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Candidates for national emergency medical technician certification must meet the following requirements:
NEW QUESTION # 39
A 74-year-old patient has epigastric pain without relief from three doses of prescribed nitroglycerin. The patient is anxious, nauseated, and diaphoretic. The vital signs are BP 180/90 mmHg, P 62/min, R 20/min and shallow, and SpO# 92% on room air. What actions should the EMT prioritize for this patient? Select the two answer options that are correct.
Answer: B,E
Explanation:
This patient's presentation is highly suspicious for acute coronary syndrome (ACS). NREMT education emphasizes that epigastric pain, especially in elderly patients, may represent myocardial ischemia. The lack of relief after three doses of nitroglycerin further increases concern for an evolving myocardial infarction.
Option A (Give aspirin) is correct because aspirin inhibits platelet aggregation and is a cornerstone of early ACS management. NREMT guidelines recommend administering aspirin as soon as possible unless contraindications exist.
Option B (Apply oxygen) is correct because the patient's oxygen saturation is 92%, which is below normal.
NREMT recommends supplemental oxygen for patients with suspected cardiac ischemia who are hypoxic or in respiratory distress.
Option C may provide comfort but does not address the underlying ischemia.
Option D is incorrect because the patient has already taken the maximum recommended prehospital doses of nitroglycerin.
Option E is outside the EMT scope of practice in many systems and is not a priority EMT intervention.
NREMT emphasizes early aspirin administration, oxygenation, continuous monitoring, and rapid transport for suspected ACS.
NEW QUESTION # 40
A 24-year-old patient was involved in an MVC. The EMT is completing the patient care report. Which of the following statements indicate pertinent negatives? Select the two correct options.
Answer: B,D
Explanation:
Pertinent negatives are findings that are not present, but would be clinically relevant if they were. For example:
* "No neck or back pain" helps rule out spinal injury
* "No loss of consciousness" informs head trauma assessment
Statements about behavior or initial refusal (B, E) may be documented under patient behavior or refusal, but they are not pertinent negatives. Positive findings like abdominal tenderness are pertinent positives.
References:
NREMT Documentation Standards
National EMS Education Standards - Communication and Documentation
Brady Emergency Care (13th ed.) - Patient Care Reporting
NEW QUESTION # 41
What should the EMT do when preserving evidence at a crime scene?
Answer: A
Explanation:
The correct answer is D. Use the knife holes to remove clothing.
When EMS providers are at a crime scene, their role is to preserve evidence while providing patient care. This includes minimizing disturbance of physical evidence.
Why D is correct:
* When removing clothing, EMTs should cut around holes such as knife or bullet holes, not through them.
* This preserves important forensic evidence (e.g., wound patterns, weapon characteristics).
* It is a standard evidence-preservation technique taught in EMS.
Why the other options are incorrect:
* A. Use gloves to tag possible evidence # EMTs should avoid handling or tagging evidence unless necessary
* B. Take pictures to document the scene # EMS providers do not photograph scenes; this is law enforcement's role
* C. Leave a deceased person uncovered # The deceased should be treated with dignity and typically covered unless directed otherwise Exact Extracts:
* "Avoid cutting through holes in clothing; cut around them to preserve evidence."
* "Do not disturb the scene more than necessary."
* "Preserve evidence while providing patient care."
References:
NREMT EMT Education Standards - EMS Operations (Crime Scene Awareness)
National EMS Education Standards - Medical/Legal Responsibilities
NREMT Candidate Handbook - Scene Safety and Legal Considerations
NEW QUESTION # 42
Which of the following actions are appropriate management for two-rescuer pediatric basic life support? Select the three correct options.
Answer: A,C,E
Explanation:
Comprehensive and Detailed Explanation From Exact Extract:
Forpediatric BLS with two rescuers, currentAHA Guidelines (2020)recommend:
* Two-thumb encircling hands technique: Most effective for infants; provides consistent depth and control.
* Compression ratio of 15:2: Enhances ventilation without compromising perfusion.
* Compression depth: 1/3 of chest or approximatelyone-half the chest's depth.
CPR begins ifpulse <60 bpm with signs of poor perfusion, not at 72 bpm. Rate of180/minis excessive; ideal rate is100-120/min.
References:
AHA BLS Provider Manual (2020) - Pediatric BLS Section
NREMT Cardiology & Resuscitation Module
Pediatric Advanced Life Support (PALS) Guidelines
NEW QUESTION # 43
A 15-year-old patient is unresponsive following an assault. The patient has a stab wound on the chest, which is gurgling. The vital signs are BP 76/48 mmHg, P 146/min, R 26/min, and SpO# 90% on room air.
Which of the following types of shock is the most likely cause of the patient's presentation?
Answer: B
Explanation:
Comprehensive and Detailed Explanation (Based on NREMT standards):
This patient has signs of penetrating chest trauma, severe hypotension, tachycardia, and respiratory distress.
A gurgling chest wound suggests an open pneumothorax, which can progress to tension pneumothorax.
Option C (Obstructive shock) is correct because air trapped in the chest can compress the heart and great vessels, preventing adequate cardiac output.
Option A is less likely because although blood loss may be present, the chest injury suggests impaired circulation due to pressure.
Option B involves pump failure, not trauma-related compression.
Option D involves abnormal vessel dilation, not mechanical obstruction.
NREMT emphasizes rapid recognition of obstructive shock and immediate intervention with occlusive dressings and rapid transport.
NEW QUESTION # 44
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