2013 Emtc Competency
Please answer the following questions.
When you have completed your test, print your certificate. ***Make a copy for yourself***, then turn in a copy to Katy Howe's bin located on the right wall of the Shift Coordinator office. This certificate is DUE no later than 12/31/2013! If the copy is lost, you will need to retake the test. This is why you should make a copy for yourself!
- 1.
The anatomical zero reference point for the external ventricular drain is at the location of the Foramen of Monro. This is approximated by leveling the reference point on the drain to the level of the:
- A.
Cleft of the chin
- B.
Mid Axillary Line
- C.
External Auditory Meatus
- D.
Base of the Occiput
Correct Answer
C. External Auditory Meatus -
- 2.
You are giving bedside report on a patient with an EVD. Part of the safe handoff inludes both nurses checking that:
- A.
The EVD is placed at the correct zero reference level
- B.
There is fluctuation in the tubing
- C.
All stopcocks are open to the drain
- D.
All the above
Correct Answer
D. All the above -
- 3.
When transporting a patient with an EVD, the stopcock should be:
- A.
Open to the collection chamber
- B.
Closed to the collection chamber
Correct Answer
B. Closed to the collection chamber -
- 4.
Management of acute brain injury is aimed at decreasing secondary brain injury. Which is not an appropriate intervention for a patient with an acute brain injury?
- A.
Maintaining neutral body alignment
- B.
Maintaining normathermia
- C.
Increasing environmental stimuli
- D.
Elevating the head of the bed 30 degrees, unless contraindicated
Correct Answer
C. Increasing environmental stimuli -
- 5.
Calculate the Cerebral Perfusion Pressure (CPP) based on the following data; Heart Rate 75bpm, Blood Pressure 120/80, MAP 93, Respiratory Rate 22, ICP 13, CVP 12
- A.
80
- B.
105
- C.
62
- D.
68
Correct Answer
A. 80Explanation
MAP-ICP=CPPRate this question:
-
- 6.
Your patient had a chest tube inserted for a hemathorax. When doing your bedside handoff, you notice the patient has become short of breath and his SPO2 is decreasing. This could mean that:
- A.
The tubing is kinked
- B.
There is a clot obstructing the chest tube
- C.
There is a dependent, fluid filled, loop in the tubing
- D.
All of the above
Correct Answer
D. All of the above -
- 7.
You are assisting the physician with the placement of an arterial line. When zeroing the transducer, the zero reference point is halfway between the anterior and posterior chest at the 4th intercostal space, when the patient is in supine position. This is called the phlebostatic axis. This approximates the level of the:
- A.
Aorta
- B.
Right Ventricle
- C.
Atria
- D.
Left Ventricle
Correct Answer
C. Atria -
- 8.
You are ready to initiate induced hypothermia on a post cardiac arrest patient. Which intervention(s) will get the patient to the target temperature the fastest:
- A.
Arctic Sun + Ice Packs
- B.
Chilled Saline Only
- C.
Chilled Saline + Arctic Sun
- D.
Arctic Sun Only
Correct Answer
C. Chilled Saline + Arctic Sun -
- 9.
It is very important to prevent shivering/microshivering in induced hypothermia patients. Which drugs prevent this from occurring?
- A.
Sedatives
- B.
Anticonvulsants
- C.
Neuromuscular Blockades
- D.
Inotropics
Correct Answer
C. Neuromuscular Blockades -
- 10.
You are preparing to administer alteplase to a patient with an ischemic stroke. Which of the following actions is correct?
- A.
Shake the alteplase vial vigorously to assure medication is thoroughly mixed
- B.
Place an in-line filter on the IV tubing that is to be used for administration
- C.
Withdraw and waste the excess amount of drug from the vial prior to administering
- D.
Withdraw the bolus dose and administr IVP
Correct Answer
C. Withdraw and waste the excess amount of drug from the vial prior to administering -
- 11.
