Ministry of Health Emergency MedicalAssistant’s (EMA ... · A first aid or other health care ... C AVPU D LOTARP 33. ... 34. Principles of proper lifting include all of the following

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Ministry of Health

Emergency Medical Assistant’s (EMA) Licensing Board Examination

EMERGENCY MEDICAL ASSISTANT FIRST RESPONDER (EMA FR)

Written Examination #9900 - Licence Renewal

Number of questions: 100

Number of Marks: 100

Minimum Pass: 70%

Time: 2 hours

Number of Attempts Allowed: 3

Please read each question carefully and select ONE best answer for each question. Eachquestion is worth one mark. This examination consists of 100 questions randomly chosenfrom an exam bank of 220 questions.

This material is owned by the Government of British Columbia and protected by copyright law. Itmay not be reproduced or redistributed without the prior written permission of the Province ofBritish Columbia and protected by copyright law. It may not be reproduced or redistributedwithout the prior written permission of the Province of British Columbia. Any reproduction ordistribution of this examination in whole or in part may result in expulsion from the examprocess.

9900 Version 2 (Licence Renewal) - 1 - 2016-06-16

1. Each of the following is considered an emergency move EXCEPT:

A Cradle carry

B Piggyback carry

C Fore and aft lift

D Shoulder drag

2. If the patient's radial pulses are absent, the First Responder should:

A give high flow O2

B start ventilating at 20/min

C perform CPR

D check for carotid pulse

3. All persons providing health care run some risk of being named a party in a legalaction.

A True B False

4. You find a patient unresponsive in a dumpster during a snowstorm. S/he has flaccidmuscles, and blue skin. Respirations are slow and shallow and there is a very slowcarotid pulse. Which one of the following is the most appropriate treatment?

A ventilate with bag valve maskand consider CPR

B re-warm the patient using hotpacks

C cover the patient with blankets

D rub the arms and legs topromote circulation

5. While doing good CPR you feel ribs breaking. You should:

A Move to different handplacement on chest

B Stop CPR

C Maintain CPR at original rateand pressure

D Start abdominal thrusts

E Continue but use less pressure


6. What is an advance directive?

A none of the answers

B a document in which a capableadult names a representativeand sets out the type and scopeof decisions that therepresentative may make onbehalf of the adult if the adultbecomes incapable

C a written instruction made by acapable adult who gives orrefuses consent to health carein the event that the adult is notcapable of giving instruction atthe time the health care isrequired

D a written summary of thecapable adult’s wishes to guidetheir temporary substitutedecision-maker orrepresentative if called to makea health care decision wherethe adult is incapable of makinga decision

7. What information is required to be reported to police in the event of a gunshotwound or stabbing?

A the fact that the person is beingtreated, or has been treated

B the injured person’s name, ifknown

C all of the answers

D the name and location of thehealth care facility or where theemergency medical assistanttreated the individual

8. The Emergency Medical Assistants Licensing Board finds that an emergencymedical assistant (EMA) has incompetently carried out the duties of an emergencymedical assistant. The board may do all of the following EXCEPT:

A bar the person from beinglicensed under the Act for aperiod of time the boardconsiders appropriate

B impose conditions on theperson’s licence

C revoke or suspend the licence

D sue the individual for damages


9. Which one of the following comprises the secondary survey?

A LOC, pulse, respirations, skincolour and temperature

B PQRST, DABC, AVPU, vitalsigns

C vital signs, DABC, sceneassessment, head to toe

D medical history, vital signs,head to toe exam

10. Your patient is displaying raccoon eyes and Battle's signs. Fluid is draining from oneof his ears. This patient should be managed by:

A placing the affected ear downto promote drainage

B applying indirect pressure only

C applying direct pressure withsterile gauze

D applying a loose clean dressingover the ear

11. Roles of the EMA-FR include all of the below EXCEPT:

A Talking to bystanders

B Providing scene cover

C Gathering scene information

D Completing documentation

E Obtaining vital signs

12. During the scene assessment, which of the following is not a consideration?

A Environment

B Hazards

C LOC of all patients

D Mechanism of injury

13. If a patient is regaining consciousness, gagging on the airway and trying to push itout with their tongue, what should you do?

A Remove the airway by pullingupward and out, following thenatural curve of the patient'smouth

B Remove the airway by pullingdownward and out, following thenatural curve of the patient'smouth

C Remove the airway in reverseof the way it was inserted (i.e.rotate 180 degrees)

D Reassure the patient and try tomaintain the airway


14. Each of the following statements, were made on EMA-FR report forms. Whichstatement is a chief complaint?

A "I hit the steering wheel"

B "I have pain in my chest"

C "patient has difficulty breathing"

D "patient stated, 'I haveemphysema”

15. A man who has been involved in a motor vehicle accident complains of severe chestpain. Upon inspection you see that a section of the chest fails to move with the restof the chest as he breathes. Your treatment should include:

A note injury but move on as thereis nothing you can do for thepatient at this time

B stabilizing the injury site

C covering the injury with anairtight dressing

D covering the injury with plasticwrap or tin foil

16. The Emergency Health Services Act defines the term “emergency health service”as:

A first aid or other health careprovided in circumstances inwhich it is necessary to providethe first aid or other health carewithout delay in order topreserve an individual's life,prevent or alleviate seriousphysical or mental harm, oralleviate severe pain

B the ability to practice medicineby an emergency medicalassistant

C a conveyance that is used forthe transport of patientsrequiring medical attention

D the provision of medicalservices solely within thehospital setting

17. When should CPR be stopped?

A While Advanced Life Support(ALS) intubate the patient

B When the AED pads areattached

C During AED analysis

D While the AED is charging


18. The patient is wearing a nitroglycerin patch on the area where the AED electrodeshould be placed. The EMA should:

A Place the electrode adjacent tothe medication patch

B Remove the medication patchwith a gloved hand; wipe thearea and apply the electrode

C Place the electrode over themedication patch

D None of the answers

19. The AED can be used on a child who is in cardiac arrest.

A True B False

20. During the Breathing check in the Primary Survey, the EMA-FR should:

A not intervene until the primarysurvey is completed

B intervene only if respirations areabsent

C count the number ofrespirations to decide if theyare adequate

D intervene if respirations areinadequate, then continue withthe primary survey

21. During a scene assessment, you are alerted to the possibility of a fracture becauseof a fall, or a delicate spine because of a head injury. These are examples ofassessment by means of:

A observing hazards at the scene

B assessment of the environment

C the mechanism of injury

D history of the chief complaint

22. An Emergency Medical Assistant (EMA) must notify the Emergency MedicalAssistants Licensing Board within how many days of legally changing his or hername?

A 30 days

B 60 days

C 14 days

D 7 days


23. In special circumstances the Emergency Medical Assistants (EMA) LicensingBoard may extend the licence of an EMA on one occasion provided all of thefollowing requirements have been met EXCEPT:

A the request is authorized by theBC Emergency Health ServicesCorporation

B The licence extension is for amaximum of 60 days

C the EMA is unable to completerenewal requirements prior tolicence expiry

D the request is made before theEMA’s licence has expired

24. A confined space is a place with limited access and egress that was not designedfor human occupancy.

A True B False

25. A professional “code of ethics” helps to ensure that the public interest is maintainedabove personal, corporate or financial considerations.

A True B False

26. Your patient is breathing at a rate of approximately 11 respirations per minute. Youapply oxygen at 10 L/min via standard facemask. The patient's decreased level ofconsciousness, bluish skin colour and irregular heartbeat remains the same. Yourtreatment should now include:

A maintaining oxygen at 10 L/minand monitor respirations

B increasing oxygen to 15 L/minvia standard face mask

C decreasing oxygen to 2-3 L/minvia standard face mask andmonitoring respirations

D assisting ventilations

27. The AED which is typically used by EMA-FR’s is:

A A manual defibrillator

B Fully automated

C Semi - automated

28. EMA-FR skills and Treatment Guidelines do not replace:

A A good attitude

B Good history taking

C The team approach

D Pattern recognition

E Good judgment


29. Which is the correct order of steps in the secondary survey?

A conduct a rapid body survey;record vital signs; take ahistory, perform head to toeexam

B conduct a rapid body survey;take a history; perform head totoe exam; record vital signs

C take a history; record vitalsigns; perform head to toeexam

D perform head to toe exam;record pulse and respirationrates; take a history

30. What should an EMA-FR observe to indicate that bag valve mask ventilations areadequate?

A The chest will rise and fall

B The patient’s abdomen willbegin to distend

C There will be resistance

D The patient’s neck muscles willstrain

31. Which of the following is NOT a principle for preserving evidence at the scene of acrime?

A Use a pen or pencil insertedinto the barrel of any gun toavoid contaminating theweapon with your fingerprints

B Avoid stepping on bloodstains

C Do not take the victim's walletto obtain personal information,try and obtain this fromwitnesses or relatives

D Do not move a body unless youhave to check a pulse orbreathing

32. A patient's level of consciousness can be measured by using the mnemonic:

A OPQRST

B DABC

C AVPU

D LOTARP

33. Following a “No Shock Advised” message, the First Responder’s next action wouldbe to:

A Check for respirations

B Ventilate the patient twice

C Immediately start chestcompressions

D Press analyze


34. Principles of proper lifting include all of the following EXCEPT:

A Use your legs to lift, not yourback

B Physical fitness

C Twist for awkward lifting whenrequired

D Keep the weight of the objectclose to your body

E Use commands tocommunicate with your partner

35. An advance directive is a medical order signed by a physician.

A True B False

36. To avoid inadequate CPR compressions due to fatigue, rescuers should:

A Compress at a slower rate

B Verbally encourage a tiringrescuer to continue even thoughthey are tiring

C Compress to a more shallowdepth

D Rotate compression duty every2 minutes

37. A child is in cardiac arrest following a blow to the chest. You would:

A Immediately start chestcompressions

B Perform a precordial thump

C Ventilate the patient twice

D Immediately apply and analyzewith an AED

38. Bandages are used to:

A provide temporary bleedingcontrol

B hold a dressing in place

C pack large gaping wounds

D cover a wound

39. If the mechanism of injury alerts you to spinal or head trauma, you open the airwayusing:

A head tilt chin lift

B oral airway

C modified jaw thrust

D crossed over finger technique


40. The purpose of the pre-hospital care report is to:

A All of the answers

B Improve your EMS system

C Transfer patient informationfrom one person to another

D Document the care youprovided

E Provide legal documentation

41. If bleeding is found during the primary survey, the EMA-FR should:

A control bleeding and wait forhelp

B only control bleeding during theprimary survey if it is life-threatening

C make sure the primary survey iscompleted before intervening

D stop, control bleeding, thencontinue with primary survey

42. You respond to an emergency. On arrival at the scene, the first action you shouldtake is to:

A Confirm that EMS has beenactivated

B Determine the location of all thepatients

C Find out what caused the injury

D Ensure the scene is safe

43. A pocket mask can be used to ventilate a person with inadequate breathing.

A True B False

44. Place the components of the "Primary Survey" in the order they are to be completed:1) Airway 2) Breathing Check 3) Rapid Body Survey 4) LOC using AVPU 5)Circulation Check 6) Delicate Spine check.

A 1,2,3,4,5,6

B 6,5,3,1,2,4

C 6,5,1,3,2,4

D 4,6,1,2,5,3

45. Signs and symptoms of a cardiac emergency may include all of the followingEXCEPT:

A Nausea and vomiting

B A feeling of peace andcontentment

C Difficulty breathing andcyanosis

D Chest pain or discomfort


46. Maintaining a professional appearance as an EMA FR is important because it:

A Is a local, provincial and federalrequirement

B Let’s bystanders know that youare important

C Allows other rescuers torecognize you from your dress

D Helps to instill confidence inpatients and their families

47. The Emergency Medical Assistants Licensing Board is investigating a complaintand determines that public safety may be at risk allowing an emergency medicalassistant (EMA) to practice. Which of the following actions may the board imposeon the EMA being investigated?

A suspend the EMA’s licence

B notify the public of the ongoinginvestigation

C terminate employment

D insist that the EMA take furthertraining

48. You should address a patient by name whenever possible, however you should notaddress an elderly patient by their first name, unless invited to do so.

A True B False

49. A drowsy child with grunting, flaring nostrils, and cyanosis, should have respirationsassisted by BVM.

A True B False

50. The purpose of the primary survey is to:

A Allow the EMA-FR to performmedical procedures normally inthe domain of a physician

B Ensure the safety of the peopleat the scene, to identify themechanism of injury or nature ofillness, and to determine anynecessary additional resources

C Identify and manage life andlimb threatening injuries andconditions

D Identify the patient’s chiefcomplaint, establish a baselineset of vital signs and gatherinformation about the patient’sinjuries and condition

E Gather or give informationregarding the patient’s statusand treatment


51. Your immediate goals in the emergency care of an overdose patient are to:

A Protect your own safety,maintain the patient’s airwayand manage threats to life

B Provide emotional support,monitor mental status andmaintain temperature

C Assess for foreign body airwayobstruction and take a patienthistory

D Assess the airway, monitormental status and maintainbody temperature

52. Under the Gunshot and Stab Wound Disclosure Act, an emergency medicalassistant is expected to determine whether a wound is criminal in nature.

A True B False

53. Which of the following is the best sign to determine the effectiveness of ventilationswhen using a Pediatric BVM?

A The stomach will begin toenlarge during ventilations

B The patient's skin colour shouldremain the same duringventilations

C The pop-off pressure regulatorvalve will continually ventexcessive inhalation pressures

D The chest should rise and fallwith each ventilation

54. In a cardiac arrest with 2 rescuers, an oropharyngeal airway should be measuredand inserted and oxygen applied:

A Prior to ventilating the patient

B While the EMA-FirstResponder is assessing theairway

C After 4 minutes of CPR

D As soon as practical after theAED protocol is started

55. As part of the EMA Code of Ethics, if an EMA witnesses any incompetent, illegal orunethical conduct by another EMA they must report the incident to the appropriateauthorities?

A True B False


56. Which of the following may be complications of a fracture? 1) damage tomuscles/nerves/blood vessels 2) contamination risk from open fracture 3) impairedcirculation 4) swelling 5) increased pain 6) Paralysis.

A 1,2,4,5

B 1,2,3,4,5,6

C 2,3,4,5,6

D 1,3,4,5

57. If an EMA decides to appoint a representative during the complaint process, whichof the following is the representative not permitted to do:

A Speak on the EMA’s behalf

B Provide advice to the EMA

C Participate in the complaintinvestigation by theinvestigation committee

58. What "Act" governs the preservation of evidence at a scene?

A Coroners Act

B Mental Health Act

C Good Samaritan Act

D Health Emergency Act

59. Non-breathing patients should be ventilated with a bag valve mask:

A while prone

B while semi-sitting

C while supine

D while in position found

60. If there is reason to suspect a spinal injury for your patient, manual stabilization of thehead and neck must be maintained until the patient is:

A Palpated in the neck area

B Completely immobilized

C Examined from head-to-toe

D Fitted with a cervical collar

61. CPR is NOT recommended on children who are victims of cold water drowningwhen they have been submerged for more than 45 minutes.

A True B False


62. Which of the following is NOT a sign or symptom of smoke inhalation?

A Facial burns

B Carbon in the sputum

C Rosy pink skin

D Smoky breath odour

63. When disinfecting equipment, what protection must be taken?

A wear mask and goggles whiledecontaminating

B decontaminate alldisassembled equipmentoutside

C wear gloves

D use exhaust fans to removedangerous fumes

64. An adult patient with respiratory distress, a breathing rate of < 8, and centralcyanosis, should have respirations assisted by bag/valve/mask.

