Medical

Which of the following signs is LEAST suggestive of a diabetic emergency?

Bradycardia

A 56-year-old diabetic man is found unresponsive by his wife. She tells you that he ate breakfast this morning, but is unsure if he took his insulin. His respirations are rapid and shallow, his skin is cool and profusely diaphoretic, and his pulse is rapid and weak. Which of the following statements regarding this patient is correct?

He needs glucose as soon as possible because he is likely hypoglycemic.

A 24-year-old female presents with a rash to her left leg and swollen, painful knee joints. She tells you that she and her friends returned from a hiking trip in the mountains a week ago. She is conscious and alert with a blood pressure of 112/62 mm Hg, a pulse of 84 beats/min, and respirations of 14 breaths/min. Her symptoms are MOST likely the result of:

Lyme disease.

When you arrive at a residence for a man who is "not acting right," you enter the house and find him sitting on his couch. Which of the following findings would be MOST indicative of an altered mental status?

Slurred speech.

A 32-year-old man who was stung by a bee has diffuse hives, facial swelling, and difficulty breathing. When he breathes, you hear audible stridor. What does this indicate?

Swelling of the upper airway structures

A 60-year-old male complains of a tearing sensation in his abdomen. He tells you the pain began suddenly and feels like someone is sticking a knife into his abdomen. He is conscious and alert with a blood pressure of 148/88 mm Hg, a pulse of 120 beats/min, and respirations of 22 breaths/min. In addition to administering high-flow oxygen, you should:

transport at once and be prepared to treat him for severe shock.

A young male experienced a syncopal episode after working in the heat for several hours. He is conscious and alert; has cool, clammy skin; and complains of nausea and lightheadedness. You should:

transport him on his side.

Which of the following is a physiologic effect of epinephrine when used to treat anaphylactic shock?

As a bronchodilator, it improves the patient's breathing.

Which of the following mechanisms cause respiratory and circulatory collapse during anaphylactic shock?

Bronchoconstriction and vasodilation

A young female is unresponsive after overdosing on an unknown type of drug. Her respirations are slow and shallow and her pulse is slow and weak. Which of the following drugs is the LEAST likely cause of her condition?

Cocaine

A known diabetic female is found unresponsive. Her respirations are rapid and shallow; her skin is cool, clammy, and pale; and her pulse is rapid and weak. Which of the following would BEST explain the likely cause of her condition?

Insulin overdose

Which of the following statements regarding the function of insulin is correct?

It facilitates the uptake of glucose from the bloodstream into the cell.

Which of the following is a later sign of hepatitis?

Jaundice

Propoxyphene (Darvon) is categorized as what type of drug?

Narcotic

Unresponsiveness, shallow breathing, and constricted pupils are indicative of what type of drug overdose?

Narcotic

Which of the following statements regarding heatstroke is correct?

Not all patients experiencing heatstroke have dry skin.

Which of the following signs or symptoms is MOST suggestive of a systemic reaction following ingestion of a poison?

Tachycardia and hypotension

Which of the following would MOST likely cause a rapid drop in a patient's blood glucose level?

Taking too much prescribed insulin

Which of the following statements regarding lightning-related injuries is correct?

The cardiovascular and nervous systems are most commonly injured during a lightning strike.

Which of the following is the MOST significant finding in a patient with a severe headache?

Unilateral weakness

Which of the following signs and symptoms are MOST characteristic of hyperglycemic ketoacidosis?

Warm, dry skin and a slow onset

A 48-year-old male became acutely hypoxic, experienced a seizure, and is now postictal. The MOST effective way to prevent another seizure is to:

administer high-flow supplemental oxygen.

Assessment and treatment of a patient with severe abdominal pain should include:

administering supplemental oxygen.

The daughter of an elderly patient states that her mother is acting confused and talking incoherently. This nature of illness is MOST consistent with:

altered mental status.

After removing a patient from the water, your assessment reveals that he is not breathing and is continuously regurgitating large amounts of water. You should:

alternate suctioning with artificial ventilations.

Rapid transport of a patient who ingested a large dose of Tylenol is important because:

an antidote may prevent liver failure if administered early enough.

A behavioral crisis is MOST accurately defined as:

any reaction to an event that interferes with the activities of daily living or has become unacceptable to the patient, family, or community.

Immediately following a generalized seizure involving tonic-clonic activity, most patients:

are unresponsive but gradually regain consciousness.

