EMT CHAPTER 15,16,17,18 QUIZ

Which of the following signs or symptoms would you NOT expect to encounter in a patient with congestive heart failure?

Hypotension and flat jugular veins

Excessive eating caused by cellular "hunger" is called:

polyphagia.

Status epilepticus is characterized by:

prolonged seizures without a return of consciousness.

How many cranial nerves are there?

12

Which of the following is MOST characteristic of adequate breathing?

24 breaths/min with bilaterally equal breath sounds and pink skin

Most patients are instructed by their physician to take up to _______ doses of nitroglycerin before calling EMS.

3

The head and brain receive their supply of oxygenated blood from the:

carotid arteries.

thromboembolism

A blood clot that has formed within a blood vessel and is floating within the bloodstream.

congestive heart failure

A condition resulting from the heart's inability to pump out all the blood that returns to it; blood backs up in the veins leading to the heart, causing an accumulation of fluid in various parts of the body

cystic fibrosis

A genetic disorder that is present at birth and affects both the respiratory and digestive systems.

Respiratory Syncytial Virus (RSV)

A virus that causes an infection of the lungs and breathing passages; can lead to other serious illnesses that affect the lungs or heart, such as bronchiolitis and pneumonia. RSV is highly contagious and spread through droplets.

When administering supplemental oxygen to a hypoxemic patient with a chronic lung disease, you should:

A. adjust the flow rate accordingly until you see symptom improvement, but be prepared to assist his or her ventilations.

Which of the following represents the MOST appropriate method of assisting a patient with his or her prescribed nitroglycerin tablet or spray?

Administer the medication sublingually and allow it to dissolve or absorb.

Emphasyma

An irreversible breakdown in alveolar walls ; Lungs become inelastic

While auscultating an elderly woman's breath sounds, you hear low-pitched "rattling" sounds at the bases of both of her lungs. This finding is MOST consistent with which of the following conditions?

Aspiration pneumonia

Which of the following is the MOST reliable method of estimating a patient's cardiac output?

Assess the heart rate and strength of the pulse.

Rales

Crackles; wet crackling noise in lungs

Which of the following is the MOST likely cause of artifact on an ECG tracing?

Excessive movement of the patient

Which of the following signs is commonly observed in patients with right-sided heart failure?

Dependent edema

A 66-year-old woman presents with a stabbing pain in the middle of her chest that radiates to her back. She tells you that the pain suddenly began about 30 minutes ago and has been severe since the onset. She has a history of hypertension, but admits to being noncompliant with her antihypertensive medications. When you assess her, you find that her blood pressure is significantly higher in her left arm than it is in her right arm. What do these signs and symptoms MOST likely indicate?

Dissecting aortic aneurysm

Which of the following is LEAST important when obtaining a medical history from a patient complaining of chest discomfort?

Family history of hypertension

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.

wheezing

High pitched sound heard in the lungs with asthmatics or lung disease

You are assessing a patient with respiratory distress and are unsure if the cause is congestive heart failure or chronic obstructive pulmonary disease (COPD). Which of the following clinical signs would be the MOST helpful in determining whether the patient has chronic heart failure or COPD?

Jugular vein distention

A 60-year-old male presents with acute respiratory distress. He is conscious and alert, has pink and dry skin, and has respirations of 22 breaths/min with adequate depth. Which of the following treatments is MOST appropriate for this patient?

Oxygen via nonrebreathing mask and a focused secondary assessment

Treatment with continuous positive airway pressure (CPAP) would MOST likely be contraindicated in which of the following situations?

Shortness of breath and a blood pressure of 76/56 mm Hg

A 59-year-old male with a history of emphysema complains of an acute worsening of his dyspnea and pleuritic chest pain following a forceful cough. Your assessment reveals that he has a barrel-shaped chest, unilaterally diminished breath sounds, and tachycardia. What is the MOST likely cause of this patient's condition?

Spontaneous pneumothorax

Which of the following statements regarding the AED and defibrillation is correct?

The AED will not analyze the rhythm of a moving patient.

Which of the following statements regarding the hypoxic drive is correct?

The hypoxic drive stimulates a person to breathe on the basis of low oxygen levels.

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:

adequate air exchange.

