Advanced EMT Practice Questions
(Complete Solution) Answered
You arrive on scene to a patient with a large gash on his forearm spurting blood.
Pressure is immediately applied with a gloved hand. He is pale with a weak, rapid
pulse; RR = 30 bpm. During initial assessment & wound bandaging, the patient
yells "get away". Your best course of action is, what?
explain to the patient that you are almost finished bandaging his wound and you will
leave him alone then
If you continue to treat a patient who is refusing treatment, what can happen?
- you can be charged with assault and or battery;
- do your best to finish up the treatment, but if the patient continues to refuse, you must
comply
The patient is an 18 month old who is "acting strange". You find the child reclined
in his mother's arms. "I don't know what's wrong with him," she says. "I came out
of the bathroom & he started making odd sounds & had spit running out of his
mouth." What is the first thing you should do?
get a general impression of the child by visually assessing the quality of his respirations,
his skin color, and his appearance
When forming a general impression of a pediatric patient, what is the best tool to
use?
Pediatric Assessment Triangle (PAT);
- work of breathing;
- skin circulation;
- appearance
Why is the Pediatric Assessment Triangle (PAT) used?
to form a rapid general impression of a child without making physical contact
When assessing a patient's appearance, what should you look for?
- muscle tone;
- deformities and characteristics;
- race;
- body build
When assessing a patient's work of breathing, what should you look for?
signs of respiratory distress
What signs of 'work of breathing' are evidence of respiratory difficulty?
takipneah (tachypnea) or retractions of sternum and or intercostal muscles, especially
with pediatric patients
When assessing a patient's skin circulation, what should you look for?
- pallor;
- flush
Pallor can be a sign of, what?
poor circulation
,Would it be appropriate to administer Dextrose (D50) to a trauma patient with a
history of hypoglycemia who hit his head on a concrete driveway after falling 8
feet off a ladder?
yes, based on his medical history and mechanism of injury, and especially if he is found
unresponsive, D50 is appropriate
List the indications for administration of Dextrose 50% (D50).
symptomatic hypoglycemia (BGL < 70 mg/dL), and:
- altered LOC for unknown reasons;
- unresponsiveness with no obtainable history;
- cardiac arrest with P.E.A., a-systole, or history of diabetes
What are contra-indications for administration of Dextrose 50% (D50)?
- presence of increased intra-cranial pressure;
- possible intra-cranial bleeding
You and your partner answer the call for a 1 year old boy who was dropped on his
head by his older brother. His mother said he hit his head on the edge of the
coffee table on the way down. You would expect to find, what?
- bruising and hematomas;
- bleeding between the skull and the scalp;
- swelling
True or False: Head injuries are more prevalent in children.
True, because their heads are larger in proportion to their bodies
When assessing a child after they have suffered a head injury, you should check
for, what?
- bleeding;
- swelling;
- bruising;
- hematomas
A sunken, or depressed fontanelle in a young child is an indication of, what?
dehydration
Swelling that occurs after a head injury in a young child is an indication of, what?
intra-cranial bleeding or pressure
True or False: D5W is used for long term therapy?
False, D5W has a short duration of action and is used for treatment of hypoglycemia
If D5W is mixed with Dilantin, what can occur?
- crystal-lization to form in the line, and or vein and cause serious injury to the patient;
- make sure you understand the compatibility of all medications with the infusion
solution
True or False: D5W is contra-indicated as a fluid replacement in patients who are
hypo-volemic.
- True, D5W (5% dextrose in water) is basically sterile water; this fluid is normally used
to replace free water in the hyper-natremic patient;
- D5W contains only 170 k cal/L from dextrose, and is not sufficient to meet energy
requirements
True or False: D5W is used to dilute concentrated drugs for I.V. infusion.
True
Albuterol is classified as a, what?
, sym-patho-mimetic; meaning, it produces physiological effects characteristic of the
sympathetic nervous system by promoting the stimulation of sympathetic nerves
What is dependant lividity?
blood settling at the lowest point in the body and visible through the skin
True or False: A patient may show signs of blood pooling and skin dis-
colorization after being in the same position for an extended period of time.
