NREMT EXAM LATEST UPDATE (2023) Brand New Questions Graded A+

NREMT EXAM LATEST UPDATE (2023) Brand New Questions Graded A+ Most severe dysrhythmia of the heart - answerAsystole Asystole - answerindicates no electrical activity in the heart PEA - answerindicates some residual electrical activity within the heart, but not enough for a pulse Ventricular fibrillation - answershockable rhythm, heart rhythm problem that occurs when the heart beats with rapid, erratic electrical impulses. This causes pumping chambers in your heart (the ventricles) to quiver uselessly, instead of pumping blood. Ventricular tachycardia - answershockable rhythm, in which the lower chambers of your heart (ventricles) beat very quickly because of a problem in your heart's electrical system. your heart may not be able to pump enough blood to your body and lungs because the chambers are beating so fast that they don't have time to properly fill. Cushing's triad - answerSing of increased intracranial pressure 3 sings 1. Brachicardia 2. hypertension 3. Altered respirations After your paramedic partner has intubated an adult cardiac arrest patient, you are providing ventilations as a firefighter performs chest compressions. When ventilating the patient, you should? - answerDeliver each breathe over 1 second at a rate of 8 to 10 breathes per minute When an advanced airway is in place, there is no pause in chest compressions to deliver breaths. An airway that is not completely obstructed - answerencourage to cough, heimlich is only performed on complete obstructions Infant respiratory rate - answer25-50 Bradycardia - answerThe condition of having a slow heartbeat, defined as under 60 beats per minute for an adult. Hypertension - answerprogressively increasing systolic blood pressure, leading to widening pulse pressure Mediastinum - answerRegion in mammals including the thoracic area just not the lungs, so the heart the trachea, the thymus gland are all included in it What are the two methods for opening the airway of an unconscious patient? When would you use one over the other? - answerJaw-thrust and head-tilt chin-lift spine injury What is the main complication of suctioning the airway for more than 10 seconds? - answerCould lead to hypoxia What flow rate for a nasal cannula and when should it be used - answerFlow rate: 1-6 lpm When it's used: Nasal cannulas are used to deliver oxygen when a low flow, low or medium concentration is required, and the patient is in a stable state. When should you use a NRM and at what flow rate? - answerUse when patent needs oxygen but can breath on their own and is getting sufficient tidal volume and O2 percent, flow rate of 10-15 lpm When should you use a bag-valve mask and at what flow rate? - answerUse when patient is unconscious and not breathing adequately or isn't getting enough O2 or has stopped breathing, use 10-15 lpm, if patient is breathing less than 12 times a min or more than 24 use BVM and check to see if it's working by looking at rise and fall of chest How would you ventilate a patient who has a Stoma? - answerIf there is a tracheostomy tube in place put the BVM on that and ventilate (after taking mask off) if no tube put a special mask over the stoma and if you don't have a special tracheostomy stoma mask use a child or infant BVM mask cover nose and mouth What is the medicine inside an MDI and how does it work? - answerA metered-dose inhaler (MDI) is a device that delivers a specific amount of medication to the lungs, in the form of a short burst of aerosolized medicine that is usually self-administered by the patient via inhalation. Medications are things like Bronchodilators like albuterol What are the indications of a MDI? - answerpatients with known COPD or asthma with acute exacerbations. patients without known respiratory disease who exhibit expiratory wheezing. must be prescribed What are the contraindications of a MDI? - answerAirflow obstruction due to foreign body Airflow obstruction and an MI Not used as the first drug to help with congestive heart failure Hypersensitivity, tachycardia, MI. What can albuterol treat? - answerAlbuterol can quickly relieve shortness of breath, coughing, wheezing, and chest tightness. relaxes muscles in the airways and increases air flow to the lungs. Administering MDI - answerShake for 30 sec, administer while patient inhales and encourage to hold breath Dyspnea - answerDifficult or labored breathing Retractions - answerSign of increased muscle use for breathing, sings of someone having difficulty breathing Belly breathing - answerSeeing the chest rise when a child is breathing because their ribcage muscles are not developed enough to get enough air, ok if the tidal volume and breathing rate are normal Auscultations - answerListening to the heart or lungs with stethoscope What does pulse oximetry measure? - answerMeasures the O2 saturation of someones blood What are three conditions that can give a false pulse oximetry reading? - answerDark nail polish Patient moving too much Dust and dirt Hand tremors The 3 conditions: peripheral vascular disease, vasoconstrictor medications, severe hypotension and hypothermia. peripheral vascular disease - answernarrowing of the blood vessels that carry blood to the extremities hypotension - answerabnormally low blood pressure, caused by sudden loss of blood (shock), severe infection, heart attack, or severe allergic reaction (anaphylaxis) hypothermia - answerBeing severely cold Decreasing mental status, Decreasing motor and sensory function and Changing vital signs. Early or superficial cold injury usually involves the tips of ears, the nose the tips of toes and fingers, and the chin Late or deep cold injury involves both the skin and tissue beneath it The pulse, breathing, and blood pressure are difficult to assess in a hypothermic patient. A pt with a core body temp of 95 or less is considered hypothermic How does Chronic Obstructive Pulmonary Disorder (COPD) affect a patient's respiratory effort and breathing? - answerPursed lips, barrel chest, tripoding, loss of elasticity of the lungs, dry cough, dyspnea Chronic obstructive lung disease (COPD) describes a group of lung conditions (diseases) that make it difficult to empty the air out of the lungs. This difficulty can lead to shortness of