Major #4 - EMT (Multiple Choice Questions)
The signs and symptoms of a transient ischemic attack (TIA) may last up to: -6 hours -24 hours -30 minutes -1 hour
24 hours
With advances in clot-busting (thrombolytic) drugs, the patient has a window of ________ hours to receive treatment. -4 -5 -3 -6
3
The normal glucose range in non-fasting children and adults is ____________. 60-80 mg/dL 80-120 mg/dL 120-200 mg/dL 550-600 mg/dL
80-120 mg/dL
Common signs and symptoms of a hypertensive emergency include: Choose one: -Syncope, a weak pulse, and bleeding from the ears -Pallor, cool skin, and a temporary loss of hearing -Tachycardia, pain behind the eyes, and weakness -A bounding pulse, a severe headache, and dizziness
A bounding pulse, a severe headache, and dizziness
What is epilepsy? -A condition in which a person has multiple seizures usually controlled by medication -A condition in which a person has an aura followed by seizure usually controlled by medication -A condition in which a person has general seizures that start in childhood -A condition caused by congenital brain abnormalities that causes seizures only twice a year
A condition in which a person has multiple seizures usually controlled by medication
Acute coronary syndrome (ACS) is a term used to describe: Choose one answer. -A severe decrease in perfusion caused by changes in HR -The exact moment that a coronary artery is completely occluded -A group of symptoms that are caused by myocardial ischemia -The warning signs that occur shortly before a heart attack
A group of symptoms that are caused by myocardial ischemia
A 75-year-old male with type 1 diabetes presents with chest pain and a general feeling of weakness. He tells you that he took his insulin today and ate a regular meal approximately 2 hours ago. You should treat this patient as though he is experiencing: Select one: -Hyperglycemia -Hypoglycemia -A heart attack -An acute stroke
A heart attack
When caring for a patient with documented hypoglycemia, you should be MOST alert for: -A seizure -Respiratory distress -An acute stroke -A febrile convulsion
A seizure
Which of the following MOST accurately describes a simple partial seizure? -A seizure that causes the patient to stare blankly -A seizure that is not preceded by an aura -A generalized seizure without incontinence -A seizure that begins in one extremity
A seizure that begins in one extremity
You are on the scene of a 44-year-old female patient who has attempted suicide by taking all 30 pills of her antidepressant medication at once. You are ordered by medical control to administer activated charcoal. How will activated charcoal reduce the effects of the medication? -Activated charcoal will inactivate the patient's stomach acid -Activated charcoal will bind to the medication, reducing absorption -Activated charcoal will coat the intestines, preventing absorption -Activated charcoal will cause the patient to vomit the medication
Activated charcoal will bind to the medication, reducing absorption
A patient tells you that he has a left ventricular assist device (LVAD). Which of the following conditions should you suspect that he has experienced? Select one: -Thoracic aortic aneurysm -Acute myocardial infarction -Uncontrolled hypertension -Obstructive lung disease
Acute myocardial infarction
A 66-year-old female with a history of hypertension and diabetes presents with substernal chest pressure of 2 hours' duration. Her blood pressure is 140/90 mm Hg, her pulse is 100 beats/min and irregular, and her respirations are 22 breaths/min with adequate depth. The patient does not have prescribed nitroglycerin, but her husband does. You should: Choose one: -Obtain a SAMPLE history & contact medical control for advice -Administer oxygen, give her 324 mg aspirin, & assess her further -Give her one nitroglycerin & reassess her systolic blood pressure -Give her 100% oxygen, attach the AED, & transport immediately
Administer oxygen, give her 324 mg aspirin, & assess her further
Which of the following is within the EMT's scope of practice for the treatment of the diabetic patient? -Assisting the patient with the administration of his insulin -Administration of oral glucose -Rectal administration of glucose -Both A and B
Administration of oral glucose
Albuterol and epinephrine both have broncho-dilation properties that improve the amount of oxygen that a person can inhale and absorb. However, Albuterol is administered only for asthma, whereas epinephrine is administered for both asthma and anaphylaxis. Why is epinephrine, and not Albuterol, the first choice for anaphylaxis? -Albuterol drops the blood pressure too low -Albuterol slows down the heart rate too much -Albuterol makes the heart rate increase too much -Albuterol is not a vasoconstrictor
Albuterol is not a vasoconstrictor.
The scene size-up step in the assessment of an immunologic emergency is critical because it may indicate __________. -What safety precautions are necessary to protect the EMTs, patient(s) and bystander(s) -The cause of the allergic or anaphylactic reaction -What additional resources, including ALS, the EMT should call for -All of these answers are correct
All of these answers are correct
Which of the following MOST accurately defines an allergic reaction? -An exaggerated immune system response to any substance -Destruction of the immune system by an external substance -A release of erythrocytes in response to a foreign substance -A direct negative effect on the body by an external substance
An exaggerated immune system response to any substance
Which of the following refers to difficulty in speaking or understanding speech as a result of a stroke? -Aphasia -Ataxia -Hemiparesis -Ischemia
Aphasia
You respond to a movie theater for a 70-year-old male who is confused. His wife tells you he has type 2 diabetes but refuses to take his pills. Your assessment reveals that the patient is diaphoretic, tachycardic, and tachypneic. Initial management for this patient should include: -Administering one to two tubes of oral glucose -Applying a nonrebreathing mask at 15 L/min. -Assisting the patient with his diabetic medication -Performing a rapid exam and obtaining vital signs
Applying a nonrebreathing mask at 15 L/min.
