EMT Ch 7 Test

When the body's water moves from the bloodstream into the interstitial space, it is called: A) edema. B) hydrostatic. C) dehydration. D) hypovolemia.

Explanation: A) CORRECT. When water migrates out of the bloodstream and cells and into the interstitial space, it can be seen in the form of edema. B) INCORRECT. The term hydrostatic refers to a type of pressure, not to fluid movement into cellular spaces. C) INCORRECT. Dehydration is an abnormal decrease in the total amount of water in the body. D) INCORRECT. Shock caused by a loss of blood is called hypovolemia. Page Ref: 168

What is FiO2? A) The amount of oxygen delivered via an airway adjunct in liters per minute B) The concentration of oxygen in our inhaled air, which is referred to as the fraction of inspired oxygen C) The concentration of gases in our expired air, which is referred to as the fraction of used oxygen D) The flow rate of gases provided to the patient by mask or nasal cannula

Explanation: A) INCORRECT. An airway adjunct is used to maintain the airway in an open position; it does not provide measured oxygen. B) CORRECT. The concentration of oxygen in the air we breathe in is referred to as the fraction of inspired oxygen, or FiO2. C) INCORRECT. FiO2 does not refer to air that has been exhaled. D) INCORRECT. The flow rates of masks or cannulas are measured in liters per minute (LPM), not FiO2. Page Ref: 154

What is the type of metabolism that occurs when energy is created with a balance of adequate oxygen and nutrients? A) Anaerobic B) Aerobic C) Hypoxic D) Homeostatic

Explanation: A) INCORRECT. Anaerobic metabolism is the result of glucose being metabolized without enough oxygen. B) CORRECT. Metabolism that occurs in the presence of sufficient oxygen and nutrients is called aerobic metabolism. C) INCORRECT. Hypoxic metabolism refers to metabolism that occurs in an oxygen poor environment. D) INCORRECT. Although the term homeostatic would describe a state that is equal and steady, it is not used in reference to a specific type of metabolism. Page Ref: 153

What is the most common digestive disorder? A) Irritable bowel and gastric esophageal disease B) Vomiting and diarrhea C) Diarrhea and gastric esophageal disease D) Flatus

Explanation: A) INCORRECT. Irritable bowel and esophageal diseases are not the most common disorders. B) CORRECT. Probably the most common digestive disorders are nausea, vomiting, and diarrhea. C) INCORRECT. Gastric esophageal disease is not a common digestive disorder. D) INCORRECT. Flatus is not the most common disorder of the digestive system. Page Ref: 170

The potential space between the lung and chest wall is called the: A) carina space. B) lung space. C) dead space. D) pleural space.

Explanation: A) INCORRECT. The carina is a cartilage structure located in the trachea. B) INCORRECT. The space between the lung and the chest wall is not referred to as the lung space. C) INCORRECT. Dead air space refers to the air sitting in the airway between the pharynx and the alveoli; not between the lung and chest wall. D) CORRECT. Although the lungs are in direct contact with the inner walls of the chest, there is a slight space between the lung tissue and chest wall called the pleural space. Page Ref: 158-159

Which of the following BEST defines adenosine triphosphate (ATP)? A) It is the form of energy produced in the mitochondria and is the cell's engine responsible for all cell function. B) It is the form of energy produced in the endoplasmic reticulum and is the cell's engine responsible for all cell function. C) It is the form of energy that is produced in the nucleus from glucose and other nutrients. D) It is the form of energy that is produced in the mitochondria from glucose and DNA.

Explanation: A) CORRECT. ATP, which is produced in the mitochondria, is essentially the cell's internally created fuel and is responsible for powering all the other cellular functions. B) INCORRECT. The endoplasmic reticulum is not responsible for production of ATP. C) INCORRECT. Adenosine triphosphate is not produced in the nucleus of the cell. D) INCORRECT. DNA is not used to create cellular energy. Page Ref: 152

The human body is made up of ________ % water. A) 60 B) 7.5 C) 17.5 D) 75

Explanation: A) CORRECT. About 60% of the body is made up of water, and without this fluid the functions of the cells would cease. B) INCORRECT. The body consists of more than 7.5% water. C) INCORRECT. The water needed to maintain health and proper body function is more than only 17.5%. D) INCORRECT. The human body consists of less than 75% water. Page Ref: 166

When a person has an exaggerated response to a body invader, the person is said to have: A) hypersensitivity. B) antibody reaction. C) histamine dump. D) hyposensitivity.

Explanation: A) CORRECT. An exaggerated immune response is referred to as hypersensitivity, which is also known as an allergic reaction. B) INCORRECT. The reaction created when an antigen combines with an antibody is called an antibody reaction; it is not generally considered an exaggerated response. C) INCORRECT. When mast cells release histamine it is often called a histamine dump, but it does not necessarily involve an exaggerated response. D) INCORRECT. The prefix hypo means under or low; hyposensitivity would indicate a muted reaction to an invader. Page Ref: 171

You respond to a patient who is choking. The victim is suffering from the most common of airway obstructions. This would indicate that the problem is in the ________ airway. A) upper B) bronchial C) lower D) alveoli

Explanation: A) CORRECT. An obstruction that causes choking would usually be found in the upper airway. B) INCORRECT. An obstruction in the bronchial portion of the airway would not be common. C) INCORRECT. Obstructions in the lower airway are not common and would not generally present as choking. D) INCORRECT. An obstruction in the tiny air sacs of the lungs would not cause choking. Page Ref: 158

