1: Which of the following is NOT a sign of internal bleeding?

A: Vomiting bile
B: Bruising
C: Painful, swollen, or deformed extremities
D: A tender, rigid abdomen
Reason: Vomiting bile is usually not a sign of internal bleeding.
However, the most common signs are bruising, a tender, rigid
abdomen, and painful, swollen, or deformed extremities.

2: How many vertebrae are in the lumbar spine?

A: 2
B: 3
C: 5
D: 7
Reason: The lumbar spine has five vertebrae, the cervical spine
has seven, and the coccyx has three bones that are fused
together in adulthood.

3: You are called to the scene where a 6-year-old child has

fallen from the back of a pickup truck and is complaining of right
arm pain. There is an obvious deformity of the right arm. The arm
needs to be immobilized prior to transport. You should:
A: have a parent distract the child, and quickly splint
his or her arm.
B: tell the child the treatment you perform will not hurt
him or her.
C: not splint the arm if it is going to hurt the child at all.
D: be honest, telling the child it might hurt when you
splint the arm, but he or she can be honest about his/her
fear, concerns, and pain.
Reason: Always be honest. Help patients understand the
reasons behind your actions, regardless of the age of the patient.
If you lie, the patient will likely not believe anything else you say.
Responses to pain such as crying or yelling are normal, and you
should not withhold necessary treatment because it will cause
discomfort.

4: Which of the following is true of a patient with a brain injury?

A: Decreased blood pressure, increased pulse
B: Decreased blood pressure, decreased pulse
C: Increased blood pressure, increased pulse
D: Increased blood pressure, decreased pulse
Reason: A patient with a brain injury most often has increased
blood pressure and a decreased pulse.
5: If you are splinting a severely deformed extremity, or distal
circulation is compromised or absent, you should:
A: align to anatomic position using gentle traction.
B: push protruding bones back into place.
C: immobilize in the position you found it in.
D: not immobilize at all and transport immediately.
Reason: The best thing to do if the extremity is severely
deformed or distal circulation is compromised is to gently align to
anatomic position. NEVER try to push protruding bones back into
place. Not immobilizing the extremity at all is not a good idea
because it can be bumped or moved while en route to the
hospital.

6: A patient is not sure he wants to be treated. After you explain

the possible consequences of refusing treatment, the patient
agrees to be treated and transported. When you arrive at the
hospital, the emergency department is very busy, and no one
can locate someone to take over care of your patient. The
department clerk says you can leave the patient by the trauma
room and she will make sure the next available nurse takes over
care of your patient. This option:
A: is acceptable because the patient has been safely
delivered to the emergency department.
B: is acceptable only if the patient is in critical
condition.
C: is acceptable because the department clerk is a
hospital employee and has basic medical knowledge.
D: is not acceptable because it would be considered
abandonment.
Reason: Although the patient is in the emergency department, if
you do not turn the patient over to someone with equal or more
medical training than yourself (such as the department clerk),
you have committed abandonment. You must turn over care to
an equally qualified or more qualified health professional than
yourself.

7: When treating an open abdominal injury with evisceration,

you should:
A: gently push the protruding organ back into the
abdomen and cover with an occlusive dressing.
B: gently push the protruding organ back into the
abdomen and cover with a bulky dressing.
C: not push the organ back into place, but cover with
an occlusive dressing.
 D: not push the organ back into place, but cover with a
moist, bulky dressing.
Reason: NEVER try to replace the organ into the abdominal
cavity. Leave it as is, and cover it with a moist, sterile, bulky
dressing, and transport immediately.

8: What layer(s) does a partial-thickness burn involve?

A: Epidermis
B: Epidermis and dermis
C: Epidermis, dermis, and subcutaneous layers
D: Epidermis, dermis, subcutaneous layers, and
muscle
Reason: A partial-thickness burn (second-degree burn) involves
the epidermis and dermis. A full-thickness burn (third degree)
would involve the epidermis, dermis, subcutaneous layers, and
possibly the underlying muscle.

9: You are dispatched to a nursing home for a 78-year-old man

who was found not breathing, with no pulse. CPR has not been
started. The nurse on scene says the patient is a "no code"
because she knows for sure he has a DNR. However, the papers
have not been found. Without these papers, your best option for
action would be to:
A: begin CPR.
B: transport the patient without treatment.
C: allow the staff as much time as they need to find the
DNR.
D: call the coroner.
Reason: If an advance directive is not at-hand, cannot be found,
or looks suspicious or incomplete, the best decision is to begin
care until medical direction can be contacted for other
instructions. Rely on local protocols regarding advance
directives.

10: The FIRST thing an EMT-B should do when arriving at the

scene of a vehicle collision is:
A: check to see whether the vehicles involved have
deployed air bags.
B: determine whether there is patient entrapment and
how you will extricate.
C: determine whether patients are low or high priority.
D: evaluate hazards and calculate the need for
additional support.
Reason: The first thing the EMT-B should do when arriving on
the scene of a vehicle collision would be to evaluate the hazards
and calculate the need for additional support. After calling for
extra support if necessary, you would see if patients are low or
high priority, how you would extricate them, and determine
treatment options.

