Exam 2 (EMT)

Question 59 Hyperventilation could be associated with all of the following, EXCEPT: Select one: A. a narcotic overdose. B. an overdose of aspirin. C. high blood glucose levels. D. a respiratory infection.

Chapter 15, Causes of Dyspnea, Page 601 The correct answer is: a narcotic overdose.

Question 65 Alkalosis is a condition that occurs when: Select one: A. dangerous acids accumulate in the bloodstream. B. slow, shallow breathing eliminates too much carbon dioxide. C. blood acidity is reduced by excessive breathing. D. the level of carbon dioxide in the blood increases.

Chapter 15, Causes of Dyspnea, Page 601 The correct answer is: blood acidity is reduced by excessive breathing.

Question 31 Common signs and symptoms of acute hyperventilation syndrome include: Select one: A. anxiety, dizziness, and severe bradypnea. B. altered mental status and bradycardia. C. unilateral paralysis and slurred speech. D. tachypnea and tingling in the extremities.

Chapter 15, Causes of Dyspnea, Page 601 The correct answer is: tachypnea and tingling in the extremities.

Question 18 Dyspnea is MOST accurately defined as: Select one: A. shortness of breath or difficulty breathing. B. a marked increase in the exhalation phase. C. labored breathing with reduced tidal volume. D. a complete cessation of respiratory effort.

Chapter 15, Introduction, Page 585 The correct answer is: shortness of breath or difficulty breathing.

Question 7 An alert patient presents with a regular pattern of inhalation and exhalation and breath sounds that are clear and equal on both sides of the chest. These findings are consistent with: Select one: A. respiratory difficulty. B. an obstructed airway. C. adequate air exchange. D. respiratory insufficiency.

Chapter 15, Pathophysiology, Page 587 The correct answer is: adequate air exchange.

Question 47 Which of the following statements regarding the AED and defibrillation is correct? Select one: A. The AED will not analyze the rhythm of a moving patient. B. Defibrillation is the first link in the AHA chain of survival. C. The AED will shock any rhythm not accompanied by a pulse. D. CPR should be performed for 5 minutes before using the AED.

Chapter 16, Cardiac Arrest, Page 657 The correct answer is: The AED will not analyze the rhythm of a moving patient.

Question 43 You are dispatched to a convenience store for a patient who passed out. Upon arriving at the scene, you find two off-duty EMTs performing CPR on the patient, a 58-year-old male. Your initial action should be to: Select one: A. request a paramedic unit and quickly attach the AED. B. have the EMTs stop CPR and assess for a pulse. C. feel for a pulse while compressions are ongoing. D. quickly attach the AED and push the analyze button.

Chapter 16, Emergency Medical Care for Cardiac Arrest, Page 660 The correct answer is: feel for a pulse while compressions are ongoing.

Question 63 When treating a patient with chest pain, you should assume that he or she is having an AMI because: Select one: A. angina and AMI present identically. B. most patients with chest pain are experiencing an AMI. C. angina usually occurs after an AMI. D. the cause of the pain cannot be diagnosed in the field.

Chapter 16, Pathophysiology, Page 638 The correct answer is: the cause of the pain cannot be diagnosed in the field.

Question 48 Common signs and symptoms of AMI include all of the following, EXCEPT: Select one: A. pain exacerbated by breathing. B. shortness of breath or dyspnea. C. irregular heartbeat. D. sudden unexplained sweating.

Chapter 16, Pathophysiology, Page 638-639 The correct answer is: pain exacerbated by breathing.

Question 41 Rapid, labored breathing in a patient with signs and symptoms of AMI should make you suspicious for: Select one: A. significant hypotension. B. congestive heart failure. C. right ventricular failure. D. a cardiac arrhythmia.

Chapter 16, Pathophysiology, Page 639 The correct answer is: congestive heart failure.

Question 39 The purpose of defibrillation is to: Select one: A. cause a rapid decrease in the heart rate of an unstable patient. B. stop the chaotic, disorganized contraction of the cardiac cells. C. improve the chance of CPR being successful in resuscitation. D. prevent asystole from deteriorating into ventricular fibrillation.