Plasma oncotic pressure is created by the movement of which of the following? A) Large proteins B) Contraction of the heart C) Constriction of the vessels D) Dilation of the vessels

Explanation: A) CORRECT. Blood plasma contains large proteins, which tend to attract water away from the area around body cells and pull it into the bloodstream. This force is called plasma oncotic pressure. B) INCORRECT. Plasma oncotic pressure is not created by contractions of the heart. C) INCORRECT. The constriction of vessels does not create plasma oncotic pressure. D) INCORRECT. When a blood vessel dilates, it does not create plasma oncotic pressure. Page Ref: 159

What do chemoreceptors found in the body and vascular system measure? A) Low oxygen and high carbon dioxide B) High oxygen and low carbon dioxide C) Low oxygen and low carbon dioxide D) High oxygen and high carbon dioxide

Explanation: A) CORRECT. Chemical sensors in the brain and blood vessels that identify low levels of oxygen and high levels of carbon dioxide are called chemoreceptors. B) INCORRECT. Chemoreceptors are not measuring for high oxygen and low carbon dioxide levels. C) INCORRECT. Low carbon dioxide levels would not trigger chemoreceptors. D) INCORRECT. Chemoreceptors do not measure for high oxygen levels. Page Ref: 159

A 19-year-old male is reported to have taken too many narcotic pain pills that were prescribed for his recent knee surgery. He is extremely sleepy with very shallow breathing. His color is pale and his SpO2 reading is 84%. His body is probably attempting to compensate for his poor level of ventilatory effort by stimulating the respiratory system to increase rate and tidal volume. Normally, respiratory drive is triggered by changing levels of: A) carbon dioxide. B) oxygen. C) pH. D) glucose.

Explanation: A) CORRECT. Chemoreceptors throughout the body constantly measure levels of carbon dioxide and oxygen. The primary stimulation to breathe is triggered from increasing levels of carbon dioxide. B) INCORRECT. Although changing oxygen levels can sometimes trigger respiration, it is not the normal trigger. C) INCORRECT. Although not the primary trigger, a secondary stimulus to breathe can be initiated by changing pH levels. D) INCORRECT. Glucose has no direct effect on respiratory drive. Page Ref: 159

________ blood returns to the right side of the heart. A) Deoxygenated B) Anemic C) Red D) Oxygenated

Explanation: A) CORRECT. Deoxygenated blood that has been returned to the right side of the heart is pumped to the lungs via the pulmonary arteries and arterioles. B) INCORRECT. Whether blood is considered anemic or not, it still follows the normal circulatory paths. C) INCORRECT. Human blood is always some shade of red. The color does not have anything to do with the circulation patterns. D) INCORRECT. Oxygenated blood does not return to the right side of the heart. Page Ref: 161

What is the best description of the chest's mechanical functions? A) The chest is a closed space with only one opening; the trachea, to inspire air; the diaphragm contracts down and the intercostal muscles expand the ribs, causing a negative pressure that fills the lungs with air. B) The diaphragm contracts, causing the intercostal muscles that are attached to the lungs to also contract, which moves the air into the lungs. C) With the chest being an airtight space, the act of breathing occurs when the muscles of the diaphragm and intercostal relax, which causes the lungs to expand and air to flow into the lungs. D) The chest is a closed space, and the pleural space surrounds the lungs; when the diaphragm contracts and the intercostals expand, the chest and lungs move outward and downward, allowing expiration and gas exchange in the lungs.

Explanation: A) CORRECT. During inspiration, the diaphragm contracts, the muscles of the chest expand, and a negative pressure is created in the chest cavity and lungs. This negative pressure pulls air in through the trachea, which is the only opening into the chest cavity. B) INCORRECT. The intercostal muscles are not attached to the lungs, and they don't contract on inspiration. C) INCORRECT. Inhalation is an active function; when the diaphragm and intercostal muscles relax, it results in exhalation. D) INCORRECT. The chest and lungs do not move outward and downward during expiration, and it is not during expiration that gas exchange occurs. Page Ref: 158

What is the name of the heart dysfunction caused by an electrical source that causes the heart to beat too fast? A) Tachycardia B) Trauma C) Heart attack D) Bradycardia

Explanation: A) CORRECT. Electrical problems typically occur from diseases such as heart attacks or heart failure that damage the electrical system of the heart. These cardiac electrical problems include bradycardias (heart rate is too slow) and tachycardias (heart rate is too fast). B) INCORRECT. A rapid heart rate is not called trauma. C) INCORRECT. A heart attack can cause the dysfunction that leads to a rapid heart rate, but it is not the dysfunction. D) INCORRECT. Bradycardia refers to a heart rate that is too slow. Page Ref: 164

The basic nutrient of the cell and the building block for energy is: A) glucose. B) protein. C) oxygen. D) water.