Your ischemic stroke patient consents to receive alteplase. The patient's weight is 84.1 kg. The calculation for dosage is 0.9 mg/ kg. (round to the nearest tenth) What is the total dose of alteplase to be given? (round to the nearest tenth)
Correct Answer
75.7
75.7 mgExplanation
84.1 x 0.9= 75.7Rate this question:
- 12.
Your ischemic stroke patient consents to receive alteplase. The patient's weight is 84.1 kg. The calculation for dosage is 0.9 mg/ kg. (round to the nearest tenth) The bolus dose of Alteplase for this patient is? (Round to the nearest hundredth)
Correct Answer
7.57
7.57 mgExplanation
75.7 (total dose) x 0.1= 7.57Rate this question:
- 13.
Your ischemic stroke patient consents to receive alteplase. The patient's weight is 84.1kg. The calculation for dosage is 0.9 mg/ kg. (round to the nearest tenth) The infusion (over 1 hour) dose is? (round to the nearest tenth)
Correct Answer
68.1
68.1 mgExplanation
75.7 (total dose) x 0.9= 68.1Rate this question:
- 14.
The Alaris pump tubing holds approximately 18-20 mL's of Fluid. This means that there will be 18-20mg of alteplase in the tubing at the end of the infusion time. To complete the infusion you must hang a small bag of Normal Saline and infuse at:
- A.
10 mL per hour
- B.
100 mL per hour
- C.
The same rate as the bolus dose
- D.
The same rate as the infusion dose
Correct Answer
D. The same rate as the infusion dose -
- 15.
Which of the following interventions/assessments are indicated for stroke patients receiving alteplase?
- A.
NPO until dysphagia screen completed
- B.
Vital Signs every 15 minutes x 2 hours
- C.
Neuro Checks every 15 minutes x 2 hours
- D.
All of the above
Correct Answer
D. All of the above -
- 16.
A 68 year old female presents to the ED after slipping on the ice and falling. She tells you, "I put my arm out to break my fall." She did not hit her head or have any dizziness prior to the fall. She has an obvious deformity to her right wrist. Neurovascular status is intact. She has a PMH of arthritis and diabetes. Vital Signs are within normal limits. She rates her pain as 6/10. What is her ESI acuity level?
- A.
Level 1
- B.
Level 2
- C.
Level 3
- D.
Level 4
Correct Answer
C. Level 3 -
- 17.
"I called the pediatrician and she told me to bring my baby in because of his fever", reports the mother of a two-week-old. Vital signs are: Temp 101 degrees Farenheit, HR 154, RR 42, SPO2 98%. The mother reports an uncomplicated delivery. The ESI level is:
- A.
Level 1
- B.
Level 2
- C.
Level 3
- D.
Level 4
Correct Answer
B. Level 2 -
- 18.
The mother of a 2-year-old tells you, "I think he has another ear infection. He is pulling at his right ear." The child has a temp of 100.2 degrees Farenheit. Other vital signs are within normal limits for the child's age. He has a history of frequent ear infections. He is alert and grabbing at your stethoscope. Mother denies other symptoms. He is eating and drinking normally. His ESI level is:
- A.
Level 2
- B.
Level 3
- C.
Level 4
- D.
Level 5
Correct Answer
D. Level 5 -
- 19.
A 76-year-old male is brought to the ED because of severe abdominal pain. He tells you, "it feels like someone is ripping me apart." The pain began 45 minutes ago and he rates the intensity as 10/10. He has a PMH of hypertension, for which he takes a duretic and a beta blocker. his skin is cool and diaphoretic. Vital Signs are: B/P 88/68, HR 88, RR 24, SPO2 94%. His ESI level is:
- A.
Level 1
- B.
Level 2
- C.
Level 3
- D.
Level 4
Correct Answer
A. Level 1 -
- 20.
