CSLB General Building (B) — All Questions

What is the normal resting respiratory rate for a healthy adult?

• a.12 to 20 breaths per minute✓
• b.20 to 30 breaths per minute
• c.6 to 10 breaths per minute
• d.30 to 40 breaths per minute

A healthy adult at rest breathes about 12 to 20 times per minute. Rates persistently above or below this range suggest respiratory distress and warrant closer assessment and possible ventilatory support.

Which airway adjunct is contraindicated in a patient with an intact gag reflex?

• a.Nasopharyngeal airway
• b.Oropharyngeal airway✓
• c.Nasal cannula
• d.Bag-valve mask

An oropharyngeal (oral) airway stimulates the gag reflex and can cause vomiting or laryngospasm if the reflex is intact. It should only be used in patients who are unresponsive with no gag reflex.

A nonrebreather mask should generally be run at what oxygen flow rate?

• a.2 to 4 L/min
• b.4 to 6 L/min
• c.10 to 15 L/min✓
• d.1 to 2 L/min

A nonrebreather mask requires 10 to 15 L/min to keep the reservoir bag inflated and deliver a high oxygen concentration (roughly 80 to 90 percent). Lower flow rates fail to keep the reservoir filled between breaths.

A nasal cannula can deliver oxygen concentrations in approximately what range?

• a.80 to 90 percent
• b.60 to 70 percent
• c.50 to 60 percent
• d.24 to 44 percent✓

At 1 to 6 L/min a nasal cannula delivers roughly 24 to 44 percent oxygen. It is best for patients needing low-concentration oxygen who cannot tolerate a mask.

What is the correct first step when a responsive adult is choking and cannot speak, cough, or breathe?

• a.Deliver abdominal thrusts (Heimlich maneuver)✓
• b.Perform a blind finger sweep
• c.Begin chest compressions immediately
• d.Lay the patient supine and start rescue breaths

A responsive adult with a complete airway obstruction should receive abdominal thrusts until the object is expelled or the patient becomes unresponsive. Blind finger sweeps are avoided because they can push the object deeper.

How should you size an oropharyngeal airway before insertion?

• a.From the tip of the nose to the earlobe
• b.From the corner of the mouth to the earlobe (or angle of the jaw)✓
• c.From the chin to the sternum
• d.From the front teeth to the back of the throat by estimate

An oral airway is measured from the corner of the mouth to the earlobe or angle of the mandible. A properly sized airway holds the tongue forward without obstructing the airway.

Which finding best indicates adequate ventilation while using a bag-valve mask?

• a.A tight mask seal alone
• b.Squeezing the bag rapidly
• c.Visible, gentle rise and fall of the chest with each breath✓
• d.Gastric distention developing

Effective BVM ventilation is confirmed by visible chest rise with each squeeze. Gastric distention suggests air is entering the stomach from ventilating too fast or forcefully.

What maneuver is preferred to open the airway of an unresponsive patient with suspected cervical spine injury?

• a.Head-tilt/chin-lift
• b.Sniffing position with neck extension
• c.Recovery position roll
• d.Jaw-thrust maneuver✓

The jaw-thrust maneuver opens the airway while keeping the head and neck in a neutral, in-line position. This minimizes spinal movement compared with the head-tilt/chin-lift.

A patient breathing 6 times per minute with shallow effort is best managed by an EMT with:

• a.Positive-pressure ventilation with a bag-valve mask and supplemental oxygen✓
• b.A nasal cannula at 2 L/min
• c.A nonrebreather mask only
• d.Encouraging the patient to breathe faster

A rate of 6 with shallow depth produces inadequate minute volume, so the patient needs assisted positive-pressure ventilation, not just passive oxygen. A BVM with oxygen restores adequate tidal volume and rate.

Stridor, a high-pitched sound heard on inspiration, most commonly indicates:

• a.Lower airway fluid
• b.Upper airway obstruction or narrowing✓
• c.Normal breathing
• d.Pneumothorax

Stridor is produced by turbulent airflow through a narrowed upper airway, such as from swelling or a foreign body. It signals a potentially serious airway threat requiring prompt attention.

Which patient is the best candidate for a nasopharyngeal airway?

• a.A patient with suspected skull base fracture and clear fluid from the nose
• b.A fully alert patient with no distress
• c.A semiconscious patient with an intact gag reflex who needs airway support✓
• d.A patient in cardiac arrest with severe facial trauma

A nasopharyngeal airway is tolerated by patients with an intact gag reflex, making it useful for semiconscious patients. It is avoided with suspected basilar skull fracture because of the risk of intracranial misplacement.

What is the appropriate ventilation rate for an apneic adult with a pulse (rescue breathing)?

• a.1 breath every 2 seconds
• b.1 breath every 15 seconds
• c.1 breath every 30 seconds
• d.1 breath every 6 seconds (about 10 per minute)✓

For an adult in respiratory arrest with a pulse, deliver one breath about every 6 seconds, roughly 10 breaths per minute. Each breath should be given over about one second with visible chest rise.