Explanation: A) CORRECT. Glucose, a simple sugar obtained from the foods we eat, is the basic nutrient of the cell. It is the building block for energy in the form of ATP. B) INCORRECT. Large molecules made up of chains of amino acids are called proteins; they are important to cell function, but they are not the basic nutrient of a cell. C) INCORRECT. Although cells require oxygen, it is not an energy building block. D) INCORRECT. Water is critical to cellular health and function, but it is not a nutrient and does not create energy. Page Ref: 153

Shock occurs as a result of which of the following? A) Inadequate perfusion B) C/Q match C) V/Q match D) Adequate perfusion

Explanation: A) CORRECT. Inadequate perfusion is referred to as hypoperfusion, which is considered to be a synonym for shock. B) INCORRECT. The term C/Q match is not used when referring to shock. C) INCORRECT. A V/Q match is actually the opposite of shock. D) INCORRECT. Adequate perfusion does not cause shock. Page Ref: 164

Janie is having difficulty breathing. Her current tidal volume is 350 mL, and she is breathing at 28 times per minute. What would be her minute volume? A) 9,800 mL B) 12.5 mL C) 342 mL D) 378 mL

Explanation: A) CORRECT. The minute volume is calculated by multiplying the tidal volume by respiratory rate; 350 mL × 28 = 9,800 mL. B) INCORRECT. For this to be correct, the patient's tidal volume would have been only about 0.45 mL. C) INCORRECT. If the patient's tidal volume is 350 mL and she is breathing 28 times per minute, there is no way that the minute volume would be less than the volume of one breath. D) INCORRECT. This would mean that the patient's tidal volume was about 13.5 mL, not 350 mL as stated. Page Ref: 163

The disruption of lung tissue by mechanical forces or medical problems can upset diffusion, which is defined as: A) the process of gas exchange between the alveoli and the capillaries. B) the ability of the lungs to expand equally during inspiration. C) maintaining enough positive pressure in the pleural space to keep the lungs from collapsing. D) the exchange of gases in the bronchi.

Explanation: A) CORRECT. The process of diffusion moves oxygen across the thin membrane from the alveoli to the capillaries. B) INCORRECT. Although the ability of the lungs to expand equally can be impacted by trauma or illness, it is not referred to as diffusion. C) INCORRECT. The process of diffusion is not directly related to pressures in the chest cavity. D) INCORRECT. Gases are not exchanged in the bronchi. Page Ref: 159

You are caring for a 25-year-old male patient that has been shot once in the head. The patient is in extremis (near the point of death) with a noticeable breathing pattern that alternates between no breathing and fast breathing. Your understanding of pathophysiology leads you to believe the breathing pattern may be due to damage to the section of his brain responsible for respiratory control, also known as the: A) medulla oblongata. B) frontal lobe. C) cerebellum. D) thalamus.

Explanation: A) CORRECT. The section of the brain known as the "seat of respiratory control" is the medulla oblongata. B) INCORRECT. Breathing is not directly controlled by the frontal lobe. C) INCORRECT. The cerebellum is not responsible for respiratory control. D) INCORRECT. Respiratory control does not reside within the thalamus. Page Ref: 158

A patient breathing in room air should be receiving ________ percent oxygen. A) 21 B) 5 C) 16 D) 100

Explanation: A) CORRECT. Typically, inhaled air contains about 79% nitrogen and 21% oxygen. B) INCORRECT. Room air contains more than 5% oxygen. C) INCORRECT. Inhaling room air will usually provide more than 16% oxygen. D) INCORRECT. Atmospheric (room) air contains more nitrogen than oxygen; it is not possible for it to contain 100% oxygen. Page Ref: 154

A 59-year-old male has suffered a severe laceration from a circular saw while cutting wood in his garage. Upon your arrival, you find the patient sitting on the floor in a pool of blood. He is extremely pale. Based on your knowledge of pathophysiology, you would expect his body to try to compensate for the blood loss in all of the following ways, except: A) sweaty skin. B) increased pulse. C) constricted pupils. D) increased respirations.

Explanation: A) INCORRECT. A sign of the body compensating for blood loss is pale, sweaty skin. B) INCORRECT. The body compensates by activating the "fight-or-flight" mechanism of the autonomic nervous system, which causes blood vessels to constrict and the heart to beat faster and stronger. C) CORRECT. The sympathetic nervous response would cause the pupils to dilate not constrict. D) INCORRECT. During the compensation process, chemoreceptors in the brain and blood vessels sense increasing carbon dioxide and hypoxia and stimulate the respiratory system to breathe faster and deeper. Page Ref: 166

The sympathetic nervous response causes which of the following to occur? A) Breathe slower and deeper, blood vessels to dilate, heart to beat stronger and faster, skin to sweat, pupils to constrict, and skin to become pale B) Breathe faster and deeper, blood vessels to constrict, heart to beat stronger and faster, skin to sweat, pupils to dilate, and skin to become pale C) Breathe faster and deeper, blood vessels to constrict, heart to beat stronger and faster, skin to sweat, pupils to constrict, and skin to become warm D) Breathe faster and deeper, blood vessels to dilate, heart to beat stronger and slower, skin to sweat, pupils to dilate, and skin to become pale

Explanation: A) INCORRECT. A sympathetic nervous response will generally not slow breathing, dilate vessels, or constrict pupils. B) CORRECT. During shock, the sympathetic nervous system causes rapid, deeper breathing, constricted blood vessels, rapid heart rates, perspiration, dilated pupils, and pale skin. C) INCORRECT. Pupils won't constrict and skin doesn't become warmer during a sympathetic nervous response. D) INCORRECT. A sympathetic nervous response will not commonly dilate vessels or slow the heart rate. Page Ref: 162

Water that is found in the space between cells and blood vessels is called: A) intravascular. B) hydrostatic. C) intracellular. D) interstitial.