You are called to an assisted living center where an attendant found a 72-year-old man unresponsive. The patient had recent hip surgery and has been taking Vicodin for pain. His respirations are slow and shallow and his pulse is slow and weak. You should:

begin ventilation assistance with a bag-mask device.

Hypoglycemia and acute ischemic stroke can present similarly because:

both oxygen and glucose are needed for brain function.

A patient who overdosed on methamphetamine would be expected to have all of the following clinical signs, EXCEPT:

bradycardia.

In the patient with diabetes, insulin shock typically presents with:

clammy skin and a rapid onset.

Immediately following a generalized motor seizure, most patients are:

confused.

A 30-year-old man with a history of schizophrenia cut his wrists and is bleeding profusely. He is confused, combative, and has slurred speech. With the assistance of law enforcement personnel, you and your partner physically restrain him in order to provide care and transport. In this situation, a court of law would MOST likely

consider your actions in providing care to be appropriate.

When treating an unresponsive man who was struck by lightning, you should:

ensure that you and the patient are in a safe place.

A 40-year-old woman presents with widespread hives that she noticed about 45 minutes after taking penicillin. She is conscious and alert and denies difficulty breathing. Her breath sounds are clear to auscultation bilaterally, her vital signs are stable, and her oxygen saturation is 94%. She tells you she is allergic to wasps and has an epinephrine auto-injector. You should:

give supplemental oxygen and transport her to the hospital.

A 44-year-old woman was bitten on the ankle by an unidentified snake while working in her garden. She is conscious and alert, has stable vital signs, and denies shortness of breath. Her only complaint is a burning sensation at the wound site. Your assessment reveals two small puncture wounds, redness, and swelling. You should:

give supplemental oxygen, splint her leg to decrease movement, and keep her leg below the level of her heart.

When insulin levels in the blood remain high:

glucose is rapidly taken out of the blood to fuel the cells.

An elderly man is found unresponsive in his kitchen. The patient's wife tells you that her husband has diabetes and that he took his insulin, but did not eat anything. You should suspect:

hypoglycemia.

A patient who overdosed on heroin would be expected to present with:

hypotension.

Hypoxia-induced unresponsiveness during a submersion injury is usually the result of:

laryngospasm.

An 80-year-old woman has pain in the right upper quadrant of her abdomen and a yellow tinge to her skin. You should suspect dysfunction of the:

liver.

Law enforcement requests your assistance to evaluate a young female who they believe has overdosed. The patient is conscious, is displaying bizarre behavior, and is very restless. Her BP is 170/90 mm Hg and her heart rate is 130 beats/min. You see needle tracks on both of her arms. She is MOST likely under the influence of a:

methamphetamine.

You are called to a local park for an ill person. It is a hot day and the humidity is high. When you arrive, a bystander directs you to the patient, a young male who is semiconscious. His skin is flushed, hot, and moist. Your FIRST action in the management of this patient should be to:

move him to a cool area.

A middle-aged man was found floating facedown in a small pond. When you arrive at the scene, bystanders are present, but nobody has removed him from the water because they thought he was dead. After reaching the victim, you should:

move him to a supine position by rotating the entire upper half of his body as a single unit.

The MOST obvious way to reduce heat loss from radiation and convection is to:

move to a warmer environment.

You are called to the residence of a 39-year-old male with flu-like symptoms. The patient tells you that he has been feeling ill for the last 2 days. He has a fever, headache, and diarrhea, and asks that you take him to the hospital. His blood pressure is 120/60 mm Hg, his pulse is 110 beats/min, and his respirations are 16 breaths/min. You should:

offer oxygen and transport him in a position of comfort.

A 50-year-old female complains of severe pain to the right lower quadrant of her abdomen. You should:

palpate the left upper quadrant of her abdomen first.

When caring for a patient with severe hypothermia who is in cardiac arrest, you should:

perform BLS and transport.

You receive a call to a restaurant where a 34-year-old man is experiencing shortness of breath. When you arrive, you immediately note that the man has urticaria on his face and arms. He is conscious, but restless, and is in obvious respiratory distress. You should:

place a nonrebreathing mask set at 15 L/min on the patient.

You are dispatched to a residence for a 20-year-old male with respiratory distress. When you arrive, you find that the patient has a tracheostomy tube and is ventilator dependent. His mother tells you that he was doing fine, but then suddenly began experiencing breathing difficulty. You should:

remove him from the mechanical ventilator and ventilate him manually.

