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| Section | Objectives |
|---|---|
| Trauma | - Trauma Assessment and Care
|
| Cardiology and Resuscitation | - Cardiac Emergencies
|
| Medical, Obstetrics and Gynecology | - Obstetrics and Gynecology
|
| Airway, Respiration and Ventilation | - Airway Management
|
| EMS Operations | - Operational Procedures
|
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NEW QUESTION # 17
A patient has heart failure with pulmonary edema. They have shortness of breath, and crackles are present in both lungs. The patient is nauseated and has vomited once. The vital signs are BP 90/40, P 110, R 10, and SpO# 89% on room air. Which of the following signs or symptoms prevent the EMT from using CPAP?
Select the three correct options.
Answer: B,C,E
Explanation:
Contraindications to CPAP (Continuous Positive Airway Pressure) include:
* Hypotension: CPAP can reduce preload and worsen shock (BP < 90 systolic is a contraindication)
* Respiratory rate too low: A rate of 10 is at the low threshold; CPAP requires spontaneous adequate effort
* Active vomiting or nausea: CPAP increases aspiration risk
Crackles and hypoxia are indications, not contraindications, for CPAP. Pulse rate does not influence CPAP use directly.
References:
NREMT Airway Management and Cardiovascular Guidelines
National EMS Education Standards - Respiratory Failure and CPAP
AHA ACLS Provider Manual - Heart Failure and Pulmonary Edema Management
NEW QUESTION # 18
Reassessment of a patient begins with repeating the
Answer: C
Explanation:
The reassessment phase in the EMT patient assessment model starts with repeating the primary survey (also called the primary assessment), which includes:
* Airway
* Breathing
* Circulation
* Disability (mental status)
* Exposure/environment
The purpose is to identify any changes or deterioration in the patient's life-threatening conditions, especially in dynamic or unstable patients. Only after this do EMTs check vitals and reevaluate secondary complaints.
References:
NREMT Assessment Guidelines - Patient Reassessment
Brady Emergency Care (13th ed.), Chapter: Assessment in EMS
National EMS Education Standards - Patient Assessment
NEW QUESTION # 19
A 9-month-old patient is unresponsive in a crib. The patient is not breathing. Which of the following actions should the EMT perform first?
Answer: D
Explanation:
Comprehensive and Detailed Explanation (Based on NREMT standards):
In pediatric patients, NREMT guidelines require EMTs to check a pulse before initiating CPR when the patient is unresponsive and not breathing. For infants, the appropriate pulse check site is the brachial artery, assessed for no more than 10 seconds.
Option D is correct because determining whether a pulse is present guides whether rescue breathing or full CPR is required.
Option B is only appropriate if a pulse is present.
Option C is indicated only if no pulse is found or if the heart rate is below 60 with signs of poor perfusion.
Option A delays critical resuscitative care.
NREMT stresses strict adherence to pediatric resuscitation sequences to ensure appropriate and timely intervention.
NEW QUESTION # 20
A 60-year-old patient has crushing, midsternal chest pain that began about 5 minutes ago with exercise. The patient has no prescription medications. The vital signs are BP 142/102 mmHg, P 90/min, R 16/min, and SpO# 95% on room air. What treatments should the EMT provide? Select the two answer options that are correct.
Answer: C,E
Explanation:
The correct answers are D. Aspirin administration and E. Attaching AED pads.
This patient is presenting with classic signs of acute coronary syndrome (ACS):
* Crushing, midsternal chest pain
* Onset with exertion
* Age and risk profile
D). Aspirin administration is a priority intervention. Aspirin helps by inhibiting platelet aggregation and limiting clot formation in coronary arteries.
NREMT-aligned guidance states:
* "Administer aspirin to patients with suspected cardiac chest pain."
E). Attaching AED pads is also correct because patients with suspected cardiac ischemia are at risk for sudden cardiac arrest. Continuous cardiac monitoring (via AED pads or monitor) allows for rapid defibrillation if needed.
NREMT material emphasizes early readiness for deterioration:
* "Be prepared to manage sudden cardiac arrest in patients with chest pain." Why the other options are incorrect:
* A. Sublingual nitroglycerin administration:EMTs may only assist with nitroglycerin if it is prescribed to the patient. This patient has no prescription medications, so nitroglycerin is contraindicated.
* B. 12-lead acquisition and transmission:This is typically an ALS (paramedic-level) intervention, not standard EMT scope in NREMT context.
* C. Applying supplemental oxygen:The patient's SpO# is 95% on room air, which does not indicate hypoxia. NREMT guidelines recommend oxygen only if SpO# is low or patient is in respiratory distress.
NREMT guidance:
* "Oxygen should be administered based on patient need, not routinely." Exact Extracts:
* "Administer aspirin to patients with suspected cardiac chest pain."
* "Oxygen should be given only if the patient is hypoxic or shows signs of respiratory distress."
* "Be prepared for cardiac arrest in patients with suspected myocardial infarction." References:
NREMT EMT Education Standards - Cardiology / Acute Coronary Syndrome
NREMT National Continued Competency Program (NCCP) - Cardiac Emergencies Standard EMT Text (aligned with NREMT): Cardiovascular Emergencies
NEW QUESTION # 21
Which of the following techniques are appropriate for examining a patient with an acute abdomen?
Select the two correct options.
Answer: D,E
Explanation:
Comprehensive and Detailed Explanation From Exact Extract:
In patients with acute abdominal pain, you mustfirst inspect (visualize)for distension, discoloration, or masses beforetouching. Palpation always beginsaway fromthe most painful area. The patient should be in asupine position with knees flexedto relax the abdominal muscles and ease the exam.
Palpating a pulsating masscould rupture an abdominal aortic aneurysm and is contraindicated.
References:
NREMT Cognitive Exam Blueprint - Medical Emergencies
Emergency Care and Transportation of the Sick and Injured (AAOS, 11th ed.) - Chapter: Abdominal and GI Emergencies EMT-B National Standard Curriculum, Module: Medical Emergencies
NEW QUESTION # 22
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