Explanation: A) INCORRECT. About 5% of the water in the human body is intravascular, in the blood stream. B) INCORRECT. The term hydrostatic refers to the pressure within vessels, not the fluid around them. C) INCORRECT. Intracellular water is found inside of the cells. D) CORRECT. Interstitial water, found between the cells and vessels in the body, makes up about 25% of the total water volume. Page Ref: 166

What substances, when dissolved, separate into charged particles? A) ATP B) Electrolytes C) Cations D) Ions

Explanation: A) INCORRECT. Adenosine triphosphate (ATP) is the energy produced by the cell; it does not break down into charged particles. B) CORRECT. Electrolytes are substances that, when dissolved in water, separate into charged particles. C) INCORRECT. Positively charged ions are called cations; they don't dissolve into charged particles. D) INCORRECT. An ion is an atom or molecule and it cannot be dissolved. Page Ref: 153

The volume of air that is moved in and out of the chest in a normal breath cycle is called: A) vital capacity. B) tidal volume. C) expiration. D) inspiration.

Explanation: A) INCORRECT. Air volume moved during the breathing cycle is not called vital capacity. B) CORRECT. The volume of air moved in one in-and-out cycle of breathing is called the tidal volume. C) INCORRECT. Expiration is another term for exhalation, which is the air breathed out at the end of the breathing cycle. D) INCORRECT. Only the first part of the breathing cycle is called inspiration, when air is drawn into the body. Page Ref: 158

Daniel has been performing landscaping on a hot, humid summer day when he suddenly becomes dizzy and feels like he might faint. This disruption of fluid balance is most likely caused by: A) hypotension. B) hyperthermia. C) tachycardia. D) dehydration.

Explanation: A) INCORRECT. Although the patient may be hypotensive, that wouldn't be the cause of the fluid imbalance. B) INCORRECT. Hyperthermia would most likely not be the cause of this fluid balance disruption. C) INCORRECT. This patient may present with tachycardia, but that wouldn't be the reason that his fluid balance was disrupted. D) CORRECT. Dehydration is an abnormal decrease in the total amount of water in the body. This may be caused by a decreased fluid intake or a significant loss of fluid from the body by one or more of a variety of means. Page Ref: 168

ou are called to a kindergarten class where a boy has fallen while climbing on playground equipment. The teacher saw him fall and hit his stomach on a step. He is sobbing and holding his abdomen. As you assess him, you find his skin cool and clammy, his pulse is 132, respiratory is 28. Why is the boy acting this way? A) He is really upset and wants his mother. B) He is embarrassed and is afraid that the other students will make fun of him. C) He possibly has wet his pants and does not want anyone to know. D) He possibly has internal injuries and is in shock.

Explanation: A) INCORRECT. Although the patient may be upset, that alone will not change the condition of his skin, heart rate, and breathing. B) INCORRECT. Patients do sometimes become embarrassed following certain injuries, but that will not cause the signs described. C) INCORRECT. Attempting to avoid embarrassment will generally not cause the combined skin, pulse, and respiratory signs. D) CORRECT. Between the mechanism of injury and the signs this patient is presenting with, the EMT should suspect shock and possible internal injuries. Page Ref: 164-165

The layer of covering that protects the nervous system is called the: A) skull. B) spinal column. C) meninges. D) cerebrospinal fluid.

Explanation: A) INCORRECT. Although the skull protects part of the nervous system, it is not a layer that covers all of it. B) INCORRECT. The spinal column only protects a portion of the nervous system. C) CORRECT. The brain and spinal cord are well-protected by bone and muscle. Additionally, they are covered by protective layers called meninges. D) INCORRECT. The cerebrospinal fluid surrounds the brain and spinal cord and provides some shock-absorption, but it is not considered a layer of covering. Page Ref: 168

Our blood transports oxygen from the lungs to the cells and returns with what byproduct of metabolism? A) Lactic acid B) Carbolic acid C) Carbon dioxide D) Carbon monoxide

Explanation: A) INCORRECT. Anaerobic metabolism produces harmful lactic acid, which accumulates in and around the cells. B) INCORRECT. Carbolic acid is generally found in plants; it is not a byproduct of human cellular metabolism. C) CORRECT. One of the primary waste products of metabolism is carbon dioxide, which is transported back to the lungs in the blood stream and released through exhalation. D) INCORRECT. Carbon monoxide is a gas produced by burning carbon-based products. Page Ref: 153

The net result of respiratory challenges is low oxygen, also called ________, within the body. A) anorexia B) hypoglycemia C) hypoxia D) anoxia

Explanation: A) INCORRECT. Anorexia is an eating disorder that is unrelated to respiration. B) INCORRECT. A low level of glucose in the blood is called hypoglycemia; it is unrelated to oxygen levels. C) CORRECT. The condition of low oxygen in the body is called hypoxia. D) INCORRECT. The term anoxia refers to a total lack of oxygen. Page Ref: 159

If a hole is created in the chest wall, air could escape or be drawn in, or if bleeding develops within the chest, air and blood can accumulate in the pleural space. This would force the lung to: A) increase respirations. B) increase the minute volume. C) collapse. D) work harder with minimal problems.

Explanation: A) INCORRECT. Blood and/or air in the pleural space would not force increased respirations. B) INCORRECT. The minute volume would not increase as a result of air or blood accumulating in the pleural space. C) CORRECT. If bleeding develops within the chest, blood can accumulate in the pleural space and force the lung to collapse away from the chest wall. This can also occur if a hole in either the lung or the chest wall (or both) allows air to accumulate between the lung and the chest wall. D) INCORRECT. Although blood or air in the pleural space will make respirations more difficult, the problem created would certainly not be minimal. Page Ref: 159

The respiratory system moves air in and out; however, to ________ cells, the air that is inhaled must meet up with the circulatory system. A) defuse B) hyperoxygenate C) register D) perfuse

Explanation: A) INCORRECT. Cells cannot be defused. B) INCORRECT. The term hyperoxygenate means to introduce high levels of oxygen, which is not a normal part of standard respiration. C) INCORRECT. Putting oxygen into the bloodstream through the respiration process has nothing to do with registering cells. D) CORRECT. The respiratory system moves air in and out, but to perfuse cells the air that is breathed in must meet up with blood. Page Ref: 159

In the normal drive to breathe, chemoreceptors are stimulated by: A) diffusion. B) low carbon dioxide. C) high oxygen. D) high carbon dioxide.

