final test part 2
a. Energy transmission to the spine
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?
d. Stabilize her entire spine.
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:
d. Immobilize the injury with a sling and swathe
A 17-year-old football player collided with another player and has pain to his left clavicular area. He is holding his arm against his chest and refuses to move it. Your assessment reveals obvious deformity to the midshaft clavicle. After assessing distal pulse, sensory, and motor functions, you should:
d. Ventricular fibrillation when the impact occurred during a critical portion of the cardiac cycle
A 19-year-old male is unresponsive, apneic, and pulseless after being struck in the center of the chest with a softball. Based on the mechanism of injury, what MOST likely occurred?
18%
A 21-year-old male was working in an auto repair shop and sustained radiator burns to the anterior aspect of both arms and to his anterior chest. According to the rule of nines, this patient has burns that cover _____ of his BSA.
c. Preparing for immediate transport.
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. Irrigating his right eye laterally.
A 22-year-old male was walking on the beach and had sand blown into his eyes. He complains of pain and decreased vision to his right eye. Treatment should include
open the patient's airway and assess his respirations.
A 22-year-old male with a history of clinical depression called 9-1-1 and stated that he has attempted to kill himself. Your unit and law enforcement officers arrive at the scene simultaneously. You find the patient lying supine on the living room floor. He is unconscious and cyanotic. An empty bottle of hydromorphone (Dilaudid) is found on an adjacent table. You should:
administer high-flow oxygen, place a sterile pad over her vagina, keep her warm, elevate her lower extremities, and transport without delay.
A 26-year-old female presents with heavy vaginal bleeding. She is conscious, but restless. Her blood pressure is 84/54 mm Hg, her pulse is 120 beats/min and weak, and her respirations are 22 breaths/min with adequate depth. She tells you that she inserted a tampon about 2 hours ago. You should:
Log roll him supine.
A 26-year-old male has been ejected from a car after it rolled several times in the median of the interstate. As you perform the primary assessment, you find him prone and unresponsive. You immediate action is to:
is significantly hyperglycemic.
A 28-year-old female patient is found to be responsive to verbal stimuli only. Her roommate states that she was recently diagnosed with type 1 diabetes and has had difficulty controlling her blood sugar level. She further tells you that the patient has been urinating excessively and has progressively worsened over the last 24 to 36 hours. On the basis of this patient's clinical presentation, you should suspect that she:
b. Prepare for immediate transport
A 28-year-old male was struck in the chest with a baseball bat during an altercation. He is conscious and alert and complains of severe chest pain. Your assessment reveals a large area of ecchymosis over the sternum and a rapid, irregular pulse. In addition to applying 100% oxygen, you should:
her spleen is enlarged because of red blood cell engorgement.
A 30-year-old female presents with severe acute pain to the left upper quadrant of her abdomen. During your assessment, she tells you that she has sickle cell disease. You should suspect that:
a. Suction her oropharynx for 15 seconds.
A 30-year-old female was robbed and assaulted by a gang as she was leaving a nightclub. She has massive facial trauma and slow, gurgling respirations. As your partner manually stabilizes her head, you should:
d. Compartment syndrome.
A 30-year-old male experienced a crushing injury when his arm was trapped between the back of a truck and a loading dock. Upon your arrival, the man's arm has been freed. Your assessment reveals that his arm is obviously deformed and swollen and is cold and pale. Further assessment reveals an absent radial pulse. You should be MOST concerned that this patient has:
protect her airway from aspiration.
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:
obtain a medical history from the patient.
A 31-year-old male is complaining of left-side flank pain that radiates into his groin. He is alert and oriented and the primary assessment reveals no life-threatening conditions. A nonrebreather face mask delivering 15 liters per minute of oxygen has been applied. Given the patient's status, from the list below. your next step should be to:
a. Cover it with moist, sterile gauze and secure with an occlusive dressing.
A 33-year-old male sustained an abdominal evisceration to the left lower quadrant of his abdomen after he was cut with a large knife. After appropriately managing his ABCs and assessing him for other life-threatening injuries, how you should care for his wound?
acute cholecystitis.
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:
d. Aggressively manage his airway.
