EMT Quiz 1

Cardiogenic shock is a(n) ______ shock and is a failure of the ______.

Obstructive Heart/Pump

Shock caused by a pulmonary embolism is a(n) ______ shock and is a failure of the ______.

Obstructive Heart/Pump

You receive a call to a residence for a sick patient. Upon your arrival, you find the patient, a 53-year-old diabetic male, lying down on his front porch. His wife tells you that he had been mowing the lawn in the heat for the past 3 hours. The patient is confused and has hot, moist skin. His pulse is weak and thready, and his blood pressure is 90/50 mm Hg. You should:

load him into the ambulance and begin rapid cooling interventions

Select which of the three basic causes of shock (pump failure, low volume, poor vessel function) match the corresponding medical condition: Drug Overdose

poor vessel function

Select which of the three basic causes of shock (pump failure, low volume, poor vessel function) match the corresponding medical condition: Spinal Cord Injury

poor vessel function

Select which of the three basic causes of shock (pump failure, low volume, poor vessel function) match the corresponding medical condition: infection

poor vessel function

You are transporting a 28-year-old man with a frostbitten foot. The patient's vital signs are stable and he denies any other injuries or symptoms. The weather is treacherous and your transport time to the hospital is approximately 45 minutes. During transport, you should:

protect the affected part from further injury

The body's natural protective mechanisms against heat loss are:

vasoconstriction and shivering

What are the three components of the pediatric triangle?

Appearance Work of breathing Circulation to skin

A 30-year-old male was rescued after being lost in the woods for approximately 18 hours. The outside temperature is 30°F (−1°C). He is immediately placed in the warmed ambulance, where you perform a primary assessment. He is unresponsive, pale, and apneic. You should:

Assess for a carotid pulse for up to 60 secs

A dysbarism injury refers to the signs and symptoms related to changes in

Barometric pressure

Select which of the three basic causes of shock (pump failure, low volume, poor vessel function) match the corresponding medical condition: Heart Attack

Pump Failure

Homeostasis

a balance of all body systems

A 73-year-old female experienced a syncopal episode while watching TV. She is now conscious, but is diaphoretic, tachycardic, and hypotensive. Your assessment reveals abdominal tenderness and a pulsating mass to the left of her umbilicus. You should suspect:

an aortic aneurysm

Shock

hypoperfusion

Obstructive shock

mechanical obstructions blocking blood volume

Temporary, widespread vasodilation and syncope caused by a sudden nervous system reaction MOST accurately describes:

psychogenic shock

Perfusion

sufficient circulation to meet all cell needs

In infants and children, a capillary refill time (CRT) that is greater than ______ second(s) is a sign of poor peripheral perfusion.

2

Hemorrhagic shock is a(n) ______ shock and is a failure of the ______.

Distributive Blood/Volume

Hypovolemic shock is a(n) ______ shock and is a failure of the ______.

Distributive Blood/Volume

Psychogenic shock is a(n) ______ shock and is a failure of the ______.

Distributive Vessels/Tank

Neurogenic shock is a(n) ______ shock and is a failure of the ______.

Distributive Vessels/Tank

Septic shock is a(n) ______ shock and is a failure of the ______.

Distributive Vessels/Tank

Anaphylactic shock is a(n) ______ shock and is a failure of the ______.

Distributive Vessels/tank

Patient presents with... Cramping of fingers, arms, legs, abdominal muscles Nausea Normotensive to mild hypotension Tachycardia Cool, pale skin Awake, alert Normal body temperature

Heat cramps

Patient presents with... Headache Dizziness Irritability Decreased LOC Seizures Bounding pulse progressing to rapid, weak pulse Hypotension secondary to vasodilation Usually not diaphoretic

Heat stroke

Shock caused by cardiac tamponade is a(n) ______ shock and is a failure of the ______.