Explanation: A) INCORRECT. Diffusion is the exchange of gases between the alveoli and capillaries and the process does not involve chemoreceptors. B) INCORRECT. In a normal drive to breathe, low carbon dioxide would not trigger chemoreceptors. C) INCORRECT. Chemoreceptors are not usually stimulated by high oxygen levels. D) CORRECT. Normally, respiration or the need to breathe is triggered in the brain by chemoreceptors detecting increasing carbon dioxide levels. Page Ref: 159

Your patient is an 86-year-old male with congestive heart failure. He called for help tonight because he cannot breathe and feels like he is "drowning in his own lungs." The patient has had several heart attacks in the past and he tells you his "heart is shot." The patient's cardiac output is likely diminished because: A) less blood fills his heart with each contraction (preload is diminished). B) the heart's force of contraction is reduced (contractility is diminished). C) the pressure in the system against which the heart must pump is increased (afterload is increased). D) All of the above are true.

Explanation: A) INCORRECT. Diminished preload is definitely one of the things that might reduce cardiac output, but not the only one. B) INCORRECT. This patient most likely has diminished contractility in addition to other causes for a reduced cardiac output. C) INCORRECT. An increased afterload might be contributing to this patient's reduced cardiac output, but there are other factors also. D) CORRECT. A patient with preexisting heart damage and the development of fluid in his lungs (congestive heart failure) is likely experiencing a diminished cardiac output because all three factors (preload, contractility, and afterload) are impaired. Page Ref: 163

When carbon dioxide is not exchanged, the net result is high carbon dioxide, a condition called ________, within the body. A) hyperemia B) hypercapnia C) hyperthermia D) hyperglycemia

Explanation: A) INCORRECT. Excess blood in the vessels supplying an organ or other part of the body is known as hyperemia; it is not related to carbon dioxide levels. B) CORRECT. Hypercapnia is the condition where carbon dioxide levels rise in the body. C) INCORRECT. An increased body temperature is called hyperthermia; it is generally unrelated to problems with carbon dioxide exchange. D) INCORRECT. Hyperglycemia means increased blood glucose levels, which does not have a connection with carbon dioxide. Page Ref: 159

What element does the cell need in order to NOT dehydrate and die? A) Glucose B) Proteins C) Water D) Oxygen

Explanation: A) INCORRECT. Glucose is critical for cellular energy production, not hydration. B) INCORRECT. The cell does not require proteins to stay hydrating C) CORRECT. Water moves into a cell from the environment around it. Without enough water, the cell will dehydrate and die. D) INCORRECT. Oxygen is not required to prevent cellular dehydration. Page Ref: 153

The metabolism that creates large amounts of carbon dioxide and lactic acid but generates little energy is called: A) homeostatic. B) hyperoxic. C) aerobic. D) anaerobic.

Explanation: A) INCORRECT. Inefficient metabolism is not called homestatic. B) INCORRECT. The term hyperoxic refers to an excess of oxygen; it is not generally used to describe a type of metabolism. C) INCORRECT. Metabolism that occurs in the presence of sufficient oxygen and nutrients to produce maximum energy with minimal waste is called aerobic metabolism. D) CORRECT. Anaerobic metabolism is the result of glucose being metabolized without enough oxygen; it produces much more waste such as lactic acid and far less energy. Page Ref: 153

In normal exhalation, the diaphragm and intercostal muscles relax to contract the chest, which creates a positive pressure. This is what type of process? A) Inspiration B) Active C) Passive D) Respiration

Explanation: A) INCORRECT. Inspiration is another term for inhaling, which occurs when the diaphragm contracts and the intercostal muscles expand. B) INCORRECT. An active process requires effort; relaxation of muscles is not active. C) CORRECT. Exhalation is normally a passive process. To exhale, the diaphragm and intercostal muscles relax to make the chest contract, creating a positive pressure that pushes air out. D) INCORRECT. The term respiration refers to the entire breathing cycle, not just to the exhalation process. Page Ref: 159

Your patient is a 22-year-old female that accidentally ate some shellfish and is now having a severe reaction. She tells you that the last time she ate shellfish, "they had to put a breathing tube in my throat and I almost died." Her face is starting to swell up and you can hear audible wheezing when she breathes. The chemical that produces edema and narrowing of the airways during hypersensitivity reactions like this is called: A) serotonin. B) acetylcholine. C) insulin. D) histamine.

Explanation: A) INCORRECT. Serotonin would not stimulate a hypersensitivity reaction. B) INCORRECT. Severe allergic reactions are not triggered by acetylcholine. C) INCORRECT. Insulin is not related to hypersensitivity reactions. D) CORRECT. Severe allergic reactions can occur when chemicals like histamine are released, which can produce edema and narrowing of the airways. Page Ref: 171

Which of the following statements provides reasons for the disruption of respiratory control? A) A medical, structural, and mechanical failure that has initiated the cascade of life-threatening problems will interrupt this control. B) A structural reason that has caused collapse of the upper and lower airways to block the flow of oxygen to the alveoli can interrupt this control. C) Medical reasons, infections, trauma, toxins, and drugs, along with neurologic disorders, can interrupt this control. D) Mechanical failure, soft-tissue damage, obstruction, and lack of perfusion will interrupt this control.

