Exam II (Multiple Choice)
Which of the following statements regarding the H1N1 virus is correct?
It is only one type of influenza among the many other strains of influenza that exist and infect humans.
What is sebum?
It is produced by the subaceous glands. It is an oily material that waterproofs the skin and keeps it safe.
What is fascia?
It is the fiberlike connective tissue that covers arteries, veins, tendons, and ligaments.
Spinal injury assos. w/ what shock?
Neurogenic Shock
Pacemaker malfuntion
Symptoms: syncope, dizziness, weakness b/c of low heart rate, pulse will be less than 60 bpm
myocardial contractility
The ability of the heart to contract.
Patients with which type of diabetes are more likely to have metabolic problems and organ damage?
Type 1
Shock
Widespread inadequate tissue perfusion
Can EMT-B use a glucometer
Yes
DTs is a syndrome associated with withdraw from
alcohol
PTCA (stent)
balloon in narrowed coronary artery to open it up
Asystole
dead :(
What is an amputation?
An injury in which part of the body is completely severed.
What is an avulsion?
An injury in which soft tissue is torn completely loose or is hanging as a flap.
If the wound is in the chest or upper abdomen place?
An occlusive dressing on the wound.
The stinger from a honeybee should be: a) squeezed with tweezers and removed. b) scraped away from the skin. c) irrigated with copious amounts of water. d) left in place and covered.
scraped away from the skin.
When caring for a patient who takes numerous medications, it is best to:
take all of the patient's medications with you to the hospital and document them on your patient care report.
The effects of epinephrine are typically observed within _________ following administration.
1 minute
the usual dose for activated charcoal is up to ____ for a pediatric patient and up to ____ for an adult patient.
12.5, 25g
What is a scald burn?
A burn caused by hot liquids.
What is a linear fraction?
A fraction where the skull seals itself when fully developed.
How is an increase in O2 demand supplied to the heart?
By dilation of the coronary arteries
"For every action, there is an equal and opposite reaction" is: A. Newton's first law. B. Newton's second law. C. Newton's third law. D. a false statement.
C
Hemoglobin
Hemoglobin is the protein molecule in red blood cells that carries oxygen from the lungs to the body's tissues and returns carbon dioxide from the tissues back to the lungs
Hypovolemic Shock
Hemorragic(Hypovolemic shock) and non-hemorragic(Metabolic). Loss of fluids and Electrolytes due to vomitting and or diahrreah.
Causes of Hypovolemic Shock
Hemorrhagic fluid/blood loss -burns can cause plasma loss
Which of the following statements regarding hepatitis A is correct?
Hepatitis A can only be transmitted by a patient who has an acute infection.
Pulse oximeter.You have a 38-year-old who has fainted. Following your local protocol you use a light wave device to determine the SpO2. As the EMT, you attach the device on the patient's finger, which gives you a reading of 91. What does that reading indicate? Significant hypoxia Severe hypoxia Normal results Hypoxia
Hypoxia
You are called to a 72-year-old patient with weakness and headache with an initial blood pressure of 140/92. His repeat blood pressure at 5 minutes is unchanged. His condition is called: Stroke. Prehypertension. Hypertension. Hypotension.
Hypertension.
Abdominal and/or Chest injuries Assos. w/ what shock?
Hypovolemic shock
Severe Fractures are assos. w/ what type of shock?
Hypovolemic shock
What are symptoms of a contusion?
ICP, widening pulse pressure, watch for Cushings triad symptoms.
What is the route of administration for the EpiPen auto-injector? Select one: A. Intravenous B. Intraosseous C. Intramuscular D. Sublingual
Intramuscular
Cardiogenic shock
Is a pump failure due to tissue becoming esquemic on the coronary arteries.
When pupils are dilated they are: Elliptical or elongated in shape. Smaller than normal. Larger than normal. Irregularly shaped.
Larger than normal.
Signs and Symptoms of Anaphylactic Shock
QUICK ONSET mild itching rash burning skin vascular dilation generalized edema especially around face and lips pallor/cyanosis dizziness/fainting sneezing/tightness in chest/cough WHEEZING
What is paraorbital achimosis?
Racoon eyes.
In a conscious adult patient, which of the following pulses should be assessed initially? Brachial Radial Carotid Pedal
Radial
You respond to a high school football field on a hot, humid day to find a 16-year-old male complaining of dizziness and weakness after playing football for an hour. Which of the following would you expect his vital signs to be? Normal pulse, blood pressure, and skin Rapid pulse, high blood pressure, and hot, dry skin Slow pulse, low blood pressure, and cool, dry skin Rapid pulse, low blood pressure, and sweaty skin
Rapid pulse, low blood pressure, and sweaty skin
Signs and Symptoms of Hypovolemic Shock
Rapid weak pulse low BP Cyanosis lips nail beds cool clammy skin dehydration/thirsty INCREASED RESPIRATORY RATE
Diabetes Insipidus
Rare Involves excessive urination Here the missing hormone is one that regulates urinary fluid reabsorption.
You are transporting a patient down a bumpy road. Your patient's blood pressure has just been measured by the monitor to be 190/110. The patient's blood pressure on scene was 130/80. You should: Ignore the blood pressure reading. Have the driver increase truck speed. Apply the automatic cuff to the other arm. Re-measure the blood pressure manually.
Re-measure the blood pressure manually.
Erythrocytes
Red blood cells (RBCs), also called erythrocytes, are the most common type of blood cell and the principal means of delivering oxygen (O2) to the body tissues.
What is Cu-Contra-Cu?
Sloshing of the brain/internal organs
Which of the following clinical signs would necessitate the administration of naloxone (Narcan)? Select one: A. Tachycardia B. Hypertension C. Slow respirations D. Extreme agitation
Slow respirations
Which of the following patients is in decompensated shock?
a 20-year-old female with absent radial pulses and dilated pupils
Which of the following patients would MOST likely have a delayed onset of an allergic reaction?
a 45-year-old male who ingested penicillin
Which of the following patients would MOST likely have a delayed onset of an allergic reaction? a) a 21-year-old female who inhaled pollen b) a 45-year-old male who ingested penicillin c) a 50-year-old male who was exposed to latex d) a 30-year-old male who was stung by a bee
a 45-year-old male who ingested penicillin
Occlusion
a blockage, usually of a tubular structure such as a blood vessel.
Thromboembolism
a blood clot that has formed within a blood vessel and is floating within the bloodstream.
What is a transverse fraction?
a break straight through bone
Leukocytes
a colorless cell that circulates in the blood and body fluids and is involved in counteracting foreign substances and disease; a white (blood) cell.
aplastic crisis
a condition in which the body stops producing red blood cells; typically caused by infection
Dissecting Aneurysm
a condition in which the inner layers of an artery, such as the aorta, become separated, allowing blood (at high pressures) to flow between the layers.
Atherosclerosis
a disorder in which a cholesterol and calcium build up inside the walls of blood vessels, forming plaque, which eventually leads to partial or complete blockage of blood flow (occlusion). It interferes with their ability to dilate and contract
when reassessing the diabetic patient after administration of oral glucose, watch for
airway problems, seizures, sudden loss of consciousness
the most commonly abused drug in the united states is
alcohol
a patient who presents with rapid breathing, nausea and vomiting, ringing in the ears, and a high fever should be suspected of ingesting a significant quantity of
aspirin
your priority in caring for a patient with a surface contact poisoning is to
avoid contaminating yourself
as you enter the residence of a patient who has possibly overdosed, you should
be alert for personal hazards
the major side effect associated with ingestion of activated charcoal is:
black stools
Obstructive shock
blockage of blood flow to the lungs. Producing a Pulmonary embolism
When assessing a patient with signs and symptoms of shock, it is MOST important to remember that:
blood pressure may be the last measurable factor to change in shock.
hospital intervention for hemophilia may include
blood transfusions, analgesics for pain, IV therapy
coronary artery bypass graft
blood vessel from chest or leg seen directly from aorta to a coronary artery past the point of obstruction
Syphilis is a:
bloodborne disease that can successfully be treated with penicillin.
The only organ that does not require insulin to allow glucose to enter its cell is the:
brain
The most basic functions of the body, such as breathing, blood pressure, and swallowing, are controlled by the: a) brain stem. b) cerebrum. c) cerebral cortex. d) cerebellum.
brain stem.
Common side effects of epinephrine include all of the following, EXCEPT:
drowsiness.
Common side effects of epinephrine include all of the following, EXCEPT: a) headache. b) dizziness. c) drowsiness. d) tachycardia.
drowsiness.
Diffusion
Gas Exchange
All patients with large surface burns should?
Have a dry dressing applied; to help maintain body temperature, prevent infection, and provide comfort.
Kussmaul respirations
Rapid and Deep respirations
A 73-year-old man presents with a generalized rash, which he thinks may have been caused by an antibiotic that he recently began taking. He has a history of coronary artery disease, hypertension, and emphysema. He is conscious and alert, his blood pressure is 144/94 mm Hg, and his pulse is 64 beats/min and regular. You auscultate his breath sounds and hear scattered wheezing, although he is not experiencing respiratory distress. In addition to administering oxygen, you should:
contact medical control if needed, transport the patient, and monitor him for signs of deterioration.
AICD (Automatic internal cardiac defibrillator)
Wire goes into atria and senses and irregulatory and sends jolt
Can you live without a spleen
Yes
Should you check a blood sugar on anybody with AMS
Yes
Should you wear gloves when adminstering oral glucose
Yes
How do you treat a patient with a Jugular Vein Laceration?
You get an acclusive dressing and tape all 4 sides.
What does the Autonomic nervous system (ANS) has two parts:
Sympathetic nervous system - "Fight-or-flight" system Parasympathetic nervous system - Slows various bodily functions
When the heart contracts and forces blood into the arteries, the pressure created is known as the: Pulse pressure. Systolic blood pressure. Diastolic blood pressure. Central venous pressure.
Systolic blood pressure.
In a blood pressure reading of 120/80, the 120 is measuring what body process? Diastolic blood pressure; when the left ventricles contract and the blood is forced into the arteries Systolic blood pressure; when the right ventricles contract and the blood is forced into the veins Systolic blood pressure; when the left ventricles contract and the blood is forced into the arteries Systolic blood pressure; when the left ventricles contract and the blood is forced into the veins
Systolic blood pressure; when the left ventricles contract and the blood is forced into the arteries
Hypertensive emergencies
Systolic bp is more than 160 Sympotoms: severe headache strong, bounding pulse ringing in ears dizziness nose bleeds ** Can lead to stroke or aortic aneurism
Polyphagia
excessive eating
Polydipsia
excessive thirst persisting for a long period of time
Splenic sequestraion
acute enlargment of the spleen
Hepatitis B is more virulent than hepatitis C, which means that it:
has a greater ability to produce disease.
A patient who is possibly experiencing a stroke is NOT eligible for thrombolytic (fibrinolytic) therapy if he or she: a) has bleeding within the brain. b) is older than 60 years of age. c) has had a prior heart attack. d) has a GCS score that is less than 8.
has bleeding within the brain.
Tuberculosis
chronic bacterial disease, caused by mycobacterium tuberculosis that usually affects the lungs but can also affect other organs such as the brain and kidneys
Major controllable risk factors for an AMI include: older age. family history. cigarette smoking. male sex.
cigarette smoking.
Capillary sphincters are:
circular muscular walls that regulate blood flow through the capillaries.
Perfusion
circulation of blood within an organ or tissue in adequate amounts to meet current needs of the cells.
Which of the following medications blocks the release of histamines?
diphenhydramine (Benadryl)
hyperglycemia
extremely high blood glucose level
The sweet or fruity odor on the breath of a diabetic patient is caused by ________ in the blood
ketones
When fat is used as an immediate energy source, _______ and fatty acids are formed as waste products
ketones
signs and symptoms of a sympathomimetic drug overdose includes
tachycardia
Hypovolemic shock is result of
low blood volume
Because diabetic coma is a complex metabolic condition that usually develops over time and involves all the tissues of the body, correcting this condition may
take many hours in a hospital setting
The greatest danger in displaying a personal bias or "labeling" a patient who frequently calls EMS is:
overlooking a potentially serious medical condition.
Thrombophilia
tendency to develop blood clots
which of the following statements regarding the salmonella bacterium is correct
the salmonella bacterium itself causes food poisoning
when treating shock patient frequently check vitals every
5 minutes
A hemia that returns to its proper body cavity is said to be: A. reducible B. extractable C. incarcerated D. replaceable
A
A young boy was riding his bicycle down the street when he hit a parked car. What was the first collision? A. The bike hitting the car. B. The bike rider hitting his bike or the car. C. The bike rider's internal organs against the solid structures of the body. D. The bike rider striking the pavement.
A
A young boy was riding his bicycle down the street when he hit a parked car. What will rate your index of suspicion for this collision? A. The mechanism of injury B. The type of bike C. How loudly he's crying D. A quick visual assessment
A
According to the Association of Air Medical Services (AAMS), you should consider air medical transport of a trauma patient if: A. traffic conditions hamper the ability to get the patient to a trauma center by ground within the ideal time frame for the best clinical outcome. B. he or she was involved in a motor vehicle crash in which another occupant in the same vehicle was killed, even if your patient's injuries are minor. C. ground transport will take your ambulance out of service for an extended period of time, regardless of the severity of the patient's injuries. D. the patient requires advanced life support care and stabilization, and the nearest ALS-ground ambulance is more than 5 to 10 minutes away.
A
Air bags are designed to: A. decrease the severity of deceleration injuries. B. prevent the driver from sustaining head trauma. C. be used with or without a shoulder harness. D. prevent a second collision inside the car.
A
An important aspect in the treatment of a patient with severe abdominal pain is to: A. provide emotional support en route to the hospital. B. administer analgesic medications to alleviate pain. C. encourage the patient to remain in a supine position. D. give 100% oxygen only if signs of shock are present.
A
An unrestrained driver collided with a bridge pillar. Upon inspection of the interior of his vehicle, you note that the lower dashboard is crushed. During your assessment of the patient, you will MOST likely encounter: A. trauma to the pelvis. B. blunt abdominal trauma. C. a severe closed head injury. D. penetrating thoracic trauma.
A
Bleeding from the nose following head trauma: A. is a sign of a skull fracture and should not be stopped. B. should be controlled by packing the nostril with gauze. C. should be assumed to be caused by a fractured septum. D. is usually due to hypertension caused by the head injury.
A
Damage to the body that resulted from a pressure wave generated by an explosion is found in what type of blast: A. primary B. secondary C. tertiary D. miscellaneous
A
Diarrhea is the principle symptom in: A. Gastroenteritis B. Esophagitis C. Pancreatits D. Peptic Ulcers
A
Distension of the abdomen is gauged by: A. visualization B. auscultaion C. palpation D. the patients complaint of pain around the umbilicus.
A
Esophageal varices MOST commonly occur in patients who: A. drink a lot of alcohol. B. have severe diabetes. C. have a history of esophagitis. D. have weak immune systems.
A
Following a blunt injury to the head, a 22-year-old female is confused and complains of a severe headache and nausea. On the basis of these signs and symptoms, you should be MOST concerned with the possibility of: A. intracranial bleeding. B. a fracture of the skull. C. spinal cord injury. D. airway compromise.
A
The accumulation of ketones and fatty acids in blood tissue can lead to a dangerous condition in diabetic patients known as: around 400 mg/dL
diabetic ketoacidosis
Dilation
widening of a tubular structure such as a coronary artery.
aplastic crisis
worsening of baseline amenia (lack of circulation red blood cells in the body)
Ten days after treating a 34-year-old patient with tuberculosis, you are given a tuberculin skin test, which yields a positive result. This MOST likely indicates that:
you were exposed to another infected person prior to treating the 34-year-old patient.
An index of suspicion is MOST accurately defined as:
your awareness and concern for potentially serious underlying and unseen injuries or illness.
A(n) _______________ set of vital signs is important for critical decision making for the EMT. Unbiased Accurate Complete Repeated
Accurate
A patient being transported by ambulance to the hospital can have his blood pressure measured by which of the following methods? Blood pressure monitor Palpation Auscultation Any of the above
Any of the above
Aortic aneurism
Aorta bursts -Dissecting aneurism: Lining of aorta separated Primary cause: uncontrolled hypertension Symptoms: chest pain different bp in arms tearing/ripping sensation
Optimally, on-scene time for critically injured patients should be less than _____ minutes. A. 5 B. 10 C. 15 D. 20
B
Pain that is localized to the lower back and/or lower abdominal quadrants is MOST suggestive of: A. acute pancreatitis. B. an aortic aneurysm. C. a kidney infection. D. acute appendicitis.
B
Pain that radiates to the right lower quadrant from the umbilical area, nausea and vomiting, and anorexia are MOST indicative of: A. pancreatitis. B. appendicitis. C. cholecystitis. D. gastroenteritis.
B
Peritonitis may result in shock because: A. intra-abdominal hemorrhage is typically present. B. fluid shifts from the bloodstream into body tissues. C. abdominal distention impairs cardiac contractions. D. severe pain causes systemic dilation of the vasculature.
B
Peritonitis, with associated fluid loss, is the result of: A. abnormal shift of fluid from body tissue into the bloodstream. B. abnormal shift of fluid from bloodstream into body tissue. C. normal shift of fluid form body tissue into the bloodstream. D. normal shift of fluid bloodstream into body tissue.
B
Regulation of acidity and blood pressure is largely attributed to the: A. liver B. kidneys C. gallbladder D. pancreas
B
Signs of a pulmonary blast injury include: A. multiple rib fractures. B. coughing up blood. C. an irregular pulse. D. vomiting blood.
B
Solid abdominal organs include the: A. stomach and small intestine. B. spleen, kidneys, and pancreas. C. gallbladder and large intestine. D. urinary bladder, colon, and ureters.
B
The _______ are found in the retroperitoneal space. A. stomach and gallbladder B. kidneys, ovaries, and pancreas C. liver and pancreas D. adrenal glands and uterus
B
The _______ links the arteries and the venules. A. Aorta B. Capillaries C. Vena cava D. Valves
B
The ability of a person's cardiovascular system to compensate for blood loss is MOST related to: A. how fast his or her heart beats. B. how rapidly he or she bleeds. C. his or her baseline blood pressure. D. the part of the body injured.
B
The amount of kinetic energy that is converted to do work on the body dictates the _____ of the injury. A. location B. severity C. cause D. speed
B
The body will not tolerate an acute blood loss of greater than _______ of blood volume A. 10% B. 20% C. 30% D. 40%
B
The cervical spine is MOST protected from whiplash-type injuries when the: A. air bag correctly deploys upon impact. B. headrest is appropriately positioned. C. rear end of the vehicle is initially struck. D. patient tenses up at the time of impact.
B
The driver of a sport utility vehicle lost control and struck a utility pole head-on. The driver was killed instantly. The passenger, a young female, is conscious and alert and has several small abrasions and lacerations to her left forearm. Treatment for the passenger should include: A. transport to a community hospital. B. transport to a trauma center. C. a secondary assessment at the scene. D. a focused exam of her forearm.
B
The function of the blood is to _______ all of the body's cells and tissues A. Remove oxygen from B. Deliver nutrients to C. Carry waste products to D. All of the above
B
The index of suspicion is MOST accurately defined as: A. a predictable pattern that leads to serious injuries. B. your concern for potentially serious underlying injuries. C. the detection of less obvious life-threatening injuries. D. the way in which traumatic injuries occur.
B
The quickest and MOST effective way to control external bleeding from an extremity is: A. a pressure bandage. B. direct pressure and elevation. C. a splint. D. a tourniquet.
B
The smaller vessels that carry blood away from the heart and connect the arteries to the capillaries are called the: A. venules. B. arterioles. C. vena cavae. D. capillary arteries.
B
When applying a tourniquet to an amputated arm, the EMT should: A. use the narrowest bandage possible. B. avoid applying the tourniquet over a joint. C. cover the tourniquet with a sterile bandage. D. use rope to ensure that the tourniquet is tight.
B
When assessing a patient who experienced a blast injury, it is important to remember that: A. secondary blast injuries are usually the least obvious. B. primary blast injuries are the most easily overlooked. C. solid organs usually rupture from the pressure wave. D. primary blast injuries are typically the most obvious.
B
When caring for a patient with severe epistaxis, the MOST effective way to prevent aspiration of blood is to: A. insert a nasopharyngeal airway and lean the patient back. B. tilt the patient's head forward while he or she is leaning forward. C. place the patient supine with his or her head in the flexed position. D. tilt the patient's head forward while he or she is leaning backward.
B
When treating a patient with signs and symptoms of hypovolemic shock and no outward signs of bleeding always consider the possibility of bleeding into the A. thoracic cavity B. Abdomen C. Skull D. Chest
B
When using a stick and square knot as a tourniquet to control severe bleeding from an amputated arm, the EMT should: A. cover the tourniquet with a sterile dressing. B. stop twisting the stick when the bleeding stops. C. twist the stick until the radial pulse disappears. D. remove the tourniquet if the bleeding has stopped.
B
_____ impacts are probably the number one cause of death associated with motor vehicle collisions. A. Frontal B. Lateral C. Rear-end D. Rollover
B
________ is the circulation of blood within an organ or tissue in adequate amounts to meet the cells current need for oxygen nutrients and waste removal A. Anatomy B. Perfusion C. Physiology D. Conduction
B
________ occur(s) when there is excess pressure within the portal system and surround vessel; may lead to life-threatening bleeding. A. esophageal rupture B. esophageal varices C. esophageal ulcers D. esophageal reflux
B
_________ commonly produces symptoms about 30 minutes after a particular fatty meal and usually at night. A. Peptic ulcers B. Cholecystitis C. Appendicitis D. Pancreatits
B
Because the stinger of a honeybee remains in the wound following a sting:
it can continue to inject venom for up to 20 minutes.
Because the stinger of a honeybee remains in the wound following a sting: a) the toxicity of the venom decreases within 10 minutes. b) the stinger can easily be removed with tweezers. c) the body's immune system deactivates the venom. d) it can continue to inject venom for up to 20 minutes.
it can continue to inject venom for up to 20 minutes.
Hypotension in a child with blunt or penetrating trauma is particularly significant because:
it often indicates the loss of half of his or her blood volume
Which of the following assessment findings is MOST indicative of a cardiovascular problem?
jugular venous distention
substance abuse is MOST accurately defined as
knowingly misusing substances to produce a desired effect
Ischemia
lack of oxygen that deprives tissues of the necessary nutrients, resulting from partial or complete blockage of blood flow; potentially reversible because pertinent injury has not yet occurred.