11: In what order should these phases of the rescue process

occur? 1. Stabilizing the vehicle 2. Gaining access 3. Sizing up
the situation 4. Untangling the patient
A: 3,1,2,4
B: 1,3,2,4
C: 4,2,1,3
D: 2,1,4,3
Reason: The correct order for the phases of the rescue process
are sizing up the situation, stabilizing the vehicle, gaining access
to the patient, and then untangling the patient.

12: You and your crew are called to the home of an older
woman who has fallen. She is complaining of severe wrist pain.
During the physical exam, you gently palpate the affected arm
and wrist. Which of the following correctly lists the order of the
bones in the arm from proximal to distal?
A: Humerus, radius and ulna, carpals, metacarpals,
phalanges
B: Femur, patella, tibia and fibula, tarsals, metatarsal,
phalanges
C: Phalanges, metacarpals, carpals, ulna and radius,
humerus
D: Frontal, parietal, temporal, occipital, sphenoid
Reason: Proximal to distal examining would mean starting at the
point closest to the body and moving out on a given extremity.
The humerus is the bone of the upper arm. The radius and ulna
make up the lower arm, or forearm. The carpals and metacarpals
make up the hand. The phalanges are the bones of the fingers.

13: If a patient goes into cardiac arrest during transport, the

driver should:
A: drive faster.
B: contact the hospital emergency department.
C: stop the ambulance and assist with CPR.
D: stop the ambulance, contact the hospital, and wait
for someone to tell you what to do.
Reason: The driver should stop the ambulance and assist in
CPR if needed. CPR may not be effectively performed in a
moving ambulance.

14: In the case of sudden infant death syndrome, the EMT-B

should always:
A: declare the infant dead.
B: transport the body without care.
C: make sure there is no evidence of child abuse.
D: attempt resuscitation and transport to the hospital.
Reason: In SIDS cases, the EMT-B should always attempt
resuscitation and transport, even if the infant is beyond
resuscitation. This extra step in compassion will greatly help the
family cope, knowing that someone tried to revive the infant.

15: You are called to the scene of a 76-year-old man in severe

respiratory distress. He has a medical history of emphysema and
is currently a three-pack-a-day cigarette smoker. He is distressed
and fatigued, and has a difficult time speaking with you. You can
see frothy sputum in his mouth. He is breathing approximately 30
breaths/min. In what order should you administer treatment?
A: Suction, insert nasopharyngeal airway, and give
supplemental oxygen via a nonrebreathing mask at 15
L/min
B: Suction, insert an oropharyngeal airway, and give
supplemental oxygen via a nasal cannula at 6 L/min
C: Immediately insert a nasopharyngeal airway and
give supplemental oxygen via a bag-valve-mask device
every 5 seconds
D: Suction, insert an oropharyngeal airway, and give
supplemental oxygen via a bag-valve-mask device every
3 seconds
Reason: The frothy sputum in the patient's mouth could be
inhaled, creating more problems. The first step would be to
suction. He is still conscious and responsive, so he would have a
gag reflex, making the oropharyngeal airway inappropriate. You
would use the nasopharyngeal airway. The patient has
tachypnea (fast breathing), but is still breathing on his own.
Therefore, he would need supplemental oxygen via a
nonrebreathing mask, and 15 L/min gives an oxygen
concentration of approximately 90%. A bag-valve-mask device
would not be necessary unless the patient wasn't breathing
adequately (for example, 8 breaths/min).

16: If you suspect a conscious toddler of being in respiratory

distress, you should do all of the following EXCEPT:
 A: open the airway.
B: administer high-concentration oxygen.
C: allow the child to sit up.
D: insert something into the child's mouth.
Reason: Opening the airway, administering oxygen, and
allowing the child to sit up are all necessary treatments of a
toddler in respiratory distress. NEVER insert anything into the
child's mouth. That action could set off spasms in the upper
airway that could completely obstruct the airway.

17: A common occurrence in a child with a very high or rapidly

rising temperature is:
A: vomiting.
B: unresponsiveness.
C: seizure.
D: dehydration.
Reason: A febrile seizure is a common occurrence in a child with
a very high fever. Vomiting can occur, but isn't a common
occurrence. Listlessness is common, but unresponsiveness
would indicate a serious problem. Dehydration would take some
time to set in.

18: Your crew is called to the home of a 78-year-old man

complaining of severe, nonradiating chest pain. His skin is cool
and clammy, and he is pale. His pulse is weak and irregular. You
are unable to obtain a blood pressure. He has nitroglycerin
tablets. After consulting medical direction, you are ordered to
assist the patient in taking his nitroglycerin tablets. What should
your main concern with administering nitroglycerin be in this
situation?
A: He may have taken Viagra and not been honest
about it with you.
B: His nitroglycerin may not be effective because he
has had them for several months.
C: You are unable to obtain a blood pressure, therefore
you cannot be sure it is adequate for administration of
nitroglycerin.
D: You are not sure he remembers whether he has
previously taken any of the nitroglycerin tablets.
Reason: A male patient needs to be discreetly asked if he is on
any medications for erectile dysfunction (Viagra, Cialis, or
Levitra). If you are honest about the risks of taking nitroglycerin in
addition to any of these medications, most patients will be honest
with you about whether or not they are taking them. His
nitroglycerin may not be effective after several months, but it will
not hurt him to take it, and still may offer some relief. However, if
you cannot obtain a blood pressure, you cannot rule out the
contraindication of a systolic blood pressure lower than 100 mm
Hg in order to give nitroglycerin.

