UPDATED Pharm mid term
The maximum volume of medication to be delivered into the deltoid muscle is ________ mL. A. 2 B. 3 C. 1 D. 5
A. 2
The standard dose of diphenhydramine for anaphylaxis is: A. 25-50 mg. B. 50-100 mg. C. 10-20 mg. D. 30-40 mg.
A. 25-50 mg.
If a newly developed drug is undergoing a double-blind study in a large patient population, it is most likely undergoing what phase of human studies? A. 3 B. 1 C. 2 D. 4
A. 3
The necessary blood flow for hemodialysis is which of the following? A. 300 to 400 mL/minute B. 100 to 200 mL/minute C. 200 to 300 mL/minute D. none of the above
A. 300 to 400 mL/minute
Pseudoseizures are best controlled by: A. A command to stop B. Phenytoin C. Lorazepam D. Using physical restraints
A. A command to stop
In which of the following situations is a significant amount of carboxyhemoglobin most likely to be present? A. A patient found unresponsive in an apartment in which there is a gas furnace B. A patient who is being treated with nitrites for cyanide poisoning C. A patient who inhaled anhydrous ammonia fumes D. A patient with COPD who is short of breath with an SpO2 of 90 percent
A. A patient found unresponsive in an apartment in which there is a gas furnace
Which of the following mechanisms is not characteristic for a rectal foreign body? A. Accidental trauma B. Sexual gratification C. Psychosis on the part of the patient D. Accidental swallowing of something
A. Accidental trauma
A patient is experiencing severe abdominal cramping, vomiting, diarrhea, and facial flushing after eating undercooked chicken. Management of this patient should include all of the following EXCEPT: A. Activated charcoal B. IV of normal saline C. Oxygen D. Transport
A. Activated charcoal
The administration of a vaccine results in ________ immunity. A. Active induced B. Natural induced C. Natural passive D. Passive induced
A. Active induced
A 56-year-old female is conscious and alert and complaining of diarrhea and nausea. The patient describes a two-day history of her symptoms and states that the pain is "all over her abdomen." All four quadrants are tender to palpation. She also describes hematochezia. PMH includes CAD, and she recently began taking 325 mg of ASA once a day. Of the following, which is the most likely cause of her clinical condition? A. Acute gastroenteritis B. Acute pancreatitis C. Peptic ulcer D. Diverticulitis
A. Acute gastroenteritis
Your patient is a 24-year-old male with a history of type I diabetes. You were called to his place of employment because he was behaving bizarrely. On your arrival he is confused and combative with a blood glucose level of 41 mg/dL. Due to poor vasculature and the patient's combativeness, you have not been able to start an IV. Which of the following is the best course of action? A. Administer 1 mg glucagon, IM. B. Administer 5 mg Valium, IM, and attempt the IV again when the patient is less agitated. C. Administer half an amp (12.5 g) of 50 percent dextrose, IM. D. Use four-point restraints to restrain the patient and transport. Attempt the IV again if the patient becomes unresponsive.
A. Administer 1 mg glucagon, IM.
You are assessing an unresponsive patient with a MedicAlert tag that indicates he is a diabetic. The patient's airway is patent, respirations are 20 per minute and adequate, radial pulse is rapid and weak, and the skin is warm and moist. You attempt to get a blood glucose reading, but your blood glucose monitor malfunctions. Which of the following is the best course of action? A. Administer 25 g of 50 percent dextrose. B. Request an order for 20 units of regular insulin. C. Request another unit to respond to the scene with a blood glucose monitor. D. Administer a 1 to 2 liter bolus of NS.
A. Administer 25 g of 50 percent dextrose.
Your patient is a 46-year-old male who is unconscious on his front lawn after being stung by a bee. You note angioneurotic edema. HR = 132, BP = 76/40, RR = 24 and shallow. You should first: A. Administer high-concentration oxygen with a nonbreather mask or similar device. B. Start an IV of NS wide open and administer epinephrine 1:10,000 IV C. Administer epinephrine 1:1000 SC D. Intubate the patient
A. Administer high-concentration oxygen with a nonbreather mask or similar device.
Which of the following drugs are often found in both topical and oral nasal decongestants? A. Alpha1 agonists B. Alpha1 antagonists C. Beta2 agonists D. Alpha2 agonists
A. Alpha1 agonists
Mushrooms from the class ________ are responsible for over 90 percent of deaths from mushroom toxicity. A. Amanita B. Shiitake C. Button D. Galerina
A. Amanita
Two 15-year-old boys have been hiking and camping and using a guide to native plants to determine which plants are edible. They drank a tea made from some plants that they picked. They are now complaining of abdominal cramping, watering eyes, vomiting, diarrhea, and sweating. Which of the following have they most likely ingested? A. Amanita B. Poison sumac C. Holly berries D. Jimson weed
A. Amanita
A larger-than-expected dose of adenosine may be necessary in patients regularly taking: A. Aminophylline. B. amphetamines. C. benzodiazepines. D. Class I anti-dysrhythmic.
A. Aminophylline.
Which of the following diseases is characterized by a progressive degeneration of the nerve cells that control voluntary movement, weakness, loss of motor control, difficulty speaking, and cramping? A. Amyotrophic lateral sclerosis B. Multiple sclerosis C. Muscular dystrophy D. Bell's palsy
A. Amyotrophic lateral sclerosis
Lung perfusion depends on all of the following EXCEPT: A. An intact alveolar membrane B. Intact pulmonary capillaries C. Efficient pumping of blood by the heart D. Adequate blood volume
A. An intact alveolar membrane
Which of the following is a potentially life-threatening condition involving the head, neck, face, and upper airway? A. Angioedema B. Urticaria C. Hives D. Wheals
A. Angioedema
Which of the following is a potentially life-threatening condition involving the head, neck, face, and upper airway? A. Angioedema B. Urticaria C. Wheals D. Hives
A. Angioedema
McBurney's point, a common site of pain secondary to appendicitis, is located: A. At the midway point of a line from 1 to 2 inches above the right iliac crest to the umbilicus B. Two inches above the umbilicus in the midline C. At the midway point of a line from the symphysis pubis to the right anterior, superior iliac crest D. One to two inches above the iliac crest in the right midaxillary line
A. At the midway point of a line from 1 to 2 inches above the right iliac crest to the umbilicus
Lithium is used to treat: A. Bipolar disorder B. Depression C. Personality disorders D. Schizophrenia
A. Bipolar disorder
Airway resistance is increased by: A. Bronchospasm B. Decreased elasticity of the chest wall C. Sympathetic nervous system stimulation D. Anticholinergic drugs
A. Bronchospasm
Which of the following is NOT a route for enteral medication administration? A. Buccal B. Gastric C. Oral D. Rectal
A. Buccal
Which of the following is a highly toxic, odorless, tasteless gas that is a by-product of incomplete combustion? A. Carbon monoxide B. Methane C. Cyanide D. Carbon dioxide
A. Carbon monoxide
Which of the following is NOT a role of the upper respiratory system? A. Carry out gas exchange with inspired air B. Humidify inspired air C. Filter inspired air D. Warm inspired air
A. Carry out gas exchange with inspired air
"Rock" and "crack" are street names for: A. Cocaine B. Marijuana C. Morphin D. Heroin
A. Cocaine
"Rock" and "crack" are street names for: A. Cocaine B. Morphin C. Marijuana D. Heroin
A. Cocaine
You respond to a patient with difficulty breathing. Upon assessment you notice that the patient is sitting in the tripod position, with marked JVD. The patient has clubbing in the fingers and new pitting edema. You should suspect: A. Cor pulmonale. B. COPD. C. Pulmonary neoplasm. D. CHF.
A. Cor pulmonale.
Which of the following statements about corticosteroid use in anaphylaxis treatment is TRUE? A. Corticosteroids can reduce the inflammation associated with anaphylaxis. B. Corticosteroids can help reverse bronchospasm associated with anaphylaxis. C. Corticosteroids stabilize mast cell and basophil membranes, preventing degranulation and histamine release. D. Administration of high-dose corticosteroids results in peripheral vasoconstriction.
A. Corticosteroids can reduce the inflammation associated with anaphylaxis.
Which of the following best describes the cardiovascular effects of calcium channel blockers, such as verapamil (Calan) and diltiazem (Cardizem)? A. Decreased automaticity and decreased AV node conductivity B. Decreased peripheral vascular resistance, widened QRS, and increased afterload C. Increased heart rate and stroke volume, decreased afterload D. Increased peripheral vascular resistance, widened QRS, and increased afterload
A. Decreased automaticity and decreased AV node conductivity
A 32-year-old is conscious and in mild distress, complaining of nausea and sweating. He states that his symptoms started two days ago when he stopped drinking "cold turkey." Physical examination reveals cool, diaphoretic skin; slightly dilated pupils bilaterally; and a general weakness to all extremities. Which of the following findings would also be likely? A. Delirium tremens, hallucinations, and anxiety B. Hypertension, bradycardia, and hyperglycemia C. Depression, hypotension, and polyuria D. Insomnia, hyperglycemia, and difficulty breathing
A. Delirium tremens, hallucinations, and anxiety
Which of the following is commonly indicated in the management of cocaine overdose? A. Diazepam B. Narcan C. Flumazenil D. Thiamine
A. Diazepam
Your patient is a 12-year-old male who is conscious and alert and complaining of diffuse abdominal pain. He states that the pain began about 3 hours after eating supper. He has had severe diarrhea and some vomiting. Any of the following could be therapeutic EXCEPT: A. Diazepam B. Promethazine C. IV of NS D. Compazine
A. Diazepam
What is the drug of choice when treating patients having generalized motor (grand mal) seizures? A. Dilantin B. Romazicon C. Valproic acid D. Lithium
A. Dilantin
What cleaning supply is toxic to living tissue and used on nonliving surfaces or objects? A. Disinfectant B. Antiseptic C. Gel D. Soap
A. Disinfectant
How do you calculate the administration of a specific amount of drug via infusion, based on weight? A. Dose ordered×total volume of bag used×drip factor of IV tubing×weight in kg/total amount of drug dissolved within the bag B. Dose ordered×total volume of the drug container×weight in kg/total amount of drug dissolved within the fluid C. Dose ordered×total volume of bag used×drip factor of IV tubing/total amount of drug dissolved within the bag D. Dose ordered×total volume of the drug container/total amount of drug dissolved within the fluid
A. Dose ordered×total volume of bag used×drip factor of IV tubing×weight in kg/total amount of drug dissolved within the bag
Your patient is a 60-year-old male with an acute exacerbation of COPD. You may consider giving the patient ipratropium because, in addition to reversing bronchospasm, it is helpful in: A. Drying bronchial secretions B. Reducing inflammation C. Expectoration of mucus D. Stimulating the respiratory center in the medulla
A. Drying bronchial secretions
Which of the following is LEAST likely to result in hypoglycemia in a type I diabetic patient? A. Eating foods high in sugar B. Taking insulin as usual but missing a meal C. Increased exercise level D. Inadvertently administering too much insulin
A. Eating foods high in sugar
A couple has been experimenting with Ecstasy. They are both complaining of anxiety, nausea, and palpitations. You would also expect: A. Elevated blood pressure B. Bradycardia C. Seizures D. Dyspnea
A. Elevated blood pressure
Your patient is a 68-year-old male complaining of difficulty breathing for two days. He is sitting up, conscious, alert, and oriented and appears to be in mild respiratory distress. Physical examination reveals cool, dry, pink skin; he is thin with well-defined accessory muscles, and you note diffuse wheezing to all lung fields. HR = 102, BP = 136/96, RR = 20, SaO2 = 92%. The patient gives a 20-pack-a-year history of smoking. These findings are most typical of: A. Emphysema B. Congestive heart failure C. Asthma D. Chronic bronchitis
A. Emphysema
Your patient is experiencing dyspnea and urticaria after ingesting penicillin. Auscultation of his lungs reveals diffuse expiratory wheezes. Which of the following medications will best help correct your patient's bronchospasm? A. Epinephrine 1:1000 SC B. 100 percent oxygen via nonrebreather mask 15 lpm C. Solu-Medrol 125 mg IV D. Ranitidine 50 mg IV
A. Epinephrine 1:1000 SC
Which of the following is considered a site of central venous access? A. Femoral vein B. Saphenous vein C. External jugular vein D. Median cephalic vein
A. Femoral vein
Your patient is an 18-year-old female college student who is supine in bed and responsive only to painful stimuli. Her roommate states that they went to a party last night. She says the patient only drank soda, but now she thinks a guy who had been following them around might have put something in the patient's drink. Physical examination reveals cool, dry skin and pupils sluggish to light bilaterally. HR = 72, BP = 112/64, RR = 10, SaO2 = 98%. Which of the following drugs was most likely slipped into her drink? A. Flunitrazepam B. Amphetamines C. Opium D. LSD
A. Flunitrazepam
After a normal inspiration and expiration, an adult patient has about 2,400 mL of air remaining in the lungs, known as the: A. Functional residual capacity B. Vital capacity C. Residual volume D. Expiratory reserve volume
A. Functional residual capacity
A seizure that begins as an aberrant electrical discharge in a small area of the brain but spreads to include the entire cerebral cortex is a ________ seizure. A. Generalized B. Simple partial C. Complex partial D. Myoclonic
A. Generalized
Which of the following best explains the process of osmotic diuresis associated with hyperglycemia? A. Glucose in the urine raises osmotic pressure inside the kidney tubule, drawing water into the tubule. B. Elevated blood glucose levels result in increased ADH secretion. C. Glucose in the urine lowers osmotic pressure inside the kidney tubule, preventing water reabsorption. D. Decreased insulin levels result in decreased ADH secretion.
A. Glucose in the urine raises osmotic pressure inside the kidney tubule, drawing water into the tubule.
You respond to an ill type 2 diabetic patient. Upon your arrival, the patient complains of not feeling well for a few days, and increasing blood glucose levels. You suspect: A. HHNK. B. TPA. C. TNK. D. DKA.
