9 free EMT practice questions: Chief Complaint & Life Threats

The swelling and tenderness of the left wrist: A swollen, tender wrist is a real injury that will need a splint. The wrist got hurt in the fall, and the chest pressure caused the fall. Splinting first treats the injury from the fall while the cause of the fall goes untreated.

The abrasion on the patient's forehead: A small forehead abrasion gets a bandage once the life threats are handled. The abrasion is superficial and does not explain why this patient sagged and went down. Dressing a scrape first leaves the chest pressure untreated.

The possibility of a neck injury from the fall: A fall is a mechanism that can injure the neck, and spinal precautions belong in your assessment. This patient is alert, denies neck and back pain, and moves all four extremities. Those findings make a serious spinal injury unlikely. Spinal precautions also do nothing for the chest pressure that started before the fall.

Swelling and deformity of the right wrist: The swollen, deformed wrist is what the patient is complaining about. A closed wrist injury with nothing else in an alert patient is not a life threat. Manage the wrist after the life threats are handled.

Blood pressure of 168/94 mmHg: The blood pressure of 168/94 is the most abnormal vital sign. A high blood pressure by itself is not the threat here. High blood pressure often comes along with a sudden brain problem like this one, and with pain.

Report of pain at the wrist only: Pain only at the wrist would matter if the patient's report covered every problem. The speech and arm findings came from your exam, not from the patient. What the patient does or does not feel cannot rule those findings out.

The reading is falsely raised by the cold outdoor air: Cold can affect a pulse oximeter. Cold tightens the blood vessels and gives a wrong or misleading value instead of a higher one. The question also says this patient's skin is warm and dry.

The reading shows the tissues are receiving enough oxygen: A high reading sounds like proof the tissues are getting oxygen. The pulse oximeter only reports the percent of hemoglobin that is saturated. The device cannot tell which gas is attached to the hemoglobin. A reading of 99% does not show that oxygen is reaching the tissues.

The reading rules out carbon monoxide as a cause here: A high reading sounds like evidence against carbon monoxide. The saturation can read normal in carbon monoxide poisoning while the patient is hypoxic. The reading cannot rule out the furnace as the cause of three people's symptoms.

Severe pain reported from the burned areas: The severe pain is what this patient notices most. Pain guides comfort care and transport decisions. Pain does not close an airway, and the soot, singed nostril hair, and hoarse voice tell you this airway could close.

Partial-thickness burns of the chest and both arms: The size and depth of a burn decide which hospital the patient goes to and how much fluid the patient needs later. These burns are partial-thickness on the chest and arms. The airway findings are already present, and an airway that swells shut is the faster threat.

Pulse of 108/min with unlabored breathing: The pulse of 108 stands out in the vital signs. A pulse that fast is expected with pain and stress after a fire. The breathing is unlabored, so the pulse is not the threat here.

Wait on scene until symptoms begin to appear: A child who is alert and playing looks well enough to watch. The child swallowed the tablets 20 minutes ago, and many are missing. The drug is still being absorbed, and the current findings tell you nothing about what the dose will do.

Give water to dilute the tablets in the stomach: Giving water to dilute a poison sounds protective. Water does not remove tablets that are already swallowed. Stopping to give water also delays transport. For a swallowed poison, an EMT has activated charcoal where local protocol allows it, and prompt transport.

Perform a head-to-toe examination before moving: A head-to-toe exam before moving makes sense when there is something to find and treat on scene. The primary assessment here found nothing to manage on scene. A head-to-toe exam spends minutes that matter, because this poisoning is time-critical.

Tension headache: A tension headache fits stress, like someone working at a desk. A tension headache is squeezing, dull, or aching, and it comes with no other findings. This patient has neck pain, keeps asking what happened, and has a very high blood pressure.

Bacterial meningitis: Neck pain can come from meningitis irritating the lining of the brain. Bacterial meningitis comes with a fever and sensitivity to light, and it builds over hours. This patient has no fever, no sensitivity to light, and a temperature of 98.4°F.

Migraine headache: This patient does have a history of migraines. A migraine builds over time and usually feels like the past ones. This headache peaked within seconds, and the patient says it does not feel the same.

The forearm laceration, because every wound must be fully bandaged before transport: A forearm laceration normally gets bandaged before transport. This laceration is minor, and the bleeding has already stopped on its own. With no active bleeding, the laceration belongs in the secondary assessment. You do not stop the primary assessment for a wound like this.

The decreased level of consciousness alone, which by itself requires ventilation: Responding only to pain is a real drop in consciousness. Pain is the P on the AVPU scale of Alert, Verbal, Pain, Unresponsive. The drop in consciousness explains why this patient cannot protect the airway. An altered mental status alone does not call for ventilation with a bag-valve mask. The gurgling is the airway problem the drop in consciousness caused, and you treat the gurgling first.

The absence of any deformity to the extremities: No deformity to the extremities is a normal finding. You note the normal finding and move past it. A normal extremity exam is never a threat to the airway, breathing, or circulation.

Any swelling after an insect sting is by definition anaphylaxis: A local reaction gives you redness, swelling, and itching right at the sting site, with nothing anywhere else on the body. Swelling at the sting site alone is not anaphylaxis. This patient's swelling is in the face, and the patient is also wheezing.

Wheezing alone is sufficient regardless of any other findings: Wheezing by itself can come from asthma or another breathing problem. A wheeze with nothing else does not separate anaphylaxis from asthma. This patient also has hives and facial swelling, so the wheezing is one part of a reaction in more than one system.

Anaphylaxis requires the patient to already have a known bee allergy: A known bee allergy makes you more suspicious, but anaphylaxis can happen on the first sting a person ever gets. Nothing in the question says this patient has a known allergy. The hives and the wheezing happening together are what make this anaphylaxis.

Simple pneumothorax: A simple pneumothorax is a collapsed lung, and it also gives you absent or decreased breath sounds on that side. The pressure in a simple pneumothorax does not keep building. Without that pressure, a simple pneumothorax does not cause the worsening breathing, the low blood pressure, or the distended neck veins this patient has.

Pulmonary contusion: bruised lung tissue. Bruised lung causes hypoxia, with crackles or diminished breath sounds. The trapped air of a tension pneumothorax shifts the mediastinum, the middle of the chest. A bruised lung does not. Pulmonary contusion does not explain absent breath sounds on one side with JVD.

Flail chest: comes from several broken ribs right next to each other. You find a flail chest by the paradoxical movement of the chest wall. This patient has absent breath sounds, JVD, a low blood pressure, and breathing that is getting worse. A flail segment does not explain those findings.