Tobi's test

The first step in caring for an adult who is apparently unconscious is to
Check the mouth for foreign object
Tilt the head back
Establish unresponsiveness
Force air into the lungs
How far down must you compress the sternum when you are giving cardiopulmonary resuscitation to an adult?
1 inch - 1-1/2 inches
1-1/2 - 2 inches
At least 2 inches (5 cm)
Depth of compression does not matter
You are called to the home of a 60-year- old man who began to experience chest pain after walking up a flight of stairs 15 minutes ago. Before your arrival, he took one nitroglycerine tablet and sat down. While you are taking his vital signs, he advises you that his pain has subsided. You should suspect
Congestive heart failure
Acute myocardial infarction
Angina pectoris
Spontaneous pneumothorax
Tourniquet should be applied tight enough to
Stop venous circulation in the extremity
Reduce arterial circulation in the extremity
Stop the bleeding from the wound
Allow a slight oozing of blood from the wound
You can tell that a patient to whom you are giving artificial ventilation is adequately ventilated if the patient's
Pulse rate increases
Chest rises
Blood pressure increases
Pupils dilate
A male parking lot attendant, age 20, has had a sudden onset of wheezing. He states that he is not asthmatic, but complains of severe itching all over his body. His skin is extremely hot, is bright red in color, and shows large red welts. His illness is probably
Heat stroke
Carbon monoxide poisoning
Spontaneous pneumothorax
Anaphylactic shock
Which of the following is not an indication of hypovolemic shock?
Shallow breathing
Dilated pupils
Red dry skin
Weak rapid pulse
A 60-year- old man with a history of high blood pressure complains of shortness of breath. His respirations are 32, with a moist crackling sound. His legs are swollen. His condition is most likely
Pulmonary embolus
Angina pectoris
An asthmatic attack
Congestive heart failure
When should the EMT ventilator deliver the major portion of the breath during two-rescuer adult CPR?
After the 30 th upstroke
After the 30th down stroke
During the 15 th down stroke
After the 15th upstroke
What is common in all forms of shock?
Hypovolemia
Inadequate tissue perfusion
Dilation of blood vessels
Slow heart rate
A patient with a head injury and increasing intracranial pressure will often present with
Depressed B/P & fast pulse
Normal B/P & fast pulse
Normal B/P & normal pulse
Elevated B/P & slow pulse
You are called to the scene of an accident where you find an unconscious patient with open eyes. What should you do in order to protect the patient's eyes from damage?
Instill sterile water frequently into both eyes
Instill a sterile saline solution frequently into both eyes
Close the eyes and bandage them shut
Shield the eyes from bright lights
In what position should an accident victim with facial injuries, but without evidence of spinal injuries, be placed in order to facilitate drainage and maintain an open airway?
Seated upright, with head tilted backward
Supine, with extremities elevated and face turned to the side
Prone, with head turned to the side
On his/her side, with head tilted back and face turned down
When water enters the trachea or larynx of a drowning victim, normal immediate response is
Laryngospasm
Bronchiolar relaxation
Laryngeal relaxation
Bronchiolar spasm
What type of injury results when overexertion causes a muscle to be stretched or torn
Fracture
Dislocation
Strain
Sprain
Which one of the following is characterized by paradoxical respiration?
Paralysis of the diaphragm
Multiple fractured ribs
Air inside the chest cavity
Shifting of the mediastinum
Which of the following anatomical structures holds bone ends in place?
Muscle
Tendon
Ligament
Cartilage
The intent of the Good Samaritan Law is to provide the basis of a legal defense for
Lay persons, physicians, and other medical professionals who provide emergency care at the scene of an accident
Lay persons who stop at the scene of an accident, decide they are unable to help, and who then leave the scene
Lay persons who stop at the scene of an accident and commit acts of gross negligence
Municipal employees who respond to the scene of an accident and render emergency care
Which one of the following is the best indicator of imminent childbirth?
Crowning
Blood discharge from the vagina
Contractions occurring 3 minutes apart
The mother's feeling of having to move her bowels
20-year- old man involved in a car accident is complaining of left-sided pain radiating to the left shoulder. His pulse is rapid and blood pressure low. This patient is probably suffering from
Perforated intestines
A ruptured kidney
A lacerated liver
A ruptured spleen
Regulation of normal body temperature is primarily controlled by the
Pancreas
Heart
Thyroid
Skin
Which of the following conditions indicate that a patient is in the early states of hypovolemic shock?
