NREMT EMT — All Questions

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

• a.Walking the patient to keep the circulation moving
• b.Supine to maintain perfusion, keeping the patient warm✓
• c.Face down, to protect the airway from vomiting
• d.Sitting fully upright to make breathing easier

A patient in shock is generally kept supine to support perfusion of the vital organs, along with oxygen and steps to prevent heat loss, since losing heat makes shock worse. Walking a hypotensive patient can cause collapse, sitting fully upright reduces blood return to the brain, and lying face down makes assessment and airway management harder.

Under a typical EMS protocol, a patient with a suspected closed femur fracture should have the limb:

• a.Left unsplinted so the patient can hold the leg in whatever position hurts least
• b.Elevated above the level of the heart on pillows to limit swelling and bleeding
• c.Gently massaged and straightened by hand before the patient is moved to the cot
• d.Immobilized, ideally with a traction or rigid splint, checking distal pulse, motor, and sensation✓

A femur fracture is stabilized with a splint to limit pain, bleeding, and further injury, and distal pulse, motor function, and sensation are checked before and after splinting. A femur can bleed heavily into the thigh, so leaving the limb unsupported, elevating it on pillows, or manipulating it by hand increases both pain and blood loss.

Which finding suggests a serious chest injury requiring rapid transport?

• a.Mild chest soreness with clear, equal breath sounds
• b.Pink, warm skin with an unlabored, regular breathing pattern
• c.Severe difficulty breathing with unequal chest rise after chest trauma✓
• d.A small superficial scratch over the ribs with no tenderness

Severe difficulty breathing with unequal chest rise after chest trauma suggests a serious injury such as a collapsed lung and calls for oxygen and rapid transport. Mild soreness with clear and equal breath sounds, normal skin with easy breathing, or a superficial scratch do not carry that level of urgency.

Under a typical EMS protocol, an open chest wound (sucking chest wound) should be treated by an EMT with:

• a.Gauze packed deep into the wound and held with pressure
• b.An occlusive dressing, monitoring for worsening breathing✓
• c.A tight circumferential wrap around the whole chest
• d.Oxygen alone, leaving the wound open to the air

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. Packing gauze into a chest wound pushes material toward the lung and does not seal it, and a tight wrap around the chest limits the movement the patient needs to breathe. Leaving the wound open lets air continue to be drawn into the pleural space with every breath.

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

• a.Stay on scene until the blood pressure comes back up on its own
• b.Raise the blood pressure by having the patient drink fluids on scene
• c.Maintain oxygenation and perfusion and prevent heat loss during rapid transport✓
• d.Give small sips of water and something to eat to keep strength up

Field management of shock focuses on oxygenation and perfusion, controlling bleeding, preventing heat loss, and moving quickly to definitive care, because an EMT cannot reverse shock in the field. Waiting on scene for the blood pressure to improve wastes that time, and nothing is given by mouth to a patient who may vomit or who may need surgery.

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

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

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.The patient asks for it to be taken off, no matter how well it fits
• b.Never, because taking a helmet off will always worsen a spinal injury
• c.It interferes with airway management or assessment, or does not hold the head snugly✓
• d.Only after arrival at the hospital, where the staff can take it off

A helmet is removed when it blocks airway management or assessment, or when it does not hold the head snugly enough to help immobilize it. A well-fitting helmet that holds the head steady may be left in place with the head stabilized, so removal is neither automatic on request nor something that must wait for the hospital.

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

• a.The blood pressure alone, watching for a rising reading
• b.Pupil size and reaction only, without tracking mental status
• c.Skin temperature and color alone, with no neurologic check
• d.Level of responsiveness (AVPU/GCS), pupils, and any change over time✓

Head injury severity is judged from level of responsiveness, pupil size and reaction, and how those findings trend over time, since a declining mental status is the critical warning sign of a worsening brain injury. Blood pressure, pupils, or skin findings taken by themselves miss that trend.

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

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

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 Cincinnati Prehospital Stroke Scale (facial droop, arm drift, speech)✓
• b.The Glasgow Coma Scale, scoring eye, verbal, and motor response
• c.The rule of nines, which divides the body into percentages
• d.OPQRST alone, the mnemonic used to characterize pain

The Cincinnati Prehospital Stroke Scale checks for facial droop, arm drift, and abnormal speech, and any one abnormal finding suggests a possible stroke and the need for rapid transport. The Glasgow Coma Scale grades overall level of consciousness rather than screening for stroke, the rule of nines estimates burn area, and OPQRST is a way to describe pain.

