Ultimate EMT Exam
Ultimate EMT[NREMT] Actual Exam 1
COMPLETE VERIFIED QUESTIONS AND CORRECT
ANSWERS with DETAILED RATIONALES GRADED
A+ GUARANTEED PASS- ACE YOUR EXAM
Tachycardia can be detrimental to a patient who is experiencing a cardiac problem because it
causes:
• A:increased cardiac oxygen usage and demand.
• B:increased cardiac filling in between beats.
• C:a profound decrease in oxygen consumption.
• D:an associated increase in breathing difficulty.
You selected A; This is correct!
Detailed Rationale:
Many patients experiencing a cardiac problem are tachycardic (heart rate greater than 100
beats/min); others are bradycardic (heart rate less than 60 beats/min). As the heart beats
A+ TEST BANK 1
, Ultimate EMT Exam
faster, it consumes, and therefore requires, more oxygen. This can be detrimental to the
patient because the heart is already deprived of oxygen (ischemia) and may not be able to
accommodate the increased need for oxygen; this may worsen the ischemia, potentially
causing further cardiac damage. A very fast heart rate (>150 beats/min) may cause
hypotension due to a decrease in cardiac output; it occurs because the ventricles are not
adequately filling with blood in between beats. Some patients with a cardiac problem may
have difficulty breathing, which may be the result of congestive heart failure and pulmonary
edema; it is not caused by the tachycardia itself.
The MOST important initial treatment for a patient whose cardiac arrest was witnessed is:
• A:high-quality CPR.
• B:rapid transport.
• C:defibrillation.
• D:cardiac drug therapy.
You selected A; This is correct!
Detailed Rationale:
Regardless of whether a patient's cardiac arrest is witnessed or unwitnessed, the single most
important initial treatment is high-quality CPR. Delays in performing CPR have been clearly
linked to poor patient outcomes. After CPR has been initiated, apply the AED as soon as it is
available. Cardiac drug therapy and rapid transport enhance the patient's chance of survival,
but are useless without minimally-interrupted, high-quality CPR.
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:
• A:congestive heart failure.
• B:severe bacterial pneumonia.
• C:acute onset emphysema.
• D:decompensated asthma.
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, Ultimate EMT Exam
The correct answer is A;
Detailed Rationale:
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, in which case 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 (for
example, the left lower lobe).
During your rapid assessment of a critically-injured patient, you should assess the chest for:
• A:crepitus and distention.
• B:distention and guarding.
• C:rigidity and guarding.
• D:symmetry and pain.
You selected D; This is correct!
Detailed Rationale:
When assessing the chest during the assessment, you should check for symmetry (equal rise
of the chest), assess for pain upon palpation, and the presence of equal breath sounds
bilaterally. Crepitus also should be noted if present, but not purposely elicited. Rigidity,
guarding, and distention should be assessed for when evaluating the abdomen. Because of
the ribcage, the chest is rigid by nature.
Treatment for a patient with congestive heart failure and shortness of breath may include:
• A:prophylactic suctioning of the airway.
• B:supine positioning and elevation of the legs.
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, Ultimate EMT Exam
• C:hyperventilation with a bag-mask device.
• D:up to three doses of sublingual nitroglycerin.
You selected D; This is correct!
Detailed Rationale:
Treatment for patients with congestive heart failure (CHF) includes supplemental oxygen as
needed to maintain an oxygen saturation equal to or greater than 94%, continuous positive
airway pressure (CPAP), ventilatory assistance with a bag-mask device if needed (do NOT
hyperventilate the patient), placing the patient in an upright or sitting position to facilitate
breathing (a supine position will clearly make it more difficult to breathe), monitoring the
patient's vital signs, and transporting to the hospital without delay. Suction the airway only if
there are secretions in the mouth; prophylactic suctioning is not indicated. Nitroglycerin
(NTG) may be of value if the patient is not hypotensive and he or she has the medication
prescribed to him or her. As a vasodilator, NTG causes systemic venous pooling of blood,
which reduces the amount of blood returned to the heart (preload), and thus, the amount of
blood available to backup in the lungs. Follow your local protocols or contact medical control
as needed regarding the use of NTG for patients with CHF.
A 50-year-old man presents with crushing chest pain of sudden onset. He is diaphoretic,
apprehensive, and tachypneic. You should:
• A:obtain baseline vital signs.
• B:ask him if he takes nitroglycerin.
• C:perform a complete physical exam.
• D:apply supplemental oxygen.
You selected D; This is correct!
