TEST BANK for Prehospital Emergency Care 11th Edition by Mistovich Joseph, Karren Keith and Hafen Br by welldoneassistant

Prehospital Emergency Care, 11e (Mistovich et al.) Chapter 1 Emergency Care Systems, Research, and Public Health 1) What is a primary purpose of the modern-day EMS system? A) Provide a means of transport to and from the hospital B) Ensure that all members of society have equal access to hospitals C) Decrease the incidence of death and disability related to injury and illness D) Provide emergency health care services to medically underserved areas Answer: C Diff: 2 Page Ref: 7 Objective: 1-2 2) Most authorities agree that the modern-day EMS system evolved after the release of which document? A) The Emergency Medical Services Act of 1973 B) The white paper "Accidental Death and Disability: The Neglected Disease of Modern Society" in 1966 C) The American Heart Association's Guidelines for Cardiac Resuscitation D) Emergency Medical Services: Agenda for the Future, in 1996 Answer: B Diff: 1 Page Ref: 3 Objective: 1-2 3) An Emergency Medical Responder comes to you and states that he would like to work for your emergency ambulance service on a full-time basis. Knowing the National EMS Scope of Practice Model, you inform him of which element? A) He will be able to take care of only patients with non-life-threatening complaints B) He will first need approval from your ambulance service's medical director C) He will be able to work only with an Advanced EMT or paramedic D) He will first have to become an Emergency Medical Technician Answer: D Diff: 1 Page Ref: 6-7 Objective: 1-1 4) As defined by the National EMS Scope of Practice Model, the four levels of EMS practitioners include: A) Ambulance drivers B) EMS medical director C) Paramedics D) Emergency medical dispatchers Answer: C Diff: 1 Page Ref: 6-7 Objective: 1-3

5) An Emergency Medical Responder (EMR) approaches you and states that he is interested in becoming an EMT. Specifically, he asks what he will be able to do as an EMT that he cannot presently do as an EMR. You respond by saying he will be able to: A) Administer some medications B) Assist in emergency childbirth C) Use an automated external defibrillator D) Obtain vital signs Answer: A Diff: 1 Page Ref: 6-7 Objective: 1-5 6) You have been dispatched for a 61-year-old female in cardiac arrest. Emergency Medical Responders (EMRs) are on scene. In your community, all EMS practitioners are trained according to the National EMS Scope of Practice Model. Given this, which type of care do you expect the EMRs to be providing? A) Emergency medication administration B) Automated external defibrillation C) Intravenous therapy D) Reading an electrocardiogram Answer: B Diff: 2 Page Ref: 6 Objective: 1-5 7) An EMT with your service states that she desires to become a paramedic because she wants to provide advanced care. Under the National EMS Scope of Practice Model, which one of these types of care will she be able to provide as a paramedic that she cannot provide as an EMT? A) Automated blood pressure monitoring B) Assistance with emergency childbirth C) Interfacility transports D) IV therapy Answer: D Diff: 1 Page Ref: 7 Objective: 1-5 8) Which statement made by an EMT requires immediate intervention by a superior or the service supervisor? A) "I always wear my seat belt whenever I am in the patient compartment of the ambulance, unless I have to remove it to care for a patient." B) "I drive as fast as I can to get to the scene of an emergency, especially if a child is sick or injured according to dispatch information." C) "When I am driving with lights and sirens, I instruct my partner that he will need to handle all radio communications." D) "I put exam gloves on for every patient I contact, even if he or she does not have a known or suspected infectious disease." Answer: B Diff: 1 Page Ref: 9 Objective: 1-7 2 Copyright © 2018 Pearson Education, Inc.

9) Which statement shows that the EMT has a good understanding of her role and responsibilities related to being an EMT? A) "The patient's needs come before anyone else's needs." B) "At the scene of an emergency, my responsibility is to get to the patient no matter what." C) "My safety comes first, and then the patient's safety." D) "As an EMT, I recognize that the public's safety comes before the safety of me or my partner." Answer: C Diff: 2 Page Ref: 8-9 Objective: 1-7 10) An ambulance with two EMTs arrives in front of a house for an unknown medical emergency. On scene, bystanders report that a female patient was beaten by her husband in the driveway and then dragged back into the house. They state that the patient appeared unconscious and was bleeding from the head. Which action would the EMTs perform next? A) Do not enter the scene until it has been controlled by law enforcement B) Quietly enter the home and quickly move the patient to the ambulance C) Remove the husband from the house, then provide emergency care to the wife D) Enter the home to protect the patient while waiting for the police to arrive Answer: A Diff: 2 Page Ref: 9 Objective: 1-7 11) Why is EMS in a unique position to contribute significantly to mobile integrated health care? A) EMS providers are familiar with and capable of functioning in the out-of-hospital environment B) Ambulances are easily identified C) The community trusts uniformed health care providers D) EMS providers are familiar with the many routes of medication administration Answer: A Diff: 1 Page Ref: 17 Objective: 1-15

12) You have arrived on the scene of a motor vehicle collision. A car has gone off the road and into a utility pole. The pole is broken and wires are hanging just above the car. You do not see any sparking or arcing of the wires. The driver of the car is slumped over the steering wheel and not moving. Several bystanders around the car are yelling for you to help. Which steps represent the correct order of your response? A) Clear the bystanders, allow the fire department to secure the wires, access the patient, extricate the patient, transport B) Access the patient, clear the bystanders, allow the fire department to secure the wires, extricate the patient, transport C) Clear the bystanders, access the patient, extricate the patient, transport, allow the fire department to secure the wires D) Access the patient, allow the fire department to secure the wires, clear the bystanders, extricate the patient, transport Answer: A Diff: 2 Page Ref: 8-9 Objective: 1-7 13) Once a scene is free of safety hazards, the EMT must recognize and focus on the needs of the: A) Rescuers B) Patient C) Family D) Bystanders Answer: B Diff: 1 Page Ref: 9 Objective: 1-7 14) You have been asked to sit on your service's quality improvement (QI) committee. As a knowledgeable EMT, you recognize that in this role you will be involved in projects that are primarily designed to: A) Communicate with insurance companies for increased reimbursement B) Recruit and educate EMTs about the Emergency Medical Services profession C) Develop ways in which the delivery of emergency care can be improved D) Identify and reeducate EMTs who routinely do not provide proper care Answer: C Diff: 2 Page Ref: 13 Objective: 1-10 15) What would be a logical project to be undertaken and developed by a quality improvement (QI) committee? A) Termination of EMTs who are chronically late to work B) A program by which pay raises are based on performance and attitude C) Community fundraiser to raise money for new EMS equipment D) Monthly continuing education programs in which seldom-used skills are practiced Answer: D Diff: 2 Page Ref: 14 Objective: 1-10 4 Copyright © 2018 Pearson Education, Inc.

