JB Learning Registry Practice Test (annotated)Practice Examination questions from the JB online test.

You are giving a presentation to a group of laypeople on the importance of calling EMS immediately for cardiac arrest patients. What point should you emphasize the MOST? A: CPR and defibrillation are key factors in patient survival. B: Laypeople are incapable of providing adequate CPR. C: Rapid transport significantly reduces patient mortality. D: Cardiac drug therapy is the most important EMS treatment. A: CPR and defibrillation are key factors in patient survival. Early high-quality CPR and defibrillation are the most crucial initial treatments to provide to a patient in cardiac arrest. Adequately performed CPR can keep the heart and brain oxygenated, thus increasing the chance of defibrillation success. Ventricular fibrillation (V-Fib) is the most common initial dysrhythmia seen in adult patients with sudden cardiac arrest and requires prompt defibrillation. Untreated V-Fib will rapidly deteriorate to asystole, the mortality rate from which is very high. You should also advise the audience that compression-only CPR has been linked to patient survival. 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: A: perform a detailed secondary assessment. B: contact medical control for further advice. C: provide immediate transport to the hospital. D: administer one more puff from her inhaler. B: contact medical control for further advice. 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. 00:32 01:17 In addition to supplemental oxygen, one of the MOST effective way to minimize the detrimental effects associated with acute coronary syndrome is to: A: reassure the patient and provide prompt transport. B: transport the patient rapidly, using lights and siren. C: administer nitroglycerin in 15 to 20 minute intervals. D: request ALS support for any patient who has chest pain. A: reassure the patient and provide prompt transport. Reason: In addition to increasing the body's oxygen supply with supplemental oxygen, it is extremely important to decrease oxygen demand and consumption. You can most effectively accomplish this by keeping the patient calm, providing reassurance, and providing safe, prompt transport to the hospital. Traveling at a high rate of speed with lights flashing and siren blasting would clearly increase the patient's anxiety and the heart's demand for oxygen. The decision to request ALS support is based on the patient's condition and your transport distance to the closest appropriate hospital. Unless contraindicated (ie, the patient is hypotensive, the medication is not prescribed to the patient), nitroglycerin should be given in 5-minute intervals, up to three (3) doses. The immobilization device MOST appropriate to use for a patient with multiple injuries and unstable vital signs is the: A: scoop immobilization device. B: short spine board immobilization device. C: long spine board immobilization device. D: vest-style immobilization device. C: long spine board immobilization device. Reason: When caring for a critically injured patient with multiple injuries, the patient's entire body should be immobilized. This is most quickly and effectively accomplished using a long spine board. Vest-style devices or short spine boards take too long to apply and will not provide full body immobilization. The scoop (orthopaedic) stretcher is effective for maneuvering patients in narrow spaces but will not allow for full spinal immobilization because of the vertical opening down the center of the device. Which of the following statements regarding two-rescuer child CPR is correct? A: The chest should not be allowed to fully recoil in between compressions as this may impair venous return B: A compression to ventilation ratio of 15:2 should be delivered without pauses in compressions to deliver ventilations C: The chest should be compressed with one hand and a compression to ventilation ratio of 30:2 should be delivered D: Compress the chest with one or two hands to a depth that is equal to one third the diameter of the chest D: Compress the chest with one or two hands to a depth that is equal to one third the diameter of the chest Reason: When performing two-rescuer CPR on a child (1 year of age to the onset of puberty [12 to 14 years of age]), the chest should be compressed with one or two hands (depending on the size of the child), and a compression to ventilation ratio of 15:2 should be delivered. It is important to compress the chest to an adequate depth—one third the anterior-posterior diameter of the chest (about 1 1/2" in the child). The chest should be allowed to fully recoil in between compressions in order to maximize venous return to the heart. If an advanced airway device (ie, ET tube, multilumen airway, supraglottic airway) is not in place, two rescuers should deliver "cycles" of CPR; the compressor should pause briefly so the ventilator can deliver two breaths. A compression to ventilation ratio of 30:2 is used for one-rescuer child CPR. After an advanced airway device has been inserted, "cycles" of CPR should not be performed; compressions should be continuous at a rate of at least 100/min and ventilations should be delivered at a rate of 8 to 10 breaths/min (one breath every 6 to 8 seconds). Shortly after assisting a 60-year-old woman with her second nitroglycerin treatment, she tells you that she is lightheaded and feels like she is going to faint. Her symptoms are MOST likely due to: A: a drop in her blood sugar. B: an irregular heartbeat. C: low blood pressure. D: nervousness and anxiety. C: low blood pressure. Reason: Nitroglycerin (NTG) is a vasodilator; as such, it may cause a drop in blood pressure (hypotension) in some patients. Signs and symptoms of hypotension include dizziness, lightheadedness, and fainting (syncope), among others. For this reason, you should always assess a patient's blood pressure before and after administering nitroglycerin. If the patient's systolic BP is less than 100 mm Hg, NTG should not be given. The patient is probably nervous and anxious, and may even have an irregular heartbeat; however, hypotension is a more likely cause of her symptoms. NTG does not affect a patient's blood sugar level. You respond to a baseball field for a person who was struck by lightning. When you arrive, you see one patient who appears confused and is ambulatory; a second patient