Obstructive Heart/Pump

Shock caused by a tension pneumothorax is a(n) _________ shock and is a failure of the ________

Obstructive Heart/Pump

Automatic Nervous System

Regulates involuntary body functions

A 70-year-old female was recently discharged from the hospital following a total hip replacement. Today, she presents with restlessness, tachycardia, and a blood pressure of 100/64 mm Hg. Her skin is hot and moist. You should be MOST suspicious that she is experiencing:

Septic Shock

You receive a call for a sick person. When you arrive, you find the patient, a 75-year-old male, lying unresponsive in his bed. His respirations are slow and irregular and his pulse is slow and weak. His daughter tells you that he fell the day before, but refused to allow her to call 9-1-1. His past medical history is significant for hypothyroidism, deep vein thrombosis, heavy alcohol use, and liver cirrhosis. His medications include blood thinners and vitamins. You should be MOST suspicious that this patient is experiencing:

a subdural hematoma

An 84-year-old male fell a week ago and has been bedridden since then. Today, he presents with an altered mental status. His skin is pale and cold and his respirations are rapid and shallow. The EMT should suspect:

a systemic infection

To assess a patient's general body temperature, pull back on your glove and place the back of your hand on his or her skin at the:

abdomen

A 70-year-old man complains of a sudden onset of difficulty breathing. He has dried blood on his lips and is very anxious. His left leg is red, swollen, and painful. The EMT should:

administer high-flow oxygen

You are dispatched to a residence for a child with respiratory distress. The patient, an 18-month-old female, is tachypneic, has sternal retractions, and is clinging to her mother. Her skin is pink and dry, and her heart rate is 120 beats/min. The MOST appropriate treatment for this child includes:

administering blow-by oxygen and transporting the child with her mother

You respond to a residence for a patient with a severe leg injury following an accident with a chainsaw. When you arrive, you find the patient, a 44-year-old male, lying supine in the backyard. He has a partial amputation of his right lower leg that is actively bleeding. The patient is conscious and breathing adequately; however, he is restless and his skin is diaphoretic. You should:

apply direct pressure to the wound.

You respond to a skate park where a 10-year-old male fell from his skateboard and struck his head on the ground; he was not wearing a helmet. He is responsive to painful stimuli only and has a large hematoma on the back of his head. After your partner stabilizes his head and opens his airway, you assess his breathing and determine that it is slow and irregular. His pulse is slow and bounding. You should:

assist his ventilations, be prepared to suction his mouth if he vomits, apply full spinal precautions, and prepare for immediate transport to a trauma center.

An 8-year-old female with a history of asthma continues to experience severe respiratory distress despite being given multiple doses of her prescribed albuterol by her mother. She is conscious, but clearly restless. Her heart rate is 130 beats/min and her respiratory rate is 30 breaths/min. She is receiving high-flow oxygen via a nonrebreathing mask. You should:

be prepared to assist her ventilations, transport at once, and request an ALS intercept en route to the hospital

A 56-year-old male is found semiconscious by his wife. Your assessment reveals that his respirations are rapid and shallow, his pulse is rapid and irregular, and his blood pressure is low. The patient's wife states that he complained of left arm pain and nausea the day before, but would not allow her to call 9-1-1. The MOST likely cause of this patient's present condition is:

cardiogenic hypoperfusion

A 2-year-old female has experienced a seizure. When you arrive at the scene, the child is conscious, crying, and clinging to her mother. Her skin is hot and moist. The mother tells you that the seizure lasted approximately 5 minutes. She further tells you that her daughter has no history of seizures, but has had a recent ear infection. You should:

cool the child with tepid water and transport to the hospital.

You are dispatched to a residence for a 40-year-old female who fainted. Upon your arrival, the patient is conscious and alert, and states that she is fine. Her husband tells you that she fainted after receiving news that her sister was killed in a car crash. You offer oxygen to the patient, but she refuses to accept it. At this point, your primary concern should be to:

determine if she was injured when she fainted

Upon arriving at the residence of an elderly female who apparently fainted, you find the patient lying supine on her living room floor. She is not moving and her eyes are closed. A neighbor tells you that she found the patient this way, but did not move her. When you gently tap the patient, she does not respond. You should:

direct your partner to manually stabilize her head while you quickly visualize her chest for signs of breathing