Chapter 16, Pathophysiology, Page 639 The correct answer is: stop the chaotic, disorganized contraction of the cardiac cells.

Question 33 Ventricular tachycardia causes hypotension because: Select one: A. the right ventricle does not adequately pump blood. B. the left ventricle does not adequately fill with blood. C. the volume of blood returning to the atria increases. D. blood backs up into the lungs and causes congestion.

Chapter 16, Pathophysiology, Page 639 The correct answer is: the left ventricle does not adequately fill with blood.

Question 64 When documenting a patient's description of his or her chest pain or discomfort, the EMT should: Select one: A. underline the patient's quotes. B. use the patient's own words. C. use medical terminology. D. document his or her own perception.

Chapter 16, Pathophysiology, Page 639 The correct answer is: use the patient's own words.

Question 72 Sudden death following AMI is MOST often caused by: Select one: A. cardiogenic shock. B. ventricular fibrillation. C. severe bradycardia. D. congestive heart failure.

Chapter 16, Pathophysiology, Page 639 The correct answer is: ventricular fibrillation.

Question 3 Cardiogenic shock following AMI is caused by: Select one: A. decreased pumping force of the heart muscle. B. hypovolemia secondary to severe vomiting. C. widespread dilation of the systemic vasculature. D. a profound increase in the patient's heart rate.

Chapter 16, Pathophysiology, Page 640 The correct answer is: decreased pumping force of the heart muscle.

Question 57 You are dispatched to a residence for a 56-year-old male with an altered mental status. Upon arrival at the scene, the patient's wife tells you that he complained of chest pain the day before, but would not allow her to call EMS. The patient is semiconscious; has rapid, shallow respirations; and has a thready pulse. You should: Select one: A. begin ventilatory assistance. B. obtain baseline vital signs. C. attach the AED immediately. D. apply a nonrebreathing mask.

Chapter 16, Pathophysiology, Page 641 The correct answer is: begin ventilatory assistance.

Question 51 A 67-year-old female presents with difficulty breathing and chest discomfort that awakened her from her sleep. She states that she has congestive heart failure, has had two previous heart attacks, and has been prescribed nitroglycerin. She is conscious and alert with adequate breathing. Her blood pressure is 94/64 mm Hg and her heart rate is 120 beats/min. Treatment for this patient includes: Select one: A. placing her in an upright position. B. nitroglycerin for her chest pain. C. oxygen at 2 L/min via nasal cannula. D. ventilations with a BVM.

Chapter 16, Pathophysiology, Page 641 The correct answer is: placing her in an upright position.

Question 27 Upon arriving at the residence of a patient with a possible cardiac problem, it is MOST important to: Select one: A. request a paramedic unit for assistance. B. assess the scene for potential hazards. C. determine if you need additional help. D. gain immediate access to the patient.

Chapter 16, Patient Assessment, Page 643 The correct answer is: assess the scene for potential hazards.

Question 9 You arrive at a local grocery store approximately 5 minutes after a 21-year-old female stopped seizing. She is confused and disoriented; she keeps asking you what happened and tells you that she is thirsty. Her brother, who witnessed the seizure, tells you that she takes valproate (Depakote) for her seizures, but has not taken it in a few days. He also tells you that she has diabetes. In addition to administering oxygen, you should: Select one: A. give her small cups of water to drink and observe for further seizure activity. B. administer one tube of oral glucose and prepare for immediate transport. C. monitor her airway and breathing status and assess her blood glucose level. D. place her in the recovery position and transport her with lights and siren.

Chapter 17, Altered Mental Status, Page 686 The correct answer is: monitor her airway and breathing status and assess her blood glucose level.

Question 52 The spinal cord exits the cranium through the: Select one: A. foramen magnum. B. foramen lamina. C. cauda equina. D. vertebral foramen.

Chapter 17, Anatomy and Physiology, Page 676 The correct answer is: foramen magnum.