16) You are interviewing for the position of EMT with a busy urban service. This morning you are to meet with the service's medical director. You have been told that she likes it when applicants ask questions about her role as the medical director. Related to her responsibilities as medical director, which question is most appropriate? A) "How do you determine the wages that the EMTs are paid?" B) "How do you determine the number and location of ambulances within the system?" C) "How often are the emergency care protocols updated?" D) "Do you assign the daily chores that must be completed around the stations?" Answer: C Diff: 2 Page Ref: 12 Objective: 1-9 17) To be a medical director of an ambulance service, which requirement must the interested individual satisfy? A) Licensed physician B) Emergency physician with surgical experience C) Physician who was a paramedic D) Physician with a college degree in EMS Answer: A Diff: 1 Page Ref: 12 Objective: 1-9 18) As an EMT, which requirement must be met so that you can provide routine and emergency medical care to the sick and injured, as an extension of the medical director's authority? A) Prior medical experience B) A service medical director C) A knowledgeable partner D) A safe driving record Answer: B Diff: 1 Page Ref: 12 Objective: 1-9 19) It has been some time since you were involved in the care of a pediatric patient. You decide to review the assessment and treatment basics that your medical director requires. To review this information, which resource should you consult first? A) Emergency Medical Responders B) Reputable websites C) Emergency department nurses D) Service protocols Answer: D Diff: 1 Page Ref: 13 Objective: 1-9

20) Before the EMT contacts medical direction for authorization to assist a patient with shortness of breath in using her metered-dose inhaler, protocols state that the EMT must first attempt to provide relief by administering oxygen if the pulse oximeter reading is less than 94%. You recognize that the administration of oxygen is best described as a(n): A) Standing order B) On-line medical direction C) Direct permission D) Quality improvement Answer: A Diff: 2 Page Ref: 13 Objective: 1-9 21) If a patient with chest pain takes a daily aspirin, your medical director wants the EMT to contact an emergency department physician first before administering additional aspirin. The act of contacting the emergency department physician by phone or radio for permission to administer additional aspirin is an example of: A) Quality improvement B) On-line medical direction C) Off-line medical direction D) Indirect medical control Answer: B Diff: 2 Page Ref: 13 Objective: 1-1 22) At the scene of a minor motor vehicle collision, you are attending to a female patient who complains of head and neck pain. A crowd has gathered to watch the action. What will the observing public most likely remember about the role EMS portrayed? A) The number of emergency vehicles that showed up B) The color of the ambulances C) If the EMTs were all wearing the same color uniforms D) EMTs who were yelling and cursing loudly at the fire department to hurry up and get the patient out of the car Answer: D Diff: 2 Page Ref: 11 Objective: 1-8 23) You work in a community that has an "enhanced" 911 system. Given this, which is true about such a system? A) The physical location of the landline used to make the 911 call is displayed to the call taker B) The EMS system uses EMTs, Advanced EMTs, and paramedics C) The fire department responds simultaneously with EMS D) The total response time for EMS will rarely exceed 9 minutes Answer: A Diff: 1 Page Ref: 5 Objective: 1-4

24) Which patient would most benefit from calling an enhanced 911 system from the home phone? A) Patient with chest pain B) Patient with sudden onset of confusion C) Patient requiring advanced medical care D) Patient who cannot reach the phone Answer: B Diff: 2 Page Ref: 5 Objective: 1-4 25) A 14-year-old boy has fallen through a plate glass window and is bleeding heavily from a laceration to his arm. His panicked mother has called 911 for help. Since the 911 operators are also emergency medical dispatchers, what sort of assistance will they be able to provide? A) Simultaneous notification of the hospital B) Whether the EMS response is covered by medical insurance C) Instructions on how to control bleeding D) The names of the EMTs who are responding Answer: C Diff: 2 Page Ref: 5 Objective: 1-3 26) Which be an EMS public health initiative? A) Educating the public on the benefit of wearing seat belts B) Volunteering time to help raise money for a sick child and his family C) Providing volunteer emergency ambulance service 24 hours a day, 7 days a week D) Purchasing new equipment to better help those persons who experience a medical emergency Answer: A Diff: 2 Page Ref: 16 Objective: 1-14 27) Your service's medical director would like to explore the idea of EMTs using special transport ventilators when caring for patients who require assistance with their breathing. When using an evidence-based medicine approach, what should you do first? A) Go to a local hospital to see which kind of ventilators it uses B) Contact vendors that sell ventilators and ask for price quotations C) Select specific EMTs to conduct a field trial of particular ventilators D) Search the medical literature for research related to this topic Answer: D Diff: 2 Page Ref: 14 Objective: 1-13

28) You are by the side of a confused patient who has diabetes and a low blood sugar level. You know that the patient needs orally administered sugar, so following your service's guidelines, you call the physician on duty at the hospital emergency department and request permission to administer it. This request is an example of: A) Standing orders B) On-line medical direction C) Medical cooperation D) Off-line medical direction Answer: B Diff: 1 Page Ref: 12 Objective: 1-1 29) Which statement about emergency medical services in the United States is true? A) The EMS system is controlled and governed by the National Highway Transport and Safety Administration (NHTSA) B) The federal government oversees all aspects of EMS in the United States C) Each state has governmental control of its own EMS system, independent of the federal government D) The U.S. Department of Health and Human Services establishes curricula for all levels of EMS education Answer: C Diff: 2 Page Ref: 4 Objective: 1-3 30) The county dispatch center where you work employs emergency medical dispatchers (EMDs) as call takers. Using EMDs as opposed to a person who is just a "call taker" enables the dispatch center to: A) Process all emergency calls, including those asking for police, fire, and EMS assistance B) Provide medical instructions to the caller prior to the arrival of EMS personnel C) Use computer technology when dispatching the closest ambulance D) Properly utilize an enhanced 911 call-taking system Answer: B Diff: 2 Page Ref: 5 Objective: 1-3 31) A 40-year-old man has been seriously injured in a car crash. He is unresponsive and has what you believe to be a collapsed lung. Additionally, his left leg is severely deformed with heavy bleeding and his vital signs are unstable. A passenger in the car informs you that the patient has diabetes and significant heart problems. Given this information, what is the best destination for this patient, assuming all of the facilities are the same distance away? A) Cardiac center B) Spine injury center C) Trauma center D) Stroke center Answer: C Diff: 2 Page Ref: 7 Objective: 1-6 8 Copyright © 2018 Pearson Education, Inc.

32) You have arrived at the scene of a medical emergency and find a woman lying on the floor of a grocery store. As you approach her, you know that your first priority as an EMT is: A) Personal safety B) Patient care C) Public safety D) Patient advocacy Answer: A Diff: 1 Page Ref: 8 Objective: 1-11 33) A female jogger has collapsed on a trail at a public park. A crowd of curious onlookers have collected and are watching as the EMT examines the patient for any life-threatening conditions. After determining that there are none and the patient is stable, the EMT acts as a patient advocate by: A) Informing the crowd that the patient appears to be okay B) Transporting the patient to the hospital using lights and sirens C) Continuing care despite the crowd's presence D) Asking curious onlookers to leave the scene Answer: D Diff: 2 Page Ref: 10 Objective: 1-7 34) At a public 911 center meeting, a concerned woman asks whether voice over Internet Protocol (VoIP) can be used to access the community emergency operations center. You would inform her that: A) Internet providers are encouraged to provide 911 access, but are not required by law, so the dispatch center may have to get an address from the caller B) Internet providers are required to provide their own 911 call-taker service to subscribers C) Internet providers must provide a callback number and physical location of the phone from which the 911 call was placed D) Internet providers are required to employ EMDs who can provide medical instructions prior to arrival of EMS Answer: C Diff: 2 Page Ref: 6 Objective: 1-4 35) What would the EMT recognize as an advantage of the 911 universal number? A) It is able to track the locations of all emergency vehicles in an EMS system B) It is a common number through which to request EMS, law enforcement, and fire services C) It is less expensive to operate than a 7- or 10-digit telephone number D) It is the most easily remembered 3-digit combination of numbers Answer: B Diff: 1 Page Ref: 5 Objective: 1-4