Cyanosis (bluish skin, lips, or nail beds) is a sign of:

• a.Inadequate oxygenation✓
• b.Excellent perfusion
• c.Hyperventilation only
• d.Normal skin in cold weather with no clinical concern

Cyanosis reflects poor oxygenation of the blood and is a late, serious sign of hypoxia. It requires immediate airway management and oxygen therapy.

When suctioning an adult's airway, you should apply suction for no longer than:

• a.30 seconds at a time
• b.15 seconds at a time✓
• c.60 seconds at a time
• d.2 minutes at a time

Suction an adult for no more than 15 seconds per attempt because suctioning also removes oxygen and can cause hypoxia. Reoxygenate the patient between attempts.

Agonal respirations in an unresponsive patient should be treated as:

• a.Normal, adequate breathing
• b.A reason to give only a nasal cannula
• c.Inadequate breathing requiring ventilatory support✓
• d.A sign the patient is improving

Agonal (gasping) respirations are ineffective and do not provide adequate ventilation, often occurring around cardiac arrest. The patient needs assisted ventilation and, if pulseless, CPR.

A patient with a history of COPD is in severe respiratory distress with low oxygen saturation. The EMT should:

• a.Withhold oxygen entirely to avoid suppressing respiratory drive
• b.Give only room air
• c.Give a nasal cannula at 1 L/min regardless of distress
• d.Provide high-concentration oxygen and support ventilation as needed✓

Never withhold needed oxygen from a hypoxic patient because of COPD concerns. Treat hypoxia with high-concentration oxygen and assist ventilations if breathing is inadequate.

Which sound suggests fluid in the lower airways, such as in pulmonary edema?

• a.Crackles (rales)✓
• b.Stridor
• c.Snoring
• d.Silence with good chest rise

Crackles, or rales, are produced by air moving through fluid in the alveoli and small airways. They are commonly heard in pulmonary edema and some pneumonias.

The primary purpose of the recovery position for an unresponsive, breathing patient without trauma is to:

• a.Increase oxygen concentration in the blood
• b.Help keep the airway open and allow drainage of secretions✓
• c.Reduce the heart rate
• d.Warm the patient

The lateral recovery position lets the tongue fall forward and secretions or vomit drain from the mouth, protecting the airway. It is used for unresponsive patients who are breathing adequately with no suspected spinal injury.

Accessory muscle use, nasal flaring, and tripod positioning are signs of:

• a.Adequate breathing
• b.A fully compensated patient with no distress
• c.Increased work of breathing / respiratory distress✓
• d.Cardiac arrest

These findings show the patient is working hard to breathe and is in respiratory distress. Early recognition allows oxygen therapy and ventilatory support before respiratory failure.

What oxygen flow rate is typically used with a bag-valve mask to maximize delivered oxygen concentration?

• a.2 L/min
• b.4 L/min
• c.6 L/min
• d.15 L/min✓

A BVM connected to an oxygen reservoir at 15 L/min can deliver nearly 100 percent oxygen. Adequate flow keeps the reservoir bag full so each ventilation delivers high-concentration oxygen.

What is the recommended compression rate for adult CPR?

• a.100 to 120 per minute✓
• b.60 to 80 per minute
• c.140 to 160 per minute
• d.80 to 100 per minute

High-quality CPR uses a compression rate of 100 to 120 per minute. Rates that are too slow or too fast reduce cardiac output and coronary perfusion.

What is the correct compression-to-ventilation ratio for one-rescuer adult CPR?

• a.15:2
• b.30:2✓
• c.5:1
• d.10:2

Single-rescuer adult CPR uses 30 compressions to 2 breaths. This ratio maximizes chest compressions while still providing ventilation.

What is the minimum compression depth for an adult during CPR?

• a.About 1 inch (2.5 cm)
• b.About 3 inches (7.5 cm)
• c.At least 2 inches (5 cm)✓
• d.About 1.5 inches (4 cm)

Adult chest compressions should be at least 2 inches (5 cm) but not more than 2.4 inches (6 cm) deep. Adequate depth is essential to generate blood flow.

For two-rescuer CPR on a child, the compression-to-ventilation ratio is:

• a.30:2
• b.5:1
• c.10:2
• d.15:2✓

When two rescuers perform CPR on an infant or child, the ratio is 15:2. With a single rescuer, the child ratio is 30:2, the same as adults.

The single most important intervention to improve survival that an EMT can deliver for witnessed sudden cardiac arrest is:

• a.Early defibrillation with an AED plus high-quality CPR✓
• b.Administering oral glucose
• c.Applying a tourniquet
• d.Placing the patient in the recovery position

Early defibrillation combined with early high-quality CPR offers the best chance of survival in cardiac arrest from a shockable rhythm. Every minute of delay to defibrillation reduces survival.