Question 13 You are caring for a 70-year-old female with signs and symptoms of an acute stroke. She is conscious, has secretions in her mouth, is breathing at a normal rate with adequate depth, and has an oxygen saturation of 96%. You should: Select one: A. insert an oral airway, apply oxygen, and transport. B. administer one tube of oral glucose and transport. C. assist her ventilations with a bag-valve mask. D. suction her oropharynx and transport immediately.

Chapter 17, Patient Assessment, Page 687 The correct answer is: suction her oropharynx and transport immediately.

Question 55 You arrive at the residence of a 33-year-old woman who is experiencing a generalized (tonic-clonic) seizure. She has a small amount of vomitus draining from the side of her mouth. After protecting her from further injury, you should: Select one: A. wait for the seizure to stop, manually open her airway, insert an oropharyngeal airway, and assess her oxygen saturation with the pulse oximeter. B. restrain her extremities to prevent her from injuring herself, suction her airway to remove the vomitus, and assist her ventilations with a bag-mask device. C. place a bite block in between her teeth, apply high-flow oxygen via a nonrebreathing mask, and consider inserting a nasopharyngeal airway. D. maintain her airway with manual head positioning, suction her airway to remove the vomitus, insert a nasopharyngeal airway, and administer high-flow oxygen.

Chapter 17, Patient Assessment, Page 687-688 The correct answer is: maintain her airway with manual head positioning, suction her airway to remove the vomitus, insert a nasopharyngeal airway, and administer high-flow oxygen.

Question 26 You are dispatched to a residence for a 66-year-old male who, according to family members, has suffered a massive stroke. Your primary assessment reveals that the patient is unresponsive, apneic, and pulseless. You should: Select one: A. assess the patient for a facial droop and hemiparesis. B. initiate CPR and attach an AED as soon as possible. C. obtain a blood glucose sample to rule out hypoglycemia. D. perform CPR for 5 minutes before applying the AED.

Chapter 17, Patient Assessment, Page 688 The correct answer is: initiate CPR and attach an AED as soon as possible.

Question 75 The mental status of a patient who has experienced a generalized seizure: Select one: A. typically does not improve, even after several minutes. B. progressively worsens over a period of a few hours. C. is likely to improve over a period of 5 to 30 minutes. D. is easily differentiated from that of acute hypoglycemia.

Chapter 17, Seizures, Page 682 The correct answer is: is likely to improve over a period of 5 to 30 minutes.

Question 69 Which of the following is a metabolic cause of a seizure? Select one: A. Head trauma B. Poisoning C. Brain tumor D. Massive stroke

Chapter 17, Seizures, Page 683 The correct answer is: Poisoning

Question 58 Febrile seizures: Select one: A. occur when a child's fever rises slowly. B. often result in permanent brain damage. C. are usually benign but should be evaluated. D. are also referred to as absence seizures.

Chapter 17, Seizures, Page 684 The correct answer is: are usually benign but should be evaluated.

Question 6 A transient ischemic attack (TIA) occurs when: Select one: A. a small cerebral artery ruptures and causes minimal damage. B. signs and symptoms resolve spontaneously within 48 hours. C. a small clot in a cerebral artery causes temporary symptoms. D. medications are given to dissolve a cerebral blood clot.

Chapter 17, Stroke, Page 680 The correct answer is: a small clot in a cerebral artery causes temporary symptoms.

Question 10 To which of the following diabetic patients should you administer oral glucose? Select one: A. A conscious 37-year-old female with nausea and vomiting B. An unconscious 33-year-old male with cool, clammy skin C. A semiconscious 40-year-old female without a gag reflex D. A confused 55-year-old male with tachycardia and pallor

Chapter 19, Emergency Medical Care for Diabetic Emergencies, Page 738 The correct answer is: A confused 55-year-old male with tachycardia and pallor

Question 56 Common signs and symptoms of severe hyperglycemia include all of the following, EXCEPT: Select one: A. rapid, thready pulse. B. cool, clammy skin. C. acetone breath odor. D. warm, dry skin.