Common signs and symptoms of a hypertensive emergency include:

a bounding pulse, a severe headache, and dizziness.

aneurysm

a localized weak spot or balloon-like enlargement of the wall of an artery

Which of the following is NOT a common sign or symptom associated with malfunction of an implanted cardiac pacemaker?

a rapid heart rate.

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

a seizure

hypertensive emergency

a situation in which blood pressure is severely elevated and there is evidence of actual or probable target organ damage

When auscultating the lungs of a patient with respiratory distress, you hear adventitious sounds. This means that the patient has:

abnormal breath sounds.

You are dispatched to a residence for a 67-year-old female who was awakened by shortness of breath and sharp chest pain. Her husband tells you that she was recently discharged from the hospital after having hip surgery. Your assessment reveals dried blood around her mouth, facial cyanosis, and an oxygen saturation of 88%. You should suspect:

acute pulmonary embolism

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, her respirations are 22 breaths/min, and her oxygen saturation is 92%. The patient does not have prescribed nitroglycerin, but her husband does. You should:

administer oxygen, give her 324 mg of aspirin, and assess her further.

pnemothorax

air in the pleural space

Diphtheria

an acute bacterial infection of the throat and upper respiratory tract

croup

an acute respiratory syndrome in children and infants characterized by obstruction of the larynx, hoarseness, and a barking cough

pnemonia

an inflammation in the lung caused by infection from bacteria, viruses, fungi, or parasites, or resulting from aspiration of chemicals

Which of the following medications is commonly given to patients with chest pain to prevent blood clots from forming or getting bigger?

aspirin.

Upon arriving at the residence of a patient with a possible cardiac problem, it is MOST important to:

assess the scene for potential hazards.

You receive a call for a 70-year-old female with respiratory distress. Her husband tells you that she has congestive heart failure; however, he does not think that she has been taking her medications as prescribed. The patient is laboring to breathe, appears tired, and has cyanosis around her lips. You should:

assist her ventilations with a bag-mask device.

The ability of cardiac muscle cells to contract spontaneously without a stimulus from a nerve source is called:

automaticity.

The electrical stimulus that originates in the heart's primary pacemaker is controlled by impulses from the brain that arrive by way of the:

autonomic nervous system.

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:

begin CPR, apply the AED, and deliver a shock if it is indicated.

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:

begin high-quality CPR and apply the AED as soon as possible.

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:

begin ventilatory assistance.

The posterior tibial pulse can be palpated:

behind the medial malleolus, on the inside of the ankle.

The inferior vena cava returns deoxygenated blood to the right side of the heart from all of the following areas, EXCEPT the:

brain.

It would be MOST appropriate for a patient to take his or her prescribed nitroglycerin when experiencing:

chest pain that does not immediately subside with rest.

angina pectoris

chest pain that results when the heart does not get enough oxygen

The EMT should assess for hypoglycemia in small children with a severe illness or injury because:

children cannot store excess glucose as effectively as adults.

The respiratory distress that accompanies emphysema is caused by:

chronic stretching of the alveolar walls.

pulmonary embolism

clot or other material lodges in vessels of the lung

cardiac arrest

complete stopping of heart activity

Rapid, labored breathing in a patient with signs and symptoms of AMI should make you suspicious for:

congestive heart failure.

The myocardium receives oxygenated blood from the __________, which originate(s) from the __________.

coronary arteries, aorta

Cardiogenic shock following AMI is caused by:

decreased pumping force of the heart muscle

In contrast to an automatic implantable cardiac defibrillator (AICD), an external defibrillator vest:

delivers high-energy shocks, similar to an AED.

A percutaneous transluminal coronary angioplasty (PTCA) restores blood flow to the ischemic myocardium by:

dilating the affected coronary artery with a small inflatable balloon.

The main legal risk in using the AED is:

failing to deliver a shock when one is needed.

Risk factors for AMI that cannot be controlled include:

family history.

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:

feel for a pulse while compressions are ongoing.

Blood that is ejected from the right ventricle:

flows into the pulmonary arteries.

Signs and symptoms of a hypertensive emergency would MOST likely be delayed in patients who:

have chronic hypertension

The MOST significant risk factor for a hemorrhagic stroke is:

hypertension.

After the AED has delivered a shock, the EMT should:

immediately resume CPR.

aphasia

impairment of language, usually caused by left hemisphere damage either to Broca's area (impairing speaking) or to Wernicke's area (impairing understanding).