When an AED advises 'no shock advised' but the patient remains pulseless, you should:

• a.Wait 5 minutes before doing anything
• b.Immediately resume CPR starting with compressions✓
• c.Remove the pads and transport
• d.Give a second analysis right away without CPR

A 'no shock advised' message means the rhythm is not shockable, so resume CPR immediately beginning with chest compressions. The AED will reanalyze after about two minutes of CPR.

How deep should chest compressions be for an infant?

• a.At least 2 inches
• b.About 1 inch
• c.About 1.5 inches (4 cm), roughly one third of chest depth✓
• d.3 inches

Infant compressions should be about 1.5 inches (4 cm), or approximately one third the depth of the chest. Two fingers or the two-thumb encircling technique is used.

A conscious adult reports crushing chest pressure radiating to the left arm. After ensuring no contraindications, the EMT may assist with:

• a.Oral glucose
• b.Activated charcoal
• c.A tourniquet
• d.Chewable aspirin✓

For suspected acute coronary syndrome, EMTs may assist with chewable aspirin, which reduces clot formation, if the patient has no allergy or contraindication. Aspirin improves outcomes in heart attack.

Before assisting a patient with prescribed nitroglycerin for chest pain, the EMT must confirm:

• a.Adequate blood pressure (typically systolic above 90 to 100 mmHg) and no recent erectile dysfunction drugs✓
• b.The patient has eaten recently
• c.The patient has a fever
• d.There is no aspirin allergy

Nitroglycerin dilates vessels and can cause dangerous hypotension, so blood pressure must be adequate first. It is also contraindicated with recent erectile dysfunction medications, which together can cause severe hypotension.

During CPR, allowing the chest to fully recoil between compressions is important because it:

• a.Increases compression rate
• b.Allows the heart to refill with blood, improving the next compression's output✓
• c.Reduces the need for ventilation
• d.Prevents rib fractures entirely

Full chest recoil lets the heart refill with blood between compressions, improving blood flow with each push. Leaning on the chest reduces venous return and lowers CPR effectiveness.

If a patient in cardiac arrest has a transdermal medication patch on the chest where an AED pad must go, you should:

• a.Place the pad directly over the patch
• b.Cancel AED use
• c.Remove the patch and wipe the area before applying the pad✓
• d.Apply the AED pad to the back only

A medication patch under an AED pad can block energy delivery or cause a burn. Remove it and wipe the skin dry before placing the pad.

What is the compression rate for infant and child CPR?

• a.60 to 80 per minute
• b.80 to 100 per minute
• c.140 to 160 per minute
• d.100 to 120 per minute✓

The compression rate for infants and children is the same as for adults, 100 to 120 per minute. Consistent rate and depth are key to effective CPR at all ages.

The purpose of minimizing interruptions in chest compressions is to:

• a.Maintain coronary and cerebral blood flow✓
• b.Save equipment
• c.Allow more time for ventilation
• d.Let the AED charge faster only

Blood flow generated by compressions falls quickly when compressions stop and takes time to rebuild. Minimizing interruptions keeps perfusion to the heart and brain as high as possible.

A patient becomes unresponsive and pulseless while you are attaching monitoring equipment. Your immediate action is to:

• a.Search for a medical bracelet first
• b.Begin high-quality chest compressions✓
• c.Give two rescue breaths first
• d.Check blood glucose

For an unresponsive, pulseless adult, start chest compressions immediately following the compressions-airway-breathing sequence. Early compressions are the priority in cardiac arrest.

AED pads for a small child when pediatric pads are unavailable should be:

• a.Never used at any energy
• b.Cut in half to fit
• c.Placed using adult pads, one on the chest and one on the back if needed to avoid overlap✓
• d.Placed only on the abdomen

If pediatric pads or a pediatric setting are unavailable, adult pads may be used on a child, ensuring the pads do not touch each other by placing one anterior and one posterior if needed. Defibrillation should not be withheld.

Which is a classic sign that a patient may be having a heart attack in addition to chest pain?

• a.Warm, dry, pink skin
• b.Slow, deep pain-free breathing
• c.Increased hunger
• d.Diaphoresis (heavy sweating), nausea, and shortness of breath✓

Acute coronary syndrome often presents with sweating, nausea, and dyspnea along with chest discomfort. Recognizing these associated signs helps identify a possible heart attack, especially when chest pain is atypical.

Hands-only CPR by bystanders is encouraged for adults primarily because:

• a.Continuous compressions maintain blood flow and bystanders are more willing to act✓
• b.Ventilations are harmful
• c.It replaces the need for an AED
• d.It is only appropriate for children

For sudden adult cardiac arrest, continuous chest compressions maintain circulation and bystanders are more likely to perform CPR without mouth-to-mouth. Early bystander compressions improve survival.

Where should the heel of the hand be placed for adult chest compressions?