When assessing for arm drift of a patient with a suspected stroke, you should: -Ask the patient to hold his or her arms up with the palms down -Observe movement of the arms for approximately 2 minutes -Ask the patient to close their eyes during the assessment -Expect to see one arm slowly drift down to the patient's side
Ask the patient to close their eyes during the assessment
Which of the following medications is most likely to be administered to a chest pain patient with a blood pressure of 88/50 and no difficulty breathing? -Albuterol -Nitroglycerin -Oxygen -Aspirin
Aspirin
Why would an EMT give aspirin to a patient? -It is given to calm the patient by reducing the pain because stress is the real killer -Aspirin reduces the blood's ability to clot and works to prevent further clot formation in patients suffering chest pain -Aspirin reduces the heart's ability to beat fast and works to prevent rapid heart rate -Aspirin reduces the pain level in patients who are in pain
Aspirin reduces the blood's ability to clot and works to prevent further clot formation in patients suffering chest pain
A 49-year-old male presents with an acute onset of crushing chest pain and diaphoresis. You should: Select one: -Administer up to three doses of nitroglycerin -Administer up to 324 mg of baby aspirin -Obtain vital signs and a SAMPLE history -Assess the adequacy of his respirations
Assess the adequacy of his respirationS
A 49-year-old male presents with an acute onset of crushing chest pain and diaphoresis. You should: Choose one: -Administer up to three doses of nitroglycerin -Administer up to 324 mg of baby aspirin -Assess the adequacy of his respirations -Obtain vital signs and a SAMPLE history
Assess the adequacy of his respirations
A 31-year-old male with a history of diabetes had a seizure that stopped prior to EMS arrival. He is unresponsive and has rapid, shallow breathing. His pulse is rapid and weak and his skin is cyanotic. The EMT should: -Assist the patient's ventilations with a bag-valve mask -Place a thin layer of oral glucose between his cheek and gums -Administer oxygen by nasal cannula and assess his blood glucose level -Position the patient on his side and give oxygen via nonrebreathing mask
Assist the patient's ventilations with a bag-valve mask
Narrowing of the coronary arteries due to a buildup of fatty deposits is called: Choose one answer. -Arteriosclerosis -Atherosclerosis -Angina pectoris -Acute ischemia
Atherosclerosis
Your patient is waking up from a seizure; it was the patient's first seizure ever. When you ask what happened, the patient tells you she had the smell of fresh mown grass just before she seized. This sensation is known as a(n): -Clonic phase -Aura -Tonic phase -Postictal phase
Aura
Which of the following is characteristic of a patient with hyperglycemia? -Sudden onset of altered mental status -Use of excessive amounts of insulin or lack of adequate food intake -A "fruity" odor of the breath -Cool, moist skin, agitated behavior, and increased heart rate
A "fruity" odor of the breath
Assessment of a patient with hypoglycemia will MOST likely reveal: -Sunken eyes -Hyperactivity -Warm, dry skin -Combativeness
Combativeness
Insulin functions in the body by: -Producing new glucose as needed -Enabling glucose to enter the cells -Increasing circulating blood glucose -Metabolizing glucose to make energy
Enabling glucose to enter the cells
You and your partner arrive at the scene of a middle-aged man who collapsed about 5 minutes ago. He is unresponsive, apneic, and pulseless. Bystanders are present, but have not provided any care. You should: Select one: -Perform two-rescuer CPR for 5 minutes and request ALS backup -Have your partner perform CPR while you question the bystanders -Immediately apply the AED pads and analyze his cardiac rhythm -Begin high-quality CPR and apply the AED as soon as possible
Begin high-quality CPR and apply the AED as soon as possible
Choose the correct completion to this statement regarding IV administration: This route is used to administer medication into the body directly or through the bloodstream and is: -Allowed in larger cities & more advanced EMS services -Beyond the scope of the EMT level -Used in advanced life support only when the patient is intubated -Only performed by air medical personnel
Beyond the scope of the EMT level
Which of the following conditions is the diabetic patient at an increased risk of developing? Select one: -Alcoholism -Hepatitis B -Depression -Blindness
Blindness
Which of the following is the cause of most strokes? -A ruptured cerebral artery due to hypertension -Blockage of an artery supplying part of the brain -A spasm in an artery supplying part of the brain A ruptured cerebral artery due to an aneurysm
Blockage of an artery supplying part of the brain
Interruption of cerebral blood flow may result from all of the following, EXCEPT: -A thrombus -Cerebral vasodilation -An acute arterial rupture -An embolism
Cerebral vasodilation
The three major parts of the brain are the: -Cerebrum, cerebellum, and brain stem -Cerebellum, medulla, and occiput -Brain stem, midbrain, and spinal cord -Midbrain, cerebellum, and spinal cord
Cerebrum, cerebellum, and brain stem
Nitroglycerin is indicated for which of the following chief complaints? -Headache -Decreased level of consciousness -Difficulty breathing -Chest pain
Chest pain
Which of the following is NOT a sign or symptom of stroke? -Sudden impairment of vision -Seizure -Vomiting -Chest pain
Chest pain
The EMT should assess for hypoglycemia in small children with a severe illness or injury because: Select one: -Children overproduce insulin during severe illness or injury -Children cannot store excess glucose as effectively as adults -A child's cells do not uptake glucose as rapidly as adults' do -Illness or injury causes the pancreas to produce less insulin
Children cannot store excess glucose as effectively as adults
Which of the following is a standardized test to evaluate a conscious patient for possible stroke? -The Functional Analysis Stroke Test -The Numbness-Aphasia-Paralysis (NAP) Test -Michigan TIA Assessment -Cincinnati Prehospital Stroke Scale
Cincinnati Prehospital Stroke Scale
