Prepare for the Advanced EMT National Registry exam with these practice questions and answers. This guide covers IV therapy, medication administration, advanced patient assessment, and emergency interventions.
Q: Compression/ Ventilation ratio for one rescuer? Two?
Answer: 1 rescuer = 30:22 rescuers = 30:2Pediatric 2 rescuer is 15:2 but otherwise stays the same
Q: What is the proper compression rate in CPR?
Answer: 100-120 per minute
Q: Compression rate for: AdultsChildren?Infants:
Answer: Adults: 2 inchesChildren: 1/3 depth of chest or 2 inInfants: 1.5 inches
Q: What are 2 rhythms are considered “shockable” rhythms?
Answer: Ventricular FibrilationPulseless Ventricular Tachycardia
Q: Use the following terms to describe the flow of blood throughout the body:Atrium, Ventricle, arteries, veins, aorta, pulmonary artery, pulmonary vein, capillaries, vena cava, arterioles.
Answer: 1. Deoxygenated blood travels through the superior and inferior vena cava to the right atrium2. The blood is pumped by the right ventricle to the pulmonary artery to the lungs. This is where the blood is oxygenated before being sent back through pulmonary veins to the left atrium.3. Blood flows into the left ventricle, which is responsible for pumping blood into the aorta and out through arteries to the body.4. Arteries branch off into arterioles, then to capillaries, which is where nutrient exchange occurs with cells.5. Last, blood flows back into the veins, into the superior and inferior vena cava before returning to the heart.
Q: What are two important roles of red blood cells?
Answer: Transport oxygen to the cellsTransport carbon dioxide to the lungs
Q: 7 signs of cardiac comporomise
Answer: 1. abnormal blood pressure2. pain, pressure, or discomfort in the chest or abdomen3. shortness of breath4. palpitations5. anxiety or irritability6. abnormal pulse7. Sudden onset of nausea or vomiting
Q: You auscultate your patient’s lungs and find crackles with difficulty breathing. Which side of the heart is affected and why?
Answer: Shortness of breath with crackles in the lungs is indicative of left-sided heart failure. Failure of the left ventricle to pump blood effectively causes blood to be backed up to into the lungs (congested)
Q: Right-sided heart failure causes blood to backup into body, causing pitting edema throughout the body. What’s the cause and name of this condition?
Answer: Cor Pulmonale. The usual cause is pulmonary disease, such as pulmonary hypertension or pulmonary stenosis (obstruction in the P.A)
Q: Preload
Answer: Preload, also known as the left ventricular end-diastolic pressure (LVEDP), is the amount of ventricular stretch at the end of diastole. Think of it as the heart loading up for the next big squeeze of the ventricles during systole. Some people remember this by using an analogy of a balloon – blow air into the balloon and it stretches; the more air you blow in, the greater the stretch
Q: Afterload
Answer: Afterload, also known as the systemic vascular resistance (SVR), is the amount of resistance the heart must overcome to open the aortic valve and push the blood volume out into the systemic circulation. If you think about the balloon analogy, afterload is represented by the knot at the end of the balloon. To get the air out, the balloon must work against that knot.
Q: List two organs in the right upper quadrant
Answer: Ventricular depolarization; less than .12 secondsQRS complex is a narrow complex usually less than or equal to 3 small boxes in length, or .12 seconds. It indicates ventricular depolarization. Conduction starts at the AV junction, through to bundle of His, left and right bundles, and the purkinje system.
Q: List two organs in the right lower quadrant
Answer: 60-100bpm.inherent rates for junctional rhythm is 40-60, accelerated junctional is typically faster and is identified by wave form
Q: List two organs in the left upper quadrant
Answer: a.k.a complete heart blockThe atria and ventricles are completely dissociated.-impulse is generated in the SA node in the atrium does not propagate into the ventricles. because the impulse is blocked, an accessory pacemaker in the lower chambers will typically activate the ventricles.-explains why two distinct rhythms can be noted in this heart block.
Q: List two organs in the left lower quadrant
Answer: Hidden or inverted.-JRs originate in the lower heart, meaning the complexes will be wide, which hides the P waves, or it can invert them depending on how low in the heart they are coming from.
Q: On a normal EKG strip, what does the QRS complex represent and what is it’s normal duration?
Answer: .12-.20 seconds.
