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| Section | Objectives |
|---|---|
| Medical, Obstetrics and Gynecology | - Obstetrics and Gynecology
|
| Airway, Respiration and Ventilation | - Airway Management
|
| Cardiology and Resuscitation | - Cardiac Emergencies
|
| Trauma | - Trauma Assessment and Care
|
| EMS Operations | - Operational Procedures
|
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質問 # 266
Activation of the EMS system begins with
正解：C
解説：
The EMS system is activated when an emergency is recognized by a bystander, patient, or first responder.
NREMT describes EMS activation as a sequence that begins with recognizing an emergency and then accessing the system.
Option D (Recognition) is correct because without recognition, no call for help occurs.
Option C (Notification) follows recognition.
Option B (Dispatch) occurs after notification.
Option A (Response) is the physical movement of EMS resources after dispatch.
NREMT emphasizes public education on recognizing emergencies as a key component of effective EMS systems.
質問 # 267
An incomplete patient care report suggests
正解：A
解説：
The correct answer is B because in EMS, the patient care report is the official record of the assessment, treatment, and transport decision-making provided to the patient. Authoritative EMS documentation guidance explains that the PCR is essential to communicate patient assessment and treatment and to support ongoing care; if it is incomplete, it suggests the care itself may not have been thorough or cannot be shown to have been thorough. In EMS practice, incomplete documentation is commonly treated as incomplete patient care documentation, which reflects poorly on the thoroughness of care. ( NCBI )
質問 # 268
A 65-year-old patient is unresponsive after falling from standing. Which of the following signs would be most indicative of increasing intracranial pressure? Select the three answer options that are correct.
正解：D、E、F
解説：
The correct answers are B. Bradycardia, C. Hypertension, and F. Cheyne-Stokes respirations.
This question is testing recognition of increased intracranial pressure (ICP), specifically the classic findings known as Cushing's triad and abnormal breathing patterns.
Why B and C are correct (Cushing's Triad):
Cushing's triad is a hallmark of increased ICP and includes:
Hypertension (widening pulse pressure)
Bradycardia
Irregular respirations
NREMT-aligned trauma guidelines state:
"Increasing intracranial pressure may present with hypertension and bradycardia." These are late and critical signs of brain herniation risk.
Why F is correct (Cheyne-Stokes respirations):
Cheyne-Stokes respirations are:
An abnormal breathing pattern (alternating periods of apnea and rapid breathing) Associated with brain injury and increased ICP Guidelines emphasize:
"Irregular breathing patterns such as Cheyne-Stokes may indicate brain injury." Why the other options are incorrect:
A). Tachycardia: Typically seen in shock, not increased ICP.
D). Hypotension: Suggests shock; ICP usually causes hypertension.
E). Kussmaul respirations: Associated with metabolic acidosis (e.g., diabetic ketoacidosis), not ICP.
Exact Extracts:
"Cushing's triad includes hypertension, bradycardia, and irregular respirations."
"Irregular respirations such as Cheyne-Stokes are associated with brain injury."
"These findings indicate increasing intracranial pressure and possible herniation." References:
NREMT EMT Education Standards - Trauma (Head Injury and Traumatic Brain Injury) NREMT National Continued Competency Program (NCCP) - Trauma Emergencies Prehospital Emergency Care (EMT) - Neurologic Trauma Management
質問 # 269
A 60-year-old patient has severe pain in the right hip after falling down four stairs. They have deformity and shortening of the right leg. The vital signs are BP 164/88, P 90, R 18, and SpO# 96% on room air. What actions should the EMT take for this patient? Select the two answer options that are correct.
正解：B、E
解説：
Comprehensive and Detailed Explanation (Based on NREMT standards):
The patient's signs-hip pain, deformity, and leg shortening-are consistent with a proximal femur or hip fracture. NREMT trauma care emphasizes immobilization, pain reduction, and prevention of further injury.
Option C (Apply mild traction) is appropriate to reduce muscle spasm and pain when a femur fracture is suspected and no contraindications are present.
Option D (Splint with blankets and pillows) is correct because soft splinting stabilizes the injury and limits movement during transport.
Option A is not required because oxygen saturation is adequate.
Option B is contraindicated because leg elevation may worsen pain or bleeding.
Option E is reserved for unstable pelvic fractures, not isolated hip fractures.
NREMT emphasizes gentle handling, immobilization, and rapid transport for suspected hip fractures.
質問 # 270
Witnesses state a patient is unresponsive and not breathing after a vehicle collision. What action should the EMT perform first?
正解：B
解説：
Even in high-acuity situations, NREMT standards require EMTs to perform a scene size-up before patient contact. Scene size-up includes ensuring scene safety, determining the mechanism of injury, identifying hazards, and assessing the need for additional resources. Entering a scene without confirming safety places the EMT at risk and can result in additional victims.
Although the patient is unresponsive and apneic, EMTs must first confirm the scene is safe to enter. Only after scene safety is established should patient care begin.
Option B is incorrect because CPR cannot be initiated until the EMT has safely accessed the patient.
Option C is incorrect because airway maneuvers are performed after scene safety and patient access are confirmed.
Option D is incorrect because spinal stabilization occurs after initial access and assessment.
NREMT emphasizes: rescuer safety always comes first, even in life-threatening emergencies.
質問 # 271
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