Which of the following MOST accurately describes what the patient will experience during the postictal state that follows a seizure? -Hyperventilation and hyper-salivation -Confusion and fatigue -A rapidly improving level of consciousness -A gradually decreasing level of consciousness
Confusion and fatigue
A 19-year-old male complains of "not feeling right." His insulin and a syringe are on a nearby table. The patient says he thinks he took his insulin and cannot remember whether he ate. He is also unable to tell you the time or what day it is. The glucometer reads "error" after several attempts to assess his blood glucose level. You should: -Contact medical control and administer oral glucose -Assist him with his insulin injection and reassess him -Request a paramedic ambulance to administer IV glucose -Transport only with close, continuous monitoring en route
Contact medical control and administer oral glucose
When assessing a patient for a possible stroke, which of the following three functions should be tested by the EMT? -Ability to walk, ability to hold both arms in an extended position for 10 seconds, and ability to name common objects -Memory, ability to speak, and ability to track movement with the eyes -Ability to walk, control of facial muscles, and balance -Control of facial muscles, ability to speak, and ability to hold both arms in an extended position for 10 seconds
Control of facial muscles, ability to speak, and ability to hold both arms in an extended position for 10 seconds
Classic signs and symptoms of hypoglycemia include: Select one: -Cool, clammy skin; weakness; tachycardia; and rapid respirations -Warm, dry skin; hunger; abdominal pain; and deep, slow respirations -Warm, dry skin; irritability; bradycardia; and rapid respirations -Cold, clammy skin; bradycardia; hunger; and deep, rapid respirations
Cool, clammy skin; weakness; tachycardia; and rapid respirations
A hormone called insulin is secreted by the: -Islets of Langerhans in the liver -Islets of Langerhans in the pancreas -Gallbladder found in the pancreas -None of the above
Islets of Langerhans in the pancreas
Ischemic heart disease is MOST accurately defined as: Choose one: -Decreased blood flow to the heart muscle due to coronary dilation -Death of a portion of the heart muscle due to a decrease in oxygen -Absent myocardial blood flow due to a blocked coronary artery -Decreased blood flow to one or more portions of the myocardium
Decreased blood flow to one or more portions of the myocardium
Cardiogenic shock following AMI is caused by: Choose one: -Hypovolemia secondary to severe vomiting -A profound increase in the patient's heart rate -Decreased pumping force of the heart muscle -Widespread dilation of the systemic vasculature
Decreased pumping force of the heart muscle
During your assessment of a 70-year-old woman, she tells you that she takes blood-thinning medication and has to wear compression stockings around her legs. This information should make you suspect that she has: -Hemophilia -Sickle-cell disease -Deep vein thrombosis (DVT) -Severe hyperglycemia
Deep vein thrombosis (DVT)
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? Choose one: -Avoid defibrillation as this will damage the patient's AICD -Contact medical control and request permission to defibrillate -Continue CPR and transport the patient to the closest appropriate hospital -Deliver the shock followed by immediate resumption of CPR
Deliver the shock followed by immediate resumption of CPR
Which of the following signs is commonly observed in patients with right-sided heart failure? Select one: -Labored breathing -Dependent edema -Pulmonary edema -Flat jugular veins
Dependent edema
Many stroke patients are candidates for thrombolytic drugs. One of the most important things that an EMT can do to optimize the care of a stroke patient who is a candidate for the drugs is: -Transport the patient to a Level 1 Trauma Center -Determine the exact time of onset of symptoms -Transport to the closest hospital since the patient must go to the operating room as soon as possible -Do a thorough physical exam of the patient
Determine the exact time of onset of symptoms
A patient with an altered mental status; high blood glucose levels; and deep, rapid breathing may have a condition known as __________. Select one: -Hyperosmolar hyperglycemic nonketotic coma -Hypoglycemic crisis -Hyperglycemic crisis -Diabetic ketoacidosis
Diabetic ketoacidosis
Nitroglycerin relieves cardiac-related chest pain by: Choose one answer. -Dilating the coronary arteries and improving cardiac blood flow -Contracting the smooth muscle of the coronary and cerebral arteries -Increasing the amount of work that is placed on the myocardium -Constricting the coronary arteries and improving cardiac blood flow
Dilating the coronary arteries and improving cardiac blood flow
Diabetes is MOST accurately defined as a(n): -Disorder of glucose metabolism -Abnormally high blood glucose level -Mass excretion of glucose by the kidneys -Lack of insulin production in the pancreas
Disorder of glucose metabolism
A patient whose speech is slurred and difficult to understand is experiencing: -Dysarthria -Paraplegia -Dysphagia -Aphasia
Dysarthria
During the primary assessment of a semiconscious 70-year-old female, you should: -Ensure a patent airway and support ventilation as needed -Ask family members if the patient has a history of stroke -Immediately determine the patient's blood glucose level -Insert a nasopharyngeal airway and assist ventilations
Ensure a patent airway and support ventilation as needed
The two main types of cells contained in blood are called _________. Select one: -Erythrocytes and leukocytes -Transport and clotting -Platelets and plasma -Hemoglobin A and S
Erythrocytes and leukocytes
If the blood sugar level is very high, which of the following may result? -Excessive insulin, excessive glucose, and excessive urination -Hyperactivity, excessive thirst, and polyuria -Excessive urination, excessive thirst, and excessive hunger -Polyuria and hyperactivity
Excessive urination, excessive thirst, and excessive hunger
Risk factors for AMI that cannot be controlled include: Select one: -Family history -Lack of exercise -Hyperglycemia -Excess stress
Family history
Which of the following is a typical cause of seizures in children 6 months to 3 years of age? -Administration of glucose to a hyperglycemic patient -Fever -Asthma -Chest pain
Fever