A. HHNK.
Your patient is a 20-year-old female who is conscious and alert, though obviously hallucinating after ingesting LSD. Her friends state that she is having a "bad trip," and you note that she is vigorously scratching her arms to the point of drawing blood. Physical examination reveals warm, slightly diaphoretic skin and dilated pupils bilaterally. Which of the following medications should be considered to manage this patient? A. Haloperidol B. Narcan C. Thiamine D. Avapro
A. Haloperidol
Your patient is a 46-year-old male truck driver who is sitting on a toilet complaining of bleeding with defecation. He states that he had to strain significantly to produce a bowel movement, then noted blood on his stool afterward. He claims no significant medical history, has had no recent illness, and takes no medications. You note the presence of bright red blood on the surface of his stool. Of the following, which is the most likely cause of his clinical condition? A. Hemorrhoids B. Colitis C. Upper GI bleed D. Crohn's disease
A. Hemorrhoids
Upon identifying an antigen in the bloodstream, B cells launch a chemical attack by producing antigens specific to the antibody. This is an example of ________ immunity. A. Humoral B. Secondary C. Antibody D. Cellular
A. Humoral
The two most common causes of fatal anaphylaxis are ________ and ________. A. Hymenoptera stings, injected penicillin B. Shellfish, sulfa drugs C. Hymenoptera stings, tree nuts D. Shellfish, tree nuts
A. Hymenoptera stings, injected penicillin
Which of the following is NOT associated with chronic alcohol ingestion? A. Hyperactivity B. Thiamine deficiency C. Esophageal varices D. Decreased sensation in hands and feet
A. Hyperactivity
Which of the following is NOT a common side effect of a loop diuretic? A. Hypernatremia B. Reflex tachycardia C. Orthostatic hypotension D. Hypokalemia
A. Hypernatremia
A 16-year-old female with a history of diabetes is found unconscious in a high school bathroom following volleyball practice. She is tachycardic; has cool, clammy skin; is lethargic; is slightly combative; and is very confused. She is most likely experiencing: A. Hypoglycemia B. Diabetic coma C. Diabetic ketoacidosis D. Hyperglycemia
A. Hypoglycemia
Which class of antiarrhythmic drugs is LEAST likely to contribute to hypotension? A. I B. III C. II D. IV
A. I
Drugs with high abuse potential and no accepted medical benefits are classified as Schedule: A. I. B. III. C. IV. D. II.
A. I.
In which class of the Vaughn-Williams classification system of antidysrhythmic medications does lidocaine belong? A. IB B. IA C. IC D. II
A. IB
What is the assigned schedule number for phenobarbital according to the Controlled Substances Act of 1970? A. IV B. I C. III D. II
A. IV
Your patient is a 44-year-old male who has been in jail for three days after being arrested for driving while intoxicated. He now presents with diaphoresis, anxiety, hallucinations, insomnia, and tremors. HR = 142, BP = 132/94, RR = 34, blood glucose = 85 mg/dL. Which of the following is appropriate? A. IV of NS KVO B. 25 gm D50 IV C. Narcan 2 mg IV D. Thiamine 100 mg IV
A. IV of NS KVO
The ___________ system is a complicated body system responsible for combating infection. A. Immune B. Nervous C. Respiratory D. Cardiovascular
A. Immune
Which of the following would you expect to see immediately after the ingestion of a large meal? A. Increase of blood glucose and blood insulin levels B. Increase of blood glucagon levels and a decrease of blood glucose levels C. Decrease of blood glucose levels followed by an increase of blood insulin levels D. Increase of blood glucagon and blood glucose levels
A. Increase of blood glucose and blood insulin levels
When a substance enters the body through the gastrointestinal tract, it has accessed the body by: A. Ingestion B. Surface absorption C. Inhalation D. Injection
A. Ingestion
Your patient was in the building when a fire started at a factory that manufactures plastics. He is complaining of a headache, palpitations, and a burning sensation in his throat. His airway, breathing, and circulation are intact. Heart rate = 128, respirations = 22, blood pressure = 148/84, and SaO2 = 93%. You should immediately: A. Initiate supportive measures B. Apply the cardiac monitor C. Prepare to intubate D. Administer amyl and sodium nitrate
A. Initiate supportive measures
Your patient is a 42-year-old male who is supine on the floor, responsive only to pain. His wife states that he has been extremely depressed recently and talked about suicide yesterday. The patient's skin is hot and dry, pupils are dilated and reactive to light bilaterally, and there is vomit around his mouth. HR = 138 and regular, BP = 82/52, RR = 16 and shallow. Temperature is 105.5°F. The patient has a history of hypothyroidism, for which he takes Synthroid. Your partner suctions the airway and initiates BVM ventilations with 100 percent oxygen and an oropharyngeal airway. In addition to monitoring the cardiac rhythm and starting an IV of normal saline, you should: A. Intubate the trachea and request orders for propranolol, IV B. Administer 25 g of 50 percent dextrose and intubate if the level of responsiveness does not improve C. Perform synchronized cardioversion and intubate if the rhythm does not convert D. Intubate the trachea and request orders for diltiazem
A. Intubate the trachea and request orders for propranolol, IV
Which of the following statements about bronchial asthma is TRUE? A. Ipratropium (Atrovent) is often added to beta-agonists to treat bronchospasm because it works through a different mechanism from beta agonists to relax bronchial smooth muscle. B. Prednisolone and methylprednisolone should be reserved for only the most severe asthma attacks. C. The nonselective sympathomimetics continue to be the most popular treatments for mild to moderate asthma attacks. D. People with bronchial asthma maintain symptom-free lifestyles with daily treatments of propranolol.
A. Ipratropium (Atrovent) is often added to beta-agonists to treat bronchospasm because it works through a different mechanism from beta agonists to relax bronchial smooth muscle.
Your ICU patient has ARDS with a pO2 of 62 mmHg, despite mechanical ventilation and oxygenation. Which of the following best explains this finding? A. It is a problem with gas diffusion in the lung. B. It is a problem with the blood gas sample collection. C. It is a problem with perfusion. D. It is a problem with ventilation.
A. It is a problem with gas diffusion in the lung.
Which of the following would be most typical of a patient suffering from diverticulitis? A. Left lower quadrant pain B. Diffuse abdominal pain C. Dark, tarry stools D. Inability to have a bowel movement
A. Left lower quadrant pain
What two components of a drug's profile are taken into consideration when determining what the therapeutic index will be? A. Lethal dose and effective dose B. Bioequivalence and half-life C. Effective dose and duration of action D. Half-life and lethal dose
A. Lethal dose and effective dose
Ammonia is converted into urea to be extruded as urine in which organ? A. Liver B. Spleen C. Kidney D. Bladder
A. Liver
Esophageal varices are most associated with: A. Liver disease B. Kidney disease C. Gastroesophageal reflux disease D. Pancreatitis
A. Liver disease
Your patient is a 45-year-old male who has been suffering from hypocalcemia since surgery to remove his thyroid gland six weeks ago. Of the following, which is most likely the cause of the patient's hypocalcemia? A. Loss of parathyroid gland function B. Loss of thyroid gland function C. Increase in parathyroid gland function D. Increased function of residual thyroid tissue
A. Loss of parathyroid gland function
The family members of a 72-year-old female state that the patient complained of a sudden, severe headache; had slurred speech; then became unresponsive. She responds to painful stimuli with decorticate posturing and has snoring respirations at a rate of 10 per minute. Her radial pulse is palpable but grossly irregular. According to her son, she also suffers from congestive heart failure, hypertension, and diabetes. Which of the following should you do first? A. Manage the airway with a head-tilt/chin-lift maneuver. B. Attach the cardiac monitor. C. Check her blood sugar. D. Insert an endotracheal tube.
A. Manage the airway with a head-tilt/chin-lift maneuver.
Narcan acts as an antagonist to all of the following medications EXCEPT: A. Midazolam B. Methadone C. Heroin D. Codeine
A. Midazolam
While you are caring for a patient on the floor of her kitchen, she begins to have a generalized seizure. Which of the following is the most appropriate first action? A. Move objects away from her and wait to see if the seizure stops. B. Insert an oropharyngeal airway. C. Start an IV, and administer 5 mg diazepam. D. Restrain her so she does not injure herself.
A. Move objects away from her and wait to see if the seizure stops.
A form of spina bifida in which some of the spinal cord and meninges are protruding from a defect in the spine is a(n): A. Myelomeningocele B. Meningioma C. Hydrocele D. Osteogenesis imperfecta
A. Myelomeningocele
Which of the following is characterized by involuntary muscle twitching? A. Myoclonus B. Dystonia C. Trismus D. Ataxia
A. Myoclonus
Naproxen, ibuprofen, and ketorolac are all examples of: A. NSAIDs B. MAOIs C. TCAs D. SSRIs
A. NSAIDs
Naproxen, ibuprofen, and ketorolac are all examples of: A. NSAIDs B. SSRIs C. MAOIs D. TCAs
A. NSAIDs
Which of the following is NOT a pulmonary route of medication administration? A. Nasal drops and sprays B. Instillation of liquid medications into an endotracheal tube C. Inhalation of aerosolized medications D. Nebulization of liquid medications by pressurized air
A. Nasal drops and sprays
You are caring for a 68-year-old patient with an altered level of consciousness and reported seizure activity. You obtain a blood pressure of 244/140 mmHg, a pulse of 90, and respirations of 18. Which of the following medications would be most suitable for this patient? A. Nitroprusside (Nipride) B. Hydralizine (Apresoline) C. Enalapril (Vasotec) D. Minoxidil (Loniten)
A. Nitroprusside (Nipride)
The postsynaptic neurotransmitter of the sympathetic nerves is: A. Norepinephrine B. Dopamine C. Acetylcholine D. Epinephrine
A. Norepinephrine
A 19-year-old female with difficulty breathing produces a peak expiratory flow rate of 425 lpm, indicating: A. Normal ventilatory state B. Moderate bronchoconstriction C. Mild bronchoconstriction D. Severe bronchoconstriction
A. Normal ventilatory state
Having a patient swallow a tablet of medication with a drink of water is an example of which route of medication administration? A. Oral B. Aural C. Buccal D. Sublingual
A. Oral
Which of the following does NOT typically enter the body through injection? A. Organophosphate B. Illicit drug overdose C. Envenomation D. Medication overdose
A. Organophosphate
Your patient is a 52-year-old female who is alert but slightly confused after a syncopal episode lasting about 1 minute. She has no complaints, and your physical exam reveals no abnormalities aside from slight confusion. She has had a stroke and has a history of type II diabetes and hypertension. HR = 100, BP = 132/84, RR = 12, SaO2 =99%. Which of the following is the LEAST likely cause of the patient's episode? A. Orthostatic hypotension B. Transient cerebral ischemia C. Transient cardiac dysrhythmia D. Hypoglycemia
A. Orthostatic hypotension
Your patient is a 36-year-old female, conscious and alert, sitting at her desk and complaining of a rash and itchiness after taking a sulfa antibiotic. Physical examination reveals warm and dry skin, urticaria on her chest and back, that reveal mild expiratory wheezing. HR = 100, BP = 132/78, RR = 18, SaO2 = 93%. Which of the following is the most appropriate treatment for this patient? A. Oxygen via nonrebreather mask, IV crystalloid solution, 0.3 mg epinephrine IM, and consider 25 mg diphenhydramine IV and albuterol 2.5 mg via nebulizer B. Oxygen via nasal cannula and transport only C. Oxygen via nasal cannula, IV crystalloid solution, 5 mg epinephrine IV, 25 mg diphenhydramine IV D. Oxygen via nonrebreather mask, IV crystalloid solution, 25 mg diphenhydramine IV push
A. Oxygen via nonrebreather mask, IV crystalloid solution, 0.3 mg epinephrine IM, and consider 25 mg diphenhydramine IV and albuterol 2.5 mg via nebulizer
Murphy's sign is: A. Pain produced by pressing under the right costal margin in the presence of an inflamed gallbladder B. Petechial hemorrhage of the abdominal wall C. Bruising around the umbilicus D. Pain produced by pushing 1 to 2 inches above the iliac crest on a line to the umbilicus
A. Pain produced by pressing under the right costal margin in the presence of an inflamed gallbladder
A 52-year-old male is in moderate distress and complaining of nausea and vomiting. He describes a three-day history of left upper quadrant abdominal pain described as sharp and radiating to his back. You note a slightly distended abdomen. He called EMS today when he developed nausea and vomiting. He denies any change of bowel habits and states he has a history of alcoholism. Of the following, which is the most likely cause of his clinical condition? A. Pancreatitis B. Peptic ulcer disease C. Gastroenteritis D. Hepatitis
A. Pancreatitis
A seizure that remains confined to a limited portion of the brain, causing localized dysfunction, is a(n) ________ seizure. A. Partial B. Petit mal C. Absence D. Tonic
A. Partial
Your patient is a 45-year-old female type I diabetic with a history of a nonhealing foot ulcer. On examination, you find that her pedal pulse is present, but she lacks sensation in her foot. This is most likely due to: A. Peripheral neuropathy B. Raynaud's disease C. Brown-Séquard syndrome D. Claudication
A. Peripheral neuropathy
The diaphragm is controlled by the ________ nerve. A. Phrenic B. Abducens C. Olfactory D. Vagus
A. Phrenic
What is the innermost layer of meninges that directly overlies the central nervous system? A. Pia mater B. Cerebrospinal membrane C. Dura mater D. Arachnoid membrane
A. Pia mater
Your patient has a history of epilepsy and is experiencing loss of consciousness, tonic-clonic muscle activity, and erratic ocular movement. Based on this, you might also expect to find all of the following EXCEPT: A. Pinpoint pupils B. Increased oral secretions C. Urinary incontinence D. Impaired respiration
A. Pinpoint pupils
Your patient is a 72-year-old female, alert and oriented, sitting up in bed at a nursing home. She is in mild respiratory distress. The staff describes a four-day history of fever, malaise, and productive cough. The patient also states that she has been experiencing chills and chest pain with deep inspiration. Physical examination reveals rales and rhonchi in the right upper lobe and warm, moist skin. HR = 116, BP = 104/76, RR = 20, SaO2 = 93%. Based on the clinical exam findings, the most appropriate diagnosis would be: A. Pneumonia B. Chronic bronchitis C. Emphysema D. Congestive heart failure
A. Pneumonia
Increased hepatic resistance to blood flow, as happens in cirrhosis, results in: A. Portal vein hypertension and esophageal varices B. Hepatic arterial hypertension and obstruction of the common bile duct C. Portal artery hypertension and ascites D. Hepatic vein hypertension and hepatic vein aneurysm
A. Portal vein hypertension and esophageal varices
Treatment of a patient in acute renal failure may include all of the following EXCEPT: A. Potassium B. Dialysis C. Furosemide D. IV normal saline
A. Potassium
Acute exacerbation of Addison's disease can lead to ECG changes and cardiovascular collapse as a result of electrolyte imbalance secondary to: A. Potassium retention and sodium excretion B. Increased mineralocorticoid secretion from the adrenal glands C. Fluid retention, potassium excretion, and sodium retention D. Decreased mineralocorticoid secretion with increased sodium and potassium excretion
A. Potassium retention and sodium excretion
During a domestic disturbance your patient experienced a sudden onset of violent, bizarre movements of the extremities followed by unresponsiveness to verbal stimuli. On your arrival the bizarre movements begin again but stop suddenly when you firmly say, "Stop!" This most indicates ________ seizure. A. Pseudo B. Simple partial C. Complex partial D. Absence
A. Pseudo
Your patient is a 24-year-old male who has been an in-patient in a rehabilitation hospital following surgical fixation of a fractured pelvis. Staff reports sudden development of hypotension and severe respiratory distress about 30 minutes ago. There is no other significant history. Physical exam findings include cold, diaphoretic skin with peripheral cyanosis; jugular venous distension; clear breath sounds bilaterally; and vitals as follows: HR = 134, BP = 74/50, RR = 28, SaO2 = 84%. Which of the following is most likely? A. Pulmonary embolism B. Myocardial infarction C. Idiopathic congestive heart failure D. Spontaneous tension pneumothorax
A. Pulmonary embolism
Your patient is a 24-year-old male Chinese citizen on vacation in the United States. He is in moderate distress, complaining of difficulty breathing and gives a four-day history of runny nose, sore throat, fever, chills, and general malaise with a productive cough. His sputum production was significantly worse when he woke this morning, and he developed difficulty breathing this afternoon. HR = 134, BP = 132/84, RR = 26, SaO2 = 90%. This presentation is most consistent with: A. SARS B. Tuberculosis C. Hantavirus pulmonary syndrome D. Pneumonia
A. SARS
When a patient requires occasional medications or IV drips but does NOT need a continuous infusion, which device might be implanted into a patient? A. Saline lock B. Constriction needle C. IV piggyback D. Through-the-needle catheter
A. Saline lock
The primary goal in the prehospital care of a patient who has been bitten by a pit viper is to: A. Slow absorption of the venom B. Induce diuresis C. Alkalinize the urine D. Remove the venom from the surrounding tissue
A. Slow absorption of the venom
A college student, in an effort to improve test scores, takes a drug, Intelliboost, which enhances cortical function by increasing dopamine release in the brain. He also is taking a cold remedy, Sneezeless, which inhibits the chemical breakdown of dopamine at all receptor sites. Which of the following best describes the drug interaction? A. Sneezeless potentiates the effects of Intelliboost. B. Sneezeless has a cumulative effect. C. Sneezeless and Intelliboost have a synergistic effect. D. Sneezeless and Intelliboost have an additive effect.