• a.Over the upper sternum near the collarbones
• b.On the center of the chest, on the lower half of the sternum✓
• c.Over the left nipple
• d.On the upper abdomen below the ribs

Compressions are delivered on the lower half of the sternum in the center of the chest. Correct hand placement maximizes cardiac output and reduces injury.

A conscious patient with a suspected heart attack should generally be placed in what position if no hypotension or altered mental status is present?

• a.Flat and supine
• b.Trendelenburg (head down)
• c.A position of comfort, often sitting up✓
• d.Prone

A conscious cardiac patient without hypotension is usually most comfortable sitting up, which can ease breathing and reduce workload. Keep the patient calm and limit exertion.

The main reason to switch compressors about every 2 minutes during CPR is to:

• a.Follow the AED's request
• b.Give the patient a rest
• c.Allow ventilations to catch up
• d.Prevent rescuer fatigue that reduces compression quality✓

Compression quality declines with fatigue, often before the rescuer notices. Switching about every two minutes, ideally during a rhythm check, keeps compressions effective.

After an AED delivers a shock, the rescuer should:

• a.Immediately resume chest compressions✓
• b.Check for a pulse for 30 seconds
• c.Wait for the AED to advise again before touching the patient
• d.Remove the pads

Immediately after a shock, resume CPR starting with compressions for about two minutes before the next rhythm analysis. This minimizes the pause in blood flow and improves outcomes.

For an unresponsive adult who is not breathing normally, how should you check for a pulse and for how long?

• a.Radial pulse for 30 seconds
• b.Carotid pulse for no more than 10 seconds✓
• c.Pedal pulse for 20 seconds
• d.Brachial pulse for 15 seconds

In an unresponsive adult, check the carotid pulse for no more than 10 seconds. If no definite pulse is felt within that time, begin chest compressions.

What is the first-line method to control severe, life-threatening external bleeding from an extremity?

• a.Direct pressure, and a tourniquet if pressure fails or bleeding is massive✓
• b.Elevation alone
• c.Applying ice
• d.Pressure points only

Severe extremity bleeding is first controlled with firm direct pressure; if that fails or the bleed is immediately life-threatening, apply a tourniquet. Rapid hemorrhage control is a top priority in trauma.

When applying a commercial tourniquet, you should tighten it until:

• a.It feels snug but bleeding continues slowly
• b.The bright red bleeding stops and the distal pulse is eliminated✓
• c.It is loose enough to slip a hand under
• d.Only venous oozing remains

A tourniquet must be tightened enough to stop arterial bleeding, which also eliminates the distal pulse. A tourniquet that only slows bleeding can worsen blood loss.

Which are early signs of shock (hypoperfusion)?

• a.Slow pulse and warm, flushed skin
• b.Falling blood pressure as the first sign
• c.Rapid pulse; pale, cool, clammy skin; and anxiety✓
• d.High blood pressure and dry skin

Early shock produces a rapid, weak pulse with pale, cool, clammy skin and restlessness or anxiety. Falling blood pressure is a late sign because the body compensates first.

After applying a tourniquet, you should note and communicate:

• a.The patient's name only
• b.Nothing further
• c.The color of the bandage
• d.The time the tourniquet was applied✓

The application time of a tourniquet must be documented and reported so hospital staff know how long the limb has been without circulation. Write it clearly, often on the patient or the device.

A patient with a suspected spinal injury who is breathing adequately should be:

• a.Manually stabilized in a neutral, in-line position✓
• b.Rapidly flexed to check range of motion
• c.Placed prone immediately
• d.Sat fully upright and asked to walk

Suspected spinal injuries are managed with manual in-line stabilization keeping the head neutral until fully immobilized or cleared. Unnecessary movement risks worsening a spinal cord injury.

How should a partial-thickness (second-degree) burn without gross contamination be initially covered?

• a.With butter or ointment
• b.With a clean, dry sterile dressing✓
• c.With a tight elastic wrap
• d.With ice packs applied directly on the skin

Burns are covered with a clean, dry sterile dressing to reduce contamination and pain. Avoid ointments, butter, ice, or breaking blisters, which can worsen injury or infection.

The 'rule of nines' is used to estimate:

• a.Blood loss volume
• b.Glasgow Coma Scale score
• c.The percentage of total body surface area burned✓
• d.Respiratory rate

The rule of nines estimates the percentage of total body surface area affected by burns. This helps gauge burn severity and guides triage and treatment decisions.

An impaled object in a patient's forearm should generally be:

• a.Removed quickly to control bleeding
• b.Pushed in deeper for stability
• c.Wrapped tightly against the skin
• d.Stabilized in place with bulky dressings✓

Impaled objects are stabilized in place and not removed in the field, because removal can cause severe bleeding or further injury. The exception is an object obstructing the airway or interfering with CPR.

