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| Section | Objectives |
|---|---|
| Topic 1: EMS Operations | - Operational Procedures
|
| Topic 2: Cardiology and Resuscitation | - Cardiac Emergencies
|
| Topic 3: Medical, Obstetrics and Gynecology | - Obstetrics and Gynecology
|
| Topic 4: Airway, Respiration and Ventilation | - Airway Management
|
| Topic 5: Trauma | - Trauma Assessment and Care
|
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NEW QUESTION # 182
Following insertion of an oropharyngeal airway in an unresponsive 1-year-old male, he develops cyanosis and bradycardia. You should
Answer: A
Explanation:
In infants, improper insertion of an OPA (oropharyngeal airway) can stimulate the vagus nerve, leading to bradycardia or even complete airway obstruction. If cyanosis and bradycardia develop after OPA insertion, immediate removal and resumption of ventilations with a bag-valve mask is critical.
The OPA must be properly sized and inserted only in patients without a gag reflex. Ventilations alone often reverse vagally induced bradycardia.
References:
NREMT Psychomotor Skills - Pediatric Airway
American Heart Association PALS Provider Manual (2020)
Brady Emergency Care (13th ed.) - Pediatric Airway Management
NEW QUESTION # 183
A 13-year-old patient is lethargic with a fever, headache, and a stiff neck. Which of the following statements should the EMT consider while caring for this patient? Select the two answer options that are correct.
Answer: B,D
Explanation:
The correct answers are A. The patient is likely contagious to others and B. Airway management is a concern for this patient.
Key Diagnosis: Suspected Meningitis
The patient presents with:
* Fever
* Headache
* Stiff neck
* Lethargy
These are classic signs of meningitis, a serious infection of the central nervous system.
Why A is correct (Contagious):
* Certain forms of meningitis (especially bacterial meningitis) are highly contagious
* Spread via respiratory droplets
NREMT-aligned guidance states:
* "Patients with suspected meningitis should be considered contagious."
* "Use appropriate PPE and precautions."
Why B is correct (Airway concern):
* Decreased level of consciousness (lethargy) increases risk of:
* Airway compromise
* Vomiting and aspiration
* Continuous airway monitoring is critical
* "Altered mental status requires close airway monitoring."
Why the other options are incorrect:
* C. Minimal stimuli to prevent vomiting# More associated with head injury or increased ICP, not primary meningitis management
* D. Cannot treat without parent consent# In emergencies, implied consent applies, especially in minors
* E. Full decontamination required# Not indicated - meningitis is not a hazardous materials exposure Exact Extracts (NREMT-aligned EMT educational references):
* "Meningitis may present with fever, headache, stiff neck, and altered mental status."
* "Consider patients contagious and use PPE."
* "Airway management is a priority in patients with decreased LOC."
Clinical Priority Summary:
Suspected meningitis requires infection control precautions and airway vigilance, making A and B the correct answers.
References:
NREMT EMT Education Standards - Medical Emergencies (Neurological/Infectious) NREMT National Continued Competency Program (NCCP) AAOS Emergency Care and Transportation of the Sick and Injured (NREMT-aligned)
NEW QUESTION # 184
Which of the following assessment findings indicates respiratory failure?
Answer: D
Explanation:
NREMT distinguishes respiratory distress from respiratory failure. Respiratory distress includes compensatory signs such as tachypnea, accessory muscle use, and diaphoresis. Respiratory failure occurs when those compensatory mechanisms fail and the body can no longer maintain adequate oxygenation or ventilation.
Option D (Altered mental status) is the most reliable indicator of respiratory failure. According to NREMT, hypoxia and hypercapnia directly affect brain function, leading to confusion, agitation, lethargy, or unresponsiveness. This indicates that oxygen delivery to the brain is no longer adequate.
Option A is common in early respiratory distress.
Option B indicates increased work of breathing but not failure.
Option C reflects sympathetic activation, not failure.
NREMT teaches that mental status changes are late and ominous signs, requiring immediate airway and ventilatory support.
NEW QUESTION # 185
A 9-year-old patient who was injured in an MCI is brought to the treatment area with a delayed triage tag.
Which of the following signs or symptoms would the EMT expect to find? Select the three correct options.
Answer: A,C,E
Explanation:
In pediatric START or JumpSTART triage, a " delayed " status is appropriate if the child is breathing adequately, has palpable pulses, and follows commands. The respiratory rate of 16 is normal for a 9-year-old, and being able to walk also supports the "delayed" tag.
" Mottled skin " and " breathing only after airway opening " would more likely lead to " immediate " or even " expectant " categories depending on associated symptoms.
References:
JumpSTART Pediatric MCI Triage Algorithm
National EMS Education Standards - Triage
PALS Provider Manual (American Heart Association)
NEW QUESTION # 186
A 3-year-old patient has drooling and stridor. The vital signs are BP 82/40, P 132, R 34, SpO# 94%, and T
102.4°F (39.1°C). Which of the following interventions should the EMT perform?
Answer: D
Explanation:
The correct answer is D. Apply humidified oxygen.
This patient presentation is highly suggestive of epiglottitis, a life-threatening upper airway infection commonly seen in pediatric patients.
Key findings:
* Drooling # inability to swallow secretions
* Stridor # upper airway obstruction
* Fever (102.4°F) # infection
* Anxiety and tachycardia # respiratory distress
Why D is correct:
* The priority is to maintain airway patency without agitating the child.
* Humidified oxygen helps improve oxygenation while minimizing airway irritation.
* It is the safest initial intervention in suspected epiglottitis.
Why the other options are incorrect:
* A. Visualize the airway # Can trigger complete airway obstruction due to swelling
* B. Suction posterior pharynx # May stimulate gag reflex and worsen obstruction
* C. Insert oropharyngeal airway # Contraindicated in conscious or semi-conscious patients and may cause airway collapse Exact Extracts:
* "Do not attempt to visualize the airway in suspected epiglottitis."
* "Avoid any procedure that may agitate the child and cause airway obstruction."
* "Provide humidified oxygen and transport promptly."
References:
NREMT EMT Education Standards - Airway, Respiration & Ventilation (Pediatric Airway) National EMS Education Standards - Pediatric Respiratory Emergencies NREMT Candidate Handbook - Airway Management
NEW QUESTION # 187
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