A. Sneezeless potentiates the effects of Intelliboost.
A 38-year-old male is conscious and alert after a black widow spider bite to his right hand. You note pain and swelling to the hand, and the patient states that he is dizzy and nauseous. HR = 117, BP = 128/78, RR = 20. During your physical examination, you note that he begins to experience severe, painful muscle spasms in his right arm. Which of the following is NOT appropriate? A. Sodium bicarbonate B. Midazolam C. Diazepam D. Calcium gluconate
A. Sodium bicarbonate
Your patient is a 22-year-old female who has increased her daily dose of lithium without her physician's knowledge. She is complaining of generalized weakness, vomiting, and diarrhea. You notice that her speech is slurred. Heart rate = 68 and irregular, respirations = 16, blood pressure = 104/70, SaO2 = 97% on room air, and the monitor shows a sinus rhythm with PACs and PJCs. Which of the following would be most beneficial to this patient? A. Sodium bicarbonate B. Calcium chloride C. Oxygen D. Magnesium sulfate
A. Sodium bicarbonate
While palpating the lower abdomen of a 63-year-old male complaining of back pain, you note a pulsating mass. You should: A. Stop palpating B. Determine if the mass is fixed or freely mobile in the abdomen C. Ask your partner to confirm the finding D. Ask the patient to take a deep breath, then palpate the mass while he exhales
A. Stop palpating
Which of the following veins is NOT a site of peripheral venous access? A. Subclavian B. External jugular C. Median basilic D. Saphenous
A. Subclavian
Your patient is a 60-year-old male complaining of chills, fever, joint pain, and vomiting. He states he was bitten by a spider yesterday morning, and now he thinks the bite might be infected. The patient has an ulcerated wound on his left leg. The best treatment for this patient would include: A. Supportive management B. Diazepam 2.5 mg C. Magnesium sulfate, 2 g D. Calcium gluconate 0.1 mg/kg
A. Supportive management
A liquid preparation that contains small particles of a solid medication is known as a(n): A. suspension B. syrup C. reconstituted medication D. elixir
A. Suspension
A solid disk of compressed medicated powder, which may be scored to permit breaking, is known as a: A. Tablet B. Suppository C. Capsule D. Lozenge
A. Tablet
Which of the following types of medication would be placed in a soufflé cup for administration to a patient? A. Tablet B. Suppository C. Syrup D. Powder
A. Tablet
As you are palpating your patient's chest, he speaks, and you can feel the vibration through the chest wall. You should document this as: A. Tactile fremitus B. Crepitus C. A pleural friction rub D. Bronchovesicular sounds
A. Tactile fremitus
Which of the following findings is most suggestive of cystitis? A. Tenderness to palpation over the pubis B. Abdominal distension C. Flank pain radiating to the groin D. Diffuse, periumbilical abdominal pain
A. Tenderness to palpation over the pubis
In order for hemodialysis to be effective in ridding the body of excess electrolytes, which of the following statements must be true? A. The dialysate must contain electrolytes in a concentration lower than in the patient's blood. B. The dialysate must contain electrolytes in the same concentration as in the patient's blood. C. The dialysate must contain electrolytes in a concentration higher than in the patient's blood. D. The dialysate must not contain electrolytes.
A. The dialysate must contain electrolytes in a concentration lower than in the patient's blood.
With regard to the endocrine system, which of the following statements is NOT true? A. The hypothalamus and pituitary glands have no physical link. B. The posterior pituitary hormones are actually synthesized in the hypothalamus. C. The hypothalamus controls many of the functions of the pituitary gland. D. The pituitary gland is often called the "master gland."
A. The hypothalamus and pituitary glands have no physical link.
Which of the following statements about vitamins is NOT true? A. The individual B vitamins are named for the order in which they are required by the body. B. The liver stores the fat-soluble vitamins; consequently, they will become deficient only after long periods of inadequate vitamin intake. C. Vitamin D is unique in that it can be produced in the skin by sunlight exposure. D. The water-soluble vitamins must be routinely ingested, because the body does not store them.
A. The individual B vitamins are named for the order in which they are required by the body.
Which of the following statements about adult respiratory distress syndrome (ARDS) is FALSE? A. The mortality rate is 20 to 30 percent. B. Pulmonary edema and disruption of the alveolar-capillary membrane contribute to respiratory failure in ARDS. C. The causes of ARDS include pancreatitis, oxygen toxicity, sepsis, and tumor destruction. D. PEEP is often required to adequately ventilate ARDS patients.
A. The mortality rate is 20 to 30 percent.
An emergency department physician tells you that the hyperglycemic diabetic you brought in earlier has a pH of 7.40. What is the likeliest explanation of this statement? A. The patient is a type II diabetic who was secreting enough insulin to prevent the use of fats for energy. B. The patient is a type II diabetic who was no longer secreting enough insulin to prevent the use of fats for energy. C. The patient is a type I diabetic who did not take his insulin and is therefore unable to use glucose for energy. D. The patient is a type I diabetic who took his insulin and did not eat, resulting in the breakdown of proteins for energy.
A. The patient is a type II diabetic who was secreting enough insulin to prevent the use of fats for energy.
Which of the following best describes the mechanism of action of ACE inhibitors? A. They inhibit the conversion of angiotensin I to angiotensin II. B. They increase the GFR directly. C. They inhibit the formation of renin in the renin-angiotensin system. D. They inhibit sodium reabsorption, causing increased excretion of sodium.
A. They inhibit the conversion of angiotensin I to angiotensin II.
Your patient is a 44-year-old female complaining of a three-day history of localized abdominal pain in her midepigastric region after eating. The pain tends to subside with antacids. Today she is experiencing nausea, and the pain did not subside with antacids. The patient gives a history of smoking and moderate alcohol consumption. The patient's skin is warm and dry, and she has a blood pressure of 128/88, a heart rate of 84, and respirations of 20. Your course of treatment should consist of: A. Transporting the patient in a position of comfort and giving reassurance B. IV of NS with 250 cc fluid bolus C. Sodium bicarbonate IV D. High-concentration oxygen by nonrebreathing mask
A. Transporting the patient in a position of comfort and giving reassurance
Your patient is a 44-year-old female complaining of a three-day history of localized abdominal pain in her midepigastric region after eating. The pain tends to subside with antacids. Today she is experiencing nausea, and the pain did not subside with antacids. The patient gives a history of smoking and moderate alcohol consumption. The patient's skin is warm and dry, and she has a blood pressure of 128/88, a heart rate of 84, and respirations of 20. Your course of treatment should consist of: A. Transporting the patient in a position of comfort and giving reassurance B. High-concentration oxygen by nonrebreathing mask C. IV of NS with 250 cc fluid bolus D. Sodium bicarbonate IV
A. Transporting the patient in a position of comfort and giving reassurance
Which of the following is NOT associated with the sympathetic nervous system? A. Vagus nerve B. Thoracolumbar C. Fight-or-flight response D. Adrenergic
A. Vagus nerve
Which of the following is a statin? A. Zocor B. Questran C. Activase D. Lovenox
A. Zocor
The primary neurotransmitter of the parasympathetic nervous system is: A. acetylcholine. B. dopamine. C. epinephrine. D. reteplase.
A. acetylcholine.
You respond to a nursing home for an ill patient. Upon your arrival, the staff tells you that over the past few days the patient's urine output has been steadily declining. Today, the patient has only voided approximately 400 mL. You suspect: A. acute renal failure. B. chronic renal failure. C. polynephritis. D. renal calculi.
A. acute renal failure.
You respond to a report of a patient with shortness of breath. Upon arrival, you find a patient who has been stung by a bee. The patient is displaying urticaria and wheezing. You suspect: A. anaphylaxis. B. ARDS. C. asthma. D. meningitis.
A. anaphylaxis.
A concern for patients taking both insulin and beta-blockers is: A. beta2 adrenergic blockers can both hide the effects of hypoglycemia, making it difficult to recognize, and decrease the release of glucagon. B. beta-blockers prevent the release of insulin from the beta cells in the pancreas. C. beta-blockers, due to their sympatholytic effects on the nervous system, can further reduce available ATP to the cells of the body in the presence of insulin. D. the two medications, when taken together, have a synergistic effect.
A. beta2 adrenergic blockers can both hide the effects of hypoglycemia, making it difficult to recognize, and decrease the release of glucagon.
Symptoms of hyperthyroidism include all of the following, EXCEPT: A. bradycardia. B. nervousness. C. insomnia. D. hypertension.
A. bradycardia.
Fibrinolytics achieve their therapeutic action by: A. breaking up a thrombus that has formed. B. interfering with the clotting cascade. C. promoting the conversion of plasminogen to plasmin. D. decreasing platelet aggregation.
A. breaking up a thrombus that has formed.
A gelatin container filled with powder, liquid, or tiny granules is called a: A. capsule. B. caplet C. tablet. D. pill.
A. capsule.
Posturing with the arms flexed and the legs extended is known as: A. decorticate. B. postictal. C. neurogenic shock position. D. decerebrate.
A. decorticate.
You respond to an unresponsive patient. Upon exam, you get a finger stick blood glucose reading of "Lo." Treatment should include administration of: A. dextrose. B. epinephrine. C. insulin. D. ASA.
A. dextrose.
You respond to an unresponsive patient. Upon exam, you get a finger stick blood glucose reading of "Lo." Treatment should include administration of: A. dextrose. B. insulin. C. ASA. D. epinephrine.
A. dextrose.
A significant characteristic of digitalis preparations is that they: A. have a very narrow therapeutic index. B. are not prodysrhythmic drugs. C. have a positive chronotropic effect. D. have a negative inotropic effect.
A. have a very narrow therapeutic index.
Your patient is complaining of "coughing up blood," or, in medical terms: A. hemoptysis. B. hemothorax. C. hemopulmonary spasm. D. neoplasm.
A. hemoptysis.
You respond to a patient who is complaining of a sudden onset of a severe headache. The patient has a history of hypertension. You should suspect: A. hemorrhagic stroke. B. hypertensive urgency. C. occlusive stroke. D. migraine.
A. hemorrhagic stroke.
One cause of alterted mental status that you are able to quickly rule out is: A. hypoglycemia. B. hyperglycemia. C. CVA. D. TIA.
A. hypoglycemia.
The thyroid releases TSH to: A. increase metabolism. B. protect the vascular system. C. decrease insulin. D. promote shivering.
A. increase metabolism.
You respond to a patient who has an AV shunt in place. You notice that the patient is unresponsive with the following vital signs: blood pressure, 180/100 mmHg; pulse: 48; respirations: 12 and irregular. You suspect: A. increased ICP. B. decreased ICP. C. seizure. D. normal status for an AV shunt patient.
A. increased ICP.
All of the following statements about insulin are true, EXCEPT: A. it must be given subcutaneously. B. it can now be produced through recombinant DNA technology. C. it is classified as either natural (regular) or modified. D. it is available as short, intermediate, or long acting.
A. it must be given subcutaneously.
The two main functions of the renal system are: A. maintaining blood volume with proper pH, and retaining glucose and excreting urea. B. maintaining pH balance and blood volume. C. maintaining hemocrit levels with the proper creatine balance, and activation of the RAAS. D. maintaining blood glucose and clearing dead blood cells.
A. maintaining blood volume with proper pH, and retaining glucose and excreting urea.
When a drug causes a change in the cell membrane, preventing additional stimulation of the cell no matter how much stimulation is offered, that drug is called a: A. noncompetitive antagonist. B. competitive antagonist. C. competitive agonist. D. noncompetitive agonist.
A. noncompetitive antagonist.
Fifty percent of accidental poisonings occur in: A. pediatric patients. B. adults. C. geriatric patients. D. dementia patients.
A. pediatric patients.
You respond to a call of an ill male patient. Upon arrival, you see a patient in a chair, hooked into two large bags—one on an IV stand, one below his waist. The tubes are going into the patient's abdomen. You should suspect that this patient is undergoing: A. peritoneal dialysis. B. hemodialysis. C. J tube feeding. D. gastric lavage.
A. peritoneal dialysis.
The diaphragm is innervated by the: A. phrenic nerve. B. pulmonary nerve. C. renal nerve. D. renic nerve.
A. phrenic nerve.
You arrive on the scene of a patient who complains of worsening shortness of breath for the past few days. The patient presents with an SpO2 of 90%, ETCO2 of 45, normal wave form, crackles, and a temperature of 101.5°F. You should suspect: A. pneumonia. B. ARDS. C. COPD. D. CHF.
A. pneumonia.
The area that connects the brain to the spinal cord is known as the: A. pons. B. medulla oblongata. C. foramen magnum. D. cerebellum.
A. pons.
Variables to consider when determining the proper method of drug storage include all of the following, EXCEPT: A. potency. B. temperature. C. light. D. moisture.
A. potency.
The paramedic's chief concern with patients taking sildenafil (Viagra) is: A. profound hypotension. B. agitation and combative behavior. C. uncontrolled hypertension. D. acute renal failure.