Where the EMT's scope permits, for a patient having a severe allergic reaction (anaphylaxis) with prescribed medication available, the EMT may assist with:

• a.A tube of oral glucose
• b.Activated charcoal by mouth
• c.Chewable aspirin tablets
• d.An epinephrine auto-injector✓

Anaphylaxis is treated with epinephrine, and an EMT may assist a patient with their own prescribed auto-injector where protocol allows. Epinephrine reverses the airway swelling and low blood pressure caused by the reaction. Oral glucose treats low blood sugar, activated charcoal is used for some ingested poisons, and aspirin is used for suspected cardiac chest pain.

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

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

The epinephrine auto-injector is delivered into the outer thigh muscle, which can be done through clothing and allows rapid absorption. The upper arm, the buttock, and the abdomen are not injection sites for an auto-injector.

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

• a.The patient can swallow and protect their airway✓
• b.Whether the patient has eaten recently
• c.The patient's systolic blood pressure is normal
• d.The patient has taken the medication before

Anything given by mouth requires the patient to be able to swallow and protect the airway, so an unresponsive or severely altered patient should not receive oral medications or glucose. Recent food intake is worth recording in the history but does not by itself bar an oral medication, a normal blood pressure is a check tied to drugs such as nitroglycerin rather than a general requirement for anything oral, and having taken the medication before says nothing about whether the patient can swallow it now.

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

• a.Hold the patient still and place a padded object between the teeth to protect the tongue
• b.Restrain the arms and legs firmly to stop the convulsive movements
• c.Insert an oropharyngeal airway during the convulsion to keep the airway open
• d.Protect the patient from injury and manage the airway, without forcing anything into the mouth✓

During an active tonic-clonic seizure, protect the patient from injury and manage the airway, but do not restrain the limbs and do not force anything between the teeth. Objects placed in the mouth risk broken teeth, airway obstruction and bitten fingers, forcible restraint can cause fractures and dislocations, and an oral airway cannot be placed safely against clenched jaws. 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.Certain oral poisonings in an alert patient who can protect the airway✓
• b.Ingestion of a petroleum distillate such as gasoline or kerosene
• c.Ingestion of a strong acid or alkali such as drain cleaner
• d.Any unresponsive poisoning patient, to bind the drug early

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 withheld after petroleum distillates because vomiting and aspiration injure the lungs worse than the swallowed product, after strong acids and alkalis because it does not bind them and it obscures the view for later endoscopy, and in patients with a decreased level of consciousness because they cannot protect the airway.

A postictal patient (after a seizure) is typically:

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

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

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.The percentage of body surface burned, using the rule of nines
• b.History (Signs/symptoms, Allergies, Medications, Past history, Last intake, Events)✓
• c.The level of responsiveness, using Alert, Verbal, Painful, Unresponsive
• d.The character of the pain: onset, quality, region, severity and time

SAMPLE stands for Signs and symptoms, Allergies, Medications, Pertinent past history, Last oral intake, and Events leading up to the call, giving a structured medical history. Burned body surface is estimated with the rule of nines, level of responsiveness is graded with AVPU, and the character of pain is drawn out with OPQRST.

The OPQRST mnemonic is primarily used to assess:

• a.The characteristics of pain or a chief complaint✓
• b.The patient's past medical history and allergies
• c.The adequacy of the airway and breathing
• d.The extent of burns on the body surface

OPQRST (Onset, Provocation, Quality, Region and radiation, Severity, Time) explores the nature of pain or a chief complaint and helps characterize symptoms such as chest or abdominal pain. Past history and allergies come from SAMPLE, airway and breathing are judged in the primary assessment, and burn extent is estimated with the rule of nines.

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

• a.Left lateral recumbent (tilted onto her left side)✓
• b.Sitting fully upright with the legs dependent
• c.Supine with the legs elevated (Trendelenburg)
• d.Right lateral recumbent, onto her right side

Late in pregnancy the uterus can compress the inferior vena cava when the mother lies supine, cutting venous return and causing dizziness and hypotension. Because the vena cava lies to the right of the spine, tilting her onto the left side lifts the uterus off it. Turning onto the right side does far less, sitting upright does not address caval compression, and raising the legs while she stays flat leaves the uterus resting on the vessel.

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

• a.Apply firm traction to the head to speed the delivery
• b.Clamp and cut the cord before the shoulders deliver
• c.Hold the head back until the ambulance reaches a hospital
• d.Support the head and check whether the cord is around the neck✓

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. Pulling on the head can injure the infant's neck and brachial plexus, and cutting the cord before the body is out removes the infant's only source of oxygen while the chest is still compressed. Holding the head back to reach a hospital does not stop labor and risks injury to both mother and infant.