36) Which statement accurately describes the hospital emergency department? A) It is a health care destination staffed by physicians, nurses, and others designed to evaluate and stabilize patients, preparing them for further care B) It requires patients to make an appointment to be seen by a physician, unless they arrive by ambulance C) It is the only health care destination to which EMS can transport patients with a medical emergency D) It provides lifesaving care instructions to callers accessing the 911 system Answer: A Diff: 1 Page Ref: 7 Objective: 1-6 37) As a supervisor with an emergency ambulance service, which situation regarding a potential employee would you recognize as falling under the Americans with Disabilities Act (ADA), and as case in which you would make reasonable accommodations? A) An EMT who has requested help with a drug and alcohol problem B) Applicant who cannot pass the EMT certification exam because he is dyslexic C) A blind patient who wants to become an EMT, but has not taken a class yet D) A dispatcher with a prosthetic leg who requires parking next to the building entrance Answer: D Diff: 3 Page Ref: 8 Objective: 1-7 38) How would the Americans with Disabilities Act (ADA) be satisfied for a pregnant emergency medical dispatcher (EMD) who suffers from paralysis of both legs and requires the use of a wheelchair? A) Wheelchair accessibility to and from dispatch B) Hourly pay rate 10 percent above that of the other EMDs C) Scheduled shifts during daylight hours only D) Transport by your service to and from work Answer: A Diff: 2 Page Ref: 8 Objective: 1-7 39) A young man wishes to become an EMT and asks you what he will need to do to become certified. You would reply that he must first: A) Volunteer with an ambulance service to gain experience B) Complete a course that meets the requirements of the U.S. Department of Transportation C) Demonstrate that he has prior medical experience D) Attend classes at a local community college Answer: B Diff: 2 Page Ref: 4 Objective: 1-3

40) The functions of a state EMS agency include: A) Determination of the number of EMRs, EMTs, AEMTs, and paramedics allowed in the state B) Review of patient care reports (PCRs) to ensure proper care C) Planning and coordination of the statewide EMS system D) Encouraging fair wages for the different levels of EMS providers Answer: C Diff: 2 Page Ref: 4 Objective: 1-3 41) What actions place the patient at greatest risk for a medical mistake? A) Driving to an emergency department at night B) Backing the ambulance into the ambulance bay at the hospital C) Responding to a call in an "unsafe" neighborhood D) Transferring care from one EMT to another Answer: D Diff: 2 Page Ref: 14 Objective: 1-11 42) Which statement best summarizes the underlying benefit of using evidence-based medicine? A) Formulates emergency care guidelines that have been reviewed by the legal community B) Improves patient care while simultaneously reducing the costs associated with EMS C) Provides for legal representation in the quality improvement process D) Allows the use of research and evidence in determining which care is effective Answer: D Diff: 2 Page Ref: 14 Objective: 1-13 43) Which item of protective gear is appropriate to wear at an automobile collision? A) Gown B) A HEPA mask C) Reflective clothing D) SCBA gear Answer: C Diff: 1 Page Ref: 9 Objective: 1-12 44) At a bare minimum, which type of personal protective equipment should be worn by EMS providers at any emergency scene involving a shooting? A) Face mask B) Gloves C) Gown D) Goggles Answer: B Diff: 1 Page Ref: 9 Objective: 1-12

45) Which of these tasks has not been identified as one that could be provided by a mobile integrated health care system? A) Manage patients who are at a high risk for hospital readmission B) Assist in the ongoing home management of chronic conditions C) Provide preventive services and check up on patients after discharge D) Conduct health screening and provide minor outpatient surgical services Answer: D Diff: 2 Page Ref: 17 Objective: 1-15 46) In the public health continuum, what is the first responsibility that public health officials must satisfy to improve the health of a community? A) Identify problems that affect the health of the population in question B) Design a plan for remediating the disturbances that cause a population's health to decline C) Integrate their work with EMS services to provide outpatient home care services designed to improve health D) Meet with city administrators to determine which type of public health budget will be provided so cost-effective plans can be established Answer: A Diff: 2 Page Ref: 16 Objective: 1-14 47) Which attribute of a person would not likely work out well in the EMS profession? A) Inability or no desire to "take charge" B) Being able to make good decisions with minimal information C) Being able to adapt to a situation when things become chaotic D) Willingness to hold what is learned about patients, good and bad, in confidence Answer: A Diff: 2 Page Ref: 11 Objective: 1-8

Prehospital Emergency Care, 11e (Mistovich et al.) Chapter 2 Workforce Safety and Wellness of the EMT 1) A distraught husband awoke to find his 26-year-old wife not breathing and cold to the touch. Since your assessment indicates that the woman has been dead for some time, you contact medical direction for authorization to withhold emergency care. The medical director agrees and the coroner is notified. At this time, your immediate responsibility is: A) Establishing the time of death B) Preparing for the next call C) Determining the cause of death D) Providing supportive care to the husband Answer: D Diff: 2 Page Ref: 22 Objective: 2-3 2) You are doing CPR on a male patient who is unresponsive, not breathing, and pulseless. Emergency Medical Responders (EMRs) were on scene first and applied the AED, which did not deliver a shock to the patient. The patient's wife is crying and asks how her husband is doing. Your response would be: A) "I have to be honest, he is probably dead, but we are going to take him to the hospital so the doctor can examine him and make sure." B) "Why don't we wait until we get to the hospital to talk about your husband's condition?" C) "Right now he is not breathing and his heart is not beating, but we are doing everything we possibly can for him." D) "I am not a doctor, but his current condition is very grave and he will likely die, based on my previous experiences." Answer: C Diff: 2 Page Ref: 22 Objective: 2-3 3) The EMT practice of protecting oneself from disease transmission through exposure to blood and other body fluids is referred to as: A) Standard Precautions B) Exposure control C) Personal protective equipment D) Body Fluid Precautions Answer: A Diff: 1 Page Ref: 28 Objective: 2-1

4) An EMT is correct when he describes a communicable disease as: A) Any of a number of diseases that are deadly once contracted B) A disease that can be spread from one person to another C) Any disease that is caused and spread by a viral agent D) A disease for which no immunization exists Answer: B Diff: 1 Page Ref: 27 Objective: 2-9 5) What is the single best technique that the EMT can use to prevent the spread of infection? A) Disinfecting equipment B) Wearing gloves C) Washing hands D) Getting immunizations Answer: C Diff: 2 Page Ref: 28 Objective: 2-9 6) The EMT is correctly performing routine handwashing when she: A) Uses an alcohol-based hand sanitizer without water B) Rinses with hot water after using a disinfectant soap C) Lathers and scrubs with plain soap for 20 seconds D) Dries hands thoroughly for 30 seconds with a reusable towel Answer: C Diff: 2 Page Ref: 29 Objective: 2-9 7) A patient with human immunodeficiency virus (HIV) infection is complaining of chest pain. In this situation, which personal protective equipment, at a minimum, is required to be donned prior to contact with the patient? A) Gloves and eyewear B) Gloves and gown C) Gloves, gown, and N-95 respirator D) Gloves, gown, goggles, and mask Answer: A Diff: 2 Page Ref: 33-34 Objective: 2-12

8) The hospital staff has just returned the long spine board that you used to immobilize a patient from a minor motor vehicle collision. There is no blood on the board, but your service policy states that all equipment is to be disinfected anytime that it is used. To properly disinfect the long spine board, which type of product should you use? A) Soap and water B) Sterilizing solution C) Germicidal solution D) Superheated steam Answer: C Diff: 2 Page Ref: 31-32 Objective: 2-9 9) Which immunization should the EMT receive annually? A) Purified protein derivative B) Measles, mumps, and rubella vaccine C) Hepatitis B vaccine D) Influenza vaccine Answer: D Diff: 2 Page Ref: 32 Objective: 2-13 10) You have been told that you must get your purified protein derivative (PPD) test for tuberculosis (TB). As a knowledgeable EMT, you recognize that the PPD test will: A) Provide continued immunity to tuberculosis B) Need to be repeated annually C) Reveal whether you need a TB immunization D) Determine the effectiveness of treatment for TB Answer: B Diff: 2 Page Ref: 32 Objective: 2-9 11) Which statement made by an EMT demonstrates that he has an accurate understanding of hepatitis C? A) "It is important to get the hepatitis C vaccine to decrease my chance of contracting the disease if exposed to the virus." B) "Wearing gloves and washing hands are the best means by which to prevent the transmission of hepatitis C to health care workers." C) "Since hepatitis C is primarily transmitted in the spring and summer, more precautions are needed during that time." D) "Respiratory droplets are the primary means by which hepatitis C is transmitted, making a mask necessary when caring for patients with this disease." Answer: B Diff: 3 Page Ref: 33 Objective: 2-11