A 31-year-old male presents to triage after sustaining a finger laceration. He tells you, "I cut my finger trying to slice a bagel". He has a 2 cm cut to his left first finger. Bleeding is controlled. Neurovascular status is intact. Vital signs are within normal limits. His last tetanus was 10 years ago. His ESI level is:
- A.
Level 2
- B.
Level 3
- C.
Level 4
- D.
Level 5
Correct Answer
C. Level 4 -
- 21.
No image
- A.
Ventricular Tachycardia
- B.
Ventricular Fibrillation
- C.
Asystole
- D.
3rd Degree Heart Block
- E.
Acute Inferior MI
- F.
1st Degree Heart Block
- G.
Failure To Capture
- H.
2nd Degree Heart Block
- I.
Acute Anterior MI
- J.
Torsades
- K.
Supraventricular Tachycardia
- L.
Paced Rhythm
- M.
Atrial Flutter
- N.
Atrial Tachycardia
- O.
Sinus Bradycardia
- P.
Atrial Fibrillation
Correct Answer
M. Atrial Flutter -
- 22.
no image
- A.
Ventricular Tachycardia
- B.
Ventricular Fibrillation
- C.
Asystole
- D.
3rd Degree Heart Block
- E.
Acute Inferior MI
- F.
1st Degree Heart Block
- G.
Failure To Capture
- H.
2nd Degree Type 2 Heart Block
- I.
Acute Anterior MI
- J.
Torsades
- K.
Supraventricular Tachycardia
- L.
Paced Rhythm
- M.
Atrial Flutter
- N.
Atrial Tachycardia
- O.
Sinus Bradycardia
- P.
Atrial Fibrillation
Correct Answer
H. 2nd Degree Type 2 Heart Block -
- 23.
No image
- A.
Ventricular Tachycardia
- B.
Ventricular Fibrillation
- C.
Asystole
- D.
3rd Degree Heart Block
- E.
Acute Inferior MI
- F.
1st Degree Heart Block
- G.
Failure To Capture
- H.
2nd Degree Heart Block
- I.
Acute Anterior MI
- J.
Torsades
- K.
Supraventricular Tachycardia
- L.
Paced Rhythm
- M.
Atrial Flutter
- N.
Atrial Tachycardia
- O.
Sinus Bradycardia
- P.
Atrial Fibrillation
Correct Answer
O. Sinus Bradycardia -
- 24.
no image
- A.
Ventricular Tachycardia
- B.
Ventricular Fibrillation
- C.
Asystole
- D.
3rd Degree Heart Block
- E.
Acute Inferior MI
- F.
1st Degree Heart Block
- G.
Failure To Capture
- H.
2nd Degree Heart Block
- I.
Acute Anterior MI
- J.
Torsades
- K.
Supraventricular Tachycardia
- L.
Paced Rhythm
- M.
Atrial Flutter
- N.
Atrial Tachycardia
- O.
Sinus Bradycardia
- P.
Atrial Fibrillation
Correct Answer
A. Ventricular Tachycardia -
- 25.
No image
- A.
Ventricular Tachycardia
- B.
Ventricular Fibrillation
- C.
Asystole
- D.
3rd Degree Heart Block
- E.
Acute Inferior MI
- F.
1st Degree Heart Block
- G.
Failure To Capture
- H.
2nd Degree Heart Block
- I.
Acute Anterior MI
- J.
Torsades
- K.
Supraventricular Tachycardia
- L.
Paced Rhythm
- M.
Atrial Flutter
- N.
Atrial Tachycardia
- O.
Sinus Bradycardia
- P.
Atrial Fibrillation
Correct Answer
L. Paced Rhythm -
- 26.
no image
- A.
Ventricular Tachycardia
- B.
Ventricular Fibrillation
- C.
Asystole
- D.
3rd Degree Heart Block
- E.
Acute Inferior MI
- F.
1st Degree Heart Block
- G.
Failure To Capture
- H.
2nd Degree Heart Block
- I.
Acute Anterior MI
- J.