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

• a.Clamp and cut the umbilical cord before doing anything else
• b.Suction the mouth and nose deeply before drying and warming
• c.Dry, warm, position, and stimulate the newborn, keeping the airway clear✓
• d.Check a blood glucose and give oral glucose if it is low

A newborn is dried, kept warm, positioned, and stimulated, with the airway cleared as needed, because preventing heat loss and getting the infant breathing are the immediate priorities. Cord clamping can wait until the infant is breathing and warm, deep suctioning is not routine and can provoke bradycardia, and glucose is not part of immediate newborn care in the field.

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

• a.Applying physical restraints to every such patient on arrival
• b.Leaving the patient alone in a quiet room until they calm down
• c.Completing a full head-to-toe physical exam before anything else
• d.Scene safety and their own and the patient's safety, requesting help as needed✓

Behavioral emergencies require attention to scene safety first, protecting the crew and the patient and summoning law enforcement or extra resources as needed. Restraint is a last resort for a patient who is a danger, applied only within local policy, leaving a potentially dangerous patient unattended abandons them and risks harm to them or to others, and a detailed physical exam is not possible until the situation is controlled.

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

• a.A stroke causing an irregular breathing pattern
• b.Hyperglycemia / diabetic ketoacidosis (high sugar)✓
• c.Hypoglycemia from a missed meal after insulin
• d.An allergic reaction with airway involvement

Fruity breath, deep rapid (Kussmaul) breathing, and thirst point to high blood sugar and diabetic ketoacidosis, which develops gradually and requires oxygen support and transport. Low blood sugar instead comes on quickly with pale, sweaty skin and no fruity odor, a stroke produces focal deficits such as one-sided weakness or speech loss rather than thirst, and an allergic reaction brings hives, swelling and wheezing.

Which set represents normal adult vital sign ranges?

• a.Pulse 40 to 60, respirations 4 to 8, systolic BP about 60 to 80
• b.Pulse 20 to 40, respirations 40 to 50, systolic BP about 40 to 60
• c.Pulse 60 to 100, respirations 12 to 20, systolic BP roughly 90 to 140✓
• d.Pulse 120 to 160, respirations 30 to 40, systolic BP about 70 to 90

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. The fast pulse and fast respiratory rate in one of the other sets are closer to what is expected in an infant than in an adult, and the remaining sets pair a slow pulse and slow breathing with a systolic pressure low enough to signal shock.

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 and following commands
• b.Responsive to Painful stimulus✓
• c.Responsive to Verbal stimulus
• d.Unresponsive to all stimuli

AVPU stands for Alert, Verbal, Painful, Unresponsive. A patient who reacts only to a painful stimulus is scored as 'P' (Painful). An alert patient is awake and interacting before you touch them, and a verbal patient reacts when spoken to, which this patient did not. Unresponsive is reserved for a patient who does not react to a painful stimulus at all, so any reaction to the pinch rules it out.

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

• a.Dehydration from vomiting
• b.Slowly rising blood sugar
• c.A brief fainting episode
• d.Low blood sugar (hypoglycemia)✓

Hypoglycemia commonly causes cool, clammy, sweaty skin with rapid onset of altered mental status. If the patient can swallow, oral glucose is indicated. A rising blood sugar builds over hours to days and usually presents with warm, dry skin and thirst rather than this sudden picture. Dehydration and a simple faint do not explain mental status that stays altered, and treating either one first delays the sugar this patient needs.

A patient with difficulty breathing and a history of asthma is prescribed a metered-dose inhaler. Under a typical EMS protocol with medical direction, the EMT may:

• a.Give the patient a family member's inhaler if it is the same drug
• b.Withhold all help because giving medication is outside the EMT role
• c.Assist the patient in using their own prescribed inhaler per protocol✓
• d.Give oral glucose, which relaxes the airway during an attack

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. An inhaler prescribed to someone else is not that patient's medication, whatever the label says, and refusing to help at all misreads the assisting role that protocols grant. Oral glucose treats low blood sugar and has no effect on bronchospasm.

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 muscle strain from lifting, with referred pain
• b.A urinary tract infection with bladder pain
• c.A possible ectopic pregnancy with internal bleeding✓
• d.Ovulation pain in the middle of the cycle

A ruptured ectopic pregnancy bleeds internally and produces lower abdominal pain, shoulder pain from blood irritating the diaphragm, and shock, so it needs oxygen, shock care, and rapid transport. A muscle strain and ovulation pain do not cause shock, ovulation pain is also ruled out by the missed period, and a urinary tract infection typically brings burning on urination and fever rather than hypotension.