The central problem in any type of diabetes is
lack of, or to much insulin
While auscultating breath sounds of a patient who was stung multiple times by a yellow jacket, you hear bilateral wheezing over all lung fields. This indicates:
narrowing of the bronchioles in the lungs.
While auscultating breath sounds of a patient who was stung multiple times by a yellow jacket, you hear bilateral wheezing over all lung fields. This indicates: a) narrowing of the bronchioles in the lungs. b) enlargement of the bronchioles in the lungs. c) a significant amount of fluid in the alveoli. d) rapid swelling of the upper airway tissues.
narrowing of the bronchioles in the lungs.
atropine sulfate and pralidoxime chloride are antidotes for
nerve gas agents
It is especially important to assess pulse, sensation, and movement in all extremities as well as pupillary reactions in patients with a suspected ___________ problem.
neurologic
hypotension,hypoventilation, and pinpoint pupils would be expected following an overdose of
oxycodone(Percocet)
airborne substances are diluted with
oxygen
After sizing up the scene of a patient with a possible infectious disease, your next priority should be to:
take standard precautions.
Causes of insulin shock include
taking too much insulin, vigorous exercise without sufficient glucose intake, nausea, vomiting and anorexia; hypoglycemia
The stinger from a honeybee should be:
scraped away from the skin.
A patient in insulin shock needs ________ immediately, and a patient in a diabetic coma needs ________ and IV fluid therapy
sugar; insulin
subclavian arteries
supply blood to the upper extremities
His blood glucose level is 65 mg/dL. You:
suspect hypoglycemia and proceed to give oral glucose
Activated charcoal is an example of a(n): Select one: A. elixir. B. suspension. C. solution. D. gel.
suspension
Dependent Edema
swelling in the part of the body closest to the ground, caused by collection of fluid in the tissues; a possible sign of congestive heart failure.
All of the following conditions would make you suspect shock, EXCEPT:
tachycardia
When the body senses a state of hypoperfusion, the sympathetic nervous system releases epinephrine, the effects of which include:
tachycardia
type of obstructive shock caused by damage to lungs allowing air to escape into chest cavity and apply pressure to structures in mediastinum such as the heart
tension pneumothorax
Automaticity
the ability of cardiac muscle cells to contract without stimulation from the nervous system.
Posterior
the back surface of the body; the software from you in the standard anatomic position.
Coronary Arteries
the blood vessels that carry blood and nutrients to the heart muscle.
Asystole
the complete absence of any electrical cardiac activity, appearing as a straight line or almost straight line on an ECG strip.
When forming your general impression of a patient with a medical complaint, it is important to remember that:
the conditions of many medical patients may not appear serious at first.
Which of the following would MOST likely provide clues regarding the source of a patient's allergic reaction?
the environment in which the patient is found
Which of the following would MOST likely provide clues regarding the source of a patient's allergic reaction? a) the time of season in which the exposure occurred b) the environment in which the patient is found c) the patient's family history d) the patient's general physical appearance
the environment in which the patient is found
Anterior
the front surface of the body; the side facing you in the standard anatomic position.
Myocardium
the heart muscle.
The Golden Period is the first 60 minutes after
the injury occurs
Lumen
the inside diameter of an artery or other hollow structure.
Aorta
the main artery that receives blood from the left trenchcoat and delivers it to all other arteries that can carry blood to the tissues of the body.
A transient ischemic attack (TIA) occurs when: a) the normal body processes destroy a clot in a cerebral artery. b) signs and symptoms resolve spontaneously within 48 hours. c) medications are given to dissolve a cerebral blood clot. d) a small cerebral artery ruptures and causes minimal damage.
the normal body processes destroy a clot in a cerebral artery.
Aortic Valve
the one-way valve that lies between the left ventricle and the aorta and keeps blood from flowing back into the left ventricle after the left ventricle ejects its blood into the aorta;one of four heart valves.
Inferior
the part of the body or any body part nearer to the feet.
Superior
the part of the body or body parts closer to the head.
Autonomic Nervous System
the part of the nervous system that regulates involuntary functions, such as heart rate, blood pressure, digestion and sweating.
What is a fracture?
Broken bone
What is a penetrating wound?
It is an injury resulting from a sharp, pointed object.
The EMT should reassess the vital signs of an unstable patient every ________ minutes. 15 10 5 2
5
What is the function of the skin?
-It protects the body, keeping pathogens out & water in -Assisting in body temperature regulation -The nerves report sensations to the brain
AMI versus aortic dissecting aneurysm
-Pain from AMI is usually preceded by other symptoms (nausea, indigestion, weakness, sweating) -AMI tends to come on gradually and is described as pressure rather than stabbing
Signs and symptoms of AMI
-Sudden onset of weakness, nausea and sweating with no obvious cause -Chest pain, discomfort or pressure that is often crushing or squeezing and does not change with each breath -Pain or discomfort in lower jaw, arms, back, abdomen or neck -irregular heartbeat and syncope -dyspnea -pink frothy sputum (indicating pulmonary edema) -sudden death -generally, pulse is increased, but you may feel irregular or slow pulse -Damage to lower part of heart often presents with bradychardia -Most will have normal or high bp
Signs and symptoms of Angina
-Typically describes as crushing or squeezing "like someone is standing on my chest". -Usually felt in mid portion of chest under sternum Can radiate to jaw, arms (usually left), lower jaw, mid portion of back, or the epigastrium (upper middle region of abdomen) -Pain usually lasts from 3-8 min, rarely longer than 15 -May be associated with SOB, nausea or vomiting
What should you do for an avulsion?
1)If hanging, place in original position only if not contaminated 2)If complete, wrap in sterile gauze and transport to ER
homeostasis
A balance of all systems of the body.
What is a flame burn?
A burn caused by an open flame.
What is a contact burn?
A burn caused by direct contact with a hot object.
What is a steam burn?
A burn caused by exposure to hot steam.
What is a flash burn?
A burn caused by exposure to very intense heat, such as in an explosion.
Hormone
A chemical substance produced by a gland that has special regulatory effects on other organs and tissues
What is the endocrine system
A complex message and control system that includes a network of glands to maintain hemostasis
shock
A condition in which the circulatory system fails to provide sufficient circulation to enable every body part to perform its function; also called hypoperfusion.
hypothermia
A condition in which the internal body temperature falls below 95 degrees Fahrenheit (35 degrees Celsius), usually as a result of prolonged exposure to cool or freezing temperatures.
distributive shock
A condition that occurs when there is widespread dilation of the small arterioles, small venules, or both.
What is an epiphyseal fracture?
A fracture near the growth plate
What is a closed fracture?
A fracture that does not break the skin
Insulin
A hormone produced by islets of Langerhans (Endocrine gland located throughout the pancreas) that enables glucose in the blood to enter cells; used in synthetic form to treat and control diabetes mellitus.
Diabetes
A metabolic disorder in which the bodys ability to metabolize simple carbohydrates(Glucose) is impaired.
Which of the following cause the pulse oximetry to give a false or incorrect reading? A patient in shock or hyperthermia, carbon monoxide and certain poisonings, excessive movements A patient in shock or hypothermia, carbon monoxide and certain poisonings, fingernail polish, excessive movements, poor batteries A patient with rapid respirations, shock or hypothermia, carbon monoxide and certain poisonings, fingernail polish, excessive movements, poor batteries A patient in shock or hypothermia, carbon monoxide and certain poisonings, excessive movements, good batteries
A patient in shock or hypothermia, carbon monoxide and certain poisonings, fingernail polish, excessive movements, poor batteries
What is an incision?
A sharp, smooth cut.
what is a nondisplaced fracture?
Crack of bone
Polyphagia
Excessive Eating
Hypotensive
Low blood pressure
Speed of Intercranial bleeding of the Epidur
it is super fast
Insulin is produced by the"
pancreas
virulence
strength or ability of a pathogen to produce disease
signs of dehydration include
sunken eyes
Hemotology
the study and prevention of blood-related diseases
Angina versus AMI
- AMI may or may not be caused by exertion, but can occur at any time, even during rest -AMI does not resolve in a few minutes, rather, it can last between 30 min and several hours -AMI may or may not be relieved by nitro
Three serious consequences of AMI:
- Sudden death resulting from cardiac arrest - Cardiogenic shock - Congestive heart failure (CHF)
Time frame of AMI
-30 min after blood flow is cut off, some heart muscles begin to die -After 2 hours as many as half of the cells in the area can be dead -after 4-6 hours more than 90% of muscles will be dead
The adult epinephrine auto-injector delivers ______ mg of epinephrine, and the pediatric auto-injector delivers ______ mg.
0.3, 0.15
The adult epinephrine auto-injector delivers ______ mg of epinephrine, and the pediatric auto-injector delivers ______ mg. a) 0.03, 0.3 b) 0.3, 0.15 c) 0.01, 0.1 d) 0.1, 0.01
0.3, 0.15
Thrombosis
Clot in the lung
Hemophilia
can't form blood clots aka you bleed a lot Two types A and B
The onset of hypoglycemia can occur within
minutes
Investigating chief complaint
-ask if they are having respiratory difficulty -if they are experiencing dyspnea, find out whether it is related to exertion or patient's position -determine if dyspnea is continuous or if it changes with deep breathing -note whether patient has cough and whether it produces sputum -ask about trauma they may have had recently
Physical examination
-check for edema in extremities (especially lower) -are breath sounds equal? -are neck veins distended? -Is trachea deviated or midline?
signs of cardiogenic shock
-elevated pulse rate -rapid and shallow breathing -naseau and vomiting -decrease in temp -Low bp is late finding that indicates decompensated shock
Coronary artery diease (CAD)
-leading death in america
Treatment for hypertensive emergency
-make comfortable with head elevated -monitor bp -transport -ALS has meds to lower bp
signs and symptoms of CHF
-patient finds it easier to breath when sitting up -chest pain may or may not be present -distended neck veins that do not collapse even when patient is sitting -may have swollen ankles from dependent edema -High bp, rapid heart rate and respiration -Rales
sings and symptoms of aortic dissecting aneurysm
-very sudden chest pain in front of the chest or in back between the shoulder blades -stabbing pain -may exhibit difference in bp between arms or diminished pulses in lower extremities
Epinephrine dosages for adults and pediatrics
.3mg for adults and .15mg for pediatrics.
The effects of epinephrine are typically observed within _________ following administration. a) 30 seconds b) 1 hour c) 30 minutes d) 1 minute
1 minute
What are the four types of open soft-tissue wounds?
1)Abrasions 2)Lacerations 3)Avulsions 4)Penetrating wounds
For the physical examination what should you look for?
1)Be alert for Raccoon eyes, Battle's sign, & Drainage 2)Jugular vein distention, Tracheal deviation & Pt's with stomas or tracheostomies 3)Check pelvis for stability 4)Check abdomen, all four quadrants 5)Check extremities & PMS (pulse, motor, & sensory)
Why is CO dangerous?
1)CO binds to receptor sites on hemoglobin at least 250 times more easily than oxygen 2)Most people have 2% CO attached to their hemoglobin; levels higher than 50% or higher may be fatal 3)Pulse oximeter readings will read normal
What are the three types of soft-tissue injuries?
1)Closed- damage occurs beneath the skin, surface intact 2)Open- break in the surface, exposing deep tissues 3)Burns- damage occurs as a result of thermal heat, frictional heat, toxic chemicals, or nuclear radiation
How do you secure open neck injuries?
1)Control bleeding & utilize an occlusive dressing 2)Apply manual pressure, but do not compress the carotid
Methods to control open injuries or external bleeding?
1)Direct, even pressure and elevation 2)Pressure dressings and/or splints 3)Tourniquets
Closed soft-tissue injuries are characterized by?
1)History of blunt trauma 2)Pain at the site of injury 3)Swelling beneath the skin 4)Discoloration
Why are radiation burns dangerous?
1)Most ionizing radiation accidents involve gamma or x-rays 2)Radiation burns require special rescue techniques beyond the training of EMT 3)4-6 Gy (severe), more than 8 Gy (immediately fatal)
Reasons why a patient will need immediate transportation:
1)Poor initial general impression 2)Altered level of consciousness 3)Dyspnea 4)Abnormal vital signs 5)Shock 6)Severe pain
What is the MOI for a blast injury is due to these factors?
1)Primary blast injury 2)Secondary blast injury 3)Tertiary blast injury
What are the steps of healing?
1)Stopping blood flow, clotting begins 2)Inflammation, cells migrate to the wound and dilation occurs with the presence of histamine 3)New layer of cells must move into the region, cells quickly multiply and redevelop across the edge of the wound 4)New blood vessels form, the body attempts to brink O2 and nutrients to the site *Wound Healing does not always follow the pattern (infection, abnormal scar, bleeding or slow healing*
What are useful techniques to determine the extent of burns?
1)The rule of palm 2)The rule of nines
How do you determine burn severity?
1)What is the depth of the burn? 2)What is the extent of the burn? 3)Are any critical areas involved? 4)Does the patient have a preexisting medical condition? 5)Is the patient younger than 5 years/older than 55 years?
examples of respiratory insufficiency
1- Carbon monoxide poisoning 2- Cyanide Poisoning 3- Anemia
What are the steps to administer an EPI-Pen?
1- Locate mid-lateral thigh. 2- Rub alcohol from big circle to small circles. 3- Administer epi for 10 seconds. 4- Place in sharps box. 5- Massage administered area.
Effects of Epinephrine on the body
1- Vaso-constrictor 2- dialates bronchioles 3- Increased heart rate
When administering epinephrine via auto-injector, you should hold the injector in place for: a) 5 seconds. b) 10 seconds. c) 20 seconds. d) 15 seconds.
10 seconds.
Which of the following is a normal respiratory rate for an adult at rest? 12 breaths per minute 10 breaths per minute 24 breaths per minute 22 breaths per minute
12 breaths per minute
The range of normal blood glucose level is from a low of 60 to 80 mg/dL to a high of: 110 to 130. 100 to 120. 90 to 100. 120 to 140.
120 to 140.
Vital signs should be reassessed every ________ minutes for a stable patient. 15 10 5 20
15
Your patient has a heart rate of 82, a respiratory rate of 16, and a blood pressure of 120/80 and does not appear to be in any distress. You should repeat vital sign measurements at least every: 5 minutes. 10 minutes. 15 minutes. 20 minutes
15 minutes.
P-wave
1st wave - atria contract
In infants and children, a capillary refill time (CRT) that is greater than ______ second(s) is a sign of poor peripheral perfusion.
2
If capillary refill is assessed in a child patient, how long should it take the normal pink color to return to the nail bed? 2 seconds t4 seconds 3 seconds 5 seconds
2 seconds
When taking blood pressure, the cuff should be inflated to what point? 20 to 30 mmHg beyond the point where the pulse disappears Until the patient says it hurts Until the Velcro starts to crackle tUntil the gauge reads 200 mmHg
20 to 30 mmHg beyond the point where the pulse disappears
QRS- complex
2nd wave - ventricles contract
Most patients who die of anaphylaxis do so within the first __________ following exposure.
30 minutes
Most patients who die of anaphylaxis do so within the first __________ following exposure. a) 90 minutes b) 5 minutes c) 60 minutes d) 30 minutes
30 minutes
T-wave
3rd wave - relaxation ventricle
In which of the following situations would it be MOST appropriate to utilize an air medical transportation service?
61-year-old man with signs and symptoms of a stroke and your ground transport time is 50 minutes
What Glasgow Coma Scale (GCS) score would you assign to a patient who responds to painful stimuli, uses inappropriate words, and maintains his or her arms in a flexed position? a) 6 b) 8 c) 9 d) 10
8
An approximate normal systolic blood pressure can be calculated for infants and children by using which of the following formulas? 80 plus 2 times the age in years 120 plus 2 times the age in years 120 minus 2 times the age in years 80 times 2 plus the age in years
80 plus 2 times the age in years
Normal blood glucose levels range from _______ mg/dL
80 to 120
What are normal glucose levels
80-120 mg/dL
At what systolic blood pressure should you recognize that an adult patient is in decompensated shock?
90 mm Hg
Your patient is warm, dry, and pink and denies shortness of breath. Which of the following should the EMT expect to find when evaluating the patient's oxygen saturation? 91 percent 98 percent 102 percent 95 percent
98 percent
A 12-year-old male jumped approximately 12′ from a tree and landed on his feet. He complains of pain to his lower back. What injury mechanism is MOST likely responsible for his back pain? A. Energy transmission to the spine B. Secondary fall after the initial impact C. Direct trauma to the spinal column D. Lateral impact to the spine
A
A 22-year-old male was kicked in the abdomen multiple times during an attack by a gang. He is conscious but restless and his pulse is rapid. Your assessment reveals a large area of bruising to the right upper quadrant of his abdomen. The MOST appropriate treatment for this patient includes: A. preparing for immediate transport. B. applying oxygen via nasal cannula. C. performing a focused physical exam. D. a detailed assessment of his abdomen.
A
A 30-year-old woman with a history of alcoholism presents with severe upper abdominal pain and is vomiting large amounts of bright red blood. Her skin is cool, pale, and clammy; her heart rate is 120 beats/min and weak; and her blood pressure is 70/50 mm Hg. Your MOST immediate action should be to: A. protect her airway from aspiration. B. keep her supine and elevate her legs. C. rapidly transport her to the hospital. D. give her high-flow supplemental oxygen.
A
A 70-year-old man is experiencing a severe nosebleed. When you arrive, you find him leaning over a basin, which contains an impressive amount of blood. He has a history of coronary artery disease, diabetes, and migraine headaches. His BP is 180/100 and his heart rate is 100 beats/min. Which of the following is the MOST likely contributing factor to his nosebleed? A. His blood pressure B. His history of diabetes C. The fact that he is elderly D. His heart rate of 100 beats/min
A
A comprehensive regional resource capable of providing every aspect of trauma care from prevention through rehabilitation is the definition of a _____ trauma center. A. Level I B Level II C. Level III D. Level IV
A
If bleeding continues after applying a pressure dressing should do all the following except A. Remove the dressing apply another sterile dressing B. Apply manual pressure through the dressing C. Add more gauze pads over the first dressing D. Secure both dressings tighter with a roller bandage
A
In a motor vehicle collision, as the passenger's head hits the windshield, the brain continues to move forward until it strikes the inside of the skull, resulting in a _____ injury. A. compression B. laceration C. lateral D. motion
A
In nontrauma patients, an early indicator of internal bleeding is: A. dizziness upon standing. B. a rapid, thready pulse. C. a decreasing blood pressure. D. rapid, shallow breathing.
A
In which of the following situations would external bleeding be the MOST difficult to control? A. femoral artery laceration and a blood pressure of 140/90 mm Hg B. jugular vein laceration and a systolic blood pressure of 90 mm Hg C. carotid artery laceration and a systolic blood pressure of 60 mm Hg D. antecubital vein laceration and a blood pressure of 138/92 mm Hg
A
Most patients with abdominal pain prefer to: A. lie on their side with their knees drawn into the abdomen. B. sit in a semi-Fowler position with their knees slightly bent. C. lie in a supine position with their knees in a flexed position. D. sit fully upright because it helps relax the abdominal muscles.
A
Pain that may be perceived at a distant point on the surface of the body, such as the back or shoulder, is called: A. referred pain. B. radiating pain. C. visceral pain. D. remote pain.
A
Severe back pain may be associated with which of the following conditions? A. Abdominal aortic aneurysm B. PID C. Appendicitis D. Mittelschmerz
A
Significant clues to the possibility of severe injuries in motor vehicle collisions include: A. death of a passenger B. a blown out tires C. broken glass D. a deployed air bag
A
The MOST common and significant complication associated with an acute abdomen is: A. peritonitis. B. high fever. C. severe pain. D. internal bleeding.
A
The energy of a moving object is called: A. kinetic energy. B. converted energy. C. potential energy. D. latent energy.
A
The only arteries of the body that carry deoxygenated blood are the A. Pulmonary arteries B. Coronary arteries C. Femoral arteries D. Subclavian arteries
A
The severity of bleeding should be based on all of the following findings, EXCEPT: A. systolic blood pressure. B. poor general appearance. C. the mechanism of injury. D. clinical signs and symptoms.
A
The systemic veins function by: A. returning deoxygenated blood back to the heart. B. delivering oxygen-poor blood to the capillaries. C. returning oxygen-rich blood back to the left atrium. D. delivering deoxygenated blood to the capillaries.
A
What is the approximate blood volume of a 75-kg adult? A. 5.25 L B. 5.50 L C. 6.25 L D. 6.50 L
A
When applying a bandage to hold a dressing in place, stretch the bandage tight enough to control the bleeding but not so tight as to decrease _____ to the extremity. A. blood flow B. pulses C. oxygen D. CRTs
A
When assessing a patient with abdominal pain, you should: A. palpate the abdomen in a clockwise direction beginning with the quadrant after the one the patient indicates is painful. B. ask the patient to point to the area of pain or tenderness and assess for rebound tenderness over that specific area. C. visually assess the painful area of the abdomen, but avoid palpation because this could worsen his or her condition. D. observe for abdominal guarding, which is characterized by sudden relaxation of the abdominal muscles when palpated.
A
When assessing an elderly patient who fell, it is important to remember that: A. osteoporosis can cause a fracture that may have resulted in the fall. B. elderly patients who fall usually have a secondary head injury. C. bilateral hip fractures usually occur when an elderly person falls. D. any fall in the elderly is considered to be high-energy trauma
A
When caring for an occupant inside a motor vehicle equipped with an air bag that did not deploy upon impact, it is MOST important to: A. remember that it could still deploy and seriously injure you. B. suspect that the patient may have experienced serious injuries. C. realize that the air bag malfunctioned at the time of impact. D. recognize that the force of impact was most likely not severe.
A
When the abdominal muscles become rigid in an effort to protect the abdomen from further irritation, this is referred to as: A. guarding D. tenderness C. rebound tenderness D. referred pain
A
When the speed of a motor vehicle doubles, the amount of kinetic energy: A. quadruples. B. triples. C. doubles. D. is not affected.
