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| Section | Weight | Objectives |
|---|---|---|
| Scene Size-Up and Safety | 15–19% | - Hazard recognition and management - Mechanism of injury / nature of illness - Scene assessment and safety protocols |
| Secondary Assessment | 5–9% | - Symptom assessment and history taking - Vital signs and monitoring - Focused history and physical exam |
| Patient Treatment and Transport | 20–24% | - Communication with receiving facilities - Medication administration and protocols - Medical and trauma care interventions - Patient packaging and transport procedures |
| Primary Assessment | 39–43% | - Airway, breathing, and circulation management - Identification and management of life-threatening conditions - General patient impression and priority determination - Initial patient assessment |
| EMS Operations | 10–14% | - Documentation and legal aspects - Emergency vehicle operations and safety - Incident command and multiple-casualty situations - EMS system roles and responsibilities |
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問題 #89
A 68-year-old patient has difficulty breathing and audible crackles. The patient has missed the last two dialysis appointments. The vital signs are BP 188/90 mmHg, P 120/min, R 24/min, and SpO# 92% on room air. Which of the following conditions should the EMT most strongly suspect?
答案：B
解題說明：
The correct answer is A. Fluid overload.
* Missed dialysis # inability to remove excess fluid
* Shortness of breath + crackles # fluid in the lungs (pulmonary edema)
* Hypertension (188/90)
* Tachycardia (120)
* Low-normal SpO# (92%)
These findings strongly indicate fluid overload leading to pulmonary edema.
* Patients who miss dialysis retain excess fluid
* Fluid accumulates in the lungs # crackles and respiratory distress
* Hypertension is common due to increased circulating volume
* B. Bronchiolitis # Typically seen in infants/children, not adults
* C. Pneumonia # May cause crackles, but does not explain missed dialysis + fluid retention + hypertension pattern
* D. Ascites # Fluid in the abdomen, not primarily causing lung crackles or acute respiratory distress
* "Patients with renal failure who miss dialysis may develop fluid overload."
* "Pulmonary edema presents with crackles and respiratory distress."
* "Hypertension is commonly associated with fluid overload states."
References:
NREMT EMT Education Standards - Medical Emergencies
National EMS Education Standards - Renal and Respiratory Emergencies
NREMT Candidate Handbook - Patient Assessment and Medical Conditions
問題 #90
What characteristics of the pediatric airway are different from the adult airway?
答案：C
解題說明：
Compared to adults, pediatric patients have:
A proportionately larger tongue, which increases the risk of airway obstruction A larger occiput, which causes natural neck flexion when lying supine, potentially occluding the airway This anatomical difference is why EMS providers often use a shoulder roll instead of a head tilt to maintain a neutral airway in infants and toddlers.
References:
NREMT Pediatric Airway Management Standards
AHA PALS Manual - Pediatric Anatomy and Airway Considerations
National EMS Education Standards - Pediatric Assessment and Airway Anatomy
問題 #91
An 86-year-old patient involved in a motor vehicle collision struck a knee on the dashboard. What injuries are most associated with the knee impacting the dashboard? Select the two answer options that are correct.
答案：B,E
解題說明：
The correct answers are B. Femur fracture and E. Posterior hip dislocation.
This mechanism is classically known as a "dashboard injury", where the knee strikes the dashboard during a motor vehicle collision. The force is transmitted along the femur toward the hip.
Why B is correct (Femur fracture):
The force applied to the knee travels up the femur, which can result in:
Femoral shaft fractures
Significant internal bleeding
NREMT trauma guidance states:
"High-energy impacts to the lower extremities can result in femur fractures." Why E is correct (Posterior hip dislocation):
Dashboard injuries commonly cause:
Posterior displacement of the femoral head from the acetabulum
This occurs when the femur is driven backward while the hip is flexed
NREMT-aligned content:
"A blow to the knee in a seated position can result in posterior hip dislocation." Why the other options are incorrect:
A). Tibia fracture: More commonly associated with direct lower leg trauma, not classic dashboard mechanism.
C). Ruptured peritoneum: Not a typical injury from this mechanism.
D). Rupture of the bladder: More associated with pelvic fractures, not isolated dashboard knee impact.
Exact Extracts:
"A dashboard injury can transmit force up the femur causing hip dislocation."
"Posterior hip dislocation is commonly associated with knee impact in MVCs."
"Femur fractures are common in high-energy trauma."
References:
NREMT EMT Education Standards - Trauma (Musculoskeletal Injuries)
NREMT National Continued Competency Program (NCCP) - Trauma Emergencies Prehospital Emergency Care (EMT) - Mechanisms of Injury and Trauma Assessment
問題 #92
A 42-year-old male states, "I can't breathe" after being shot in his upper thigh. Bystanders have applied direct pressure to his thigh and the bleeding is controlled. You should first
答案：A
解題說明：
Comprehensive and Detailed Explanation From Exact Extract:
Thepatient's complaint of difficulty breathingis anairway/breathing issueand takes precedence over a controlled extremity bleed. The first action is toadminister oxygenand evaluate respiratory effort.
Though reassessing the wound is important,oxygenation is the prioritywhen airway compromise or respiratory distress is present. Tourniquets are foruncontrolled bleeding, which is not the case here.
References:
NREMT Trauma Assessment Guidelines
National EMS Education Standards - Primary Assessment Priorities
Brady Emergency Care (13th ed.) - Chapter: Patient Assessment
問題 #93
A 67-year-old patient reports crushing chest pressure. The vital signs are BP 156/98, P 64, R 14, and SpO2 94%. What treatments should the EMT provide first? Select the two correct options.
答案：A,D
解題說明：
Comprehensive and Detailed Explanation From Exact Extract:
The patient's symptoms are consistent withacute coronary syndrome (ACS). Thefirst-line treatmentsare:
* Aspirin(160-325 mg): inhibits platelet aggregation, reducing clot progression.
* Oxygen: administered when SpO# <94% or signs of hypoxia/distress are present.
CPAPis for pulmonary edema or respiratory failure.Nitroglycerinrequires BP >90 systolic and medical direction approval. Laying the patient supine may increase myocardial workload and is inappropriate unless hypotension occurs.
References:
NREMT Cardiology and Resuscitation Guidelines
AHA ACLS Provider Manual (2020) - Acute Coronary Syndrome Treatment
National EMS Education Standards - Cardiovascular Emergencies
問題 #94
......
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