CSLB General Building (B) — All Questions

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.