Explanation: A) INCORRECT. Medical, structural, and mechanical failures that result in life-threatening problems will not necessarily impact respiratory control. B) INCORRECT. A traumatic injury that collapses the upper and lower airways, blocking the flow of oxygen will not initially impact the respiratory control function. C) CORRECT. Medical events like strokes, infections, and toxin or drug exposure, and brain trauma can all disrupt respiratory control in the medulla oblongata. D) INCORRECT. Disruption of respiratory control is not necessarily related to mechanical failure, trauma, obstruction, or lack of perfusion. Page Ref: 158

An infection of the brain is called: A) multiple sclerosis. B) encephalitis. C) rhinitis. D) meningitis.

Explanation: A) INCORRECT. Multiple sclerosis is a disease that affects the transmission of messages in the nervous system. B) CORRECT. Encephalitis is an infection in the brain tissue. C) INCORRECT. An inflammation of the membranes in the nose is called rhinitis. D) INCORRECT. Meningitis is an infection of the protective layers of the brain and spinal cord. Page Ref: 169

A 12-year-old female patient is having an asthma attack after participating in some strenuous activity during recess at school. She's taken several doses of her own bronchodilator with little relief. Your partner immediately administers oxygen. Providing supplemental oxygen will increase the amount of oxygen molecules carried by the ________ in her blood, helping oxygenate critical organs like the brain. A) plasma B) hemoglobin C) white blood cells D) albumin

Explanation: A) INCORRECT. Only a small amount (~2%) of oxygen is dissolved in the liquid portion of blood known as plasma. B) CORRECT. Blood transports oxygen by binding the vast majority of it to hemoglobin in red blood cells. C) INCORRECT. White blood cells primarily function to fight infection. D) INCORRECT. Albumin helps regulate oncotic pressure. Page Ref: 159

Cells make up tissues, tissues make up organs, and organs make up: A) organelles. B) sections. C) systems. D) groups.

Explanation: A) INCORRECT. Organelles are components within a cell. B) INCORRECT. The term section would not be used to describe a collection of organs. C) CORRECT. Cells work together to form tissues, tissues form organs, and organs make up systems. D) INCORRECT. The next step in the hierarchy of cells, tissues and organs, are not called a group. Page Ref: 154

A disruption of the balance between oncotic pressure and hydrostatic pressure is critical to regulating: A) oxygenation and perfusion. B) blood pressure and cell hydration. C) perfusion and proper circulation to the tissues. D) waste removal and urine.

Explanation: A) INCORRECT. Oxygenation and perfusion are not directly impacted by a disruption to both oncotic and hydrostatic pressures. B) CORRECT. The balance between the pulling-in force of plasma oncotic pressure and the pushing-out force of hydrostatic pressure is critical to regulating both blood pressure and cell hydration. C) INCORRECT. Perfusion and proper circulation to the tissues mean the same thing. D) INCORRECT. Waste removal and urine are not regulated by the balance disruption of oncotic and hydrostatic pressures. Page Ref: 160

A condition that is caused by a decreased number of red blood cells is called: A) polycythemia. B) erythrocythemia. C) leukemia. D) anemia.

Explanation: A) INCORRECT. Polycythemia is a disease state where the number of red blood cells increase or the volume of plasma decreases. B) INCORRECT. An increase in red blood cells in circulation is called erythrocythemia. C) INCORRECT. Leukemia is a type of cancer that usually begins in the white blood cells. D) CORRECT. Anemia is a decrease in the number of red blood cells. When severe, anemia decreases the blood's ability to carry oxygen. Page Ref: 160

Stroke volume depends on a series of factors: one is the force the myocardial muscle exerts to move the blood. This is known as: A) preload. B) contractility. C) automaticity. D) afterload.

Explanation: A) INCORRECT. Preload is how much blood is returned to the heart prior to the contraction B) CORRECT. Contractility is the force of contraction; that is, how hard the heart squeezes. The more forceful the muscle squeezes, the greater the stroke volume. C) INCORRECT. The ability of cardiac cells to depolarize is called automaticity. D) INCORRECT. Afterload is how much pressure the heart has to pump against in order to force blood out into the system. Page Ref: 163

Which of the following is an indicator that a patient's nervous system has been impaired? A) Changes in pupil dilation B) Hearing disturbances C) General weakness D) All of the above

Explanation: A) INCORRECT. Pupil changes are one of many indicators of nervous system impairment. B) INCORRECT. Hearing and visual disturbances, among other signs and symptoms, can indicate an impairment of a patient's nervous system. C) INCORRECT. A patient with nervous system impairment can present with general or specific weaknesses, or any of a number of other signs and symptoms. D) CORRECT. All of the signs and symptoms provided can indicate an impairment of the nervous system. Page Ref: 169

The seat of respiratory control is found in the: A) nose. B) lungs. C) chest. D) medulla oblongata.