Blood that is ejected from the right ventricle: Choose one: -Flows into the pulmonary arteries -Has a high concentration of oxygen -Was received directly from the aorta -Enters the systemic circulation
Flows into the pulmonary arteries
Hemoglobin is: -The fluid portion of the blood that transports cells throughout the body -Essential for the formation of clots, such as when vessel damage occurs -Found within the red blood cells & is responsible for carrying oxygen -A key component of the blood & is produced in response to an infection
Found within the red blood cells & is responsible for carrying oxygen
A patient who is possibly experiencing a stroke is NOT eligible for thrombolytic (fibrinolytic) therapy if he or she: -Is older than 60 years of age -Has bleeding within the brain -Has had a prior heart attack -Has a GCS score that is less than 8
Has bleeding within the brain
Signs and symptoms of a hypertensive emergency would MOST likely be delayed in patients who: Select one: -Are older than 40 years of age -Regularly take illegal drugs -Have chronic hypertension -Have had a stroke in the past
Have chronic hypertension
During your assessment of a 19-year-old male, you are told that he is being treated with factor VIII. This indicates that: Select one: -His blood clots too quickly -He has thrombophilia -He has hemophilia A -He has a thrombosis
He has hemophilia A
A 30-year-old male experienced a generalized (tonic-clonic) seizure, which stopped before you arrived at the scene. The patient is conscious, is answering your questions appropriately, and refuses EMS transport. Which of the following would be the MOST compelling reason to disagree with his refusal of transport? -He has experienced seizures since he was 20 -His wife states that this was his "usual" seizure -His Glasgow Coma Scale (GCS) score is 15 -He is currently not prescribed any medications
He is currently not prescribed any medications
The MOST significant risk factor for a hemorrhagic stroke is: -Heavy exertion -Hypertension -Diabetes mellitus -Severe stress
Hypertension
The condition in which there is an insufficient amount of sugar in the blood is called: -Diabetic coma -Hyperglycemia -Diabetic ketoacidosis -Hypoglycemia
Hypoglycemia
Which of the following conditions would be the LEAST likely to mimic the signs and symptoms of a stroke? -A postictal state -Hypovolemia -Intracranial bleeding -Hypoglycemia
Hypovolemia
A seizure that occurs spontaneously from an unknown cause is called: -Hypoxic -Hypoglycemic -Idiopathic -Toxinic
Idiopathic
Your patient is a 59-year-old female with a sudden onset of slurred speech and weakness on her right side. Which of the following measures is appropriate? -Administer oral glucose and then assess the patient's blood sugar -Immediately transport the patient to a hospital with specialized treatment for stroke patients -Keep the patient in a supine position -Test the patient's sensation with a series of pinpricks, beginning at the feet and working upward
Immediately transport the patient to a hospital with specialized treatment for stroke patients
Which of the following statements regarding sickle cell disease is correct? Select one: -Because of their abnormal shape, red blood cells in patients with sickle cell disease are less apt to lodge in a blood vessel -In sickle cell disease, the red blood cells are abnormally shaped and are less able to carry oxygen -The red blood cells of patients with sickle cell disease are round and contain hemoglobin -Sickle cell disease is an inherited blood disorder that causes the blood to clot too quickly
In sickle cell disease, the red blood cells are abnormally shaped and are less able to carry oxygen
You are treating a 40-year-old male with a documented blood sugar reading of 480 mg/dL. The patient is semiconscious and breathing shallowly, and is receiving assisted ventilation from your partner. You should recognize that definitive treatment for this patient includes: Select one: -Glucagon -Dextrose -Insulin Oxygen
Insulin
Diabetic ketoacidosis occurs when: -Blood glucose levels rapidly fall -The cells rapidly metabolize glucose -The pancreas produces excess insulin -Insulin is not available in the body
Insulin is not available in the body
Which of the following conditions may be mimicked by hypoglycemia? -Respiratory distress -Heart attack -Intoxication -All of the above
Intoxication
Type 1 diabetes: -Is typically treated with medications such as Metformin -Is a condition in which no insulin is produced by the body -Typically occurs in patients between 50 and 70 years of age -Is defined as a blood sugar level that is less than 120 mg/dL
Is a condition in which no insulin is produced by the body
In contrast to type 1 diabetes, type 2 diabetes: Select one: -Occurs when antibodies attack insulin-producing cells -Is caused by a complete lack of insulin in the body -Is caused by resistance to insulin at the cellular level Is commonly diagnosed in children and young adults
Is caused by resistance to insulin at the cellular level
A 28-year-old female patient is found to be responsive to verbal stimuli only. Her roommate states that she was recently diagnosed with type 1 diabetes and has had difficulty controlling her blood sugar level. She further tells you that the patient has been urinating excessively and has progressively worsened over the last 24 to 36 hours. On the basis of this patient's clinical presentation, you should suspect that she: -Is significantly hyperglycemic -Has a low blood glucose level -Has a urinary tract infection -Has overdosed on her insulin
Is significantly hyperglycemic
How does nitroglycerin decrease the level of chest pain that a patient experiences? -It constricts the blood vessels, forcing more blood into the heart muscle -It dilates the blood vessels, allowing more blood flow to wash away the toxic lactic acid -It constricts the blood vessels, forcing the toxic lactic acid out of the heart -It dilates the blood vessels, allowing more blood to enter the heart muscle
It dilates the blood vessels, allowing more blood to enter the heart muscle
Which of the following is an action of insulin? -It increases the transfer of sugar from the stomach and small intestine to the bloodstream -It blocks the uptake of sugar by the body's cells -It increases the movement of sugar from the bloodstream to the cell -It increases the circulating level of glucose in the blood