Pulse weak and slow, decreased blood pressure
Lethargy; a decreased pulse rate
Skin flushed, decreased blood pressure
Thirst, restlessness and rapid respirations
Immediately after the convulsive seizure of an epileptic has stopped, it is likely that he/she will be
Excited and restless
Perfectly normal
Very hungry and thirsty
Drowsy and in need of sleep
An oropharyngeal airway that has been properly placed in a patient should end in the
Cervical and lumbar
Thoracic and sacral
Thoracic and lumbar
Lumbar and sacral
Which of the following is least likely to result from a penetrating injury to the chest?
Hemorrhage
Pneumothorax
Flail chest
Fracture
Interruption in cerebral blood flow to a portion of the brain results in a condition known as
Epidural hematoma
Myocardial infarction
Cerebrovascular accident
Epilepsy
When ventilating a child in respiratory arrest, ventilation should be given at a rate of:
One every two seconds
One every three to five seconds
One every five to seven seconds
One every ten seconds
An elderly woman is found lying on the floor and complaining of pain in the hip. The patient's knee is flexed and rotated inward. You should suspect a
Dislocated hip
Fractured hip
Fractured pelvis
Fractured femur
How often do you stop CPR to have the AED reanalyze?
About every 2 minutes (completion of 5 cycles)
Every 5 minutes for the first 20 minutes of CPR
After the first 15 seconds of CPR and every 5 minutes thereafter
After the first minute of CPR and every few minutes thereafter
You are the first rescuer to arrive on the scene of a "head-on" automobile accident where you find the following - Patient #1 - appears to be intoxicated, has pain in his right shoulder, and is belligerent toward the rescuers; Patient #2 - also appears to be intoxicated, is very slow in responding to questions, has burns on his lower legs and feet from the car heater, and complains of a pain in his back; Patient #3 - has an open wound to the brain which is not bleeding, has no pulse or respiration, and his chest is pinned between the steering wheel and the seat; and Patient #4 - has a laceration across the abdomen that is bleeding profusely, and a portion of the colon is protruding. Which patient should be treated first?
Patient #1
Patient #2
Patient #3
Patient #4
What is the most common problem encountered with the use of "bag mask resusicators"?
Inability to properly seal the face-piece over the victim's mouth and nose
Inability to provide the correct volume of air with each squeeze
Failure to maintain cleanliness of the exhalation valve
Failure to squeeze the bag at the proper inflation rate
Which one of the following statements is not true of a well-written medical report?
It facilitates the transmission of information to the hospital staff
It includes all relevant information
It contains personal comments of the EMT
It serves as legal documentation in a court of law
In correct sequence, starting from the head, the regions of the spine are the
Medullar, cervical, lumbar, sacral and coccyx
Cervical, thoracic, lumbar, sacral and coccyx
Medullar, lumbar, thoracic, sacral and coccyx
Cervical, lumbar, thoracic, sacral and coccyx
Loss of voice, severe airway obstruction, and air leakage in the soft tissue of the neck can result from an injury to the
Epiglottis
Nasopharynx
Esophagus
Trachea
A worker who has been installing pipe in a warm humid boiler room is found in a state of collapse. He shows no sign of injury but has hot dry skin and an exceedingly high body temperature. The EMT should suspect the condition of heat
Exhaustion
Prostration
Stroke
Cramps
As a general rule, during the on-going assessment, the critical patient should be re-evaluated every ( ? ) minutes.
One
Five
Ten
Fifteen
Which one of the following conditions is characterized by constricted pupils?
Cardiac arrest
Shock
Narcotics abuse
Heat exhaustion
It is important for the driver of an emergency vehicle to remember that, when approaching an intersection under emergency condition, he/she
Has the right of way over all other vehicles
May proceed across the intersection without slowing or stopping
Has the right-of- way over all vehicles except a police car
Must be prepared to stop if the traffic signal is red
Which one of the following is an incorrect procedure with regard to a lone rescuer performing external cardiac compression on an infant?