A
Which of the following conditions is more common in women than in men? A. cystitis B. hepatitis C. pancreatitis D. cholecystitis
A
Which of the following findings would be LEAST suggestive of the presence of high-energy trauma? A. Deployment of the air bag B. Steering wheel deformity C. Intrusion into the vehicle D. Dismounted seats
A
Which of the following interventions is the MOST critical to the outcome of a patient with multisystem trauma? A. Rapid transport to a trauma center B. Elevation of the lower extremities C. Intravenous fluid administration D. Early administration of oxygen
A
Which of the following organs would MOST likely bleed profusely if injured? A. liver B. stomach C. appendix D. gallbladder
A
Which of the following sets of vital signs is LEAST indicative of internal bleeding? A. BP, 140/90 mm Hg; pulse rate, 58 beats/min; respirations, 8 breaths/min B. BP, 100/50 mm Hg; pulse rate, 120 beats/min; respirations, 24 breaths/min C. BP, 98/60 mm Hg; pulse rate, 110 beats/min; respirations, 28 breaths/min D. BP, 102/48 mm Hg; pulse rate, 100 beats/min; respirations, 22 breaths/min
A
Which of the following splinting devices would be MOST appropriate to use for a patient who has an open fracture of the forearm with external bleeding? A. air splint B. vacuum splint C. sling and swathe D. cardboard splint
A
Whiplash injuries are MOST common following _________ impacts. A. rear-end B. rollover C. frontal D. lateral
A
You have been dispatched to the home of a 52-year-old woman with severe flank pain. In addition to the patient's presentation, which of the following would NOT be an additional expected sign or symptom? A. Diarrhea B. Hematuria C. Nausea D. Vomiting
A
You have been dispatched to the home of a 52-year-old woman with severe flank pain. You should transport her: A. in a position of comfort. B. supine. C. left lateral recumbent. D. in the recovery position.
A
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 high-flow 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: A. leave him in a sitting position, keep him warm, and prepare for immediate transport. B. place him in a supine position, elevate his lower extremities, and transport at once. C. treat for shock and request a paramedic unit to respond to the scene and assist you. D. perform a detailed secondary assessment and then transport him to a dialysis center.
A
_______ is inadequate tissue perfusion A. Shock B. Hyperperfusion C. Hypertension D. Contraction
A
_______ shock is a condition in which low blood volume results in inadequate perfusion or even death A. Hypovolemic B. Metabolic C. Septic D. Psychogenic
A
Upon assessment of your patient, you notice that he has cool, sweaty skin. This finding is best described as which of the following? A diagnosis A sign A complaint A symptom
A sign
aneurysm
A swelling or enlargement of a part of an artery, resulting from weakening of the arterial wall.
Intrapulmonary shunting occurs when: A) blood coming from the right side of the heart bypasses nonfunctional alveoli and returns to the left side of the heart in an unoxygenated state. B) a decrease in respiratory rate and depth causes carbon dioxide accumulation in the alveoli and an overall decrease in blood oxygen levels. C) any impairment in circulatory function causes a reduced ability for oxygen and carbon dioxide to diffuse across the alveolar-capillary membrane. D) the presence of pulmonary surfactant causes a decrease in alveolar surface tension, thus impairing the exchange of gases in the lungs.
A) blood coming from the right side of the heart bypasses nonfunctional alveoli and returns to the left side of the heart in an unoxygenated state.
When perfusion to the core of the body decreases: A) blood is shunted away from the skin. B) the voluntary nervous system releases hormones. C) decreased cardiac contractility occurs. D) blood is diverted to the gastrointestinal tract.
A) blood is shunted away from the skin.
Which of the following statements regarding methicillin-resistant Staphylococcus aureus (MRSA) is correct?
A)Most cases of MRSA transmission occur following an accidental needlestick. CORRECT B)MRSA is a bacterium that causes infections and is resistant to most antibiotics. C)The communicable period for MRSA is 10 days to 2 weeks after being infected. D)Studies have shown that less than 1% of health care providers are MRSA carriers.
Early signs and symptoms of viral hepatitis include all of the following, EXCEPT:
A)loss of appetite and a cough. B)vomiting, fever, and fatigue. C)pain in the muscles and joints. CORRECT D)jaundice and abdominal pain.
Which of the following statements regarding the hypoxic drive is MOST correct? A. The hypoxic drive stimulates a person to breathe on the basis of low oxygen levels. B. Chronic carbon dioxide elimination often results in activation of the hypoxic drive. C. The hypoxic drive serves as the primary stimulus for breathing in healthy individuals. D. 100% supplemental oxygen will always cause apnea in patients with a hypoxic drive.
A. The hypoxic drive stimulates a person to breathe on the basis of low oxygen levels.
Hyperventilation could be associated with all of the following, EXCEPT: A. a narcotic overdose. B. a respiratory infection. C. an overdose of aspirin. D. high blood glucose levels.
A. a narcotic overdose.
In what area of the lungs does respiration occur? A. alveoli B. trachea C. bronchi D. capillaries
A. alveoli
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: A. assist her ventilations with a bag-mask device. B. apply a pulse oximeter and obtain vital signs. C. administer oxygen via a nonrebreathing mask. D. obtain a complete list of all of her medications.
A. assist her ventilations with a bag-mask device.
Alkalosis is a condition that occurs when: A. blood acidity is reduced by excessive breathing. B. dangerous acids accumulate in the bloodstream. C. the level of carbon dioxide in the blood increases. D. slow, shallow breathing eliminates too much carbon dioxide.
A. blood acidity is reduced by excessive breathing.
Weakening of the airway in patients with chronic bronchitis is the result of: A. destruction of protective mechanisms that remove foreign particles. B. loss of the lubricating substance that facilitates alveolar expansion. C. airway irritation caused by a marked decrease in mucus production. D. acute constriction of the bronchioles caused by an external irritant.
A. destruction of protective mechanisms that remove foreign particles.
Asthma is caused by a response of the: A. immune system. B. endocrine system. C. respiratory system. D. cardiovascular system.
A. immune system.
You are assisting an asthma patient with his prescribed metered-dose inhaler. After the patient takes a deep breath and depresses the inhaler, you should: A. instruct him to hold his breath for as long as he comfortably can. B. immediately reapply the oxygen mask and reassess his condition. C. advise him to exhale forcefully to ensure medication absorption. D. allow him to breathe room air and assess his oxygen saturation.
A. instruct him to hold his breath for as long as he comfortably can.
Dyspnea is MOST accurately defined as: A. shortness of breath or difficulty breathing. B. a complete cessation of respiratory effort. C. a marked increase in the exhalation phase. D.labored breathing with reduced tidal volume.
A. shortness of breath or difficulty breathing.
Head injury indicators
ALOC, Acute iindicator of neurological damage and should be looked at close.
AMI v Angina
AMI - Not always due to exertion -Last 30 min to several hours -not always relieved by rest or nitro
A 37-year-old male is having a severe allergic reaction to penicillin. He does not have an epinephrine auto-injector and your protocols do not allow you to carry epinephrine on the ambulance. How should you proceed with the treatment of this patient?
Administer oxygen, transport at once, and request a paramedic intercept.
A 37-year-old male is having a severe allergic reaction to penicillin. He does not have an epinephrine auto-injector and your protocols do not allow you to carry epinephrine on the ambulance. How should you proceed with the treatment of this patient? a) Remain at the scene with the patient and request a paramedic ambulance. b) Quickly determine if there are any bystanders who may carry epinephrine. c) Administer oxygen, transport at once, and request a paramedic intercept. d) Ask the patient if he has any diphenhydramine (Benadryl) tablets that you can administer.
Administer oxygen, transport at once, and request a paramedic intercept.
Neurogenic Shock
Affects vasomotor center. Damage to cervical spine may affect the size and muscular tone. 2 tone skin.
An inaccurate oxygen saturation reading can result in all of the following EXCEPT: Carbon monoxide inhalation. A patient that smokes cigarettes. A patient wearing fingernail polish. All of the above
All of the above
The main advantage of the AED is: it provides quick delivery of a shock. it is easier than performing CPR. there is no need for ALS providers to be on scene. All of the above.
All of the above.
What is an open fracture?
Also known as a Compound fracture is an external wound associated with fracture.
What is an acclusive dressing?
An air tight dressing.
anaphylaxis
An unusual or exaggerated allergic reaction to foreign protein or other substances.
Injections, Stings, ingestion and inhalation of a substance or substances are assos. w/ what type of shock?
Anaphylactic Shock
Kinetic energy is a calculation of: A. weight and size. B. weight and speed. C. mass and weight. D. speed and force.
B
You are transporting a patient to the hospital from a motor vehicle crash. Your patient's initial blood pressure was 88/52. You should reassess blood pressure: At least every 5 minutes. At least every 15 minutes. Only if the pulse rate changes. Only if the patient gets worse.
At least every 5 minutes.
Where do baseline vital signs fit into the sequence of patient assessment? Ongoing assessment At primary assessment At secondary assessment At the patient's side
At secondary assessment
You are unable to find a radial pulse on a patient from a motor vehicle crash. You should: Listen for heart sounds Begin chest compressions. Attempt to find the carotid pulse Apply the pulse oximeter.
Attempt to find the carotid pulse
Which of the following methods should the EMT attempt first when transporting a patient to the hospital? Palpation Auscultation Blood pressure monitor Any of the above
Auscultation
The method of taking blood pressure by using a stethoscope to listen to the characteristic sounds produced is called: Auscultation. Articulation. Palpation. Pulsation.
Auscultation.
In the presence of ileus, the only way the stomach can empty itself is by: A. diarrhea. B. vomiting. C. muscular contraction. D. spontaneous rupture.
B
A 35-year-old mildly 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: A. acute cystitis. B. acute cholecystitis. C. appendicitis. D. pancreatitis.
B
A 39-year-old male accidentally cut his wrist while sharpening his hunting knife. He is conscious and alert with adequate breathing, but is bleeding significantly from the wound. You should: A. ensure the patient has a patent airway. B. control the bleeding with direct pressure. C. apply oxygen with a nonrebreathing mask. D. apply a tourniquet proximal to the wound.
B
A 40-year-old unrestrained female impacted the steering wheel of her vehicle with her chest when she hit a tree while traveling at 45 mph. She is conscious and alert, but is experiencing significant chest pain and shortness of breath. Which of the following injuries did this patient likely NOT experience? A. Cardiac contusion B. Head injury C. Multiple rib fractures D. Pulmonary contusion
B
A 43-year-old man is experiencing a severe nosebleed. His blood pressure is 190/110 mm Hg and his heart rate is 90 beats/min and bounding. Appropriate treatment for this patient includes: A. having the patient pinch his own nostrils and then lie supine. B. pinching the patient's nostrils and having him lean forward. C. placing a rolled 4″ × 4″ dressing between his lower lip and gum. D. packing both nostrils with gauze pads until the bleeding stops.
B
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: A. transport him in a supine position. B. be alert for signs and symptoms of shock. C. assess his blood pressure to determine perfusion adequacy. D. determine the exact location and cause of his pain.
B
A 59-year-old male presents with a sudden onset of severe lower back pain. He is conscious and alert, but very restless and diaphoretic. Your assessment reveals a pulsating mass to the left of his umbilicus. You should: A. vigorously palpate the abdomen to establish pain severity. B. administer oxygen and prepare for immediate transport. C. place the patient in a sitting position and transport at once. D. request a paramedic unit to give the patient pain medication.
B
A contusion to a patient's forehead along with a spider-webbed windshield suggests possible injury to the: A. nose B. brain C. face D. heart
B
A driver involved in a rollover motor vehicle crash will MOST likely experience serious injuries or death if he or she: A. experiences multiple impacts. B. is ejected or partially ejected. C. remains within the vehicle. D. is wearing only a lap belt.
B
A fall from more than _____ times the patient's height is considered to be significant. A. two B. three C. four D. five
B
A lack of one or more of the blood clotting factors is called A. A deficiency B. Hemophilia C. Platelet anomaly D. Anemia
B
A patient complains of heartburn, pain with swallowing, and feeling like an object is stuck in the throat. Which of the following is MOST likely cause? A. esophageal varices B. esophagitis C. peptic ulcer D. gastroenteritis
B
A patient present with lower quadrant abdominal pain, tenderness above the pubic bone, and frequent urination with urgency. What is the MOST likely underlying condition? A. Cholecystitis B. Cystitis C. Gastroenteritis D. Diverticulitis
B
A patient who presents with vomiting, sign of shock, and history of eating disorder and alcohol abuse is likely to be suffering from: A. diverticulitis B. Mallory-Weiss Syndrome C. appendicitis D. cholecytitis
B
A young boy was riding his bicycle down the street when he hit a parked car. What was the second collision? A. The bike hitting the car. B. The bike rider hitting his bike or the car. C. The bike rider's internal organs against the solid structures of the body. D. The bike rider striking the pavement.
B
A young female presents with costovertebral angle tenderness. She is conscious and alert with stable vital signs. Which of the following organs is MOST likely causing her pain? A. liver B. kidney C. pancreas D. gallbladder
B
A young male experienced severe blunt chest trauma when his passenger car struck another vehicle head-on. During your inspection of the interior of his vehicle, you would MOST likely find: A. deployed airbags. B. steering wheel deformity. C. starring of the windshield. D. a crushed instrument panel.
B
Air bags decrease injury to all of the following EXCEPT: A. chest B. heart C. face D. head
B
An infant with a total blood volume of 800 mL would start showing signs of shock when as little as ______ of blood is lost. A. 50 mL B. 100 mL C. 150 mL D. 200 mL
B
An organ or tissue may be better able to resist damage from hypoperfusion if the: A. body's demand for oxygen is markedly increased. B. body's temperature is considerably less than 98.6°F (37.0°C). C. systolic arterial blood pressure is at least 60 mm Hg. D. heart rate is maintained at more than 100 beats/min.
B
An organ or tissue that is considerably _______ is much better able to resist damage from hypoperfusion A. warmer B. colder C. younger D. older
B
Blood enters the left atrium from the A. Coronary arteries B. Lungs C. Vena cava D. Coronary veins
B
By what mechanism is a person injured when he or she falls from a significant height? A. Potential energy is created as the person is falling; the potential energy is then converted into kinetic energy upon impact. B. Potential energy is converted to kinetic energy; the kinetic energy is then converted into the work of bringing the body to a stop. C. As the person falls, the amount of kinetic energy is converted into work; work is then converted to kinetic energy upon impact. D. Kinetic energy is converted to potential energy; the potential energy is then converted into the work of bringing the body to a stop.
B
Controlling internal bleeding requires: A. applying a tourniquet. B. surgery in a hospital. C. positioning the patient in the sitting position. D. providing slow and considerate transport.
B
During transport of a 40-year-old female with acute abdominal pain, you note that she has stopped talking to you and has become extremely diaphoretic. You should: A. assess the quality of her pulse. B. repeat the primary assessment. C. perform a secondary assessment. D. begin assisting her ventilations.
B
During your assessment of a patient with a head injury, you note that he opens his eyes when you pinch his trapezius muscle, is mumbling, and has his arms curled in toward his chest. You should assign him a GCS score of: A. 9. B. 7. C. 8. D. 10.
B
Early signs and symptoms of intra-abdominal bleeding include: A. bruising only. B. pain and distention. C. widespread ecchymosis. D. significant hypotension.
B
Erosion of the protective layer of the stomach or duodenum secondary to overactivity of digestive juices results in: A. ileus. B. an ulcer. C. appendicitis. D. cholecystitis.
B
Factors that should be considered when assessing a patient who has fallen include all of the following, EXCEPT: A. the height of the fall. B. the speed of the fall. C. the surface struck. D. the primary impact point.
B
Following blunt trauma to the abdomen, a 21-year-old female complains of left upper quadrant abdominal pain with referred pain to the left shoulder. Your assessment reveals that her abdomen is distended and tender to palpation. On the basis of these findings, you should be MOST suspicious of injury to the: A. liver. B. spleen. C. pancreas. D. gallbladder.
B
Functions of the liver include: A. storage of bile, which is produced in the gallbladder. B. production of substances necessary for blood clotting. C. production of hormones that regulate blood sugar levels. D. release of amylase, which breaks down starches into sugar.
B
Hypovolemic shock occurs when: A. the clotting ability of the blood is enhanced. B. the body cannot compensate for rapid blood loss. C. the patient's systolic blood pressure is less than 100 mm Hg. D. at least 10% of the patient's blood volume is lost.
B
If the typical adult loses more than 1L of blood, significant changes in vital signs, such as _____ will occur A. Decreased heart rate B. Increased respiratory rate C. Increased blood pressure D. All of the above
B
In older patients, the first indicator of nontraumatic internal bleeding may be: A. a low blood pressure. B. weakness or dizziness. C. a heart rate over 120 beats/min. D. diaphoresis and pale skin.
B
Whether you are using a commercial device or a stick and triangular bandage as a tourniquet, it is important to remember that: A. you should try to control the bleeding by applying pressure to a proximal arterial pressure point first. B. the tourniquet should only be removed at the hospital because bleeding may return if the tourniquet is released. C. bulky dressings should be securely applied over the tourniquet to further assist in controlling the bleeding. D. the tourniquet should be applied directly over a joint if possible because this provides better bleeding control.
B
Which of the following is NOT a component of the cardiovascular system? A. Heart B. Lungs C. Venules D. Plasma
B
Which of the following is considered a type of impact from a motor vehicle collision? A. Ejection B. Rollover C. Crush D. Peneration
B
Which of the following is not considered a type of impact associated with a motorcycle crash? A. Head-on B. Rotational C. Controlled D. Ejection
B
Which of the following statements regarding gastrointestinal bleeding is correct? A. In the majority of cases, bleeding within the gastrointestinal tract occurs acutely and is severe. B. Bleeding within the gastrointestinal tract is a symptom of another disease, not a disease itself. C. Lower gastrointestinal bleeding results from conditions such as Mallory-Weiss syndrome. D. Chronic bleeding within the gastrointestinal tract is usually more severe than bleeding that occurs acutely.
B
Which of the following statements regarding hemophilia is correct? A. Hemophilia is defined as a total lack of platelets. B. Patients with hemophilia may bleed spontaneously. C. Hemophiliacs take aspirin to enhance blood clotting. D. Approximately 25% of the population has hemophilia.
B
With regard to the three collisions that occur during a motor vehicle crash, which of the following statements regarding the first collision is correct? A. It provides the least amount of information about the mechanism of injury. B. It is the most dramatic part of the collision and may make extrication difficult. C. It occurs when the unrestrained occupant collides with the interior of the vehicle. D. It has a direct effect on patient care because of the obvious vehicular damage.
B
You are dispatched to a store in the downtown mall for an arm injury. When you arrive, you are directed to a small stock room where you find a teenaged girl holding a blood-soaked cloth tightly onto her left forearm. You notice blood droplets high up the wall and on the floor several feet from where she is sitting. "I was opening a shipment with a box-cutter," she says, her skin noticeable pale. "And it slipped and cut my arm." What type of bleeding should you anticipate? A. You should suspect heavy venous bleeding. B. She most likely has arterial bleed. C. Internal bleeding is probably causing her skin to appear pale. D. Very sharp blades usually only cause capillary bleeding.
B
You arrive at the home of a 50-year-old female with severe epistaxis. As you are treating her, it is MOST important to recall that: A. the patient may be significantly hypertensive. B. the patient is at risk for vomiting and aspiration. C. a detailed exam is needed to determine the cause. D. many medications interfere with blood clotting.
B
You respond to a 33-year-old man who was hit in the ear by a line drive during a softball game. He is complaining of a severe headache, ringing in the ears, and dizziness. He has blood draining from his ear. Why would you not apply pressure to control bleeding? A. It should be collected to be re-infused at the hospital. B. It could collect within the head and increase the pressure on the brain. C. It is contaminated. D. You could fracture the skull with the pressure needed to staunch the flow of blood.
B
You should consider bleeding to be serious if all of the following conditions are present except A. Blood loss is rapid B. There is no mechanism of injury C. The patient has a poor general appearance D. Assessment reveals signs and symptoms of shock
B
Your awareness and concern for potentially serious obvious and underlying injuries is referred to as the: A. mechanism of injury. B. index of suspicion. C. scene size-up. D. general impression.
B
Which of the following statements regarding anaphylaxis is correct? A. Patients with asthma are at lower risk of developing anaphylaxis. B. Anaphylaxis is characterized by airway swelling and hypotension. C. Most anaphylactic reactions occur within 60 minutes after exposure. D. The signs of anaphylaxis are caused by widespread vasoconstriction.
B. Anaphylaxis is characterized by airway swelling and hypotension.
When auscultating the lungs of a patient with respiratory distress, you hear adventitious sounds. This means that the patient has: A. normal breath sounds. B. abnormal breath sounds. C. diminished breath sounds. D. an absence of breath sounds.
B. abnormal breath sounds.
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: A. an obstructed airway. B. adequate air exchange. C. respiratory difficulty. D. respiratory insufficiency.
B. adequate air exchange.
When administering supplemental oxygen to a hypoxemic patient with a chronic lung disease, you should: A. recall that most patients with chronic lung diseases are stimulated to breathe by increased carbon dioxide levels. B. adjust the flow rate accordingly until you see symptom improvement, but be prepared to assist his or her ventilations. C. begin with a low oxygen flow rate, even if the patient is unresponsive, because high-flow oxygen may depress his or her breathing. D. avoid positive-pressure ventilation because the majority of patients with chronic lung disease are at increased risk for lung trauma.
B. adjust the flow rate accordingly until you see symptom improvement, but be prepared to assist his or her ventilations.
A 62-year-old man with a history of congestive heart failure presents with severe respiratory distress and an oxygen saturation of 82%. When you auscultate his lungs, you hear widespread rales. He is conscious and alert, is able to follow simple commands, and can only speak in two- to three-word sentences at a time. You should: A. place him in a position of comfort, deliver oxygen via nasal cannula, and closely monitor his breathing. B. apply a continuous positive airway pressure (CPAP) device, monitor his blood pressure, and observe him for signs of improvement or deterioration. C. force fluid from his alveoli by hyperventilating him with a bag-mask device at a rate of at least 20 breaths/min. D. place him in a supine position and assist his ventilations with a bag-mask device and high-flow oxygen.
B. apply a continuous positive airway pressure (CPAP) device, monitor his blood pressure, and observe him for signs of improvement or deterioration.
The respiratory distress that accompanies emphysema is caused by: A. repeated exposure to cigarette smoke. B. chronic stretching of the alveolar walls. C. massive constriction of the bronchioles. D. acute fluid accumulation in the alveoli.
B. chronic stretching of the alveolar walls.
A young female is unconscious after intentionally ingesting a large amount of aspirin. You will MOST likely find her respirations: A. slow and deep. B. deep and rapid. C. slow and shallow. D. rapid and shallow.
B. deep and rapid.
A 30-year-old male presents with acute shortness of breath, widespread hives, and facial swelling. He denies any past medical history and takes no medications. During your assessment, you hear wheezing over all lung fields. His blood pressure is 90/50 mm Hg and his heart rate is 110 beats/min. In addition to giving him 100% oxygen, the MOST important treatment for this patient is: A. albuterol. B. epinephrine. C. an antihistamine. D. a beta-antagonist.