Chapter 19, Endocrine Emergencies, Page 730 The correct answer is: cool, clammy skin.

Question 4 When assessing an unresponsive diabetic patient, the primary visible difference between hyperglycemia and hypoglycemia is the: Select one: A. presence of a medical identification tag. B. rate of the patient's pulse. C. rate and depth of breathing. D. patient's mental status.

Chapter 19, Endocrine Emergencies, Page 730 The correct answer is: rate and depth of breathing.

Question 16 Which of the following signs or symptoms would the EMT MOST likely encounter in a patient with new-onset type 1 diabetes? Select one: A. Weight loss and polyuria B. Weight gain and edema C. Low blood glucose level D. Total lack of appetite

Chapter 19, Endocrine Emergencies, Page 730-731 The correct answer is: Weight loss and polyuria

Question 42 Kussmaul respirations are an indication that the body is: Select one: A. attempting to eliminate acids from the blood. B. compensating for decreased blood glucose levels. C. trying to generate energy by breathing deeply. D. severely hypoxic and is eliminating excess CO2.

Chapter 19, Endocrine Emergencies, Page 731 The correct answer is: attempting to eliminate acids from the blood.

Question 22 Ketone production is the result of: Select one: A. fat metabolization when glucose is unavailable. B. rapid entry of glucose across the cell membrane. C. acidosis when blood glucose levels are low. D. blood glucose levels higher than 120 mg/dL.

Chapter 19, Endocrine Emergencies, Page 731 The correct answer is: fat metabolization when glucose is unavailable.

Question 15 When administering epinephrine via auto-injector, you should hold the injector in place for: Select one: A. 10 seconds. B. 20 seconds. C. 5 seconds. D. 15 seconds.

Chapter 20, Emergency Medical Care of Immunologic Emergencies, Page 762 The correct answer is: 10 seconds.

Question 74 Acute pulmonary edema would MOST likely develop as the result of: Select one: A. an upper airway infection. B. severe hyperventilation. C. right-sided heart failure. D. toxic chemical inhalation.

Chapter 15, Causes of Dyspnea, Page 594 The correct answer is: toxic chemical inhalation.

Question 28 Which of the following statements regarding anaphylaxis is correct? Select one: A. Most anaphylactic reactions occur within 60 minutes of exposure. B. Anaphylaxis is characterized by airway swelling and hypotension. C. Patients with asthma are at lower risk of developing anaphylaxis. D. The signs of anaphylaxis are caused by widespread vasoconstriction.

Chapter 15, Causes of Dyspnea, Page 598 The correct answer is: Anaphylaxis is characterized by airway swelling and hypotension.

Question 71 Which of the following statements regarding the hypoxic drive is correct? Select one: A. 100% supplemental oxygen will always cause apnea in patients with a hypoxic drive. B. Chronic carbon dioxide elimination often results in activation of the hypoxic drive. C. The hypoxic drive stimulates a person to breathe on the basis of low oxygen levels. D. The hypoxic drive serves as the primary stimulus for breathing in healthy individuals.

Chapter 15, Pathophysiology, Page 589 The correct answer is: The hypoxic drive stimulates a person to breathe on the basis of low oxygen levels.

Question 36 When administering supplemental oxygen to a hypoxemic patient with a chronic lung disease, you should: Select one: A. begin with a low oxygen flow rate, even if the patient is unresponsive, because high-flow oxygen may depress his or her breathing. B. recall that most patients with chronic lung diseases are stimulated to breathe by increased carbon dioxide levels. C. avoid positive-pressure ventilation because the majority of patients with chronic lung disease are at increased risk for lung trauma. D. adjust the flow rate accordingly until you see symptom improvement, but be prepared to assist his or her ventilations.

Chapter 15, Pathophysiology, Page 589 The correct answer is: adjust the flow rate accordingly until you see symptom improvement, but be prepared to assist his or her ventilations.