It increases the movement of sugar from the bloodstream to the cell
How does aspirin actually reduce the chances that a patient suffering a heart attack will die? -It reduces the inflammation in the heart -It reduces the ability of the blood to form clots -It prevents a deadly fever from developing -It reduces the amount of pain in the heart
It reduces the ability of the blood to form clots
Compared to hypoglycemia, which of the following is true of hyperglycemia? -Its onset is preceded by an aura, such as hallucinations or detecting unusual odors -It is more easily treated in the prehospital environment than hypoglycemia -Its onset is more gradual -Its onset is more sudden
Its onset is more gradual
Bronchodilator inhalers have several common side effects, which include: -Decreased blood pressure and increased HR -Vasoconstriction and increased HR -Broncho-dilation and decreased HR -Jitteriness and increased HR
Jitteriness and increased heart rate
You have just administered nitroglycerin to a 68-year-old patient. Within a few minutes, she complains of feeling faint and lightheaded, but states that she is still having some chest pain. Which of the following would be the BEST sequence of actions? -Advise the patient that this is a normal occurrence & administer a 2nd dose of nitroglycerin -Administer activated charcoal to prevent further absorption of the nitroglycerin & closely monitor the patient's BP -Lower the head of the stretcher and take the patient's BP -Increase the amount of oxygen you are giving to the patient before administering a 2nd dose of nitroglycerin
Lower the head of the stretcher and take the patient's BP
A patient with atherosclerotic heart disease experiences chest pain during exertion because the: Choose one: -Lumen of the coronary artery is narrowed and cannot accommodate increased blood flow -Coronary arteries suddenly spasm and cause a marked reduction in myocardial blood flow -Ragged edge of a tear in the coronary artery lumen causes local blood clotting and arterial narrowing -Tissues of the myocardium undergo necrosis secondary to a prolonged absence of oxygen
Lumen of the coronary artery is narrowed and cannot accommodate increased blood flow
The main function of the endocrine system is to _________. Select one: -Regulate blood flow -Regulate glucose and calcium -Produce glandular secretions -Maintain homeostasis
Maintain homeostasis
Which statement below is NOT true about seizures? -A generalized seizure affects the entire brain -The most common seizure that EMTs are likely to be called on is a tonic-clonic seizure -A partial seizure affects one part, or one side, of the brain -Many seizures are followed by an aura
Many seizures are followed by an aura
The purpose of the endocrine system is to send ______________ throughout the body to control its function. -Oxygen -Particles -Messages -Carbon dioxide
Messages
Your patient is a 21-year-old female with a history of epilepsy. She is having a convulsion upon your arrival. Which of the following should you do? -Place a tongue depressor or spoon in the back of the mouth to prevent the patient from swallowing her tongue -Move furniture and other objects away from the patient to prevent injury -Insert a bite block, cloth, wallet, or similar item between the patient's teeth to prevent her from biting her tongue -Restrain the patient's extremities to prevent injury from flailing of the arms and legs
Move furniture and other objects away from the patient to prevent injury
Angina pectoris occurs when: Select one: -Myocardial oxygen demand exceeds supply -A coronary artery is totally occluded by plaque -Myocardial oxygen supply exceeds the demand -One or more coronary arteries suddenly spasm
Myocardial oxygen demand exceeds supply
Angina pectoris occurs when: Choose one: -Myocardial oxygen demand exceeds the supply -A coronary artery is totally occluded by plaque -Myocardial oxygen supply exceeds the demand -One or more coronary arteries suddenly spasm
Myocardial oxygen demand exceeds the supply
An acute myocardial infarction (AMI) occurs when: Choose one: -The heart muscle progressively weakens & dysfunctions -Coronary artery dilation decreases blood flow to the heart -The entire left ventricle is damaged & cannot pump blood -Myocardial tissue dies secondary to an absence of oxygen
Myocardial tissue dies secondary to an absence of oxygen
Which of the following is often prescribed for a patient with a heart condition? -Ventolin -Epinephrine auto-injector -Nitroglycerin -Non-aspirin pain relievers such as Tylenol
Nitroglycerin
Which of the following is an example of a medication's trade name? -4 dihydroxyphenyl acetate -Oxygen -Nitrostat -Epinephrine
Nitrostat
Which of the following medications can an EMT administer to an unconscious diabetic patient? -Oral glucose -IV dextrose -IM glucagon -None of these answers are correct
None of these answers are correct
A patient with an altered mental status is: -Not thinking clearly or is incapable of being aroused -Typically alert but is confused as to preceding events -Completely unresponsive to all forms of stimuli -Usually able to be aroused with a painful stimulus
Not thinking clearly or is incapable of being aroused
In contrast to AMI, a dissecting aortic aneurysm: Choose one: -Usually presents gradually, often over a period of hours -Often presents with pain that is maximal from the onset -Is typically preceded by other symptoms, such as nausea -Is more commonly associated with pressure in the chest
Often presents with pain that is maximal from the onset
A man finds his 59-year-old wife unconscious on the couch. He states that she takes medications for type 2 diabetes. He further tells you that his wife has been ill recently and has not eaten for the past 24 hours. Your assessment reveals that the patient is unresponsive. You should: Select one: -Open and maintain her airway and assess breathing -Administer 100% oxygen via a nonrebreathing mask -Assess for the presence of a medical identification tag -Administer oral glucose between her cheek and gum
Open and maintain her airway and assess breathing
What is the first medication that should be administered to a patient experiencing chest pain with difficulty breathing? -Nitroglycerin -Aspirin -Albuterol -Oxygen