A 37-year-old male was pinned between a flatbed truck and a loading dock. On exam, you find bruising to the chest, distended neck veins, bilaterally diminished breath sounds, and bilateral scleral hemorrhaging. You should:
restrain the patient with appropriate force in order to treat his injuries.
A 38-year-old male with a history of schizophrenia is reported by neighbors to be screaming and throwing things in his house. You are familiar with the patient and have cared for him in the past for unrelated problems. Law enforcement officers escort you into the residence when you arrive. The patient tells you that he sees vampires and is attempting to ward them off by screaming and throwing things at them. He has several large lacerations to his forearms that are actively bleeding. The MOST appropriate way to manage this situation is to:
c. Follow appropriate standard precautions.
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:
calmly identify yourself to the patient.
A 40-year-old male intentionally cut his wrist out of anger after losing his job. Law enforcement has secured the scene prior to your arrival. As you enter the residence and visualize the patient, you can see that he has a towel around his wrist and a moderate amount of blood has soaked through it. You should:
b. Giving him small sips of plain water.
A 40-year-old male presents with severe abdominal pain following blunt trauma. He is diaphoretic, intensely thirsty, and has a weak and rapid pulse. Appropriate treatment for this patient includes all of the following, EXCEPT:
a. Cover both of his eyes and transport to the hospital.
A 40-year-old male was in his woodworking shop when he felt a sudden, sharp pain in his left eye. Your assessment reveals a small splinter of wood embedded in his cornea. You should:
Deliver the shock followed by immediate resumption of CPR.
A 40-year-old man is in cardiac arrest. Your partner is performing CPR. You are attaching the AED when the patient's wife tells you that he has an implanted pacemaker. The AED advises that a shock is indicated. What should you do?
Palpation of the pelvic region.
A 41-year-old male patient has fallen from a second-story roof. He is complaining of right leg pain and pain to his pelvic region. When performing the secondary assessment on this patient, which one of the following should the EMT intentionally not perform?
suspect that he has intracranial bleeding, assist his ventilations, and transport rapidly to an appropriate hospital.
A 42-year-old male is found unresponsive on his couch by a neighbor. During your assessment, you find no signs of trauma and the patient's blood glucose level is 75 mg/dL. His blood pressure is 168/98 mm Hg, his heart rate is 45 beats/min and bounding, and his respirations are 8 breaths/min and irregular. The patient is wearing a medical alert bracelet that states he has hemophilia. You should:
a. Pinching the patient's nostrils and having him lean forward.
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
b. Padding between the ear and the scalp
A 44-year-old male sustained a laceration to his left ear during a minor car accident. Your assessment reveals minimal bleeding. Appropriate care for this injury includes:
b. Immobilize his spine and perform a focused secondary exam
A 45-year-old male was working on his roof when he fell approximately 12', landing on his feet. He is conscious and alert and complains of an ache in his lower back. He is breathing adequately and has stable vital signs. You should:
b. Immobilize his spine and perform a focused secondary exam.
A 45-year-old male was working on his roof when he fell approximately 12′, landing on his feet. He is conscious and alert and complains of an ache in his lower back. He is breathing adequately and has stable vital signs. You should:
be alert for signs and symptoms of shock.
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:
assess the adequacy of his respirations.
A 49-year-old male presents with an acute onset of crushing chest pain and diaphoresis. You should:
30%
A 5-year-old female pulled a pot of boiling water from the stove. She has superficial and partial-thickness burns to her head and anterior trunk. What percentage of her body surface area has been burned?
a. Apply supplemental oxygen, immobilize her spine, attempt to locate the dislodged teeth, suction as needed, and transport
A 52-year-old unrestrained female struck the steering wheel with her face when her truck collided with another vehicle. She has obvious swelling to her face and several dislodged teeth. A visual exam of her mouth reveals minimal bleeding. She is conscious and alert with a blood pressure of 130/80 mmHg, a pulse of 110 beats/min, and respirations of 22 breaths/min with adequate tidal volume. You should:
c. Replace the avulsed flap to its original position and cover it with a sterile dressing.
A 56-year-old male has an incomplete avulsion to his right forearm. After controlling any bleeding from the wound, you should:
administer oxygen and prepare for immediate transport.