12) While you are assessing a patient with abdominal pain, the patient informs you that he is a chronic carrier of hepatitis B. His skin is not jaundiced, nor does he have a fever. As an EMT, you realize: A) The patient has the disease but is not infectious B) The hepatitis B vaccine will not protect you if you are exposed to the virus C) The patient's blood and body fluids are infectious D) A mask must be placed over the patient's mouth Answer: C Diff: 3 Page Ref: 32 Objective: 2-13 13) You are treating a patient with active tuberculosis. What will afford you the best protection from the disease while you care for the patient? A) Surgical mask with a face shield B) Purified protein derivative injection C) Gloves, gown, and goggles D) High-efficiency particulate aspirator mask Answer: D Diff: 2 Page Ref: 33 Objective: 2-12 14) A patient informs you that he was recently diagnosed with the human immunodeficiency virus (HIV) infection, but has yet to develop AIDS. Given this information, which statement is true? A) Until the patient develops AIDS, he is not infectious B) Family members should not share the patient's hand towels or utensils C) The hepatitis B and C vaccines provide the EMT with limited protection from transmission of HIV D) Gloves and eye protection will be enough protection under most conditions unless body fluids are present Answer: D Diff: 2 Page Ref: 33-34 Objective: 2-12 15) Preincident stress education, one-on-one support, and disaster support services are all part of: A) A comprehensive CISM program B) A balanced work environment C) Burnout prevention programs D) Stress reduction techniques Answer: A Diff: 2 Page Ref: 26 Objective: 2-8

16) You are dispatched to a motor vehicle collision on a remote country road. It is night, and your scene size-up reveals a heavily damaged car that rolled several times. The driver has been ejected and is lying prone in the middle of the road. In this situation, which type of protective clothing is it most essential that you don prior to making patient contact? A) Rubber-soled boots B) Reflective vest C) Protective helmet D) Leather gloves Answer: B Diff: 2 Page Ref: 37 Objective: 2-14 17) As EMTs leave a house where the patient refused care, a panicked boy approaches them and states that some men just shot his friend in a house two doors up the street. The EMTs' immediate action should be to: A) Instruct the boy to carry the patient from the house to the yard B) Gather basic equipment and go to the home to care for the patient C) Notify dispatch and proceed to the home to care for the patient D) Contact the police and move the ambulance from the immediate area Answer: D Diff: 2 Page Ref: 39 Objective: 2-14 18) You are transporting a 58-year-old female with terminal breast cancer. While in the ambulance, she becomes tearful yet agitated, and repeatedly asks, "Why me?" As a knowledgeable EMT, you recognize that she is in which stage of grieving? A) Anger B) Denial C) Bargaining D) Depression Answer: A Diff: 2 Page Ref: 21 Objective: 2-2 19) A reaction to death or dying where the patient asserts "Not me!" is recognized as which stage of grieving? A) Anger B) Denial C) Bargaining D) Depression Answer: B Diff: 2 Page Ref: 21 Objective: 2-2

20) What statement would you expect to hear from a patient who has accepted the fact that he is terminally ill and will die sooner than later? A) "It is just not fair." B) "It's okay. I am not afraid." C) "I have no energy to even think anymore." D) "I cannot go on like this any longer." Answer: B Diff: 2 Page Ref: 21 Objective: 2-3 21) Organisms that cause diseases are called: A) Pathogens B) Toxins C) Antigens D) Antibodies Answer: A Diff: 1 Page Ref: 27 Objective: 2-1 22) A reference tool that should be placed in every emergency vehicle for use when responding to a possible "hazmat" incident is: A) The Emergency Response Guidebook B) The Physician's Desk Reference C) The Merck Manual D) A list of chemicals processed by local industries Answer: A Diff: 1 Page Ref: 36 Objective: 2-14 23) To ensure your own safety and the safety of your crew, you should: A) Request police assistance on all calls B) Search each and every patient for weapons C) Evaluate every scene for danger before entering D) Ensure the availability of a paramedic for most medical calls Answer: C Diff: 1 Page Ref: 26 Objective: 2-14

24) You have worked with the same partner for several years and know him well. Over the past three months, the two of you have had four horrific pediatric calls with death as the outcome of each. Which observation would make you the most suspicious that your partner is experiencing a possible stress reaction that might encumber his ability to work as an EMT? A) Excessive and uncharacteristic irritability B) Request to be scheduled for night shifts C) Interest in going back to school to study accounting D) Statement that he intends to drop to part-time status Answer: A Diff: 2 Page Ref: 23 Objective: 2-5 25) Changes in your lifestyle that may help you manage stress include: A) Eating a high-protein and fatty diet B) Concentrating on your job 24 hours a day C) Self-medication with over-the-counter medicines D) Practicing relaxation techniques such as meditation Answer: D Diff: 1 Page Ref: 24 Objective: 2-7 26) You have just been instructed to stop emergency care on an unresponsive and pulseless 61year-old man found by his wife in the bathroom. When you tell his wife that there is nothing more that can be done, she erupts in an episode of rage and starts screaming that there must be something else that can be done and you are not doing your job well enough. In this situation, which action is best? A) Resume resuscitation for another 5 minutes B) Be tolerant of the angry reaction C) Leave the scene immediately D) Contact medical direction for advice Answer: B Diff: 2 Page Ref: 22 Objective: 2-2 27) After a particularly disturbing call the previous day, your partner is unusually angry and having a difficult time concentrating on his work. Which type of stress reaction would you suspect? A) Acute stress reaction B) Posttraumatic stress reaction C) Physical stress reaction D) Cumulative stress reaction Answer: A Diff: 2 Page Ref: 23 Objective: 2-4

28) A coworker is suffering from posttraumatic stress. Which statement made by you would be the most appropriate and beneficial to the coworker? A) "It would be best to take a few weeks off from work." B) "Maybe you can get the medical director to write a prescription for some medication." C) "I think that it would be best if you saw a mental health professional." D) "How about taking a Benadryl before bed to promote restful sleep?" Answer: C Diff: 2 Page Ref: 23 Objective: 2-4 29) A prospective student is interested in becoming an EMT, but is unsure how it will affect his family. He says that his wife is very worried about the danger associated with EMS and has never had to deal with him being gone for 24 hours at a time. What is the most appropriate response? A) "The long hours actually make things easier since there is less time to argue." B) "I have found that the family becomes used to it and things are okay after about six months." C) "It may help to bring your wife here so she can see what we do and the safety precautions we take." D) "I would just tell her that everything will be okay and avoid talking about work when you are home." Answer: C Diff: 1 Page Ref: 25 Objective: 2-6 30) You and your partner were among several rescuers on a call involving a house fire in which a 4-year-old girl died. That night, your partner states that he did not sleep well and is extremely bothered by the little girl's death. The next day he calls you and states that he is so upset that he is now having chest pain. What is the most appropriate response? A) "Why don't you request a week off of work to get things sorted out?" B) "Maybe you should get an appointment with a behavioral health professional." C) "Perhaps we need to have a critical incident stress debriefing so we can all talk." D) "You really need to get yourself to the emergency department to get checked out." Answer: D Diff: 2 Page Ref: 26 Objective: 2-5 31) You would be concerned about cumulative stress when an EMS provider informs you that she: A) Is physically tired and would like one week of unpaid leave to recuperate B) Drinks a small amount of alcohol every night to help her sleep C) Is taking prescribed antidepressants to treat mild depression D) Is bothered by a call she had yesterday and does not feel like talking Answer: B Diff: 3 Page Ref: 23-24 Objective: 2-4

