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Format: Multiple choices, multiple answers
NEW QUESTION # 162
A 37-year-old female presents with increased work of breathing after blunt chest trauma. During transport, her SpO# is 92% and decreasing. You auscultate clear lung sounds. The most likely cause of her condition is
Answer: B
Explanation:
Pericardial tamponade is a life-threatening condition often associated with blunt or penetrating chest trauma.
NREMT instruction highlights that tamponade occurs when blood accumulates in the pericardial sac, compressing the heart and impairing cardiac output.
Option D is correct because patients with pericardial tamponade often present with increased work of breathing, hypoxia, and clear lung sounds, as the problem is cardiac rather than pulmonary. Decreasing oxygen saturation results from reduced cardiac output and poor tissue perfusion.
Option B is incorrect because tension pneumothorax typically presents with absent or diminished lung sounds on one side.
Option C usually produces crackles or signs of lung injury rather than clear lung sounds.
Option A is rare and usually associated with severe vomiting or penetrating trauma.
Early recognition of tamponade and rapid transport are critical per NREMT trauma care priorities.
NEW QUESTION # 163
A 24-year-old patient was involved in an MVC. The EMT is completing the patient care report. Which of the following statements indicate pertinent negatives? Select the two correct options.
Answer: B,D
Explanation:
Pertinent negatives are findings that are not present, but would be clinically relevant if they were. For example:
* "No neck or back pain" helps rule out spinal injury
* "No loss of consciousness" informs head trauma assessment
Statements about behavior or initial refusal (B, E) may be documented under patient behavior or refusal, but they are not pertinent negatives. Positive findings like abdominal tenderness are pertinent positives.
References:
NREMT Documentation Standards
National EMS Education Standards - Communication and Documentation
Brady Emergency Care (13th ed.) - Patient Care Reporting
NEW QUESTION # 164
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: A,E,F
Explanation:
Comprehensive and Detailed Explanation From Exact Extract:
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 areindications, 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 # 165
Calling your medical director for orders to assist with administration of an additional dose of nitroglycerin is an example of
Answer: B
Explanation:
This situation describes contacting the medical director directly for patient-specific instructions , which is the definition of on-line medical direction . In national EMS education guidance used by NREMT-aligned programs, EMTs must be able to consult on-line medical direction when needed.
Why B is correct:
When an EMT calls for permission or orders to give an additional dose of nitroglycerin , that is real-time communication with physician oversight. This is on-line medical direction rather than a standing order. The EMS curriculum also explains that medication administration such as nitroglycerin may occur with medical direction approval .
Why the other options are wrong:
A). standard operating protocols - these are standing rules or preapproved procedures followed without calling for a new patient-specific order.
C). evidence-based medicine - this means care guided by research and best evidence, not a phone/radio order from medical control.
D). continuous quality improvement - this refers to reviewing and improving system performance, not obtaining treatment orders during active patient care.
NEW QUESTION # 166
A mountain climber tells you that he came down from a hike because he was coughing up blood. You should suspect
Answer: C
Explanation:
Comprehensive and Detailed Explanation From Exact Extract:
Hemoptysis (coughing up blood)in a physically active person, such as a mountain climber, strongly suggests apulmonary embolism (PE), particularly due to:
* Dehydration
* Prolonged exertion or immobility
* High altitude increasing clot risk
Symptoms may include:
* Shortness of breath
* Chest pain
* Tachypnea
* Hemoptysis
Pulmonary edemagenerally causes pink frothy sputum and is more associated with heart failure.Neoplasm (lung cancer)is possible but much less acute in onset.Spontaneous pneumothoraxcauses dyspnea and pleuritic chest pain but not typically hemoptysis.
References:
NREMT Medical Assessment - Pulmonary and Hematologic Emergencies
AAOS EMT Textbook - Chapter: Respiratory Emergencies
CDC Guidelines - High-Risk Conditions for Pulmonary Embolism
NEW QUESTION # 167
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