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:
c. Rapidly transporting her to the hospital
A 6-year-old female was riding her bicycle and struck a clothesline with her throat. She is breathing, but with obvious difficulty. Your assessment reveals a crackling sensation in the soft tissues of her neck and facial cyanosis. In addition to the appropriate airway management, the intervention that will MOST likely improve her chance of survival is:
administer oxygen, give her 2 (81mg each tablet) chewable aspirin, and assess her further.
A 66-year-old female with a history of hypertension and diabetes presents with substernal chest pressure of 2 hours' duration. Her blood pressure is 140/90 mm Hg, her pulse is 100 beats/min and irregular, and her respirations are 22 breaths/min with adequate depth. The patient does not have prescribed nitroglycerin, but her husband does. You should
ask the daughter how her father normally behaves.
A 66-year-old male presents with bizarre behavior. His daughter states that he did not seem to recognize her and was very rude to her. The patient is conscious, and has a patent airway and adequate breathing. You should:
d. Have you experienced recent abdominal trauma?
A 66-year-old male presents with dark red rectal bleeding and abdominal pain. He is conscious and alert; however, his skin is cool and clammy and his heart rate is elevated. Further assessment reveals that his blood pressure is 112/60 mmHg. Which of the following questions would be MOST pertinent to ask him?
placing her in an upright position.
A 67-year-old female presents with difficulty breathing and chest discomfort that awakened her from her sleep. She states that she has congestive heart failure, has had two previous heart attacks, and has prescribed nitroglycerin. She is conscious and alert with adequate breathing. Her blood pressure is 94/64 mm Hg and her heart rate is 120 beats/min. Treatment for this patient includes
immediately begin CPR, apply an AED, stop along the side of the road to allow the AED to analyze, and shock as indicated
A 67-year-old female with severe chest pain becomes unresponsive, pulseless, and apneic during transport. You should:
a. Gastrointestinal bleeding.
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:
c. Gastrointestinal bleeding
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 mmHg and his pulse is 120 beats/min and thready. Your should be MOST suspicious that this patient is experiencing:
a heart attack.
A 75-year-old male with type 1 diabetes presents with chest pain and a general feeling of weakness. He tells you that he took his insulin today and ate a regular meal approximately 2 hours ago. You should treat this patient as though he is experiencing:
c. Place her onto a scoop stretcher, pad around her left hip with pillows, and secure her to the scoop with straps
A 77-year-old woman slipped and fell on a throw rug and landed on her left hip. She denies striking her head or losing consciousness. Assessment of her left leg reveals that it is shortened and externally rotated. Distal pulses, sensory, and motor functions are intact. You should:
inquire about the possibility of head trauma.
A 78-year-old female presents with an acute change in her behavior. The patient's son tells you that his mother has type 2 diabetes and was diagnosed with Alzheimer's disease 6 months ago. The patient's speech is slurred and she is not alert to her surroundings. You should:
c. Is ejected or partially ejected.
A driver involved in a rollover motor vehicle crash will MOST likely experience serious injuries or death if he or she:
Liver disease.
A patient has called 911 for abdominal pain and generalized weakness. On arrival you note that the patient's skin is a yellow-orange color. Which one of the following diseases revealed to you during the history would best correlate to this patient' skin.
Apply direct pressure to the laceration.
A patient has fallen through a large plate glass window. As you approach, you note the patient to be sitting up holding his hand over a large laceration that is spurting bright red blood. Which one of the following should you do immediately?
a. Compression of the head against the roof
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. Rapidly assess the patient after ensuring that the power line is not live
A utility worker was trimming branches and was electrocuted when he accidentally cut a high-power line. He fell approximately 20' and is lying unconscious on the ground; the power line is lying across his chest. You should:
d. Assist the patient's ventilations.
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:
d. Report the incident to the appropriate authorities
An 8-year-old male was bitten by a stray dog. He has a large laceration to the back of his left hand, which your partner covered with a sterile dressing and bandage. In addition to transporting the child to the hospital, you should:
No abdominal guarding is noted.
An alert and oriented 69-year old female is complaining of low, right-sided abdominal pain. She describes the pain as "knife-like" and states that it started suddenly one hour ago. Her only medical history is hypertension for which she takes the medication enalapril. Which one of the following assessment findings shows that the EMT is appropriately assessing this patient?
start by examining the patient's head.
