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NEW QUESTION # 230
Defusing sessions should do which of the following in order to be successful? Select the two correct options.
Answer: B,C
Explanation:
Defusing is an informal, short-term intervention after a critical incident. It should:
* Occur within hours of the event (ideally the same shift)
* Encourage voluntary open discussion in a confidential setting
It is not a full debrief or counseling session and doesn't require mental health professionals present. Forcing participation or waiting too long (e.g., 72+ hours) can reduce its effectiveness.
References:
NREMT EMS Operations - Critical Incident Stress Management (CISM)
International Critical Incident Stress Foundation (ICISF) Guidelines
National EMS Education Standards - Mental Health and Stress Response
NEW QUESTION # 231
A 60-year-old has severe shortness of breath. Audible wheezing is present. The patient has a history of COPD, asthma, and diabetes with prescribed medications. The vital signs are BP 138/80, P 110, R 30, and SpO# 89% on room air. What actions should the EMT take? Select the two answer options that are correct.
Answer: C,D
Explanation:
The correct answers are B. Apply continuous positive airway pressure (CPAP) and D. Administer a beta-2 agonist.
This patient is in moderate to severe respiratory distress with:
* Tachypnea (R 30)
* Hypoxia (SpO# 89%)
* Wheezing # indicates bronchoconstriction (asthma/COPD exacerbation)
Why B is correct (CPAP):
* CPAP helps keep alveoli open, improves oxygenation, and reduces work of breathing.
* It is indicated in patients who are awake, breathing, and in respiratory distress with hypoxia.
* Especially beneficial in COPD exacerbations.
Why D is correct (Beta-2 agonist):
* Beta-2 agonists (e.g., albuterol) relax bronchial smooth muscle, relieving wheezing and bronchospasm.
* This directly treats the underlying problem in asthma/COPD exacerbation.
Why the other options are incorrect:
* A. 3 LPM nasal cannula # Too low for significant hypoxia (SpO# 89%); patient needs more aggressive support
* C. Recovery position # Used for unconscious patients, not alert patients in respiratory distress
* E. Rescue breathing # Indicated for inadequate respirations, but this patient is breathing (though rapid) Exact Extracts:
* "CPAP is indicated for patients with respiratory distress who are breathing spontaneously."
* "Beta-agonists are used to relieve bronchospasm in asthma and COPD."
* "Patients with wheezing benefit from bronchodilator therapy."
References:
NREMT EMT Education Standards - Airway, Respiration & Ventilation
National EMS Education Standards - Respiratory Emergencies
NREMT Candidate Handbook - Patient Management
NEW QUESTION # 232
A choking patient becomes unresponsive. What should the EMT perform next? Select the two correct options.
Answer: A,D
Explanation:
If a choking patient becomes unresponsive, EMTs should:
* Check for a pulse
* Begin chest compressions if no pulse is foundChest compressions can help dislodge the object. After compressions, the airway should be opened and inspected. Back blows are not appropriate for unconscious patients.
Ventilation is attempted after clearing the airway or if no object is seen. Do not withhold compressions waiting for object removal.
References:
AHA BLS Provider Manual (2020) - Foreign Body Airway Obstruction Algorithm NREMT Airway Skills Sheet - Obstructed Airway National EMS Education Standards - Respiratory and Airway Management
NEW QUESTION # 233
A 38-year-old patient is unconscious with slow, shallow, and gasping breaths. The patient is not moving.
What should the EMT perform first?
Answer: D
Explanation:
In any unresponsive patient, the first step is to assess and open the airway to determine patency and identify obstruction or inadequate breathing.
Gasping respirations (agonal) are not effective; they require BVM ventilation support. The airway must be open before checking for a pulse or performing auscultation. A secondary assessment is performed only after primary survey and stabilization.
References:
AHA BLS Provider Manual (2020) - Unresponsive Patient Algorithm
NREMT Airway Skills - Primary Assessment
National EMS Education Standards - Airway, Breathing, Circulation (ABC) Sequence
NEW QUESTION # 234
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: A,C,D
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 # 235
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