Feel for a carotid pulse
Place the fingers over the lower half of the breastbone (just below nipple line)
Compress at a rate of at least 100 per minute
Administer 30 compressions to 2 ventilation
The uterus is massaged after the placenta is delivered in order to
Relax the mother
Control bleeding
Reduce contractions
Reduce pain
Fractures to the elbow joint are dangerous because the
Artery may be pinched off, causing shock in minutes
Artery to the humerus may be injured
Artery and nerves to the forearm may be injured
Nerve leaving the humerus may be injured
The vital sign most characteristic of cardiogenic shock is
Slow respiratory rate
Low blood pressure
Widening pulse pressure
Slow pulse rate
The rescuer must assess the cardiac arrested patient and proceed with CPR care following the mnemonic:
OASS
ABC
CAB
AVPU
An adult male burn victim has third degree burns on his abdomen, chest, and the front of both arms. The area of burn coverage over his entire body is approximately
18%
27%
35%
45%
Which one of the following conditions is characterized by alveolar damage accompanied by labored respirations and wheezing?
Emphysema
Pulmonary edema
Asthma
Apnea
The least dependable artery for taking a pulse when a patient is in shock is the
Radial
Brachial
Carotid
Femoral
Stridor is a sign of:
Lower airway obstruction.
Fluid in the lungs.
Collapse of the alveoli.
Upper airway obstruction.
Which of the following is an uncommon - but often fatal - result of bleeding from a large neck vein?
Air may enter the vein and be carried to the heart
The possibility of respiratory shock is increased
May lead to overwhelming infection
Oxygen supply to the lungs may be reduced
The period of relaxation or filling of the heart is called
Fibrillation
Systole
Diastole
Stand still
A person arrested for public drunkenness suddenly loses consciousness. A police officer at the scene reports that the patient was irritable and his speech slurred. Your assessment shows a rapid pulse, shallow breathing, and pale moist skin. In addition to intoxication, you should suspect
Hyperglycemia (diabetic coma)
Hypoglycemia (insulin shock)
Hyperventilation
Petit mal seizure
The tubelike anatomical structure that carries air from the throat to the lungs is the
Pharynx
Larynx
Trachea
Esophagus
During CPR, the EMT should support the spine of an infant in order to allow for
Proper airway seal
Hyperflexion of neck
Proper cardiac compression
Hyperextension of neck
The first objective in the care for any burn is to
Stop the burning process
Exclude air from the area of the burn
Transport the patient to a burn treatment center
Prevent infection
Which component of arterial blood normally stimulates respiration?
Carbon dioxide
Nitrogen
Oxygen
Hemoglobin
The description used by the AHA to describe proper chest compressions is to push:
Fast & steady
Slow & steady
Hard & fast
Hard & deep
A common reaction to amphetamine abuse is
Tranquility or drowsiness, or a trans-like state
Tremors, convulsions, and constricted pupils
Drowsiness, lapsing into light sleep which the abuser can easily be aroused
Excitement, agitation, and rapid respirations
Immediately following delivery, in which order should the EMT care for the newborn who is not breathing?
Stimulate by slapping feet, suction, ventilate
Stimulate by slapping feet, suction, ventilate
Suction, cut cord, stimulate by slapping feet, ventilate
Ventilate, stimulate by slapping feet, CPR
When the nature of the accident and observation of the patient indicate spinal injury, the EMT should first
Hyperextend the neck to secure the airway
Determine the extent of paralysis
Apply an extrication collar
Apply manual stabilization and secure the airway
The term hemothorax refers to
Air in the chest cavity
Blood in the chest cavity
Blood in the airway
Blood in the peritoneal area
Emergency treatment for a fracture of the wrist is to splint the
Forearm and elbow
Forearm, elbow and wrist/hand
Forearm and wrist
Forearm
Which areas of the spine are comprised of five vertebrae each?
Lumbar and sacral
Sacrum and cervical
Cervical and coccygeal
Thoracic and lumbar
To control a nosebleed, the EMT should
Have the patient sit up, with the head tilted backward
Apply tepid compresses to the face and nose
Have the patient positioned forward with the head between the legs
Have patient lean forward and pinch nostrils together
Have patient lean forward and pinch nostrils together
Nasal cannula
Non-rebreathing mask
Venturi mask
Partial-rebreathing mask
In what order is the physical examination usually conducted on an adult patient?