When obtaining a 12-lead ECG, the patient should be:

in a supine position with legs uncrossed.

You are dispatched to an apartment complex where a 21-year-old female has apparently overdosed on several narcotic medications. She is semiconscious and has slow, shallow respirations. You should:

insert a nasopharyngeal airway and begin assisted ventilation.

You are assisting an asthma patient with his prescribed metered-dose inhaler. After the patient exhales, and before inhaling, the patient should put his or her lips around the inhaler, take a deep breath, and depress the inhale. You should:

instruct him to hold his breath for as long as he comfortably can.

stroke

interruption of blood flow to the brain

The mental status of a patient who has experienced a generalized seizure:

is likely to improve over a period of 5 to 30 minutes.

Ronchi

loud rumbling sounds heard on auscultation of bronchi obstructed by sputum

hypogylcemia

low blood sugar

Hyperventilation could be associated with all of the following, EXCEPT:

narcotic overdose.

In contrast to AMI, a dissecting aortic aneurysm:

often presents with pain that is maximal from the onset

In order for efficient pulmonary gas exchange to occur:

oxygen and carbon dioxide must be able to freely diffuse across the alveolar-capillary membrane.

Common signs and symptoms of AMI include all of the following, EXCEPT:

pain exacerbated by breathing.

Your EMS team is performing CPR on a 60-year-old male in cardiac arrest. You connect the AED, push the analyze button, and receive a "no shock advised" message. You should:

perform CPR for 2 minutes and reassess.

chronic obstructive pulmonary disease (COPD)

permanent, destructive pulmonary disorder that is a combination of chronic bronchitis and emphysema

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:

placing her in an upright position.

The left ventricle has the thickest walls because it:

pumps blood into the aorta and systemic circulation.

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:

reassess airway and breathing and treat accordingly.

A patient in cardiac arrest is wearing an external defibrillator vest, which is interfering with effective chest compressions. The EMT should:

remove the battery from the monitor and then remove the vest.

Most AEDs are set up to adjust the voltage based on the impedance, which is the:

resistance of the body to the flow of electricity.

When the level of arterial carbon dioxide rises above normal:

respirations increase in rate and depth.

cariogenic shock

results when an inefficient heart cannot sustain adequate circulation

Deoxygenated blood from the body returns to the:

right atrium

The left cerebral hemisphere controls:

right side of the body

The right coronary artery supplies blood to the:

right ventricle and inferior wall of the left ventricle.

Which of the following conditions would be LEAST likely to result in hypoxia?

severe anxiety.

In contrast to the sympathetic nervous system, the parasympathetic nervous system:

slows the heart and respiratory rates.

Harsh, high-pitched inspiratory sounds are characteristic of:

stridor.

When assessing for fluid collection in the lungs during auscultation of lung sounds, you should:

start at the lower lung fields and determine at which level you start hearing clear breath sounds.

stridor

strained, high-pitched sound heard on inspiration caused by obstruction in the pharynx or larynx

acute coronary syndrome (ACS)

sudden symptoms of insufficient blood supply to the heart indicating unstable angina or acute myocardial infarction

Common signs and symptoms of acute hyperventilation syndrome include:

tachypnea and tingling in the extremities.

Types of headaches

tension, migraine, sinus

When the myocardium requires more oxygen:

the arteries supplying the heart dilate.

When treating a patient with chest pain, you should assume that he or she is having an AMI because:

the cause of the pain cannot be diagnosed in the field.

Acute Myocardial Infarction (AMI)

the condition in which a portion of the myocardium dies as a result of oxygen starvation; often called a heart attack by laypersons

A dissecting aortic aneurysm occurs when:

the inner layers of the aorta become separated.

Ventricular tachycardia causes hypotension because:

the left ventricle does not adequately fill with blood.

Cardiac output may decrease if the heart beats too rapidly because:

there is not enough time in between contractions for the heart to refill completely.

Successful treatment of a stroke depends on whether:

thrombolytic therapy is given within 3 hours of symptoms beginning.

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.

When documenting a patient's description of his or her chest pain or discomfort, the EMT should:

use the patient's own words.

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.

Nitroglycerin is contraindicated in patients:

who have experienced a head injury.

Defibrillator pads are placed on the patient's chest:

with one pad to the right of the upper sternum and the other pad to the left lower chest below the armpit.