19: At a scene where hazardous materials are present, the "safe

zone" should be located where?
A: Upwind and downhill
B: Downwind and at the same level
C: Downwind and downhill
D: Upwind and at the same level
Reason: The safe zone at a scene where there are hazardous
materials present would be upwind, but at the same level, rather
than uphill or downhill from the scene.

20: The type of consent based on the idea that an unconscious

patient would consent to life-saving treatment if he or she were
conscious is:
A: expressed consent.
B: implied consent.
C: informed consent.
D: indirect consent.
Reason: Implied consent is the idea that if a patient were
conscious he or she would agree to treatment. Expressed
consent is when a patient verbally gives permission to be treated.
Informed consent is permission for treatment given by a
competent patient. Indirect consent is not a form of consent.

21: You are called to the residence of a 34-year-old woman who

is "not acting right," according to her husband. She has a history
of diabetes. She is conscious, but has slurred speech and is not
making sense when answering questions. Medical direction
advises that you give the patient glucose in the cheek. However,
by the time you prepare the medication, the patient is
unconscious. What should you do?
A: Follow the advice of medical direction and
administer the oral glucose, then transport.
B: Consider calling ALS for some other way to
administer her medication.
C: Transport the patient immediately, and do not
administer any medication at all.
D: Transport the patient immediately, calling medical
control en route to ask for direction because the patient's
condition has changed.
Reason: If the patient's condition changes significantly, medical
direction should be contacted. In this situation, you were advised
to administer a medication orally to a conscious patient, but the
patient was unconscious before it could be administered, so
medical direction should be consulted before administering the
medication. However, because the patient's condition is
declining, she should be transported immediately, and medical
direction should be called en route.

22: Forcing a competent adult patient to receive care and/or go

to the hospital can result in ________ charges against the EMT-
B.
A: negligence
B: assault and battery
C: abandonment
D: kidnapping
Reason: It is considered assault and battery to treat a competent
patient who has refused treatment. The EMT-B could also be
charged with kidnapping if the patient is unwillingly transported.
Negligence is not treating a patient at all, or not treating the
patient appropriately. Abandonment is leaving the patient after
care has begun, without leaving them under the care of someone
equally or more qualified than the EMT-B.

23: When treating a critically injured patient with an organ donor

card, you should:
A: withhold any lifesaving measures that would
potentially damage the organs.
B: assume the patient has a DNR.
C: treat the patient as you would any other patient, but
inform the emergency physician that the patient is an
organ donor when you turn over care.
D: concentrate only on giving the patient oxygen to
make sure the organs stay perfused.
Reason: Organ donors should not be treated differently in any
way. Do your best to save the patient's life, and inform the
emergency department physician that the patient is an organ
donor in the event he or she does not survive.

24: Your ambulance responds to a call for a 23-year-old female

with extreme difficulty breathing. You are told by a family
member that she is allergic to peanuts, and she just finished a
meal at a local restaurant. She is pale, sitting in a tripod position,
and is beginning to panic. She has an EpiPen, but it is not with
her. A bystander happens to be allergic to bees, and is carrying
her EpiPen. What should you do?
A: Contact medical control for permission to administer
the bystander's EpiPen because it is a respiratory
emergency.
B: Call for ALS and try to meet them en route to the
hospital.
C: Give the patient oxygen via a nonrebreathing mask
at 15 L/min and transport.
D: Help the patient administer the bystander's EpiPen
in order to alleviate her respiratory distress, then
transport.
Reason: The rules for an EMT-B to help administer a patient's
medication is that it belong to the patient, that it have an
expiration date that has not passed, that it is one of the
medications EMT-Bs are allowed to help administer, and that the
EMT-B has permission from medical control to help administer
the medication. In this case, the patient did not have her own
medication with her, and the EMT-B is not permitted to help her
use someone else's prescription. Administering the patient
oxygen and transporting is not enough because the patient is
having an anaphylactic response. The EMT-B must also call for
ALS backup, because ALS personnel can administer epinephrine
and other medications before the patient arrives at the hospital.

25: The right atrium of the heart:

A: pumps blood to the body.
B: pumps blood to the lungs.
C: receives blood from the pulmonary veins.
D: receives blood from the venae cavae.
Reason: The right atrium of the heart receives blood from the
venae cavae.

26: In what order does oxygen travel from the environment to

the lungs?
A: Nose, bronchi, larynx, trachea, lung
B: Epiglottis, trachea, bronchi, alveoli
C: Mouth, pharynx, trachea, bronchi, alveoli
D: Larynx, esophagus, trachea, bronchi, alveoli
Reason: The order in which oxygen gets from the environment
into the lungs is the mouth, pharynx, trachea, bronchi, and
alveoli.

27: You are called to a scene in which a child has ingested a

cleaning product containing lye. You call poison control and are
advised to immediately transport the child. You also call medical
direction and are advised to administer activated charcoal en
route to the hospital. You know that lye is a caustic substance
and that administering activated charcoal is contraindicated.
What should you do?
A: Administer the charcoal anyway, following the
directions of medical control.
B: Argue with medical control, telling them that poison
control advised you to transport only.
C: Follow the advice of poison control only, and do not
inform medical control of your decision.
D: Repeat the orders of poison control to medical
control, and question the contraindication that you know
exists.
Reason: The EMT-B should always repeat back the orders of
medical control, and always question orders they are unsure of.
Questioning should not be done in an argumentative manner,
however.