A. profound hypotension.
Tricyclic antidepressants achieve their therapeutic effect by: A. prolonging the duration of norepinephrine and serotonin at the receptor sites. B. blocking the release of norepinephrine and serotonin at the synapse. C. enhancing degradation of norepinephrine and serotonin at the synapse. D. blocking the release of acetylcholine at the synapse.
A. prolonging the duration of norepinephrine and serotonin at the receptor sites.
Pulmonary shunting can be seen in patients with suspected: A. pulmonary embolism. B. hypovolemic shock. C. hemothorax. D. tension pneumothorax.
A. pulmonary embolism.
In a patient experiencing a myocardial infarction, a medication that reduces afterload is beneficial because it: A. reduces the workload of the heart, reducing myocardial oxygen consumption. B. reduces the blood flow to unnecessary areas, redirecting blood to the heart. C. prolongs the Q-T interval, thereby allowing time for complete atrial contribution to the ventricles. D. improves the stroke volume of blood ejected from the heart by also reducing preload.
A. reduces the workload of the heart, reducing myocardial oxygen consumption.
Sildenafil (Viagra) achieves its therapeutic action in the treatment of erectile dysfunction by: A. relaxing vascular smooth muscle, which increases blood flow to the corpus cavernosum. B. stimulating sympathetic receptors in the nerve fibers leading to the sexual organs. C. stimulating parasympathetic receptors in the nerve fibers leading to the sexual organs. D. enhancing neuronal stimulation of the amygdala in the brain.
A. relaxing vascular smooth muscle, which increases blood flow to the corpus cavernosum.
Your first priority in the treatment of an inhaled toxin is to: A. remove the patient from the source. B. deluge with water. C. flood with oxygen. D. decontaminate the patient.
A. remove the patient from the source.
The chief physiologic effect of nerve gas, such as VX, is to: A. reversibly block the enzyme acetylcholinesterase. B. competitively block the muscarinic receptor sites at the target organs. C. competitively block the nicotinic receptor sites at the neuromuscular junction. D. produce an adrenergic blockade throughout the body.
A. reversibly block the enzyme acetylcholinesterase.
Abdominal pain that is sharp in nature and can be localized is known as: A. somatic pain. B. Kehr's sign. C. visceral pain. D. referred pain.
A. somatic pain.
The two mechanisms capable of producing alterations in mental state are: A. structural and toxic-metabolic. B. physiologic and RAS. C. structural and RAAS. D. cranial nervous and the central nervous system.
A. structural and toxic-metabolic.
Lung compliance is described as: A. the ease with which the chest expands. B. the depth at which the chest expands. C. the rate at which the chest expands. D. the diameter of the chest wall.
A. the ease with which the chest expands.
Homeostasis refers to: A. the tendency of the body to maintain an appropriate internal environment. B. extrinsic environmental regulatory factors. C. the body's ability to regulate the external environment. D. intrinsic environmental regulatory factors.
A. the tendency of the body to maintain an appropriate internal environment.
A major concern during the administration of an alpha agonist is infiltration, because it may cause: A. tissue necrosis. B. cardiac dysrhythmias. C. excessive bleeding at the site of infiltration. D. enhanced systemic effects.
A. tissue necrosis.
You respond to a call of an ill person. Upon arrival, you find your patient complaining of diffuse abdominal pain and hematemesis. When asked, the patient states that the emesis was "coffee ground" in nature. You suspect: A. upper GI bleed. B. lower GI bleed. C. esophageal varices. D. melena.
A. upper GI bleed.
Oliguria is defined as: A. urine output of 400-500 mL daily. B. urine output of 1000-2000 mL daily. C. urine output of 100-200 mL daily. D. urine output of 4000-5000 mL daily.
A. urine output of 400-500 mL daily.
An "orphan drug" is best defined as a drug that is: A. used specifically to treat a rare disease. B. intended only for the pediatric population. C. in its own chemical classification. D. not producible as a generic alternative.
A. used specifically to treat a rare disease.
Stimulation of the histamine (H1) receptors often results in: A. vasodilation and increased vascular permeability. B. inhibition of antibody production C. bronchodilation. D. increased gastric acid release.
A. vasodilation and increased vascular permeability.
When preparing for venipuncture, a constricting band should be applied tight enough to restrict ________ flow. A. venous but not arterial B. arterial but not venous C. neither arterial nor venous D. both arterial and venous
A. venous but not arterial
An intrinsic risk factor is one that is influenced: A. within the patient. B. by the atmosphere. C. by a carcinogen. D. outside the patient.
A. within the patient.
Your diabetic patient asks you why he "passes out" when his blood sugar gets too low. Which of the following responses is most accurate? A. "Brain cells need a constant supply of glucose, or sugar, to function. Without sugar the brain cells cannot work to maintain consciousness." B. "The cells of the heart can only use glucose, or sugar, for energy. Without sugar the heart cannot effectively pump blood to the brain." C. "When the blood sugar is low, the blood vessels relax and the blood pressure drops, causing you to faint." D. "When the blood sugar is low, the brain does not get enough oxygen."
A. "Brain cells need a constant supply of glucose, or sugar, to function. Without sugar the brain cells cannot work to maintain consciousness."
Your patient is a 25-year-old female who is complaining of pain in the midline of the lower abdomen. Which of the following questions helps LEAST when determining the etiology of the patient's pain? A. "Do you feel nauseated?" B. "Are you having any pain with urination?" C. "Are you experiencing pain anywhere other than your lower abdomen?" D. "When was your last menstrual period?"
A. "Do you feel nauseated?"
Your patient is a 22-year-old female in mild distress that is complaining of left lower quadrant abdominal pain and nausea. Which of the following questions would be LEAST helpful when determining the etiology of her abdominal pain? A. "Have you ever had a sexually transmitted disease?" B. "When did the pain start?" C. "When did your last menstrual period start?" D. "Are you having any vomiting or diarrhea?"
A. "Have you ever had a sexually transmitted disease?"
When dealing with a possible renal emergency, it is imperative to ask: A. "How many times have you urinated today?" B. "Do you think you can walk?" C. "When was the last time you saw your nephrologist?" D. "How much do you weigh?"
A. "How many times have you urinated today?"
Your patient has a history of benign prostatic hypertrophy. Which of the following complaints is most consistent with this history? A. "I can't seem to urinate." B. "I have blood in my urine first thing in the morning." C. "It seems like I urinate a gallon at a time." D. "My urine is cloudy and has a strong odor."
A. "I can't seem to urinate."
You have been called for a 46-year-old female complaining of a headache. Which of the following statements made by the patient should you find most concerning? A. "I have never had a headache this bad." B. "The pain gets worse when the lights are on." C. "I have never been nauseated like this with a headache before." D. "I took two Tylenol tablets 2 hours ago, and the pain is still there."
A. "I have never had a headache this bad."
Which of the following complaints is most typical for a patient suffering an exacerbation of multiple sclerosis? A. "My legs feel heavy, and I am having trouble walking." B. "I have no feeling in either my arms or my legs." C. "Each night I seem to get a fever and break out in a sweat." D. "I cannot remember my address or phone number."
A. "My legs feel heavy, and I am having trouble walking."
The father of a 15-year-old male who has had a generalized seizure asks you why his son turned blue during the seizure. Which of the following is the best answer? A. "The muscles used in breathing cannot work effectively during the seizure, decreasing the amount of oxygen in the blood." B. "It is a normal part of the seizure process and nothing to worry about." C. "The heart slows down and the blood pressure drops during a seizure, causing a lack of circulation to the skin." D. "The brain stem stops working during a seizure, which causes breathing to stop, decreasing the amount of oxygen in the blood."
A. "The muscles used in breathing cannot work effectively during the seizure, decreasing the amount of oxygen in the blood."
The father of a 15-year-old male who has had a generalized seizure asks you why his son turned blue during the seizure. Which of the following is the best answer? A. "The muscles used in breathing cannot work effectively during the seizure, decreasing the amount of oxygen in the blood." B. "The brain stem stops working during a seizure, which causes breathing to stop, decreasing the amount of oxygen in the blood." C. "It is a normal part of the seizure process and nothing to worry about." D. "The heart slows down and the blood pressure drops during a seizure, causing a lack of circulation to the skin."
A. "The muscles used in breathing cannot work effectively during the seizure, decreasing the amount of oxygen in the blood."
Your patient is a 68-year-old female who is conscious but confused and lying supine in bed without complaint. Her daughter states that the patient was recently diagnosed with a bladder infection and has been taking antibiotics. She also states that her mother has not produced urine for two days, during which she has become increasingly confused. Physical examination reveals swelling to the face, hands, and feet; cool and moist skin; and lung sounds that are clear and equal bilaterally. HR = 104 , BP = 142/88, RR = 14, SaO2 = 96%. In addition to administering oxygen and monitoring the cardiac rhythm, which of the following courses of action is most appropriate? A. 12-lead ECG, prepare a large bore IV line, administer fluid or medication only by IV or IM routes B. IV of saline, furosemide, 40 mg C. Have the patient drink water while you provide comfort; prepare for an ECG D. IV of saline, intubate the patient
A. 12-lead ECG, prepare a large bore IV line, administer fluid or medication only by IV or IM routes
Acute renal failure occurs when a patient loses _____ of the functioning nephrons. A. 80% B. 50% C. 60% D. 70%
A. 80%
When evaluating a patient with a possible neurologic emergency, which acronym can help you remember the causes? A. AEIOU-TIPS B. TICKLES C. ISAL D. AVPU
A. AEIOU-TIPS
Which of the following correctly pairs a toxin with its antidote? A. Acetaminophen: N-acetylcysteine B. Carbon monoxide: amyl nitrite C. Benzodiazepine: naloxone D. Aspirin: magnesium citrate
A. Acetaminophen: N-acetylcysteine
What is a process in which a cell may decrease the number of receptors exposed to a particular substance to reduce its sensitivity? A. Down-regulation B. Up-regulation C. Adaptation D. Resourcing
A. Down-regulation
Which of the following correctly lists the organs and regions of the gastrointestinal tract in sequence after the stomach? A. Duodenum, jejunum, ileum, ascending colon, transverse colon, descending colon, rectum, anus B. Duodenum, jejunum, ileum, descending colon, transverse colon, ascending colon, rectum, anus C. Jejunum, duodenum, ileum, large intestine, anus, rectum D. Duodenum, ileum, jejunum, large intestine, anus, rectum
A. Duodenum, jejunum, ileum, ascending colon, transverse colon, descending colon, rectum, anus
Which three cranial nerves are involved in the cardinal positions of gaze? A. III, IV, and VI B. I, III, and VI C. VI, VII, and X D. I, III, and IV
A. III, IV, and VI
Your patient is a 68-year-old female who has been in a rehabilitation hospital for one week following hip replacement surgery. According to the staff, the patient is a type II diabetic and is being treated for a postoperative infection. The patient was lethargic yesterday and was found unresponsive this morning, just before your arrival. Physical exam reveals an accumulation of secretions in her airway, lung sounds clear and equal bilaterally, and skin and mucous membranes warm and dry. HR = 119, BP = 86/58, RR = 16, blood glucose = 864 mg/dL. In addition to initiating basic airway management measures and gaining IV access, which of the following is the best treatment for this patient? A. Intubate, 1 to 2 L NS bolus B. Oxygen by nonrebreather mask, NS at a KVO rate, 50 mEq sodium bicarbonate IV C. BVM ventilations with supplemental oxygen, NS at a KVO rate D. Intubate, 1 to 2 L NS bolus, 25 g dextrose IV
A. Intubate, 1 to 2 L NS bolus
Your patient is a 48-year-old female who is supine on the floor of a neighborhood health clinic. She became unconscious after receiving 250 mg of IM doxycycline. Clinic staff reports that the patient "broke out in hives and lost consciousness." The patient is being ventilated by bag-valve mask and has an IV of normal saline running wide open. A nurse practitioner on the scene informs you that, before your arrival, he administered 2 doses of 0.5 mg of epinephrine SC, 50 mg of diphenhydramine IV, and 1 L of NS. HR = 138; BP = 84/60; RR = 12/min, assisted with BVM; SaO2 = 94%. Of the following, which is the most appropriate continued treatment of this patient? A. Intubate, administration of dopamine IV infusion, rapid transport B. Initiate a second IV of NS wide open, intubate and hyperventilate, transport C. Intubate, Solu-Medrol IV, 250 cc NS fluid challenge, transport D. Continue administering fluids and transport to the nearest facility
A. Intubate, administration of dopamine IV infusion, rapid transport
The pathophysiology of toxic inhalation involves: A. Irritation, edema, and destruction of alveolar tissue B. Bronchoconstriction and dispersal of surfactant C. Bronchodilation and destruction of cilia D. Pulmonary hypertension, alveolar atelectasis, and destruction of cilia
A. Irritation, edema, and destruction of alveolar tissue
Your patient is a 24-year-old, 176-pound male who is alert and oriented 12 hours after ingesting thirty 500 mg tablets of Tylenol. Which of the following are the most likely complaints or findings? A. Nausea, vomiting, weakness, and fatigue B. Abdominal pain and oliguria C. Signs and symptoms of liver failure D. Confusion, lethargy, and hyperthermia
A. Nausea, vomiting, weakness, and fatigue
Your patient is a 72-year-old male who is conscious but lethargic and sitting in a chair. His son states that the patient has been a bit slow lately and has been gaining weight. The medical history includes hypothyroidism and myocardial infarction. The patient has been compliant with his Synthroid and has nitroglycerin for use as needed. The patient responds to verbal stimuli, is confused, has a large tongue, and pale, cold, doughy skin. His only complaint is constipation. HR = 60 and regular, BP = 112/80, RR = 10 and shallow, SaO2 = 92%, temperature = 88°F, blood glucose = 180 mg/dl. Your treatment of this patient should include: A. Oxygen, 4 lpm by nasal cannula B. Atropine 0.5 mg IV C. Rewarm with heat packs D. Infusion of 1 to 2 liters of warm normal saline
A. Oxygen, 4 lpm by nasal cannula
Which of the following is a risk factor for pneumonia? A. immune-compromising diseases B. exposure to hot and balmy weather C. drug abuse D. cardiac output
A. immune-compromising diseases
Your patient is experiencing right lower quadrant pain following a syncopal episode. She reports that her last menstrual period (LMP) was about six weeks ago. While she is awaiting an abdominal CT, the surgery resident asks that you initiate an IV of lactated Ringer's solution using a blood set (10 drops/mL) and infuse 1 liter over 1 hour. What drip rate (in drops/minute) will you use to attain this rate of administration? A. 167 B. 600 C. 17 D. 67
A. 167
Which of the following is NOT a valid reason for releasing confidential patient information? A.A newspaper reporter promises not to reveal his source. B.A judge signs a court order requesting the information. C.The patient's insurance company needs the information for filing and reimbursement purposes. D.The patient's other medical care providers have a need to know.
