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| Section | Objectives |
|---|---|
| EMS Operations | - Operational procedures
|
| Medical, Obstetrics & Pediatrics | - Medical emergencies
|
| Trauma | - Traumatic injuries
|
| Airway, Respiration & Ventilation | - Airway management
|
| Cardiology & Resuscitation | - Cardiac emergencies
|
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NEW QUESTION # 198
A 1-year-old patient has meningitis. Which of the following signs and symptoms should the EMT expect to find? Select the three answer options that are correct.
Answer: B,C,D
Explanation:
The correct answers are A. Fever, D. Lethargy, and E. Bulging fontanelles.
Meningitis is an infection of the meninges (coverings of the brain and spinal cord) and presents differently in infants compared to adults.
Common signs of meningitis in infants include:
Fever (A)
Lethargy or decreased level of consciousness (D)
Bulging fontanelles (E) # due to increased intracranial pressure
Irritability
Poor feeding
Seizures
NREMT-aligned references state:
"Infants with meningitis may present with fever and lethargy."
"A bulging fontanelle is a key sign of increased intracranial pressure in infants." Why the other options are incorrect:
B). Drooling # More associated with epiglottitis or airway obstruction, not meningitis C). Pale skin # Nonspecific finding, not characteristic of meningitis F). Inability to stay still # More commonly associated with pain, anxiety, or stimulant conditions, not a classic meningitis sign Exact Extracts (NREMT-aligned EMT educational references):
"Signs of meningitis in infants include fever, lethargy, and bulging fontanelles."
"Increased intracranial pressure may cause bulging of the fontanelle."
"Altered mental status is common in CNS infections."
Clinical Priority Summary:
In infants, meningitis typically presents with fever, decreased responsiveness, and bulging fontanelles, making A, D, and E 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 # 199
What sign is the best indication that an 8-year-old is in hypovolemic shock?
Answer: C
Explanation:
In pediatric patients, NREMT emphasizes that hypotension is a late and ominous sign of shock. Children compensate well and may maintain blood pressure until shock is severe.
Option C (Tachypnea) is the earliest and most reliable indicator of hypovolemic shock in children. Increased respiratory rate reflects metabolic acidosis and compensatory mechanisms for poor perfusion.
Option A may be present but is less specific.
Option B is a very late finding.
Option D indicates decompensated shock and impending cardiovascular collapse.
NREMT stresses early recognition of shock through subtle signs such as tachypnea and tachycardia.
NEW QUESTION # 200
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: A,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 # 201
An EMT is using a BVM to ventilate a 28-year-old patient with asthma. The patient is unresponsive, and their vital signs are BP 70/40, P 142, R 8, and SpO2 89% on room air. The patient is becoming increasingly difficult to ventilate. What should the EMT do next?
Answer: A
Explanation:
Comprehensive and Detailed Explanation From Exact Extract:
In patients with asthma experiencing respiratory failure, improper ventilation (especially excessive rates) can lead to air trapping and increased intrathoracic pressure, reducing venous return and worsening hypotension.
The correct technique is to ventilate slowly to allow full exhalation - around 1 breath every 5-6 seconds for adults.
CPAP is contraindicated in unresponsive patients who cannot maintain their own airway. A non-rebreather mask would be insufficient for an unresponsive patient, and forceful ventilation risks barotrauma.
References:
NREMT EMT Psychomotor Exam Guide: Airway, Respiration and Ventilation
American Heart Association (AHA) BLS Provider Manual (2020)
National EMS Education Standards (2011) - Airway Management Section
NEW QUESTION # 202
Which of the following findings are indicative of increasing intracranial pressure? Select the two answer options that are correct.
Answer: A,E
Explanation:
The correct answers are C. Bradycardia and E. Widening pulse pressure.
This question is based on recognizing increased intracranial pressure (ICP), specifically components of Cushing's reflex (Cushing's triad).
Cushing's triad includes:
* Bradycardia
* Hypertension with widening pulse pressure
* Irregular respirations
Why C is correct (Bradycardia):
As ICP increases, pressure on the brainstem leads to:
* Vagal stimulation
* Slowing of the heart rate
NREMT-aligned guidance:
* "Bradycardia is a late sign of increased intracranial pressure."
Why E is correct (Widening pulse pressure):
ICP causes:
* Increased systolic pressure
* Decreased diastolic pressure
This results in a widening pulse pressure, a hallmark of worsening ICP.
Guidelines state:
* "Hypertension with widening pulse pressure is associated with increased intracranial pressure." Why the other options are incorrect:
* A. Tachypnea: Early stress response; ICP causes irregular, not simply rapid breathing.
* B. Hypotension: Opposite of ICP findings; suggests shock.
* D. Muffled heart sounds: Associated with cardiac tamponade, not ICP.
Exact Extracts:
* "Cushing's triad includes bradycardia, hypertension, and irregular respirations."
* "Widening pulse pressure is a sign of increased intracranial pressure."
* "These are late signs indicating possible brain 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 # 203
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