Question 12 A 62-year-old man with a history of congestive heart failure presents with severe respiratory distress and with an oxygen saturation of 82%. When you auscultate his lungs, you hear widespread rales. He is conscious and alert, is able to follow simple commands, and can only speak in two- to three-word sentences at a time. You should: Select one: A. force fluid from his alveoli by hyperventilating him with a bag-valve mask at a rate of at least 20 breaths/min. B. place him in a supine position and assist his ventilations with a bag-valve mask and high-flow oxygen. C. place him in a position of comfort, deliver oxygen via nasal cannula, and closely monitor his breathing. D. apply a CPAP device, monitor his blood pressure, and observe him for signs of improvement or deterioration.

Chapter 15, Treatment of Specific Conditions, Page 615 The correct answer is: apply a CPAP device, monitor his blood pressure, and observe him for signs of improvement or deterioration.

Question 54 A 22-year-old female patient is complaining of dyspnea and numbness and tingling in her hands and feet after an argument with her fiancé. Her respirations are 40 breaths/min. You should: Select one: A. provide reassurance. B. position her on her left side and transport at once. C. request a paramedic to give her a sedative. D. have her breathe into a paper or plastic bag.

Chapter 15, Treatment of Specific Conditions, Page 617 The correct answer is: provide reassurance.

Question 46 Blood that is ejected from the right ventricle: Select one: A. was received directly from the aorta. B. enters the systemic circulation. C. has a high concentration of oxygen. D. flows into the pulmonary arteries.

Chapter 16, Anatomy and Physiology, Page 630 The correct answer is: flows into the pulmonary arteries.

Question 32 When an electrical impulse reaches the AV node, it is slowed for a brief period of time so that: Select one: A. blood returning from the body can fill the atria. B. the SA node can reset and generate another impulse. C. the impulse can spread through the Purkinje fibers. D. blood can pass from the atria to the ventricles.

Chapter 16, Anatomy and Physiology, Page 631 The correct answer is: blood can pass from the atria to the ventricles.

Question 35 The head and brain receive their supply of oxygenated blood from the: Select one: A. iliac arteries. B. carotid arteries. C. subclavian arteries. D. brachial arteries.

Chapter 16, Anatomy and Physiology, Page 631 The correct answer is: carotid arteries.

Question 14 The right coronary artery supplies blood to the: Select one: A. right ventricle and inferior wall of the left ventricle. B. left ventricle and posterior wall of the right ventricle. C. left ventricle and inferior wall of the right atrium. D. right atrium and posterior wall of the right ventricle.

Chapter 16, Anatomy and Physiology, Page 631 The correct answer is: right ventricle and inferior wall of the left ventricle.

Question 19 In contrast to the sympathetic nervous system, the parasympathetic nervous system: Select one: A. prepares the body to handle stress. B. slows the heart and respiratory rates. C. causes an increase in the heart rate. D. dilates the blood vessels in the muscles.

Chapter 16, Anatomy and Physiology, Page 631 The correct answer is: slows the heart and respiratory rates.

Question 60 When the myocardium requires more oxygen: Select one: A. the arteries supplying the heart dilate. B. the heart rate decreases significantly. C. the AV node conducts fewer impulses. D. the heart contracts with less force.

Chapter 16, Anatomy and Physiology, Page 631 The correct answer is: the arteries supplying the heart dilate.

Question 73 The posterior tibial pulse can be palpated: Select one: A. in the fossa behind the knee. B. behind the medial malleolus, on the inside of the ankle. C. between the trachea and the neck muscle. D. on the dorsum of the foot.

Chapter 16, Anatomy and Physiology, Page 634-635 The correct answer is: behind the medial malleolus, on the inside of the ankle.

Question 38 Cardiac output may decrease if the heart beats too rapidly because: Select one: A. there is not enough time in between contractions for the heart to refill completely. B. as the heart rate increases, more blood is pumped from the ventricles than the atria. C. a rapid heartbeat causes a decrease in the strength of cardiac contractions. D. the volume of blood that returns to the heart is not sufficient with fast heart rates.

