Dispatch sends you to a house for an unknown problem. The door is open and you hear someone yelling that they have a gun. What do you do?
Choose the one best answer.
Correct. You do not enter. Law enforcement secures the scene before you approach.
Wrong. The primary assessment is the right next step, after the scene is secure. The gun is still the first problem.
Wrong. Vital signs come after scene safety. The porch is not a secure scene.
Wrong. Oxygen and SAMPLE are real care. They wait until you are not walking toward a stated weapon.
Scene size-up and safety
You smell a strong chemical odor at a warehouse and see a diamond-shaped placard you do not recognize. Workers are coughing at the door. What do you do?
Choose the one best answer.
Wrong. Naming the placard from a safe distance is part of the report. It does not replace keeping people out and calling the hazmat team.
Wrong. Vital signs are appropriate after the workers are in fresh air. Driving into the plume contaminates the ambulance.
Wrong. Oxygen and triage are the right care once people are out of the vapor. Going in with them is not how you get there.
Correct. Scene size-up here is isolation and the right resource. Treatment happens after people are out of the vapor.
Scene size-up and safety
Which actions belong in scene size-up before you touch the patient? Select every action that applies.
Select all that apply. This item is correct only if every selection is right.
Correct. Mechanism of injury is gathered during size-up so the primary assessment knows what to suspect.
Wrong. A blood pressure is a patient exam, not size-up.
Correct. Body-substance isolation is part of approaching safely.
Correct. The number of patients decides whether you need more units.
Wrong. Splinting is treatment. It is not done before you have sized up the scene and found life threats.
Primary assessment
An unresponsive patient is breathing normally and has a pulse. There is no trauma. How do you position them while you prepare to move?
Choose the one best answer.
Wrong. Vital signs belong with the secondary assessment. The airway position does not wait for a blood pressure.
Wrong. Oxygen and SAMPLE are reasonable after the airway is protected. A breathing unresponsive patient is positioned on the side first.
Correct. The recovery position lets fluid drain and helps keep the tongue forward. Confirm breathing first, then keep checking it.
Wrong. A back exam is part of the secondary assessment when trauma is possible. This patient has no trauma, and the recovery position comes before that exam.
Primary assessment
You are about to place an oropharyngeal airway in an unresponsive adult. The patient gags as the airway reaches the tongue. What do you do?
Choose the one best answer.
Correct. A gag means the oropharyngeal airway comes out. Manual opening is the move. A nasal airway is a later option only when there is no sign of basilar skull injury.
Wrong. A nasal airway can be a later adjunct if there is no sign of basilar skull injury. The gagged oropharyngeal airway has to come out first.
Wrong. Ventilation may be next if breathing is inadequate, after a tolerated airway is in place. Taping a gagged airway in place causes vomiting.
Wrong. Ventilation may be the next step if breathing is poor. Advancing an airway the patient is gagging on causes vomiting first.
Primary assessment
The AED analyzes and advises a shock. You deliver the shock. What is the next action?
Choose the one best answer.
Wrong. A second shock may be indicated later, after two minutes of CPR, if the rhythm is still shockable. Compressions come first.
Wrong. A pulse check comes at the next rhythm analysis, about two minutes later. Stopping now for vital signs leaves the patient without circulation.
Wrong. A pulse check is the right step at the next AED analysis, about two minutes from now. Stopping immediately after the shock leaves no circulation.
Correct. Start CPR again at once. The AED will prompt the next rhythm check after about 2 minutes.
Primary assessment
A conscious adult is choking and cannot speak or cough. What do you do?
Choose the one best answer.
Wrong. Coaching a cough is right when the patient can still cough and speak. This patient cannot. Oxygen does not move the object.
Wrong. Abdominal thrusts are part of the sequence. They come after back blows, not before.
Correct. Back blows are the first move for a severe obstruction in a conscious adult. Abdominal thrusts follow. If the patient becomes unresponsive, start CPR and look in the mouth before each breath.
Wrong. That is the correct care after they lose consciousness. They are conscious now, so back blows come first.
Primary assessment
During adult CPR, which performance is correct?
Choose the one best answer.
Wrong. 140 is too fast, and leaning prevents recoil, so the heart does not refill.
Wrong. Without compressions there is no circulation. Arrest care is compressions first.
Correct. Rate, depth, and full recoil are the three parts of a useful compression. Avoid depths greater than about 2.4 inches.
Wrong. That rate and depth are too low to circulate blood.
Primary assessment
An adult is breathing slowly after taking pills. You are not sure you feel a pulse. How long do you check before you decide?
Choose the one best answer.
Wrong. Ventilation is right when there is a pulse and breathing is bad. You decide about the pulse within 10 seconds before you choose ventilation or compressions.
Wrong. Oxygen and a two-minute recheck fit a patient you have already found has a pulse. You have not found that yet.
Wrong. The history is useful and comes after circulation is being supported.
Correct. If the pulse is not definite within 10 seconds, treat it as absent and start compressions.
Primary assessment
A patient has a pulse and slow breathing after a suspected opioid overdose. Which actions apply? Select every action that applies.
Select all that apply. This item is correct only if every selection is right.
Correct. Slow breathing with a pulse is respiratory failure. Ventilate.
Correct. For suspected opioid overdose with a pulse and abnormal breathing, naloxone is reasonable in addition to ventilation.
Wrong. Compressions are for no pulse. A definite pulse means you ventilate instead.
Wrong. The bottle and the history are useful. They come after breathing is being supported, not instead of it.
Secondary assessment
A patient can follow commands, has facial droop, and arm drift. What history matters most for the hospital?
