A patient is having a stroke. Which of the following details are most important to report to the receiving hospital? Select the two answer options that are correct.
Correct Answer: C,D
NREMT stroke management focuses on rapid identification and time-sensitive intervention, particularly for patients who may be eligible for thrombolytic therapy or endovascular treatment. Option D (Time of first signs or symptoms) is critical. This determines the patient's eligibility for treatments such as tissue plasminogen activator (tPA), which must be administered within a defined time window. Option C (Patient's denial of a headache) is also important because sudden, severe headache suggests hemorrhagic stroke, whereas its absence may support ischemic stroke. This information helps guide diagnostic urgency and treatment planning. Option A is not immediately relevant prehospital. Option B is administrative, not emergent. Option E does not impact acute stroke management. NREMT stresses the importance of early notification, accurate time history, and focused neurological reporting to improve stroke outcomes.
Question 52
A mountain climber tells you that he came down from a hike because he was coughing up blood. You should suspect
Correct Answer: D
Hemoptysis (coughing up blood) in a physically active person, such as a mountain climber, strongly suggests a pulmonary embolism (PE), particularly due to: * Dehydration * Prolonged exertion or immobility * High altitude increasing clot risk Symptoms may include: * Shortness of breath * Chest pain * Tachypnea * Hemoptysis Pulmonary edema generally causes pink frothy sputum and is more associated with heart failure. Neoplasm (lung cancer) is possible but much less acute in onset. Spontaneous pneumothorax causes dyspnea and pleuritic chest pain but not typically hemoptysis. References: NREMT Medical Assessment - Pulmonary and Hematologic Emergencies AAOS EMT Textbook - Chapter: Respiratory Emergencies CDC Guidelines - High-Risk Conditions for Pulmonary Embolism
Question 53
An EMT is responding to a motor vehicle collision on a busy highway at nighttime. Which of the following tactics should the EMT employ to keep themselves safe from moving traffic? Select the three answer options that are correct.
Correct Answer: A,B,F
The correct answers are A. Wear a safety vest, B. Limit scene time, and F. Park with wheels turned toward the scene. Why A is correct (High-visibility vest): EMS providers must wear ANSI-compliant reflective vests when operating on roadways This significantly improves visibility, especially at night NREMT-aligned guidance states: "Wear high-visibility apparel when operating near traffic." Why B is correct (Limit scene time): Reducing time on the roadway minimizes exposure risk Rapid assessment, treatment, and transport are key safety strategies "Minimize time spent in hazardous environments." Why F is correct (Wheel positioning): Turning wheels toward the scene helps: Prevent the ambulance from being pushed into responders if struck Provide a protective barrier "Position vehicles to protect the scene and personnel." Why the other options are incorrect: C). Keep back turned to vehicles# Dangerous - EMTs should face traffic when possible D). Place flares 10 feet away# Incorrect distance - flares should be placed much farther away for advance warning E). Reduce scene lighting# Incorrect - proper lighting is essential for scene safety and visibility Exact Extracts (NREMT-aligned EMT educational references): "Use reflective safety vests when working on roadways." "Limit exposure time in hazardous scenes." "Position emergency vehicles to create a safe work zone." Clinical Priority Summary: Key roadway safety measures include visibility, minimizing exposure, and proper vehicle positioning, making A, B, and F the correct answers. References: NREMT EMT Education Standards - EMS Operations (Scene Safety) NREMT National Continued Competency Program (NCCP) FHWA Traffic Incident Management Guidelines (aligned with NREMT)
Question 54
A 3-year-old patient has drooling and stridor. The vital signs are BP 82/40, P 132, R 34, SpO# 94%, and T 102.4°F (39.1°C). Which of the following interventions should the EMT perform?
Correct Answer: D
The correct answer is D. Apply humidified oxygen. This pediatric patient presents with: Drooling Stridor Fever (102.4°F) These are classic signs of epiglottitis, a life-threatening upper airway infection. Critical Concept: DO NOT agitate or manipulate the airway In suspected epiglottitis: The airway is severely inflamed and unstable Any attempt to visualize, suction, or insert an airway adjunct can cause: Sudden airway closure Complete obstruction NREMT-aligned guidance states: "Avoid examining the airway in patients with suspected epiglottitis." "Do not insert airway adjuncts or suction unless absolutely necessary." Why D is correct: Humidified oxygen helps improve oxygenation without irritating the airway It is the safest and most appropriate intervention Keep the child calm and in a position of comfort Why the other options are incorrect: A). Visualize the airway # Dangerous; may cause airway collapse B). Suction posterior pharynx # Can trigger complete obstruction C). Insert an oropharyngeal airway # Contraindicated in this condition Exact Extracts (NREMT-aligned EMT educational references): "Drooling, stridor, and fever suggest epiglottitis." "Do not place anything in the mouth." "Provide oxygen and avoid agitating the child." Clinical Priority Summary: In suspected epiglottitis, the priority is to maintain a calm environment and provide oxygen without airway manipulation, making D the correct answer. References: NREMT EMT Education Standards - Airway, Respiration & Ventilation (Pediatrics) NREMT National Continued Competency Program (NCCP) AAOS Emergency Care and Transportation of the Sick and Injured (NREMT-aligned)
Question 55
Which of the following signs and symptoms indicate dehydration in an infant? Select the three correct options.
Correct Answer: C,E,F
Dehydration signs in infants include: Poor skin turgor (elasticity) Sunken fontanelles (indicative of fluid loss) Delayed capillary refill ( > 2 seconds) Flushed skin is more common in fever or heat illness, not dehydration. Hypotension, not hypertension, is associated with dehydration in late stages. References: NREMT Pediatric Assessment and Fluid Emergencies PALS Provider Manual - Dehydration in Infants AAOS Emergency Care (11th ed.) - Pediatric Emergency Chapter