The most appropriate position for a hypotensive trauma patient in shock (without spinal injury) is generally:

• a.Supine to maintain perfusion, keeping the patient warm✓
• b.Sitting fully upright
• c.Prone
• d.Standing to improve circulation

A patient in shock is usually kept supine to support perfusion of vital organs, along with oxygen and warmth. Preventing heat loss helps limit worsening of shock.

A patient with a suspected closed femur fracture should have the limb:

• a.Left free to move for comfort
• b.Immobilized, ideally with a traction or rigid splint, checking distal pulse, motor, and sensation✓
• c.Massaged to reduce swelling
• d.Elevated above the head

A femur fracture is stabilized with a splint to reduce pain, bleeding, and further injury, and distal circulation and sensation are checked before and after. Femur fractures can cause significant internal blood loss.

Which finding suggests a serious chest injury requiring rapid transport?

• a.Pink, warm skin with normal breathing
• b.A small superficial scratch
• c.Severe difficulty breathing with unequal chest rise after chest trauma✓
• d.Mild soreness with clear lungs

Severe dyspnea with unequal chest rise after chest trauma suggests a serious injury such as a collapsed lung and needs rapid transport. Early recognition and oxygen support are essential.

An open chest wound (sucking chest wound) should be treated by an EMT with:

• a.A tight circumferential wrap
• b.Direct firm pressure packed into the wound
• c.Nothing but transport
• d.An occlusive dressing, monitoring for worsening breathing✓

An open chest wound is covered with an occlusive dressing to prevent air entering the chest, while watching for signs of increasing pressure. If breathing worsens, a side of the dressing may be lifted to release trapped air.

The primary goal of treating shock in a trauma patient in the field is to:

• a.Maintain oxygenation and perfusion and prevent heat loss during rapid transport✓
• b.Raise blood pressure with oral fluids
• c.Give the patient food and water
• d.Delay transport until vitals normalize

Field management of shock focuses on oxygen, controlling bleeding, keeping the patient warm, and rapid transport to definitive care. EMTs cannot fully reverse shock, so time to the hospital is critical.

Bright red blood that spurts from a wound in time with the pulse indicates:

• a.Venous bleeding
• b.Arterial bleeding✓
• c.Capillary bleeding
• d.Minor bleeding that will stop on its own

Spurting, bright red blood synchronized with the heartbeat is arterial bleeding, which is the most serious and rapid. It requires immediate control with direct pressure and possibly a tourniquet.

A helmet on a patient with a possible spine injury should generally be removed by EMTs when:

• a.It always stays on no matter what
• b.It never needs removal
• c.It interferes with airway management or assessment, or does not hold the head snugly✓
• d.The patient asks, regardless of fit

A helmet is removed if it prevents airway control or adequate assessment, or if it does not fit snugly enough to immobilize the head. Otherwise a well-fitting helmet holding the head steady may be left in place with the head stabilized.

To estimate the severity of a head injury, an EMT commonly assesses:

• a.Only the blood pressure
• b.Skin temperature alone
• c.Pupil size only, ignoring mental status
• d.Level of responsiveness (AVPU/GCS), pupils, and any change over time✓

Head injury severity is judged by monitoring level of responsiveness, pupil response, and trends over time. A declining mental status is a critical warning sign of worsening brain injury.

A diabetic patient who is conscious, able to swallow, and has an altered mental status with likely low blood sugar should receive:

• a.Oral glucose✓
• b.Activated charcoal
• c.Aspirin
• d.Nitroglycerin

A conscious diabetic with a protected airway and suspected hypoglycemia is treated with oral glucose. The patient must be able to swallow and protect the airway to receive anything by mouth.

The classic signs of a stroke can be quickly screened using:

• a.The rule of nines
• b.The Cincinnati Prehospital Stroke Scale (facial droop, arm drift, speech)✓
• c.The Glasgow burn scale
• d.OPQRST only

The Cincinnati Prehospital Stroke Scale checks for facial droop, arm drift, and abnormal speech. Any one abnormal finding suggests a possible stroke and the need for rapid transport.

For a patient having a severe allergic reaction (anaphylaxis) with prescribed medication available, the EMT may assist with:

• a.Oral glucose
• b.Activated charcoal
• c.An epinephrine auto-injector✓
• d.Aspirin

Anaphylaxis is treated with epinephrine, and EMTs may assist a patient with their prescribed auto-injector. Epinephrine reverses airway swelling and low blood pressure caused by the reaction.

An epinephrine auto-injector is most commonly injected into the:

• a.Upper arm muscle
• b.Abdomen
• c.Buttock
• d.Lateral (outer) thigh✓

The epinephrine auto-injector is delivered into the outer thigh muscle, which can be done through clothing. This site allows rapid absorption of the medication.

The most important consideration before giving any oral medication or glucose is:

• a.The patient can swallow and protect their airway✓
• b.The patient's age only
• c.The room temperature
• d.The patient's insurance status

Anything given by mouth requires the patient to be able to swallow and protect the airway to prevent choking or aspiration. An unresponsive patient should not receive oral medications.