Oxygen
A patient with hypoglycemia will often present with which of the following signs/symptoms? Select one: -Warm, red, and dry skin -Deep, rapid respirations -Pale, cool, and clammy skin -Hypertension
Pale, cool, and clammy skin
There are two types of seizures; if your patient is having a seizure that affects only one body part and does not cause her to lose consciousness, it is called a: -Generalized seizure -Postictal seizure -Partial seizure -Tonic-clonic seizure
Partial seizure
It is critical to closely monitor and reassess a victim of an immunologic emergency because the patient may __________. -Suddenly improve -Wish to refuse treatment and transport -Rapidly deteriorate -Get re-exposed to the allergen
Rapidly deteriorate
Nitroglycerin (Nitro) is used for patients with recurrent chest pain or a history of heart attack. Nitro is most commonly supplied in what two forms? -Ointment and pills -Pills and spray -Aerosol and spray -Pills and injectable
Pills and spray
Your patient is a 44-year-old male with a history of diabetes. He is lying on the living room floor, unresponsive to all stimuli. He has a respiratory rate of 12 breaths per minute, heart rate of 112 beats per minute, and is pale and sweaty. Which of the following should you do to treat this patient? -Apply oral glucose solution to a tongue depressor and insert it between the patient's cheek and gums -Place the patient in the recovery position to protect the airway and place oral glucose solution under the patient's tongue -Place the patient in the recovery position, administer oxygen, and monitor his airway status -Encourage the patient's family to administer his insulin
Place the patient in the recovery position, administer oxygen, and monitor his airway status
Treatment of someone with a seizure disorder includes all of the following except: -Placing the patient on the floor or ground -Removing objects that might harm the patient -Loosening restrictive clothing -Placing a bite block in the patient's mouth so he does not bite his tongue
Placing a bite block in the patient's mouth so he does not bite his tongue
Excessive eating caused by cellular "hunger" is called: Select one: -Dyspepsia -Polyphagia -Dysphasia -Polydipsia
Polyphagia
As an EMT, you will be called on frequently to treat diabetic emergencies. Diabetic emergencies are usually caused by: -Hypoxia -Falls -Poor management of the patient's diabetes -Pancreatitis
Poor management of the patient's diabetes
You respond to a 32-year-old female who is having a seizure. You arrive on the scene to find the patient drowsy, confused, and complaining of a headache. This patient is demonstrating the: -Clonic phase -Tonic phase -Aura phase -Postictal phase
Postictal phase
Your patient is an unresponsive 30-year-old male wearing a Medic-Alert bracelet indicating that he is a diabetic. The patient's coworkers came by his house to check on him when he did not show up for work and did not call in sick. Your assessment does not clearly indicate to you whether the patient may be hypoglycemic or hyperglycemic. Which of the following should you do next? -Protect the patient's airway, administer oxygen, and consider assessing the patient's blood glucose per local protocoL -Use your glucometer to check his blood sugar before taking any further action -Administer oral glucose, as it will not cause additional harm in hyperglycemia, but may prevent brain damage if the patient is hypoglycemic -Use the patient's glucometer to check his blood sugar level
Protect the patient's airway, administer oxygen, and consider assessing the patient's blood glucose per local protocol
A 29-year-old female presents with confusion and disorientation. Her respirations are rapid and shallow and her pulse is 120 beats/min and thready. She is markedly diaphoretic and has an oxygen saturation of 89%. You should: -Transport immediately -Administer oral glucose -Provide ventilatory support -Treat her for hyperglycemia
Provide ventilatory support
A 66-year-old woman experienced a sudden onset of difficulty breathing. She has a history of type 2 diabetes and deep vein thrombosis (DVT). On the basis of her medical history, which of the following should the EMT suspect? Select one: -Pulmonary embolism -Severe hypoglycemia -Diabetic ketoacidosis -Congestive heart failure
Pulmonary embolism
Patients with thrombophilia are at an increased risk for: -Various cancers -Hemorrhagic stroke -Acute arterial rupture -Pulmonary embolism
Pulmonary embolism
You are caring for a 68-year-old man with sudden onset of left-sided paralysis and slurred speech. His airway is patent, his respirations are 14 breaths/min with adequate depth, and his oxygen saturation is 98%. Treatment for this patient should include: -Oral glucose gel and transport -Ventilatory assistance and transport -Recovery position and transport -High-flow oxygen and transport
Recovery position and transport
Most of the diabetic emergencies that you will be called to deal with will be related to hypoglycemia. However, occasionally you will experience an instance of hyperglycemia. In the list below, which item is NOT likely to be a sign or symptom of hyperglycemia? -Nausea -Chronic thirst -Excessive urination -Reduced rate of breathing
Reduced rate of breathing
The most common medical emergency for the diabetic is hypoglycemia, or low blood sugar. Which one of the factors below is NOT a cause of hypoglycemia? -Overexercises or overexerts himself -Takes too much insulin -Reduces sugar intake by eating too much -Vomits a meal
Reduces sugar intake by eating too much
A patient in cardiac arrest is wearing an external defibrillator vest, which is interfering with effective chest compressions. The EMT should: Select one: -Perform ventilations only and allow the vest device to defibrillate -Remove the battery from the monitor and then remove the vest -Leave the battery attached to the monitor and remove the vest -Remove the battery from the monitor and leave the vest in place
Remove the battery from the monitor and then remove the vest
Deoxygenated blood from the body returns to the: Choose one: -Right atrium -Right ventricle -Left ventricle -Left atrium
Right atrium
Deoxygenated blood from the body returns to the: Select one: -Left ventricle -Right atrium -Right ventricle -Left atrium