Q: Rate for an Accelerated Junctional Rhythm is how many bpm?
Answer: Atrial Depolarization
Q: What occurs in a third degree heart block?
Answer: a variety of configurations.Multifocal PVC’s have a variety of configurations due to the fact that the spot of origination moves. It’s never in the same spot causing a variety of different looking waves and morphology
Q: In junctional rhythms, P waves can be:
Answer: .04 seconds
Q: In Normal Sinus Rhythm, P-R interval must fall between
Answer: Trigenmeny.Just as Bigeminy PVCs in every two beats, Trigeminy PVCs regularly appear in every third beat.
Q: The P-wave is representative of what cardiac event?
Answer: Unifocal PVC’s have constant configuration because they originate from the same spot every time- wherever the pacemaker may be. No change in morphology.
Q: The morphology of multifocal PVC’s have:
Answer: Single irritable beatsA premature ventricular contraction (PVC) is a single irritable beat.
Q: Every little box on a 12-lead EKG is representative of how many seconds of recording?
Answer: .2 seconds.
Q: PVC’s that appear in every third beat are referred to as:
Answer: .12 seconds or greaterVentricular rhythms are wide in complex, thus signifying where it originates from, with a .12 seconds or greater measurement
Q: The morphology associated with unifocal PVC’s have:
Answer: an absent p-wave with a very high rate
Q: Your patient is a 23-year-old college student. He states that he has had an intermittent fluttering sensation in his chest since this morning. He further states that he was up all night cramming for his final exams today. When asked if the patient had taken anything, he replies that throughout the night he had consumed about 4 large energy drinks, had some “No-Doz” anti-sleep medication and a few cups of coffee. The patient is most likely exhibiting PVC’s, which are:
Answer: 25mm/sec
Q: Every big box on a 12-lead EKG is representative of how many seconds of recording?
Answer: Atrial fibrilation.
Q: A basic rule for ventricular arrhythmia’s is that the QRS measurement will be:
Answer: Sinus bradycardiaAll of the intervals fall within the normal range except for the rate of 42 beats per minute. Signifying Bradycardia.
Q: On an EKG, Supraventricular Tachycardia can be identified by
Answer: Left ArmThe positive end of lead I and the negative end of lead III intersect at the left arm. This point on the ECG is opposite lead II on the triangle and creates the wave for lead II seen on the monitor
Q: ECG paper on a normal EKG will move at which rate of speed?
Answer: The answer is a couplet. Not to be confused with a bigeminy PVC. Bigeminy PVCs are PVCs that regularly appear in every second beat.
Q: You respond to a nursing home to find a 90-year-old male complaining of chest pain and shortness of breath. The nurse tells you that the patient has an extensive cardiac history, but she cannot find his chart to explain the exact history. You take his vital signs and find that he is tachycardic with a blood pressure of 100/50 and a pulse oximetry of 97%. You place him on a cardiac monitor and find the following rhythm which you identify as
Answer: .08 to .12 seconds
Q: A patients EKG shows a rhythm at a rate of 42 beats per minute, regular RR intervals, a PR interval of .16 seconds, and a QRS of .12 seconds. This best fits the criteria for:
Answer: Abdominal thrusts are indicated for this patient since he is older than 1.Patient’s less than 1 years of age should receive chest thrusts and back blows. Even though your patient is coughing, it has become weak (ineffective) and you can hear inspiratory stridor. If you do not act quickly, this partial airway obstruction could become a full airway obstruction.
Q: You place the 4-lead cardiac monitor on a patient with general weakness during transport for monitoring purposes. When considering Einthoven’s triangle, which lead placement is where the positive/negative poles intersect?
Answer: The order that you received from medical control was to assist the patient in self-administering the inhaler. Due to his altered mental status he is unable to self-administer the medication. You should provide 100% supplemental oxygen, managing his airway as needed, and have ALS transport immediately.
Q: Explain Einthoven’s triangle.
Answer: Respiratory acidosis.Due to the patient’s COPD, he has inadequate gas exchange in the lungs. This causes his pCO2 to increase above 45 mmHg and pH to drop below 7.35.
Q: Two PVC’s attached to each other are referred to as a
Answer: rhythmino refers to muscles
Q: The normal duration of a P-wave is represented by which of the following?