Detailed Rationale:
All of the interventions and assessments listed in this question should be performed on a
patient who presents with chest pain, pressure, or discomfort. However, supplemental
oxygen is indicated for any patient with a potential cardiac problem and should be given as
soon as possible; this is especially true when the patient has potential respiratory involvement
A+ TEST BANK 4
Ultimate EMT[NREMT] Actual Exam 1
COMPLETE VERIFIED QUESTIONS AND CORRECT
ANSWERS with DETAILED RATIONALES GRADED
A+ GUARANTEED PASS- ACE YOUR EXAM
Tachycardia can be detrimental to a patient who is experiencing a cardiac problem because it
causes:
• A:increased cardiac oxygen usage and demand.
• B:increased cardiac filling in between beats.
• C:a profound decrease in oxygen consumption.
• D:an associated increase in breathing difficulty.
You selected A; This is correct!
Detailed Rationale:
Many patients experiencing a cardiac problem are tachycardic (heart rate greater than 100
beats/min); others are bradycardic (heart rate less than 60 beats/min). As the heart beats
A+ TEST BANK 1
, Ultimate EMT Exam
faster, it consumes, and therefore requires, more oxygen. This can be detrimental to the
patient because the heart is already deprived of oxygen (ischemia) and may not be able to
accommodate the increased need for oxygen; this may worsen the ischemia, potentially
causing further cardiac damage. A very fast heart rate (>150 beats/min) may cause
hypotension due to a decrease in cardiac output; it occurs because the ventricles are not
adequately filling with blood in between beats. Some patients with a cardiac problem may
have difficulty breathing, which may be the result of congestive heart failure and pulmonary
edema; it is not caused by the tachycardia itself.
The MOST important initial treatment for a patient whose cardiac arrest was witnessed is:
• A:high-quality CPR.
• B:rapid transport.
• C:defibrillation.
• D:cardiac drug therapy.
You selected A; This is correct!
Detailed Rationale:
Regardless of whether a patient's cardiac arrest is witnessed or unwitnessed, the single most
important initial treatment is high-quality CPR. Delays in performing CPR have been clearly
linked to poor patient outcomes. After CPR has been initiated, apply the AED as soon as it is
available. Cardiac drug therapy and rapid transport enhance the patient's chance of survival,
but are useless without minimally-interrupted, high-quality CPR.
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:
• A:congestive heart failure.
• B:severe bacterial pneumonia.
• C:acute onset emphysema.
• D:decompensated asthma.
A+ TEST BANK 2
, Ultimate EMT Exam
The correct answer is A;
Detailed Rationale:
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, in which case 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 (for
example, the left lower lobe).
During your rapid assessment of a critically-injured patient, you should assess the chest for:
• A:crepitus and distention.
• B:distention and guarding.
• C:rigidity and guarding.
• D:symmetry and pain.
You selected D; This is correct!
Detailed Rationale:
When assessing the chest during the assessment, you should check for symmetry (equal rise
of the chest), assess for pain upon palpation, and the presence of equal breath sounds
bilaterally. Crepitus also should be noted if present, but not purposely elicited. Rigidity,
guarding, and distention should be assessed for when evaluating the abdomen. Because of
the ribcage, the chest is rigid by nature.
Treatment for a patient with congestive heart failure and shortness of breath may include:
• A:prophylactic suctioning of the airway.
• B:supine positioning and elevation of the legs.
A+ TEST BANK 3
, Ultimate EMT Exam
• C:hyperventilation with a bag-mask device.
• D:up to three doses of sublingual nitroglycerin.
You selected D; This is correct!
Detailed Rationale:
Treatment for patients with congestive heart failure (CHF) includes supplemental oxygen as
needed to maintain an oxygen saturation equal to or greater than 94%, continuous positive
airway pressure (CPAP), ventilatory assistance with a bag-mask device if needed (do NOT
hyperventilate the patient), placing the patient in an upright or sitting position to facilitate
breathing (a supine position will clearly make it more difficult to breathe), monitoring the
patient's vital signs, and transporting to the hospital without delay. Suction the airway only if
there are secretions in the mouth; prophylactic suctioning is not indicated. Nitroglycerin
(NTG) may be of value if the patient is not hypotensive and he or she has the medication
prescribed to him or her. As a vasodilator, NTG causes systemic venous pooling of blood,
which reduces the amount of blood returned to the heart (preload), and thus, the amount of
blood available to backup in the lungs. Follow your local protocols or contact medical control
as needed regarding the use of NTG for patients with CHF.
A 50-year-old man presents with crushing chest pain of sudden onset. He is diaphoretic,
apprehensive, and tachypneic. You should:
• A:obtain baseline vital signs.
• B:ask him if he takes nitroglycerin.
• C:perform a complete physical exam.
• D:apply supplemental oxygen.
You selected D; This is correct!
Detailed Rationale:
All of the interventions and assessments listed in this question should be performed on a
patient who presents with chest pain, pressure, or discomfort. However, supplemental
oxygen is indicated for any patient with a potential cardiac problem and should be given as
soon as possible; this is especially true when the patient has potential respiratory involvement
A+ TEST BANK 4