28: The pressure on the walls of an artery when the left ventricle
contracts is:
A: diastolic.
B: systolic.
C: venous.
D: arterial.
Reason: Systolic blood pressure is the pressure on the walls of
an artery when the left ventricle contracts. Diastolic pressure is
the pressure remaining in the arteries when the left ventricle of
the heart relaxes and refills.

29: Inadequate breathing can be defined as:

A: breathing too fast.
B: breathing too slowly.
C: breathing too fast or too slowly.
D: breathing too deeply.
Reason: Inadequate breathing can be breathing too fast or too
slow, because neither provides the correct exchange of oxygen
and carbon dioxide that the body needs to keep adequate
perfusion.

30: Your crew responds to a call for a 33-year-old man

complaining of severe chest pain and difficulty breathing. When
you arrive, you find the patient sitting in a tripod position and
breathing 35 breaths/min. He is pale, and his skin is cool and
sweaty. He tells you the chest pain was sudden, and is sharp
and nonradiating. He also tells you he has no history or chest
pain or any other pertinent medical history. He did have a water
skiing accident 12 days ago. How would you appropriately treat
this patient?
A: Perform a detailed physical exam, give patient
oxygen via a nasal cannula at 4 L/min, and transport.
B: Give the patient oxygen via a nonrebreathing mask
at 15 L/min and rapidly transport.
C: Give the patient oxygen via a nasal cannula at 4
L/min and call medical control to ask if you should
administer nitroglycerin.
D: Tell patient to take two baby aspirin and call his
family physician.
Reason: You do not need to perform a detailed physical exam
because his pain is limited to his chest. Nitroglycerin is
inappropriate because he has no cardiac history and would not
have a nitroglycerin prescription of his own. Baby aspirin would
not work for the same reason. A nasal cannula at 4 L/min will not
help slow his breathing rate, and is not adequate. The correct
answer would be to give him oxygen via a nonrebreathing at 15
L/min and transport him immediately.

31: What is most likely the problem for the patient in question
30?
A: Pulmonary embolism
B: Impending heart attack
C: Angina
D: Indigestion
Reason: This patient is probably dealing with a pulmonary
embolism. The clues are that he has no cardiac or other pertinent
history of chest pain or cardiac problems, he had a skiing
accident 12 days ago that could have created a blood clot or
dislodged some other material that is causing the embolism. The
most common signs of pulmonary embolism are sudden onset of
sharp, stabbing chest pain and difficulty breathing, increased
respiratory and heart rate, and possible hypotension.

32: How should an oropharyngeal airway be inserted in an adult

patient?
A: Anatomically correct.
B: Upside down, then turned 180 degrees over the
tongue.
C: Into the left side of the mouth, and turned to hold the
tongue out of the airway.
 D: Into the right side of the mouth and turned to hold
the tongue out of the airway.
Reason: In an adult patient, the oropharyngeal airway in inserted
upside down, with the tip towards the roof of the mouth, and then
turned 180 degrees so that it is anatomically correct, holding the
tongue out of the airway. It would be inserted anatomically
correct in an infant.

33: If a choking patient refuses care and then becomes

unconscious, the EMT-B should:
A: treat the patient, because being unconscious means
implied consent.
B: ask family members for permission to treat the
patient.
C: call medical direction.
D: refuse to treat or transport the patient.
Reason: Once a patient is unconscious, implied consent is
assumed, and you may treat the patient. If you are unsure, it can
never hurt to call medical direction and ask advice.

34: If you are called to treat an unconscious child whose parents

are not present, you should:
A: assume expressed consent and treat the child.
B: assume implied consent and treat the child.
C: call medical direction for permission to treat the
child.
D: refuse to treat the child until you obtain permission
from a parent or guardian.
Reason: Implied consent is assumed for minors whose parent or
guardian is not present in a medical emergency. Expressed
consent is actual spoken consent to treat the child. If you refuse
to treat the child in a true medical emergency, you may face
charges.

35: What was founded in 1970 to establish professional

standards for EMS personnel?
A: US Department of Transportation
B: National Highway Traffic Safety Administration
C: American Medical Association
D: National Registry of Emergency Medical
Technicians
Reason: The National Registry of Emergency Medical
Technicians was founded in 1970 to establish professional
standards for EMS personnel.
36: Your crew is called to an office complex for a 51-year-old
female complaining of dizziness. When you arrive, the patient is
lying on the floor. She is breathing and conscious. Her co-
workers inform you that a few minutes ago she had fallen to the
floor and "shook violently" for about a minute and a half. After
establishing scene safety, how would you treat this patient?
A: Check airway, breathing and circulation, perform a
rapid physical exam, and transport.
B: Insert an oropharyngeal airway, provide oxygen via
a nonrebreathing mask at 15 L/min, and transport.
C: Perform a detailed physical exam, take care of any
life-threatening injuries, and transport.
D: Check airway, breathing, and circulation, insert an
oropharyngeal airway, provide oxygen via a bag-valve-
mask device at 15 L/min, and transport.
Reason: Immediately after scene size-up, the initial assessment
should be performed. This includes ABCs, assessment of
patient's mental status, and identification and treatment of any
life-threatening injuries. A nonrebreathing mask at 15 L/min
would be appropriate oxygen therapy, unless the patient is not
breathing adequately. An oropharyngeal airway can only be
inserted if patient remains unconscious.