32) A shooting at a public mall leaves three people dead and nine injured, several critically. As operations wind down, many rescuers are physically and emotionally upset. Which event may be most appropriate at this specific time? A) A critical incident stress debriefing session (CISD) B) A discussion on how to reduce cumulative stress C) A gathering that allows the rescuers to vent their emotions D) Providing information about mental health programs Answer: C Diff: 2 Page Ref: 26 Objective: 2-8 33) A tornado ripped through a small town, killing 5 people and seriously injuring 21, including several young children. At a defusing session, which action is most appropriate? A) Allow the rescuers to vent their emotions B) Evaluate and critique the rescue effort C) Provide information on stress reduction techniques D) Have a mental health professional available to talk with the rescuers Answer: A Diff: 2 Page Ref: 26 Objective: 2-8 34) If you have questions regarding the steps to take when exposed to an infectious disease, your best resource would be: A) The U.S. Department of Health and Human Services B) Your service's written exposure control plan C) Your service's medical director D) Your primary care physician or ED physician Answer: B Diff: 1 Page Ref: 27 Objective: 2-13 35) You have just transferred care of a patient to an emergency department nurse. There is no blood, fluid, or dirt on your gloves. After taking them off, your best action would be to: A) Use an alcohol-based hand sanitizer B) Disinfect the stretcher and equipment C) Wash your hands with soap and water D) Complete the prehospital care report Answer: C Diff: 1 Page Ref: 28-29 Objective: 2-11

36) A 38-year-old male is complaining of generalized weakness and fatigue. Assessment findings include abdominal pain, fever, and yellowing of the eyes. Given these signs and symptoms, you would be suspicious of: A) Hepatitis B) Tuberculosis C) AIDS D) West Nile virus Answer: A Diff: 1 Page Ref: 33 Objective: 2-10 37) You are accidentally stuck with a needle used to administer a medication to a patient with a known history of hepatitis B. You have already completed your hepatitis B vaccine series. In this case, which statement is true? A) You have complete protection from hepatitis B and no further action is needed B) You have two weeks from the time of exposure to start medical care for a potential infection C) You will have to get another series of three vaccines to give you protection in the future D) You need to report the needle stick to your supervisor as soon as possible Answer: D Diff: 2 Page Ref: 33 Objective: 2-13 38) A patient with a history of hepatitis C has called 911 because he has a headache. Given the complaint and medical history, which personal protective equipment, at a minimum, is most appropriate? A) Goggles B) Gloves C) Gloves and gown D) No protection is needed. Answer: B Diff: 1 Page Ref: 33 Objective: 2-11 39) The primary personal threat to a person with AIDS is: A) Infection B) Organ damage C) Heart failure D) Weight loss Answer: A Diff: 1 Page Ref: 34 Objective: 2-10

40) In the field setting, the best way to avoid becoming infected with human immunodeficiency virus (HIV) is: A) Avoid unnecessarily touching patients with confirmed HIV infection B) Always ask patients if they have HIV infection or AIDS C) Always wear gloves, goggles, and a gown for all patient contacts D) Use the appropriate protective personal equipment Answer: D Diff: 1 Page Ref: 34 Objective: 2-13 41) You are by the side of a patient whom you suspect has severe acute respiratory syndrome (SARS). What is an effective way to prevent transmission of the disease from the patient to you? A) Use eye protection or a face shield B) Use an alcohol-based hand sanitizer frequently during transport C) Place a surgical mask on the patient D) Sterilize all equipment used in the care of the patient Answer: C Diff: 1 Page Ref: 34 Objective: 2-11 42) You have been called to transport a patient from one medical facility to another. The patient is infected with vancomycin-resistant enterococci (VRE), but does not have any open wounds and is medically stable. Given this information, which action is most appropriate? A) Place a surgical mask on the patient B) Place a surgical mask on the patient and yourself C) Use an N-95 respirator or HEPA mask D) Use the appropriate personal protective equipment and handwashing Answer: D Diff: 2 Page Ref: 35 Objective: 2-13 43) Which organism is classified as multi-drug resistant? A) Methicillin/oxacillin-resistant Staphylococcus aureus B) Hepatitis B virus C) Human immunodeficiency virus D) Zika virus Answer: A Diff: 1 Page Ref: 35 Objective: 2-10

44) Which rationale best explains the reason for wearing a high-visibility safety vest at the scene of a motor vehicle collision? A) Wearing the vest makes you easily identifiable as an EMT B) The use of the vest can increase your visibility to passing drivers at the scene of an accident C) Federal law requires that you wear the vest or the EMS system can be fined D) The vest increases your visibility to bystanders and protects you from blood and body fluids Answer: B Diff: 2 Page Ref: 37 Objective: 2-14 45) What action taken by an EMT illustrates an effort toward maintaining well-being in the field of EMS? A) Taking a body-building class B) Avoiding all alcohol and fatty foods C) Creating a healthy balance between work and family life D) Establishing a relationship with a mental health professional Answer: C Diff: 1 Page Ref: 41 Objective: 2-15 46) After 20 minutes of performing CPR on a 65-year-old female with end-stage multiple sclerosis, your medical director orders you to stop resuscitation and inform the family that the patient has died. The family members are upset and crying. You notice the patient's daughter holding her hand. Your immediate response would be: A) "It's okay to hold her hand, but you should really use gloves like we do." B) "It's important not to touch her since she may be infectious from her disease." C) "I know that you are upset, but it is best not to touch her since she just passed." D) "It's okay to hold her hand." Answer: D Diff: 3 Page Ref: 22 Objective: 2-3 47) A young girl with end-stage cancer is unresponsive, not breathing, and pulseless. Her mother and father are by her side, both crying as you start resuscitation. Which statement indicates the most appropriate thing you could say to the parents as you begin? A) "I think that it would be best for you both to leave the room so we can care for your daughter." B) "If you feel comfortable, it's okay to stay and watch how we care for your daughter." C) "It is important not to cry since she may still be able to hear you and needs you to be strong for her." D) "I can show you how to do chest compressions so that you can take part in caring for your daughter." Answer: B Diff: 3 Page Ref: 22 Objective: 2-3

48) A patient with terminal lung cancer has called EMS for shortness of breath. At the request of your paramedic partner, you are obtaining the patient's blood pressure. While inflating and then deflating the blood pressure cuff, the patient angrily shouts, "That thing is too tight! What are you trying to do–send me to the funeral home early?" Your best reply would be: A) "I have to get your blood pressure. The paramedic needs it." B) "Why are you so mad at me? I am just trying to help you." C) "I know that this is tight and uncomfortable, but I am almost done now." D) "Do not yell at me. There is no need for yelling and I do not appreciate it." Answer: C Diff: 3 Page Ref: 22 Objective: 2-3 49) As an EMT, you would recognize what situation as having the greatest potential for causing emotional stress? A) Lifting and moving an obese patient from a second-floor bedroom B) Being required to show up for a shift 15 minutes prior to its start C) Caring for a child whose parents have appeared to have neglected him D) Responding to many EMS calls during the course of a shift Answer: C Diff: 2 Page Ref: 23 Objective: 2-5 50) Regarding "burnout" and the emergency medical services, what statement is most accurate? A) Employers are required to have a written plan addressing EMT burnout B) Burnout can diminish an EMT's ability to provide competent care C) Research indicates that burnout affects all EMS personnel within a five-year period D) Burnout often tends to resolve on its own over time Answer: B Diff: 2 Page Ref: 23 Objective: 2-4 51) Your supervisor has assigned you the task of designing a program that provides for stress management and health promotion within the department. Which program would accomplish this task in the best way? A) Complementary passes to a local fitness center B) Mandatory monthly meetings for all EMS personnel with a mental health counselor C) Doughnuts and coffee every morning for all EMS personnel D) A weekly night out for beer, wings, and other snacks at a local eatery Answer: A Diff: 3 Page Ref: 24 Objective: 2-7