who is conscious, sitting on the ground, and holding his arm; and a third patient who is supine and motionless. After requesting additional responders, you should: A: proceed to the ambulatory patient, sit him down, and assess his mental status. B: assess and begin treating the sitting patient first because he is obviously injured. C: treat the conscious patients because the motionless patient is likely deceased. D: assess the motionless victim and perform CPR and defibrillation if necessary. D: assess the motionless victim and perform CPR and defibrillation if necessary. Reason: The process of triaging multiple victims of a lightning strike is different than the conventional triage methods used during a mass-casualty incident. When a person is struck by lightning, respiratory or cardiac arrest, if it occurs, usually occurs immediately. Those who are conscious following a lightning strike are much less likely to develop delayed respiratory or cardiac arrest; they usually survive. Therefore, you should focus your efforts on those who are in respiratory or cardiac arrest. This process, called reverse triage, differs from conventional triage, where such patients would ordinarily be classified as deceased. Which of the following is a physiologic effect of epinephrine when used to treat anaphylactic shock? A: As a bronchodilator, it improves the patient's breathing. B: As a vasoconstrictor, it lowers the blood pressure. C: As an antihistamine, it blocks chemicals that cause the reaction. D: As a vasodilator, it increases the blood pressure. A: As a bronchodilator, it improves the patient's breathing. Reason: Epinephrine possesses dual effects. As a bronchodilator, it relaxes the smooth muscle of the bronchioles and improves the patient's breathing. As a vasoconstrictor, it constricts the blood vessels and increases the patient's blood pressure. Diphenhydramine (Benadryl) is an antihistamine; it blocks H1 histamine receptor sites, which blocks the release of the chemicals (histamines) that are causing the allergic reaction. You are called to a residence for a woman in cardiac arrest. Shortly after starting CPR, the patient's husband presents you with an unsigned document that states "do not attempt resuscitation." You should: A: stop CPR until the document can be validated by a physician. B: contact medical control prior to continuing any resuscitative efforts. C: stop all resuscitative efforts in accordance with the document. D: continue CPR until you have contacted medical control for guidance. D: continue CPR until you have contacted medical control for guidance. Reason: Do not attempt resuscitate (DNAR) orders are particularly challenging for EMS providers. When presented with documentation, especially if it does not appear to be valid (in this case, an unsigned document), you should err on the side of patient care and continue resuscitative efforts until medical control orders you to stop. You should not attempt to actively rewarm a patient with moderate or severe hypothermia in the field because: A: it is painful for the patient and you cannot give analgesic drugs. B: active rewarming has been shown to cause severe hypertension. C: rewarming too quickly can cause a fatal cardiac dysrhythmia. D: the risk of inadvertently inducing hyperthermia is too high. C: rewarming too quickly can cause a fatal cardiac dysrhythmia. Reason: When caring for a patient with hypothermia, your goal is to prevent further heat loss; this involves removing wet clothing, applying warm blankets, and allowing the patient's body temperature to rise gradually and naturally (passive rewarming). If the patient is moderately or severely hypothermic, you should not try to rewarm him or her actively (placing heat on or into the body). Rewarming too quickly may cause a fatal cardiac dysrhythmia, such as ventricular fibrillation (V-Fib). Active rewarming may also cause rewarming shock, a condition in which the blood vessels dilate when heat is applied to the body, resulting in significant hypotension. For these reasons, active rewarming should only be performed in the controlled setting of a hospital. The pain associated with acute aortic dissection: A: is typically described as a stabbing or tearing sensation. B: originates in the epigastrium and radiates down both legs. C: typically comes on gradually and progressively worsens. D: is usually preceded by nausea, sweating, and weakness. A: is typically described as a stabbing or tearing sensation. Reason: Aortic dissection occurs when the inner layers of the aorta become separated, allowing blood to flow between the layers at high pressure. This separation of layers significantly weakens the aortic wall, making it prone to rupture. Signs and symptoms of acute aortic dissection include a sudden onset of a ripping, tearing, or stabbing pain in the anterior part of the chest or in the back between the scapulae. It may be difficult to differentiate the pain of acute aortic dissection from that of an acute myocardial infarction (AMI), but a number of distinctive features may help. The pain from an AMI is often preceded by other signs and symptoms (ie, nausea, indigestion, weakness, sweating [diaphoresis]). It tends to come on gradually and becomes more severe as time progresses, and is usually described as a crushing pain or as a feeling of heaviness or pressure. By contrast, the pain associated with aortic dissection is acute and is often of maximum intensity from the onset; it is typically described as a ripping, tearing, or stabbing sensation. Unresponsiveness, shallow breathing, and constricted pupils are indicative of what type of drug overdose? A: Amphetamine B: Narcotic C: Barbiturate D: Marijuana B: Narcotic Reason: Signs of a narcotic (opiate) overdose from drugs such as heroin, morphine (Astromorph, Duramorph), meperidine (Demerol), or codeine include altered mental status; slow, shallow breathing; pupillary constriction (miosis), hypotension; and bradycardia. Narcotics are central nervous system depressants that, when taken in excess, suppress the vital functions necessary for life, such as breathing, heart rate, and blood pressure. Barbiturates produce the same effects; however, the pupils are typically dilated (mydriasis), not constricted. Marijuana and amphetamine drugs are central nervous system stimulants and would thus cause the patient to become restless or even combative.