A tonic-clonic (grand mal) seizure is actively occurring. The EMT's priority is to:

• a.Restrain the limbs firmly
• b.Protect the patient from injury and manage the airway, without forcing anything into the mouth✓
• c.Insert an oral airway during the convulsion
• d.Hold the patient still and place a spoon in the mouth

During an active seizure, protect the patient from injury and manage the airway, but do not restrain them or put objects in the mouth. After the seizure, place the patient in the recovery position and give oxygen as needed.

Activated charcoal may be indicated (per protocol/medical direction) for:

• a.A caustic acid ingestion
• b.A petroleum product ingestion
• c.Certain oral poisonings in an alert patient who can protect the airway✓
• d.An unresponsive patient

Activated charcoal can bind some ingested poisons in an alert patient able to protect the airway, when directed by protocol or medical control. It is not used for caustics, hydrocarbons, or patients with decreased consciousness.

A postictal patient (after a seizure) is typically:

• a.Fully alert immediately with no confusion
• b.Combative and requiring restraint by default
• c.Ready to walk and refuse care
• d.Confused, drowsy, and gradually improving✓

The postictal phase after a seizure involves confusion, drowsiness, and gradual recovery of orientation. Support the airway, provide reassurance, and monitor as the patient recovers.

Time of symptom onset is especially critical to determine and report in patients with suspected:

• a.Stroke✓
• b.A minor sprain
• c.A common cold
• d.Motion sickness

Knowing when stroke symptoms began determines eligibility for time-sensitive treatments like clot-dissolving therapy. EMTs should establish and clearly report the last-known-well time.

The mnemonic SAMPLE is used to gather a patient's:

• a.Vital signs
• b.History (Signs/symptoms, Allergies, Medications, Past history, Last intake, Events)✓
• c.Burn percentage
• d.Airway status

SAMPLE stands for Signs and symptoms, Allergies, Medications, Pertinent past history, Last oral intake, and Events leading up. It provides a structured medical history for the patient.

The OPQRST mnemonic is primarily used to assess:

• a.A patient's allergies
• b.Blood glucose
• c.The characteristics of pain or a chief complaint✓
• d.Airway patency

OPQRST (Onset, Provocation, Quality, Region/Radiation, Severity, Time) explores the nature of pain or a chief complaint. It helps characterize symptoms like chest or abdominal pain.

A woman in her third trimester complains of dizziness when lying flat on her back. The best position is:

• a.Prone
• b.Trendelenburg
• c.Fully upright and walking
• d.Left lateral recumbent (tilted onto her left side)✓

Late in pregnancy the uterus can compress the vena cava when supine, reducing blood return and causing hypotension. Placing the patient on her left side relieves this pressure and improves circulation.

During normal childbirth, once the infant's head delivers, the EMT should:

• a.Support the head and check whether the cord is around the neck✓
• b.Pull firmly on the head to speed delivery
• c.Push the head back to delay birth
• d.Place the mother prone

As the head delivers, support it gently and check for a nuchal cord (umbilical cord around the neck). Never pull on the infant; allow the body to deliver with the contractions.

The first priority for a newborn immediately after delivery is to:

• a.Cut the cord immediately
• b.Dry, warm, position, and stimulate the newborn, keeping the airway clear✓
• c.Give oral glucose
• d.Place the infant in cold air to stimulate crying

A newborn is dried, kept warm, positioned, and stimulated, with the airway cleared as needed. Preventing heat loss and ensuring breathing are the immediate priorities.

A patient exhibiting a behavioral emergency who is a potential danger requires the EMT to prioritize:

• a.Immediately restraining every such patient
• b.Ignoring the behavior
• c.Scene safety and their own and the patient's safety, requesting help as needed✓
• d.Leaving the patient alone

Behavioral emergencies require attention to scene safety first, protecting the crew and patient and summoning law enforcement or additional resources if needed. Approach calmly and avoid escalation.

Fruity (acetone) breath odor, deep rapid breathing, and excessive thirst in a diabetic suggest:

• a.Hypoglycemia (low sugar)
• b.An allergic reaction
• c.A stroke
• d.Hyperglycemia / diabetic ketoacidosis (high sugar)✓

Fruity breath, deep rapid (Kussmaul) breathing, and thirst point to high blood sugar and diabetic ketoacidosis. This develops gradually and requires oxygen support and transport.

Which set represents normal adult vital sign ranges?

• a.Pulse 60 to 100, respirations 12 to 20, systolic BP roughly 90 to 140✓
• b.Pulse 40 to 60, respirations 4 to 8
• c.Pulse 120 to 160, respirations 30 to 40
• d.Pulse 20 to 40, respirations 40 to 50

A typical resting adult has a pulse of 60 to 100, respirations of 12 to 20, and a systolic blood pressure roughly in the 90 to 140 range. Values well outside these suggest a problem requiring assessment.