B. epinephrine.
What are thermal burns?
Burns caused by heat.
The two processes that occur during respiration are: A. ventilation and diffusion. B. inspiration and expiration. C. diffusion and oxygenation. D. oxygenation and ventilation.
B. inspiration and expiration.
A 60-year-old male presents with acute respiratory distress. He is conscious and alert, has pink and dry skin, and has respirations of 24 breaths/min with adequate depth. Which of the following treatment modalities is MOST appropriate for this patient? A. assisted ventilation with a bag-mask device and a head-to-toe exam B. oxygen via nonrebreathing mask and a focused secondary assessment C. positive-pressure ventilations and immediate transport to the closest hospital D. oxygen via a nasal cannula, vital signs, and prompt transport to the hospital
B. oxygen via nonrebreathing mask and a focused secondary assessment
A 22-year-old female patient is complaining of dyspnea and numbness and tingling in her hands and feet after an argument with her fiancé. Her respirations are 40 breaths/min. You should: A. have her breathe into a paper or plastic bag. B. provide reassurance and give oxygen as needed. C. request a paramedic to give her a sedative drug. D. position her on her left side and transport at once.
B. provide reassurance and give oxygen as needed.
When the level of arterial carbon dioxide rises above normal: A. the brain stem inhibits respirations. B. respirations increase in rate and depth. C. exhalation lasts longer than inhalation. D. respirations decrease in rate and depth.
B. respirations increase in rate and depth.
Which of the following conditions would LEAST likely result in hypoxia? A. pleural effusion B. severe anxiety C. pulmonary edema D. prolonged seizures
B. severe anxiety
Harsh, high-pitched inspiratory sounds are characteristic of: A. rales. B. stridor. C. rhonchi. D. wheezing.
B. stridor.
Signs and Symptoms of Neurogenic Shock
BRADYCARDIA Low BP SIGNS OF NECK INJURY
The first set of vital sign measurements obtained are often referred to as which of the following? Baseline vital signs Normal vital signs Standard vital signs None of the above
Baseline vital signs
Why do sickle cell patients have a tolerance to opiates
Because it's so painful they take drugs for it which leads to a tolerance
When should you check vitals in a hypoglycemic patient
Before and after you administer oral glucose
HOw do you treat a patient with a Flail Chest?
Big bulky trauma dressing and tapedown.
What happens in the Decompensated stage of shock?
Blood Pressure is below 90 Systolic
Vaso-occlusive crisis
Blood flow to organs is restrcted
S/s of Hypoglycemia and Definition
Blood glucose is below normal BGL Below 80 Thirst=IAbsent Hunger=Intense Vomitting=uncommon Breathing=Normal or rapid Breath=Normal Blood pressure=Normal to low Pulse=Weak and rapid Irritability, confusion, seizure, or coma; unsteady gait Response to treatment is immidieate.
S/S of Hyperglycemia and Definition
Blood glucose is higher than normal BGL Above 120 Thirst=Intense Hunger=Absent Vomitting=Common Breathing=Kusmaul (rapid and deep) Breath=Sweet/Fruity Blood pressure=normal to low Pulse=Weak, rapid and thready restlessness, possibly progressing to coma; abnormal or slurred speech;unsteady gait. Response to treatment is gradual withing 6-12 hours
Hyperglycemic crisis (Diabetic Coma)
Blood glucose is too high A state of unconsciousness resulting from several problems, including ketoacidosis, hyperglycemia and dehydration resulting from excessive urination A lot more critical. If untreated can result in death. You have to bring it down slowly. If you drop it down to fast it could result in severe brain swelling Needs ALS
What kills brain tissue?
Blood on brain tissue.
Subcutaneous Emphysema
Blood rising to top of skin. (Rice Crispies)
The term cyanosis is used when the patient's skin color is noted to be which of the following characteristics? Yellow Blue-gray Very pale Flushed
Blue-gray
cyanosis
Bluish color of the skin resulting from poor oxygenation of the circulating blood.
What happens in the Compensated stage of shock?
Body fights, goes into fight or flight mode.
20-year-old man has major open facial injuries after his vehicle struck a tree head-on. Which of the following findings within the car would MOST likely explain his injury pattern? A. Deployed airbag B. Bent steering wheel C. Nonintact windshield D. Crushed instrument panel
C
A 15-year-old female was struck by a small car while riding her bicycle. She was wearing a helmet and was thrown to the ground, striking her head. In addition to managing problems associated with airway, breathing, and circulation, it is MOST important for you to: A. obtain baseline vital signs. B. inspect the helmet for cracks. C. stabilize her entire spine. D. leave her bicycle helmet on.
C
A 30-year-old male sustained a stab wound to the neck when he was attacked outside a nightclub. During your assessment, you should be MOST alert for: A. alterations in his mental status. B. damage to internal structures. C. potential airway compromise. D. injury to the cervical spine.
C
A 39-year-old male sustained a large laceration to his leg during an accident with a chainsaw and is experiencing signs and symptoms of shock. You should: A. apply direct pressure to the wound. B. place the patient on 100% oxygen. C. follow appropriate standard precautions. D. perform a rapid head-to-toe assessment.
C
A fractured femur can result in the loss of ______ or more of blood into the soft tissues of the thigh. A. 250 mL B. 500 mL C. 1 L D. 2 L
C
A small compact car was involved in a rollover crash. As you are approaching the vehicle, you note that the roof is significantly collapsed. The patient, a 29-year-old male, is complaining of severe pain in his neck and to the top of his head as well as numbness and tingling in his extremities. Witnesses who removed the patient from the vehicle state that he was wearing his seatbelt. What injury mechanism is MOST likely responsible for this patient's condition? A. Impact of the head against the steering wheel B. Whiplash injury to the neck during the rollover C. Compression of the head against the roof D. Lateral bending of the neck during the crash
C
A young boy was riding his bicycle down the street when he hit a parked car. How many collisions took place? A. 1 B. 2 C. 3 D. 4
C
A young male sustained a gunshot wound to the abdomen during an altercation with a rival gang member. As your partner is assessing and managing his airway, you should control the obvious bleeding and then: A. auscultate bowel sounds. B. apply a cervical collar. C. assess for an exit wound. D. obtain baseline vital signs.
C
As red blood cells begin to clump together to form a clot, __________ reinforces the clumped red blood cells. A. fibrin B. plasma C. fibrinogen D. plasminogen
C
Blood contains all of the following except A. White blood cells B. Plasma C. Cerebrospinal fluid D. Platelets
C
Blood enters the right atrium from the A. Coronary arteries B. Lungs C. Vena cava D. Coronary veins
C
Blood leaves each chamber of a normal heart through a A. Vein B. Artery C. One way valve D. Capillary
C
Bowel inflammation, diverticulitis, and hemorrhoids are common causes of bleeding in the: A. upper GI tract B. middle GI tract C. lower GI tract D. all of the above
C
Chronic renal failure is a condition that: A. can be reversed with prompt treatment. B. occurs from conditions such as dehydration. C. is often caused by hypertension or diabetes. D. causes dehydration from excessive urination.
C
Energy can be: A. created. B. destroyed. C. converted. D. all of the above.
C
Hypoperfusion is another name for: A. hypoxemia. B. cyanosis. C. shock. D. cellular death.
C
If direct pressure with a sterile dressing fails to immediately stop severe bleeding from an extremity, you should apply: A. additional sterile dressings. B. a splint and elevate the extremity. C. a tourniquet proximal to the injury. D. digital pressure to a proximal artery.
C
What are superficial burns?
First-degree; involve only the top layer of skin, the epidermis (sun burn)
Internal injuries caused by gunshot wounds are difficult to predict because: A. the area of damage is usually smaller than the bullet. B. the caliber of the bullet is frequently unknown. C. the bullet may tumble or ricochet within the body. D. exit wounds caused by the bullet are usually small.
C
Medium-velocity penetrating injuries may be caused by a: A. knife. B. military assault rifle. C. handgun. D. sling-shot.
C
Pain that initially starts in the umbilical area and then later moves to the lower right quadrant is typically associated with: A. gastroenteritis B. pancreaitis C. appendicitis D. diverticulitis
C
Passengers who are seated in the rear of a vehicle and are wearing only lap belts have a higher incidence of injuries to the: A. lumbar and coccygeal spine. B. thoracic and sacral spine. C. thoracic and lumbar spine. D. lumbar and sacral spine.
C
Patients suffering from an open wound to the neck may suffer from all of the following EXCEPT: A. significant bleeding. B. air embolism. C. tension pneumothorax. D. subcutaneous crepitation.
C
Patients with acute abdominal pain should not be given anything to eat or drink because: A. it will create referred pain and obscure the diagnosis. B. food will rapidly travel through the digestive system. C. substances in the stomach increase the risk of aspiration. D. digestion prevents accurate auscultation of bowel sounds.
C
Perfusion is MOST accurately defined as: A. the removal of adequate amounts of carbon dioxide during exhalation. B. the intake of adequate amounts of oxygen during the inhalation phase. C. circulation of blood within an organ with sufficient amounts of oxygen. D. the production of carbon dioxide, which accumulates at the cellular level.
C
Pregnancy, straining at stool, and chronic constipation cause increased pressure that could result in: A. Mallory-Weiss Syndrome B. Diverticulitis C. Hemorrhoids D. Gallstones
C
Severe abrasion injuries can occur when motorcycle riders are slowed after a collision by road drag. Road drag is most often associated with which type of motorcycle impact? A. Head-on collision B. Angular collision C. Ejection D. Controlled crash
C
Significant blood loss demands your immediate attention as soon as the _______ has been managed A. Fracture B. Extraction C. Airway D. None of the above
C
The MOST important treatment for a patient with severe abdominal pain and signs of shock includes: A. administering high-flow oxygen. B. giving oral fluids to maintain perfusion. C. transporting the patient without delay. D. positioning the patient on his or her side.
C
The _______ only requires a minimal blood supply when at rest A. Lungs B. Kidneys C. Muscles D. Heart
C
The energy of a moving object is called: A. potential energy. B. thermal energy. C. kinetic energy. D. work.
C
The first sign of hypovolemic shock is change in A. Respiration B. Heart rate C. Mental status D. Blood pressure
C
The kidneys help to regulate blood pressure by: A. retaining key electrolytes, such as potassium. B. eliminating toxic waste products from the body. C. removing sodium, and thus water, from the body. D. accommodating a large amount of blood volume.
C
The most common life-threatening event in a rollover is ____ or partial ejection of the passenger from the vehicle. A. vehicle intrusion B. centrifugal force C. ejection D. spinal cord injury
C
The parietal peritoneum lines the: A. retroperitoneal space. B. lungs and chest cavity. C. walls of the abdominal cavity. D. surface of the abdominal organs.
C
The phenomenon of pressure waves emanating from the bullet, causing damage remote from its path, is known as: A. conversion. B. congruent. C. cavitation. D. capitation.
C
The process of blood clotting and plugging the hole is called A. Conglomeration B. Configuration C. Coagulation D. Coalition
C
The term _______ means constantly adapting to changing conditions A. Perfusion B. Conduction C. Dynamic D. Autonomic
C
The three collisions in a frontal impact include all of the following EXCEPT: A. car striking object. B. passenger striking vehicle. C. air bag striking passenger. D. internal organs striking solid structures of the body.
C
Two of the MOST common mechanisms of injury for blunt trauma are: A. motor vehicle collisions and stabbings. B. low-caliber gunshot wounds and falls. C. falls and motor vehicle collisions. D. gunshot wounds and vehicle ejections.
C
When a motor vehicle strikes a tree while traveling at 40 mph, the unrestrained occupant: A. is thrust under the steering column onto the floorboard. B. will decelerate at the same rate as the motor vehicle. C. remains in motion until acted upon by an external force. D. will most likely be thrown over the steering column.
C
You are dispatched to an apartment complex for a young male with abdominal pain. Your priority upon arriving at the scene should be to: A. quickly gain access to the patient. B. notify the dispatcher of your arrival. C. assess the scene for potential hazards. D. place a paramedic ambulance on standby.
C
When evaluating the mechanism of injury of a car versus pedestrian collision, you should first: A. determine if the patient was struck and pulled under the vehicle. B. determine if the patient was propelled away from the vehicle. C. approximate the speed of the vehicle that struck the pedestrian. D. evaluate the vehicle that struck the patient for structural damage.
C
When treating a patient who experienced a pulmonary blast injury, you should: A. suspect an accompanying cardiac tamponade. B. use a demand valve to ventilate the patient. C. avoid giving oxygen under positive pressure. D. administer large amounts of intravenous fluid.
C
When using an air splint to control bleeding in the fractured extremity you should reassess the A. Airway B. Breathing C. Circulation in the injured extremity D. Fracture site
C
Which of the following injuries would MOST likely occur as a direct result of the third collision in a motor vehicle crash? A. Forehead lacerations B. Extremity fractures C. Aortic rupture D. Flail chest
C
Which of the following organs assists in the filtration of blood, serves as a blood reservoir, and produces antibodies? A. liver B. kidney C. spleen D. pancreas
C
Which of the following organs is part of the lymphatic system and plays a role in regulation of red blood cells and the immune system? A. bladder B. liver C. spleen D. pancreas
C
Which of the following organs lies in the retroperitoneal space? A. liver B. spleen C. pancreas D. gallbladder
C
Which of the following patients has experienced the MOST significant fall? A. A 5′0″ patient who fell 13′ B. A 5′9″ patient who fell 14′ C. A 4′6″ patient who fell 13′ D. A 4′8″ patient who fell 13′
C
Which of the following statements regarding dialysis is correct? A. Acute hypertension is a common adverse effect of dialysis. B. Hemodialysis is effective but carries a high risk of peritonitis. C. Patients who miss a dialysis treatment often present with weakness. D. The purpose of dialysis is to help the kidneys retain salt and water.
C
Which of the following statements regarding low-energy penetrating injuries is correct? A. Exit wounds are typically easy to locate with low-energy penetrating injuries. B. It is usually easy to differentiate between an entrance wound and an exit wound. C. The area of injury is usually close to the path the object took through the body. D. Internal injuries caused by low-velocity bullets are usually easy to predict.
C
Which of the following statements regarding the acute abdomen is correct? A. The most common cause of an acute abdomen is inflammation of the gallbladder and liver. B. The parietal peritoneum is typically the first abdominal layer that becomes inflamed or irritated. C. The initial pain associated with an acute abdomen tends to be vague and poorly localized. D. An acute abdomen almost always occurs as the result of blunt trauma to solid abdominal organs.
C
While assessing a young male who was struck in the chest with a steel pipe, you note that his pulse is irregular. You should be MOST suspicious for: A. a lacerated coronary artery. B. underlying cardiac disease. C. bruising of the heart muscle. D. traumatic rupture of the aorta.
C
While en route to a major motor vehicle crash, an on-scene police officer advises you that a 6-year-old male who was riding in the front seat is involved. He further states that the child was only wearing a lap belt and that the air bag deployed. On the basis of this information, you should be MOST suspicious that the child has experienced: A. open abdominal trauma. B. lower extremity fractures. C. neck and facial injuries. D. blunt trauma to the head.
C
You and your partner respond to a patient who has had his hand nearly severed by a drill press. As you approach, you note that the patient is pale and there appears to be a lot of blood on the floor. The wound continues to bleed copiously. After applying a tourniquet, you write ______ and _______ on a piece of adhesive tape and apply it to the patient's forehead. A. the patient's name; tourniquet location B. your last name; unit number C. the letters "TK"; the exact time applied D. the date and time; estimated amount of blood loss
C
You have been dispatched to the home of a 52-year-old woman with severe flank pain. Which of the following is NOT a function of the liver? A. It filters toxic substances B. It creates glucose stores C. It acts as reservoir for bile D. It produces substances for blood clotting.
C
You have been dispatched to the home of a 52-year-old woman with severe flank pain. Which of the following would be an appropriate question to ask regarding the pain? A. Have you experienced any belching? B. Do you feel nauseous? C. Is the pain constant or intermittent? D. Have you been urinating more or less?
C
You respond to a 25-year-old man who has cut his arm with a circular saw. The bleeding appears to be a bright red and spurting. The patient is alert and oriented and converses with you freely. He appears to be stable at this point. What is your first step of controlling his bleeding? A. Direct pressure B. Maintain the airway C. Standard precautions D. Elevation
C
Your patient has a Glasgow Coma Scale (GCS) score of 13, a systolic blood pressure of 80 mm Hg, and a respiratory rate of 8 breaths/min, his Revised Trauma Score (RTS) is: A. 8. B. 11. C. 9. D. 10.
C
Your quick primary assessment of the patient and evaluation of the _____ can help to direct lifesaving care and provide critical information to the hospital staff. A. environment B. index of suspicion C. mechanism of injury D. abdominal area
C
_______ can be caused by an obstructing gallstone, alcohol abuse, and other diseases A. Appendicitis B. Peptic ulcer C. Pancreatitis D. Diverticulitis
C
_______ is responsible for the breakdown of starches into sugar A. insulin B. bile C. amylase D. bicarbonate
C
_________ regulates the amount of glucose in the bloodstream A. Bicarbonate B. Amylase C. Insulin D. Bile
C
Which of the following is MOST characteristic of adequate breathing? A. 22 breaths/min with an irregular pattern of breathing and cyanosis B. 20 breaths/min with shallow movement of the chest wall and pallor C. 24 breaths/min with bilaterally equal breath sounds and pink skin D. 30 breaths/min with supraclavicular retractions and clammy skin
C. 24 breaths/min with bilaterally equal breath sounds and pink skin
Albuterol is a generic name for: A. Alupent. B. Atrovent. C. Proventil. D. Singulair.
C. Proventil.
Which of the following statements regarding pulse oximetry is correct? A. The pulse oximeter is a valuable assessment tool that measures the percentage of red blood cells that contain hemoglobin molecules. B. Caution must be exercised when using the pulse oximeter on a patient with carbon monoxide poisoning because falsely low readings are common. C. Pulse oximetry measures the percentage of hemoglobin that is saturated with oxygen, but does not measure the actual hemoglobin content of the blood. D. Most otherwise healthy patients can maintain adequate oxygenation and good skin color with oxygen saturation readings as low as 70% to 80%.
C. Pulse oximetry measures the percentage of hemoglobin that is saturated with oxygen, but does not measure the actual hemoglobin content of the blood.
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%. This patient's presentation is MOST consistent with: A. acute pulmonary edema. B. right-sided heart failure. C. acute pulmonary embolism. D. spontaneous pneumothorax.
C. acute pulmonary embolism.
While auscultating an elderly woman's breath sounds, you hear low-pitched "rattling" sounds at the bases of both of her lungs. With which of the following conditions is this finding MOST consistent? A. acute asthma attack B.widespread atelectasis C. aspiration pneumonia D. early pulmonary edema
C. aspiration pneumonia
A pleural effusion is MOST accurately defined as: A. a unilaterally collapsed lung. B. diffuse collapsing of the alveoli. C. fluid accumulation outside the lung. D. a bacterial infection of the lung tissue.
C. fluid accumulation outside the lung.
In a healthy individual, the brain stem stimulates breathing on the basis of: A. increased oxygen levels. B. decreased oxygen levels. In a healthy individual, the brain stem stimulates breathing on the basis of: A. increased oxygen levels. B. decreased oxygen levels. C. increased carbon dioxide levels. D. decreased carbon dioxide levels.
C. increased carbon dioxide levels.
What kind of movement does a flail chest depict?
Paradoxical movement?
Acute pulmonary edema would MOST likely develop as the result of: A.right-sided heart failure. B. severe hyperventilation. C. toxic chemical inhalation. D. an upper airway infection.
C. toxic chemical inhalation.
what is Rule #1 for splinting?
CMS before an dafter splinting
Which of the following medications would the EMT LEAST likely administer to a patient with a medical complaint?
CORRECT A)naloxone (Narcan) B)aspirin C)albuterol D)oral glucose
Non-traumatic brain injuries are?
CVA- Cerebral vascular Accident or a Stroke.
Major Heart attack are assos. with what shock?
Cardiogenic Shock
What does the Ventury effect cause in the human body?
Causes an embolysm also known as Thrombosys in the lungs.
Unstable Angina
Characterized by pain in chest that occurs in response to progressively less exercise or fewer stimuli than what usually causes the angina.
Hormone
Chemical produced by a gland that regulates body organs
Coronary artery bypass graft (CABG)
Chest or leg blood vessel is seen from aorta to coronary artery beyond point of obstruction (making a new path)
What is most important to assess during patient assessment during secondary assessment? Airway Pulse Respiration Chief complaint
Chief complaint
sphincters
Circular muscles that encircle and, by contracting, constrict a duct, tube, or opening.
perfusion
Circulation of blood within an organ or tissue in adequate amounts to meet the cells' current needs.
neurogenic shock
Circulatory failure caused by paralysis of the nerves that control the size of the blood vessels, leading to widespread dilation; seen in patients with spinal cord injuries.
Thrombolytic drugs
Clot busting within one hour to prevent damage
What are the three stages of Shock?
Compensated, decompensated and Irreversible
What is the normal response of the pupils when exposed to bright light? Fluttering Dilation Constriction No effect
Constriction
To determine blood pressure, the EMT should position the cuff over the upper arm and place the stethoscope over the brachial artery. Next, she should inflate the cuff, then slowly deflate the cuff, listening for clicks or tapping sounds whi le remembering the number at the first sound. What is the next step in taking a blood pressure? Dump all the pressure and record the number as the diastolic pressure. Re-inflate the cuff on the patient's arm and repeat the process to verify the reading. Continue releasing pressure until the clicks or tapping stop, and record both numbers. These are the blood pressure. Remove the cuff from the patient's arm, place it on the opposite arm, and repeat the process to verify the reading.
Continue releasing pressure until the clicks or tapping stop, and record both numbers. These are the blood pressure.
A 56-year-old man has an acute myocardial infarction. Which of the following blood vessels became blocked and led to his condition? Coronary veins Coronary arteries Pulmonary veins Pulmonary arteries
Coronary arteries
Which of the following BEST describes the proper placement of the blood pressure cuff? Covering two-thirds of the upper arm Midway between the elbow and shoulder One inch below the armpit Covering the patient's elbow
Covering two-thirds of the upper arm
A 40-year-old man was standing near a building when it exploded. He has multiple injuries, including a depressed skull fracture, severe burns, and an impaled object in his abdomen. His head injury MOST likely occurred during the ___________ phase of the explosion. A. blast B. primary C. secondary D. tertiary
D
A 67-year-old male presents with weakness, dizziness, and melena that began approximately 2 days ago. He denies a history of trauma. His blood pressure is 90/50 mm Hg and his pulse is 120 beats/min and thready. You should be MOST suspicious that this patient is experiencing: A. acute appendicitis. B. intrathoracic hemorrhaging. C. an aortic aneurysm. D. gastrointestinal bleeding.