breath (also called breathlessness) or the feeling of being tired What treatment would you administer to a patient with difficulty breathing due to COPD? - answerPosition of comfort and administer O2 with NRM or PPV w/ BVM MDI How does Emphysema affect a patient's respiratory effort and breathing? - answer• Dyspnea (difficulty breathing) • Tachypnea (accelerated breathing) • Expiatory Wheezes • Retractions • Pursed lip • Dry cough • Fatigue • Anxiety • Barrel chest • Hypoxic drive- based on 02 levels in lungs, low 02 levels tell you to breath Emphysema is a chronic respiratory disease where there is over-inflation of the air sacs (alveoli) in the lungs, causing a decrease in lung function, and often, breathlessness. What treatment would you administer to a patient with difficulty breathing due to Emphysema? - answer♣ Position of comfort O2 • 2-4L/min • Re-evaluate/adjust • PPV BVM • DO NOT WITHHOLD O2 Metered-dose-inhaler/ Bronchodilator When a patient states that they are having an asthma attack, what is happening inside their body? - answer• Allergic reaction creating a spasm of the airways; difficulty exchanging air What treatment would you administer for a patient having an asthma attack? - answerTheir inhaler that is not expired • Position of comfort (tripod) • O2 o NRM 10-15L/min o Humidified o PPV BVM o Pt.'s Inhaler (do not administer yourself), albuterol What medical condition is "pink puffer" referring to and why does it have this name? - answerA facetious term sometimes used by doctors to describe patients breathless from CHRONIC lung disease but still able to maintain sufficient oxygenation of the blood to avoid CYANOSIS A descriptive term for a patient with COPD and severe emphysema, who has a pink complexion and dyspnea You walk into an office and find a 38-year-old male in the tripod position. He is speaking in one-word sentences and appears very anxious. What information will be important to gather during your assessment? What should your first medical intervention be? - answerdoes he suffer from COPD or asthma and does he have an MDI non-rebreather mask at 15lpm What does CPAP stand for and what kind of medical emergency is it used for? - answerContinuous Positive Airway Pressure and is udes for COPD and asthma How is CPAP administered? - answerstrapped to your face and forces oxygen threw the nose Simple pneumothorax: - answera non-expanding collection of air around the lung. Tension pneumothorax - answerThe accumulation of air under pressure in the pleural space. When to use supplemental oxygen? - answerUse on someone with low SPO2 saturation levels (under 94%) What kind of mask gives the most accurate flow rate? - answerventuri mask Ronchi - answerRhonchi are breathing sounds that are indicative of an airway obstruction Your patient is a 9-year-old female who is unusually quiet according to her mother. She looks distant and is responding to verbal commands. When you take her vitals, you notice a slowed pulse. You suspect she is experiencing? - answerHypoxia In children, hypoxia often presents as altered mental status and bradycardia. Hypoxia occurs when there is a deprivation of oxygen to the body. An elderly man is found lying unresponsive next to his bed. His wife is unsure what happened or why he is lying unconscious. The patient has a strong carotid pulse. What is your next priority? - answerJaw-thrust You have been dispatched for a respiratory distress call. Upon your arrival, you find a 34-year-old male in the tripod position and you can hear stridorous respirations from the doorway. The patient is drooling and feels hot to the touch. What life-threatening condition does your patient have? - answerEpiglottitis Epiglottitis - answerEpiglottis is a life-threatening, upper respiratory illness. The epiglottis becomes inflamed and begins to obstruct airflow to the trachea. The fever, drooling, and respiratory distress are class presentation. Epiglottitis occurs in adults and children. You are called to a local restaurant where you find an unconscious 65-year-old male. Bystanders say the patient appeared to be choking, then slumped over in his chair. You attempt ventilations and reposition the airway with no success. Your next action would be to? - answerInitiate CPR A 68-year-old male patient states that he had a myocardial infarction three years ago. What is he is referring to? - answerA myocardial infraction, more commonly referred to as a "heart attack", is when part of the patient's myocardium (heart muscle) is starved for oxygen and dies. While performing chest compressions, where do you want to ensure your hands are located? - answerCorrect hand placement for chest compressions is the center of the chest over the lower half of the breastbone. You respond to a patient who stated he was woken from a sound sleep with shortness of breath. Your assessment finds a BP of 180/100, pulse 116, respirations 36 and a pulse oximeter reading of 87%. Lung sounds reveal crackles in the bases. You suspect this patient to be suffering from? - answerThis patient is presenting with classic signs/symptoms of congestive heart failure. Most patients present present with shortness of breath, elevated BP and L/S with crackles. Alot of patients will have shortness of breath after laying flat while sleeping. Blood follows a specific pathway through the heart. After traveling through the right atrium, blood goes through WHICH valve into the right ventricle? - answertricuspid valve What is the pathway of blood through the heart - answerThe pathway of blood through the heart is superior vena cava, right atrium, tricuspid valve, right ventricle, lungs for oxygenation, pulmonary valve, left atrium, bicuspid valve, left ventricle, aortic valve, aorta. Mottling - answerMottling of the skin is an indicator of poor perfusion that is a result of peripheral blood vessel constriction. Which of the following symptoms is most commonly associated with cardiac related chest pain? - answerJaw pain Which of the following is the only acceptable reason to withhold compressions for longer than ten seconds? - answerIf a patient needs to be moved or there is a dangerous situation, you may pause compressions momentarily. When you stop chest compressions, circulating blood and oxygen is deprived from the brain and heart.