A patient who responds only when you pinch their shoulder but does not respond to your voice is classified on the AVPU scale as:

• a.Alert
• b.Responsive to Painful stimulus✓
• c.Responsive to Verbal stimulus
• d.Unresponsive

AVPU stands for Alert, Verbal, Painful, Unresponsive. A patient who reacts only to a painful stimulus is scored as 'P' (Painful).

Cool, clammy skin in a diabetic patient with a rapid onset of altered mental status most often indicates:

• a.High blood sugar
• b.Normal condition
• c.Low blood sugar (hypoglycemia)✓
• d.Dehydration only

Hypoglycemia commonly causes cool, clammy, sweaty skin with rapid onset of altered mental status. If the patient can swallow, oral glucose is indicated.

A patient with difficulty breathing and a history of asthma is prescribed a metered-dose inhaler. The EMT may:

• a.Give the patient someone else's inhaler
• b.Give oral glucose instead
• c.Refuse to help because it is a medication
• d.Assist the patient in using their own prescribed inhaler per protocol✓

EMTs may help a patient self-administer their own prescribed inhaler for respiratory distress, following local protocol and medical direction. Confirm the medication, dose, and expiration and that it is prescribed to that patient.

Severe lower abdominal or shoulder pain, dizziness, and signs of shock in a woman of childbearing age with a missed period may indicate:

• a.A possible ectopic pregnancy with internal bleeding✓
• b.A simple headache
• c.Motion sickness
• d.A minor muscle strain

A ruptured ectopic pregnancy can cause internal bleeding, abdominal or shoulder pain, and shock. This is a life-threatening emergency requiring oxygen, shock care, and rapid transport.

The primary treatment an EMT provides for most poisonings by inhalation is to:

• a.Give oral glucose
• b.Move the patient to fresh air and provide oxygen once the scene is safe✓
• c.Induce vomiting
• d.Give aspirin

For inhaled poisons, first ensure scene safety, then remove the patient to fresh air and give high-concentration oxygen. Ensuring rescuer safety prevents additional victims.

A patient with a possible opioid overdose has slow, shallow breathing. The EMT's first priority is to:

• a.Give oral glucose
• b.Give aspirin
• c.Support ventilation and oxygenation with a bag-valve mask✓
• d.Encourage the patient to walk it off

The immediate life threat in opioid overdose is respiratory depression, so support ventilation with a BVM and oxygen. Naloxone may be administered per protocol, but airway and breathing come first.

During delivery, if the umbilical cord presents first (prolapsed cord), the EMT should:

• a.Pull the cord out of the way
• b.Push the cord back inside
• c.Have the mother stand up
• d.Position the mother to relieve pressure (knees to chest or hips elevated), keep pressure off the cord, and transport rapidly✓

A prolapsed cord can cut off the baby's oxygen supply, so relieve pressure by positioning the mother hips-up and gently keeping the presenting part off the cord. This is a true emergency requiring immediate transport.

A patient reporting a sudden severe headache, described as the worst of their life, with vomiting should be evaluated for:

• a.A possible stroke or brain bleed✓
• b.A simple tension headache to ignore
• c.Low blood sugar only
• d.Motion sickness

A sudden severe headache, often called the worst of one's life, can indicate bleeding in the brain and is a possible stroke. This requires oxygen support, monitoring, and rapid transport.

Hives, itching, swelling of the face and tongue, and wheezing after a bee sting indicate:

• a.A minor local reaction
• b.A systemic allergic reaction possibly progressing to anaphylaxis✓
• c.A stroke
• d.Hypoglycemia

Widespread hives, facial and airway swelling, and wheezing indicate a systemic allergic reaction that may become anaphylaxis. Prepare to assist with epinephrine and support the airway and breathing.

A patient having a seizure that does not stop, or repeated seizures without regaining consciousness, is called:

• a.A simple partial seizure
• b.A postictal state
• c.Status epilepticus, a life-threatening emergency✓
• d.A febrile seizure only

Status epilepticus is a prolonged or repeated seizure without recovery of consciousness and is life-threatening. It requires airway support, oxygen, and rapid transport for definitive treatment.

Nitroglycerin assists a cardiac patient primarily by:

• a.Raising the heart rate
• b.Thickening the blood
• c.Constricting blood vessels
• d.Dilating blood vessels to reduce the heart's workload✓

Nitroglycerin dilates blood vessels, reducing the workload on the heart and improving blood flow to the heart muscle. Because it lowers blood pressure, adequate pressure must be confirmed before assisting.

In the START triage system, a patient who is not breathing but begins breathing after you open the airway is tagged:

• a.Immediate (red)✓
• b.Delayed (yellow)
• c.Minor/walking wounded (green)
• d.Deceased/expectant (black)

In START triage, a patient who only breathes after the airway is opened is classified Immediate (red). This indicates a critical patient needing the highest transport priority.

