Modules (Ch. 18&19)

Which of the following statements regarding the acute abdomen is correct?

The initial pain associated with an acute abdomen tends to be vague and poorly localized.

An area of swelling or enlargement in a weakened arterial wall is called:

an aneurysm

Your patient answers your questions appropriately, although her eyes remain closed the entire time. She moves each extremity on command, although her left side is weaker than the right. You should assign a Glasgow Coma Scale (GCS) score of:

12

Your patient opens his eyes, moans, and pulls away from you when you pinch his trapezius muscle. You should assign a glasgow coma scale (GCS)

8

You are assessing a 49-year-old man who, according to his wife, experienced a sudden, severe headache and then passed out. He is unresponsive and has slow, irregular breathing. His blood pressure is 190/94 mm Hg, and his pulse rate is 50 beats/min. His wife tells you that he has hypertension and diabetes. He has MOST likely experienced:

A ruptured cerebral artery.

When caring for a patient with documented hypoglycemia, you should be MOST alert for:

A seizure

Which of the following MOST accurately describes a focal-onset aware seizure?

A seizure that begins in one extremity

A 35-yearold obese woman is complaining of localized pain in the right upper quadrant with referred pain to the right shoulder. The MOST likely cause of her pain is:

Acute cholecystitis

Erosion of the protective layer of the stomach or duodenum secondary to overactivity of digestive juices results in:

An ulcer

A 60-year-old female presents with a tearing sensation in her lower back. Her skin is sweaty, and she is tachycardic. The EMT should suspect:

Aortic aneurysm

Pain that radiates to the right lower quadrant from the umbilical area, nausea and vomiting, and lack of appetite are MOST indicative of:

Appendicitis

Febrile seizures:

Are usually benign but should be evaluated.

Components of the cincinnati prehospital stroke scale include:

Arm drift, speech, and facial droop

When assessing for arm drift of a patient with a suspected stroke, you should:

Ask the patient to close his or her eyes during the assessment.

A 58-year-old male presents with confusion, right sided weakness and slurred speech. His airway is patent, and his breathing is adequate. His wife is present and is very upset. Which of the following has the MOST immediately priority?

Asking his wife when she noticed the symptoms

Which of the following statements regarding gastrointestinal bleeding is correct?

Bleeding within the gastrointestinal tract is a symptom of another disease, not a disease itself.

Which of the following MOST accurately describes the cause of an ischemic stroke?

Blockage of a cerebral artery

The most basic functions of the body, such as breathing, blood pressure, and swallowing, are controlled by the:

Brain stem.

Which of the following is characteristic of epic ulcer disease (PUD)?

Burning or gnawing stomach pain that subsides immediately after eating

Muscle control and body coordination are controlled by the:

Cerebellum

The three major parts of the brain are the:

Cerebrum, cerebellum, and brain stem.

Esophageal varices MOST commonly occur in patients who:

Consume a lot of alcohol

Which of the following conditions is more common in women than in men?

Cystitis

Pain that is localized to the lower back and/or lower abdominal quadrants is MOST suggestive of:

an aortic aneurysm.

The principal symptom in both infectious and noninfectious gastroenteritis is:

Diarrhea

A patient whose speech is slurred and difficult to understand is experiencing:

Dysarthria

A 40-year-old patient without a history of seizures experiences a generalized (tonic-clonic) seizure. The LEAST likely cause of this seizure is:

Epilepsy

The spinal cord exits the cranium through the:

Foramen magnum

Chapter 19

Gastrointestinal and Urological Emergencies

A patient who is possibly experiencing a stroke is NOT eligible for thrombolytic (fibrinolytic) therapy if he or she:

Has bleeding within the brain.

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 is currently not prescribed any medications

Your patient's past medical history includes hypertension, congestive heart failure, diabetes, and seizures. Today, he presents with signs of acute renal failure. Which of his medical problems MOST likely caused this?

Heart failure

The MOST significant risk factor for a hemorrhagic stroke is:

Hypertension

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, apenic, and pulseless. You should:

Initiate CPR and attach an AED as soon as possible.

Chronic renal failure is a condition that:

Is often caused by hypertension or diabetes.