Right atrium
Which of the following BEST describes the five rights? -Right decision, right medication, right order, right dose, right place -Right patient, right medication, right time, right dose, right route -In date, right medication, right order, right dose, right time -Right patient, right medication, in date, right dose, right route
Right patient, right medication, right time, right dose, right route
Epinephrine delivered by auto-injector may be indicated for patients with which of the following conditions? -Chest pain -Chronic pulmonary diseases -Drug overdose -Severe allergies to peanut, shellfish, penicillin, or bee stings
Severe allergies to peanut, shellfish, penicillin, or bee stings
The electrical impulse generated by the heart originates in the: Select one: -Atrioventricular node -Bundle of His -Coronary sinus -Sinoatrial node
Sinoatrial node
Which of the following is NOT a sign of a hypoglycemic diabetic emergency? -Cold, clammy skin -Slow HR -Combativeness -Anxiety
Slow HR
Which of the following statements regarding glucose is correct? Select one: -The brain requires insulin to allow glucose to enter the cells -The brain requires glucose as much as it requires oxygen -Blood glucose levels decrease in the absence of insulin -Most cells will function normally without glucose
The brain requires glucose as much as it requires oxygen
A 67-year-old female with severe chest pain becomes unresponsive, pulseless, and apneic during transport. You should: Choose one: -Stop the ambulance, begin CPR, and attach the AED as soon as possible -Alert the receiving hospital and perform CPR for the duration of the transport -Defibrillate with the AED while continuing transport to the hospital -Perform CPR for 1 to 2 minutes and then analyze her rhythm with an AED
Stop the ambulance, begin CPR, and attach the AED as soon as possible
The death of brain tissue due to deprivation of oxygen because of a blocked or ruptured artery in the brain is known as which of the following? -Seizure -Aphasia -Transient ischemic attack -Stroke
Stroke
Nitroglycerin is given via the ________ route. -Enteral -Sublingual -Lingual -Parenteral
Sublingual
Patients experiencing a sickle cell crisis should receive which of the following treatments to help improve perfusion? -Bandaging to stop bleeding -Oral glucose to boost nutrition -Supplemental oxygen to hyper-saturate the remaining hemoglobin -All of these answers are correct.
Supplemental oxygen to hyper-saturate the remaining hemoglobin
A 42-year-old male is found unresponsive on his couch by a neighbor. During your assessment, you find no signs of trauma and the patient's blood glucose level is 75 mg/dL. His blood pressure is 168/98 mm Hg, his heart rate is 45 beats/min and bounding, and his respirations are 8 breaths/min and irregular. The patient is wearing a medical alert bracelet that states he has hemophilia. You should: -Administer oxygen via a nonrebreathing mask, apply oral glucose in between his cheek and gum, & transport. -Suspect that he has internal bleeding and is in shock, administer high-flow oxygen, & transport at once. -Administer high-flow oxygen, perform a detailed secondary assessment at the scene, & transport promptly. -Suspect that he has intracranial bleeding, assist his ventilations, & transport rapidly to an appropriate hospital.
Suspect that he has intracranial bleeding, assist his ventilations, and transport rapidly to an appropriate hospital
The medical term for fainting is: -Vertigo -Altered RAS status -Syncope -Dehydration
Syncope
Symptomatic hypoglycemia will MOST likely develop if a patient: Select one: -Markedly overeats and misses an insulin dose -Takes too much of his or her prescribed insulin -Misses one or two prescribed insulin injections -Eats a regular meal followed by mild exertion
Takes too much of his or her prescribed insulin
Which of the items below is NOT part of the Cincinnati Prehospital Stroke Scale? -Test the patient for arm droop or lack of movement -Test for equal grip strength -Ask the patient to smile -Have the patient repeat a simple sentence
Test for equal grip strength
Looking at the following list, which of the items does NOT correctly compare the signs and symptoms of hypoglycemia and hyperglycemia? -Hyperglycemic patients often have warm, red, dry skin, whereas hypoglycemic patients have cold, pale, moist, or clammy skin -The hyperglycemic patient often has acetone breath, whereas the hypoglycemic patient does not -The hypoglycemic patient is usually complaining of a headache, whereas the hyperglycemic patient is not -Hyperglycemia usually has a slower onset than hypoglycemia
The hypoglycemic patient is usually complaining of a headache, whereas the hyperglycemic patient is not
A dissecting aortic aneurysm occurs when: Select one: -A weakened area develops in the aortic wall -The aorta ruptures, resulting in profound bleeding -The inner layers of the aorta become separated -All layers of the aorta suddenly contract
The inner layers of the aorta become separated
A patient with atherosclerotic heart disease experiences chest pain during exertion because: Select one: -The ragged edge of a tear in the coronary artery lumen causes local blood clotting and arterial narrowing -Tissues of the myocardium undergo necrosis secondary to a prolonged absence of oxygen -The lumen of the coronary artery is narrowed and cannot accommodate increased blood flow -The coronary arteries suddenly spasm and cause a marked reduction in myocardial blood flow
The lumen of the coronary artery is narrowed and cannot accommodate increased blood flow
Which of the following symptoms would lead the EMT to believe that a patient's headache is caused by sinus congestion? -The pain is worse when bending over -There is associated neck stiffness -The headache began suddenly -There is numbness in the extremities
The pain is worse when bending over
What condition must be present before you give oral glucose? -The patient must not have a history of diabetes -The patient must be conscious & able to swallow w/ an altered mental status and history of diabetes -The patient, if conscious, must be able to swallow; if unconscious, you can apply the gel to a tongue depressor and place it between the cheek and gum or under the tongue -The patient must be unconscious and have a history of diabetes.
