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| Section | Objectives |
|---|---|
| Topic 1: EMS Operations | - Operational procedures
|
| Topic 2: Cardiology & Resuscitation | - Cardiac emergencies
|
| Topic 3: Airway, Respiration & Ventilation | - Airway management
|
| Topic 4: Medical, Obstetrics & Pediatrics | - Medical emergencies
|
| Topic 5: Trauma | - Traumatic injuries
|
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NEW QUESTION # 99
A 32-year-old patient fell 10 feet off of an embankment. The patient is unresponsive with non-purposeful extension of the extremities. The vital signs are BP 220/106, P 54, and R 16 and irregular. Which of the following conditions should the EMT most strongly suspect?
Answer: C
Explanation:
The correct answer is D. Brainstem herniation.
This question is testing recognition of Cushing's triad, a classic sign of increased intracranial pressure (ICP) and impending brainstem herniation.
Key findings in the question:
* Hypertension (BP 220/106)
* Bradycardia (P 54)
* Irregular respirations
These three together form Cushing's triad, which strongly indicates increased ICP and brain herniation.
Additionally:
* Non-purposeful extension of extremities (decerebrate posturing) is a sign of severe brain injury and brainstem involvement.
Why D is correct:
* Brainstem herniation results from severe increased ICP.
* It produces Cushing's triad and abnormal posturing.
* This is a life-threatening neurological emergency requiring rapid recognition.
Why the other options are incorrect:
* A. Distributive shock: Typically presents with hypotension, not hypertension.
* B. Spinal cord injury: May cause paralysis but does not cause Cushing's triad.
* C. Hemorrhagic shock: Presents with hypotension and tachycardia, not bradycardia and hypertension.
Exact Extract (EMT-aligned educational content):
* Cushing's triad consists of widening pulse pressure (hypertension), bradycardia, and irregular respirations, indicating increased intracranial pressure.
* Severe head injury may present with abnormal posturing (decerebrate or decorticate).
* These findings suggest impending brain herniation, a critical and often fatal condition without rapid intervention.
References:
NREMT National EMS Education Standards - Trauma (Head Injury & Increased Intracranial Pressure) EMT Training Curriculum - Neurological Emergencies and Traumatic Brain Injury National EMS Scope of Practice Model - Recognition of Life-Threatening Head Injuries
NEW QUESTION # 100
The police have placed a 20-year-old patient into custody. The patient is in handcuffs, is agitated, and is angry. The skin is hot and diaphoretic. The vital signs are BP 180/98, P 150, R 28, and SpO# 97% on room air. Which of the following actions would be appropriate for the EMT to take while transporting this patient?
Select the two answer options that are correct.
Answer: A,C
Explanation:
This is one of those EMS custody questions where the safest answer comes from remembering two transport rules at the same time: the patient needs medical transport , and the patient also needs safe restraint management .
Because the patient is being transported by EMS, the patient should be secured with appropriate medical restraints , not simply left in police handcuffs alone. That makes removing the handcuffs and applying soft restraints the proper EMS approach, provided law enforcement is involved in that process. Just as important, the officer with the key should ride along so the restraint situation remains safe and legally controlled during transport.
The rest of the scenario also hints that this patient may be medically unstable, not just angry. The hot, diaphoretic skin , marked tachycardia , and severe agitation raise concern for a serious behavioral or medical emergency, so EMS transport is appropriate. Also, NREMT-style operations questions consistently reject prone restraint because face-down positioning increases the risk of respiratory compromise during transport.
NEW QUESTION # 101
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.
Answer: C,D,E
Explanation:
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
NEW QUESTION # 102
When using the SALT method for triage, which of the following interventions should the EMT perform during the individual assessment step?
Answer: C
Explanation:
Comprehensive and Detailed Explanation From Exact Extract:
SALT (Sort, Assess, Lifesaving interventions, Treatment/Transport) is a mass casualty triage method recommended by the CDC and the National Association of EMS Physicians (NAEMSP). During the " Assess" step, responders:
* Check respirations
* Provide lifesaving interventions such as rescue breaths if the patient is not breathing but has a pulse
* Evaluate mentation (e.g., ability to follow commands)
Airway adjuncts and full transport do not happen at this stage. Scorecards and pediatric-specific modifications are addressed later in the protocol.
References:
NREMT EMS Operations - Mass Casualty and Triage Guidelines
CDC SALT Mass Casualty Triage Guidelines
National EMS Education Standards - Disaster Response
NEW QUESTION # 103
Following insertion of an oropharyngeal airway in an unresponsive 1-year-old male, he develops cyanosis and bradycardia. You should
Answer: A
Explanation:
The correct answer is A. Remove the airway and ventilate him.
In pediatric patients, improper placement or incorrect sizing of an oropharyngeal airway (OPA) can cause:
* Airway obstruction instead of opening
* Worsening hypoxia
* Leading to cyanosis and bradycardia
* The patient's cyanosis (low oxygen) and bradycardia (late hypoxia sign) indicate that the airway intervention has failed or worsened the situation.
* Immediate action is to:
* Remove the OPA
* Provide effective ventilations with BVM
* B. Continue ventilation with the airway in place # Incorrect because the airway is likely malpositioned or obstructing airflow
* C. Increase ventilation rate to 40-60 # Excessive and inappropriate; does not correct obstruction
* D. Start CPR if HR < 100 # In pediatrics, CPR begins if HR < 60 with poor perfusion, not < 100
* "If an airway adjunct worsens ventilation, it should be removed immediately."
* "Bradycardia in infants is a sign of hypoxia."
* "Ensure adequate ventilation before initiating compressions."
References:
NREMT EMT Education Standards - Airway, Respiration & Ventilation
National EMS Education Standards - Pediatric Airway Management
NREMT Candidate Handbook - Airway Management and Resuscitation
NEW QUESTION # 104
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