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| Section | Objectives |
|---|---|
| Trauma | - Trauma Assessment and Care
|
| Cardiology and Resuscitation | - Cardiac Emergencies
|
| EMS Operations | - Operational Procedures
|
| Medical, Obstetrics and Gynecology | - Obstetrics and Gynecology
|
| Airway, Respiration and Ventilation | - Airway Management
|
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NEW QUESTION # 109
An 83-year-old patient is unresponsive and lying on the floor. The patient has a large bruise and laceration on the forehead. The patient's vital signs are BP 90/60 mmHg, P 126/min, and R 0. Which of the following conditions should the EMT most suspect?
Answer: A
Explanation:
This patient presents with severe head trauma, unresponsiveness, hypotension, tachycardia, and apnea (R = 0).
NREMT education stresses that apnea following head injury is a critical red flag for increased intracranial pressure (ICP) and potential brain herniation.
Option B is correct because brain herniation occurs when swelling or bleeding within the skull forces brain tissue downward, compressing the brainstem. Compression of the brainstem can result in loss of respiratory drive, explaining the absence of respirations. Elderly patients are at increased risk due to cerebral atrophy and fragile bridging veins.
Option A is possible but does not directly explain apnea.
Option C is associated with sudden cardiac arrest after chest impact, not head trauma.
Option D would present with respiratory compromise but not directly from a forehead injury.
NREMT emphasizes rapid airway management, ventilation, spinal precautions, and immediate transport for suspected brain herniation.
NEW QUESTION # 110
Which of the following actions are steps for inserting a nasopharyngeal airway? Select the two answer options that are correct.
Answer: A,E
Explanation:
The correct answers are D. Place the device in the larger nostril and E. Lubricate the distal tip.
Proper insertion of a nasopharyngeal airway (NPA) follows specific steps outlined in NREMT-aligned airway management guidelines.
Correct Steps:
1. Choose the larger nostril (D):
The NPA should be inserted into the nostril with better airflow (larger nostril) to reduce resistance and trauma.
This improves ease of insertion and patient comfort.
2. Lubricate the distal tip (E):
The airway must be lubricated with a water-soluble lubricant before insertion.
This minimizes friction and reduces the risk of nasal mucosal injury or bleeding.
NREMT-aligned references state:
"Insert the NPA into the larger nostril when possible."
"Lubricate the airway prior to insertion."
Why the other options are incorrect:
A). Measure from the corner of the mouth to the tip of the ear # Incorrect This measurement is used for an oropharyngeal airway (OPA), not an NPA.
NPA is measured from nose to earlobe.
B). Follow the base of the tongue during insertion # Incorrect
This applies to OPA insertion, not NPA.
NPA is inserted along the floor of the nasal passage.
C). Insert the bevel away from the septum # Incorrect
The bevel should face toward the septum (medially), not away.
Exact Extracts (NREMT-aligned EMT educational references):
"Measure NPA from the nostril to the earlobe."
"Lubricate the airway before insertion."
"Insert into the larger nostril if possible."
"Advance gently along the nasal floor."
Clinical Priority Summary:
Correct NPA insertion requires proper nostril selection and lubrication, making D and E the correct answers.
References:
NREMT EMT Education Standards - Airway, Respiration & Ventilation
NREMT National Continued Competency Program (NCCP)
AAOS Emergency Care and Transportation of the Sick and Injured (NREMT-aligned)
NEW QUESTION # 111
A 67-year-old patient reports crushing chest pressure. The vital signs are BP 156/98, P 64, R 14, and SpO2
94%. What treatments should the EMT provide first? Select the two correct options.
Answer: A,E
Explanation:
The patient's symptoms are consistent with acute coronary syndrome (ACS). The first-line treatments are:
* Aspirin (160-325 mg): inhibits platelet aggregation, reducing clot progression.
* Oxygen: administered when SpO# < 94% or signs of hypoxia/distress are present.
CPAP is for pulmonary edema or respiratory failure. Nitroglycerin requires BP > 90 systolic and medical direction approval. Laying the patient supine may increase myocardial workload and is inappropriate unless hypotension occurs.
References:
NREMT Cardiology and Resuscitation Guidelines
AHA ACLS Provider Manual (2020) - Acute Coronary Syndrome Treatment
National EMS Education Standards - Cardiovascular Emergencies
NEW QUESTION # 112
Calling your medical director for orders to assist with administration of an additional dose of nitroglycerin is an example of
Answer: A
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 # 113
A 78-year-old female tripped and fell while walking. Her left leg is rotated externally and shorter than her right leg. You should suspect
Answer: D
Explanation:
An externally rotated, shortened leg is a classic sign of a proximal femur fracture, specifically a femoral neck or intertrochanteric fracture, commonly seen in elderly fall patients. This presentation reflects muscle pull and fracture displacement.
* Posterior hip dislocations cause internal rotation.
* Pelvic fractures may cause instability but not specific leg rotation/shortening.
* Colles ' fracture is a distal radius (wrist) injury, unrelated to leg trauma.
References:
NREMT Trauma Module - Musculoskeletal Injuries
National EMS Education Standards - Geriatric Trauma
AAOS Emergency Care (11th ed.), Chapter: Orthopedic Injuries
NEW QUESTION # 114
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