D
A man involved in a motorcycle crash has multiple abrasions and lacerations. Which of the following injuries has the HIGHEST treatment priority? A. Widespread abrasions to the back with pinkish ooze B. 3" laceration to the forehead with dark red, flowing blood C. Laceration to the forearm with obvious debris in the wound D. 1" laceration to the thigh with spurting, bright red blood
D
A patient complaining of chest tightness, coughing up blood, and subcutaneous emphysema following an explosion may be suffering from a: A. myocardial blast injury. B. ruptured tympanic membrane. C. ruptured peritoneal cavity. D. pulmonary blast injury.
D
A strangulated hernia is one that: A. spontaneously reduces without any surgical intervention. B. can be pushed back into the body cavity to which it belongs. C. is reducible if surgical intervention occurs within 2 hours. D. loses its blood supply due to compression by local tissues.
D
A young male was shot in the abdomen by an unknown type of gun. He is semiconscious, has shallow breathing, and is bleeding externally from the wound. As you control the external bleeding, your partner should: A. obtain baseline vital signs. B. apply a nonrebreathing mask. C. perform a secondary assessment. D. assist the patient's ventilations.
D
According to the American College of Surgeons, an adult trauma patient meets Level I criteria if he or she: A. has a systolic blood pressure of less than 110 mm Hg or a heart rate greater than 110 beats/min. B. was involved in a motor vehicle crash in which another patient in the same vehicle was killed. C. has a bleeding disorder or takes anticoagulant medications and has any blunt or penetrating injury. D. has a GCS score of less than or equal to 8 with a mechanism attributed to trauma.
D
All of the following are considered types of motorcycle impacts EXCEPT: A. head-on collision. B. angular collision. C. controlled crash. D. rear collision.
D
Approximately 25% of severe injuries to the aorta occur during: A. rear-end collisions. B. rollover collisions. C. frontal collisions. D. lateral collisions.
D
At the arterial end of the capillaries, the muscles dilate and constrict in response to conditions such as A. Fright B. A specific need for oxygen C. A need to dispose of metabolic wastes D. All the of above
D
Blood stasis, changes in the vessel wall, and certain medications affect the: A. systolic blood pressure exclusively. B. white blood cell's ability to fight infection. C. ability of red blood cells to carry oxygen. D. ability of the blood to effectively clot.
D
Burns from hot gases and respiratory injuries from inhaling toxic gas are associated with which type of blast injury? A. Primary B. Secondary C. Tertiary D. Miscellaneous
D
Death from a rollover motor vehicle crash is MOST often secondary to: A. crushing injuries. B. airbag-related trauma. C. multiple collisions to the interior of the car. D. ejection of the patient from the motor vehicle.
D
During your assessment of a patient who experienced a blast injury, you note that he has a depressed area to the front of his skull. This injury MOST likely occurred: A. during the secondary phase. B. during the primary phase. C. as a direct result of the pressure wave. D. during the tertiary phase.
D
Elderly patients with abdominal problems may not exhibit the same pain response as younger patients because of: A. chronic dementia, which inhibits communication. B. interactions of the numerous medications they take. C. progressive deterioration of abdominal organ function. D. age-related deterioration of their sensory systems.
D
Evaluation of the interior of a crashed motor vehicle during extrication will allow the EMT to: A. determine the vehicle's speed at the time of impact. B. recognize if the driver hit the brakes before impact. C. assess the severity of the third collision of the crash. D. identify contact points and predict potential injuries.
D
Even though the body is very efficient at controlling bleeding on it's own it may fail in situations such as A. When medication interferes with normal clotting B. When damage to the vessel maybe so large that a clot cannot completely block the hole C. When only part of the vessel is cut preventing it from constricting D. All of the above
D
Force acting over a distance defines the concept of: A. potential energy. B. latent energy. C. kinetic energy. D. work.
D
Gastrointestinal bleeding should be suspected if a patient presents with: A. dyspnea. B. hematuria. C. hemoptysis. D. hematemesis.
D
If a patient misses a dialysis treatment, weakness and _____ can be the first in a series of conditions that can become progressively more serious. A. diarrhea B. chest pain C. vomiting D. pulmonary edema
D
If a person is standing near a building that explodes, which of the following injuries would he or she MOST likely experience as a result of the pressure wave? A. Impaled objects B. Fractured bones C. Severe burns D. Stomach rupture
D
If one or more occupants in the same vehicle are killed in a crash, the EMT should: A. rapidly assess only the survivors who have experienced obvious trauma. B. transport the survivors only if they have injuries or complain of pain. C. allow the survivors to refuse transport if they have no obvious injuries. D. suspect that all living occupants experienced the same serious trauma.
D
In contrast to a Level III trauma center, a Level I trauma center must: A. be able to stabilize patients before transferring to a higher level facility. B. be involved in trauma prevention programs. C. have access to an emergency physician within 30 minutes. D. have general surgeons that are in-house 24 hours a day.
D
In contrast to the parietal peritoneum, the visceral peritoneum: A. is supplied by the same nerves from the spinal cord that supply the skin of the abdomen. B. lines the walls of the abdominal cavity and is stimulated when the solid abdominal organs contract. C. is less likely to become inflamed or infected because it lines the abdominal organs themselves. D. is supplied by nerves of the autonomic nervous system, which are less able to localize pain or sensation.
D
Infected pouches in the lining of the colon are associated with: A. Cholecystitis B. Cystitis C. Gastroenteritis D. Diverticulitis
D
Injury to a hollow abdominal organ would MOST likely result in: A. pain secondary to blood in the peritoneum. B. profound shock due to severe internal bleeding. C. impairment in the blood's clotting abilities. D. leakage of contents into the abdominal cavity.
D
Most cases of external bleeding from an extremity can be controlled by: A. elevating the injured extremity. B. packing the wound with gauze. C. compressing a pressure point. D. applying local direct pressure.
D
Nontraumatic internal bleeding may be caused by an A. Ulcer B. Ruptured ectopic pregnancy C. Aneurysm D. All of the above
D
Perfusion is MOST accurately defined as the: A. effective transfer of oxygen from the venules across the systemic capillary membrane walls. B. ability of the systemic arteries to constrict as needed to maintain an adequate blood pressure. C. effective removal of carbon dioxide and other metabolic waste products from the body's cells. D. circulation of blood within an organ in adequate amounts to meet the body's metabolic needs.
D
Significant vital sign changes will occur if the typical adult acutely loses more than ______ of his or her total blood volume. A. 5% B. 10% C. 15% D. 20%
D
Signs and symptoms of internal bleeding in both trauma and medical patients include A. hematemesis B. melena C. hemoptysis D. all of the above
D
The _______ is the thickest chamber of the heart A. Right atrium B. Right ventricle C. Left atrium D. Left ventricle
D
The brain and spinal cord usually cannot go for more than _______ minutes without perfusion or the nerve cells will be permanently damaged A. 30 -45 B. 12-20 C. 8-10 D. 4-6
D
The cardiovascular system consists of A. A pump B. A container C. Fluid D. All of the above
D
The most common symptom of internal bleeding is: A. bruising around the abdomen. B. distention of the abdomen. C. rigidity of the abdomen. D. acute abdominal pain.
D
What types of motor vehicle collisions present the greatest potential for multiple impacts? A. Rear-end and rotational B. lateral and rollover C. frontal and rotational D. rotational and rollover
D
When a driver is in a car equipped with an air bag, but is not wearing a seatbelt, he or she will MOST likely strike the __________ when the air bag deploys upon impact. A. windshield B. dashboard C. steering wheel D. door
D
When an organ of the abdomen is enlarged, rough palpation may cause ________ of the organ. A. distension B. nausea C. swelling D. rupture
D
When assessing a stab wound, it is important for the EMT to remember that: A. stabbings to an extremity are rarely associated with an exit wound. B. the majority of the internal trauma will be near the path of the knife. C. most stabbings are unintentional and cause less severe internal injury. D. more internal damage may be present than the external wound suggests.
D
When assessing the interior of a crashed motor vehicle for damage, you are gathering information regarding the: A. index of suspicion. B. kinetic energy. C. potential energy. D. mechanism of injury.
D
When caring for a patient with internal bleeding, the EMT must first: A. ensure a patent airway. B. obtain baseline vital signs. C. control any external bleeding. D. take appropriate standard precautions.
D
Which of the following body systems or components is the LEAST critical for supplying and maintaining adequate blood flow to the body? A. an effectively pumping heart B. an intact system of blood vessels C. adequate blood in the vasculature D. the filtering of blood cells in the spleen
D
Which of the following is NOT a common disease that produces signs of an acute abdomen? A. Diverticulitis B. Cholecystitis C. Acute appendicitis D. Glomerulonephritis
D
Which of the following is NOT considered appropriate use of air medical services? A. The distance to a trauma center is greater than 25 miles. B. Traffic/road conditions make it unlikely to get the patient to the hospital in a timely manner. C. There is a mass-casualty incident. D. The closest trauma center is 10 minutes away by ground transport.
D
Which of the following is NOT part of the male reproductive system? A. Epididymis B. Prostate gland C. Seminal vesicles D. Fallopian tubes
D
Which of the following is characteristic of peptic ulcer disease (PUD)? A. the passage of bright red blood in the stool or coughing up blood B. symptom relief after taking nonsteroidal anti-inflammatory drugs C. sharp pain that is typically located in both lower abdominal quadrants D. burning or pain in the stomach that subsides immediately after eating
D
Which of the following is the MOST common cause of death from a blast injury? A. amputation B. burns C. chest trauma D. head trauma
D
Which of the following organs can tolerate inadequate perfusion for up to 2 hours? A. brain B. heart C. kidneys D. skeletal muscle
D
Which of the following statements regarding gunshot wounds is correct? A. The size of a bullet has the greatest impact on producing injury. B. High-velocity bullets will cause less severe internal injuries. C. Low-velocity bullets will cause the greatest amount of trauma. D. The speed of a bullet has the greatest impact on producing injury.
D
Which of the following statements regarding the clotting of blood is correct? A. Venous and capillary blood typically does not clot spontaneously. B. Bleeding begins to clot when the end of a damaged vessel dilates. C. Direct contact with the environment prevents blood from clotting. D. A person taking aspirin will experience slower blood clotting.
D
Which of the following would MOST likely result from the third collision in the "three-collision" effect that occurs during a high-speed, frontal impact motor vehicle crash? A. Extensive damage to the automobile B. Flail chest and lower extremity fractures C. Massive external trauma with severe bleeding D. Aortic rupture or compression injury to the brain
D
Which of the following would MOST likely occur as the direct result of the second collision in a motor vehicle crash? A. Caved-in passenger door B. Collapsed dashboard C. Intrathoracic hemorrhage D. Deformed steering wheel
D
You and your partner respond to a patient who has had his hand nearly severed by a drill press. As you approach, you note that the patient is pale and there appears to be a lot of blood on the floor. The wound continues to bleed copiously. In the above call, when applying the tourniquet you know you must be sure to: A. use the narrowest bandage possible to minimize the area restricted. B. cover the tourniquet with a bandage. C. never pad underneath the tourniquet. D. not loosen the tourniquet after you have applied it.
D
You are called to a playground for an 8-year-old girl who has an uncontrolled nosebleed. The child is crying and will not to talk to you. The babysitter and other children present did not witness any trauma, but there is a bump on the temporal portion of the girl's head. The babysitter does state that the girl has had a cold for several days but can give you no further information on her medical history. What could be the possible cause(s) of the bleeding? A. A skull fracture B. Sinusitis C. Coagulation disorder D. All of the above
D
You are transporting a 49-year-old male with "tearing" abdominal pain. You are approximately 30 miles away from the closest hospital. During your reassessment, you determine that the patient's condition has deteriorated significantly. You should: A. assist his ventilations with a bag-mask device. B. immediately perform a rapid physical examination. C. continue transporting and alert the receiving hospital. D. consider requesting a rendezvous with an ALS unit.
D
You have been dispatched to the home of a 52-year-old woman with severe flank pain. The patient tells you that she has right flank pain that radiates into her groin. What is MOST likely cause of her condition? A. cholecystitis B. Ileus C. appendicitis D. kidney stone
D
A 25-year-old unrestrained female struck the steering wheel with her chest when her car hit a tree while traveling at a high rate of speed. She has signs and symptoms of shock, which you suspect are the result of intrathoracic bleeding. Which of the following interventions will provide this patient with the greatest chance for survival? A) full immobilization of her spine B) application of the pneumatic antishock garment (PASG) C) 100% oxygen administration D) rapid transport to a trauma center
D) rapid transport to a trauma center
A 70-year-old female was recently discharged from the hospital following a total hip replacement. Today, she presents with restlessness, tachycardia, and a blood pressure of 100/64 mm Hg. Her skin is warm and moist. You should be MOST suspicious that she is experiencing: A) pump failure. B) a local infection. C) decompensated shock. D) septic shock.
D) septic shock.
Which of the following statements regarding severe acute respiratory syndrome (SARS) is correct? A.Multiple bacteria have been identified as being the cause of SARS. B. SARS is most commonly transmitted by direct contact with blood. C. The onset of SARS is typically marked by acute, severe pneumonia. D. SARS is a viral infection that often begins with flulike symptoms.
D. SARS is a viral infection that often begins with flulike symptoms.
Paroxysmal nocturnal dyspnea (PND), rales, and dependent edema are clinical indicators of: A. emphysema. B. severe pneumonia. C. bronchitis or asthma. D. congestive heart failure.
D. congestive heart failure.
A conscious and alert 29-year-old female with a history of asthma complains of difficulty breathing that began after her morning jog. The temperature outside is 40°F (5°C). On exam, you hear bilateral expiratory wheezing. After providing 100% oxygen, you should: A. place her in a recumbent position to facilitate breathing. B. contact medical control and administer an antihistamine. C. call medical control and ask how to proceed with treatment. D. determine if she has been prescribed a beta-agonist inhaler.
D. determine if she has been prescribed a beta-agonist inhaler.
At the onset of an acute asthma attack, patients commonly experience difficulty breathing and: A. audible stridor. B. rales and rhonchi. C. profound cyanosis. D. expiratory wheezing.
D. expiratory wheezing.
In order for efficient pulmonary gas exchange to occur: A. the percentage of inhaled carbon dioxide must exceed the percentage of inhaled oxygen. B. there must be low quantities of pulmonary surfactant to allow for full alveolar expansion. C. the pulmonary capillaries must be completely constricted and the alveoli must be collapsed. D. oxygen and carbon dioxide must be able to freely diffuse across the alveolar-capillary membrane.
D. oxygen and carbon dioxide must be able to freely diffuse across the alveolar-capillary membrane.
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: A. insert an oropharyngeal airway and perform oral suctioning. B. apply oxygen via a nonrebreathing mask and transport at once. C. insert a nasopharyngeal airway and begin assisted ventilation. D. place her in the recovery position and monitor for vomiting.
D. place her in the recovery position and monitor for vomiting.
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? A. rupture of the diaphragm B. exacerbation of his COPD C. acute pulmonary embolism D. spontaneous pneumothorax
D. spontaneous pneumothorax
When assessing for fluid collection in the lungs during auscultation of lung sounds, you should: A. note the presence of a high-pitched whistling sound, which is an indicator of fluid in the lungs. B. pay special attention to the exhalation phase since this is when you will likely hear rales or rhonchi. C. auscultate the posterior chest first and compare the apex of one lung to the base of the opposite lung. D. start at the lower lung fields and determine at which level you start hearing clear breath sounds.
D. start at the lower lung fields and determine at which level you start hearing clear breath sounds.
Common signs and symptoms of acute hyperventilation syndrome include: A. altered mental status and bradycardia. B. unilateral paralysis and slurred speech. C. anxiety, dizziness, and severe bradypnea. D. tachypnea and tingling in the extremities.
D. tachypnea and tingling in the extremities.
a 49 year old male presents with confusion, sweating, and visual hallucinations. the patients wife tells you that he is a heavy drinker and thinks he had a seizure shortly before your arrival. this patient is Most likely experiencing
DT's
You are administering oxygen to a 25-year-old male with a heart rate of 120. To verify the effectiveness of your therapy, you would expect to see the patient's heart rate: Decrease. Increase. Remain the same. Become irregular.
Decrease.
AED shocks
Detect and deliver based off of v-fib and ventricular tachycardia
sensitization
Developing a sensitivity to a substance that initially caused no allergic reaction.
Type I diabetes
Diabetes that usually starts in childhood; requires insulin
__________________ is a serious complication of diabetes that occurs when your body produces high levels of blood acids called ketones. The condition develops when your body can't produce enough insulin.
Diabetic Ketoacidosis (DKA)
What is the pressure remaining in the arteries after the pulse wave has passed through? Venous pressure Systolic blood pressure Diastolic blood pressure Resting blood pressure
Diastolic blood pressure
What questions should you ask? When establishing an accurate history.
Did you take anything to lower your blood sugar? Have you eaten normally today ? Are you insulin dependent?
What is ecchymosis
Discoloration associated with a closed wound; signifies bleeding
Recording and documenting your patient's first set of vital signs is very important because, when combined with reassessments, it allows you to do which of the following? Make an accurate diagnosis of the patient's illness. Compare your patient's condition with other patients' conditions. Discover trends and changes in the patient's condition. Fill in all of the blanks on the patient care report form.
Discover trends and changes in the patient's condition.
Ischemic heart disease
Disease involving a decrease in blood flow to one or more portions of the heart muscle
What is a dislocation?
Disruption of a joint
Obstructive shock is usually seen in?
Diving accidents
What does the acronym D.I.C.E stand for?
Drug dose, Integrity of container, color and clarity, expiration date.
Which of the following statements regarding anaphylactic shock is MOST correct?
Each subsequent exposure following sensitization often produces a more severe reaction.
Chain of survival for patients who experience sudden cardiac arrest
Early recognition and activation of EMS Immediate bystander CPR Rapid defibrillation Basic and advanced EMS ALS and postarrest care
What is compartment syndrome?
Elevated pressure within a fascial compartment.
Errors in AED happen when?
Errors can happen when patient is moving, because it may pick up electrical signals from muscles rather than heart **AED cannot analyze rhythm while ambulance is in motion
How often should a patient's vital signs be reassessed during transport to the hospital after he has had his pulse restored with CPR and the use of an AED? Every 10 minutes Every 15 minutes Every 2 minutes Every 5 minutes
Every 5 minutes
Polyuria
Excessive urination
syncope
Fainting.
Fatty Acids
Fatty acids are the building blocks of the fat in our bodies and in the food we eat. During digestion, the body breaks down fats into fatty acids, which can then be absorbed into the blood. Fatty acid molecules are usually joined together in groups of three, forming a molecule called a triglyceride.
Purkinje Fibers
Fibers in which the electrical impulses spread throughout both ventricles
You are about to apply a blood pressure cuff to an unconscious patient when you notice that she appears to have a tube underneath the skin of her arm. The tube feels like it has fluid going through it. You should: Move the cuff down to the forearm and inflate Continue to take her blood pressure in the arm. Find another site to measure her blood pressure. Use an automatic blood pressure cuff instead.
Find another site to measure her blood pressure.
You respond to a cafeteria to find an unconscious person with gurgling sounds upon exhalation and inhalation. What is the probable cause of the respiratory sounds? Cardiac arrest A complete airway obstruction Fluids in the airway The tongue blocking the airway
Fluids in the airway
What does the history look like with a Hyperglycemic patient.
Food Intake-Excessive Insulin Dosage-Insufficient Onset-Gradual(Days) Skin-PWD Infection-Common
What does the history look like with a Hypoglycemic patient.
Food Intake-Insufficient Insulin Dosage-Excesive Onset-rapid within minutes Skin-PCC Infection-UNcommon
What happens in Anaphylactic Shock?
Foreign body invaders attach to the Mast Cells and explode releasing Leukotrenes and Histamines.
Treatment for Cardiogenic Shock
Fowlers or semi-fowlers, Blanket and Oxygen. Only go Code 3 if there is Myocardial Infarction.
Treatment for Anaphylactic Shock
Fowlers position, Oxygen, and blanket
Polyuria
Frequent, plentiful urination
Polydipsia
Frequently drinking to satisfy taste
Which of the following is NOT a cause of unequal pupils? Fright An artificial eye Stroke Eye injury
Fright
Complications of Sickle cell
Gall Stones Jaundice Avascular Necrosis Splenic Infections Osteomyelitis Opiate tolerance Leg Ulcers Retinopathy Chronic Pain Pulmonary Hyertension Chronic renal Failure
Endocrine Glands
Glands that secrete or release chemicals that are used inside the body
Which of the following statements regarding glucose is correct? Select one: A. Glucose is given to patients who are suspected of being hyperglycemic. B. Glucose is usually administered by the EMT via the intravenous route. C. Glucose is a complex sugar that rapidly absorbs into the bloodstream. D. Glucose is a simple sugar that is readily absorbed by the bloodstream.
Glucose is a simple sugar that is readily absorbed by the bloodstream.
Signs of hypertensive emergency
HIGH BP -one of the most common signs is a severe headache (may be sign of cerebral hemmorage) -strong, bounding pulse -ringing in ears -nausea and vomiting -dizziness -warm skin (dry or moist) -sudden development of pulmonary edema - AMI
How do you tapedown a big bulky trauma dressing on a patient?
Hashtag or cross.
Myocardial Infarction
Heart Attack
Arrhythmia
Heart rhythm abnormalities -Premature ventricle contraction -tachycardia: faster than 100 bpm -bradycardia: slower than 60 bpm
Perfusion Triangle
Heart, Blood Vessels, and Blood
Hypertension
High bp: above 140 systolic and 90 diastolic
Altered mental status is what priority?
High priority
Insulin
Hormones that enables glucose to enter the cells
What is the poem for remembering what the skin tells you about hyper and hypoglycemia patients
Hot and dry, sugar is high Cool and clammy, needs some candy
Signs and Symptoms of Anaphylactic Shock
Hot, Flush, Diaphoretic 1 -Wheezing, due to contricted bronchioles. 2- Itchy, Body is telling you to get rid of it. 3- Blood pressure drops- Hypotensive. 4- Eutokarya - Red skin bumps.