Torsades
- K.
Supraventricular Tachycardia
- L.
Paced Rhythm
- M.
Atrial Flutter
- N.
Atrial Tachycardia
- O.
Sinus Bradycardia
- P.
Atrial Fibrillation
Correct Answer
I. Acute Anterior MI -
- 27.
No image
- A.
Ventricular Tachycardia
- B.
Ventricular Fibrillation
- C.
Asystole
- D.
3rd Degree Heart Block
- E.
Acute Inferior MI
- F.
1st Degree Heart Block
- G.
Failure To Capture
- H.
2nd Degree Heart Block
- I.
Acute Anterior MI
- J.
Torsades
- K.
Supraventricular Tachycardia
- L.
Paced Rhythm
- M.
Atrial Flutter
- N.
Atrial Tachycardia
- O.
Sinus Bradycardia
- P.
Atrial Fibrillation
Correct Answer
P. Atrial Fibrillation -
- 28.
No image
- A.
Ventricular Tachycardia
- B.
Ventricular Fibrillation
- C.
Asystole
- D.
3rd Degree Heart Block
- E.
Acute Inferior MI
- F.
1st Degree Heart Block
- G.
Failure To Capture
- H.
2nd Degree Heart Block
- I.
Acute Anterior MI
- J.
Torsades
- K.
Supraventricular Tachycardia
- L.
Paced Rhythm
- M.
Atrial Flutter
- N.
Atrial Tachycardia
- O.
Sinus Bradycardia
- P.
Atrial Fibrillation
Correct Answer
D. 3rd Degree Heart Block -
- 29.
No image
- A.
Ventricular Tachycardia
- B.
Ventricular Fibrillation
- C.
Asystole
- D.
3rd Degree Heart Block
- E.
Acute Inferior MI
- F.
1st Degree Heart Block
- G.
Failure To Capture
- H.
2nd Degree Heart Block
- I.
Acute Anterior MI
- J.
Torsades
- K.
Supraventricular Tachycardia
- L.
Paced Rhythm
- M.
Atrial Flutter
- N.
Atrial Tachycardia
- O.
Sinus Bradycardia
- P.
Atrial Fibrillation
Correct Answer
J. Torsades -
- 30.
no image
- A.
Ventricular Tachycardia
- B.
Ventricular Fibrillation
- C.
Asystole
- D.
3rd Degree Heart Block
- E.
Acute Inferior MI
- F.
1st Degree Heart Block
- G.
Failure To Capture
- H.
2nd Degree Heart Block
- I.
Acute Anterior MI
- J.
Torsades
- K.
Supraventricular Tachycardia
- L.
Paced Rhythm
- M.
Atrial Flutter
- N.
Atrial Tachycardia
- O.
Sinus Bradycardia
- P.
Atrial Fibrillation
Correct Answer
B. Ventricular Fibrillation -
- 31.
Please select all that apply. As I discharge patients, I know that I am to:
- A.
Verify that the discharge paperwork is for the correct patient
- B.
Call the Charge Nurse, Shift Coordinator or Manager to help if I get behind.
- C.
Verify that the Prescriptions are for the correct patient that I am discharging
- D.
Ensure the patient understands their medications to be taken at home.
- E.
Ensure the patient understands when to follow-up with PCP/Referral
- F.
Ensure the patient understands when they should return to the EMTC, if their condition worsens.
- G.
Take Vital Signs, if not taken within the last 60 minutes.
- H.
Remove PIV's
- I.
Escort them to the waiting room, if necessary
- J.
Answer all of the patient's questions
Correct Answer(s)
A. Verify that the discharge paperwork is for the correct patient
B. Call the Charge Nurse, Shift Coordinator or Manager to help if I get behind.
C. Verify that the Prescriptions are for the correct patient that I am discharging
D. Ensure the patient understands their medications to be taken at home.
E. Ensure the patient understands when to follow-up with PCP/Referral
F. Ensure the patient understands when they should return to the EMTC, if their condition worsens.
G. Take Vital Signs, if not taken within the last 60 minutes.
H. Remove PIV's
I. Escort them to the waiting room, if necessary
J. Answer all of the patient's questions -
- 32.
