EMT medical and OB/GYN practice questions

A. Begin active cooling by applying cold packs to the neck, armpits, and groin. The key clues are confusion, hot dry skin, and a rapid weak pulse in a patient found in desert heat. These findings point to heat stroke, a true emergency where the body's cooling mechanism has failed and core temperature is dangerously elevated. Unlike heat exhaustion, where the skin is typically cool and moist, the hot dry skin here signals the thermoregulatory system has shut down. Placing cold packs over the neck, armpits, and groin targets major superficial blood vessels, rapidly transferring heat away from the core. The rule: hot, dry, confused equals aggressive cooling now, not after transport.

B. Maintain the airway, assess breathing and circulation, provide supportive care, and continue reassessment during the postictal period. The key clues are that the seizure has stopped, the patient is confused and drowsy, and responsiveness is gradually improving while breathing remains adequate. This is consistent with the postictal period, during which altered mental status, fatigue, and confusion are common. The EMT should maintain airway patency, assess ventilation and oxygenation, provide oxygen or ventilatory support when indicated, evaluate for injuries and possible causes, and frequently reassess the patient. Mental status should gradually improve, and failure to improve should increase concern for another underlying emergency. After a seizure stops, supportive airway care and repeated reassessment are priorities while the patient progresses through the postictal period.

D. Move nearby hazards, protect the patient’s head, and never restrain them. The key clues are active generalized convulsions, nearby environmental hazards, and bystanders attempting to physically restrain the patient. During an active seizure, the EMT should protect the patient from injury by moving dangerous objects away and cushioning or protecting the head without restricting movement. Nothing should be placed in the patient's mouth, and the extremities should not be forcibly restrained. Once the seizure stops, airway patency, breathing, circulation, mental status, and possible injuries should be immediately reassessed. During an active seizure, protect the patient from injury without restraining movement, then immediately address airway and breathing when the convulsions stop.

D. Manage the airway and support ventilations as needed. The key clues are the patient is unresponsive, has slow, shallow respirations, pinpoint pupils, and bystanders report possible heroin use shortly before the patient collapsed. These findings are highly consistent with an opioid overdose causing respiratory depression, but the immediate threat to life is inadequate ventilation rather than the overdose itself. The EMT should immediately open and maintain the airway, provide assisted ventilations with a bag-valve mask and supplemental oxygen as needed, and administer naloxone if permitted by local protocol while continuing frequent reassessments. Even if naloxone is given, ventilatory support remains the priority because the medication may take several minutes to work and may not completely reverse the respiratory depression. In suspected opioid overdose, always treat the airway and breathing first because inadequate ventilation—not the drug itself—is the immediate cause of death.

C. Carbon monoxide poisoning. The key clues are several family members are experiencing headache, nausea, dizziness, and weakness, and a gas-powered generator is running inside the attached garage. These findings are classic for carbon monoxide poisoning, which occurs when fuel-burning equipment produces carbon monoxide that accumulates in enclosed or poorly ventilated spaces. Carbon monoxide binds to hemoglobin with an affinity far greater than oxygen, reducing the blood's ability to deliver oxygen to vital tissues and producing symptoms that often resemble a viral illness or food poisoning in the early stages. EMTs should recognize the environmental hazard immediately, avoid entering or remaining in the contaminated environment, request the fire department or hazardous materials resources as appropriate, move patients to fresh air when it can be done safely, administer high-concentration oxygen, and provide rapid transport while continuing frequent reassessment. When multiple people in the same location develop similar nonspecific symptoms, always suspect carbon monoxide poisoning until the environment has been proven safe.

B. Stroke Sudden onset of unilateral facial droop, arm weakness, and difficulty speaking is highly suggestive of an acute stroke involving the left cerebral hemisphere, which commonly controls language and motor function on the right side of the body. These neurologic deficits develop when blood flow to part of the brain is interrupted by an arterial occlusion or hemorrhage, causing loss of function in the affected brain tissue. Rapid recognition is critical because some patients may be candidates for time-sensitive reperfusion therapies that can significantly improve neurologic outcomes if delivered promptly. EMTs should perform a validated stroke assessment, determine the patient's last known well time, provide appropriate supportive care, notify the receiving stroke center early, and minimize scene time.

B. Initiate rapid transport to the most appropriate stroke center while continuing assessment. The patient's sudden slurred speech, unilateral weakness, and symptom onset only 20 minutes ago strongly suggest an acute stroke requiring immediate transport to a stroke-capable facility. Brain tissue is progressively injured when blood flow is interrupted, making rapid recognition and transport essential because some patients may qualify for time-sensitive reperfusion therapies. While transport is underway, the EMT should continue the assessment, obtain the last known well time, perform a validated stroke scale, assess blood glucose when available, and provide early notification to the receiving stroke center. Minimizing scene time while gathering critical information en route gives the patient the greatest opportunity for definitive treatment.

A. Do not administer oral glucose, protect the airway, request ALS, and transport rapidly. The key clues are a blood glucose of 42 mg/dL, confusion, combativeness, and inability to follow commands. These findings indicate symptomatic hypoglycemia with an altered mental status, making the patient's ability to safely swallow unreliable. Giving oral glucose could result in aspiration, so the EMT should protect the airway, obtain ALS assistance when available, and transport for treatment that does not require swallowing. Do not give oral glucose to a patient who cannot reliably protect the airway or safely swallow.

B. Protect the child from injury, maintain the airway as able, and prepare for transport once the seizure ends. The key clues are the active generalized seizure, the history of fever, and the child's spontaneous breathing. During an active seizure, the EMT's priority is to protect the child from injury while monitoring the airway and breathing without attempting to restrain the patient or place objects into the mouth. Once the seizure ends, the airway should be reassessed, supportive care provided, and the child transported for further evaluation. Recognizing the priorities during an active febrile seizure helps prevent unnecessary interventions and reduces the risk of additional injury.

B. Position the patient on her left side and reassess her perfusion. The key clues are late pregnancy, hypotension, dizziness, and nausea developing while the patient is lying supine. The gravid uterus can compress the inferior vena cava, decreasing venous return to the heart and reducing cardiac output and blood pressure. Positioning the patient on her left side helps shift the uterus away from the vena cava and can improve maternal circulation. The EMT should then reassess mental status, pulse, blood pressure, and other indicators of perfusion. Suspected supine hypotensive syndrome is treated by moving the pregnant patient off her back, typically into a left lateral position.

B. Preeclampsia The key clues are pregnancy beyond 20 weeks accompanied by severe hypertension, persistent headache, visual disturbance, and swelling of the hands and face. These findings are strongly concerning for preeclampsia, a pregnancy-related hypertensive disorder that can progress to serious maternal and fetal complications. The EMT should minimize stimulation, provide appropriate supportive care, closely monitor the patient, and transport promptly. Severe hypertension with headache or visual changes during later pregnancy should immediately raise concern for preeclampsia.

A. Support the infant as delivery progresses without pulling on the body. The infant should be supported as the breech delivery progresses spontaneously without pulling on the body. Traction can injure the infant and may interfere with the natural delivery of the shoulders and head. The EMT should prepare for complications, maintain control of the delivery, and avoid unnecessary manipulation while arranging rapid transport when appropriate. During a progressing breech delivery, support the infant's body but allow delivery to occur without pulling or twisting.