The very first priority when arriving at any emergency scene is:

• a.Reaching the patient as fast as possible
• b.Ensuring scene safety for yourself, the crew, and bystanders✓
• c.Obtaining a full medical history
• d.Applying oxygen

Scene safety comes before patient contact because an injured rescuer cannot help and may create more victims. Assess for hazards such as traffic, violence, fire, and toxins before approaching.

Which type of consent applies to treating an unresponsive patient who cannot agree to care?

• a.Informed consent
• b.Expressed consent
• c.Implied consent✓
• d.Involuntary consent

Implied consent assumes that a reasonable unresponsive person would want life-saving care. It allows EMTs to treat patients who cannot give expressed consent.

In the START triage system, the first step to sort a large group of patients is to:

• a.Check every pulse individually first
• b.Start CPR on all non-breathing patients
• c.Immobilize all patients
• d.Direct everyone who can walk to a designated area (identifying the walking wounded)✓

START begins by asking everyone who can walk to move to a designated area, quickly identifying minor (green) patients. Remaining patients are then assessed by respirations, perfusion, and mental status.

A competent adult refuses care after being informed of the risks. The EMT should:

• a.Respect the refusal, document it thoroughly, and encourage the patient to call back if needed✓
• b.Force treatment anyway
• c.Leave without any documentation
• d.Have the patient sign nothing and depart quietly

A competent, informed adult has the right to refuse care, and the refusal must be clearly documented after explaining the risks. Encourage the patient to seek help if symptoms worsen and involve medical direction as appropriate.

Which patient should be moved with an emergency move (before full assessment)?

• a.Any patient to save time
• b.A patient in immediate danger from fire, explosion, or an unsafe scene✓
• c.A stable patient with a sprained ankle
• d.Every trauma patient

An emergency move is used when there is an immediate threat to life, such as fire or hazardous materials, even if it means less spinal protection. Otherwise, non-urgent moves preserve stabilization.

When lifting a heavy patient or stretcher, proper body mechanics include:

• a.Bending at the waist and lifting with the back
• b.Twisting while lifting to save steps
• c.Keeping the back straight, lifting with the legs, and keeping the load close to the body✓
• d.Lifting quickly with the arms fully extended

Safe lifting uses the leg muscles with a straight back and the load held close to the body, avoiding twisting. This reduces the risk of back injury to the EMT.

The purpose of providing a radio report to the receiving hospital is to:

• a.Fill required air time
• b.Replace written documentation
• c.Ask the hospital to complete your assessment
• d.Alert staff and allow them to prepare for the incoming patient✓

A concise radio (MedComm) report gives the hospital key information so they can prepare appropriate staff and resources. It typically includes age, chief complaint, vital signs, treatment, and ETA.

Standard precautions (body substance isolation) mean an EMT should:

• a.Assume all blood and body fluids are potentially infectious and use appropriate PPE✓
• b.Wear gloves only for known infections
• c.Skip protection when the patient looks healthy
• d.Use PPE only during CPR

Standard precautions treat every patient's blood and body fluids as potentially infectious. Appropriate PPE such as gloves and eye protection is used on all patient contacts.

Positioning an ambulance at a highway crash to shield the work area from traffic is an example of:

• a.Triage
• b.Scene safety and hazard protection✓
• c.Patient assessment
• d.Documentation

Positioning the apparatus to block traffic protects the crew and patients from being struck, which is part of scene safety. Traffic is a major hazard at roadway incidents.

In a mass-casualty incident (MCI), the goal of triage is to:

• a.Give the most care to the first patient found
• b.Transport patients in the order they are discovered
• c.Do the greatest good for the greatest number of patients✓
• d.Treat only the most severely injured, regardless of survivability

MCI triage aims to do the greatest good for the greatest number by prioritizing patients most likely to benefit from limited resources. This differs from routine care that focuses fully on one patient.

Which is an example of expressed consent?

• a.Treating an unconscious patient
• b.Assuming a minor agrees
• c.Treating without asking in an emergency
• d.A conscious, competent adult verbally agreeing to be treated✓

Expressed consent occurs when a competent, informed patient specifically agrees to care, verbally or otherwise. The patient must understand the nature of the treatment and its risks.

Abandonment occurs when an EMT:

• a.Stops care of a patient without ensuring an equal or higher level of care takes over✓
• b.Transfers a patient to a paramedic
• c.Documents a refusal properly
• d.Calls medical control for orders

Abandonment is terminating care without handing the patient to a provider of equal or higher training. Proper transfer of care and documentation prevent abandonment claims.

During START triage, a patient with a respiratory rate over 30 per minute is tagged:

• a.Minor/green
• b.Immediate (red)✓
• c.Delayed (yellow)
• d.Deceased (black)

In START, a respiratory rate above 30 indicates a critical patient tagged Immediate (red). Respirations, perfusion, and mental status are the three assessments used to categorize patients.