What medication is contraindicated in a Right-Sided Myocardial Infarction?
- A.
Aspirin
- B.
Plavix
- C.
Beta-Blockers
- D.
Nitroglcerin
Correct Answer
D. NitroglcerinExplanation
Because the injured right ventricle needs adequate filling pressure, and because nitroglycerin vasodilatation can decrease the filling pressure, giving these patients nitroglycerin can cause profound hypotension.Rate this question:
-
- 33.
I know that all specimens should be labeled using two patient identifiers. This means specimens may be labeled at the nursing station verifying the correct patient with the computer charting system and the labels printed for the indicated labs.
- A.
True
- B.
False
Correct Answer
B. FalseExplanation
ALL specimens should be labeled at the bedside using two patient identifiersRate this question:
-
- 34.
If I have a blood specimen going to blood bank, I should ask another staff member to come to the patient's bedside. Use two patient identifiers, apply label and have both staff members sign the label
- A.
True
- B.
False
Correct Answer
A. True -
- 35.
I know a specimen going to blood bank must be:
- A.
Initialed by two staff members
- B.
Labeled at the bedside using two patient identifiers
- C.
Verification must be done by 4 staff members
- D.
Verification must be done by 2 staff members at the bedside
- E.
All signatures must be legible
Correct Answer(s)
B. Labeled at the bedside using two patient identifiers
D. Verification must be done by 2 staff members at the bedside
E. All signatures must be legible -
- 36.
I am told my patient admits to being a victim of domestic violence, I should contact
- A.
The Secretaries
- B.
The Shift Coordinator
- C.
The Forensic Nurse
- D.
Secured Holding
Correct Answer
C. The Forensic Nurse -
- 37.
Another name for Domestic Violence is Intimate Partner Violence, or IPV. These can both be used interchangeably.
- A.
True
- B.
False
Correct Answer
A. True -
- 38.
When my patient is a fall risk, I know the following interventions may be implemented:
- A.
Yellow Footies
- B.
Bed Alarm
- C.
Enclosed Bed
- D.
Side Railings Up
- E.
Bed in Lowest Position
- F.
Alert other staff to the potential fall risk
Correct Answer(s)
A. Yellow Footies
B. Bed Alarm
C. Enclosed Bed
D. Side Railings Up
E. Bed in Lowest Position
F. Alert other staff to the potential fall risk -
- 39.
I know that if my patient falls and is injured I must do the following:
- A.
Complete an Incident Report
- B.
A Fall Huddle is exempt because I am completing an incident report
- C.
Call Kathy Hendershot
- D.
Call Mary Ross
- E.
Complete a Fall Huddle
- F.
Notify the Charge Nurse
- G.
Notify the Shift Coordinator
Correct Answer(s)
A. Complete an Incident Report
C. Call Kathy Hendershot
E. Complete a Fall Huddle
F. Notify the Charge Nurse
G. Notify the Shift CoordinatorExplanation
ALWAYS complete a Fall Huddle Form, and please don't call Mary Ross!Rate this question:
-
- 40.
When my patient screens positive for suicide, I must make them an ESI Acuity Level I.
- A.
True
- B.
False
Correct Answer
B. FalseExplanation
The patient would be an ESI Acuity level 2Rate this question:
-
- 41.
I must report that my patient is suicidal to the staff physician in my area and document this in the patient record.
- A.
True
- B.
False
Correct Answer
A. True -
- 42.
I have watched the EMTC Stroke Education Video on eLMS in 2013. I will print my transcript and show my designated evaluator when completing the EMTC Stroke Module.
- A.
Agreed
- B.
Answer option2
Correct Answer
A. Agreed -
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