Answer: Decreased preload.Preload is the amount of returning blood that puts pressue against the walls of the ventricles just before they contract. Factors that affect preload are circulating blood volume, volume of blood returning to the heart, and strength of atrial contraction. The patient is dehydrated and hypotensive. This should clue you into a problem with preload
Q: You have been dispatched to a restaurant for a possible choking. Your patient is an 18-month-old male who was eating chicken nuggets when he began to cough and appeared to experience respiratory distress. Your patient has a weak cry and cough and you can hear inspiratory stridor from your patient when you walk in the door. What should your immediate action be?
Answer: Oculomotor (III)
Q: You are treating a 56-year-old male who has been diagnosed with chronic obstructive pulmonary disorder (COPD). The patient’s skin is cool and clammy, respirations are slow and shallow, and appears to have a slightly altered mental status. The patient has labored breathing at a rate of 8 breaths per minute and has a heart rate of 125 beats per minute. The patient has an Albuterol inhaler prescribed to treat his COPD. You call medical control and are ordered to assist the patient in self-administering the inhaler. You check that the inhaler is the right medication, dosage, and is prescribed in his name. The patient tries to self administer the medication, but is having difficulty due to his altered mental status. You should
Answer: Type of unstable angina in which a coronary artery spasm is the cause for diminished blood flow. Like unstable angina, onset cannot be predicted
Q: You respond to a 58-year-old male with shortness of breath. The patient’s wife tells you he has COPD and this has been going on for 3 days. What acid-base imbalance is this patient most likely experiencing?
Answer: Dull chest pain radiating typically to the left shoulder, neck, jaw, or back
Q: cardiac tamponade
Answer: Infarction is death of the tissue, at the end of ischemia. Result of absence of blood supply to the heartIschemia is decrease in blood supply to the heart leading to chest pain or angina
Q: An inotropic effect refers to one that effects the heart’s?
Answer: Results in congestion of blood in vena cavaJugular venous distentionPeripheral edemaEnlarged liverProbably hypotension
Q: You are on scene at the local health club with a 42-year-old accountant who was working out after work. Bystanders report that the patient had been running on the treadmill for an hour when he “passed out” and hit his head as he fell off the treadmill. The patient has a weak, rapid pulse and has hot, dry skin. A manual blood pressure reads 70/P. What component of stroke volume is most likely the cause of the patient’s condition?
Answer: Congestion of blood in lungsRespiratory distressPulmonary edemaLung sounds crackles or cardiac asthma
Q: Which cranial nerve is responsible for pupil size, shape, and reactivity?
Answer: Term used to describe fractures to the face including the maxillary and nasal bones. Usually by blunt force
Q: Prinzmetal angina ( variant angina )
Answer: .3-.5mg for adults.01mg/kg for pediatric
Q: Most classic features of MI
Answer: Thunderclap headache
Q: Difference between myocardial infarction and myocardial ischemia
Answer: Total GCS is 13. 3 for verbal command, 5 for oriented and converses, 5 for oriented and converses.
Q: Signs of Right-Sided Heart Failure
Answer: Collection of blood over the surface of the brain between the dura mater and arachnoid meninges
Q: Signs of Left-Sided Heart Failure
Answer: Diastole.The rest of the body is perfused during systole
Q: Le Fort II fracture
Answer: abnormal decrease in systolic pressure during inspiration. Due to decreased cardiac output. Usually more than 10mmhg
Q: Dose for epinephrine
Answer: BSA x 4ml x kg body weight. 50% in first 8 hours, 50% the next 16Lactated ringer’s for fluid replacementBSA is body surface area %
Q: Classic symptom of subarachnoid hemorrhage
Answer: Shows signs of increased intracranial pressureHypertension, bradycardia, and irregular respiratory rate (usually decreasing)
Q: Your patient responds to your commands, is oriented and converses, and localizes pain. What is his GCS and give each score
Answer: Quick, shallow respirations that have intervals of apenea
Q: subdural hematoma
Answer: Active processNegative Pressure
Q: What stage of contraction is blood delivered to the arteries?
Answer: 1-2 mins
Q: pulsus paradoxus
Answer: your care is limited, so you are treating for shock as an AEMT.oxygen, fluid bolus (500ml), IV, and transport
Q: Parkland burn formula
Answer: states that an increase in preload will result in an increase in the next ventricular contraction, to a certain point.