Head, neck, extremities, chest, pelvis, abdomen
Head, neck, chest, abdomen, pelvis, extremities
Head, neck, abdomen, chest, pelvis, extremities
Head, chest, abdomen, neck, pelvis, extremities
A ten-month- old infant is having a seizure. The parents tell you that the infant has 10 not been well for the past 2 days. Which of the following is the probable diagnosis and the appropriate immediate action?
Febrile seizure - maintain the airway and prevent injury
Epilepsy - turn the infant's head to the side to prevent aspiration
Febrile seizure - immerse the child in cold water to get the temperature down
Meningitis - sponge the child with alcohol to get the temperature down
When it is necessary to perform CPR while transporting a patient on a litter(stretcher), the EMT should
When it is necessary to perform CPR while transporting a patient on a litter(stretcher), the EMT should
Move the stretcher slowly so that effective CPR can continue
Keep the stretcher in a high position, especially when going down stairs
Keep the patients head raised in order to make ventilations easier
In caring for a non-breathing patient, you should look for evidence of an operation in which the "voice box" has been removed and the trachea shortened and brought to the front or side of the neck. What is this operation called?
Laryngectomy
Lobotomy
Tracheostomy
Cricothyrotomy
For a patient who has an injured cervical spine, manual stabilization should be released after the
Head has been secured to the short board
Extrication collar has been secured in place
Torso has been secured to the short board
Patient has been completely fixed to the long board
Bluish tint to the skin is an indication of
Asphyxia
Carbon monoxide poisoning
Diabetic coma
Liver disease
In taking blood pressure, the cuff of the sphygmomanometer is placed around the arm just above the elbow, with the bladder portion of the cuff over the brachial artery. The EMT should pump the bladder to a point 20 mmHg further than last pulse sounds heard with a stethoscope. To determine the systolic B/P, one should begin releasing pressure in the cuff and listen with a stethoscope over the brachial artery. The systolic B/P is where the:
First pulse sound is heard
Last pulse sound is heard
Needle on the gauge becomes steady
When the cuff is fully inflated
Which one of the following procedures is not to be used in treating a fractured hand?
Place the hand in a sling to reduce pain
Place the hand in the most functional position
Splint the hand with the palm flat
Splint the hand above the wrist
The normal rate of breathing for an adult at rest is approximately
8 respirations per minute
16 respirations per minute
24 respirations per minute
32 respirations per minute
Which area of the heart has the highest oxygen concentration?
Right atrium
Right ventricle
Pulmonary artery
Pulmonary vein
Fractured ribs may result during external cardiac compression if the hands are placed
Too low on the sternum
Off center from the sternum
Two finger widths above the xiphoid process
Too high on the sternum
Which one of the following is an illness caused by acute spasm of the airway that results in airway constriction?
Congestive heart failure
Emphysema
Tuberculosis
Asthma
An accident victim who is a minor has a lacerated brachial artery. The parents are not present. Which one of the following actions should you take if you cannot reach the parents after making an effort to do so?
Telephone the physician at the emergency care center and ask for permission to proceed
Get permission from the police to proceed with treatment
Take the child to the hospital but give no treatment
Assume the parents' consent to treatment
The PCR is
Part of the patients medical record
Can only be used for medical research
May be discussed with non-emergency personnel
Is rarely read
The condition in which blood is trapped in the sac surrounding the heart is known as
Myocardial infarction
Congestive heart failure
Pectoral tamponade
Pericardial tamponade
When relieving choking in a responsive infant, the number of back slaps and chest thrusts in one cycle is:
Three and three
Four and four
Five and five
Six to ten
The most important observation that an EMT can make concerning the condition of a patient with a head injury is to record changes in the patient's
Level of consciousness
Pupil reaction
Respiratory rate
Blood pressure
During normal delivery of a baby, the EMT should support the baby's head with one hand to prevent an "explosive" delivery; the other hand should be
On the sterile drape on one leg to prevent the mother from closing her legs during the delivery
On the mother's abdomen, pushing on her uterus to aid delivery and reduce bleeding
Just below the vaginal opening with the fingers adjacent to the perineum but not touching it
Holding a bulb syringe ready to suction the baby's mouth
If difficulties arise during delivery of the baby's upper shoulder, the EMT should assist by gently
Pulling at the baby's shoulders
Guiding the baby's head downward
Guiding the baby's head upward
Pushing a gloved hand into the vagina
The only artery in the body to carry deoxygenated blood is the
Aorta
Pulmonary artery
Subclavian artery
Superior vena cava
At the scene of an accident, you find an unconscious non-breathing male patient who is trapped in a vehicle in a sitting position. Although the victim can be reached, he cannot be immediately extricated from the vehicle. Your first action to aid the patient should be to
Apply stabilization to his head and gently remove him to a flat surface
Apply stabilization to his head and begin to immobilize him on a short spine board
Support him in an upright position, stabilize head, establish an airway, and start ventilation
Examine him for any further injuries since he should not be moved until a thorough evaluation has been made
Which of the following is the least reliable indicator of early shock?
