A 60-year-old patient has crushing, midsternal chest pain that began about 5 minutes ago with exercise. The patient has no prescription medications. The vital signs are BP 142/102 mmHg, P 90/min, R 16/min, and SpO# 95% on room air. What treatments should the EMT provide? Select the two answer options that are correct.
Correct Answer: D,E
The correct answers are D. Aspirin administration and E. Attaching AED pads. This patient is presenting with classic signs of acute coronary syndrome (ACS): * Crushing, midsternal chest pain * Onset with exertion * Age and risk profile D). Aspirin administration is a priority intervention. Aspirin helps by inhibiting platelet aggregation and limiting clot formation in coronary arteries. NREMT-aligned guidance states: * "Administer aspirin to patients with suspected cardiac chest pain." E). Attaching AED pads is also correct because patients with suspected cardiac ischemia are at risk for sudden cardiac arrest. Continuous cardiac monitoring (via AED pads or monitor) allows for rapid defibrillation if needed. NREMT material emphasizes early readiness for deterioration: * "Be prepared to manage sudden cardiac arrest in patients with chest pain." Why the other options are incorrect: * A. Sublingual nitroglycerin administration:EMTs may only assist with nitroglycerin if it is prescribed to the patient. This patient has no prescription medications, so nitroglycerin is contraindicated. * B. 12-lead acquisition and transmission:This is typically an ALS (paramedic-level) intervention, not standard EMT scope in NREMT context. * C. Applying supplemental oxygen:The patient's SpO# is 95% on room air, which does not indicate hypoxia. NREMT guidelines recommend oxygen only if SpO# is low or patient is in respiratory distress. NREMT guidance: * "Oxygen should be administered based on patient need, not routinely." Exact Extracts: * "Administer aspirin to patients with suspected cardiac chest pain." * "Oxygen should be given only if the patient is hypoxic or shows signs of respiratory distress." * "Be prepared for cardiac arrest in patients with suspected myocardial infarction." References: NREMT EMT Education Standards - Cardiology / Acute Coronary Syndrome NREMT National Continued Competency Program (NCCP) - Cardiac Emergencies Standard EMT Text (aligned with NREMT): Cardiovascular Emergencies
Question 97
Which of the following components can be determined by assessing the mechanism of injury? Select the two correct options.
Correct Answer: A,E
Mechanism of Injury (MOI) assessment is a cornerstone of trauma care. It helps providers determine: Extent of injury: High-speed collisions, falls from height, or penetrating trauma suggest internal injuries even if external signs are limited. Need for additional resources: MOI may indicate the necessity of ALS backup, air transport, or technical rescue. MOI cannot determine a patient's medical history or guarantee survival predictions. The destination facility depends on multiple factors including triage protocols, vital signs, and local trauma system regulations. References: NREMT Trauma Assessment Skills Sheet National EMS Education Standards - Trauma Module AAOS Emergency Care and Transportation (11th ed.), Chapter: Mechanism of Injury and Trauma Assessment
Question 98
A 38-year-old patient is unconscious with slow, shallow, and gasping breaths. The patient is not moving. What should the EMT perform first?
Correct Answer: D
Comprehensive and Detailed Explanation From Exact Extract: In anyunresponsive patient, the first step is toassess and open the airwayto determine patency and identify obstruction or inadequate breathing. Gasping respirations (agonal) are not effective; they requireBVM ventilationsupport. The airway must be openbefore checking for a pulse or performing auscultation. A secondary assessment is performed only after primary survey and stabilization. References: AHA BLS Provider Manual (2020) - Unresponsive Patient Algorithm NREMT Airway Skills - Primary Assessment National EMS Education Standards - Airway, Breathing, Circulation (ABC) Sequence
Question 99
Which of the following adverse conditions typically occurs during hemodialysis treatment?
Correct Answer: D
The correct answer is D. Muscle cramps. Hemodialysis is a process that removes waste products and excess fluid from the blood in patients with kidney failure. During this process, rapid shifts in fluid and electrolytes can lead to several complications. One of the most common adverse effects during hemodialysis is muscle cramps, which are primarily caused by: Rapid fluid removal (hypovolemia) Electrolyte imbalances Changes in osmolarity Why D is correct: NREMT-based medical guidelines highlight that: "Patients undergoing dialysis commonly experience complications such as hypotension and muscle cramping." Muscle cramps are frequently reported during or immediately after dialysis due to fluid shifts. Why the other options are incorrect: A). Tinnitus: Not associated with dialysis treatment. B). Gallstones: A chronic condition unrelated to dialysis sessions. C). Hypertension: While kidney patients may have hypertension, dialysis more commonly causes hypotension, not hypertension, during treatment. Exact Extracts: "Complications of dialysis include hypotension and muscle cramps." "Rapid fluid shifts during dialysis can result in painful muscle cramping." "Dialysis patients may experience electrolyte imbalances leading to neuromuscular symptoms." References: NREMT EMT Education Standards - Medical Emergencies (Renal and Urologic Conditions) NREMT National Continued Competency Program (NCCP) - Medical Content Prehospital Emergency Care (EMT) - Renal Emergencies
Question 100
A 42-year-old male states, "I can't breathe" after being shot in his upper thigh. Bystanders have applied direct pressure to his thigh and the bleeding is controlled. You should first
Correct Answer: C
Comprehensive and Detailed Explanation From Exact Extract: Thepatient's complaint of difficulty breathingis anairway/breathing issueand takes precedence over a controlled extremity bleed. The first action is toadminister oxygenand evaluate respiratory effort. Though reassessing the wound is important,oxygenation is the prioritywhen airway compromise or respiratory distress is present. Tourniquets are foruncontrolled bleeding, which is not the case here. References: NREMT Trauma Assessment Guidelines National EMS Education Standards - Primary Assessment Priorities Brady Emergency Care (13th ed.) - Chapter: Patient Assessment