Explanation: A) INCORRECT. Respiration is not controlled by the nose. B) INCORRECT. Although the lungs are obviously an important part of respiration, they do not control it. C) INCORRECT. The chest is not the seat of respiratory control. D) CORRECT. A section of the brain called the medulla oblongata is the seat of respiratory control. From time to time, disorders that affect this portion of the brain can interfere with respiratory function. Page Ref: 158

Injuries to the brain and spinal cord, sepsis, and severe allergic reactions can cause what similar cardiovascular problem? A) Increased SVR B) Loss of tone C) Hypertension D) Permeability

Explanation: A) INCORRECT. Systemic vascular resistance (SVR) is the pressure within the vessels that the heart must push against. Brian and spinal injuries do not generally cause an increase in SVR. B) CORRECT. Loss of tone, or vasodilation, can be caused by brain and spinal cord injuries, severe allergies, or sepsis. C) INCORRECT. Sepsis, allergic reactions, and brain injuries do not commonly cause increased blood pressure (hypertension). D) INCORRECT. Injuries, sepsis, and severe allergies will not commonly all affect permeability. Page Ref: 162

Not all inspired air reaches the alveoli; 150 mL is stopped in the airway leading to the alveoli. This is called: A) vital capacity. B) bronchial air. C) tidal volume. D) dead air space.

Explanation: A) INCORRECT. The air in the airway that never reaches the alveoli is not known as vital capacity. B) INCORRECT. Since the inspired air that doesn't reach the alveoli is found throughout the lower and upper airways, it is not referred to as just bronchial air. C) INCORRECT. The total volume of air moved in one in-and-out cycle of breathing is called the tidal volume. D) CORRECT. Air that occupies the space between the mouth and alveoli, but that does not actually reach the area of gas exchange is call dead air space. Page Ref: 158

What is the correct order of air flow from the nose to the alveoli in the lungs? A) Nose, pharynx, hypopharynx, epiglottis, trachea, crania, mainstem bronchi, alveoli B) Mouth, pharynx, epiglottis, hypopharynx, trachea, mainstem bronchi, crania, alveoli C) Nose, nasopharynx, pharynx, hypopharynx, larynx, trachea, bronchi, alveoli D) Nose, hyperpharynx, pharynx, hypopharynx, trachea, mainstem bronchi, bronchi, alveoli

Explanation: A) INCORRECT. The crania are not part of the airflow path in the respiratory system. B) INCORRECT. The mouth would not be included when mapping air flow entering through the nose; the epiglottis and crania would also not be involved. C) CORRECT. Air follows a path from the openings of the nose into the nasopharynx, travels to the rear of the throat (hypopharynx), and then enters the larynx, below which the trachea begins. It then travels down the trachea to the point where it branches into two large tubes called the mainstem bronchi, one leading to each lung, until they reach their endpoints at the multitude of tiny air pockets in the lungs called alveoli. D) INCORRECT. The term hyperpharynx does not describe a proper anatomic structure of the airway. Page Ref: 155 Objective: 7.4

You and your EMT partner respond to a local shipping warehouse for a worker who was hit by a falling crate. Upon arrival, you find the man lying on the concrete floor of the facility, alert and oriented but unable to move or even feel his legs below the waist. Based on the mechanism of injury and the symptoms, which of the patient's body systems would you suspect has been impaired? A) Endocrine system B) Nervous system C) Cardiopulmonary system D) Immune system

Explanation: A) INCORRECT. The endocrine system is made up of a variety of glands that secrete hormones that dictate and control a variety of body functions, such as glucose transfer and water absorption in the kidneys. B) CORRECT. Mechanical damage to the spine and other nervous pathways results in disruption of nervous system communication. That means when a nervous pathway is damaged, movement, sensation, and even automatic functions like breathing and blood vessel dilation may be altered. C) INCORRECT. The cardiopulmonary system controls breathing, circulation of the blood, and perfusion. D) INCORRECT. The immune system is responsible for fighting infection. It responds to specific body invaders by identifying them, marking them, and destroying them. Page Ref: 169

Production of energy occurs in what part of the cell? A) Endoplasmic reticulum B) Mitochondria C) Nucleus D) Potassium pump

Explanation: A) INCORRECT. The endoplasmic reticulum plays a key role in the synthesizing of proteins in the cell, not the production of energy. B) CORRECT. Energy for the cell is produced largely by the mitochondria, the structures responsible for the conversion of glucose and other nutrients into energy. C) INCORRECT. The cell nucleus contains DNA, the genetic blueprint for cellular reproduction. D) INCORRECT. Ions are moved across cell membranes by the sodium potassium pump mechanism, which requires energy produced elsewhere in the cell. Page Ref: 152

The movement of ions across the cell membrane is needed to accomplish repolarization. What cell structure is used to prepare for depolarization? A) Mitochondria B) Nucleus C) Endoplasmic reticulum D) Sodium potassium pump

Explanation: A) INCORRECT. The mitochondria are not directly involved in the movement of ions for depolarization. B) INCORRECT. Depolarization and repolarization do not involve the nucleus of the cell. C) INCORRECT. The endoplasmic reticulum synthesizes proteins; it does not manage the movement of ions. D) CORRECT. Ions are moved across cell membranes by the sodium potassium pump mechanism. Page Ref: 152

The most vulnerable part of the cell is the: A) mitochondria. B) DNA. C) membrane. D) nucleus.