Symptoms for Septic Shock
Hot, flush and diaphoretic.
What special precaution should you look out for when dealing with patients who went through Psychogenic shock or a Syncople episode?
If a patient falls check for injuries and take spinal precautions.
What causes a heart attack?
If coronary artery gets blocked
Angina Pectoris
If the heart becomes esquemic or oxygen deprived.
Name one good thing about scalp lacerations?
If there is fair ammount of bleeding it is good because there is not much room for ICP to present itself.
For impaled objects, do not attempt to move or remove teh object unless it is?
Impaled through the cheek causing airway obstruction, or if the object is in the chest and interferes with CPR.
Cardiogenic shock may result from all of the following, EXCEPT:
Increaded preload
You are administering oxygen to a 25-year-old male with an oxygen saturation of 90 percent. To verify the effectiveness of your therapy, you would expect to see the patient's oxygen saturation: Decrease. Increase. Remain the same. Become irregular.
Increase
How is cardiac output increased?
Increasing heart rate or stroke volume
Sickle Cell Disease
Inherited disease that affects red blood cells
Hypoglycemic Crisis (Insulin Shock)
Insufficient glucose in the blood. to much insulin. May have vomited after a meal or just engaged in rigorous physical acitivity treat with oral glucose should have a set of vitals before and after glucose.
What is a fracture of the the proximal femur?
Isolated midshaft femur fracture.
Why is the skin temperature such an important vital sign? It can provide information about the patient's ability to maintain normal body temperature. It can provide reportable information about the patient's level of consciousness, a drop in oxygen, and if the blood vessels in the brain constrict, which could indicate a life-threatening problem. It can provide reportable information about the patient's breathing, a drop in oxygen, and if the blood vessels in the skin constrict, which could indicate a life-threatening problem. It can provide valuable information about the patient's circulation, a drop in perfusion, and if the blood vessels in the skin constrict, which could indicate a life-threatening problem.
It can provide valuable information about the patient's circulation, a drop in perfusion, and if the blood vessels in the skin constrict, which could indicate a life-threatening problem.
What is a greenstick fracture?
It is a bend that is common with children
What is a concussion?
It is a brain injury with no permanent damage.
What is a contusion?
It is a bruise from an injury that causes bleeding beneath the skin without breaking the skin.
What is a laceration?
It is a jagged, open wound.
What does Aspirin do?
It is a platelet inhibitor.
What is crush syndrome?
It is a significant metabolic derangement that develops when crushed extremities or body parts remain trapped for prolonged periods. This can lead to renal failure and death. *Body part released, floods with toxins*
What is rabies, and what is the cause for concern?
It is an acute, potentially fatal viral infection of the central nervous system that can affect all warm blooded animals
What is a crushing injury?
It is an injury that occurs when a great amount of force is applied to the body. -Extent is determined by force & amount of time
What is a hematoma?
It is blood that has collected within damaged tissue or in a body cavity.
When can a hematoma occur?
It occurs whenever a large blood vessel is damaged and bleeds rapidly; usually associated with extensive tissue damage. Can result from: soft tissue injury, fracture, or injury to large blood vessel
In persons with lightly pigmented skin, a pink line of scar tissue is?
It signals the presence of collagen, a structural protein that has reinforced the damaged tissue.
Your patient is in late stages of liver failure and has requested to be transported to the emergency department. You take your body substance isolation and move him to your cot and notice his skin is warm and dry with a yellow color. Your radio report to the hospital should state your patient is: Flushed. Mottled. Jaundiced. Cyanotic.
Jaundiced.
Paracardial tamponaude/ Myocardial Tamponaude
Jugular Vein Distention (JVD), Muffled heart sounds, heart filled with fluids, hypotensive.
Ketones
Ketones are produced when the body burns fat for energy or fuel. They are also produced when you lose weight or if there is not enough insulin to help your body use sugar for energy. Without enough insulin, glucose builds up in the blood. Since the body is unable to use glucose for energy, it breaks down fat instead.
Hyperglycemia crisis symptoms
Kussmaul respirations (rapid, deep respirations), dehydration (dry, warm, "tenting skin" and sunken eyes), sweet or fruity acetone odor in breath caused by unusual waste products in the blood (ketones), rapid thready pulse weak; normal or slightly low blood pressure; varying degrees of unresponsiveness; weakness, nausea, vomiting, polyuria, polydipsia (excessive thirst), polyphagia
The increase in the work of breathing is reported as: Labored breathing. Troubled breathing. Nosey breathing. Obstructed breathing.
Labored breathing.
What skull fractions account for 80% of skull fractions?
Linear fractions.
dehydration
Loss of water from the tissues of the body.
What is an abrasion?
Loss or damage of the superficial layer of skin as a result of a body part rubbing or scraping across a rough or hard surface.
Which of the following is required for an EMT to administer a drug to a patient? Select one: A. A patient with an altered level of consciousness B. An alert adult patient C. Medical direction approval D. A patient with stable vital signs
Medical direction approval
What are the two types of diabetes?
Mellitus and Insipidus
A sick patient who is vomitting and has diahrreah is assos. w/ which shock?
Metabolic/Hypovolemic Shock.
The abbreviation mmHg indicates that the blood pressure is measured by which of the following comparisons? Minimum heart rate Millimeters of mercury Millimeters of water Atmospheric pressure
Millimeters of mercury
Where is cardiogenic shock more common?
More commonly found in AMI that affects bottom and back parts of the left ventricle because this provides circulation to the majority of the body
(HHNC) Hyperosmolar hyperglycemic nonketotic coma
More often caused by type 2 no sweet smelling breath Excessive urination results in dehydration Slower, more gradual onset 800 or above it will say HI on a glucometer Could be in a coma
what are the three P's of diabetes
Polyuria, Polydipsia and Polyphagia
You are called to care for a chi ld who has fal len out of a third-story window. You arrive to find the chi ld in his mother's arms. As you approach, you notice the child's skin is pale with dark spots of cyanosis. You would report this uncommon condition of blotchy skin as: Mottled. Flushed. Jaundiced. Cyanotic.
Mottled.
Because the patient is unconscious and his blood glucose level is 48mg/dL, how should the glucose be delivered
NOT BY: placing between check and gum, on back or tip of tongue NO oral glucose intake
Can we as EMTs give insulin?
No
You respond to a 30-month-old patient who has passed out. Is the patient's blood pressure important to your treatment and why? Yes, blood pressure must be taken on everyone because without it we cannot impact the patient's field management. No, blood pressure taken on children younger than age 3 can cause damage to the tender tissues of the arm that could lead to hypertension in later life. Yes, blood pressure can be taken on children because it is the only way we can understand the patient's condition. No, blood pressure taken on children younger than age 3 is difficult and has little impact on the patient's field management.
No, blood pressure taken on children younger than age 3 is difficult and has little impact on the patient's field management.
An oxygen saturation of 97 percent is considered which of the following? Severe hypoxia Normal Hypoxia Significant hypoxia
Normal
S/s of Hemophilia
Nosebleeds. Bruising, especially a large, lumpy bruise. Bleeding for no known reason. Blood in the urine or stool. Bleeding that does not stop after getting a cut, having a tooth out, getting an injury to the mouth or having surgery. Bleeding that does not stop after circumcision.
respiratory Insufficiency
Not enough Oxygen flow to the blood can produce shock
SAMPLE history
OPQRST Onset Provocation or pallination Quality Region/radiation Severity Timing
You are attempting to assess the blood pressure of a 35-year-old male at the scene of a multiple vehicle collision. The scene is very noisy and you are unable to clearly hear the patient's heartbeat. You should: Use an automatic blood pressure machine. Obtain the blood pressure by palpation. Try using the patient's other arm. Have your partner try auscultating the blood pressure.
Obtain the blood pressure by palpation.
Psychogenic Shock
Occurs after a patient faints and has no blood return to head.
Anaphylactic Shock
Occurs when a person reacts violently to a substance.
Glucose
On of the basic sugars; it is the primary fuel , in conjuction with oxygen for cellular metabolism.
Treatment for Neurogenic Shock
Oxygen, Blanket, Supine position to let body fight it out.
Treatment for Septic Shock
Oxygen, semi-fowlers or fowlers, can use blankets.
What are the three ways to take blood pressure? Sphygmomanometer, blood pressure monitor, and heart monitor Palpation, auscultation, and blood pressure monitor Sphygmomanometer, auscultation, and blood pressure monitor Auscultation, palpation, and osculation
Palpation, auscultation, and blood pressure monitor
Which of the following statements regarding parenteral medications is correct? Select one: A. Tylenol is an example of a parenteral medication because it is taken orally. B. Compared to enteral medications, parenteral medications have fewer side effects. C. Parenteral medications are absorbed by the body through the digestive system. D. Parenteral medications are absorbed more quickly than enteral medications.
Parenteral medications are absorbed more quickly than enteral medications
Acidosis
Pathologic condition resulting from the accumulation of acids in the body
Syncople Episode
Patient faints and blood returns to the head.
Type 1 Diabetes
Patients do not produce insulin They daily injections to control their blood glucose Usually develops during childhood More likely to have metabolic problems and organ damage, such as blindness, heart disease, kidney failure and nerve disorders.
Which of the following patient populations typically require a modified drug dose? Select one: A. Females B. Pediatric patients C. Patients with asthma D. Middle adults
Pediatric patients
S/s of Sickle Cell
Periodic episodes of pain, called crises, are a major symptom of sickle cell anemia
What is a contusion?
Permanent damage(Bruise to the head)
How do you tell if there is blood in the trachea?
Pink, frothy septum
Which of the following is the BEST way to assess a patient's skin temperature? Place your cheek against the patient's forehead. Place the back of your hand against the patient's forehead. Place your cheek against the patient's abdomen. Place the back of your hand against the patient's abdomen.
Place the back of your hand against the patient's forehead.
Platlets
Platelets, also called thrombocytes are a component of blood whose function is to stop bleeding by clumping and clotting blood vessel injuries.
What category would include a patient with a blood pressure of 134/84 mmHg? Hypotension Normotension Hypertension Prehypertension
Prehypertension
Tension pneumothorax
Pressure in the Pleura
Respirations are 28 breaths/min, her pulse is 110 beats/min, and her blood pressure is 94/52 mm Hg. How should you intervene for her?
Provide high-flow oxygen
Fainting is assos. with which shock?
Psychogenic shock?
You are assessing a 55-year-old male complaining of chest pain and have determined that his radial pulse is barely palpable. You also determine that there were 20 pulsations over a span of 30 seconds. Based on this, how would you report this patient's pulse? Pulse 20, weak, and regular Pulse 20 and weak Pulse 40 and weak Pulse 40, weak, and irregular
Pulse 40 and weak
The device that some EMS services use as a light wave device to measure oxygen saturation (SpO2) is called Capnography. Sphygmomanometer. End tidal CO meter. Pulse oximeter.
Pulse oximeter.
Which of the following are the vital signs that need to be recorded? Pulse, respiration, skin color, skin temperature and condition Pulse, respiration, skin color, skin temperature and condition, pupils, blood pressure, and bowel sounds Pulse, respiration, skin color, skin temperature and condition, pupils, and blood pressure Pulse, respiration, skin color, skin temperature, pupils, and blood pressure
Pulse, respiration, skin color, skin temperature and condition, pupils, and blood pressure
peripheral pulses
Pulses felt in extremities (like radial and posterior tibial)
Central pulses
Pulses near the trunk of the body, like carotid and femoral
What are the control centers?
Respiratory, Cardiac, Vasomotor and R.A.S(Reticular Activating System)
Unstable angina
Response to fewer stimuli than normal *Treat angina like MI
Treat a closed soft-tissue injury by applying?
Rest - keep pt as quiet & comfortable as possible Ice - slow bleeding and reduce pain Compression - apply pressure to slow bleeding Elevation - raise above heart to decrease swelling Splinting - decreases bleeding & reduces pain by immobolizing
Which of the following statements regarding severe acute respiratory syndrome (SARS) is correct?
SARS is caused by a virus and usually starts with flulike symptoms that deteriorate to pneumonia and respiratory failure.
What are partial-thickness burns?
Second-degree; involve the epidermis and some portion of the dermis. Blisters are present & cause intense pain*
___________ are a potentially life-threatening complication of insulin shock
Seizures
Infections are assos. w/ what type of shock?
Septic Shock
How to determine burns
Severe - FT more than 10%, PT more than 30% Moderate - FT 2-10%, PT 15-30%, Superficial more than 50% Minor - FT less 2%, PT less 15%, Superficial less than 50%
anaphylactic shock
Severe shock caused by an allergic reaction.
Slight movement of the chest during respiration is usually indicative of which of the following? Labored breathing Normal breathing Noisy breathing Shallow breathing
Shallow breathing
Your patient has a rapid, regular, and thready pulse. Which of the following is a possible cause of this finding? Exertion Shock Fright All of the above
Shock
psychogenic shock
Shock caused by a sudden temporary reduction in blood supply to the brain that causes fainting (syncope).
hypovolemic shock
Shock caused by fluid or blood loss.
cardiogenic shock
Shock caused by inadequate function the heart, or pump failure.
septic shock
Shock caused by severe infection, usually a bacterial infection.
obstructive shock
Shock that occurs when there is a block to blood flow in the heart or great vessels, causing an insufficient blood supply to the body's tissues.
Sickle Cell Disease
Sick red blood cells only live for 16 days could cause hypoxia rupture of blood vessels for spleen S shaped red blood cell
When the EMT checks the pupils he or she is checking for what three things? Movement, gaze, and equality Color, equality, and reactivity Reactivity, gaze, and equality Size, equality, and reactivity
Size, equality, and reactivity
Breathing sounds that should concern the EMT are: Snoring, gurgling, wheezing, crowing, and crowning. Retractions, diaphragmatic breathing. Tachycardia, retractions, diaphragmatic breathing. Snoring, gurgling, wheezing, and crowing.
Snoring, gurgling, wheezing, and crowing.
What is the leading form of injury?
Soft-tissue trauma.
When treating a patient who exhibits signs and symptoms of shock, which of the following actions would not be appropriate?
Splint all suspected extremity fractures.
What is rule #2 for splinting?
Splint in position found, unless there is no distal cms, then move it.
Blood flow through the heart
Starts in the aorta, then goes to the right coronary artery (supplies blood to right ventricle and sometimes inferior wall of the left ventricle) and the left coronary artery (divided into 2 branches and supplies blood to left ventricle)
Diabetic coma
State of unconsciousness resulting from several problems, including ketoacidosis, dehydration, and hyperglycemia or insufficient insulin
What is a Strain?
Stretching or tearing of a muscle.
Pathophysiology
Study of how normal physiological processes are affected by diease
What is the Ventury effect?
Sucking in of air
You are assessing a 48-year-old male who is unconscious. The scene is safe and you hear the patient gurgling. What is your next action? Suction the airway. Insert an airway adjunct. Open the airway with a head tilt. Quickly check the pulse.
Suction the airway.
How do you take a proper glucose reading
Swab it Dry IT Poke it Wipe It Test It
What compartment syndrome?
Swelling in a confined space that produces dangerous pressure; may cut off blood flow or damage sensitive tissue. *Pain out of proportion to the injury*
Pedal Edema also known as Pitting Edema
Swelling of the feet
A patient with a pulse rate of 120 beats per minute is considered which of the following? Dyscardic Normocardic Tachycardic Bradycardic
Tachycardic
You respond to a childcare center for a report of an injured 4-year-old. Her pulse is 130 beats per minute. Which of the following BEST describes this finding? Bradycardic Normal for the chi ld's age Tachycardic Unable to determine without knowing the family history
Tachycardic
What is Cushings Triad?
Tachypnea- High BP, Bradycardia - Low Heart Rate, Hypertension.
What is a Sprain?
Tearing of ligaments
In general, the severity of a thermal injury correlates directly with?
Temperature, concentration, or amount of heat energy possessed by the object.
Perfusion
Transfer of oxygenated blood
Which of the following is an example of a rules-based medication error? Select one: A. The EMT administers a drug that is not approved by the medical director. B. The EMT administers the correct drug, but gives it by the wrong route. C. The EMT accidentally gives a higher drug dose than what is indicated. D. The EMT administers a drug that is contraindicated for the patient.
The EMT administers a drug that is not approved by the medical director
Red Blood Cells
The blood cells that carry oxygen. Red cells contain hemoglobin and it is the hemoglobin which permits them to transport oxygen
Plasma
The colorless fluid part of blood.
compensated shock
The early stage of shock, in which the body can still compensate for blood loss.
irreversible shock
The final stage of shock, resulting in death.
afterload
The force or resistance against which the heart pumps.
What is the dermis?
The inner layer of the skin, containing hair follicles, sweat glands, nerve endings, and blood vessels.
decompensated shock
The late stage of shock when blood pressure is falling.
What are mucous membranes?
The linings of body cavities and passages that are in direct contatct with the outside environment (mucous membranes are moist, while skin is dry)
What is the epidermis?
The outer layer of skin that acts as a watertight protective covering.
autonomic nervous system
The part of the nervous system that regulates involuntary functions, such as heart rate, blood pressure, digestion, and sweating.
What happens in the Irreversible stage of shock?
The patien is pretty much dead
What position is used to splint for the wrist or hand?
The position of function.
preload
The precontraction pressure in the heart as the volume of blood builds up.
edema
The presence of abnormally large amounts of fluid between cells in body tissues, causing swelling of the affected area.
What is contamination?
The presence of infective organisms or foreign bodies such as dirt, gravel, or metal.
Which of the following statements regarding the human immunodeficiency virus (HIV) is correct?
The risk of HIV infection is greatest when deposited on a mucous membrane or directly into the bloodstream.
What is the largest organ in the body?
The skin, it is also our first line of defense against external forces and infection
Hematology
The study and prevention of blood related disorders
Stroke volume
The volume of blood ejected with each ventricular contraction.
You respond to a nursing home to find an elderly patient with a pulse of 100, blood pressure of 100/60, respiratory rate of 12, and cool, pale skin. Which of the following describes this set of vital signs? They are normal. They indicate the patient is criticallyill. They will serve as a basis of comparison for later vital signs. The patient is stable and will not require additional vital signs during transport.
They will serve as a basis of comparison for later vital signs.
Which areas have thick/thin skin?
Thick - Scalp, Back, and Soles of the feet Thin - Eyelids
What is a full-thickness burn?
Third-degree; extend through all skin layers and may involve subcutaneous layers, muscles, bone, or internal organs
Treatment of AMI
Thrombolytic medication (clot bluster) or angioplasty (surgery to clear artery) -can prevent damage if done within first hour of onset of symptoms
Thrombophilia
Thrombophilia is a condition where the blood has an increased tendency to form clots. Blood clots can cause problems such as deep vein thrombosis (DVT) or pulmonary embolism.
Why do diabetics get thirsty and drink more fluids?
To dilute the high blood sugar.
Monophasic shock from AED
To send energy in one direction from negative to positive
TACOS
Tobacco Alcohol Caffeine Over the counter meds/herbs Sexual and street drugs
Septic shock
Toxins damage the vessel walls, causing leaking and impairing contraction. Usually ALOC due to head trauma.
Diabetes Mellitus
Two types... 1 and 2 Diabetes Mellitus means "Sweet" Diabetes. This refers to the presence of glucose (sugar) in the urine.
Acute coronary syndrome (ACS)
Umbrella term for situations that involve myocardial ischema (blood supply to the heart muscle is blocked)
How are the upper and lower airway affected with inhalation burns?
Upper - associated with inhalation of superheated gases Lower - associated with inhalation of chemicals & particle matter
When glucose is unavailable the body turns to fat. Why is that bad?
Using fat results in a build up of ketones and fatty acids in the blood tissue that makes your body even more off in ph levels
Type 2 Diabetes
Usually appears later in life Produces inadequate amounts of insulin or they may produce a normal amount it just doesnt function effectivley Can be reveresed with a lifestyle change.
Signs and Symptoms of Septic Shock
WARM SKIN tachycardia low BP
You are assessing an 82-year-old female that has been lost in the woods behind her nursing home for several hours on a crisp fall evening. Your pulse oximeter shows her oxygen saturation to be 82 percent even though she appears to be breathing adequately. In order to ensure an accurate reading you should: Try a different pulse oximeter. Place the probe on the patient's toe. Place the probe on the patient's earlobe. Warm the patient's hands and try again.
Warm the patient's hands and try again.
Biphasic shock from AED
Waveform flows in positive and negative directions -reflected by current going in one direction then turning around -advantage is that it produces more efficient defibrillation and may require lower energy setting
How do we get an idea of CO?
We rely on heart rate and strength of pulse
Signs of MI
Weakness, Naseau, sweating, constant chest pain, Lower jaw, arm, back, abdomen, neck pain, Irregular heart beats, Shortness of breath, Insane feeling of dying
A patient who was bitten by a mosquito and presents with signs and symptoms of illness should be suspected of having:
West Nile virus.
What is the Reflex arc?
When a sensor in the arc detects an irritating stimulus, instead of going to the brain the message is sent to a motor nerve. (e.g.: Detecting Heat, sharps ect.)
What is cavitation
When pressure waves exert force on an object as it passes through its trajectory.(e.g.: exit wound on a bullet)
Thermal burns can occur?
When the skin is exposed to temperatures higher than 111F (44C)
When does Anemia occur?
When there is an abnormally low number of red blood cells
White Blood Cells
White blood cells (WBCs), also called leukocytes or leucocytes, are the cells of the immune system that are involved in protecting the body
Congestive Heart Failure (CHF)
a disorder in which the heart loses part of its ability to effectively pump blood, usually as a result of damage to the heart muscle and usually resulting in pulmonary edema.
Syncope
a fainting spell or transient a loss of consciousness,often caused by an interruption of blood flow to the brain.
Acute Myocardial Infarction (AMI)
a heart attack; death of heart muscle following obstruction of blood flow in coronary artery -More likely to occur in larger, thick walled left ventricle, which needs more blood and O2 than right ventricle -1/3 of patients never seek medical attention because symptoms are not noticeably severe or they are afraid -40% do not reach hospital alive -A variety of other arhythmias may follow AMI, usually within 1st hour
during your assessment of a 50 year old male who was found unconscious in an alley, you note that he has slow, shallow respirations, significant bradycardia, facial cyanosis, and pinpoint pupils. as your partner begins assisting the patients ventilations, he directs your attention to the patients arms, which have multiple needle tracks on them. this patients clinical presentation is MOST consistent with
a heroin overdose
Cardiac Output
a measure of the volume of blood circulated by the heart and 1 min., calculated by multiplying the stroke line of the heart rate.