37: A continuous self-review with the purpose of identifying and

correcting parts of the EMS system that need improvement is
called:
A: protocols.
B: standing orders.
C: CISM.
D: quality improvement.
Reason: Quality improvement is a continuous self review with
the purpose of identifying and correcting parts of the EMS
system that need improvement. Protocols are described in a
comprehensive guide explaining the EMT's scope of practice.
Standing orders are part of protocols, and designate what the
EMT is required to do for a specific condition.

38: The legal limits of the EMT-B's job duties are formally
defined by the:
A: medical director.
B: scope of practice.
C: Department of Transportation.
D: state in which the EMT-B works.
Reason: The scope of practice formally defines the legal limits of
all EMS personnel.

39: You respond to a call for a 42-year-old man with an altered

mental status. He lives alone and is unable to coherently answer
your questions. You examine him and find that he has a dry
mouth and his breath has a faint odor, somewhat like alcohol. His
pulse is weak and regular. His blood pressure is 96/94 mm Hg.
His respirations are 24 breaths/min. His skin is warm, dry, and
pink. He complains of nausea. How would you treat this patient
from this point?
A: Tell dispatch you believe he is simply intoxicated
and leave.
B: Assume the patient has diabetes and give him oral
glucose.
C: Check the patient's blood glucose level with a
glucometer, and if it is too low, ask medical direction if
you can give him oral glucose. Follow medical direction's
advice, and then transport.
D: Tell medical control you believe the patient has
diabetes, obtain permission to give him oral glucose, and
if his vital signs and mental status return to normal,
leave.
Reason: You cannot assume intoxication, because too often
symptoms of diabetes mimic alcohol consumption. You can
assume by the patient's vital signs and altered mental status, as
well as your physical findings, that he is diabetic. You must
obtain permission from medical control to give him oral glucose.
Because low blood glucose levels may not be the problem, or
may not be the only problem, you should still transport the
patient. Even if the oral glucose returns his mental status and
vital signs to normal, you should not leave the patient at the
scene.

40: What important act established a path in which emergency

response workers can find out if they have been exposed to life-
threatening infectious diseases?
A: Ryan White CARE Act
B: Highway Safety Act of 1966
C: AIDS Protection Act
D: Emergency Medical Act of 1973
Reason: The Ryan White CARE Act was established so that
emergency response workers can find out if they have been
exposed to any life-threatening infectious diseases.

41: _______ are described in a comprehensive guide explaining

the EMT's scope of practice, while __________ are part of
protocols, and designate what the EMT is required to do for a
specific condition.
A: Offline medical direction; on-line medical direction
B: On-line medical direction; offline medical direction
C: Protocols; standing orders
D: Standing orders; protocols
Reason: Protocols are described in a comprehensive guide
explaining the EMT-B's scope of practice, while standing orders
are part of protocols and designate what the EMT-B is required
to do for a specific condition.

42: You are called to the scene of a one-vehicle collision where

a car has hit a pole holding power lines. There is only one person
in the vehicle. He seems to be unconscious. Damage to the
vehicle is minimal. Which of the following is the BEST answer for
what you might look for in your scene size-up before you treat
the patient?
A: Downed power lines, any fluids leaking from the
vehicle, any smoke rising from the vehicle, oncoming
traffic
B: Broken glass from the vehicle, signs that another
vehicle was involved and fled the scene, hazardous
materials, whether or not the police have secured the
scene
C: Whether the car is too damaged for easy access to
the patient, whether an airbag has deployed or may
threaten your safety upon extrication of the patient
D: Whether the pole the car hit is stable or unstable,
whether the patient's injuries may require more than just
minimal body substance isolation precautions
Reason: Although all of the answers have valid concerns for
EMS personnel, the most dangerous things to look for are listed
in answer A. The most threatening situation would be downed
power lines, possible hazardous or flammable materials leaking
from the vehicle, smoke coming from anywhere in the vehicle,
and the location of the vehicle with regard to oncoming traffic.

43: Medical direction has to be given and transferred to the

EMT-B by the physician himself. True or False?
A: TRUE
B: FALSE
Reason: Medical direction can be transferred by the physician to
another person (such as a nurse or other emergency department
worker) and then to the EMT-B.
44: What would be the LAST choice for ventilating a patient?
A: Mouth-to-mask with high-flow supplemental oxygen
B: Flow-restricted oxygen-powered ventilation device
C: One-rescuer bag-valve-mask ventilation
D: Two-rescuer bag-valve-mask ventilation
Reason: The least effective method for ventilating a patient, and
therefore the last choice, would be one-rescuer bag-valve-mask
ventilation.

