NREMT [ EMT ] Predictor Exam COMPLETE TEST
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EXAM
Which of the following signs would you expect to see in the early stages of shock?
A:Thready pulses
B:Unconsciousness
C:Hypotension
D:Restlessness
D;
A+ TEST BANK 1
, EMT[NREMT] Actual Exam
Detailed Rationale:
In the early stages of shock, decreased perfusion to the brain causes the patient to become
restless and anxious. As shock progresses, the pulse becomes thready (weak), signifying a
falling blood pressure (hypotension), and the patient eventually loses consciousness. It is
critical to recognize the early signs of shock and initiate immediate care and rapid transport.
You should not rely on the blood pressure as an indicator of perfusion in any patient; by the
time hypotension manifests, the patient's compensatory mechanisms have failed and he or
she is in decompensated shock.
A football player complains of severe neck pain and tingling in his arms and legs after being
tackled. He is conscious and alert, has a patent airway, and is breathing adequately. He is in a
supine position and is still wearing his helmet, which is tight-fitting. The MOST appropriate
treatment for this patient includes:
A:carefully removing his helmet, manually stabilizing his head, applying a cervical collar,
administering high-flow oxygen, placing him onto a long backboard, and restricting spinal
motion with straps and a lateral head stabilizer.
B:manually stabilizing his head with his helmet still on, removing the face mask, administering
high-flow oxygen, placing him onto a long backboard, and restricting spinal motion with
straps and a lateral head stabilizer.
C:manually stabilizing his head, leaving his helmet on, applying a vest-style spinal
immobilization device, placing him onto a long backboard, and restricting spinal motion with
straps and a lateral head stabilizer.
D:manually stabilizing his head, carefully removing his helmet, administering high-flow oxygen,
applying a cervical collar, placing him onto a long backboard, and restricting spinal motion
with straps and a lateral head stabilizer.
B;
Detailed Rationale:
A helmet that fits well prevents the patient's head from moving and should be left on,
A+ TEST BANK 2
, EMT[NREMT] Actual Exam
provided (1) there are no impending airway or breathing problems, (2) it does not interfere
with your assessment and treatment of airway or ventilation problems, and (3) you can
properly immobilize the spine. You should also leave the helmet on if there is any chance that
removing it will further injure the patient. The mask on most sports helmets can be removed,
without affecting helmet position or function, by using a trainer's tool designed for cutting
retaining clips or unscrewing the retaining clips for the face mask. Your patient has severe
neck pain and tingling in his extremities; these are obvious signs of a spinal injury. However,
he is conscious and alert, has a patent airway, and is breathing adequately. Thus, the safest
approach is to remove the face mask as previously described, apply high-flow oxygen, and
restrict spinal motion by securing him to a long backboard. A vest-style device is more suitable
for seated patients; it is impractical to use on supine patients.
A man was struck in the side of the head with a steel pipe. Blood-tinged fluid is draining from
the ear and bruising appears behind the ear. The MOST appropriate treatment for this patient
includes:
A:controlling the drainage from the ear and immobilizing the entire spine.
B:elevating the lower extremities and providing immediate transport.
C:immobilizing the spine, administering oxygen, and monitoring for vomiting.
D:applying high-flow oxygen and packing the ear with sterile gauze pads.
C;
Detailed Rationale:
Patients with significant head injury should be treated by applying high-flow oxygen, assisting
ventilations as needed, immobilzing the entire spine, and transporting promptly. Closely
monitor the patient for vomiting and be prepared to suction the airway. Elevation of the foot
of the spine board may cause more blood to engorge the brain and may increase intracranial
pressure (ICP). You should never attempt to control bleeding or fluid drainage from the ears
of a patient with a head injury because this too may result in increased ICP. If a patient with an
isolated head injury begins showing signs of shock (ie, tachycardia, diaphoresis, tachypnea,
hypotension), you should assume that he or she has internal bleeding from another injury and
treat accordingly (ie, elevation of the foot-end of the backboard, preventing body heat loss).
A+ TEST BANK 3
, EMT[NREMT] Actual Exam
During your assessment of a patient who experienced blunt facial trauma, you note the
presence of a hyphema. This indicates:
A:a fracture of the nasal bone.
B:that the pupils are unequal.
C:direct trauma to the eyeball.
D:an orbital blowout fracture.
C;
Detailed Rationale:
Some patients with blunt trauma to the eyeball (globe) may present with a hyphema, or
bleeding into the anterior chamber of the eye, that obscures a portion of or the entire iris.
This condition may seriously impair vision and should be considered a sight-threatening
emergency. A fracture of the orbital floor (blowout fracture) is characterized by double vision
and an inability of the patient to move his or her eyes above the midline (paralysis of an
upward gaze) following blunt facial trauma. In an orbital blowout fracture, fragments of
fractured bone can entrap some of the muscles that control eye movement. Anisocoria is the
term used to describe unequal pupils. Unequal pupils following head trauma indicates
increased intracranial pressure.
Internal or external bleeding would be especially severe in a patient:
A:who takes aspirin.
B:with hemophilia.
C:who is hypotensive.
D:with heart disease.
B;
Detailed Rationale:
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