You respond to the residence of a 70-year-old male who complains of weakness and severe shortness of breath. His wife tells you that he is a dialysis patient, but has missed his last two treatments. After applying oxygen, you auscultate his lungs and hear diffuse rhonchi. The patient is conscious, but appears confused. His blood pressure is 98/54 mm HG, his pulse rate is 120 beats/min and irregular, and his respirations are 24 breaths/min and labored. You should:

Leave him in a sitting position, keep him warm, and prepare for immediate transport.

Most patients with abdominal pain prefer to:

Lie on their side with their knees drawn into the abdomen

Individuals with chronic alcoholism are predisposed to intracranial bleeding and hypoglycemia secondary to abnormalities in the:

Liver

Which of the following organs would MOST likely bleed profusely if injured?

Liver

A strangulated hernia is one that:

Loses its blood supply due to compression by local tissues.

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:

Maintain her airway with manual head positioning, suction her airway to remove the vomitus, insert a nasopharyngeal airway, and administer high-flow oxygen.

A 29-year-old pregnant woman has had severe vomiting for the last 2 days. Today, she is vomiting large amounts of blood. Her skin is cool and pale, and she is tachycardic. The EMT should suspect:

Mallory-Weiss tear

Which of the following findings should concern the EMT the MOST when assessing a patient who complains of a headache?

Neck stiffness or pain

Chapter 18

Neurologic Emergencies

Which of the following is characteristic of a focal-onset aware seizure?

Normal level of consciousness

A patient with an altered mental status is:

Not thinking clearly or is incapable of being aroused.

You arrive at a grocery store shortly after a 35-year-old male stopped seizing. Your assessment reveals that he is confused and incontinent of urine. The patient's girlfriend tells you that he has a history of seizures and takes topiramate (topamax). When obtaining further medical history from the girlfriend, it is MOST important to:

Obtain a description of how the seizure developed.

When assessing a patient with abdominal pain, you should:

Palpate the abdomen in a clockwise direction, beginning with the quadrant after the one the patient indicates is painful.

Which of the following organs lies in the retroperitoneal space?

Pancreas

The MOST common and significant complication associated with an acute abdomen is:

Peritonitis

Status epilepticus is characterized by:

Prolonged seizures without a return of consciousness.

Pain that may be perceived at a distant point n the surface of the body, such as the back or shoulder, is called:

Referred pain

The kidneys help regulate blood pressure by:

Removing sodium and water from the body.

Which of the following conditions would MOST likely affect the entire brain?

Respiratory failure or cardiopulmonary arrest

A generalized (tonic-clonic) seizure is characterized by:

Severe twitching of all body's muscles.

Which of the following organs assists in the filtration of blood, serves as a blood reservoir, and produces antibodies?

Spleen

Solid abdominal organs include the:

Spleen, kidneys, and pancreas.

Patients with acute abdominal pain not be given anything to eat or drink because:

Substances in the stomach increase the risk of aspiration

Which of the following clinical signs is MOST suggestive of a ruptured aneurysm?

Sudden, severe headache

A patient who is experiencing aphasia is:

Unable to produce or understand speech

The parietal peritoneum lines the:

Walls of the abdominal cavity

Which of the following patients would MOST likely demonstrate typical signs of infection, such as a fever?

a 17-year-old male with anxiety

You are dispatched to an apartment complex for a young male with abdominal pain. Your priority upon arriving at the scene should be to:

assess the scene for potential hazards.

Law enforcement has summoned you to a nightclub, where a 22-year-old female was found unconscious in an adjacent alley. Your primary assessment reveals that her respirations are rapid and shallow and her pulse is rapid and weak. She is wearing a medical alert bracelet that identifies her as an epileptic. There is an empty bottle of vodka next to the patient. You should:

assist ventilations, perform a rapid exam, and prepare for immediate transport.

A 47-year-old male presents with severe abdominal pain of 3 hours' duration. His abdomen is distended and guarded. Your MOST important consideration for this patient should be to:

be alert for signs and symptoms of shock.

Peritonitis may result in shock because:

fluid shifts from the bloodstream into body tissues.

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:

monitor her airway and breathing status and assess her blood glucose level.