45: You are called to the apartment of a college student with an

"unknown" medical issue. When you arrive, you find a woman
lying in bed. Prescription medication bottles and beer cans are
on the nightstand. The patient is conscious, but crying, and will
not answer any of your questions but does not appear to have an
altered mental status. As she's crying, you can see that there are
some pill fragments in her mouth. What should you do?
A: Tell the patient you are going to remove the
fragments that you can see in her mouth, and then
slowly and calmly remove the fragments you can easily
see.
B: Ask the patient to spit out the fragments. If she does
not comply, tell her you will have to use a suction device
to remove them.
C: Leave the fragments of pills in her mouth, they will
probably do no more harm than the pills she has already
taken.
D: Give the patient water or some other way to wash
the fragments down so that they do not compromise her
airway.
Reason: The best answer is B. You should never put your
fingers in the mouth of someone who could have an altered
mental status-the problem stated that she only appeared to not
have an altered mental status. If you leave the pill fragments in
her mouth they will dissolve, putting more of the drug into her
system. Washing them down with water or any other liquid will do
the same thing. Your best option is to ask her to spit out the
fragments. If she does not comply after repeated attempts, try
using suction to remove them.

46: An EMT-B must switch oxygen cylinders before the pressure

gauge reads ______ psi.
A: 200
B: 400
C: 600
 D: 800
Reason: If the psi reads 200, the oxygen cylinder must be
changed so that adequate oxygen is available for the next patient
who may need it.

47: Which ventilation device is contraindicated for use on infants

or children?
A: Nonrebreathing mask
B: Bag-valve-mask device
C: Pediatric pocket mask
D: Flow-restricted, oxygen-powered ventilation device
Reason: A flow-restricted, oxygen-powered ventilation device is
contraindicated for use in infants and children because of its
power and the delicate lung tissue of infants and children.

48: In scenario number 15, which of the following would you do

first?
A: Initial assessment
B: Baseline vital signs
C: SAMPLE history
D: Detailed physical exam
Reason: The initial assessment should always come first in this
kind of situation. You must assess the patient's mental status,
airway, breathing, circulation and any life-threatening conditions
before taking any history. If the patient is unconscious, a detailed
physical exam should follow initial assessment.

49: When arriving on scene where there are already police, fire
vehicles, and other ambulances present, you should conduct
your own scene size-up. True or False?
A: TRUE
B: FALSE
Reason: No matter who is already on scene, you should
ALWAYS conduct your own scene size-up upon arrival.

50: What is the key element of body substance isolation (BSI)

equipment?
A: Determine what BSI is needed after you have done
your initial assessment of the patient.
B: Always have all personal protective equipment
readily available.
C: Always wear all personal protective equipment, and
take off what you don't need once you have done your
initial assessment of the patient.
 D: Put personal protective equipment on the patient as
well as yourself.
Reason: The minimum BSI equipment you should have on for all
calls is gloves. Other equipment is appropriate based on the call
you are responding to. Always have any personal protective
equipment you may need within reach, just in case.

51: You respond to a call for a 44-year-old man working in a

chemical manufacturing plant. You are told on arrival by his
coworkers that he was burned when a container of lye powder
broke open as he was moving it, covering most of his body. The
Hazmat team has been called, but their estimated arrival time is
nearly 30 minutes. What should you do?
A: Put on gloves, a face shield, a breathing mask and a
gown, and then attempt to help the patient remove his
clothing. Then provide constant irrigation with water until
HazMat arrives.
B: Do nothing until HazMat arrives, and then follow
their instructions.
C: Instruct the patient to dust himself off the best that
he can, move to an area away from the dry powder, and
wait for the HazMat team to arrive.
D: Stand far enough away to not compromise your own
safety and monitor his breathing and mental status until
HazMat arrives.
Reason: Despite extensive body substance isolation
precautions, as an EMT-B you are not trained in handling
hazardous materials. Doing nothing at all may compromise the
patient's breathing, sight, mental status, or other functions. The
best thing to do is to instruct the patient to dust off as much of the
powder as he could, then walk somewhat away from the area of
the spill. If breathing or other problems develop, instruct him to
remove all clothing and jewelry, and continuously irrigate his skin
with water only until HazMat arrives.

52: While treating a patient for headache, nausea, and

weakness, your eyes begin to water and you begin to feel
nauseous. Your partner is feeling the same. What should you
do?
A: Call the police and fire departments.
B: Call for additional ambulances.
C: Evacuate all people from the area/building.
D: Call medical direction for advice.
Reason: If more than one person is experiencing the same signs
and symptoms, you can safely assume something at the scene is
causing it, and the best thing to do would be to immediately
remove all people from that area or building.

53: How would you accurately evaluate the skin color of a dark-
skinned patient?
A: Look at the color of the bottom of the patient's feet.
B: Look at the color of the lips and nail beds.
C: Look at the color of the palms of the hands.
D: All of the above.
Reason: The best way to accurately evaluate the skin color of a
dark-skinned patient would be to look at the color of the inside of
the lips and the nail beds.

54: If you are called to respond to a scene in which a patient

was found floating in a frozen lake, and you are told that the
patient was underwater approximately 3 to 5 minutes, the patient
is cold to the touch and cyanotic, how long should you assess for
pulselessness before starting CPR?
A: 5 seconds
B: 15 seconds
C: 25 seconds
D: 45 seconds
Reason: Severely hypothermic patients will have a very slow
heart rate, so the pulse should be checked for a longer period of
time. As a rule, heart rates are generally assessed from 15 to 30
seconds and then multiplied, so in this case, 45 seconds would
be the best choice.