An unresponsible 54-year-old male was found by family in his bed. They state that he has not been feeling well and complained of chest pain before going to bed approximately one hour ago. According to family, he has no prior medical history and does not take any medications. The primary assessment reveals no life-threatening conditions. When performing the secondary assessment on this patient, the EMT should:
a. Open his airway and assess his breathing status
As you approach a young male who was involved in an industrial accident, you note that his eyes are closed and that he is not moving. You can see several large contusions to his arms, a laceration to his forehead with minimal bleeding, and a closed deformity to his right leg. You should:
perform a manual jaw-thrust maneuver.
As you assess a 64-year-old unresponsive female with shortness of breath, you hear snoring respiration. Your immediate action when you reach her side is to:
b. Repeat the primary assessment
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:
assist her ventilations with a bag-mask device.
During your assessment of a young female with nontraumatic vaginal bleeding, you note that her level of consciousness is decreased, her respirations are rapid and shallow, her skin is cool and moist, and her pulse is rapid and weak. You should:
b. Spleen
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 the injury to the:
d. Provide some form of positive-pressure ventilation
Following blunt trauma to the chest, an 18-year-old female presents with respiratory distress, reduced tidal volume, and cyanosis. Her blood pressure is 80/50 mmHg and her pulse is 130 beats/min and thread. You should:
limit physical contact with the patient as much as possible and avoid interrupting him if he is attempting to communicate with you.
Law enforcement personnel request your assistance for a 30-year-old man who they pulled over for erratic driving. The patient became acutely violent while he was being questioned, which required one of the officers to subdue him with a Taser. When you arrive and assess the patient, you find that he is very agitated and is experiencing apparent hallucinations. His skin is flushed and diaphoretic. You should:
provide emotional support and visually assess her for obvious trauma.
Law enforcement personnel request your assistance to assess a 31-year-old female who was sexually assaulted. When you arrive at the scene, you find the patient sitting on a curb outside her apartment. She is conscious, alert, and crying. When you ask her what happened, she tells you that she does not want to be treated or transported to the hospital. She further tells you that all she wants to do is clean up. You should:
"Get the suction out and clear out the airway."
On scene you find a 91-year-old female who fell down two steps after suddenly complaining of a severe headache. She is unresponsive with gurgling respiration. What instructions should you immediately give your partner?
a. Transport to a trauma center.
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:
provide positive pressure ventilation.
The patient's family states that their 16-year-old daughter has a history of asthma and has been complaining of shortness of breath for the past two days. She has been taking her metered-dose inhaler with some relief, but today they found her lethargic and struggling to breathe in bed. Your assessment reveals her to be responsive to verbal stimuli with an open airway and respiration's of 36 per minute. You hear minimal bilateral wheezing. Your immediate action in caring for this patient is to:
b. Lift the air bag and look for deformity to the steering wheel.
While assessing a 21-year-old female who struck a tree head-on with her small passenger car, you note that her air bag deployed. You should:
b. Neck and facial fractures
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:
c. Administer oxygen and transport to the hospital.
While jogging, a 19-year-old male experienced an acute onset of shortness of breath and pleuritic chest pain. He is conscious and alert with stable vital signs. Your assessment reveals that he has diminished breath sounds over the left side of the chest. You should:
Unstable.
While treating a patient who was assaulted by a mob of angry people in a bar, the EMT finds the patient to be confused, tachycardic, with cool skin and a poor capillary refill. Into which physiologic category should the EMT place this patient?
begin high-quality CPR and apply the AED without delay.
You and your partner arrive at the scene of a middle-aged man who collapsed about 5 minutes ago. He is unresponsive, apneic, and pulseless. Bystanders are present, but have not provided any care. You should:
Ask the patient if she has developed a suicidal plan.
You are assessing a 45-year-old female who is severely depressed. She states that it seems as though her entire world is crashing down around her. She further states that she has had frequent thoughts of suicide, but is not sure if she can actually go through with it. How should you manage this situation?
a. Has a history of eye surgeries.
You are assessing a 59-year-old male and note that his pupils are unequal. He is conscious and alert. When obtaining his medical history, it is MOST pertinent to ask him if he:
Open the patient's airway using a head-tilt, chin-lift maneuver.
