonia can cause respiratory distress; however, it usually presents with fever and diminished breath sounds to a localized area of a lung (eg, the left lower lobe). After an adult cardiac arrest patient has been intubated by a paramedic, you are providing ventilations as your partner performs chest compressions. When ventilating the patient, you should: - When ventilating an adult cardiac arrest patient with an advanced airway in place (ie, ET tube, multilumen airway, supraglottic airway), you should deliver each breath over a period of 1 second--just enough to produce visible chest rise--at a rate of 10 breaths/min (one breath every 6 seconds). Do not attempt to synchronize ventilations with chest compressions once the airway has been secured with an advanced device. Hyperventilation should be avoided, as it may result in increased intrathoracic pressure, decreased blood return to the heart, and, as a result, less effective chest compressions. Which of the following is a common side effect of nitroglycerin? - Because nitroglycerin (NTG) causes vasodilation, including the vessels within the brain, cerebral blood flow increases following its administration. This often causes a pounding headache for the patient. As uncomfortable as it is for the patient, headaches are a common and expected side effect of the drug. The vasodilatory effects of nitroglycerin could result in hypotension; therefore, the patient's blood pressure should be carefully monitored. Nausea and anxiety are common symptoms of acute coronary syndrome; they are not common side effects of nitroglycerin. A 56-year-old man has labored, shallow breathing at a rate of 28 breaths/min. He is responsive to pain only. You should: - This patient in this scenario is not breathing adequately. He is responsive to pain only, and his respirations are rapid, labored, and shallow. You should insert a nasopharyngeal airway, which is usually well tolerated in patients who are semiconscious and have a gag reflex, and assist his ventilations with a bag-valve-mask device. When assisting a patient's breathing, you should squeeze the bag-valve-mask device to ensure that he or she receives 10 to 12 adequate breaths per minute. Do not hyperventilate the patient, as this increases the risks of vomiting and aspiration. Hyperventilation also increases intrathoracic pressure, which may impair venous return to the heart (preload) and cause a decrease in cardiac output. Oxygen via nonrebreathing mask is appropriate for patients who are breathing adequately, but are suspected of being hypoxic. The recovery position (patient is placed on his or her side) is appropriate for unresponsive, uninjured patients with adequate breathing. ou are assessing a 66-year-old man who has emphysema and complains of worsened shortness of breath. He is confused, has a heart rate of 120 beats/min, and has an oxygen saturation of 83%. Which of the following assessment findings should concern you the MOST? - All of your assessment findings in this patient are significant. Worsened shortness of breath in a patient with a preexisting respiratory disease could indicate exacerbation of his or her condition or a new problem. Tachycardia and a low oxygen saturation (SpO2) are signs of hypoxemia, a low level of oxygen in arterial blood. Of all the patient's assessment findings, the fact that he is confused should concern you the most. Altered mentation in a patient with respiratory distress indicates that the brain is not getting enough oxygen and that carbon dioxide is accumulating in the blood. It is important to recognize the signs of hypoxemia and begin immediate treatment (eg, high-flow oxygen via a nonrebreathing mask, assisted ventilation) to prevent hypoxia, a dangerous condition in which the body's cells and tissues do not receive enough oxygen. Left untreated, hypoxia may cause permanent brain damage or death. Hypoxia is defined as: - Hypoxia is a dangerous condition in which the body's cells and tissues do not have enough oxygen. Hypoxemia is a decreased amount of oxygen in arterial blood. Untreated hypoxemia will lead to hypoxia. An absence of oxygen to any part of the body is called anoxia. An excess amount of carbon dioxide in arterial blood is called hypercarbia. If the body cannot bring in enough oxygen, it is also unable to eliminate carbon dioxide from the blood; therefore, hypoxemia and hypercarbia occur together. Which of the following devices is contraindicated in patients with blunt thoracic trauma? - The oxygen-powered ventilator, also called a manually triggered ventilator, should not be used in patients with chest trauma; it delivers oxygen under high pressure and may worsen the patient's injury. Oxygen-powered ventilators are also associated with a high incidence of gastric distention. They are also contraindicated in pediatric patients and in patients with COPD. Infants and children have small lungs; the high ventilatory pressure delivered by the oxygen-powered ventilator can cause a pneumothorax. Patients with COPD often have air trapped in their lungs; excessive ventilatory pressure may cause alveolar rupture or a pneumothorax. A 60-year-old man complains of chest pain and difficulty breathing. He is pale, diaphoretic, and in severe pain. As your partner applies supplemental oxygen, you assess his vital signs. His blood pressure is 180/90 mm Hg, pulse is 110 beats/min and irregular, respirations are 24 breaths/min and labored, and oxygen saturation is 93%. You ask him if has taken any nitroglycerin and he tells you that he does not have any but his wife does. You should: - If a patient with suspected cardiac compromise does not have prescribed nitroglycerin (NTG), complete your focused physical examination, continue oxygen therapy (if indicated), and transport immediately. Do not administer, or request to administer, any medication that is not prescribed to the patient. If the patient develops cardiac arrest, apply the AED and follow its voice prompts. Do not apply the AED to any patient who is not in cardiac arrest. If your protocols allow you to administer aspirin, give up to 325 mg of chewable baby aspirin (have the patient chew the aspirin before swallowing it). Enteric-coated aspirin (aspirin that is coated to prevent stomach upset) is intended to be swallowed without chewing. It takes too long to dissolve, whereas chewable aspirin has a much faster effect. A 42-year-old male presents with fever, a severe headache, and a stiff neck. He is conscious, but confused. His wife tells you that he does not have any medical problems and does not take any medications. You should be MOST suspicious for: - Meningitis is an inflammation of the protective coverings of the brain and spinal cord (meninges). Common signs and symptoms of meningitis include fever, headache, neck stiffness (nuchal rigidity), and vomiting. An altered mental status is common in severe cases. Meningococcal meningitis, caused by a bacterium, is the most contagious and potentially fatal type of meningitis. The patient's signs and symptoms are not consistent with acute stroke, tuberculosis (TB), or influenza (the flu). Although fever is