Q: Cushing’s Triad
Answer: Hypotension, JVD, muffled heart soundsIndicates Cardiac Tamponade
Q: Biot’s Respirations
Answer: affects the conduction speed in the AV node, and subsequently the rate of electrical impulses in the heart.
Q: Inspiration is a/an _______ Process causing __________ pressure in the pleural space
Answer: Rate
Q: After giving nitroglycerin, how long must you wait until you can administer another dose?
Answer: Nitroglycerin will increase the “container size”, meaning it will dilate the vessels and decrease the pressure against which the ventricles must pump against (afterload). A decrease in afterload will decrease the workload of the heart.
Q: Treatment for cardiac tamponade is?
Answer: The main thing with this patient is that they are stable, eliminating the need for synchronized cardioversion. Often, vagal maneuvers are able to slow the heart rate and correct the problem, before resorting to the more invasive Adenosine.
Q: Starling’s law of the heart
Answer: 20-40
Q: three signs of Beck’s Triad
Answer: 60bpm
Q: dromotropic agent
Answer: Atrial fibrillation is a heart rhythm that does not adequately perfuse the body with blood due to abnormal electrical impulses in the atria, leading to a usually rapid and irregular heart rhythm. During A-fib, the atria fire at approximately 400-600 beats per minute. Hypotension is common due to the inefficiency in contractions of the heart. Altered LOC is commonly seen with A-fib due to lack of adequate blood flow, specifically to the brainIn short, Tachycardia, Hypotension, and altered LOC
Q: chronotropic effect refers to one that effects the heart’s?
Answer: condition that affects the 7th cranial nerve and causes facial paralysis. This condition can mimic the signs/symptoms of a stroke or CVA.
Q: You are on scene with a 60-year-old male patient complaining of chest pain. Vitals signs: BP 204/100, P 86, RR 20, SpO2 96%. Your protocols indicate that you should administer 0.4 mg of Nitroglycerin. What aspect of stroke volume is Nitroglycerin decreasing in order to decrease workload of the heart?
Answer: Blue- Health HazardRed- Fire HazardYellow- ReactivityWhite- Specific agents ex: Corrosive, acid, or oxidizer0= normal – 4 = very volatile
Q: You are dispatched to a 28-year-old female complaining of dizziness. You determine that the patient is stable, but anxious and showing SVT on the monitor. Your first course of action is?
Answer: ERG- Emergency resource guidebook
Q: Bundle of His has an intrinsic firing rate of approximately how many bpm
Answer: National Incident Management SystemCommand, finance, logistics, planning, operations
Q: What is the intrinsic rate for impulses originating in the atria?
Answer: Chronic inflammatory disorder of the airways. Increased sensitivity of the lower airways to irritants and allergens. This causes bronchospasm and inflammation to the lining of the bronchioles
Q: symptoms is most consistent with a patient presenting with new onset atrial fibrillation
Answer: Bronchial tubes become inflamed, sputum production can increase creating a productive cough.
Q: Bell’s Palsy
Answer: Related to COPD. Inflammation, swelling, and thickening of the lining of the bronchi and bronchioles. Thick mucus restricts airflow to alveoli so they don’t expand fully causing respiratory distress.
Q: What do the 4 sections of an NFPA placard represent?
Answer: Diagnosis given to young PT’s who have acute onset of lower and upper airway inflammation. Disturbs V/Q ratio and causes labored breathing
Q: Tool on ambulances to help identify hazardous substances?
Answer: air in the pleural cavity caused by a puncture of the lung or chest wall. Causes resp. distress. Open pneumo comes from outside, closed comes from air escaping a hole in the lung into the pleural space
Q: NIMS
Answer: condition in which air entrapped in the pleural space puts pressure on the lung and heart.
Q: Asthma
Answer: Commonly causes pulmonary dysfunction due to changes of mucus secreting glands. Mucus lining all over respiratory tree is normally watery and warm. Abnormal gene causes an overabundance of mucus that’s very thick and sticky. As this thick layer develops, blockage of airways occurs with increase of infections that can readily grow in thick mucus. Repeated infections cause scarring of lung tissue. Resp. function diminishes as ability to clear thick mucus is decreased which leads to pulmonary failure and death.
Q: Acute bronchitis
Answer: Contract. Chest wall expands and diaphragm drops.
Q: chronic bronchitis
Answer: HyperventilationNumbness in fingers and toes