You are at the scene where a 19-year-old female college student has been drinking large quantities of alcohol throughout the evening. On your arrival, the patient is lying on her back, has vomited, and has slow, wet sounding respirations. Which of the following should you do next?
d. Apply direct pressure above and below the wound
You are dispatched to a convenience store, where the clerk sustained a laceration to the side of his neck during a robbery attempt. During your assessment, you note bright red blood spurting from the laceration. You should:
a shuffling gait when walking
You are dispatched to a residence for a 40-year-old female who complains of lower abdominal pain, fever and chills, and a foul-smelling vaginal discharge. Which of the following additional assessment findings would increase your index of suspicion for PID?
begin ventilatory assistance.
You are dispatched to a residence for a 56-year-old male with an altered mental status. Upon arrival at the scene, the patient's wife tells you that he complained of chest pain the day before, but would not allow her to call EMS. The patient is semiconscious; has rapid, shallow respirations; and has a thready pulse. You should:
c. Insert an airway adjunct if he will tolerate it and begin assisting his ventilations with a bag-mask device.
You are transporting a 42-year-old male who experienced blunt abdominal trauma. He is receiving oxygen at 12 L/min via a nonrebreathing mask, and full spinal precautions have been applied. During your reassessment, you note his level of consciousness has decreased and his respirations have become shallow. You should:
Taking time to carefully re-palpate the face and scalp.
You are transporting an 18-year-old male, who has been injured in a motor-vehicle collision. He has a decreased level of consciousness and has suffered injuries to his, chest, and lower right leg. When you are conducting the reassessment of the patient's head and neck, which one of the following is appropriate?
Insulin
You are treating a 40-year-old male with a documented blood sugar reading of 300 mg/dL. The patient is semiconscious and breathing shallowly, and is receiving assisted ventilation from your partner. You should recognize that definitive treatment for this patient includes:
monitor her airway and breathing status and assess her blood glucose level
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:
She is alert with an open airway.
You arrive at the scene of a fall, where a 42-year-old woman fell backward off a step-ladder while cleaning windows in her kitchen. She is lying on the floor complaining of pain to her ankle. She tells you, "If I had just gone to work today instead of using vacation time, this never would have happened!" Based on information thus far, which one of the following can you conclude?
d. Laceration of the aorta
You arrive at the scene of a major motor vehicle crash. The patient, a 50-year-old female, was removed from her vehicle prior to your arrival. Bystanders who removed her state that she was not wearing a seatbelt. The patient is unconscious, tachycardic, and diaphoretic. Your assessment reveals bilaterally clear and equal breath sounds, a midline trachea, and collapsed jugular veins. You should be MOST suspicious that this patient has experienced a:
Open the patient's airway using a manual maneuver.
You have arrived on the scene at a high school football field where a 17-year-old male is lying on the ground. He is unresponsive and cyanotic, and he is making obvious respiratory effort without moving adequate amounts of air. Which of the following should be done first?
Jugular vein distention.
You have been called for an 83-year-old female who is having difficulty breathing. She informs you that she has congestive heart failure and feels as though she is filled up with fluid. The primary assessment shows her to be alert and oriented with inadequate breathing. Her pulse is rapid and weak, and her skin is cool and dry. When performing a secondary assessment, which one of the following signs related to heart failure would you specifically look for when examining the patient's neck?
his large body
You receive a call for a domestic dispute. When you arrive at the scene, you find a young male standing on the front porch of his house. You notice that an adjacent window is broken. The patient has a large body, is clenching his fists, and is yelling obscenities at you. Which of the following findings is LEAST predictive of this patient's potential for violence?
remain in a safe place and request law enforcement.
You respond to a call for an unknown emergency. When you arrive at the scene, the patient's husband meets you at the door and states that his wife has been depressed and has locked herself in an upstairs bedroom. He further tells you that he keeps his handgun in the bedroom. You should:
leave him in a sitting position, keep him warm, and prepare for immediate transport.
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:
perform CPR for 2 minutes and reassess
Your EMS team is performing CPR on a 60-year-old male in cardiac arrest. You connect the AED, push the analyze button, and receive a "no shock advised" message. You should:
Open the airway.
Your patient is a 33-year-old man who has been ejected from his vehicle during a high-speed collision. During your general assessment it is discovered that he is not moving, does not appear to have adequate respiration, and has suffered a large amount of external bleeding. Which of the following should be done first?