True, and this can be an indication of death
The most important treatment when caring for a patient with an irritant gas
exposure is, what?
ventilation; although oxygen is always important, you need to treat the under-lying
problem
Irritant gases are harmful to patients in, what manner?
exposure restricts the lungs ability to ventilate; therefore, the need for ventilation is
priority
How many minutes of oxygen remain in a D-size cylinder, which has 1600 p.s.i.,
when the flow rate is set to 4 L/min?
56 (1600 - 200 x 0. Lpm = 56 minutes)
What is the formula for calculating minutes of oxygen remaining?
take the Gauge pressure (p.s.i.), minus the Safe Residual (200 for all size cylinders),
then times the Cylinder Factor (0.16 for D-size cylinder), and divide by Flow Rate
(L/min)
The correct dosage for dextrose for a pediatric patient is, what?
- for infants, 0.5 gm/kg 25% dextrose;
- for patients over 1 year of age, 0.5 gm/kg 50% dextrose
Provide an example of a patient who would be declared more viable to treat.
a 5 year old apneeik (apneic) and pulseless patient who fell through the ice and was
submerged for 10 minutes before being brought to the ambulance
True or False: Drowning victims should be treated even if they have been
submerged for a long time.
True, the rule 'no patient should be pronounced dead, until warm and dead' applies
True or False: Children, in particular, have a good chance of survival if they have
been submerged in water for a long time.
True, but only < 3 minutes, or < 10 minutes in cold water
If a infant patient is found with rigor mortis, should you treat them?
No; all muscles stiffen in rigor mortis and this process occurs between two and six hours
following death
Does a DNR negate the need to begin CPR on an elderly patient?
Yes, regardless if the patient is or is not breathing, and is with or without a pulse, a valid
DNR must be honored
A 9 month old infant is found apneeik (apneic), pulseless, cool, blue, and stiff
after a nap. What do you suspect.
the patient is dead
A 38 year old male has had both legs torn off from a railway incident. He has ag-
onal respirations, and no palpable pulse. Is he a viable patient?
this patient has suffered major trauma, and while all efforts will be given, the odds of
surviving a traumatic arrest are very small
(Complete Solution) Answered
You arrive on scene to a patient with a large gash on his forearm spurting blood.
Pressure is immediately applied with a gloved hand. He is pale with a weak, rapid
pulse; RR = 30 bpm. During initial assessment & wound bandaging, the patient
yells "get away". Your best course of action is, what?
explain to the patient that you are almost finished bandaging his wound and you will
leave him alone then
If you continue to treat a patient who is refusing treatment, what can happen?
- you can be charged with assault and or battery;
- do your best to finish up the treatment, but if the patient continues to refuse, you must
comply
The patient is an 18 month old who is "acting strange". You find the child reclined
in his mother's arms. "I don't know what's wrong with him," she says. "I came out
of the bathroom & he started making odd sounds & had spit running out of his
mouth." What is the first thing you should do?
get a general impression of the child by visually assessing the quality of his respirations,
his skin color, and his appearance
When forming a general impression of a pediatric patient, what is the best tool to
use?
Pediatric Assessment Triangle (PAT);
- work of breathing;
- skin circulation;
- appearance
Why is the Pediatric Assessment Triangle (PAT) used?
to form a rapid general impression of a child without making physical contact
When assessing a patient's appearance, what should you look for?
- muscle tone;
- deformities and characteristics;
- race;
- body build
When assessing a patient's work of breathing, what should you look for?
signs of respiratory distress
What signs of 'work of breathing' are evidence of respiratory difficulty?
takipneah (tachypnea) or retractions of sternum and or intercostal muscles, especially
with pediatric patients
When assessing a patient's skin circulation, what should you look for?
- pallor;
- flush
Pallor can be a sign of, what?
poor circulation
,Would it be appropriate to administer Dextrose (D50) to a trauma patient with a
history of hypoglycemia who hit his head on a concrete driveway after falling 8
feet off a ladder?
yes, based on his medical history and mechanism of injury, and especially if he is found
unresponsive, D50 is appropriate
List the indications for administration of Dextrose 50% (D50).
symptomatic hypoglycemia (BGL < 70 mg/dL), and:
- altered LOC for unknown reasons;
- unresponsiveness with no obtainable history;
- cardiac arrest with P.E.A., a-systole, or history of diabetes
What are contra-indications for administration of Dextrose 50% (D50)?
