EMR First Responder 4 — Questions and Answers
Question 1: A patient is found with gurgling respirations and an altered mental status. The FIRST priority airway intervention is:
- Insert a nasopharyngeal airway
- Suction the oropharynx (Correct answer)
- Perform endotracheal intubation
- Deliver oxygen via non-rebreather mask
Correct answer: Suction the oropharynx
Gurgling indicates fluid in the airway; suctioning is the immediate priority to clear the airway before other interventions.
Question 2: When inserting an oropharyngeal airway (OPA) in an adult, the device is initially inserted:
- Tip pointing downward toward the tongue
- Tip pointing upward toward the hard palate, then rotated 180° (Correct answer)
- Tip angled to the left cheek
- Straight in following the curve of the tongue
Correct answer: Tip pointing upward toward the hard palate, then rotated 180°
In adults, the OPA is inserted with the tip toward the hard palate and then rotated 180° to follow the curve of the airway.
Question 3: A patient presents with tachycardia, hypotension, distended neck veins, and absent breath sounds on the left side after a stab wound. These signs suggest:
- Hemothorax
- Tension pneumothorax (Correct answer)
- Pericardial tamponade
- Flail chest
Correct answer: Tension pneumothorax
Tension pneumothorax presents with absent breath sounds unilaterally, distended neck veins, hypotension, and tracheal deviation away from the affected side.
Question 4: During patient handoff, which report format do most EMS systems use to ensure complete information transfer?
- SOAP
- SAMPLE with OPQRST
- CHART
- SBAR (Correct answer)
Correct answer: SBAR
SBAR (Situation, Background, Assessment, Recommendation) is widely adopted in EMS and hospital settings for structured patient handoff.
Question 5: A 7-year-old child is unresponsive and has no pulse. The compression depth for pediatric CPR is:
- At least 1 inch
- At least 2 inches
- About one-third the depth of the chest (Correct answer)
- About half the depth of the chest
Correct answer: About one-third the depth of the chest
For children and infants, chest compressions should be at least one-third the anterior-posterior chest depth.
Question 6: A patient in respiratory distress is sitting upright, leaning forward on their hands with labored breathing. This posture is known as:
- Fowler's position
- Tripod position (Correct answer)
- Semi-prone position
- Recovery position
Correct answer: Tripod position
The tripod position — sitting up, leaning forward on outstretched arms — is a classic sign of severe respiratory distress.
Question 7: Which of the following is a contraindication for using a nasopharyngeal airway (NPA)?
- Patient has a gag reflex
- Suspected basal skull fracture (Correct answer)
- Patient is unconscious
- Suspected cervical spine injury
Correct answer: Suspected basal skull fracture
A suspected basal skull fracture is a contraindication for NPA because the device could be inadvertently inserted into the cranial vault.
EMR First Responder 4
A patient is found with gurgling respirations and an altered mental status.
The FIRST priority airway intervention is: