The correct answers are B. Crackles and E. Dependent edema.
Why B is correct (Crackles):
Crackles (rales) are a hallmark sign of pulmonary edema, which occurs in left-sided heart failure.
Fluid accumulates in the alveoli
Causes crackling sounds on auscultation
Indicates impaired cardiac pumping ability
NREMT-aligned guidance states:
"Pulmonary edema presents with crackles due to fluid in the lungs."
Why E is correct (Dependent edema):
Dependent edema is a classic sign of right-sided heart failure.
Fluid backs up into systemic circulation
Leads to swelling in:
Legs
Ankles
Lower extremities
NREMT-aligned guidance:
"Right-sided heart failure results in peripheral or dependent edema."
Why the other options are incorrect:
A). Ascites: Can occur in severe right-sided failure but is less common and not a primary EMT-level finding.
C). Wheezing: More commonly associated with asthma or bronchospasm (though CHF can cause "cardiac wheezing," it is not the best answer here).
D). Chest pain: Suggests cardiac ischemia, not specifically CHF.
Exact Extracts:
"Left-sided heart failure leads to pulmonary edema and crackles."
"Right-sided heart failure causes dependent edema."
"Fluid accumulation results from the heart's inability to pump effectively." References:
NREMT EMT Education Standards - Medical Emergencies (Cardiology)
NREMT National Continued Competency Program (NCCP) - Cardiovascular Emergencies Prehospital Emergency Care (EMT) - Congestive Heart Failure

Dehydration signs in infants include:
Poor skin turgor (elasticity)
Sunken fontanelles (indicative of fluid loss)
Delayed capillary refill ( > 2 seconds)
Flushed skin is more common in fever or heat illness, not dehydration. Hypotension, not hypertension, is associated with dehydration in late stages.
References:
NREMT Pediatric Assessment and Fluid Emergencies
PALS Provider Manual - Dehydration in Infants
AAOS Emergency Care (11th ed.) - Pediatric Emergency Chapter

This is a high-risk cardiac event due to unstable angina or possible myocardial infarction. The EMT should:
Administer oxygen if SpO# is < 94%
Avoid nitroglycerin if systolic BP is < 90 mmHg
Obtain a 12-lead ECG to identify ST-elevation MI (STEMI) and transmit it if trained and authorized CPAP is indicated for pulmonary edema, and albuterol is for bronchospasm, neither of which applies here.
References:
AHA ACLS and BLS Guidelines - ACS Management
NREMT Cardiology Guidelines - Chest Pain/MI
National EMS Education Standards - Cardiovascular Emergencies and ECG Recognition

The correct answer is C. Administer epinephrine.
This patient is presenting with classic signs of anaphylaxis, a life-threatening allergic reaction:
Dyspnea (respiratory distress)
Facial swelling (angioedema)
Recent exposure to a likely allergen (food)
Why C is correct (Epinephrine):
Epinephrine is the first-line, life-saving treatment for anaphylaxis. It works by:
Dilating bronchioles (improving breathing)
Constricting blood vessels (improving blood pressure)
Reducing airway swelling
NREMT-aligned guidelines state:
"Administer epinephrine immediately in patients with signs of anaphylaxis."
"Do not delay epinephrine administration in life-threatening allergic reactions." Why the other options are incorrect:
A). Provide oxygen: Important, but not the priority over epinephrine in anaphylaxis.
B). Initiate rapid transport: Necessary, but after immediate life-saving intervention.
D). Obtain vital signs: Should not delay treatment in a critical patient.
Key Concept:
In anaphylaxis, epinephrine is the first and most critical intervention.
Delays in administration significantly increase mortality risk.
Exact Extracts:
"Epinephrine is the drug of choice for anaphylaxis."
"Immediate administration is critical in respiratory distress with allergic reactions."
"Airway swelling and bronchoconstriction must be rapidly treated."
References:
NREMT EMT Education Standards - Medical Emergencies (Allergic Reactions) NREMT National Continued Competency Program (NCCP) - Medical Emergencies Prehospital Emergency Care (EMT) - Allergic Reactions and Anaphylaxis

This is one of those EMS custody questions where the safest answer comes from remembering two transport rules at the same time: the patient needs medical transport , and the patient also needs safe restraint management .
Because the patient is being transported by EMS, the patient should be secured with appropriate medical restraints , not simply left in police handcuffs alone. That makes removing the handcuffs and applying soft restraints the proper EMS approach, provided law enforcement is involved in that process. Just as important, the officer with the key should ride along so the restraint situation remains safe and legally controlled during transport.
The rest of the scenario also hints that this patient may be medically unstable, not just angry. The hot, diaphoretic skin , marked tachycardia , and severe agitation raise concern for a serious behavioral or medical emergency, so EMS transport is appropriate. Also, NREMT-style operations questions consistently reject prone restraint because face-down positioning increases the risk of respiratory compromise during transport.