- presence of increased intra-cranial pressure;
- possible intra-cranial bleeding
You and your partner answer the call for a 1 year old boy who was dropped on his
head by his older brother. His mother said he hit his head on the edge of the
coffee table on the way down. You would expect to find, what?
- bruising and hematomas;
- bleeding between the skull and the scalp;
- swelling
True or False: Head injuries are more prevalent in children.
True, because their heads are larger in proportion to their bodies
When assessing a child after they have suffered a head injury, you should check
for, what?
- bleeding;
- swelling;
- bruising;
- hematomas
A sunken, or depressed fontanelle in a young child is an indication of, what?
dehydration
Swelling that occurs after a head injury in a young child is an indication of, what?
intra-cranial bleeding or pressure
True or False: D5W is used for long term therapy?
False, D5W has a short duration of action and is used for treatment of hypoglycemia
If D5W is mixed with Dilantin, what can occur?
- crystal-lization to form in the line, and or vein and cause serious injury to the patient;
- make sure you understand the compatibility of all medications with the infusion
solution
True or False: D5W is contra-indicated as a fluid replacement in patients who are
hypo-volemic.
- True, D5W (5% dextrose in water) is basically sterile water; this fluid is normally used
to replace free water in the hyper-natremic patient;
- D5W contains only 170 k cal/L from dextrose, and is not sufficient to meet energy
requirements
True or False: D5W is used to dilute concentrated drugs for I.V. infusion.
True
Albuterol is classified as a, what?
, sym-patho-mimetic; meaning, it produces physiological effects characteristic of the
sympathetic nervous system by promoting the stimulation of sympathetic nerves
What is dependant lividity?
blood settling at the lowest point in the body and visible through the skin
True or False: A patient may show signs of blood pooling and skin dis-
colorization after being in the same position for an extended period of time.
True, and this can be an indication of death
The most important treatment when caring for a patient with an irritant gas
exposure is, what?
ventilation; although oxygen is always important, you need to treat the under-lying
problem
Irritant gases are harmful to patients in, what manner?
exposure restricts the lungs ability to ventilate; therefore, the need for ventilation is
priority
How many minutes of oxygen remain in a D-size cylinder, which has 1600 p.s.i.,
when the flow rate is set to 4 L/min?
56 (1600 - 200 x 0. Lpm = 56 minutes)
What is the formula for calculating minutes of oxygen remaining?
take the Gauge pressure (p.s.i.), minus the Safe Residual (200 for all size cylinders),
then times the Cylinder Factor (0.16 for D-size cylinder), and divide by Flow Rate
(L/min)
The correct dosage for dextrose for a pediatric patient is, what?
- for infants, 0.5 gm/kg 25% dextrose;
- for patients over 1 year of age, 0.5 gm/kg 50% dextrose
Provide an example of a patient who would be declared more viable to treat.
a 5 year old apneeik (apneic) and pulseless patient who fell through the ice and was
submerged for 10 minutes before being brought to the ambulance
True or False: Drowning victims should be treated even if they have been
submerged for a long time.
True, the rule 'no patient should be pronounced dead, until warm and dead' applies
True or False: Children, in particular, have a good chance of survival if they have
been submerged in water for a long time.
True, but only < 3 minutes, or < 10 minutes in cold water
If a infant patient is found with rigor mortis, should you treat them?
No; all muscles stiffen in rigor mortis and this process occurs between two and six hours
following death
Does a DNR negate the need to begin CPR on an elderly patient?
Yes, regardless if the patient is or is not breathing, and is with or without a pulse, a valid
DNR must be honored
A 9 month old infant is found apneeik (apneic), pulseless, cool, blue, and stiff
after a nap. What do you suspect.
the patient is dead
A 38 year old male has had both legs torn off from a railway incident. He has ag-
onal respirations, and no palpable pulse. Is he a viable patient?
this patient has suffered major trauma, and while all efforts will be given, the odds of
surviving a traumatic arrest are very small