A.A newspaper reporter promises not to reveal his source.
EMT-P Smith came to work feeling very tired and decided to nap before doing his equipment and vehicle checklist. After about 45 minutes the tones went off, and EMT-P Smith and his EMT-B partner, Jones, were dispatched for a seizure. The patient was still actively seizing when they arrived at the scene. Smith discovered that the previous shift had used all the Valium and failed to replace it. As a result Smith could administer no medication to stop the seizure. Ultimately, the patient stopped seizing and suffered no apparent adverse consequences. Which of the following elements to establish negligence is missing in this case? A.Actual damages B.Breach of duty C.Duty to act D.Consent
A.Actual damages
You have responded to a physician's office for a terminal cancer patient in cardiac arrest. The physician says, "This is a chemical code only. Just give the meds, but don't intubate or do CPR." Which of the following should you do? A.Tell the physician you are bound to treat the patient according to protocol. If the physician would like you to do something different, she must take complete responsibility for patient care. B.Tell the physician you cannot comply with her orders under any circumstances, and then file a report with the state medical licensing board about her negligence in this case. C.Because this is the patient's personal physician, you must comply with her orders. D.Comply with her orders on the scene to avoid a confrontation, but initiate appropriate care once you are in the back of the ambulance.
A.Tell the physician you are bound to treat the patient according to protocol. If the physician would like you to do something different, she must take complete responsibility for patient care.
A patient has been treated by paramedics for a sprained wrist. En route to the hospital, she suffers a stroke. What is the likely outcome of a negligence lawsuit brought by the patient? A.The suit would fail because the plaintiff could not demonstrate that the paramedics' actions were the proximate cause of the stroke. B.The suit would fail because the plaintiff failed to demonstrate malice on the part of the plaintiffs. C.The suit would succeed because the paramedics had a duty to act and the patient suffered actual damages. D.The suit would succeed because this was a foreseeable event.
A.The suit would fail because the plaintiff could not demonstrate that the paramedics' actions were the proximate cause of the stroke.
When a patient care report is found to be incomplete or inaccurate, the paramedic should: A.add a dated and signed written amendment to the original report. B.cross out the incorrect information so that it cannot be read and add the correct information to the bottom of the report, dating and signing it. C.erase or white out the incorrect information and write in the correct facts. D.file a completely new report with the correct information.
A.add a dated and signed written amendment to the original report.
OSHA's development of requirements to be followed at hazardous materials emergencies is an example of ________ law. A.administrative B.legislative C.common D.constitutional
A.administrative
You are treating a patient who you think needs an IV of lactated Ringer's. The patient, however, says he is frightened of needles and refuses to give his consent. If you display the IV catheter and bring it toward the patient, you may be charged with: A.assault. B.battery. C.libel. D.negligence.
A.assault.
Malfeasance, misfeasance, and nonfeasance are three types of: A.breach of duty. B.aggravated assault. C.negligence. D.criminal acts.
A.breach of duty.
The category of law that deals with issues involving conflicts between two or more parties, such as personal injury cases, contract disputes, and matrimonial issues, is ________ law. A.civil B.magistrate C.common D.criminal
A.civil
"Case" law and "judge-made" law are other names for ________ law. A.common B.legislative C.constitutional D.administrative
A.common
A paramedic who transports patients without their consent or other legal authority would most likely be subject to charges of: A.false imprisonment. B.abandonment. C.negligence. D.defamation.
A.false imprisonment.
All of the following are matters of civil law, EXCEPT: A.homicide. B.marriage. C.negligence. D.malpractice.
A.homicide.
A paramedic may treat an unconscious diabetic patient by relying on: A.implied consent. B.primum non nocere. C.res ipsa loquitur. D.informed consent.
A.implied consent.
Injuring a person's name or character through false written statements is known as: A.libel. B.perjury. C.slander. D.misfeasance.
A.libel.
An action or inaction by a paramedic that causes or worsens damages suffered by a patient is called the ________ of the damages. A.proximate cause B.primary cause C.potential agent D.precipitating agent
A.proximate cause
Which of the following is a disadvantage to intravascular volume replacement with isotonic crystalloid solutions? A. Two-thirds of the volume leaves the intravascular space within 1 hour. B. Intracellular fluid shifts to the vascular space. C. There is an immediate shift of vascular volume to the interstitial space. D. Sodium shifts into cells, and potassium shifts out of cells.
A. Two-thirds of the volume leaves the intravascular space within 1 hour.
Generally, a patient under age 18 can be considered an emancipated minor in all of the following situations EXCEPT when the patient is a: A.16-year-old living in foster care. B.16-year-old female who is pregnant. C.17-year-old who is in the military. D.16-year-old female who is the parent of a 1-year-old child.
A.16-year-old living in foster care.
Your protocols call for a dopamine infusion beginning at 5 micrograms per kilogram per minute. You estimate that your patient weighs 190 pounds. Using a standard dopamine concentration of 800 mg in 500 mL, at what drip rate (in drops/minute) will you need to administer the infusion using microdrip tubing? A. 4 B. 16 C. 27 D. 432
B. 16
Glucose is excreted through the urea above which level? A. 150 mg/dL B. 180 mg/dL C. 250 mg/dL D. 500 mg/dL
B. 180 mg/dL
Your patient is a 27-year-old male who has possibly overdosed on heroin. He is unresponsive and bradypneic. Which of the following is appropriate? A. 25 mg diphenhydramine B. 2 mg of naloxone C. 1 mg of flumazenil D. 100 mg of thiamine
B. 2 mg of naloxone
What must be done to the concentration of a medication if it is given endotracheally? A. 1.5 times normal IV dose B. 2 to 2.5 times normal IV dose C. 3 times the IV dose D. Same as IV dose
B. 2 to 2.5 times normal IV dose
You respond to a patent who complains of having dark, tarry stools. Upon arrival, you notice that the patient is pale, cool, and clammy. After initiation of two large-bore IVs, your initial fluid bolus should be: A. 250 mL. B. 20 mL/kg. C. 1000 mL. D. 10 mL/kg.
B. 20 mL/kg.
Your patient is a 56-year-old male who is conscious and exhibits slurred speech, irritability, and cool, clammy skin. Blood glucose is 54 mg/dL. Proper treatment for this patient could include all of the following EXCEPT: A. Consideration of D50 IV if the patient cannot follow simple commands B. 5 to 10 mg of glucagon IM C. IV of NS D. Administration of oral glucose if the patient is able to swallow
B. 5 to 10 mg of glucagon IM
A patient with COPD should present with a normal PO2 of: A. 35-45 mmHg B. 50-60 mmHg C. 94-96 mmHg D. 70-80 mmHg
B. 50-60 mmHg
Normal tidal volume in an average 70-kg adult is approximately ________ mL. A. 750 B. 500 C. 1,000 D. 1,500
B. 500
The average adult tidal volume is: A. 1200 mL. B. 500 mL. C. 750 mL. D. 2400 mL.
B. 500 mL.
Persistent abdominal pain is considered a surgical emergency when lasting longer than: A. 2 days. B. 6 hours. C. 2 hours. D. 6 days.
B. 6 hours.
Using microdrip IV tubing, how many drops of fluid equal 1 mL? A. 10 B. 60 C. 20 D. 15
B. 60
Your patient is a 46-year-old with a history of pancreatitis. He has had abdominal pain and vomiting for 24 hours. The ED physician requests that you initiate an IV for rehydration. You will be using a 15 drops/mL infusion set to administer 250 mL of 5 percent dextrose in 0.9 percent NS per hour. What drip rate (at drops/minute) is needed to deliver the fluids at this rate? A. 41 B. 63 C. 100 D. 75
B. 63
Acute renal failure occurs when a patient loses _____ of the functioning nephrons. A. 50% B. 80% .C. 60% D. 70%
B. 80%
Pseudoseizures are best controlled by: A. Phenytoin B. A command to stop C. Using physical restraints D. Lorazepam
B. A command to stop
Which of the following statements about the use of vasopressors in the treatment of anaphylaxis is TRUE? A. A norepinephrine infusion can correct the peripheral vasodilation that occurs secondary to SRS-A release by basophils and mast cells. B. A dopamine infusion can correct the peripheral vasodilation that occurs secondary to histamine release by basophils and mast cells. C. An epinephrine infusion can correct the peripheral vasodilation that occurs secondary to SRS-A release by basophils and mast cells. D. A norepinephrine infusion encourages a net movement of plasma from the intravascular space to the vascular space, raising blood pressure.
B. A dopamine infusion can correct the peripheral vasodilation that occurs secondary to histamine release by basophils and mast cells.
Which of the following statements regarding a dialysis fistula is TRUE? A. The fistula is the preferred site of venous access in an emergency situation. B. A fistula is a surgical anastomosis of an artery and a vein. C. A fistula uses a dual lumen tube to connect an artery and a vein. D. The fistula is inserted peripherally, but the end of it is placed near the right atrium.
B. A fistula is a surgical anastomosis of an artery and a vein.
A disorder of lung diffusion that results from increased fluid in the interstitial space is known as: A. COPD. B. ARDS. C. PHTN. D. AIDS.
B. ARDS.
An eight-year-old male child is alert and oriented after a brief episode of eyelid fluttering and slight loss of muscle tone, which caused him to slump in his chair. His teacher reports that the child was inattentive for 15 to 20 seconds during the episode but was fine after. This most indicates a(n) ________ seizure. A. Generalized B. Absence C. Simple partial D. Pseudo
B. Absence
Which of the following mechanisms is not characteristic for a rectal foreign body? A. Accidental swallowing of something B. Accidental trauma C. Psychosis on the part of the patient D. Sexual gratification
B. Accidental trauma
A patient undergoes neurological changes during hemodialysis. Of the following, which is the most likely cause of these neurologic abnormalities? A. Hypotension B. Accumulated blood urea C. Acute myocardial infarction D. Hyperglycemia
B. Accumulated blood urea
Which of the following is an acceptable antidote for a specific poisoning? A. Naloxone for diazepam overdose B. Acetylcysteine (Mucomyst) for acetaminophen overdose C. Amyl nitrite, sodium nitrite, and sodium thiosulfate for organophosphate exposure D. Sodium bicarbonate for muriatic acid ingestion
B. Acetylcysteine (Mucomyst) for acetaminophen overdose
A 19-year-old male has ingested fifty 325 mg aspirin tablets 20 minutes before your arrival. He is alert and complaining of burning abdominal pain. Which of the following is appropriate in the prehospital management of this patient? A. Sodium bicarbonate B. Activated charcoal C. N-acetylcysteine D. Syrup of ipecac
B. Activated charcoal
Which of the following medications has the shortest half-life? A. Verapamil B. Adenosine C. Epinephrine D. Digitalis
B. Adenosine
Your patient is a 20-year-old male with a peanut allergy who inadvertently ate some candy containing peanuts. He is complaining of a "lump" in his throat, his voice is hoarse with mild inspiratory stridor, and he appears anxious. You are giving oxygen by nonrebreathing mask and have started an IV. Next, you should: A. Administer 2.5 mg albuterol by nebulizer B. Administer 0.4 mg of 1:1000 epinephrine, SQ and 50 mg diphenhydramine IV C. Place the patient in a supine position and prepare for transtracheal ventilation D. Administer an induction agent and a paralytic and perform endotracheal intubation
B. Administer 0.4 mg of 1:1000 epinephrine, SQ and 50 mg diphenhydramine IV
You are assessing an unresponsive patient with a MedicAlert tag that indicates he is a diabetic. The patient's airway is patent, respirations are 20 per minute and adequate, radial pulse is rapid and weak, and the skin is warm and moist. You attempt to get a blood glucose reading, but your blood glucose monitor malfunctions. Which of the following is the best course of action? A. Request another unit to respond to the scene with a blood glucose monitor. B. Administer 25 g of 50 percent dextrose. C. Administer a 1 to 2 liter bolus of NS. D. Request an order for 20 units of regular insulin.
B. Administer 25 g of 50 percent dextrose.
Prehospital management of an unresponsive patient with hypoglycemia should NOT include: A. BVM ventilations with 100 percent O2 and an OPA B. Administration of oral glucose C. Administration of D50 IV D. Administration of glucagon IM
B. Administration of oral glucose
Cushing's syndrome is a disorder of the: A. Thyroid gland B. Adrenal glands C. Posterior pituitary gland D. Ovaries
B. Adrenal glands
Which medication would be the best choice for reducing the bronchospasm and laryngeal edema associated with anaphylaxis? A. Dexamethasone B. Albuterol C. Solu-Medrol D. Oxygen
B. Albuterol
You are assessing your respiratory patient. Of the following findings, which would concern you the most? A. Stridor B. Alerted mental status C. Intercostal retractions D. Tachycardia
B. Alerted mental status
Which of the following cause(s) injury by inducing liquefaction necrosis? A. Acids B. Alkalis C. Caustics D. Emulsifiers
B. Alkalis
Which of the following cause(s) injury by inducing liquefaction necrosis? A. Emulsifiers B. Alkalis C. Acids D. Caustics
B. Alkalis
Which of the following is LEAST pertinent in the prehospital setting when obtaining the history of a patient with a suspected transient ischemic attack or stroke? A. History of diabetes B. Allergies C. History of cardiovascular disease D. Medications
B. Allergies
Which of the following classes of drugs is commonly abused to produce alertness and euphoria? A. Benzodiazepines B. Amphetamines C. Alcohol D. Barbiturates
B. Amphetamines
Which of the following diseases is characterized by a progressive degeneration of the nerve cells that control voluntary movement, weakness, loss of motor control, difficulty speaking, and cramping? A. Muscular dystrophy B. Amyotrophic lateral sclerosis C. Bell's palsy D. Multiple sclerosis
B. Amyotrophic lateral sclerosis
Oxygen can benefit patients with chronic renal failure because it is common for patients with chronic renal failure to be: A. Anemic due to the blood loss associated with hemodialysis B. Anemic due to decreased production of RBCs C. Hypoxic secondary to associated congestive heart failure D. Hypoxic secondary to associated hypotension
B. Anemic due to decreased production of RBCs
Which of the following statements about using antihistamines in the treatment of anaphylaxis is TRUE? A. Antihistamines block H1 and H2 receptors and prevent further release of histamine from B and T cells. B. Antihistamines block histamine receptors and reduce histamine release from mast cells and basophils. C. Blocking of H1 receptors results in mild vasoconstriction, while the blocking of H2 receptors results in bronchodilation. D. Antihistamines displace histamine, then block histamine receptors.