A True B False

65. Which of the following statements about suctioning is true?

A suction for a maximum of 30seconds

B always preoxygenate thepatient for 2-3 min. beforesuctioning

C suction any patient with adecreased LOC

D suction only as long as youneed to, to clear the airway

66. The hand is __________ to the elbow.

A Medial

B Proximal

C Distal

D Lateral

67. Shock is described as:

A when the cells do not receiveenough oxygen or nutrients

B profuse external bleeding, rapidand weak pulse, decreasedLOC

C any patient who has sufferedfrom major trauma

D a psychological or physicalstate of trauma


68. A patient is found unconscious at a fire scene. You are told that he was removedfrom a structure fire. Which of the following conditions is the most likely cause of hisunconsciousness?

A cardiac arrest

B CO poisoning

C heart attack

D hypoglycemia

69. The First Responder Report

A if not complete prior to theambulance crew departing,must be forwarded to thereceiving hospital within 12hours of the incident

B must be completed and turnedover to the ambulance crewprior to their departure

C is filed by the ambulanceservice as part of theirpermanent records

D forms part of the patient'spermanent medical record

70. After you bandage your patient's forearm, she complains of tingling in her fingers.You should:

A loosen the bandage

B gently reposition the arm

C tighten the bandage

D apply an additional bandage

71. A hand-off report should include:

A Patient responses, airwaystatus, treatments, estimatedtime of arrival

B Level of consciousness, patientage and gender, chiefcomplaint, insurance provider

C Patient age and gender, chiefcomplaint, SAMPLE,interventions

D Secondary assessmentfindings, patient name,circulation status, SAMPLE

72. Personal Protective Equipment is a component of the:

A Primary survey

B Scene assessment

C Ongoing assessment

D Secondary survey


73. An Emergency Medical Assistant (EMA) is obligated to assume responsibility forpersonal and professional development, and maintain professional standardsthrough training and peer mentoring. Where is this statement found?

A Emergency Health Services Act

B Emergency Medical AssistantsRegulation: Schedule 3 Codeof Ethics

C Health Professions Act

D Emergency Health ServicesRegulation

74. A patient's pain can be assessed by using the mnemonic:

A AVPU

B RBS

C DABC

D OPQRST

75. If a complaint against you is investigated, you will be asked to submit your accountof the incident.

A True B False

76. What are some of the Acts that affect the way you will perform your duties whileworking/volunteering as an EMA FR? 1) Emergency Health Services Act 2) GoodSamaritan Act 3) First Responder Act 4) Mental Health Act 5) Coroners Act.

A 2 only

B 1,2,3

C 1 only

D 1,4,5

77. The proper rate of CPR compressions for all patients is:

A 120 per minute

B 72 per minute

C 100 per minute

D 80 per minute

78. A rape victim should be encouraged to clean up as much as possible beforetransporting to a medical facility.

A True B False


79. When should cooling for a significant burn be initiated?

A After the secondary survey

B During transport

C During the secondary survey

D During the rescue sceneevaluation

E During the primary survey

80. After applying a dressing and bandage to your patient's calf, the bandage becomesblood-soaked. You should:

A apply a tourniquet

B tighten the bandage

C apply additional dressings andre-secure the bandage

D apply an additional bandage

81. When ventilating a non-breathing 3-year old child, the correct rate would be?

A 30 - 40 times a minute

B 18 - 24 times a minute

C 12 - 20 times a minute

D 8 - 12 times a minute

82. Your patient is breathing at a rate of approximately 10 respirations per minute. Afterapplying oxygen at 10 L/min via standard facemask, your initial assessment ofdecreased level of consciousness, bluish skin colour and irregular heartbeatremains the same. Your treatment should now include:

A increasing oxygen to 15 L/minvia standard face mask

B decreasing oxygen to 2-3 L/minvia standard face mask andmonitoring respirations

C maintaining oxygen at 10 L/minvia pocket mask

D assisting ventilations via Bag-Valve-Mask with oxygen at 15L/min

83. EMAs must be able to function independently in a non-structured, constantlychanging environment.

A True B False


84. What are some of the early signs of Hypothermia? 1) shivering 2) bluish skin 3)slurred speech 4) slow breathing 5) combativeness 6) dilated pupils 7)disorientation.