Compensated Shock

early stages of shock

A 6-year-old male presents with acute respiratory distress. His mother states that she saw him put a small toy into his mouth shortly before the episode began. The child is conscious, obviously frightened, and is coughing forcefully. You should:

encourage him to cough, give oxygen as tolerated, and transport

EMTs are dispatched to a residence for an 80-year-old woman who is ill. The patient's daughter states that her mother almost fainted after going to the bathroom, and that her pulse was very slow. The patient's pulse rate is 80 beats/min and irregular and she is conscious and alert. The EMTs should suspect that the patient:

experienced a vasovagal response

Syncope

fainting

Patient presents with... Headache Dizziness Fatigue Nausea Confusion Weakness Syncope Profuse perspiration, pallor skin Tachycardia, hypotension, tachypnea Orthostatic changes Normal core temperature

heat exhaustion

You are assessing a 70-year-old female who complains of intense thirst, frequent urination, and dizziness. She has a history of type 2 diabetes, heart disease, rheumatoid arthritis, and gout. Her blood glucose reads "high." She is conscious, but confused. Her blood pressure is 92/52 mm Hg, her pulse rate is 130 beats/min and weak, and her respirations are 22 breaths/min and shallow. This patient's clinical presentation is MOST consistent with:

hyperosmolar hyperglycemic nonketotic syndrome.

Select which of the three basic causes of shock (pump failure, low volume, poor vessel function) match the corresponding medical condition: Trauma to vessels or tissues

low volume

Select which of the three basic causes of shock (pump failure, low volume, poor vessel function) match the corresponding medical condition: Vomiting

low volume

Select which of the three basic causes of shock (pump failure, low volume, poor vessel function) match the corresponding medical condition: diarrhea

low volume

You and your partner are standing by at a large social event at a river resort when a frantic woman tells you that she found a young male floating face-down in the water. Nobody claims to have witnessed the event. After you and your partner enter the water and reach the patient, you should:

move him as a unit to a supine position

You are dispatched to a local high school track and field event for a 16-year-old male who fainted. The outside temperature is approximately 95°F (35°C) with high humidity. Upon your arrival, the patient is conscious, alert, and complains of nausea and a headache. His skin is cool, clammy, and pale. You should:

move him into the cooled ambulance

The MOST accurate method for determining if you are delivering adequate tidal volume to a child during bag-valve mask ventilations is to:

observe the chest for adequate rise

An older woman with osteoporosis presents with pain and deformity to her left hip after she shifted her weight onto her other foot. She has MOST likely experienced a(n):

pathologic fracture

A 2-year-old child who has no recent history of illness suddenly appears cyanotic and cannot speak after playing with a small toy. You should:

perform abdominal thrusts

Your assessment of a 23-year-old female reveals a core body temperature of 93.4°F (34°C). She is conscious, answers your questions appropriately, is shivering, and complains of nausea. Her skin is cold and pale, her muscles appear rigid, and her respirations are rapid. You should:

place heat packs near her groin, axillae, and behind her neck, cover her with warm blankets, and avoid rough handling

Hypovolemic shock caused by severe burns is the result of a loss of

plasma

Select which of the three basic causes of shock (pump failure, low volume, poor vessel function) match the corresponding medical condition: Anaphylaxis

poor vessel function

Select which of the three basic causes of shock (pump failure, low volume, poor vessel function) match the corresponding medical condition: Large pulmonary embolus

pump failure

Select which of the three basic causes of shock (pump failure, low volume, poor vessel function) match the corresponding medical condition: Trauma to heart

pump failure

A 19-year-old male was stung multiple times by fire ants. He is experiencing obvious signs and symptoms of anaphylactic shock. You administer high-flow oxygen and give him epinephrine via intramuscular injection. Upon reassessment, you determine that his condition has not improved. You should:

repeat the epinephrine injection after consulting medical control

You are assessing a man with suspected hypothermia. The patient is conscious and alert, and is actively shivering. His respiratory rate is increased, but his breathing is unlabored, and the pulse oximeter reads 72%. The pulse oximetry reading is MOST likely:

secondary to decrease perfusion in the extremities

You are dispatched to a residence for an 80-year-old female who fell. When you arrive, you find the patient conscious, lying in a recumbent position on the floor in her living room. In addition to providing the appropriate treatment, you should ask the patient if:

she became dizzy or fainted before falling

You are dispatched to a local elementary school for an injured child. As you approach the child, you note that he is lying at the base of the monkey bars. He is unresponsive and there are no signs of breathing. You should:

stabilize his head and check for a pulse

A construction worker fell approximately 30 feet. He is semiconscious with rapid, shallow respirations. Further assessment reveals deformity to the thoracic region of his spine. His blood pressure is 70/50 mm Hg, his pulse is 66 beats/min and weak, and his skin is warm and dry. In addition to spinal immobilization and rapid transport, the MOST appropriate treatment for this patient includes:

assisted ventilation, thermal management, and elevation of the lower extremities