B. Antihistamines block histamine receptors and reduce histamine release from mast cells and basophils.
Which of the following is the most important determinant of ventilatory rate? A. Venous PO2 B. Arterial PCO2 C. Arterial PO2 D. Venous PCO2
B. Arterial PCO2
Most carbon dioxide from cellular metabolism reaches the alveoli by being transported: A. Bound to hemoglobin B. As bicarbonate ion C. As carbonic anhydrase D. Dissolved in plasma
B. As bicarbonate ion
Shortly after you have treated a patient who was experiencing a cardiac dysrhythmia, the patient complains of dry mouth, blurred vision, palpitations, and sensitivity to light. Which of the following drugs is most likely to cause these effects? A. Lidocaine B. Atropine C. Adenosine D. Amiodarone
B. Atropine
Your patient is a 32-year-old female who is alert but in significant distress, complaining of a migraine. She has a history of migraines, describes a gradual onset of headache this morning, and is now experiencing nausea and intense throbbing pain behind her temples. She is lying on a couch in a dim room and keeps her eyes closed while talking to you in a low voice. HR = 100, BP = 148/100, RR = 12, SaO2= 99%. Which of the following is MOST appropriate in the prehospital management of this patient? A. Morphine sulfate, IV in 2 mg increments, up to 10 mg B. A calm, quiet environment and dim lights C. Lorazepam, 2 mg D. NTG SL, 0.4 mg, up to 3 tablets or a diastolic blood pressure of 80 mmHg
B. A calm, quiet environment and dim lights
What is a method of determining the concentration, activity, or effect of a change to a substance by testing its effect on a living organism and comparing this with the activity of an agreed standard? A. Idiosyncrasy B. Bioassay C. Adverse effect D. Potentiation
B. Bioassay
Which of the following pharmacokinetic processes would be LEAST affected by the hypotensive state of a patient in cardiogenic shock? A. Absorption B. Biotransformation C. Distribution D. Elimination
B. Biotransformation
Which of the following is evaluated in the Los Angeles Prehospital Stroke Screen but is not part of the Cincinnati Prehospital Stroke Scale? A. Facial droop B. Blood glucose level C. Speech D. Arm drift
B. Blood glucose level
Which of the following drug names are the same? A. Chemical and trade B. Brand and trade C. Chemical and generic D. Proprietary and official
B. Brand and trade
Your patient complains of coughing up "greenish-brown" sputum. This is most consistent with: A. Cancer B. Bronchitis C. Seasonal allergies D. Pulmonary edema
B. Bronchitis
Which of the following is NOT a common obstructive lung disease encountered in the prehospital setting? A. Asthma B. CHF C. Emphysema D. Chronic bronchitis
B. CHF
You have been called to a residence by the parents of a 14-year-old boy, whom they found sniffing paint fumes in an effort to get high. The patient is agitated, coughing, and complaining of dizziness and shortness of breath. His airway is patent, respirations adequate, and radial pulse easily palpable. Closer assessment of the patient reveals paint around his mouth and breath sounds that are clear and equal. Heart rate = 96, respirations = 20, blood pressure = 116/78, and SaO2 = 96%. Oxygen via a nonrebreather has been applied and an IV established. Which of the following is the most important in the assessment and care of this patient? A. Antipyretics B. Cardiac monitoring C. Benzodiazepines D. Albuterol administration
B. Cardiac monitoring
Which of the following is associated with CAPD? A. Catheter placed in the central circulation B. Catheter providing access to the abdominal cavity C. Dialysis shunt in either arm D. Dialysis fistula in either arm
B. Catheter providing access to the abdominal cavity
The nervous system is divided into which two main parts? A. Autonomic and cranial B. Central and peripheral C. Peripheral and autonomic D. Central and autonomic
B. Central and peripheral
Which of the following medications is appropriate for the routine treatment of type 2 diabetes mellitus? A. Ultralente insulin B. Chlorpropamide (Diabinese) C. Glucagon D. NPH insulin
B. Chlorpropamide (Diabinese)
All of the following may be associated with urinary tract infection EXCEPT A. Cystitis B. Cholecystitis C. Pyelonephritis D. Prostatitis
B. Cholecystitis
Which of the following best explains why many former prescription drugs have become over-the-counter (OTC) drugs? A. Many drug actions, once believed to be harmful, have been found to be relatively safe. B. Consumers are more aware, and pharmaceutical marketing strategies have improved. C. Prescription-only medications are much more expensive to manufacture. D. Physicians have lobbied to reduce the number of prescriptions they must write.
B. Consumers are more aware, and pharmaceutical marketing strategies have improved.
Which of the following explains the profound protein catabolism and gluconeogenesis associated with Cushing's syndrome? A. Cushing's syndrome affects normal fat deposition. B. Cortisol is an antagonist to insulin. C. Increased epinephrine and norepinephrine release result in hypermetabolism. D. Glucocorticoids cause sodium retention and increased blood volume.
B. Cortisol is an antagonist to insulin.
You are caring for an elderly woman with suspected vertebral fracture secondary to osteoporosis. She frequently takes a hydrocodone-containing preparation (Vicoprofen) for pain. With her current injury, you find it necessary to administer a greater-than-expected dosage of morphine. Why is this higher dosage needed? A. Psychological dependency B. Cross tolerance C. Synergism D. Potentiation
B. Cross tolerance
Which of the following is the purpose of lung surfactant? A. Aid in the facilitated diffusion of carbon dioxide and oxygen across the alveolar membrane B. Decrease the surface tension of water in the alveoli C. Aid in the facilitated diffusion of oxygen across the alveolar membrane D. Destroy and remove foreign material from the alveoli
B. Decrease the surface tension of water in the alveoli
A 32-year-old is conscious and in mild distress, complaining of nausea and sweating. He states that his symptoms started two days ago when he stopped drinking "cold turkey." Physical examination reveals cool, diaphoretic skin; slightly dilated pupils bilaterally; and a general weakness to all extremities. Which of the following findings would also be likely? A. Insomnia, hyperglycemia, and difficulty breathing B. Delirium tremens, hallucinations, and anxiety C. Depression, hypotension, and polyuria D. Hypertension, bradycardia, and hyperglycemia
B. Delirium tremens, hallucinations, and anxiety
Alcohol is classified as a(n): A. Stimulant B. Depressant C. Anxiolytic D. Hallucinogen
B. Depressant
On-scene you are presented with a confused patient suffering from altered mental status. Additionally, in front of the family, the patient is very irritable and verbally abusive toward all present, including EMS. His wife states that his "kidneys are no good" and he also has "sugar" problems. Your assessment indicates that he is dyspneic with pale skin that is covered with a fine white sediment. His radial pulse is weak, rapid, and irregular. Additionally, you note edema to his hands, feet, and face. Crackles are noted to the lungs bilaterally and he has a dialysis graft on his right forearm. Your partner reports that his heart rate is 164, respirations 26, blood pressure 176/90, and SpO2 89%. After applying high-concentration oxygen, which of the following would you perform next? A. Administer furosemide, 120 mg B. Determine the blood glucose level C. Consider a small IV bolus for fluid resuscitation as hypovolemia is evident D. Administer sodium bicarbonate, 50 mEq
B. Determine the blood glucose level
Which of the following statements about hemodialysis is TRUE? A. Dialysate enters the circulation through the venous site of a fistula and leaves through the arterial side of the fistula. B. Dialysis approximates the physiology of the nephron by placing blood on one side of a semipermeable membrane and dialysate on the other side. C. Blood is removed from the body, wastes are collected in a filter, and blood is then returned to the body. D. Dialysate is placed in the abdominal cavity, the peritoneum acts as a dialysis membrane, and dialysate is then removed from the abdominal cavity.
B. Dialysis approximates the physiology of the nephron by placing blood on one side of a semipermeable membrane and dialysate on the other side.
Your patient is a 29-year-old male who is conscious, alert, and extremely hyperactive after using cocaine. HR = 134, BP = 148/102, RR = 20. Physical examination reveals warm, diaphoretic skin and dilated pupils bilaterally. Which of the following medications should be considered to manage this patient? A. Propranolol B. Diazepam C. Naloxone D. Metoprolol
B. Diazepam
Your patient states that he often experiences a painful cramping and "freezing up" of his hands and feet while handwriting or walking, respectively. This best describes: A. Palsy B. Dystonia C. Myoclonus D. Torticollis
B. Dystonia
Which of the following chemistry findings would suggest acute renal failure? A. Decreased creatinine B. Elevated blood urea nitrogen (BUN) C. Elevated iron D. Decreased potassium
B. Elevated blood urea nitrogen (BUN)
Atrial fibrillation is most associated with ________ strokes. A. Hypoxic B. Embolic C. Hemorrhagic D. Thrombotic
B. Embolic
A 46-year-old female alcoholic is hypotensive, in severe distress, complaining of dysphagia, and vomiting bright red blood. Of the following, which is the most likely cause of this patient's clinical condition? A. Acute gastroenteritis B. Esophageal varices C. Acute gastric ulcer perforation D. Hemorrhagic pancreatitis
B. Esophageal varices
A Mallory-Weiss tear is a disorder of the: A. Liver B. Esophagus C. Stomach D. Rectum
B. Esophagus
Your patient is a 49-year-old male complaining of a headache and weakness of his left arm, accompanied by nausea and vomiting. The information that would be most helpful in differentiating a brain abscess from a brain tumor is whether or not the patient: A. Has a recent history of brain surgery B. Exhibits nuchal rigidity C. Has had a seizure D. Has had a change in the level of responsiveness
B. Exhibits nuchal rigidity
Your patient is a 49-year-old male complaining of a headache and weakness of his left arm, accompanied by nausea and vomiting. The information that would be most helpful in differentiating a brain abscess from a brain tumor is whether or not the patient: A. Has had a seizure B. Exhibits nuchal rigidity C. Has had a change in the level of responsiveness D. Has a recent history of brain surgery
B. Exhibits nuchal rigidity
As antiemetics, phenothiazines (Compazine, Phenergan) have which of the following undesirable side effects? A. Headache and diarrhea B. Extrapyramidal effects and sedation C. Hallucinations D. Euphoria
B. Extrapyramidal effects and sedation
Your patient is a 35-year-old male whom you suspect of having a kidney stone. All of the following would be consistent with this impression EXCEPT: A. A description of "knifelike" pain B. Fever C. Restlessness D. Hematuria
B. Fever
You are examining a patient who is exhibiting signs of hypovolemia. Upon inspection of the patient's flank, you notice ecchymosis. This is known as: A. Cullen's sign. B. Grey Turner's sign. C. Edwards sign. D. rigidity sign.
B. Grey Turner's sign.
LSD and PCP are examples of: A. Sedatives B. Hallucinogens C. Narcotics D. Amphetamines
B. Hallucinogens
Which of the following should occur with the administration of insulin? A. Lipolysis B. Hepatic glycogen synthesis C. Gluconeogenesis D. Glycogenolysis
B. Hepatic glycogen synthesis
Which of the following statements about hepatitis is TRUE? A. The most common cause of hepatitis is alcohol abuse. B. Hepatitis is caused by a wide range of potential causes. C. All types of hepatitis lead to chronic liver disease. D. All types of hepatitis are typically fatal within six months to two years.
B. Hepatitis is caused by a wide range of potential causes.
Which of the following is NOT a modifiable risk factor for type II diabetes? A. Poor diet B. Heredity C. Obesity D. Lack of exercise
B. Heredity
Which of the following is a narcotic? A. Crack B. Heroin C. Mescaline D. Cocaine
B. Heroin
A chemical substance that is released into the blood by a gland and that controls or affects processes in other glands or body systems is a(n): A. Neurotransmitter B. Hormone C. Leukotriene D. Enzyme
B. Hormone
What is the name of the needle used to access an implanted port? A. Hickman B. Huber C. Portacath D. Broviac
B. Huber
Which of the following is the most direct cause of polyuria in untreated diabetes? A. Hypoglycemia B. Hyperglycemia C. Too much insulin D. Too little insulin
B. Hyperglycemia
Which of the following most accurately represents the pathophysiological sequence of untreated type I diabetes? A. Glucose is not absorbed through the gastrointestinal tract, resulting in hyposecretion of insulin and hypoglycemia. Lack of glucose results in anaerobic metabolism and acidosis. B. Hyposecretion of insulin results in inability of glucose to enter cells; blood glucose levels rise, and cells convert to the use of fats for energy, resulting in the production of ketone bodies. C. Oversecretion of insulin results in hypoglycemia; cells convert to the use of fats for energy resulting in the production of ketone bodies. D. Hyposecretion of insulin prevents glucose from being broken down in the gastrointestinal tract; too much glucose is absorbed from the gastrointestinal tract resulting in hyperglycemia and ketoacidosis.
B. Hyposecretion of insulin results in inability of glucose to enter cells; blood glucose levels rise, and cells convert to the use of fats for energy, resulting in the production of ketone bodies.
In which class of the Vaughn-Williams classification system of anti-dysrhythmic medications does propranolol belong? A. IA B. II C. IC D. IB
B. II
You respond to a patient with shortness of breath after he took a dose of an antibiotic. You find your patient with audible stridor and uticaria. You should administer: A. SQ epinephrine 1:1000 0.3-0.5 mg. B. IM epinephrine 1:1000 0.3-0.5 mg. C. albuterol 5 mg. D. diphenhydramine 75 mg.