A 1,2,3,5,7

B 1,3,4,6

C 1,2,6

D 1,3,5,7

85. You respond to a motor vehicle accident. The first action you take is to:

A perform a scene assessment

B assess the level ofconsciousness of all patients

C determine which patient is mostseriously injured (triage)

D begin extrication of patients

86. Cooling a major burn is limited to a maximum of ___ minutes.

A 3

B 10

C 5

D 2

87. An emergency medical assistant must follow a patient’s instructions, as described inan advance directive, unless the patient’s representative disagrees.

A True B False

88. Which of the following is a unique characteristic of a toddler (2-year old)?

A They are easier to assess if youseparate them from theircaregiver

B They may be scared of the FirstResponder

C They spend most of their timeeating and sleeping

D Their pulse rate is the same asan adult

89. Which of the following is NOT a sign or symptom of a fracture or dislocation?

A Point tenderness

B Numbness and tingling

C Deformity

D Shortening


90. The purpose of the scene assessment is to:

A Allow the EMA-FR to performmedical procedures normally inthe domain of a physician.

B Identify and manage life andlimb threatening injuries andconditions

C Identify the patient’s chiefcomplaint, establish a baselineset of vital signs and gatherinformation about the patient’sinjuries and condition

D Ensure the safety of the peopleat the scene, to identify themechanism of injury or nature ofillness, and to determine anynecessary additional resources

91. You should consider the patient of a motor vehicle rollover incident as unstable, evenif he/she was wearing a seatbelt.

A True B False

92. Which of the following is NOT a good characteristic of a professional EMA?

A Excellent judgment

B Confident leadership

C Ability to function independently

D Strong opinions about ethnicgroups

E Ability to develop a rapport witha wide variety of patients

93. Signs and symptoms of respiratory distress include all of the following except:

A None of the answers

B Increased pulse rate

C Tripod positioning

D Inability to speak in fullsentences

E Use of accessory muscles

94. The foundation of patient care is:

A Medication administration

B Assessment

C The detailed physical exam

D PCP skills

E ACP skills


95. An emergency medical assistant (EMA) must notify the Emergency MedicalAssistants Licensing Board of any change of name, address, or employment within30 days after the change.

A True B False

96. Before applying direct pressure to a bleeding wound, the EMA-FR should:

A take and record pulse rate

B treat the patient for shock

C assess the amount of bloodloss

D put on personal protectiveequipment

97. The Emergency Medical Assistants Licensing Board may endorse an EmergencyMedical Assistant - First Responder (EMA-FR) for the maintenance of intravenouslines without medications or blood products.

A True B False

98. An advance directive must state:

A that the patient understands thetype of emergency healthservice he or she hasconsented to or refused

B all of the answers

C that the patient acknowledges ahealth care provider may notprovide health care for which apatient has refused consent inthe advance directive

D that the patient acknowledges adelegate may not be chosen tomake decisions on behalf of thepatient about health care forwhich the patient has given orrefused consent in the advancedirective

99. You should have a higher index of suspicion for complications to injury when dealingwith the very young and the very old.

A True B False


100. Which of the following is a sign or symptom of a flail chest?

A A sucking sound is heard oninspiration

B Coughing up blood

C Decreased pain on inspiration

D Very shallow respirations


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Ministry of Health Emergency MedicalAssistant’s (EMA ... · A first aid or other health care ... C AVPU D LOTARP 33. ... 34. Principles of proper lifting include all of the following