Chapter 16, Anatomy and Physiology, Page 635 The correct answer is: there is not enough time in between contractions for the heart to refill completely.

Question 40 During your treatment of a woman in cardiac arrest, you apply the AED, analyze her cardiac rhythm, and receive a "no shock advised" message. This indicates that: Select one: A. she has a pulse and does not need CPR. B. the AED detected patient motion. C. she is not in ventricular fibrillation. D. the AED has detected asystole.

Chapter 16, Cardiac Arrest, Page 656 The correct answer is: she is not in ventricular fibrillation.

Question 29 The AED has delivered a shock to an elderly male in cardiac arrest. Following 2 minutes of CPR, you re-analyze the patient's cardiac rhythm and receive a "no shock advised" message. After further resuscitation, you restore a palpable carotid pulse. Your next action should be to: Select one: A. reassess airway and breathing and treat accordingly. B. transport at once and re-analyze his rhythm en route. C. place him in the recovery position and apply oxygen. D. obtain a blood pressure and apply the pulse oximeter.

Chapter 16, Emergency Medical Care for Cardiac Arrest, Page 661 The correct answer is: reassess airway and breathing and treat accordingly.

Question 2 You and your EMT partner are the first to arrive at the scene of an unresponsive 70-year-old man. Your assessment reveals that he is apneic and pulseless. A paramedic unit is en route to the scene and will arrive in approximately 5 minutes. You should: Select one: A. perform CPR only and wait for the manual defibrillator to arrive. B. begin CPR, apply the AED, and deliver a shock if it is indicated. C. begin CPR and have your partner update the responding paramedics. D. apply the AED while your partner provides rescue breathing.

Chapter 16, Emergency Medical Care for Cardiac Arrest, Page 664-665 The correct answer is: begin CPR, apply the AED, and deliver a shock if it is indicated.

Question 5 Which of the following statements regarding nitroglycerin is correct? Select one: A. Nitroglycerin should be administered between the cheek and gum. B. The potency of nitroglycerin is increased when exposed to light. C. Nitroglycerin usually relieves anginal chest pain within 5 minutes. D. A maximum of five nitroglycerin doses should be given to a patient.

Chapter 16, Emergency Medical Care for Chest Pain or Discomfort, Page 648 The correct answer is: Nitroglycerin usually relieves anginal chest pain within 5 minutes.

Question 67 It would be MOST appropriate for a patient to take his or her prescribed nitroglycerin when experiencing: Select one: A. difficulty breathing that awakens the patient from sleep. B. chest pain that does not immediately subside with rest. C. sharp chest pain that lasts longer than 10 to 15 minutes. D. an acute onset of dizziness during a period of exertion.

Chapter 16, Emergency Medical Care for Chest Pain or Discomfort, Page 648 The correct answer is: chest pain that does not immediately subside with rest.

Question 37 Nitroglycerin relieves cardiac-related chest pain by: Select one: A. contracting the smooth muscle of the coronary and cerebral arteries. B. increasing the amount of stress that is placed on the myocardium. C. dilating the coronary arteries and improving cardiac blood flow. D. constricting the coronary arteries and improving cardiac blood flow.

Chapter 16, Emergency Medical Care for Chest Pain or Discomfort, Page 648 The correct answer is: dilating the coronary arteries and improving cardiac blood flow.

Question 53 Common side effects of nitroglycerin include all of the following, EXCEPT: Select one: A. severe headache. B. hypertension. C. bradycardia. D. hypotension.

Chapter 16, Emergency Medical Care for Chest Pain or Discomfort, Page 648 The correct answer is: hypertension.

Question 66 Prior to assisting a patient with his or her prescribed nitroglycerin, the EMT must: Select one: A. determine who prescribed the nitroglycerin. B. wait at least 5 minutes after assessing the blood pressure. C. obtain authorization from medical control. D. ensure the medication is in tablet form.

Chapter 16, Emergency Medical Care for Chest Pain or Discomfort, Page 648 The correct answer is: obtain authorization from medical control.