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

• a.Enter immediately and begin ventilating the patient in place
• b.Move the patient to fresh air and provide oxygen once the scene is safe✓
• c.Administer activated charcoal to bind the inhaled toxin
• d.Induce vomiting to clear the poison from the stomach

For inhaled poisons, first ensure scene safety, then remove the patient to fresh air and give high-concentration oxygen. Entering a contaminated atmosphere without the right protection and training simply produces a second patient. Activated charcoal binds some swallowed poisons and does nothing about a gas already in the lungs, and inducing vomiting is no longer used for poisoning by any route.

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

• a.Check a blood glucose level before doing anything else
• b.Walk the patient around to keep them awake
• c.Support ventilation and oxygenation with a bag-valve mask✓
• d.Give oral glucose between the cheek and gum

The immediate life threat in opioid overdose is respiratory depression, so support ventilation with a bag-valve mask and oxygen first. Naloxone may follow where protocol allows, but airway and breathing come first. Walking a patient does not restore respiratory drive, anything placed in the mouth risks aspiration in a patient who cannot protect the airway, and a glucose reading, while worth obtaining, does not treat hypoventilation.

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

• a.Position the mother to relieve pressure (knees to chest or hips elevated), keep pressure off the cord, and transport rapidly✓
• b.Have the mother stand and walk to the ambulance so that gravity moves the baby down and delivery progresses
• c.Gently pull on the cord to move it aside, then deliver the baby normally on the scene and clamp the cord
• d.Push the cord back into the birth canal, hold it in place, and wait for the head to deliver on its own

A prolapsed cord is squeezed between the presenting part and the pelvis and cuts off the baby's oxygen supply, so relieve the pressure by positioning the mother hips-up or knees-to-chest, gently keep the presenting part off the cord, and transport immediately. Standing and walking increases the pressure on the cord, pulling on the cord can tear it or shear the placenta, and pushing it back inside does not relieve the compression while the delay costs the baby oxygen.

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

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

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 systemic allergic reaction possibly progressing to anaphylaxis✓
• b.Hypoglycemia brought on by the stress of being stung
• c.An asthma attack triggered by exertion in the heat
• d.A local reaction confined to the area of the sting

Hives away from the sting site, facial and airway swelling, and wheezing are signs of a body-wide response, which marks a systemic allergic reaction that may become anaphylaxis. Prepare to assist with epinephrine and support the airway and breathing. A local reaction stays confined to the sting site, asthma alone does not cause hives or facial swelling, and low blood sugar produces altered mental status and sweating rather than hives.

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

• a.A febrile seizure caused by a high temperature
• b.A postictal state following a single seizure
• c.A simple partial seizure with awareness intact
• d.Status epilepticus, a life-threatening emergency✓

Status epilepticus is a prolonged seizure, or repeated seizures without recovery of consciousness in between, and is life-threatening because of the hypoxia it produces. It requires airway support, oxygen, and rapid transport for definitive treatment. A postictal state is the recovery period after a seizure has already stopped, a febrile seizure is a brief seizure in a young child with a fever, and a simple partial seizure involves one part of the body with awareness intact.

Nitroglycerin assists a cardiac patient primarily by:

• a.Dilating blood vessels to reduce the heart's workload✓
• b.Constricting blood vessels to raise blood pressure
• c.Dissolving a clot already in a coronary artery
• d.Slowing the heart rate to reduce oxygen demand

Nitroglycerin dilates blood vessels, reducing the workload on the heart and improving blood flow to the heart muscle. Because that same dilation lowers blood pressure, adequate pressure must be confirmed before assisting. It does not constrict vessels, it does not dissolve a clot that has already formed (that is the work of hospital fibrinolytics or catheter treatment), and it does not slow the heart rate.

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.Minor/walking wounded (green)
• c.Deceased/expectant (black)
• d.Delayed (yellow)

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.Obtaining a full SAMPLE history from the patient
• b.Ensuring scene safety for yourself, the crew, and bystanders✓
• c.Reaching the patient's side as quickly as possible
• d.Applying high-concentration oxygen to every patient

Scene safety comes before patient contact because an injured rescuer cannot help and becomes another victim. Assess for hazards such as traffic, violence, fire, unstable structures and toxins before approaching. Taking a history, reaching the patient's side, and giving oxygen all matter, but each of them happens only after the scene has been judged safe to enter.