B. IM epinephrine 1:1000 0.3-0.5 mg.
Your patient is a 44-year-old male who has been in jail for three days after being arrested for driving while intoxicated. He now presents with diaphoresis, anxiety, hallucinations, insomnia, and tremors. HR = 142, BP = 132/94, RR = 34, blood glucose = 85 mg/dL. Which of the following is appropriate? A. Thiamine 100 mg IV B. IV of NS KVO C. 25 gm D50 IV D. Narcan 2 mg IV
B. IV of NS KVO
Your patient is a 45-year-old type I diabetic complaining of a five-day history of abdominal pain, nausea and vomiting, and increased urination and thirst. His skin and mucous membranes are warm and dry. HR = 112 bpm and regular, BP = 94/60, RR = 12 and regular. Your treatment for this patient would most likely include: A. IV of NS KVO, nitroglycerin 0.4 mg SL, every 3 to 5 minutes B. IV of NS 1-2 L C. IV of NS KVO, 50 percent dextrose IVP D. IV of D5W KVO, 50 percent dextrose IVP
B. IV of NS 1-2 L
You are called to a local physician's office where you find a 52-year-old male patient with a history of chronic renal failure. He is conscious but disoriented. The physician reports that the patient's wife brought him in because he has had a "chest cold," missed dialysis yesterday, and is now "acting strangely." Physical examination reveals cool, diaphoretic skin; edema to dependent areas, and lung sounds with rhonchi in the right upper lobe. HR = 118, BP = 142/100, RR = 20 and deep, SaO2 = 97%, blood glucose = 79 mg/dL. Bloodwork performed by the physician in his office indicates a pH of 7.2. In addition to 15 liters per minute of oxygen by nonrebreathing mask and an IV of normal saline at a keep-open rate, which of the following is most appropriate for this patient in the prehospital setting? A. IV magnesium sulfate, 10 gm B. IV sodium bicarbonate, 1 mEq/kg C. IV dextrose, 25 gm D. IV furosemide, 120 mg
B. IV sodium bicarbonate, 1 mEq/kg
Which of the following is NOT a possible source of cyanide poisoning? A. Ingestion of apricot, pear, and cherry pits B. Improperly vented heating systems C. Fume inhalation from burning plastic, synthetic carpeting, or silk D. Long-term sodium nitroprusside therapy
B. Improperly vented heating systems
Which of the following best explains the underlying problem in diverticulitis? A. Increased motility of the colon with increased mucus production B. Infection in an outpouching of the distal colon C. Ulceration of the lining of the colon D. The presence of polyps in the sigmoid colon
B. Infection in an outpouching of the distal colon
Which of the following is NOT a percutaneous route of medication administration? A. Transdermal B. Inhalation C. Buccal D. Sublingual
B. Inhalation
An allergen's most common route of entry in an anaphylactic reaction is: A. Inhalation B. Injection C. Ingestion D. Absorption
B. Injection
Which of the following is the most common chief complaint related to acute pancreatitis? A. Headache B. Intense abdominal pain C. Blood in the stool D. Diarrhea
B. Intense abdominal pain
Your patient is a 24-year-old male who is alert and oriented, complaining of severe "dizziness" and an earache for two days. He states that any movement of his head causes him to become very dizzy and nauseated. The patient's skin is warm and dry, his pupils are equal and reactive, and there is no gross neurological deficit. HR = 82, BP = 120/82, RR = 12, SaO2 = 99%. Which of the following is most likely? A. Subdural hematoma B. Labyrinthitis C. Transient cerebral ischemia D. Hypersensitivity of the carotid sinus
B. Labyrinthitis
When assessing a fistula used for hemodialysis, which of the following should concern you? A. Pulsation with each heartbeat B. Lack of a palpable vibration C. A bruit on auscultation D. Bruising around the fistula
B. Lack of a palpable vibration
Which statement about levodopa in the treatment of Parkinson's disease is NOT true? A. Levodopa is an effective therapy because it converts to dopamine in the brain. B. Levodopa remains an effective therapy throughout the disease. C. Levodopa is often combined with another ingredient to prevent metabolism outside the brain. D. Levodopa crosses the blood-brain barrier.
B. Levodopa remains an effective therapy throughout the disease.
Esophageal varices are most associated with: A. Pancreatitis B. Liver disease C. Kidney disease D. Gastroesophageal reflux disease
B. Liver disease
The family members of a 72-year-old female state that the patient complained of a sudden, severe headache; had slurred speech; then became unresponsive. She responds to painful stimuli with decorticate posturing and has snoring respirations at a rate of 10 per minute. Her radial pulse is palpable but grossly irregular. According to her son, she also suffers from congestive heart failure, hypertension, and diabetes. Which of the following should you do first? A. Check her blood sugar. B. Manage the airway with a head-tilt/chin-lift maneuver. C. Insert an endotracheal tube. D. Attach the cardiac monitor.
B. Manage the airway with a head-tilt/chin-lift maneuver.
With occlusion of the SMA or IMA vascular structures, what gastrointestinal emergency may occur? A. Renal infarction B. Mesenteric ischemia C. Hepatic encephalitis D. Pancreatitis
B. Mesenteric ischemia
Which of the following is NOT a factor that affects drug absorption? A. Drug solubility B. Metabolism rate C. Dosage form D. pH
B. Metabolism rate
Your patient is a 56-year-old female who is sitting on a park bench. She is conscious, though lethargic, and complaining of faintness. She states she has had a "chest cold" for the past week so had decided to stop taking her "blood pressure pills" until she felt better. She states that this morning she ingested five tablets instead of her normal one tablet dose to "catch up" after the days off. You note cool, slightly diaphoretic skin; lungs clear bilaterally; PEARL; and no motor deficits. HR = 48, BP = 76/30, RR = 12, SaO2 = 97%. Which of the following is LEAST likely to be the medication she overdosed on? A. Verapamil B. Metaproterenol C. Procardia D. Cardizem
B. Metaproterenol
Which of the following is a common inorganic source of medications? A. Animals B. Minerals C. Plants D. Synthetic materials
B. Minerals
Which of the following is a collection of genetic diseases characterized by progressive muscle weakness and skeletal muscle degeneration? A. Multiple sclerosis B. Muscular dystrophy C. Myasthenia gravis D. Amyotrophic lateral sclerosis
B. Muscular dystrophy
Which of the following is characterized by involuntary muscle twitching? A. Dystonia B. Myoclonus C. Trismus D. Ataxia
B. Myoclonus
Which of the following statements about nitroglycerin is NOT true? A. Nitroglycerin commonly causes headache and orthostatic hypotension. B. Nitroglycerin is poorly lipid soluble, which prevents it from passing through cell membranes, thereby prolonging its effects. C. Nitroglycerin primarily dilates veins and coronary vessels. D. Nitroglycerin achieves its therapeutic effects by blocking the entry of calcium into the cells of smooth muscle.
B. Nitroglycerin is poorly lipid soluble, which prevents it from passing through cell membranes, thereby prolonging its effects.
You are caring for a young mother who just gave birth to her first child. Despite taking all the appropriate measures, she continues to exhibit postpartum hemorrhage. In addition to crystalloid intravenous infusions, what medication might you consider to manage this patient? A. Epinephrine infusion B. Oxytocin (Pitocin) C. Dopamine (Intropin) infusion D. Terbutaline (Brethine)
B. Oxytocin (Pitocin)
Which of the following statements concerning Africanized honeybees is accurate? A. Envenomation by Africanized honeybees requires treatment with specific antivenin. B. Patients stung by Africanized honeybees tend to have more stings than patients stung by other types of bees. C. The venom of Africanized honeybees causes acute renal failure. D. The venom of Africanized honeybees is more toxic than that of other types of bees.
B. Patients stung by Africanized honeybees tend to have more stings than patients stung by other types of bees.
Pulmonary embolism is a problem of: A. Ventilation of lungs B. Perfusion of the lungs C. Thickness of the respiratory membrane D. Interstitial edema
B. Perfusion of the lungs
Which term best describes the effects a drug has on its target organs? A. Bioavailability B. Pharmacodynamics C. Pharmacokinetics D. Biotransformation
B. Pharmacodynamics
A 54-year-old female is conscious and alert and in significant pain after a rattlesnake bite to her hand. You note two small puncture wounds surrounded by a swollen, red area. She states that she is nauseous and has chills. Your management of this patient should include immobilization of the affected arm and: A. Elevating it above the level of the heart B. Placing it at the level of the heart C. Placing it at the level of the heart with ice packs to the affected area D. Placing it below the level of the heart with a constricting band proximal to the wound
B. Placing it at the level of the heart
Which of the following characteristics is LEAST associated with emphysema? A. Cor pulmonale B. Productive cough throughout the day C. Barrel chest appearance D. Polycythemia
B. Productive cough throughout the day
What is the preferred access site for intraosseous infusion in both pediatric and adult patients? A. Distal femur B. Proximal tibia C. Proximal humerus D. Distal tibia
B. Proximal tibia
You are working at the triage desk in the ED when a young man on crutches approaches the desk. He appears moderately short of breath. He states he had a cast put on his left leg seven days ago after surgery for a ruptured Achilles tendon. This morning, while he was watching television, he suddenly became short of breath. He has a history of asthma, for which he takes Xopenex as needed, and is taking Tylenol with codeine for pain related to his surgery. The patient's lung sounds are clear and equal, SpO2 is 90 percent on room air, heart rate is 100 and regular, respirations are 24 and slightly labored, blood pressure is 128/88, and the patient is afebrile. These findings are most consistent with: A. Asthma exacerbated by recent anesthesia B. Pulmonary embolism associated with immobilization of the lower extremity C. Pneumonia secondary to recent anesthesia D. Allergic reaction to codeine
B. Pulmonary embolism associated with immobilization of the lower extremity
Which of the following statements about pulse oximetry is FALSE? A. Pulse oximetry has the ability to noninvasively measure total hemoglobin (SpHb) in addition to SpO2 and other parameters. B. Pulse oximetry values can be expected to decrease within seconds in cases of developing hypoxia. C. Pulse oximetry should be used on all patients with respiratory complaints. D. Oxygen saturation is the percentage of hemoglobin that is bound with some molecular structure.
B. Pulse oximetry values can be expected to decrease within seconds in cases of developing hypoxia.
Just as you are arriving at the emergency department bay, your patient, on whom you started an IV at the scene, complains of sudden chills, back pain, and nausea. The patient appears flushed, and his skin is hot and moist to the touch. Which of the following most likely accounts for your patient's presentation? A. Circulatory overload B. Pyrogenic reaction C. Anaphylaxis D. Pulmonary thromboembolism
B. Pyrogenic reaction
Which of the following is an advantage of sublingual drug administration? A. Uniform absorption through the conjunctival mucosa B. Rapid absorption due to sublingual vasculature C. Rapid dissolution of tablets so the medication can be swallowed D. Slow rate of drug absorption
B. Rapid absorption due to sublingual vasculature
Your patient is a 32-year-old male who is alert and oriented and complaining of severe pain. He states he has a history of disk herniation. Today, he experienced an acute onset of lower back pain while lifting a heavy box. Physical examination reveals a palpable muscle spasm and pain with palpation at the level of L4 and L5. He is lying on his right side and states that the pain is too severe for him to move. HR = 132, BP = 152/104, RR = 20, SaO2 = 99%. Which of the following would NOT be appropriate? A. Cervical collar, supine immobilization on a long backboard B. Right lateral recumbent position on a long backboard for transport C. Valium IV D. Morphine sulfate IV
B. Right lateral recumbent position on a long backboard for transport
The dorsal roots of the spinal cord contain afferent fibers that transmit impulses from ________ to ________. A. The central nervous system, sensory nerves B. Sensory nerves, central nervous system C. The central nervous system, motor nerves D. Motor nerves, the central nervous system
B. Sensory nerves, central nervous system
A 72-year-old female has a one-week history of 101°F fever, chills, and dark-brown sputum production. She also has rhonchi and rales throughout her right lung. If this condition is left untreated, it could result in: A. Chronic bronchitis B. Septic shock C. Cardiogenic shock D. Pneumonia
B. Septic shock
A 38-year-old male is conscious and alert after a black widow spider bite to his right hand. You note pain and swelling to the hand, and the patient states that he is dizzy and nauseous. HR = 117, BP = 128/78, RR = 20. During your physical examination, you note that he begins to experience severe, painful muscle spasms in his right arm. Which of the following is NOT appropriate? A. Calcium gluconate B. Sodium bicarbonate C. Diazepam D. Midazolam
B. Sodium bicarbonate
A series of two or more generalized motor seizures without an intervening period of consciousness is known as: A. Hypertonic seizures B. Status epilepticus C. A complex partial seizure D. A petit mal seizure
B. Status epilepticus
Which of the following would result in an increased respiratory rate? A. Stimulation of baroreceptors by an increase of PCO2 B. Stimulation of chemoreceptors by an increase of PCO2 C. A decrease of cerebrospinal fluid PO2 D. An increase of cerebrospinal fluid pH
B. Stimulation of chemoreceptors by an increase of PCO2
Which of the following statements about histamines and antihistamines is NOT true? A. Although asthma attacks can be caused by allergens, antihistamines should not be administered as a treatment. B. Stimulation of the H1 histamine receptors plays a major role in the development of anaphylaxis. C. A chief side effect of antihistamines is sedation. D. There are antagonists for both H1 and H2 histamine receptor sites.
B. Stimulation of the H1 histamine receptors plays a major role in the development of anaphylaxis.
Your patient is a 19-year-old female who is exhibiting generalized seizure activity. Her roommate states that she had a seizure that lasted about 3 minutes. She remained unresponsive, then started having another seizure about 5 minutes after the first. The patient has peripheral cyanosis and copious oral secretions. Which of the following is of HIGHEST priority for this patient? A. Starting an IV and administering 5 mg of diazepam B. Suctioning the airway, assisting ventilations with a bag-valve-mask device C. Starting an IV, administering succinylcholine, and intubation D. Suctioning the airway, applying 15 liters per minute of oxygen by nonrebreathing mask
B. Suctioning the airway, assisting ventilations with a bag-valve-mask device
Which of the following is a medication that, when inserted into a body opening, dissolves into the surrounding mucosa? A. Ointment B. Suppository C. Liniment D. Enteric-coated capsule
B. Suppository
Part of the reason that tricyclic antidepressants (TCAs) have fallen somewhat out of favor compared with selective serotonin reuptake inhibitors (SSRIs) is because: A. TCA overdoses often create a hypertensive crisis in patients. B. TCA overdoses have a cardiotoxic effect. C. SSRIs have the added advantage of also blocking norepinephrine and dopamine. D. SSRIs have the added advantage of also blocking histamine and acetylcholine.
B. TCA overdoses have a cardiotoxic effect.
After a person turns 40, what is the rate of nephron loss in the kidneys? A. Five percent per year. B. Ten percent per decade. C. Twenty percent per decade. D. Five percent per decade.
B. Ten percent per decade.
A patient presents with a history of frequent urination, signs and symptoms of dehydration, and a blood glucose of 958 mg/dL. There is no acetone odor on his breath. To which of the following can the absence of an acetone odor most likely be attributed? A. Elimination of ketoacids by the blood buffer system B. The ability to use enough glucose to meet metabolic needs C. The ability to convert to the use of amino acids for energy metabolism D. Elimination of ketoacids through Kussmaul's respirations
B. The ability to use enough glucose to meet metabolic needs
Which of the following best describes the relationship between the hypothalamus and the endocrine system? A. The hypothalamus regulates most endocrine activities via positive feedback mechanisms. B. The hypothalamus is the link between the CNS and the endocrine system. C. The hypothalamus is also known as the posterior pituitary gland. D. The hypothalamus produces all of the releasing hormones that act on other endocrine organs.
B. The hypothalamus is the link between the CNS and the endocrine system.
You have administered 25 g of 50 percent dextrose to a patient who was initially unresponsive with a blood glucose level of 23 mg/dL. Which of the following is the best indication that the patient's condition is improving? A. The respiratory rate decreases from 24 to 16 per minute. B. The patient opens his eyes but is confused. C. The patient seems less diaphoretic. D. The heart rate decreases from 112 to 96 per minute.
B. The patient opens his eyes but is confused.
Which of the following best describes why the secondary response to an antigen is faster than the primary response? A. The secondary response uses memory cells, which immediately release antigens specific to the antibodies. B. The secondary response uses memory cells, which immediately release antibodies specific to the antigen. C. The secondary response has fewer steps than the primary response, allowing it to progress faster. D. The primary response uses B and T cells specific to the antigens.