55: When considering the pulse of an adult patient, which of the

following means that something may be seriously wrong with the
patient?
A: A sustained pulse below 50 beats/min
B: A sustained pulse above 120 beats/min
C: A sustained irregular and weak pulse
D: All of the above
Reason: A sustained pulse below 50 beats/min, above 120
beats/min, or irregular and weak are ALL signs that something
could be seriously wrong with the patient.

56: The skin of a patient with serious liver problems will appear:
A: jaundiced (yellow).
B: red and blotchy.
C: pale.
D: cyanotic.
Reason: Jaundice appears as yellow in the skin and eyes of
patients with liver problems.

57: If you are instructed by medical control to provide active,

rapid rewarming of areas of a patient's body affected by deep
cold injury, this would be best accomplished by:
A: covering the areas with a room temperature blanket.
B: applying warm, but not hot, circulating water to the
affected areas.
C: massaging affected areas to restore circulation.
D: immersing affected areas in hot water.
Reason: Covering the affected areas with a blanket is passive
rewarming, not active. Massaging any area with a deep cold
injury is not suggested because it could cause severe tissue
damage. Hot water is not recommended because it can further
harm the skin already damaged by the extreme cold. The best
idea is to apply warm, circulating water to affected areas and
transport immediately.

58: A patient's pupils may become _________ due to blood loss,

drug use, use of eye drops, or extreme fright.
A: unequal
B: unreactive
C: dilated
D: constricted
Reason: Pupils often dilate (expand) due to blood loss, drug use,
use of eye medications and extreme fright.

59: A pulse oximeter will produce falsely high readings in

patients with:
A: drug overdose.
B: hypoxia.
C: carbon monoxide poisoning.
D: COPD.
Reason: A pulse oximeter will produce falsely high readings in
patients with carbon monoxide poisoning.

60: You and your crew respond to a call for a 23-year-old man
complaining of weakness, nausea, fatigue, and joint pain. He
believes he is coming down with a cold or flu, but you are told he
felt fine when he went on a scuba diving trip early that morning.
He denies medical conditions or any pertinent medical history.
On the way to the hospital, the patient has a full body seizure
and does not regain consciousness. What is the probable
diagnosis for this patient?
A: Hypoglycemia brought on by the patient's nausea
B: Decompression sickness
C: Barotrauma
D: Undiagnosed epilepsy
Reason: Given that the patient denied having any medical
conditions or pertinent medical history but mentioned his scuba
diving trip that morning, he is most likely experiencing
decompression sickness. He has common signs of
decompression sickness, and additional signs would be
shortness of breath, dizziness, headache, paralysis, and
unconsciousness. Epilepsy is usually diagnosed at an early age
and controlled with medication. Hypoglycemia would not normally
result in a seizure that rapidly, followed by unconsciousness.

61: With a severe head injury, clear fluid draining from the ears
and nose would be:
A: cerebrospinal fluid.
B: lymphatic fluid.
C: synovial fluid.
D: tears.
Reason: Clear fluid draining from the ears and nose after a head
injury would be cerebrospinal fluid.

62: Stable patients should be reassessed every _____ minutes,

while unstable patients should be reassessed every ______
minutes.
A: 10; 3
B: 15; 5
C: 20; 10
D: 30; 15
Reason: Stable patients should be assessed every 15 minutes;
unstable patients should be assessed every 5 minutes.

63: In a behavioral emergency, if a patient denies treatment,

who is the best person(s) to give you advice on providing care
against that patient's will if you believe he may harm himself or
others?
A: Law enforcement personnel
B: The patient's family doctor
C: The patient's family members
D: Your medical director
Reason: The best source of information for any area that is
uncertain for EMT-Bs is their medical director. If the behavioral
emergency involved any sort of crime or damage to property or
another person, law enforcement would also be involved, but
would have little or no say in whether or not you could treat the
patient against his will.

64: Blind finger sweeps are NEVER performed on an infant or

child. True or False?
A: TRUE
B: FALSE
Reason: Blind finger sweeps are NEVER performed on an infant
or child because they could further lodge an obstruction into the
airway.

65: A situation in which a drug should not be used because it

may cause harm to the patient or offer little effect in improving
their condition is called a(n):
A: adverse reaction.
B: side effect.
C: contraindication.
D: indication.
Reason: A contraindication is a situation in which a drug should
not be used because it may cause harm to the patient, or offer
little effect for improving the patient's condition.

66: When responding to a call for a patient who is 7 months'

pregnant with her first child, she tells you she has been ill with
flu-like symptoms for the last 3 days. She asks that you transport
her to the emergency department. How should she be
transported?
A: On her left side
B: Flat on her back with her legs elevated
C: Flat on her back with her head lower than her feet
D: The position makes no difference.
Reason: The preferred position for pregnant patient's after 20
weeks' gestation is on the left side to prevent the baby from
compressing any of the major blood vessels of the mother's
abdomen. If the patient were in shock or some other medical
emergency, you may have to consider another position, but this
patient is stable.

67: Why is nitroglycerin given to a patient having chest pain?