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

• a.Implied consent✓
• b.Involuntary consent
• c.Informed consent
• d.Expressed 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.Begin CPR on every patient who is found not breathing before moving on
• b.Direct everyone who can walk to a designated area (identifying the walking wounded)✓
• c.Check a radial pulse and capillary refill on each patient in turn
• d.Immobilize every patient on a long backboard before sorting them

START begins by asking everyone who can walk to move to a designated area, which quickly identifies the minor (green) patients and shrinks the number left to assess. The remaining patients are then sorted by respirations, perfusion, and mental status. CPR is not begun during START because it ties up rescuers still needed for sorting, checking every pulse one at a time is far too slow for a large group, and immobilization is treatment rather than sorting.

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.Treat and transport the patient anyway, because the risk of harm is too high
• c.Leave the scene without documenting the contact or the refusal at all
• d.Have a family member sign the refusal form in place of the patient

A competent, informed adult has the right to refuse care, and the refusal must be clearly documented after the risks have been explained. Encourage the patient to call back if symptoms worsen and involve medical direction as local policy requires. Treating a competent adult over their refusal is battery, leaving no record destroys the evidence that the risks were explained, and a relative's signature does not substitute for the decision of the patient who holds it.

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

• a.A stable patient with an isolated ankle injury who wants to leave
• b.A patient in immediate danger from fire, explosion, or an unsafe scene✓
• c.Any patient, whenever the crew is trying to save time on scene
• d.Every trauma patient, to move them clear of the vehicle quickly

An emergency move is used when there is an immediate threat to life, such as fire, explosion or hazardous materials, and it is accepted precisely because the danger of staying outweighs the reduced spinal protection during the drag. It is not chosen for stable patients, not chosen to save time, and not the routine method for trauma patients, who are better served by a non-urgent move that preserves stabilization.

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

• a.Keeping the back straight, lifting with the legs, and keeping the load close to the body✓
• b.Lifting quickly with the arms fully extended and the load held away from you
• c.Twisting at the waist while lifting so you can move in one motion
• d.Bending at the waist and lifting with the back muscles rather than the legs

Safe lifting uses the leg muscles with a straight back and the load held close to the body, avoiding twisting, which reduces the risk of back injury to the EMT. Holding the load away from the body multiplies the leverage acting on the spine, twisting under load loads the spine in the direction it tolerates worst, and bending at the waist shifts the work onto the back muscles instead of the legs.

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

• a.Serve as the legal record of the call for the run report
• b.Alert staff and allow them to prepare for the incoming patient✓
• c.Give the receiving staff the patient's full medical history
• d.Transfer responsibility for the patient before you arrive

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. The written patient care report, not the radio call, is the legal record, and a full history belongs in that report and in the bedside handoff rather than on the air. Responsibility for the patient stays with the crew until care is formally transferred to hospital staff.

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

• a.Wear personal protective equipment only during CPR and airway care
• b.Assume all blood and body fluids are potentially infectious and use appropriate PPE✓
• c.Base the level of protection on how sick the patient appears to be
• d.Wear gloves only for patients with a known infectious disease

Standard precautions treat every patient's blood and body fluids as potentially infectious, so appropriate PPE such as gloves and eye protection is used on all patient contacts. Reserving protection for CPR, for patients who look unwell, or for patients with a documented diagnosis all fail for the same reason: an infection is often unknown to the patient and to the crew at the time of contact.

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

• a.Ongoing patient reassessment
• b.Patient care documentation
• c.Multiple-casualty incident triage
• d.Scene safety and hazard protection✓

Positioning the apparatus to block the work area protects the crew and the patients from being struck, which is part of scene safety and hazard control. Traffic is a leading hazard at roadway incidents. Reassessment, documentation and triage are all patient-facing tasks that do nothing about oncoming vehicles.

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

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

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 adult who cannot answer questions
• b.A conscious, competent adult verbally agreeing to be treated✓
• c.Assuming a young child agrees without a parent present
• d.Starting care without asking during a true emergency

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. Treating an unconscious adult, or acting at once in a true emergency, relies on implied consent, where the law presumes a reasonable person would agree. A young child generally cannot give consent at all; consent is sought from a parent or guardian, and care that cannot wait proceeds under implied consent.

Abandonment occurs when an EMT:

• a.Stops care of a patient without ensuring an equal or higher level of care takes over✓
• b.Documents a competent adult's informed refusal and then clears the scene
• c.Transfers care of the patient to a paramedic at the hospital door
• d.Contacts medical control for orders before giving a medication

Abandonment is terminating care without handing the patient to a provider of equal or higher training, or without an appropriate release, so proper transfer of care and documentation prevent abandonment claims. Documenting a competent adult's informed refusal ends the encounter lawfully, handing over to a paramedic or to hospital staff is a transfer to an equal or higher level of care, and contacting medical control is consultation, not termination.

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

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