An infectious disease is MOST accurately defined as:
a medical condition caused by the growth and spread of small harmful organisms within the body.
Ventricular Tachycardia
a rapid heart rhythm in which the electrical impulse begins in the ventricle (instead of the atrium). Does not allow adequate time between beats for left ventricle to fill with blood, so bp may fall and pulse may be lost
Tachycardia
a rapid heartbeat, more than 100 beats/minute.
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) acute hypoglycemia. b) a ruptured cerebral artery. c) a complex partial seizure. d) an occluded cerebral artery.
a ruptured cerebral artery.
When caring for a patient with documented hypoglycemia, you should be MOST alert for: a) an acute stroke. b) a febrile convulsion. c) respiratory distress. d) a seizure.
a seizure.
Bradycardia
a slow heart rate, less than 60 beats/minutes.
Cardiogenic Shock
a state in which not enough oxygen is delivered to the tissues of the body caused by low output of blood from the heart. This can be a severe complication of an AMI, as well as other conditions.
Cardiac Arrest
a state in which the heart fails to generate effective and detectable blood flow; pulses are not palpable and cardiac arrest, even if muscular and electrical activity continues in the heart.
Acute Coronary Syndrome
a term used to describe a group of symptoms caused by myocardial ischemia (decrease in blood flow to the heart); includes angina and myocardial infarction.
Aortic Aneurysm
a weakness in the wall of the aorta that makes it susceptible to rupture.
A raised, swollen, well-defined area on the skin that is the result of an insect bite or sting is called:
a wheal.
A raised, swollen, well-defined area on the skin that is the result of an insect bite or sting is called: a) purpura. b) urticaria. c) a wheal. d) a pustule.
a wheal.
Basic causes of shock:
a)pump failure b)blood or fluid loss c)blood vessel dialation
Arrhythmia
abnormal heart rhythm.
Clinical signs of compensated shock include all of the following, EXCEPT:
absent peripheral pulse
activated charcoal administration in contraindicated in patients who have ingested
acids or alkalis
it is MOST important to determine a patients weight when asking questions pertaining to a toxic ingestion because
activated charcoal is given based on a patients weight
The primary prehospital treatment for most medical emergencies:
addresses the patient's symptoms more than the actual disease process.
percutaneous transluminal coronary angioplasty
aims to dilate coronary artery by inserting a balloon through the skin in groin and inflating it. sometimes a metal stent is put in place to maintain dilation
a 3 year old female ingested several leaves from a plant in the living room. the childs mother is not sure what type of plant it is, stating that she bought it simply because it was pretty. after completing your initial assessment of the child, you should
administer 25g of activated charcoal
While assisting a paramedic in the attempted resuscitation of a 55-year-old male in cardiac arrest, you should expect the paramedic to: Select one: A. give the patient nitroglycerin to increase his blood pressure. B. withhold drug therapy until an intraosseous catheter is in place. C. give the patient activated charcoal to rule out a drug overdose. D. administer drugs via the IV route to achieve the fastest effect.
administer drugs via the IV route to achieve the fastest effect.
You are dispatched to a state park for a young female experiencing an allergic reaction. Your assessment reveals that her breathing is severely labored and her blood pressure is very low. You carry epinephrine auto-injectors on your ambulance and have been trained and approved by your medical director to administer them. As your partner gives the patient supplemental oxygen, you attempt to contact medical control but do not have a signal from your cell phone. You should: Select one: A. immediately load the patient into the ambulance, begin transport, and reattempt to contact medical control when you receive a cell signal. B. notify dispatch and request that a paramedic unit respond to the scene so they can administer epinephrine to the patient. C. place her in a supine position, keep her warm, begin transport to the hospital, and request a paramedic intercept en route. D. administer epinephrine to the patient, begin immediate transport, and attempt to contact medical control en route to the hospital.
administer epinephrine to the patient, begin immediate transport, and attempt to contact medical control en route to the hospital.
A 19-year-old female was stung multiple times on the legs by fire ants. She states that she is allergic to fire ants, but does not carry her own epinephrine. The patient is conscious and alert and complains of pain to the area of the bites. Her blood pressure is 122/70 mm Hg, her pulse is 100 beats/min and strong, and her respirations are 18 breaths/min and unlabored. You should
administer oxygen and transport her to the hospital.
A 19-year-old female was stung multiple times on the legs by fire ants. She states that she is allergic to fire ants, but does not carry her own epinephrine. The patient is conscious and alert and complains of pain to the area of the bites. Her blood pressure is 122/70 mm Hg, her pulse is 100 beats/min and strong, and her respirations are 18 breaths/min and unlabored. You should: a) advise her to see her physician as soon as possible. b) position her legs well above the level of her heart. c) administer oxygen and transport her to the hospital. d) request a paramedic unit to administer epinephrine.
administer oxygen and transport her to the hospital.
Your primary assessment of an elderly woman reveals that she is conscious and alert, but is experiencing difficulty breathing. She has a history of emphysema, hypertension, and congestive heart failure. As you assess the patient's circulatory status, you should direct your partner to:
administer oxygen with the appropriate device.
A 59-year-old woman presents with chest pressure. She is conscious and alert, but her skin is cool, pale, and clammy. Your first step in providing care (treatment) should be: apply the AED. administer oxygen. ask her if she takes nitroglycerin. take a complete set of vital signs.
administer oxygen.
a 4 year old male ingested an unknown quantity of acetaminophen (Tylenol). the child's mother states that the ingestion occurred approximately 20 minutes ago. the child is conscious and alert and in no apparent distress. after contacting medical control, you should
administer up to 25 g of activated charcoal
The process of binding or sticking to a surface is called: Select one: A. digestion. B. suspension. C. adsorption. D. absorption.
adsorption
The determination of whether a medical patient is a high-priority or low-priority transport is typically made:
after the primary assessment has been completed.
The foreign substance responsible for causing an allergic reaction is called a(n):
allergen.
The foreign substance responsible for causing an allergic reaction is called a(n): a) allergen. b) leukotriene. c) antibody. d) histamine.
allergen.
insulin shock
altered level of consciousness caused by insufficient glucose; hypoglycemia and too much insulin
Hemolytic Crisis
an acute, accelerated drop in hemoglobin level
always suspect hypoglycemia in any patient with
an altered mental status
Hypertensive Emergency
an emergency situation created by excessively high blood pressure (usually more than 160 or rapid rise), which can lead to serious complications such as stroke or aneurysm.
Which of the following MOST accurately defines an allergic reaction?
an exaggerated immune system response to any substance
Which of the following MOST accurately defines an allergic reaction? a) an exaggerated immune system response to any substance b) destruction of the immune system by an external substance c) a direct negative effect on the body by an external substance d) a release of erythrocytes in response to a foreign substance
an exaggerated immune system response to any substance
Noncardiovascular causes of shock are respiratory failure and?
anaphylaxis
Signs and symptoms associated with hypoglycemia include
anxious or combative behavior
You are assessing a young male who was stung on the leg by a scorpion. He is conscious and alert, his breathing is regular and unlabored, and his blood pressure is 122/64 mm Hg. Assessment of his leg reveals a wheal surrounded by an area of redness. He states that he had a "bad reaction" the last time he was stung by a scorpion, and carries his own epinephrine auto-injector. You should: a) apply high-flow oxygen, obtain approval from medical control to assist him with his epinephrine, and transport. b) assess his ABCs and vital signs in 15 minutes and allow him to drive himself to the hospital if he remains stable. c) apply oxygen as needed, clean the area with soap and water or a mild antiseptic, and transport him to the hospital. d) apply high-flow oxygen, apply a chemical cold pack directly to the injection site, and transport at once.
apply oxygen as needed, clean the area with soap and water or a mild antiseptic, and transport him to the hospital.
You respond to a residence for a patient with a severe leg injury following an accident with a chainsaw. When you arrive, you find the patient, a 44-year-old male, lying supine in the backyard. He has a partial amputation of his right lower leg that is actively bleeding. The patient is conscious and breathing adequately; however, he is restless and his skin is diaphoretic. You should:
apply pressure directly to wound
in general, injected poisons are impossible to dilute or remove because they
are usually absorbed quickly into the body.
Febrile seizures: a) are usually benign but should be evaluated. b) are also referred to as petit mal seizures. c) occur when a child's fever progressively rises. d) often result in permanent brain damage.
are usually benign but should be evaluated.
You respond to the residence of a 55-year-old female with a possible allergic reaction to peanuts that she ate approximately 30 minutes ago. The patient is conscious and alert, but has diffuse urticaria and the feeling that she has a lump in her throat. As your partner applies oxygen to the patient, you should: a) ask her when her last allergic reaction occurred. b) obtain a complete set of baseline vital signs. c) ask her if she has prescribed epinephrine. d) ascertain if she has a family history of allergies.
ask her if she has prescribed epinephrine.
A 58-year-old man complains of chest discomfort and nausea. He is conscious and alert; his blood pressure is 140/90 mm Hg, his pulse is 104 beats/min, and his respirations are 16 breaths/min. Your partner has applied supplemental oxygen. Prior to assisting the patient with one of his prescribed nitroglycerin tablets, you ask him if he takes medication to treat erectile dysfunction and he tells you that he does. You should:
ask him what he takes, how much, and when he last took it.
A 58-year-old male presents with confusion, right-sided weakness, and slurred speech. His wife is present and is very upset. As your partner is applying oxygen, it is MOST important for you to: a) administer glucose to rule out hypoglycemia. b) ask his wife when she noticed the symptoms. c) obtain a complete set of baseline vital signs. d) list all of the patient's current medications.
ask his wife when she noticed the symptoms.
When obtaining the medical history of a patient experiencing a sickle cell crisis, you should
ask the patient if he has been compliant with his medications
Which of the following will MOST reliably allow you to determine the nature of a patient's illness?
asking questions related to the chief complaint
A 33-year-old female presents with lower abdominal quadrant pain. She is conscious and alert, but in moderate pain. While your partner is asking her questions about her medical history, you take her vital signs. When you assess her radial pulse, you are unable to locate it. You should:
assess the rate, regularity, and quality of her carotid pulse.
A 38-year-old female was bitten by fire ants while at the park with her kids. Your primary assessment reveals that she is semiconscious, has profoundly labored breathing, and has a rapid, thready pulse. She has a red rash on her entire body and her face is very swollen. You should:
assist her ventilations with 100% oxygen.
A 38-year-old female was bitten by fire ants while at the park with her kids. Your primary assessment reveals that she is semiconscious, has profoundly labored breathing, and has a rapid, thready pulse. She has a red rash on her entire body and her face is very swollen. You should: a) administer 0.3 mg of epinephrine. b) place her supine with her legs elevated 6″ to 12″. c) perform a rapid secondary assessment. d) assist her ventilations with 100% oxygen.
assist her ventilations with 100% oxygen.
A 62-year-old male is seen with crushing chest pain, which he describes as being the same kind of pain that he had with a previous heart attack. He has prescribed nitroglycerin but states that he has not taken any. After administering supplemental oxygen if needed and contacting medical control, you should: Select one: A. administer up to three doses of nitroglycerin before assessing his blood pressure. B. administer the nitroglycerin unless he has taken Viagra within the past 72 hours. C. begin immediate transport and request a rendezvous with a paramedic unit. D. assist him with his nitroglycerin unless his systolic blood pressure is less than 100 mm Hg
assist him with his nitroglycerin unless his systolic blood pressure is less than 100 mm Hg
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: a) apply oxygen via a nonrebreathing mask, place her on her left side, and transport. b) apply oxygen via nonrebreathing mask and transport her for a blood-alcohol test. c) assist ventilations, perform a rapid exam, and prepare for immediate transport. d) place a bite block in her mouth in case she has a seizure and transport at once.
assist ventilations, perform a rapid exam, and prepare for immediate transport
you are dispatched to a local nursery for a 39 year old female who is sick. when you arrive, you find the patient lying on the floor. she is semiconscious, has copious amounts of saliva coming from her mouth, and is incontinent of urine. you quickly feel her pulse and note that it is very slow. initial management for this patient should include
assisted ventilation with bag mask device
you and your paramedic partner are caring for a patient who ingested codeine, acetaminophen, and propoxyphene (daron). the patient is unresponsive , his breathing is slow and shallow, and his pulse is slow and weak. treatment for this patient with include
assisted ventilation, naloxone (narcan), and rapid transport
Upon initial contact with a patient who appears to be unconscious, you should:
attempt to elicit a verbal response by talking to the patient.
you respond to a college campus for a young male who is acting strangely. after law enforcement has secured the scene, you enter the patients dorm room and find him sitting on the edge of the bed, he appears agitated. as you approach him, you note that he has dried blood around both nostrils. he is breathing adequately, his pulse is rapid and irregular, and his blood pressure is 200/110. treatment for this patient includes
attempting to calm him and giving him oxygen is tolerated
index of suspicion
awareness that unseen life-threatening injuries or illness may exist
Which of the following MOST accurately describes septic shock?
bacterial damage to the vessel wall, leaking blood vessels, and vasodilation
after administering activated charcoal to a patient, it is MOST important to
be alter for vomiting
determination of diabetic coma or insulin shock should
be based upon your knowledge of the signs and symptoms of each condition
treatment for CHF
because the risk of pulmonary edema is very high positive-pressure ventilation by BVM or CPAP is needed. CPAP is best way to treat
Where do you administer oral glucose
between the gum and cheek
activated charcoal is given to patients who have ingested certain substance because because it
binds to the substance and prevents absorption.
The patient loses consciousness and a second blood glucose level reads 48mg/dL. You should:
call for an ALS units, ensure a patient airway, provide high-flow oxygen
Medications encased in a gelatin shell that are taken by mouth are called: Select one: A. pills. B. caplets. C. capsules. D. tablets.
capsules
One of the primary waste products of normal cellular metabolism that must be removed from the body by the lungs is:
carbon dioxide
Which of the following injuries would MOST likely cause obstructive shock?
cardiac tamponade
A collection of fluid between pericardial sac and myocardium caused by blunt force trauma to chest/ type of obstructive shock
cardiac tamponade/pericardial tamponade
Pulmonary edema and impaired ventilation occur during: A) neurogenic shock. B) anaphylactic shock. C) septic shock. D) cardiogenic shock.
cardiogenic shock
When assessing an elderly male who complains of nausea and generalized weakness, you find that he takes atorvastatin (Lipitor) and amlodipine (Norvasc). These medications suggest a history of: Select one: A. cardiovascular disease. B. non-insulin-dependent diabetes. C. reactive airway disease. D. bacterial infection.
cardiovascular disease
Regulation of blood flow is determined by?
cellular need
Muscle control and body coordination are controlled by the: a) cerebral cortex. b) cerebrum. c) cerebellum. d) brain stem.
cerebellum.
Interruption of cerebral blood flow may result from all of the following, EXCEPT: a) an embolism. b) an acute arterial rupture. c) a thrombus. d) cerebral vasodilation.
cerebral vasodilation.
The three major parts of the brain are the: a) cerebrum, cerebellum, and brain stem. b) brain stem, midbrain, and spinal cord. c) cerebellum, medulla, and occiput. d) midbrain, cerebellum, and spinal cord.
cerebrum, cerebellum, and brain stem.
Nuerogenic shock usually develops from damage to spinal cord at the:
cervical level
When treating an 80-year-old patient who is in shock, it is important to remember that:
changes in gastric motility may delay gastric emptying, which increases the risk for vomiting.
In addition to looking for severe bleeding, assessment of circulation in the conscious patient should involve:
checking the radial pulse and noting the color, temperature, and condition of his or her skin.
Signs and Symptoms of Cardiogenic Shock
chest pain irregular weak pulse/low BP cyanosis cool clammy skin anxiety rales in breathing pulmonary edema/possibly short of breath
which of the following drugs is NOT a sedative-hypnotic
cocaine
When assessing breathing for a patient in shock, an increased respiratory rate can be a sign of:
compensated shock
Which of the following MOST accurately describes what the patient will experience during the postictal state that follows a seizure? a) hyperventilation and hypersalivation b) a gradually decreasing level of consciousness c) confusion and fatigue d) a rapidly improving level of consciousness
confusion and fatigue
#1 cause of death for men and women in the US
coronary artery disease. Peak ages are between 40 and 70 years
Patients with tuberculosis pose the greatest risk for transmitting the disease when they:
cough
Consequences of AMI
death (cardiac arrest) cardiogenic shock CHF (congestive heart failure)
Infarction
death of a body tissue, usually caused by interruption of blood flow.
Kussmaul respirations
deep, rapid breathing
A patient with cardiac arrest secondary to ventricular fibrillation has the greatest chance for survival if: CPR is initiated within 10 minutes. oxygen and rapid transport are provided. defibrillation is provided within 2 minutes. paramedics arrive at the scene within 5 minutes.
defibrillation is provided within 2 minutes.
Golfer collapsed, skin pale, cool, diaphoretic providing incoherent answers. Type 2 diabetic meaning:
developed diabetes later in life, produced inadequate amounts of insulin, takes noninsulin-type oral medications
Pulmonary Edema
develops when the Right ventricles pump blood back down to the feet
__________ is one of the basic sugars in the body
dextrose (glucose)
Type 2 diabetes
diabetes with onset later in life; may be controlled by diet and oral medication
A 29-year-old male complains of a severe headache and nausea that has gradually worsened over the past 12 hours. He is conscious, alert, and oriented and tells you that his physician diagnosed him with migraine headaches. He further tells you that he has taken numerous different medications, but none of them seem to help. His blood pressure is 132/74 mm Hg, his pulse is 110 beats/min and strong, and his respirations are 20 breaths/min and adequate. In addition to high-flow oxygen, further treatment should include: a) assisting him with his migraine medication and transporting without lights and siren. b) applying warm compresses to the back of his neck and transporting with lights and siren. c) dimming the lights in the back of the ambulance and transporting without lights and siren. d) placing him in a supine position and transporting with lights and siren to a stroke center.
dimming the lights in the back of the ambulance and transporting without lights and siren.
Which of the following medications blocks the release of histamines? a) epinephrine b) diphenhydramine (Benadryl) c) albuterol (Ventolin) d) acetaminophen (Tylenol)
diphenhydramine (Benadryl)
What is anascoria?
disorder of unequal pupils. Accounts for 3% of population.
hemophilia
disorder that causes an inability to develop blood clots
Ventricular Fibrillation
disorganized, ineffective twitching of the ventricles, resulting in no blood flow and a state of cardiac arrest.
What is rule #3 for splinting?
don't tape or strap over injuries or uninjured joints( you don't want to cut off distal CMS.)
The amount of medication that is given is known as the _________. Select one: A. indication B. side effect C. contraindication D. dose
dose
most poisonings occur via the ________ route
ingestion
your paramedic partner administers atropine to a 49 year old male with bradycardia which of the following side effects would you expect the patient to experience
dry mucous membranes
Common signs and symptoms of an allergic reaction include all of the following, EXCEPT:
drying of the eyes.
Common signs and symptoms of an allergic reaction include all of the following, EXCEPT: a) drying of the eyes. b) persistent dry cough. c) abdominal cramps. d) flushing of the skin.
drying of the eyes.
A patient whose speech is slurred and difficult to understand is experiencing: a) aphasia. b) dysphagia. c) paraplegia. d) dysarthria.
dysarthria.
While palpating the radial pulse of a 56-year-old man with chest pain, you note that the pulse rate is 86 beats/min and irregular. This indicates: pain. fear. anxiety. dysrhythmia.
dysrhythmia.
During the primary assessment of a semiconscious 70-year-old female, you should: a) insert a nasopharyngeal airway and assist ventilations. b) ensure a patent airway and support ventilation as needed. c) ask family members if the patient has a history of stroke. d) immediately determine the patient's blood glucose level.
ensure a patent airway and support ventilation as needed.
Anaphylaxis is MOST accurately defined as a(n):
extreme allergic reaction that may affect multiple body systems.
Anaphylaxis is MOST accurately defined as a(n): a) moderate allergic reaction that primarily affects the vasculature. b) severe allergic reaction that typically resolves without treatment. c) extreme allergic reaction that may affect multiple body systems. d) allergic reaction that causes bronchodilation and vasoconstriction.
extreme allergic reaction that may affect multiple body systems.
Neurogenic shock occurs when:
failure of the nervous system causes widespread vasodilation.
speed of intercranial bleeding of the intracerebral
fast
Typical chief complaints in patients with an infectious disease include:
fever, rash, nausea, and difficulty breathing.
Thrombo-embolism
floating blood clot
When performing a secondary assessment on a conscious patient with nontraumatic abdominal pain and stable vital signs, you should:
focus on his or her chief complaint.
A 39-year-old male sustained a large laceration to his leg during an accident with a chainsaw and is experiencing signs and symptoms of shock. You should:
follow appropriate standard precautions.
The spinal cord exits the cranium through the: a) foramen lamina. b) vertebral foramen. c) foramen magnum. d) cauda equina.
foramen magnum.
What is a displaced fracture?
fracture where there is deformity
common names for activated charcoal include all of the following except
fructose
Drugs most often prescribed to patients with CHF
furosemide (Lasix), digoxin, and amiodarone (Cordarone)
nature of illness (NOI)
general type of illness a patient is experiencing
Without _________, or with very low levels, brain cells rapidly suffer permanent damage
glucose
All of the following are common signs and symptoms of cardiac ischemia, EXCEPT: headache. chest pressure. shortness of breath. anxiety or restlessness.
headache
A sickle cell crisis caused by an acute drop in hemoglobin levels in known as an
hemolytic crisis
insulin shock can develop more often and more severely in children than in adults due to their
high activity level and failure to maintain a strict schedule of eating
Chemicals that are responsible for the signs and symptoms of an allergic reaction to a bee sting include:
histamines and leukotrienes.
Chemicals that are responsible for the signs and symptoms of an allergic reaction to a bee sting include: a) histamines and leukotrienes. b) adrenaline and histamines. c) the bee venom itself. d) leukocytes and epinephrine.
histamines and leukotrienes.
When assessing a patient with a medical complaint, which of the following would MOST likely reveal the cause of his or her problem?
history taking
Urticaria is the medical term for:
hives.
Urticaria is the medical term for: a) a wheal. b) hives. c) burning d) swelling.
hives.
The MOST significant risk factor for a hemorrhagic stroke is: a) severe stress. b) heavy exertion. c) diabetes mellitus. d) hypertension.
hypertension.
the patient in insulin shock is experiencing
hypoglycemia
Shock is the result of:
hypoperfusion to the cells of the body.