A: It constricts blood vessels and raises blood
pressure.
B: It dilates blood vessels and decreases the workload
 of the heart.
C: It increases blood flow to the brain.
D: It is a painkiller.
Reason: Nitroglycerin dilates blood vessels, decreasing the
workload of the heart, thereby decreasing chest pain.

68: Which one of the following is NOT a shockable rhythm?

A: Asystole and pulseless electrical activity
B: Ventricular tachycardia
C: Ventricular fibrillation
D: Pulseless ventricular tachycardia
Reason: Asystole and PEA (pulseless electrical activity) are
nonshockable rhythms. Ventricular tachycardia, ventricular
fibrillation, and pulseless ventricular tachycardia are all
shockable rhythms.

69: You are called to the home of a woman in labor with her
fourth child. She is full term, and her water has broken. When
you examine her, you see a loop of umbilical cord protruding
from the vaginal opening. How do you treat her?
A: Prepare the area and the patient for a home
delivery.
B: Gently push the umbilical cord back into the birth
canal, put the patient on her left side, and transport
rapidly.
C: Leave the umbilical cord where it is, and rapidly
transport.
D: Put the patient in a position with her knees to her
chest, gently push the fetus away from the cord, and
keep the cord moist while rapidly transporting.
Reason: The care the patient needs for this condition, a
prolapsed umbilical cord, can only be received at the hospital.
Your job is to make sure adequate blood flow continues through
the umbilical cord to the infant until you get the mother to the
hospital. The best way to do this is to put the patient in a knee
chest position to keep the infant's head away from the birth
canal, give the mother oxygen, and keep the cord moist while
rapidly transporting.

70: If a patient has a pacemaker and needs to be defibrillated,

you should:
A: not worry about the pacemaker and perform
defibrillation as you would with any other patient.
B: increase the joules on the AED.
 C: remove the pacemaker.
D: place the defibrillator pad several inches away from
the pacemaker.
Reason: A patient who has a pacemaker and needs to be
defibrillated should be treated by placing the defibrillator pad
several inches away from the pacemaker, usually visible under
the skin.

71: A patient who has continuous seizures, one after another, is

experiencing:
A: convulsions.
B: repeating seizure disorder.
C: brain damage.
D: status epilepticus.
Reason: Status epilepticus is a condition in which a patient has
back-to-back seizures without regaining consciousness. It is a
serious condition that must be treated immediately.

72: While transporting a woman 8 months' pregnant with her first

child, she says she feels the need to push. Upon examining her,
you see one of the infant's arms hanging from the vaginal
opening. What should you do?
A: Go ahead and deliver the infant in the ambulance.
B: Gently push the infant's arm back into the birth
canal and rapidly transport the mother to the emergency
department.
C: Adjust the stretcher so that the mother's pelvis is
higher than her head, tell her to do her best not to push,
and rapidly transport.
D: Leave the mother as is, tell her not to push, and
rapidly transport.
Reason: It is best not to try this potentially difficult delivery in the
field. You would not try to push the infant's arm back into the birth
canal, or leave it dangling out and tell the mother not to push. If
you put the mother in a position where the pelvis is elevated, it
decreases pressure on the infant and decreases the strong urge
the mother has to push. Transport rapidly.

73: If a patient has signs and symptoms of a stroke, but all signs
and symptoms disappear in less than 24 hours, the patient
experienced a(n):
A: cerebrovascular accident (CVA).
B: transient ischemic attack (TIA).
C: altered mental status (AMS).
 D: acute myocardial infarction (AMI).
Reason: If a patient shows signs and symptoms of a stroke that
disappear completely within 24 hours, he or she has experienced
a TIA (transient ischemic attack).

74: In what order would the following bleeding control measures

be used to stop serious bleeding? 1. Tourniquet 2. Firm pressure
on the wound 3. Pressure on a pressure point 4. Elevation of the
wound in addition to pressure
A: 1,2,3,4
B: 2,4,3,1
C: 3,1,2,4
D: 4,3,1,2
Reason: The first step in stopping serious bleeding is firm
pressure on the wound. If this does not stop it, the second step is
to keep firm pressure while elevating the wound site. If this still
does not work, putting pressure on a pressure point such as the
closest major artery, is suggested. A tourniquet is only suggested
as a very last result, and only if the bleeding may otherwise result
in life-threatening blood loss.

75: You respond to the scene of a sexual assault of a 31-year-

old woman. Police have secured the scene. Your patient states
she was hit in the head with a bat, fell to the ground, and was
then raped. What are necessary interventions?
A: Spinal immobilization, focused history and physical
exam, and rapid transport
B: Letting law enforcement transport the patient after
you address any bleeding or other injuries
C: Focused physical exam of all injuries, an exam to
determine whether or not the patient was actually raped,
then transport
D: Using a c-collar for immobilization, focused physical
exam, allowing her to clean up, and completion of the
police report before transport
Reason: Spinal immobilization is a necessary precaution
because the patient was hit in the head with a bat and then fell to
the ground. Focused history and physical exam will then treat
any other injuries she may have experienced. Being gentle and
understanding are important. It is not your job to try to determine
whether or not she has been raped, but it is important that the
patient not clean up in any way that may destroy evidence that
will be obtained in a rape kit at the hospital.
You got 23 out of 75 correct.

You got 31% out of the total questions correct.