Question 1 After assisting your patient with prescribed nitroglycerin, you should: Select one: A. avoid further dosing if the patient complains of a severe headache. B. place the patient in a recumbent position in case of fainting. C. perform a secondary assessment before administering further doses. D. reassess his or her blood pressure within 5 minutes to detect hypotension.

Chapter 16, Emergency Medical Care for Chest Pain or Discomfort, Page 648 The correct answer is: reassess his or her blood pressure within 5 minutes to detect hypotension.

Question 34 Most patients are instructed by their physician to take up to _______ doses of nitroglycerin before calling EMS. Select one: A. two B. three C. five D. four

Chapter 16, Emergency Medical Care for Chest Pain or Discomfort, Page 648 The correct answer is: three

Question 17 A 40-year-old man is in cardiac arrest. Your partner is performing CPR. You are attaching the AED when the patient's wife tells you that he has an automatic implanted cardiac defibrillator (AICD). The AED advises that a shock is indicated. What should you do? Select one: A. Contact medical control and request permission to defibrillate. B. Continue CPR and transport the patient to the closest appropriate hospital. C. Avoid defibrillation as this will damage the patient's AICD. D. Deliver the shock followed by immediate resumption of CPR.

Chapter 16, Heart Surgeries and Cardiac Assistive Devices, Page 654 The correct answer is: Deliver the shock followed by immediate resumption of CPR.

Question 50 Ischemic heart disease is defined as: Select one: A. death of a portion of the heart muscle due to a decrease in oxygen. B. decreased blood flow to one or more portions of the myocardium. C. decreased blood flow to the heart muscle due to coronary dilation. D. absent myocardial blood flow due to a blocked coronary artery.

Chapter 16, Pathophysiology, Page 636 The correct answer is: decreased blood flow to one or more portions of the myocardium.

Question 68 Acute coronary syndrome (ACS) is a term used to describe: Select one: A. the warning signs that occur shortly before a heart attack. B. a severe decrease in perfusion caused by changes in heart rate. C. a group of symptoms that are caused by myocardial ischemia. D. the exact moment that a coronary artery is completely occluded.

Chapter 16, Pathophysiology, Page 637 The correct answer is: a group of symptoms that are caused by myocardial ischemia.

Question 23 Major risk factors for AMI include all of the following, EXCEPT: Select one: A. diabetes mellitus. B. elevated cholesterol. C. hypoglycemia. D. hypertension.

Chapter 16, Pathophysiology, Page 637 The correct answer is: hypoglycemia.

Question 24 Which of the following statements regarding the pain associated with AMI is correct? Select one: A. It often fluctuates in intensity when the patient breathes. B. It can occur during exertion or when the patient is at rest. C. Nitroglycerin usually resolves the pain within 30 minutes. D. It is often described by the patient as a sharp feeling.

Chapter 16, Pathophysiology, Page 638 The correct answer is: It can occur during exertion or when the patient is at rest.

Question 61 You respond to a residence for a patient who is "not acting right." As you approach the door, the patient, a 35-year-old male, begins shouting profanities at you and your partner while holding a baseball bat. The man is confused and diaphoretic, and is wearing a medical identification bracelet. You should: Select one: A. be assertive and talk the patient down. B. retreat at once and call law enforcement. C. contact medical control for instructions. D. calm him down so you can assess him.

Chapter 19, Patient Assessment of Diabetes, Page 734 The correct answer is: retreat at once and call law enforcement.

Question 44 When obtaining a SAMPLE history from a patient with diabetes, it would be MOST important to determine: Select one: A. if there is a family history of diabetes or related conditions. B. approximately how much water the patient drank that day. C. if he or she has had any recent illnesses or excessive stress. D. the name of the physician who prescribed his or her insulin.

Chapter 19, Patient Assessment of Diabetes, Page 735 The correct answer is: if he or she has had any recent illnesses or excessive stress.