In an acute injury setting, neurogenic shock is commonly accompanied by: A) hypovolemia. B) diaphoresis. C) tachycardia. D) hypothermia.
hypothermia
Which of the following conditions would be the LEAST likely to mimic the signs and symptoms of a stroke? a) hypovolemia b) a postictal state c) intracranial bleeding d) hypoglycemia
hypovolemia
Advil, Nuprin, and Motrin are trade names for the generic medication: Select one: A. acetaminophen. B. aspirin. C. nitrostat. D. ibuprofen.
ibuprofen
In compensated shock, the pulse of the patient usually:
increases
a hypnotic drug is one that:
induces sleep
Factors that may contribute to diabetic coma include:
infection, alcohol consumption, insufficient insulin (too much glucose)
meningitis
inflammation of the meningeal coverings of the brain ad spinal cors, usually caused by a virus or bacterium
You are dispatched to a residence for a 66-year-old male who, according to family members, has suffered a massive stroke. Your primary assessment reveals that the patient is unresponsive, apneic, and pulseless. You should: a) assess the patient for a facial droop and hemiparesis. b) perform CPR for 5 minutes before applying the AED. c) obtain a blood glucose sample to rule out hypoglycemia. d) initiate cardiopulmonary resuscitation (CPR) and attach an automated external defibrillator (AED) as soon as possible.
initiate cardiopulmonary resuscitation (CPR) and attach an automated external defibrillator (AED) as soon as possible.
you receive a call to a residence where a man found his wife unconscious on the couch. the patient is unresponsive, her respiratory rate is 8 breaths/min, her breathing is shallow, her heart rate is 40 beats per minutes, and her pulse is weak. the husband hands you an empty bottle of hydrocodone(vicodin) which was refilled the day before. you should:
initiate ventilator assistance
a poison that enters the body by ______ is the MOST difficult to treat.
injection
trauma emergencies
injuries that are the result of physical forces applied to the body
___________ is the hormone that is normally produced by the pancreas that enable glucose to enter the cell
insulin
diabetes is a metabolic disorder in which the hormone _______ is missing or ineffective
insulin
Because of his low blood glucose level and rapid respirations, you suspect:
insulin shock/hypoglycemia
when caring for a know alcoholic patient with severe trauma to the chest and abdomen, you should be concerned that
internal bleeding may be profuse because prolonged alcohol use may impair the bloods ability to colt
A patient in insulin shock or a diabetic coma may appear to be
intoxicated
What does the Autonomic nervous system (ANS) control?
involuntary activities such as heart rate, blood pressure, breathing and sweating.
the poison control center will be able to provide you with the most information regarding the appropriate treatment for a patient with a drug overdose if the center
is aware of the substance that is involved
In contrast to the assessment of a trauma patient, assessment of a medical patient:
is focused on the nature of illness, the patient's chief complaint, and his or her symptoms.
The mental status of a patient who has experienced a typical seizure: a) typically does not improve, even after several minutes. b) is easily differentiated from that of acute hypoglycemia. c) is likely to improve over a period of 5 to 30 minutes. d) progressively worsens over a period of a few hours.
is likely to improve over a period of 5 to 30 minutes.
In contrast to viral hepatitis, toxin-induced hepatitis:
is not a communicable disease.
The secondary assessment of a medical patient
is not practical if the patient is critically ill or your transport time is short.
Patients develop septic shock secondary to
poor vessel function and severe volume loss
medical emergencies
life threats that require EMS attention because of illnesses or conditions not caused by outside force
When caring for a patient with an altered mental status and signs of circulatory compromise, you should:
limit your time at the scene to 10 minutes or less, if possible.
Diabetes
literal meaning: "A passer through; a siphon;" refers to a metabolic disorder in which the body's ability to metabolize simple carbs (glucose) is impaired
an overdose on acetaminophen, the active ingredient in Tylenol, will most likely cause
liver failure
Which of the following would MOST likely result in hemorrhagic shock? A) liver laceration B) excessive sweating C) severe vomiting D) repeated diarrhea
liver laceration
Individuals with chronic alcoholism are predisposed to intracranial bleeding and hypoglycemia secondary to abnormalities in the: a) kidneys. b) liver. c) brain. d) pancreas.
liver.
which of the following statements regarding inhaled poisons is correct
lung damage may progress after the patient is removed from the environment
You arrive at the residence of a 33-year-old woman who is experiencing a generalized seizure. She has a small amount of vomitus draining from the side of her mouth. After protecting her from further injury, you should: a) place a bite block in between her teeth, apply high-flow oxygen via a nonrebreathing mask, and consider inserting a nasopharyngeal airway. b) wait for the seizure to stop, manually open her airway, insert an oropharyngeal airway, and assess her oxygen saturation with the pulse oximeter. c) maintain her airway with manual head positioning, suction her airway to remove the vomitus, insert a nasopharyngeal airway, and administer high-flow oxygen. d) restrain her extremities to prevent her from injuring herself, suction her airway to remove the vomitus, and assist her ventilations with a bag-mask device.
maintain her airway with manual head positioning, suction her airway to remove the vomitus, insert a nasopharyngeal airway, and administer high-flow oxygen.
A 48-year-old male is found unconscious in the garden by his wife. When you arrive at the scene and assess the man, you find that he is unresponsive, has severely labored breathing, and has hives over his entire trunk. You should:
maintain his airway and assist his ventilations.
A 48-year-old male is found unconscious in the garden by his wife. When you arrive at the scene and assess the man, you find that he is unresponsive, has severely labored breathing, and has hives over his entire trunk. You should: a) apply the automated external defibrillator (AED) in the event that cardiac arrest occurs. b) ask his wife if he has any known allergies. c) perform a detailed secondary assessment. d) maintain his airway and assist his ventilations.
maintain his airway and assist his ventilations.
You and your EMT partner arrive at the residence of a 50-year-old man who complains of weakness. Your primary assessment reveals that he is critically ill and will require aggressive treatment. The closest hospital is 25 miles away. You should:
manage all threats to airway, breathing, and circulation and consider requesting an ALS unit.
syrup of ipecac is no longer recommended to treat patients who have ingested a poisonous substance because it
may result in aspiration of vomitus
your unit is dispatched to the county jail for an intoxicated inmate. upon arrival, you find the patient, a 33 year old male. lying supine in a jail cell. he is responsive to painful stimuli only and has slow, shallow respirations. you should be MOST concerned that this patient
may vomit and aspirate
Causes of Obstructive Shock
mechanical obstruction of cardiac muscle leading to pump failure
Which of the following is NOT an assessment parameter included in the Cincinnati Prehospital Stroke Scale? a) speech b) memory c) arm drift d) facial droop
memory
A patient who presents with a headache, fever, confusion, and red blotches on his or her skin should be suspected of having:
meningitis.
Oral diabetic medication include
micronase, glucotrol, diabinese
Blood glucose levels are measured in
milligrams per deciliter
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 phenytoin (Dilantin) for her seizures, but has not taken it in a few days. He also tells you that she has diabetes. In addition to applying high-flow oxygen, you should: a) administer one tube of oral glucose and prepare for immediate transport. b) give her small cups of water to drink and observe for further seizure activity. c) monitor her airway and breathing status and assess her blood glucose level. d) place her in the recovery position and transport her with lights and siren.
monitor her airway and breathing status and assess her blood glucose level.
After administering 0.3 mg of epinephrine via auto-injector to a 22-year-old female with an allergic reaction, you note improvement in her breathing and dissipation of her hives. However, she is still anxious and tachycardic. You should:
monitor her closely but recall that anxiety and tachycardia are side effects of epinephrine.
After administering 0.3 mg of epinephrine via auto-injector to a 22-year-old female with an allergic reaction, you note improvement in her breathing and dissipation of her hives. However, she is still anxious and tachycardic. You should: a) monitor her closely but recall that anxiety and tachycardia are side effects of epinephrine. b) transport her rapidly, as it is obvious that she is having a severe reaction to the epinephrine. c) consider administering 0.15 mg of epinephrine to completely resolve her allergic reaction. d) contact medical control and obtain authorization to administer another 0.3 mg of epinephrine.
monitor her closely but recall that anxiety and tachycardia are side effects of epinephrine.
Hypoglycemia crisis symptoms
normal to shallow or rapid respirations; pale, moist skin; diaphoresis (sweating); dizziness, headache; rapid pulse; normal to low blood pressure; altered mental status (aggressive, confused, lethargic, or unusual behavior); anxious or combative behavior; hunger; seizures, fainting coma; weakness on one side of body (may mimic stroke); rapid changes in mental status
A patient with an altered mental status is: a) not thinking clearly or is incapable of being aroused. b) completely unresponsive to all forms of stimuli. c) typically alert but is confused as to preceding events. d) usually able to be aroused with a painful stimulus.
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 carbamazepine (Tegretol). When obtaining further medical history from the girlfriend, it is MOST important to: a) determine when he was last seen by his physician. b) ask her how long the patient has been taking his medication. c) determine if the patient is a known alcohol abuser. d) obtain a description of how the seizure developed.
obtain a description of how the seizure developed.
before giving activated charcoal you should
obtain approval form medical control
People who may not feel pain during AMI
older people women (often only com pain of fatigue) people with diabetes
Atrium
one of two (right and lef upper chambers of the heart. The right atrium receives blood from the vena cava and delivers it to the right ventricle. The left atrium receives blood from the pulmonary veins and delivers it to the left ventricle.
Ventricle
one of two (right and left) lower chambers of the heart. The left ventricle receives blood from the left atrium (upper chamber) and delivers blood to the aorta. The right ventricle receives blood from the right atrium and pumps it into the pulmonary artery.
the most important step in caring for the unresponsive diabetic patients is to
open the airway
heroin is an example of an
opioid
It is uncommon to encounter ________ patients with thrombophilia
pediatric
In ___________ administration, you are administering medication to yourself or your partner. Select one: A. patient-assisted B. peer-assisted C. EMT-administered D. paramedic-administered
peer-assisted
An absence seizure is also referred to as a: a) grand mal seizure. b) petit mal seizure. c) total body seizure. d) generalized motor seizure.
petit mal seizure.
The term for excessive eating as a result of cellular "hunger" is
polyphagia
The term for excessive urination is
polyuria
If a patient with an implanted pacemaker is in cardiac arrest, the EMT should: avoid defibrillation with the AED and transport at once. not apply the AED until he or she contacts medical control. place the AED pads away from the pacemaker. apply the AED pads directly over the implanted pacemaker.
place the AED pads away from the pacemaker.
Hypovolemic shock caused by severe burns is the result of a loss of:
plasma
SARS (severe acute respiratory syndrome)
potentially life threatening viral infection that usually starts with flulike symptoms
You have just completed your primary assessment of a 48-year-old man with crushing chest pain. The patient has been given 324 mg of aspirin and is receiving high-flow oxygen via nonrebreathing mask. As you begin your secondary assessment, you note that his mental status has deteriorated and he is now bradycardic. You should:
prepare the patient for immediate transport.
Aspirin
prevents clots from forming or getting bigger -recommended dose is 162 mg (2 tablets) to 324 mg (4 tablets) -ask patient if they have history of internal bleeding and if so contact med control
Glucose
primary fuel, along with oxygen, for cellular metabolism
Factors that increase the risk for developing methicillin-resistant Staphylococcus aureus (MRSA) include:
prolonged hospitalization, especially in an intensive care unit.
Status epilepticus is characterized by: a) profound tachycardia and total muscle flaccidity. b) an absence seizure that is not preceded by an aura. c) prolonged seizures without a return of consciousness. d) generalized seizures that last less than 5 minutes.
prolonged seizures without a return of consciousness.
Immediately after giving an epinephrine injection, you should:
properly dispose of the syringe.
Immediately after giving an epinephrine injection, you should: a) record the time and dose given. b) properly dispose of the syringe. c) reassess the patient's vital signs. d) notify medical control of your action.
properly dispose of the syringe.
What is a sudden reaction of nervous system causing temporary vasodilation and fainting?
psychogenic shock
Neurogenic shock is caused by
radical change in size of blood vessels
Emergency care of a patient with hemophilia includes all of the following:
rapid transport, bleeding control, ventilations if needed
A 31-year-old female is experiencing an acute asthma attack. She is conscious and alert, but in obvious respiratory distress. After assisting her with her prescribed MDI, you should: Select one: A. administer another treatment in 30 seconds if she is still in distress. B. reassess the patient and document her response to the medication. C. check the drug's expiration date to ensure that it is still current. D. contact medical control and apprise him or her of what you did.
reassess the patient and document her response to the medication
After administering a nitroglycerin tablet to a patient, the EMT should: check the expiration date of the nitroglycerin. reassess the patient's blood pressure within 5 minutes. instruct the patient to chew the tablet until it is dissolved. ensure that the nitroglycerin is prescribed to the patient.
reassess the patient's blood pressure within 5 minutes.
In addition to obtaining a SAMPLE history and asking questions related to the chief complaint, what else should you inquire about when assessing a patient with a potentially infectious disease?
recent travel
the EMTs primary responsibility to the patient who has been poisoned is to
recognize that a poisoning has occurred
A 50-year-old male was stung by a honeybee approximately 15 minutes ago. He presents with respiratory distress, facial swelling, and hypotension. After placing him on oxygen and administering his epinephrine via auto-injector, you note that his breathing has improved. Additionally, his facial swelling is resolving and his blood pressure is stable. Your next action should be to: a) record the time and dose of the injection, and transport promptly. b) reassess his breathing and blood pressure in 15 minutes. c) notify medical control of the patient's response to your treatment. d) visualize his airway to assess for oropharyngeal swelling.
record the time and dose of the injection, and transport promptly.
When transporting a stable stroke patient with unilateral paralysis, it is best to place the patient in a: a) recumbent position with the paralyzed side up. b) recumbent position with the paralyzed side down. c) sitting position with the head at a 45° to 90° angle. d) supine position with the legs elevated 6″ to 12″.
recumbent position with the paralyzed side down.
Nitro
relaxes muscles of blood vessel walls, dilates coronary arteries, increases blood flow and O2 to heart -dilates vessels in other parts of the body and can cause low bp and/or severe headache -cotraindications: presence of head injury, use of erectile dysfunction drugs within 24 hours, and three doses already given -works in 5 min for most patients -"Nitrostat" is one trade name
Stable angina
relieved by things that usually relieve angina for the patient, like resting or taking nitro
reassessment
repeat primary assessment
You are assessing the arm drift component of the Cincinnati Prehospital Stroke Scale on a 60-year-old woman. When she holds both of her arms out in front of her and closes her eyes, both of her arms immediately fall to her sides. You should: a) instruct the patient to keep her eyes open and then repeat the arm drift test. b) repeat the arm drift test and ensure that her palms are facing downward. c) defer this part of the test and assess her for facial droop and slurred speech. d) repeat the arm drift test, but move the patient's arms into position yourself.
repeat the arm drift test, but move the patient's arms into position yourself.
Reassessment of a patient with a medical complaint should begin by:
repeating the primary assessment.
You have administered one dose of epinephrine to a 40-year-old female to treat an allergic reaction that she developed after being stung by a scorpion. Your reassessment reveals that she is still having difficulty breathing, has a decreasing mental status, and has a blood pressure of 80/50 mm Hg. You should:
request permission from medical control to give another dose of epinephrine.
You have administered one dose of epinephrine to a 40-year-old female to treat an allergic reaction that she developed after being stung by a scorpion. Your reassessment reveals that she is still having difficulty breathing, has a decreasing mental status, and has a blood pressure of 80/50 mm Hg. You should: a) administer a nebulized bronchodilator to improve the status of her breathing. b) monitor her en route to the hospital and call medical control if she worsens. c) crush up an antihistamine tablet and place it in between her cheek and gum. d) request permission from medical control to give another dose of epinephrine.
request permission from medical control to give another dose of epinephrine.
End-tidal carbon dioxide (ETCO2) monitoring is clearly indicated for patients who present with:
respiratory distress.
in an apparent suicide attempt, a 19 year old female ingested a full bottle of amitriptyline (Elavil) at present, she is conscious and alert and states that she swallowed the pills approximately 30 minutes earlier. her blood pressure is 90/50 her pulse is 140 and irregular , and her respirations are 22 breaths with adequate depth. when transporting this patient, you should be most alert for
seizures and cardiac arrhythmias
An African American patients complaining of severe, generalized pain may have undiagnosed
sickle cell disease
After taking diphenhydramine (Benadryl) for an allergic reaction, a person begins experiencing drowsiness and a dry mouth. These findings are an example of a(n): Select one: A. untoward effect. B. unpredictable effect. C. side effect. D. therapeutic effect.
side effect
Speed of intercranial bleeding of the subdural
slow
Which of the following sounds indicates swelling of the upper airway? a) stridor b) wheezing c) rhonchi d) rales
stridor
Which of the following conditions often requires transport to a hospital with specialized capabilities that may not be available at the closest hospital?
stroke and heart attack
Parasympathetic Nervous System
subdivision of the autonomic nervous system, involved in the control of involuntary, vegetative functions, mediated largely by the vagus nerve to the chemical acetylcholine.
Which of the following conditions is NOT categorized as a psychiatric condition?
substance abuse
You are caring for a 70-year-old female with signs and symptoms of an acute stroke. She is conscious, has secretions in her mouth, and is breathing at a normal rate with adequate depth. You should: a) use a bag-mask device to assist her ventilations. b) insert an oral airway, apply oxygen, and transport. c) place her on her side and prepare for rapid transport. d) suction her oropharynx and apply 100% oxygen.
suction her oropharynx and apply 100% oxygen.
The left cerebral hemisphere controls: a) breathing and blood pressure. b) the right side of the body. c) the right side of the face. d) heart rate and pupil reaction.
the right side of the body.
What is rule #4 for splinting?
the splint should extend past 2 nearest uninjured joints distal and proximal to injury.
The term "pharmacology" is MOST accurately defined as: Select one: A. the study of how medications affect the brain. B. the study of drugs that are produced illegally. C. the study of drugs and their actions on the body. D. the study of drug excretion from the human body.
the study of drugs and their actions on the body
phosphorus or elemental sodium should be brushed off the skin instead of irrigated with water because
these chemicals may ignite upon contact with water
Diabetic coma may develop as a result of
too little insulin
Successful treatment of a stroke depends on whether: a) thrombolytic therapy is given within 3 hours after symptoms began. b) the stroke occurs within the left or right hemisphere of the brain. c) surgical intervention is performed to remove obstructive clots. d) medications are given to restore the function of infarcted cells.
thrombolytic therapy is given within 3 hours after symptoms began.
acidosis
to much acids in the body
Defibrillate
to shock of celebrating (chaotically beating) heart with specialized electrical current and attempt to restore a normal rhythmic beat.
a person who routinely misuses a substance and requires increasing amounts to achieve the same effect is experiencing an
tolernance
Angina Pectoris
transient (short-lived) chest discomfort caused by partial or temporary blockage of blood flow to the heart muscle. Most often a symptom of atherosclerosis coronary artery disease
A patient who is experiencing aphasia is: a) not able to swallow without choking. b) unable to produce or understand speech. c) usually conscious but has slurred speech. d) experiencing a right hemispheric stroke.
unable to produce or understand speech.
contraindications for the use of oral glucose include
unconsciousness
Which of the following negative effects of anaphylaxis will be the MOST rapidly fatal if not treated immediately? a) diffuse urticaria b) systemic vasodilation c) severe hypotension d) upper airway swelling
upper airway swelling
The principal clinical difference between a stroke and hypoglycemia is that patients with hypoglycemia: a) are typically alert and attempt to communicate with health care providers. b) always take oral medications to maintain normal blood glucose levels. c) do not present with slurred speech or weakness to one side of the body. d) usually have an altered mental status or decreased level of consciousness.
usually have an altered mental status or decreased level of consciousness.
Which of the following physiologic actions does epinephrine produce when given for an allergic reaction?
vasoconstriction and bronchodilation
ventricular fibrilation (v-fib)
ventricles shaking
herpes simplex
virus caused by human herpesviruses 1 and 2, characterized by small blisters whose location depends on the type of virus. Type 2 results in blisters on the genital area, while type 1 results in blisters in non genital areas
you respond to a local motel for a young female who was sexually assaulted. the patient is conscious but confused, she tells you that the last thing she remembers was drinking beer at a club with her friends the night before, when she awoke, she was in the bed of the motel room. you should be most suspicious that this patient
was given flunitrazepam (Rohypnol)
Symptoms of Classic Compensated Shock
weak rapid pulse, More than 2 seconds on Cap. Refill, rapid breathing, Pale Skin, Marked Thirst,**** Blood pressure maintained at adequate level***
Diabetic Ketoacidosis (DKA) - Signs and Symptoms
weakness and nausea Kussmaul respiration weak and rapid pulse sweet breath/fruity (two-day old drunk breath) can progress to coma and death blood sugar 400 or above All we can do is drive the truck fast
Which of the following clinical signs is unique to anaphylactic shock?
wheezing
Epinephrine is indicated for patients with an allergic reaction when:
wheezing and hypotension are present
Epinephrine is indicated for patients with an allergic reaction when: a) the patient is anxious and tachycardic. b) a paramedic is present at the scene. c) wheezing and hypotension are present. d) the reaction produces severe urticaria.
wheezing and hypotension are present.
The two MOST common signs of anaphylaxis are:
wheezing and widespread urticaria.
The two MOST common signs of anaphylaxis are: a) wheezing and widespread urticaria. b) expiratory stridor and tachycardia. c) hypertension and swollen hands. d) watery eyes and localized itching.
wheezing and widespread urticaria.
When obtaining medical history information from the family of a suspected stroke patient, it is MOST important to determine: a) if the patient has been hospitalized before. b) if there is a family history of a stroke. c) when the patient last appeared normal. d) the patient's overall medication compliance.
when the patient last appeared normal.
which of the following questions would be LEAST pertinence during the initial questioning of a patient who ingested a substance
why was the substance ingested
Distributive shock occurs when:
widespread dilation of the blood vessels causes blood to pool in the vascular beds.
In anaphylatic shock poor oxygenation and poor perfusion is a result of
widespread vasodilation
Cardiac pace maker
wires in direct contact with myocardium
Nitroglycerin is contraindicated in patients: with a systolic blood pressure less than 100 mm Hg. with chest pain of greater than 30 minutes duration. who are currently taking antibiotics for an infection. who are younger than 40 years of age and have diabetes.
with a systolic blood pressure less than 100 mm Hg.