Transport priority
Your patient is a 42-year-old woman who fell a couple of feet from a ladder and is complaining of pain in her ankle. Which of the following are you unable to determine from the information given?
Ask if the patient has pain anywhere besides her ankle.
Your patient is a 72-year-old female who has "twisted her ankle" coming down some steps. She is alert and complaining of pain in her right ankle, but she jokes about her "clumsiness." Which of the following should you do next
d. Control any external bleeding, administer oxygen, and transport at once
Your presence is requested by law enforcement to assess a 33-year-old female who was sexually assaulted. The patient is conscious and obviously upset. As you are talking to her, you note an impressive amount of blood on her clothes in the groin area. Her blood pressure is 98/58 mmHg, her pulse is 130 beats/min, and her respirations are 24 breaths/min. 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 in the area of the bites. her blood pressure is 122/70, her pulse is 100 beats/minute and strong, and her respirations are 18 bretahs per minute and unlabored you should
contact the regional poison control center.
a 3 year old female ingested several leaves from a plant in the living room. the child's 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
cholecystitis
a 35-year-old mildly obese woman is complaining of localized pain in the upper right quadrant with referred pain to the right shoulder. the most likely cause of her pain is
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?
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 rapid, thready pule. she has a red rash on her entire body and her face is very swollen. you should:
administer up to 25 g of activated charcoal
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
maintain his airway and assist his ventilations
a 48 year old male is found in the garden by his wife. when you arrive at the scene and assess the man, you find that he is unresponsive, his severely labored breathing, and has hives over his entire trunk. you should:
DT's
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
record the time and the dose of the injection and transport promptly
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
ask his wife when she noticed symptoms
a 58-year-old male presents with confusion, right-sided weakness, and slurred speech. as your partner is applying oxygen, it is most important for you to
contact medical control if needed, transport the patient, and monitor him for signs of deterioration
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 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
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 tachycardia. you should
a heroin overdose
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
seizures and cardiac arrhythmias
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
assist ventilations, perform a rapid exam, and prepare for immediate transport.
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:
check for a carotid pulse for no longer than 10 seconds.
suspect that he has intracranial bleeding, assist his ventilations, and transport rapidly to an appropriate hospital.
obtain a description of how the seizure developed
transport the child to the hospital and reassure the mother en route
assisted ventilation, naloxone (narcan), and rapid transport
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
a ruptured cerebral artery
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:
apply oxygen as needed, clean the area with soap and water or a mild antiseptic,and transport him to the hospital
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. 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:
suction her oropharynx and apply 100% oxygen
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 as a normal rate with adequate depth. you should
oxygen via nonrebreathing mask, left lateral recumbent position, and transport
you are caring for a conscious, confused patient with left-sided hemiparalysis. his airway is patent and his respirations are 22 breaths/min with adequate tidal volume. treatment for this patient should include
assisted ventilation with bag mask device
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
initiate CPR and attach an AED as soon as possible
you are dispatched to a residence for a 66-year-old male who, according to family members, has suffered a massive stroke. your initial assessment reveals that the patient is pulseless and apneic. you should
is hypoglycemic
you are transporting a semiconscious patient to the hospital. en route, you note that the patient's mental status is not improving, despite 100% supplemental oxygen. you should suspect that this patient
obtain a description of how the seizure developed
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 had a history of seizures and takes Tegretol. when obtaining further medical history from the girlfriend, it is most important to
maintain her airway with manual head positioning, suction her airway to remove the vomitus, insert a nasopharyngeal airway, and administer high-flow oxygen
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:
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 you should:
initiate ventilator assistance
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:
is postictal following a seizure
you receive a call to a residence, where a neighbor has found the resident, a 40-year-old female, semiconscious on her living room floor. during your assessment you discover a bottle of Dilantin on a nearby table. you should be most suspicious that this patient
attempting to calm him and giving him oxygen is tolerated
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
was given flunitrazepam (Rohypnol)
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
ask her if she has prescribed epinephrine
you respond to the residence of a 55 year old female with a possible allergic reaction to peanuts that she has ate approximately 30 minutes ago. the patient is conscious and alert, but has diffuse urticarial and the feeling that she has a lump in her throat. as your partner applies oxygen to the patient, you should
may vomit and aspirate
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