Question 8 The foreign substance responsible for causing an allergic reaction is called a(n): Select one: A. leukotriene. B. histamine. C. allergen. D. antibody.

Chapter 20, Anatomy and Physiology, Page 753 The correct answer is: allergen.

Question 25 A raised, swollen, well-defined area on the skin that is the result of an insect bite or sting is called: Select one: A. purpura. B. urticaria. C. a pustule. D. a wheal.

Chapter 20, Common Allergens, Page 756 The correct answer is: a wheal.

Question 45 Which of the following physiologic actions does epinephrine produce when given for an allergic reaction? Select one: A. Vasoconstriction and bronchodilation B. Blocking of further histamine release C. Bronchodilation and vasodilation D. Bronchoconstriction and vasoconstriction

Chapter 20, Emergency Medical Care of Immunologic Emergencies, Page 761 The correct answer is: Vasoconstriction and bronchodilation

Question 30 Epinephrine is indicated for patients with an allergic reaction when: Select one: A. the reaction produces severe urticarial. B. a paramedic is present at the scene. C. the patient is anxious and tachycardic. D. wheezing and hypotension are present.

Chapter 20, Emergency Medical Care of Immunologic Emergencies, Page 761 The correct answer is: wheezing and hypotension are present.

Question 11 Immediately after giving an epinephrine injection, you should: Select one: A. record the time and dose given. B. reassess the patient's vital signs. C. properly dispose of the syringe. D. notify medical control of your action.

Chapter 20, Emergency Medical Care of Immunologic Emergencies, Page 762 The correct answer is: properly dispose of the syringe.

Question 62 Common side effects of epinephrine include all of the following, EXCEPT: Select one: A. headache. B. tachycardia. C. dizziness. D. drowsiness.

Chapter 20, Emergency Medical Care of Immunologic Emergencies, Page 763 The correct answer is: drowsiness.

Question 20 After administering 0.3 mg of epinephrine via auto-injector to a 22-year-old female with an allergic reaction, you note improvement in her breathing and resolution of her hives. However, she is still anxious and tachycardic. You should: Select one: A. monitor her closely but recall that anxiety and tachycardia are side effects of epinephrine. B. transport her rapidly, as it is obvious that she is having a severe reaction to the epinephrine. C. contact medical control and obtain authorization to administer another 0.3 mg of epinephrine. D. consider administering 0.15 mg of epinephrine to completely resolve her allergic reaction.

Chapter 20, Emergency Medical Care of Immunologic Emergencies, Page 763 The correct answer is: monitor her closely but recall that anxiety and tachycardia are side effects of epinephrine.

Question 70 You have administered one dose of epinephrine to a 40-year-old female to treat an allergic reaction that she developed after being stung by a scorpion. Your reassessment reveals that she is still having difficulty breathing, has a decreasing mental status, and has a blood pressure of 80/50 mm Hg. You should: Select one: A. administer a nebulized bronchodilator to improve the status of her breathing. B. request permission from medical control to give another dose of epinephrine. C. monitor her en route to the hospital and call medical control if she worsens. D. crush up an antihistamine tablet and place it in between her cheek and gum.

Chapter 20, Emergency Medical Care of Immunologic Emergencies, Page 763 The correct answer is: request permission from medical control to give another dose of epinephrine.

Question 21 Which of the following statements regarding epinephrine administration via the intramuscular (IM) route is correct? Select one: A. The preferred injection site is the upper arm. B. The IM route should not be used in children. C. The maximum single adult dose is 0.15 mg. D. The 1:1000 concentration should be used.

Chapter 20, Emergency Medical Care of Immunologic Emergencies, Page 764 The correct answer is: The 1:1000 concentration should be used.

Question 49 Which of the following negative effects of anaphylaxis will be the MOST rapidly fatal if not treated immediately? Select one: A. Severe hypotension B. Systemic vasodilation C. Diffuse urticaria D. Upper airway swelling

Chapter 20, Patient Assessment of Immunologic Emergencies, Page 758 The correct answer is: Upper airway swelling