Explanation: A) INCORRECT. The mitochondria are not the most vulnerable part of the cell. B) INCORRECT. DNA, stored in the nucleus of the cell, is not the most vulnerable part. C) CORRECT. The cell membrane is the most vulnerable element of the cell. Many disease processes alter its permeability, or its ability to effectively transfer fluids, electrolytes, and other substances in and out of the cell. D) INCORRECT. Located within the center of the cell, the nucleus is not the most vulnerable part. Page Ref: 152

You are on the scene at a local park where a 51-year-old male is reported to be confused and having difficulty walking. Your partner notes that the patient is wearing a bracelet indicating he is diabetic. Upon questioning, the patient is able to report that he has not eaten in 8 hours. Your knowledge of pathophysiology suggests that the patient may be suffering from a diabetic emergency. Glucose is a building block for what form of energy in the cell? A) Mitochondria B) Electrolytes C) ATP D) Endoplasmic reticulum

Explanation: A) INCORRECT. The mitochondria are where the glucose is converted into energy in the cell. B) INCORRECT. Although electrolytes play an important role in cellular activity, they are not directly related to creating forms of energy. C) CORRECT. Adenosine triphosphate (ATP) is the energy created in the mitochondria of the cell when glucose and other nutrients are converted. D) INCORRECT. The endoplasmic reticulum is specifically responsible for creating proteins. Page Ref: 152

The cellular structure that is responsible for synthesizing proteins is: A) mitochondria. B) endoplasmic reticulum. C) nucleus. D) sodium pump.

Explanation: A) INCORRECT. The mitochondria produces energy for the cell; it does not synthesize proteins. B) CORRECT. The endoplasmic reticulum plays a key role in the synthesizing of proteins in the cell. C) INCORRECT. The DNA is stored in the nucleus and primarily functions to store genes. D) INCORRECT. The sodium pump manages ion movement across the cell walls, not protein synthesis. Page Ref: 152

The major organs of the endocrine system are the: A) brain, pituitary, thyroid, and adrenal glands. B) pituitary, thyroid, and adrenal glands. C) kidneys and the brain. D) liver, pancreas, and the kidneys.

Explanation: A) INCORRECT. The pituitary, thyroid, and adrenal are glands, not organs. B) INCORRECT. Although important, glands are not considered organs. C) CORRECT. The major organs of the endocrine system include the kidneys and the brain. D) INCORRECT. The liver is not an organ of the endocrine system, and the pancreas is considered a gland. Page Ref: 169

The process by which glucose and other nutrients are converted into energy is called: A) catabolism. B) respiration. C) metabolism. D) depolarization.

Explanation: A) INCORRECT. The process of breaking down fats and proteins is known as catabolism; it is not related to turning glucose into energy. B) INCORRECT. Respiration is breathing; it does not directly convert glucose into energy. C) CORRECT. The conversion of glucose into energy is an essential process of metabolism. D) INCORRECT. Depolarization refers to the changing polarity of cellular membranes; it is not related to converting nutrients into energy. Page Ref: 153

Certain blood vessels that contain specialized sensors that detect the level of internal pressure and transmit messages to the nervous system, which then triggers the smooth muscle in the vessel walls to make any needed size adjustments, are called: A) pressure receptors. B) stretch receptors. C) chemoreceptors. D) volume receptors.

Explanation: A) INCORRECT. The receptors that trigger changes in the size of a blood vessel are not called pressure receptors. B) CORRECT. Certain blood vessels contain specialized sensors called stretch receptors that detect the level of internal pressure and transmit messages to the nervous system, which then triggers the smooth muscle in the vessel walls to make any needed size adjustments. C) INCORRECT. Chemoreceptors detect the levels of oxygen and carbon dioxide in the blood, not the internal pressure of the vessel. D) INCORRECT. Internal pressure within blood vessels is not measured by volume receptors. Page Ref: 162

The study of how disease affects the functioning of the human body is called: A) psychology. B) physiology. C) pathophysiology. D) anatomy.

Explanation: A) INCORRECT. The study of the human mind and its functions is called psychology. B) INCORRECT. Physiology is the study of the normal function of the human body. C) CORRECT. Pathophysiology is the study of how disease processes affect the function of the body. D) INCORRECT. The study of the parts and structures of the human body is called anatomy. Page Ref: 151

The pressure that is created when the heart pushes the blood throughout the circulatory system is called: A) hyperstatic pressure. B) osmotic pressure. C) oncotic pressure. D) hydrostatic pressure.

Explanation: A) INCORRECT. The term hyperstatic pressure is not generally used in reference to circulation. B) INCORRECT. Osmotic pressure relates to the fluid levels of the cells, not to circulatory pressure. C) INCORRECT. When large proteins attract water from the spaces between the cells and back into the bloodstream it is known as oncotic pressure. D) CORRECT. When the heart beats, it creates hydrostatic pressure which pushes fluid back out of the blood vessels toward the cells. Page Ref: 160

What is a patent airway? A) A rigid suction device used to remove fluid and foreign objects from the pharynx to secure the airway B) A term used by EMS practitioners to indicate that the patient has a secured and opened airway necessary for life C) The condition of the patient's airway at the start of a lifesaving intervention D) An airway that is in need of securing via an oral or nasal pharyngeal airway

Explanation: A) INCORRECT. The term patent airway does not refer to a suction device. B) CORRECT. A patent airway is one that is open, clear and free from obstructions. C) INCORRECT. The condition of a patient's airway at the outset of lifesaving care may or may not be patent. D) INCORRECT. An airway that is blocked or otherwise occluded would not be referred to as patent. Page Ref: 158 Objective: 7.4

Carbon dioxide is transported back to the lungs in two ways: via the red blood cells and: A) white blood cells. B) oncotic pressure. C) hydrostatic pressure. D) plasma.

Explanation: A) INCORRECT. White blood cells do not carry carbon dioxide. B) INCORRECT. Oncotic pressure is related to proteins in plasma, not carbon dioxide transportation. C) INCORRECT. When the heart beats, the pressure created tends to push fluid back out of the blood vessels toward the cells and is called hydrostatic pressure. D) CORRECT. Some carbon dioxide is dissolved in the blood plasma and transported back to the lungs. Page Ref: 159