The patient must be conscious & able to swallow w/ an altered mental status and history of diabetes
You have arrived on the scene of a call for a possible stroke. On your arrival, the patient denies signs and symptoms, is alert and oriented, and moves all extremities well. Her husband states that before you arrived the patient could not move her right arm and the left side of her face seemed to be "slack." Which of the following has most likely occurred? -The patient suffered a transient ischemic attack -The patient suffered a stroke -The patient has had a subarachnoid hemorrhage -The patient is suffering from aphasia
The patient suffered a transient ischemic attack
The left cerebral hemisphere controls: -The right side of the face -Heart rate and pupil reaction -Breathing and blood pressure -The right side of the body
The right side of the body
You are on the scene of a 48-year-old male patient complaining of chest pain. He has nitroglycerin prescribed and available. After performing your physical examination, you contact medical control and are ordered to assist the patient in taking his nitroglycerin. Five minutes after taking his nitroglycerin, the patient complains of being dizzy and having a headache. You lie the patient down on the stretcher and reassess his vital signs. He is now hypotensive. The patient is suffering from: -An untoward reaction to nitroglycerin -The side effects of nitroglycerin -An allergic reaction to nitroglycerin -An anaphylactic reaction to nitroglycerin
The side effects of nitroglycerin
When someone is experiencing hypoglycemia, the body attempts to compensate by using the fight-or-flight mechanism of the autonomic nervous system. Which one of the statements below is NOT one of the fight-or-flight responses? -The skin is hot and dry -The heart pumps faster -Breathing accelerates -Blood vessels constrict
The skin is hot and dry
Cardiac output may decrease if the heart beats too rapidly because: Choose one: -The volume of blood that returns to the heart is not sufficient with fast heart rates -There is not enough time in between contractions for the heart to refill completely -A rapid heart beat causes a decrease in the strength of cardiac contractions -As the heart rate increases, more blood is pumped from the ventricles than the atria
There is not enough time in between contractions for the heart to refill completely
Many diabetics today have an insulin pump. Which of the following statements about insulin pumps is NOT true? -They have a catheter that enters into the abdomen -They are about the size of an MP3 player or a pager -They are usually worn around the ankle -They are usually worn on the belt
They are usually worn around the ankle
You are on the scene at a fancy hotel room for a 60-year-old male patient who calls 911 at 10 p.m. for chest pains. He states he was about to go to bed when he suddenly had chest pain that would not go away. He rates his pain as a 7 out of 10 and is diaphoretic. His vital signs are stable, and he takes medications for hypertension, high cholesterol, and erectile dysfunction. The patient is allergic to morphine. After placing the patient on oxygen, you contact medical control and request: -To administer aspirin to the patient -To administer both aspirin and nitroglycerin to the patient -No orders -To administer nitroglycerin to the patient
To administer aspirin to the patient
You respond to a residence for a child who is having a seizure. Upon arrival at the scene, you enter the residence and find the mother holding her child, a 2-year-old male. The child is conscious and crying. According to the mother, the child had been running a high fever and then experienced a seizure that lasted approximately 3 minutes. You should: -Transport the child to the hospital and reassure the mother en route -Cover the child with wet towels and give oxygen via nasal cannula -Call medical control and request permission to give the child aspirin -Advise the mother to take her child to the doctor the following day
Transport the child to the hospital and reassure the mother en route
Which of the following BEST describes status epilepticus? -A seizure that occurs without a known cause -A seizure involving convulsions on only one side of the body -Two or more seizures with tonic-clonic activity without an intervening period of consciousness -A period of drowsiness following tonic-clonic seizures
Two or more seizures with tonic-clonic activity without an intervening period of consciousness
Which of the following is one of the most common characteristics of a stroke? -Sudden onset of bizarre behavior -Weakness on one side of the body -Sudden, severe headache -Projectile vomiting
Weakness on one side of the body
When you are obtaining medical history from the family of a suspected stroke patient, it is MOST important to determine: -When the patient last appeared normal -If there is a family history of a stroke -If the patient has been hospitalized before The patient's overall medication compliance
When the patient last appeared normal
Nitroglycerin is contraindicated in patients: Select one: -Who have taken up to two doses -Who have experienced a head injury -With a systolic blood pressure less than 120 mm Hg -With a history of an ischemic stroke
Who have experienced a head injury
