CCMA Emergency Management and First Aid 6

Question 1

During a code in the clinic, a patient in cardiac arrest has just had an advanced airway (endotracheal tube) placed by the provider. The medical assistant is giving ventilations with a bag-valve device. According to current AHA adult BLS guidelines, how should compressions and ventilations be coordinated now?

Accepted Answer

Give continuous compressions at 100–120/min and 1 breath every 6 seconds without pausing compressions

Answer

Once an advanced airway is in place, compressions no longer stop for breaths. Compressions continue at 100–120 per minute, and the rescuer gives 1 breath every 6 seconds (10 breaths/min). The 30:2 ratio applies only before an advanced airway is placed. Breathing faster than this (for example, every 3 seconds) causes hyperventilation, which raises intrathoracic pressure and reduces venous return and coronary perfusion. A 15:2 ratio is used for two-rescuer CPR on children and infants, not for adults with an advanced airway.

Question 2

A diabetic patient taking acarbose (an alpha-glucosidase inhibitor) becomes shaky and diaphoretic in the waiting room. Fingerstick glucose is 58 mg/dL, and the patient is alert and able to swallow. Which treatment is MOST appropriate?

Accepted Answer

15–20 g of glucose (dextrose) tablets or gel

Answer

Acarbose blocks the intestinal enzymes that break complex carbohydrates and disaccharides such as sucrose (table sugar, most candy) into absorbable monosaccharides. Hypoglycemia in a patient on acarbose must be treated with pure glucose (dextrose), which needs no enzymatic breakdown. Juice contains a lot of sucrose and absorbs less reliably. Fat and protein slow absorption, so a sandwich is the wrong first-line treatment. Recheck glucose in 15 minutes and repeat if it is still below 70 mg/dL.

Question 3

A worker arrives at the clinic with dry powdered lime (calcium oxide) on the skin of the forearm. What should the medical assistant do FIRST?

Accepted Answer

Brush off as much of the dry powder as possible, then irrigate with copious water

Answer

Dry chemicals such as lime should be brushed off before irrigation. Water reacts with calcium oxide in an exothermic reaction and can activate or concentrate the chemical, which makes the burn worse. After the bulk of the powder is removed, flush with large amounts of running water. Never try to neutralize the chemical: the neutralizing reaction produces heat and can cause more tissue damage. Ice and a dry dressing leave the chemical on the skin, where it keeps burning.

Question 4

A conscious 8-month-old infant is choking. The infant cannot cry or cough effectively and is becoming cyanotic. Which sequence is correct?

Accepted Answer

Up to 5 back slaps followed by up to 5 chest thrusts, repeated until the object comes out or the infant becomes unresponsive

Answer

For a responsive infant under 1 year with a severe airway obstruction, give up to 5 back slaps between the shoulder blades with the head lower than the chest, then up to 5 chest thrusts with two fingers on the lower sternum. Repeat the cycle. Abdominal thrusts are not used in infants because of the risk of injury to the liver and other abdominal organs. Blind finger sweeps can push the object further in. CPR starts only if the infant becomes unresponsive, and you should look in the mouth before giving breaths.

Question 5

After a long wait outdoors in summer heat, a patient is confused and agitated, with hot, flushed skin and a core temperature of 105°F (40.6°C). The patient is still sweating. EMS has been called. Which action takes priority?

Accepted Answer

Start rapid whole-body cooling right away (cold-water immersion or continuous cold water with fanning), with ice packs to the groin, axillae, and neck

Answer

A core temperature of 104°F (40°C) or higher with central nervous system dysfunction (confusion, agitation) means heat stroke, even if the patient is still sweating. Exertional heat stroke patients often keep sweating, so dry skin is not required for the diagnosis. Rapid cooling is the priority, and cold-water immersion works best. Antipyretics do not work because the hyperthermia is not driven by the hypothalamic set point. Oral fluids are unsafe in a patient with altered mental status because of aspiration risk. Waiting to cool the patient increases the risk of death and organ damage.

CCMA - Certified Clinical Medical Assistant Practice Test

CCMA - Certified Clinical Medical Assistant Practice Test

CCMA Emergency Management and First Aid 6