Choose the one best answer.
Wrong. Aspirin is a real chest-pain treatment. Do not give it for a suspected stroke. The deficit may be a bleed.
Correct. Last known well is the clock the hospital uses. Ask when someone saw the patient normal.
Wrong. A blood pressure is part of the secondary exam. Walking is not how you test a new stroke, and it delays transport.
Wrong. SAMPLE is appropriate and can be gathered on the way. The last-known-well time is the history that changes the hospital's window.
Secondary assessment
Which set of findings is a secondary-assessment vital sign set rather than a life-threat decision?
Choose the one best answer.
Wrong. That bleeding is a primary-assessment life threat, not a number you record and move past.
Wrong. That is cardiac arrest, found and treated in the primary assessment.
Wrong. Gurgling is suctioned during the primary assessment.
Correct. A complete set of stable vital signs is documented during the secondary assessment.
Patient treatment and transport
A diabetic patient is confused, sweaty, and able to swallow and follow simple commands. A finger-stick glucose is low. What treatment is appropriate?
Choose the one best answer.
Wrong. The hospital can continue care. A patient who can swallow should get oral glucose before the ride, not instead of ever getting it.
Wrong. A secondary exam can follow. Sugar comes first while they can still swallow.
Correct. The patient can swallow and follow commands, and the glucose is low. Give oral glucose and reassess.
Wrong. Ventilation is the right tool when breathing is inadequate. This patient is following commands and can swallow.
Primary assessment
A patient is seizing on the floor. What do you do?
Choose the one best answer.
Wrong. A glucose check is appropriate after the seizure, especially if the patient stays confused. It is not done by wrestling a seizing patient.
Wrong. Oxygen may help after the seizure if breathing is poor. Restraint during the seizure causes injury and does not stop it.
Correct. Clear the area and protect the head. After the seizure, open the airway and check breathing. Suction if needed.
Wrong. Airway and breathing care is the right next step when the seizure stops. During the seizure you protect them from injury.
Patient treatment and transport
A patient with prescribed nitroglycerin has chest pain. The systolic blood pressure is 86 mm Hg. The patient took a drug for erectile dysfunction yesterday. What do you do about the nitroglycerin?
Choose the one best answer.
Correct. A systolic pressure of 86 is too low, and a recent erectile-dysfunction drug can drop the pressure further. Follow protocol and do not give it.
Wrong. Rechecking the pressure between doses is the right sequence when nitroglycerin is allowed. The first dose is not allowed here.
Wrong. The extra history is appropriate. It does not remove the low pressure or the recent erectile-dysfunction drug.
Wrong. Walking is never the test for chest pain. The nitroglycerin is contraindicated whether they walk or not.
Patient treatment and transport
A knife is impaled in the abdomen. Bleeding is moderate. What do you do with the knife?
Choose the one best answer.
Wrong. Bleeding control around the object is right. Removal is a later hospital step. The blade may be tamponading the wound.
Correct. Stabilize the object so it does not move, control external bleeding, and transport.
Wrong. Oxygen, vital signs, and a secondary exam are all reasonable after the object is stabilized. The knife moves if you delay the dressing.
Wrong. A dressing that stabilizes the object is a form of splinting. Walking comes never with an abdominal impalement.
Patient treatment and transport
Arrange the care of a chemical splash in the eye.
Put every step in the order you would do it. This item is correct only if the whole list is right.
Steps still to place
Your order
Step 1, correct. Stop the burning exposure and keep the patient from rubbing the eye. This is first. Rubbing spreads the chemical, and the exposure has to stop.
Step 2, correct. Flush the eye with a large amount of water or saline, away from the other eye. Dilution is the treatment. Flush so the runoff does not contaminate the uninjured eye.
Step 3, correct. Remove contact lenses if they come out easily during the flush. Lenses can trap chemical. Take them out during irrigation if they release easily.
Step 4, correct. Cover the eye loosely after the flush and transport. A loose cover comes after the chemical is diluted, not before.
Operations
At a bus crash, a person walks to your collection area when you ask anyone who can walk to move. Which START tag applies?
Choose the one best answer.
Correct. Walking patients are sorted as minor and directed to the collection point. You then triage the people who cannot walk.
Wrong. They are patients. They are tagged minor so they are not lost.
Wrong. The vehicle does not set the tag. The ability to walk does.
Wrong. A walking patient is not expectant. Expectant or dead is for patients who are not breathing after the airway is opened.
Operations
A patient says they want to die and took a handful of pills. They are alert and refuse transport. What do you do?
Choose the one best answer.
Wrong. SAMPLE and vital signs are part of the exam. Normal numbers do not make a suicide attempt a valid refusal.
Correct. A suicide attempt is an emergency, and the patient cannot refuse. The pill list goes with them. Get law enforcement if the scene is unsafe.
Wrong. Documentation belongs in the report. A refusal they cannot legally make is not documented as accepted.
Wrong. An informed refusal is right for a decisional adult. Suicidal intent means this patient is not treated as free to refuse.
Operations
You are first on scene of a three-car crash. What operations action happens during size-up?
Choose the one best answer.
Wrong. Staging and protection are right. Oxygen on one patient before a size-up report skips command.
Correct. Naming command and asking for help early is the operations piece of size-up.
Wrong. More units are part of the size-up. A detailed exam of one driver waits until you know who is immediate.
Wrong. Vital signs on walking patients come after triage. You cannot cancel help before you know the number of patients.
Original study items. Not an official examination, not affiliated with the National Registry of Emergency Medical Technicians, and not medical advice.