52) An EMT has an understanding of the different types of pathogens when she states: A) "Bacteria tend to be larger than viruses and can be seen without a microscope." B) "Protozoa are considered parasitic worms and can live within the human body." C) "Fungal infections typically attack the immune systems of healthy persons." D) "Viruses are resistant to antibiotics because they live within the body's cells." Answer: D Diff: 1 Page Ref: 27 Objective: 2-10 53) You are at a long-term care facility at the bedside of an 89-year-old female with an infected area on her back. The staff members state that they are fearful that the patient has a MRSA infection, so they have requested transport to the emergency department for further evaluation. To decrease your chance of acquiring MRSA, what should you, as an EMT, do? A) Wash your hands following patient contact B) Place a mask on the patient C) Wash the infected area with an alcohol sanitizer prior to transporting the patient D) Avoid unnecessarily touching the patient Answer: A Diff: 2 Page Ref: 28 Objective: 2-11 54) You are attempting to increase your cardiovascular endurance in an effort to better perform your job as an EMT. Which action would be most appropriate in working toward this goal? A) Increasing sleep to 8 to 10 hours per day B) Weight lifting with attention to the upper body C) Walking on a treadmill 3 to 4 times per week D) Doing stretching exercises every 4 hours while awake Answer: C Diff: 2 Page Ref: 40 Objective: 2-15 55) A coworker is constantly tired and asks you for advice on how to better sleep after a busy night shift. Which response would best address this situation? A) "A small amount of alcohol can be relaxing and effective in helping you to sleep." B) "Try to make your bedroom dark and keep the temperature cool." C) "Research has shown that exercising prior to bed helps you fall asleep faster." D) "Try eating a meal before going to bed, since digestion makes you drowsy." Answer: B Diff: 3 Page Ref: 40-41 Objective: 2-15

56) Your friend and coworker got married a little more than a year ago, and then shortly thereafter she became an EMT and started working with you. On your shifts, she complains that her new husband doesn't like the fact she is an EMT, saying that the job is "too risky." Which bit of advice could you provide to your partner to help her calm the nerves of her new husband? A) Explain to her husband that EMS is "just a job" and is not any risker than other occupations B) Let the husband know about all the training EMTs have to complete and which types of safety precautions they take on each call C) Tell your partner that you personally would like to talk to her husband to let him know that you have been in EMS for years without any incident or injury D) Do not tell the husband about the types of calls or situations encountered in EMS so that he starts to believe it's becoming safer Answer: B Diff: 2 Page Ref: 25 Objective: 2-6

Prehospital Emergency Care, 11e (Mistovich et al.) Chapter 3 Medical, Legal, and Ethical Issues 1) A patient with diabetes has an elevated blood sugar (545 mg/dL) and, based on your assessment of his condition, will require an injection of insulin. Your EMT partner also has diabetes and administers insulin injections to himself throughout the day as needed. Although the Scope of Practice lists nothing about EMTs giving insulin, your partner administers the insulin injection to the patient. The patient's blood sugar comes down and her condition improves. Given this information, which statement is true? A) It was permissible for your partner to give the insulin since he has diabetes and knows how to give the injections B) Since the patient benefited from the insulin, your partner acted appropriately C) Because your partner used the patient's insulin rather than his own, he cannot be reprimanded D) Your partner violated the Scope of Practice and may have his certification revoked Answer: D Diff: 2 Page Ref: 47 Objective: 3-2 2) You have moved to another state and wish to work as an EMT. In your previous state of employment, EMTs were allowed to administer a specific set of drugs. To determine whether EMTs can administer drugs in your new state of residence, you should review the: A) State Emergency Medical Technicians' Scope of Practice B) National EMS Scope of Practice Model C) National EMS Education Standards D) State Emergency Medical Services Act Answer: A Diff: 2 Page Ref: 47 Objective: 3-2 3) What best illustrates the EMT's failure to meet the standard of care when treating a patient with chest pain? A) Failing to assist the patient in taking her heart palpitation medication B) Failing to notify the patient's primary care physician C) Failing to give the patient oxygen D) Failing to start an IV on the patient Answer: C Diff: 1 Page Ref: 47 Objective: 3-2

43) You are transporting a patient who has a history of simple partial seizures. During transport, she experiences a simple partial seizure involving her right arm. Her pulse is 92, respirations are 14 breaths/min and adequate, blood pressure is 168/88 mmHg, and SpO2 is 98%. Your primary concern would be: A) Administering supplemental oxygen via nasal cannula B) Loss of bowel or bladder control C) Placing the patient's arm tightly in a sling to prevent injury D) Progression to a generalized seizure Answer: D Diff: 2 Page Ref: 590-591 Objective: 19-5 44) Which of these statements about seizures is true? A) Simple partial seizures do not cause an alteration in mental status B) The cause of most seizures is easily identified C) Generalized seizures always last longer than partial seizures D) Complex partial seizures involve both cerebral hemispheres Answer: A Diff: 3 Page Ref: 590 Objective: 19-5 45) An 86-year-old male patient has experienced a sudden change in mental status and is repeatedly striking a fist against his leg. When you question him, he does not respond. This presentation is most consistent with which condition? A) Seizure B) Dementia C) Diabetes D) Delirium Answer: A Diff: 1 Page Ref: 591 Objective: 19-5 46) A 72-year-old male patient with a history of elevated thyroid function and a brain tumor is experiencing a psychomotor seizure. When you enter the room, he is standing up and walking in a circle. He is awake but does not respond to your questions. Family members state that he has had three similar episodes over the past six months, which his physician diagnosed as complex partial seizures. Vital signs are pulse, 112; respirations, 16 breaths/min; blood pressure, 166/68 mmHg; and SpO2, 98%. Which action would be most appropriate in the care of this patient? A) Determine if a durable power of attorney exists B) Restrain the patient and apply high-concentration oxygen C) Proceed with a nonemergency transport D) Insert a nasopharyngeal airway to ensure airway patency Answer: C Diff: 2 Page Ref: 590 Objective: 19-7

47) Which of these medications is most closely associated with a history of seizures? A) Celexa B) Prozac C) Xopenex D) Depakote Answer: D Diff: 1 Page Ref: 595 Objective: 19-7 48) A 20-year-old patient is unresponsive with snoring respirations. She is in a public restroom and has no family or friends with her. After addressing the airway, breathing, and circulation, you begin the secondary assessment. Which of these signs most likely indicates the patient experienced a seizure? A) Snoring respirations B) Urinary incontinence C) Altered mental status D) Constricted pupils Answer: B Diff: 2 Page Ref: 595 Objective: 19-7 49) The EMT would recognize that a 49-year-old male patient has experienced a primary seizure when his wife states: A) "He has never had a seizure before–this is his first seizure." B) "He had seizures in the past, but they are not sure what causes them." C) "The doctors said that his seizures come from one spot in his brain." D) "His arms and legs were jerking and he would not talk to me." Answer: B Diff: 3 Page Ref: 586 Objective: 19-3 50) A 36-year-old male patient with diabetes and hypertension has experienced a secondary seizure. The patient responds to verbal stimuli with garbled speech, and his airway, breathing, and circulation are intact. Vital signs are pulse, 128; respirations, 20 breaths/min and adequate; blood pressure, 158/96 mmHg; and SpO2, 97% on room air. At this time, it is important that the EMT: A) Administer oral glucose as a precautionary measure B) Position the patient supine on the stretcher and transport C) Check the patient's blood sugar with a glucometer D) Administer supplemental oxygen at 2 lpm to maintain the oxygen saturation at its current level Answer: C Diff: 3 Page Ref: 587 Objective: 19-9