Level of consciousness
Respiration rate
Blood pressure
Pulse rate
Proper traction splinting must accomplish all of the following except
Counter action of overriding
Reduction of the fracture
Correction of angulation
Counter action of muscle spasm
A correct description of the diaphragm during inspiration (inhalation) is that the diaphragm
Contracts, moves upwards and enlarges the thoracic cavity
Relaxes, causing the chest cavity to decrease in size
Relaxes, causing the chest cavity to increase in size
Contracts, moves downward, and enlarges the thoracic cavity
After assuring adequate respiration, what is the next step in caring for a patient who has injuries to bones and joints?
Stop all serious bleeding
Immobilize angulated fractures
Check for paralysis of the limbs
Determine level of consciousness
A temporary loss of some or all of the ability of the brain to function because of a blow to the head is called a
Stroke
Vertebral hematoma
Contusion
Concussion
You are assisting at the scene of a cardiac arrest with CPR in progress. While you are ventilating the patient with 100% oxygen, a family member informs you that the patient has a long history of chronic obstructive pulmonary disease. You should
Reduce the oxygen concentration to approximately 25%
Discontinue oxygen and ventilate only with room air
Reduce the oxygen concentration to approximately 50%
Continue to ventilate with 100% oxygen
All of the following are symptoms except:
Headache
Weak pulse
Chest pain
Nausea
The purpose of uterine contractions in the first stage of labor is to:
Position the unborn child for delivery
Fully stretch (dilate) the cervix
Pass the unborn child’s head through the birth canal
Fully deliver the infant
Which one of the following is not a first priority in triage?
Back injuries
Acute poisoning
Open chest wound
Severe shock
You arrive at the scene of an MVA where a power line has fallen on the vehicle. You observe three victims inside the vehicle. Your first action should be:
Call the power company
Tell victims to remain in vehicle
Assist victims to exit vehicle
Remove power line from vehicle
NYS BLS Protocols state that if during the delivery process the EMT notices the umbilical cord wrapped tightly around the infant's neck, or if the cord is wrapped around the neck more than once, and it cannot be freed, the EMT should:
Immediately clamp the umbilical cord with two clamps and cut the cord between them
Apply gentle traction on infants head to speed delivery
Administer oxygen to the infant
Continue with normal deliver, the umbilical cord can be dealt with after delivery
Compressions of the chest of a 4 year old in cardiac arrest should be done with:
Both thumbs
Tips of fingers
Heel of either 1 or 2 hands
2 fingers just below the nipple line
A 24 year old female has been involved in an automobile accident. She complains of difficulty breathing and tingling of her fingers. She has ventilations of 36 and deep. What would you expect of her carbon dioxide level?
Increased
Tips of fingers
Heel of either 1 or 2 hands
2 fingers just below the nipple line
A 24 year old female has been involved in an automobile accident. She complains of difficulty breathing and tingling of her fingers. She has ventilations of 36 and deep. What would you expect of her carbon dioxide level?
Increased
Decreased
Unchanged
Same as w/ normal breathing
The EMT should inflate MAST if he notices a B/P below 50 systolic and:
Inadequate tissue perfusion
Decreased level of consciousness
Irregular pulse
Mental confusion
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