You should not attempt to actively rewarm a patient with moderate or severe hypothermia in the field because:

rewarming too quickly can cause a fatal cardiac dysrhythmia.

When dealing with an emotionally disturbed patient, you should be MOST concerned with:

whether the patient could harm you

Which of the following actions should be carried out during the primary assessment of an unresponsive patient?

Assessing the skin

A 16-year-old, 125-pound male ingested a bottle of aspirin approximately 20 minutes ago. Medical control orders you to administer activated charcoal in a dose of 1 g/kg. How much activated charcoal should you administer?

57 g

Which of the following patients with diabetes is the BEST candidate for oral glucose?

A confused patient who has cool, clammy skin

How should you classify a patient's nature of illness if he or she has a low blood glucose level, bizarre behavior, and shallow breathing?

Altered mental status

A 34-year-old female complains of persistent fever, fatigue, and night sweats. During your assessment, you note that she has purple blotches on her arms and legs. She MOST likely has:

HIV/AIDS.

A young woman reports significant weight loss over the last month, persistent fever, and night sweats. When you assess her, you note the presence of dark purple lesions covering her trunk and upper extremities. You should suspect:

HIV/AIDS.

Which of the following conditions would MOST likely cause flushed skin?

Exposure to heat

Which of the following structures is NOT part of the endocrine system?

Gallbladder

Which of the following is the MOST significant finding in a patient experiencing an allergic reaction?

Hoarseness

Which of the following conditions would be the LEAST likely to be present in a patient who was submerged in water?

Hyperglycemia

Which of the following structures is responsible for regulating body temperature?

Hypothalamus

Which of the following organs are contained within the right upper quadrant of the abdomen?

Liver and gallbladder

You are transporting a 30-year-old man who is experiencing an emotional crisis. The patient does not speak when you ask him questions. How should you respond to his unwillingness to speak?

Remain silent until the patient speaks to you.

A 42-year-old male presents with fever, a severe headache, and a stiff neck. He is conscious, but confused. His wife tells you that he does not have any medical problems and does not take any medications. You should be MOST suspicious for:

meningitis

Your patient is a 75-year-old female who, according to her son, tripped on a throw rug and fell. The patient is conscious and alert, is sitting on the couch, and has a hematoma to her forehead. When you ask her what happened, her son interjects by saying, "I already told you, she tripped and fell." As you further question her, you find that she is hesitant to answer your questions and keeps looking at her son. You should:

interview the patient and her son separately if possible.

You respond to a grocery store where a 39-year-old man reportedly experienced a seizure. When you arrive at the scene, a clerk begins to escort you to the patient. She tells you that the man stopped seizing about 5 minutes ago. If the patient truly experienced a seizure, you will MOST likely find that he:

is confused and disoriented.

You are transporting a 35-year-old male who has a history of alcoholism. He stopped drinking 4 days ago and is now disoriented, diaphoretic, and tachycardic. You should be MOST concerned that he:

may have a seizure.

A 28-year-old woman has severe lower quadrant abdominal pain. When assessing her abdomen, you should:

ask her where the pain is located and palpate that area last.

You respond to a baseball field for a person who was struck by lightning. When you arrive, you see one patient who appears confused and is ambulatory; a second patient who is conscious, sitting on the ground, and holding his arm; and a third patient who is supine and motionless. After requesting additional responders, you should:

assess the motionless victim and perform CPR and defibrillation if necessary.

Approximately 5 minutes after being stung by a bee, a 21-year-old male develops hives and begins experiencing difficulty breathing. When you arrive at the scene, you note that his level of consciousness is decreased, his breathing is labored, and wheezing can be heard without a stethoscope. The patient has a bee sting kit, but has not used it. You should:

assist his ventilations with a bag-mask device, administer epinephrine from his bee sting kit after receiving approval from medical control, and prepare for immediate transport.

A 55-year-old woman with a history of diabetes is found unresponsive with rapid, shallow respirations. The patient's husband tells you that he does not know when his wife last took her insulin. Management of this patient should include:

assisted ventilations and rapid transport.

The two MOST important steps in treating a patient with a contact poisoning are:

avoiding self-contamination and removing the irritating or corrosive substance from the patient as rapidly as possible.

Activated charcoal is contraindicated for a patient who is:

awake and alert and has swallowed a commercial drain cleaner.

The bite of a brown recluse spider is characterized by:

delayed onset of pain, swelling, and blister formation at the site.