51) When treating a patient who has had a seizure, the most important aspect of providing care is to: A) Ensure that the patient does not bite his or her tongue B) Identify the type and duration of seizure, as well as any history of seizures C) Provide supplemental oxygen during the seizure to ensure adequate oxygenation of the brain D) Assess for and manage any life-threatening condition found Answer: D Diff: 2 Page Ref: 585 Objective: 19-7 52) Regarding a generalized tonic-clonic seizure, which of these statements is true regarding the different stages? A) The aura comes before a loss of consciousness B) The patient is postictal prior to convulsion activity C) A loss of consciousness occurs after the clonic (convulsion) phase D) The patient becomes postictal just before the hypertonic phase Answer: A Diff: 3 Page Ref: 588-589 Objective: 19-4 53) You believe that a patient experienced a simple partial (focal motor) seizure. Which of these statements made by the patient would reinforce this suspicion? A) "I cannot remember anything that happened. I must have passed out." B) "I think that I may have lost control of my bladder and bit my tongue." C) "My left arm would not stop shaking. I did not know what was happening." D) "I remember my arms and legs shaking, and then I can't remember anything else." Answer: C Diff: 3 Page Ref: 590-591 Objective: 19-5 54) The EMT would recognize a simple partial seizure when she observes: A) Jerky muscular activity of a single extremity B) Repetitive actions such as lip smacking or finger rolling C) Blank staring that begins and ends abruptly D) Abrupt personality changes, including fits of rage Answer: A Diff: 2 Page Ref: 590-591 Objective: 19-5 55) A complex partial (psychomotor) seizure can easily be mistaken for: A) An asthma exacerbation B) A left-sided stroke C) An absence (petit mal) seizure D) Alcohol intoxication Answer: D Diff: 3 Page Ref: 591 Objective: 19-5 14 Copyright © 2018 Pearson Education, Inc.

56) You have been called for a 71-year-old male patient with seizure activity. When you reach the patient's side, you find him lying motionless on the floor of his bedroom with a family member performing chest compression-only CPR. In this situation, your immediate action would be to: A) Open the airway and begin positive pressure ventilation B) Ask the provider to stop CPR and feel for a carotid pulse C) Take over CPR and attach the automated external defibrillator D) Continue CPR and call for advanced life support assistance Answer: B Diff: 2 Page Ref: 592 Objective: 19-7 57) A young male patient with a seizure history is postictal in his bed. His airway is patent, breathing labored, and radial pulse strong and fast. Vital signs are pulse, 140; respirations, 20 breaths/min; blood pressure, 158/92 mmHg; and SpO2, 96% on room air. At this time, which action would be most appropriate? A) Provide supplemental oxygen B) Insert an oropharyngeal airway C) Start positive pressure ventilation D) Place the patient in a lateral recumbent position Answer: D Diff: 2 Page Ref: 595 Objective: 19-7 58) You are on the scene of a patient who just experienced a seizure. The patient is still in the postictal phase and is not fully oriented. Family members state that he has a history of diverticulitis, gastric ulcers, and diabetes. Your partner asks you if you think he should obtain a blood glucose level. Your response should be: A) "Yes, that is a good idea since he has a history of diabetes." B) "Yes, because if we don't, the hospital may get angry with us." C) "No, since the seizure has stopped, it is not from a blood sugar abnormality." D) "No, because even if the sugar is too high or too low, there is nothing we can do about it." Answer: A Diff: 2 Page Ref: 587 Objective: 19-9

Prehospital Emergency Care, 11e (Mistovich et al.) Chapter 20 Acute Diabetic Emergencies 1) You suspect that an unresponsive female patient may be diabetic. To help confirm this suspicion, where would you send your partner to look for vials of insulin? A) Bathroom B) Bedside table C) Refrigerator D) Nightstand Answer: C Diff: 1 Page Ref: 627 Objective: 20-3 2) An elderly patient has an altered mental status. On scene, the patient's son informs you that his father has type 1 diabetes. Based on this information, you would understand that the patient: A) Needs to take insulin B) Has a history of high blood pressure C) Requires daily oral glucose to maintain his blood sugar D) Has a chronically low blood sugar level Answer: A Diff: 2 Page Ref: 610 Objective: 20-2 3) The EMT should suspect that a patient has diabetes when which medication is found on the scene? A) Nitrostat B) Metformin C) Ecotrin D) Lexapro Answer: B Diff: 1 Page Ref: 621, Table 20-3 Objective: 20-11 4) Which of these most accurately describes insulin? A) Pill that must be taken by patients with diabetes B) Hormone that breaks food into simple sugars C) Drug that increases the sugar in the blood D) Hormone that enables glucose to move into the cells Answer: D Diff: 3 Page Ref: 605 Objective: 20-3

5) You are reviewing a prehospital care report for a patient with altered mental status that occurred after he took too much insulin. Based on this information, you should assume that at the time of EMS contact, the patient's blood sugar level was probably: A) High B) Low C) Normal D) Concentrated Answer: B Diff: 3 Page Ref: 610 Objective: 20-2 6) Family members have called you for a young female patient with a history of diabetes who took insulin earlier in the day. She is confused and combative. Which of these questions is most important for the EMT to immediately ask the family? A) "How long has she had diabetes?" B) "Do you think that her blood sugar is high?" C) "Did she eat after taking the insulin?" D) "Did she take any drugs or drink alcohol?" Answer: C Diff: 3 Page Ref: 610 Objective: 20-3 7) Your partner reports that he has found some small areas of bruising to the abdomen of a patient who takes insulin. He is puzzled by the finding. Which response would be most appropriate? A) "The patient must have been involved recently in a car crash or suffered some other sort of trauma." B) "There could be several reasons for the bruising, but insulin injections are often administered to the abdomen." C) "That is a concerning finding. Since patients with diabetes are prone to GI bleeds, we should treat her as having one." D) "Why don't we contact the patient's primary care physician and see if there are additional medical issues we are not aware of?" Answer: B Diff: 2 Page Ref: 622 Objective: 20-11 8) What is a glucometer used to evaluate? A) Glucose levels B) Insulin levels C) Glucogen levels D) Insulin and glucose levels Answer: A Diff: 1 Page Ref: 608 Objective: 20-5

9) A glucometer reads 50 mg/dL. The EMT would recognize this reading as: A) High B) Normal C) Average D) Low Answer: D Diff: 1 Page Ref: 608 Objective: 20-5 10) With which of these patients would the EMT have the strongest suspicion of a diabetic emergency? A) A confused patient with a blood glucose of 58 mg/dL B) An alert and oriented patient with diabetes and generalized weakness C) A combative patient with a blood glucose level of 122 mg/dL D) A patient with diabetes who complains of chest pain and shortness of breath Answer: A Diff: 2 Page Ref: 608 Objective: 20-5 11) A 17-year-old patient is unresponsive. A medical identification bracelet states that he has diabetes. Which action should you perform first? A) Administer oral glucose B) Determine the type of diabetes C) Assess the airway D) Check for a pulse Answer: C Diff: 2 Page Ref: 622 Objective: 20-11 12) You are instructing EMT students on how to obtain a blood sample for use in a glucometer. You are providing accurate information when you state: A) "It is best to check the blood three times and then use the highest reading." B) "Approximately 15 mL of blood will be needed for an accurate result." C) "A small drop of blood obtained from the patient's fingertip is sufficient." D) "Have the patient raise his or her arm in the air before you obtain the blood sample." Answer: C Diff: 1 Page Ref: 609, Table 20-1 Objective: 20-5

13) How would an EMT best describe a confused and combative patient with labored respirations and a blood glucose level of 33 mg/dL? A) Hypoglycemic B) Altered blood glucose C) Hyperglycemic D) Hyper-insulinemic Answer: A Diff: 1 Page Ref: 608 Objective: 20-1 14) A patient with diabetes who took insulin earlier is found unresponsive with a blood glucose level of 29 mg/dL. Which piece of information provided by family gives the best explanation for the patient's altered mental status? A) "He ate pancakes with syrup after taking his insulin." B) "His blood sugar normally goes up after eating." C) "He took only half of his required dose of insulin this morning." D) "He didn't eat breakfast or lunch today because his belly hurt." Answer: D Diff: 3 Page Ref: 610 Objective: 20-7 15) Which individual finding would most lead the EMT to suspect that a patient has hypoglycemia? A) A rapid onset of altered mental status B) A slow pulse rate and low blood pressure C) A blood glucose reading of 256 mg/dL D) Warm and dry skin with a blood glucose of 90 mg/dL Answer: A Diff: 2 Page Ref: 610 Objective: 20-10 16) A patient's glucometer measurement reads 39 mg/dL. The patient is alert, but confused. The patient's son states that he has a friend who becomes unresponsive when his sugar is less than 50 mg/dL; therefore, the reading for his father cannot be correct. Which of these statements would be your best response? A) "You are probably right; I feel comfortable in having him sign a refusal." B) "I agree. Anyone with a blood sugar less than 50 mg/dL should be unconscious." C) "The response to a low blood sugar can vary from patient to patient." D) "I agree. Just to be safe, I am not going to give him any oral glucose." Answer: C Diff: 2 Page Ref: 610 Objective: 20-7

17) You determine a patient's blood glucose level to be 289 mg/dL. You would document this result on the prehospital care report as: A) Normal B) Hyperglycemic C) Depressed D) Hypoglycemic Answer: B Diff: 1 Page Ref: 608 Objective: 20-5 18) You are called to an outpatient clinic to transfer a 39-year-old male patient in diabetic ketoacidosis (DKA) to an acute-care hospital. When assessing this patient, which sign or symptom would you expect to find? A) Slow and shallow respirations B) Slow heart rate and high blood pressure C) Blood glucose level of 50 mg/dL D) Fruity or acetone odor on his breath Answer: D Diff: 2 Page Ref: 616 Objective: 20-9 19) You have been called to a residence for a patient with altered mental status. On arrival, a neighbor informs you that he saw the patient washing windows several minutes earlier and then suddenly saw him lying on the ground. He also mentions that the patient has diabetes and has been in and out of the hospital lately because his blood sugar has been dropping suddenly. Your scene size-up reveals the patient to be lying next to a ladder propped up to the second-story window. Water from a bucket is spilled on the side of the house and yard. The patient is supine and unresponsive. What should be your next most immediate action? A) Insert a nasopharyngeal airway B) Take manual spine motion restriction precautions C) Check the glucose level and administer oral glucose if needed D) Open the airway with the jaw-thrust maneuver Answer: B Diff: 2 Page Ref: 625, Figure 20-13 Objective: 20-11 20) You have arrived on the scene of a 64-year-old patient with diabetes. He is supine in bed and exhibits snoring respirations. Family members state that they just tested his blood sugar and it is 25 mg/dL. What should be your immediate action? A) Prepare and administer oral glucose B) Have the family recheck the blood sugar C) Determine what the patient has eaten D) Open the airway with a manual technique Answer: D Diff: 2 Page Ref: 612 Objective: 20-11 5 Copyright © 2018 Pearson Education, Inc.

21) After you administer oral glucose to a patient with diabetes, his level of conscious deteriorates and he becomes unresponsive with snoring respirations. Which action should you take immediately? A) Administer half a second tube of glucose B) Provide high-concentration oxygen via a nonrebreather mask C) Administer a full second dose of oral glucose D) Manually open the airway Answer: D Diff: 2 Page Ref: 612 Objective: 20-11 22) You are transporting a patient with diabetes who has low blood sugar. En route, you receive orders to administer oral glucose. Which piece of emergency equipment is most important to have readily available during this procedure? A) Nasopharyngeal airway B) Suction device C) Oropharyngeal airway D) Automated external defibrillator Answer: B Diff: 2 Page Ref: 613 Objective: 20-8 23) Five minutes after administering oral glucose to a confused patient with diabetes, you do not see any improvement in her mental status. Which action should you take? A) Administer a second dose of oral glucose B) Continue to monitor the patient C) Recheck the expiration date on the oral glucose D) Contact medical direction for further orders Answer: B Diff: 2 Page Ref: 613 Objective: 20-11 24) A patient with diabetes is alert but confused. You have decided to administer oral glucose. Which of these descriptions indicates the proper way to administer the glucose? A) Squeeze the glucose under the patient's tongue B) Place the glucose between the patient's cheek and gum C) Use a tongue depressor to place the glucose on the back of the tongue D) Have the patient slowly swallow the glucose Answer: B Diff: 2 Page Ref: 613 Objective: 20-11

25) Which of these patients is a candidate for oral glucose? A) An unresponsive patient with diabetes and a rapid heart rate B) A combative patient with no history of diabetes C) An alert but confused patient with diabetes and cool skin D) A patient who is newly diagnosed with diabetes and who is responsive to painful stimuli Answer: C Diff: 2 Page Ref: 612 Objective: 20-8 26) In which form is oral glucose packaged? A) Gel B) Liquid C) Powder D) Sugar granules Answer: A Diff: 1 Page Ref: 613 Objective: 20-1 27) What would be the priority action to take prior to administering oral glucose to a young female patient? A) Determine the patient's blood glucose level B) Make sure the patient has insulin available if needed C) Ask whether the patient is allergic to glucose D) Determine whether the patient is pregnant Answer: A Diff: 2 Page Ref: 612 Objective: 20-8 28) Prior to the administration of oral glucose, a patient's blood glucose level was 49 mg/dL. After administering the oral glucose, the patient is alert and oriented. Which repeat blood glucose levels would the EMT expect with this clinical presentation? A) "Low" B) 155 mg/dL C) 30 mg/dL D) "High" Answer: B Diff: 2 Page Ref: 608 Objective: 20-8

29) When administering oral glucose to a patient with diabetes, the EMT must take precautions to prevent which adverse effect? A) High blood glucose level B) Airway obstruction C) Low blood glucose level D) Increased blood pressure Answer: B Diff: 2 Page Ref: 613, Figure 20-6 Objective: 20-8 30) Medical direction has ordered you to administer one dose of oral glucose to a patient with diabetes who is exhibiting confusion. Which of these best describes what you should do? A) Repeat and question the order to medical direction B) Place half the contents of the tube of glucose in the patient's mouth C) Carefully administer the entire tube of glucose D) Have the patient swallow all of the glucose in the tube Answer: C Diff: 1 Page Ref: 613, Figure 20-6 Objective: 20-11 31) An alert but confused patient with diabetes is complaining of weakness. Your service carries oral glucose, which has been authorized through off-line medical direction. In this case, you should: A) Contact the patient's primary care physician B) Transport the patient for further evaluation in the hospital C) Contact medical direction for authorization to administer the oral glucose D) Prepare and administer the oral glucose Answer: D Diff: 2 Page Ref: 613, Figure 20-6 Objective: 20-8 32) You have been called for an adult male patient who is hypoglycemic and responsive to painful stimuli. The family has oral glucose and wants you to administer it. However, at this time, your medical director has not authorized this agent's use and there are no protocols regarding its use. Given the patient's condition and the family's request, which action should you take? A) Contact ALS backup and remain on scene until they arrive so they can give glucose via the IV line B) Instruct the family to administer the oral glucose C) Initiate transport of the patient to the emergency department D) Carefully administer the oral glucose at the family's request Answer: C Diff: 2 Page Ref: 622 Objective: 20-8