Your FIRST action in managing a patient with an altered mental status should be to:

determine if the patient is breathing adequately.

When caring for a patient with an acute behavioral crisis, your primary concern should be:

ensuring you and your partner's safety.

A 36-year-old male, who is a known diabetic, presents with severe weakness, diaphoresis, and tachycardia. He is conscious, but confused. His blood pressure is 110/58 mm Hg, pulse is 120 beats/min and weak, and respirations are 24 breaths/min. The glucometer reads error after several attempts to assess his blood glucose level. In addition to high-flow oxygen, medical control will MOST likely order you to:

give at least one tube of oral glucose.

A 73-year-old male presents with confusion; cool, pale, clammy skin; absent radial pulses; and a blood pressure of 70/40 mm Hg. The patient's wife tells you that he has had abdominal pain for a week and began vomiting a coffee-ground substance yesterday. His past medical history includes hypertension and gastric ulcer disease. Your MOST immediate concern should be that:

he is in shock and requires prompt transport.

A 72-year-old woman is found unresponsive in her poorly ventilated home. Her skin is flushed, hot, and dry, and her respirations are rapid and shallow. She is wearing a medical alert bracelet that states she is a diabetic and is allergic to sulfa drugs. You should be MOST suspicious for:

heat stroke.

All of the following are signs of gastrointestinal bleeding, EXCEPT:

hemoptysis.

When caring for any patient with a decreased level of consciousness, your primary concern should be the:

potential for airway compromise.

After moving a hypothermic patient to a warmer area, your primary focus should be to:

prevent further body heat loss.

A 50-year-old woman with a history of epilepsy is actively seizing. Care for this patient should focus primarily on:

protecting her from injury and ensuring adequate ventilation.

A man is experiencing a severe allergic reaction after being stung by a scorpion. He does not have his own epinephrine; however, his wife is allergic to bees and has a prescribed epinephrine auto-injector. You should:

provide rapid transport and consider an ALS rendezvous.

You are caring for a conscious patient who you believe is having an acute ischemic stroke. After administering oxygen, your next priority should include:

providing prompt transport for possible fibrinolytic therapy.

You are at the scene where a man panicked while swimming in a small lake. Your initial attempt to rescue him should include:

reaching for the victim with a long stick.

A 50-year-old woman who is conscious and alert complains of a severe migraine headache. When caring for her, you should generally avoid:

shining a light into her pupils.

A patient with a core body temperature of 94°F would MOST likely present with:

shivering and pale skin.

You and your partner arrive at the home of a 60-year-old man with shortness of breath. As you enter the residence, you find the patient sitting in his recliner; he is in obvious respiratory distress. As you approach him, he becomes verbally abusive, stating that it took you too long to get to his home. A small handgun is sitting on a table next to his recliner. You should:

slowly back your way out of the residence and call law enforcement.

When restraining a violent patient, you should make sure that:

someone talks to the patient during the process.

A 46-year-old man presents with generalized weakness and shortness of breath after he was bitten on the leg by a rattlesnake. His blood pressure is 106/58 mm Hg and his pulse rate is 112 beats/min. In addition to supplemental oxygen, further treatment for this patient should include:

splinting and lowering of the affected part.

A near-drowning is MOST accurately defined as:

survival for at least 24 hours following submersion in water.

You are assessing a 40-year-old male with an apparent psychiatric crisis. According to the mans's wife, he has a history of depression and schizophrenia and takes Zoloft and Zyprexa. A police officer is present at the scene. The patient, who is obviously scared, tells you that he sees snakes everywhere. You should:

tell him that you do not see any snakes, but they are obviously scaring him.

In general, you should avoid rewarming a frostbitten body part in the field if:

the affected part could refreeze after rewarming.

You receive a call for a 54-year-old female who is having a seizure. When you arrive at the scene, the patient is actively seizing. Her husband tells you that she has a history of seizures, and that she has been seizing continuously for 20 minutes. It is MOST important for you to recognize that:

the patient is hypoxic and needs oxygen as soon as possible.

A 60-year-old man presents with a severe right-sided headache. He is conscious and alert. As you are assessing him, he tells you that the left side of his body feels weak. His blood pressure is 190/100 mm Hg, pulse is 88 beats/min, and respirations are 14 breaths/min. His past medical history includes diabetes, arthritis, and hypertension. You should be MOST concerned with:

the presence of hemiparesis.

When assessing a conscious patient who overdosed on a drug, you should FIRST determine:

the type of medication ingested.