B. The secondary response uses memory cells, which immediately release antibodies specific to the antigen.
Which of the following statements about hemostatic agents, such as adenosine diphosphate (ADP) and thromboxane A2 (TXA2), is TRUE? A. They are responsible for converting plasminogen to plasmin. B. They have their effect early in the clotting process. C. They convert fibrinogen to fibrin. D. They limit the clotting cascade to the immediate area of the vessel injury.
B. They have their effect early in the clotting process.
You are working in the ED caring for a 55-year-old female with a long history of COPD. She is more short of breath today than usual and states she has an increased cough. She has a tympanic temperature of 99.8°F. You have drawn arterial blood gases with the patient on room air and when the report comes back, it shows that the patient has a pO2 of 52 mmHg. Which of the following is most likely? A. The lab performed the test incorrectly. B. This is the typical value for this patient. C. You have inadvertently drawn a venous sample. D. The patient is critically hypoxic and requires assisted ventilation.
B. This is the typical value for this patient.
A three-year-old male patient has a history of an underdeveloped cell-mediated immune system. Which of the following MOST likely contribute to this deficiency? A. Hypoadrenalism B. Thymus gland insufficiency and a lack of thymosin secretion C. HIV infection D. Type I diabetes mellitus
B. Thymus gland insufficiency and a lack of thymosin secretion
You are transporting a male patient with the complaint of expressive aphasia and right upper extremity paralysis to the hospital. When calling the hospital, which of the following pieces of information is it most critical to convey? A. SaO2 94% despite oxygen B. Time of symptom onset C. Blood pressure 168/82 mmHg D. History of hypertension
B. Time of symptom onset
Your patient is a two-year-old male who is alert and crying after ingesting bathroom cleaner. Physical examination reveals no obvious burns or irritation to his oropharynx, and his skin is cool and dry. HR = 112, BP = 108/60, RR = 24, SaO2 = 99%. Which of the following is most appropriate? A. Administration of activated charcoal B. Transport C. Having the patient drink a glass of milk D. Administration of ipecac
B. Transport
Your patient is a 16-year-old female who has taken an overdose of phenobarbital. She is unresponsive. Her skin is cool and pale, BP = 92/60, HR = 60, RR = 6. You have intubated the patient and started an IV. Which of the following is appropriate? A. Naloxone 2mg, 25 gm dextrose, transport B. Transport without additional pharmacological intervention C. Sodium bicarbonate 100 mEq D. 50 gm activated charcoal through an NG tube en route to the hospital
B. Transport without additional pharmacological intervention
The leading cause(s) of end-stage renal failure is (are): A. Kidney infection B. Uncontrolled diabetes mellitus and hypertension C. Renal calculi and kidney infection D. Acute renal failure
B. Uncontrolled diabetes mellitus and hypertension
Which of the following sites on the body is used for an intradermal injection? A. Upper chest B. Upper back C. Abdomen D. Groin
B. Upper Back
Bleeding in the gastrointestinal tract proximal to the ligament of Treitz is considered to be in the: A. Lower GI tract B. Upper GI tract C. Small intestine D. Colon
B. Upper GI tract
Of the following, which is TRUE of the changes in blood chemistry and composition in a patient with chronic renal failure? A. H+ excretion leads to alkalosis. B. Urea and creatinine levels increase. C. Polycythemia occurs. D. Blood glucose decreases.
B. Urea and creatinine levels increase.
Into which of the following containers would it be necessary to inject a volume of air equal to the intended volume of medication before withdrawing the medication with a needle and syringe? A. Nebulizer B. Vial C. Prefilled syringe D. Ampule
B. Vial
Your male patient complaining of abdominal pain describes his pain as a dull, crampy sensation that is making him nauseous. The patient is most likely describing ________ pain. A. Parietal B. Visceral C. Referred D. Somatic
B. Visceral
The order Hymenoptera includes: A. Jellyfish B. Wasps C. Scorpions D. Spiders
B. Wasps
A condition seen in chronic alcoholics that causes ataxia, eye muscle weakness, and mental derangement is known as: A. Wolff-Parkinson-White syndrome. B. Wernicke's syndrome C. Korsakoff's psychosis. D. Brugada syndrome.
B. Wernicke's syndrome
Which sign associated with an allergic reaction should concern a caregiver the most? A. GI distress B. Wheezing C. Urticaria D. Warm, flushed skin
B. Wheezing
Which sign associated with an allergic reaction should concern a caregiver the most? A. Urticaria B. Wheezing C. Warm, flushed skin D. GI distress
B. Wheezing
Inhalation of a poison causes: A. absorption by the trachea. B. absorption in the alveolar capillary. C. aspiration. D. increase in secretions.
B. absorption in the alveolar capillary.
You are called to a patient with severe shortness of breath. Upon arrival, you find your patient in the tripod position, with pursed lips and audible wheezing. SpO2 is at 89% and capnography shows a "shark fin" pattern with an ETCO2 of 50. You should: A. administer an alpha agonist. B. administer a beta agonist. C. administer an alpha antagonist. D. administer a beta antagonist.
B. administer a beta agonist
The narcotic nalbuphine (Nubain) not only binds to opiate receptor sites to provide analgesia, but it also prevents other opioids, such as morphine sulfate, from binding to these sites, lessening respiratory depression. These characteristics make the drug a(n): A. competitive antagonist. B. agonist-antagonist. C. agonist. D. competitive agonist.
B. agonist-antagonist.
The acronym AVPU is used to quickly assess a patient's: A. judgment. B. alertness. C. thought. D. mood.
B. alertness.
Sympathetic nervous system stimulation that results in vasoconstriction is most likely affecting: A. beta1 receptor sites. B. alpha1 receptor sites. C. beta2 receptor sites. D. alpha2 receptor sites.
B. alpha1 receptor sites.
The chemical analysis of the strength, purity, and effectiveness of a drug is termed a(n): A. teratogen. B. assay. C. formulary. D. bioassay.
B. assay.
Medications best suited for treating bronchoconstriction generally stimulate ________ receptors. A. alpha2 B. beta2 C. beta1 D. alpha
B. beta2
A majority of carbon dioxide in the body is transported as: A. hydrogen ion. B. bicarbonate ion. C. hemoglobin. D. plasma.
B. bicarbonate ion.
The relative therapeutic effectiveness of chemically comparable drugs is regarded as the: A. bioassay of the drugs. B. bioequivalence. C. relative efficacy of the drugs. D. therapeutic index.
B. bioequivalence.
One important reason medications are given intravenously is that they: A. can be more easily reversed if an untoward effect occurs. B. bypass the liver initially. C. have a delayed onset of action compared to the oral route. D. have minimal effects on the CNS system.
B. bypass the liver initially.
You respond to an ill male patient. Upon arrival, you note a farmer who is complaining of not feeling well. The patient presents in a tripod position with copious secretions, lacrimation, vomiting, and evidence of urination and defecation. You suspect: A. extrapyramidal syndrome. B. cholinergic exposure. C. sympathomimetic exposure. D. anticholinergic exposure.
B. cholinergic exposure.
The FDA's numerical classification of a newly approved drug as "3" denotes it as a new: A. generation of a marketed drug. B. formulation or dosage form not previously marketed. C. combination not previously marketed. D. molecular drug.
B. formulation or dosage form not previously marketed.
The half-life of carboxyhemoglobin is reduced to approximately 22 minutes by using: A. 100% oxygen. B. hyperbaric oxygen therapy. C. hypobaric oxygen therapy. D. 44% oxygen.
B. hyperbaric oxygen therapy.
The half-life of carboxyhemoglobin is reduced to approximately 22 minutes by using: A. 100% oxygen. B. hyperbaric oxygen therapy. C. 44% oxygen. D. hypobaric oxygen therapy.
B. hyperbaric oxygen therapy.
One cause of alterted mental status that you are able to quickly rule out is: A. CVA. B. hypoglycemia. C. TIA. D. hyperglycemia.
B. hypoglycemia.
Upon examining your patient, you note that he has a clubbing of the fingers. You would suspect a history of: A. hypertension. B. hypoxemia. C. peripheral vascular disease. D. neoplasm.
B. hypoxemia.
You are called to the home of a patient who suddenly "stopped breathing." The patient has a history of a neoplasm at C3 and C4 You suspect: A. cervical fractures. B. impingement on the phrenic nerve. C. lung cancer. D. myocardial infarction.
B. impingement on the phrenic nerve.
Digoxin is prescribed to patients with congestive heart failure primarily to: A. control rapid ventricular rates, because many of these patients also have atrial fibrillation. B. improve myocardial contractility and cardiac output. C. improve blood flow to the lungs, thereby reducing pulmonary edema. D. achieve a negative chronotropic effect and thereby reduce the myocardial workload.
B. improve myocardial contractility and cardiac output.
You respond to a patient who has an AV shunt in place. You notice that the patient is unresponsive with the following vital signs: blood pressure, 180/100 mmHg; pulse: 48; respirations: 12 and irregular. You suspect: A. normal status for an AV shunt patient. B. increased ICP. C. decreased ICP. D. seizure.
B. increased ICP.
Histamine causes the all of the following EXCEPT: A. bronchoconstriction. B. increased intracranial pressure. C. vasodilation. D. increased permeability.
B. increased intracranial pressure.
Medications to treat extrapyramidal side effects from antipsychotic medications, as well as drugs used to treat Parkinson's disease, achieve their therapeutic effects by: A. enhancing the effects of acetylcholine, an inhibitory neurotransmitter, in the basal ganglia. B. increasing the amount of dopamine at the receptor sites in the basal ganglia. C. blocking the release of dopamine from the substantia nigra in the basal ganglia. D. blocking the transmission of neural impulses through the pyramidal decussation of the brain.
B. increasing the amount of dopamine at the receptor sites in the basal ganglia.
An antidote: A. is not indicated in the field. B. neutralizes the toxin. C. is universally oxygen. D. enhances the toxin.
B. neutralizes the toxin.
Some of the most immediate effects from ingesting a poison include: A. localized skin reaction. B. oral burns. C. clotting disorders. D. absorption by the lower intestine.
B. oral burns.
The mortality rate of ruptured esophageal varices is ________ percent. A. 10 to 15 B. over 35 C. 20 to 30 D. 15
B. over 35
A drug that blocks the muscarinic receptors in the peripheral nervous system would be classified as a: A. parasympathomimetic. B. parasympatholytic. C. sympathomimetic. D. sympatholytic.
B. parasympatholytic.
The immune response is a cascade that reacts to a: A. toxin. B. pathogen. C. bacteria. D. virus.
B. pathogen.
You respond to a call of an ill male patient. Upon arrival, you see a patient in a chair, hooked into two large bags—one on an IV stand, one below his waist. The tubes are going into the patient's abdomen. You should suspect that this patient is undergoing: A. hemodialysis. B. peritoneal dialysis. C. gastric lavage. D. J tube feeding.
B. peritoneal dialysis.
The study of the basic processes that determine the duration and intensity of a drug's effect and how those drugs are absorbed, distributed, biotransformed, and eliminated is called: A. drug profiling. B. pharmacokinetics. C. polypharmacy. D. pharmacodynamics.
B. pharmacokinetics.
The cause of esophageal varices can be attributed to: A. pulmonary hypertension. B. portal hypertension. C. pulmonary hypotension. D. portal hypotension.
B. portal hypertension.
Tachyphylaxis can best be described as: A. an unexpected increase in heart rate as a side effect of a drug. B. rapidly decreasing effects with repeated administration of a drug. C. an allergic reaction that occurs when a drug is administered for the first time. D. anaphylactoid episodes occurring due to cross-sensitivity.
B. rapidly decreasing effects with repeated administration of a drug.
The three steps of decontamination are: A. water, elimination in urine, atropine. B. reduce intake of the toxin, reduce absorption, enhance elimination. C. reduce absorption, reduce metabolism, increase absorption by the kidney. D. elimination in urine, water, oxygen.
B. reduce intake of the toxin, reduce absorption, enhance elimination.
ATIA typically: A. never resolves. B. resolves within 24 hours. C. is caused by intracranial hemorrhage. D. can be reversible with tPA.
B. resolves within 24 hours.
A drug with a wax-like base that melts at body temperature, allowing absorption into body tissue, is called a(n): A. suspension. B. suppository. C. elixir. D. capsule.
B. suppository.
Normally, taken alone, neither substance would cause serious harm, but if taken together, the combination could cause coma or death. This is an example of: A. duration of action. B. synergism. C. summation. D. efficacy.
B. synergism.
You are assessing a patient who is presenting with shortness of breath, JVD, and tracheal deviation. You suspect: A. tracheal tugging. B. tension pneumothorax. C. subcutaneous emphysema. D. flail chest.
B. tension pneumothorax.
Lung compliance is described as: A. the rate at which the chest expands. B. the ease with which the chest expands. C. the depth at which the chest expands. D. the diameter of the chest wall.
B. the ease with which the chest expands.
An important physiologic distinction between the sympathetic and parasympathetic divisions of the autonomic nervous system is: A. the parasympathetic nervous system contains no ganglionic fibers. B. the sympathetic ganglia are close to the spinal cord. C. only the sympathetic division innervates the target organs or tissue directly. D. the sympathetic division does not use acetylcholine as a neurotransmitter.
B. the sympathetic ganglia are close to the spinal cord.
Which of the following is an intrinsic risk factor that would increase the likelihood of a patient developing a respiratory disease? A. exposure to smog and pollution B. underlying circulatory problems C. cigarette use D. exposure to noxious chemicals
B. underlying circulatory problems
Abdominal pain that is dull in nature and cannot be narrowed to one specific area is known as: A. Kehr's sign. B. visceral pain. C. somatic pain. D. referred pain.
B. visceral pain.
Your diabetic patient asks you why he "passes out" when his blood sugar gets too low. Which of the following responses is most accurate? A. "When the blood sugar is low, the brain does not get enough oxygen." B. "Brain cells need a constant supply of glucose, or sugar, to function. Without sugar the brain cells cannot work to maintain consciousness." C. "When the blood sugar is low, the blood vessels relax and the blood pressure drops, causing you to faint." D. "The cells of the heart can only use glucose, or sugar, for energy. Without sugar the heart cannot effectively pump blood to the brain."
B. "Brain cells need a constant supply of glucose, or sugar, to function. Without sugar the brain cells cannot work to maintain consciousness."
Which of the following statements would be most typical of an undiagnosed diabetic? A. "I haven't had much of an appetite. I am not hungry at all." B. "I am so thirsty I have to keep a glass of water by my bed at night." C. "I have gained ten pounds over the past two weeks." D. "It seems like I am dehydrated because I hardly urinate at all."
B. "I am so thirsty I have to keep a glass of water by my bed at night."
Which of the following statements would be most typical of a patient with hepatitis? A. "I have sharp pain on the left side of my abdomen." B. "My stools are really light in color." C. "It seems like everything has a yellow tinge to it." D. "I have to urinate all the time."
B. "My stools are really light in color."
Your patient is a 55-year-old male whose wife called EMS after the patient complained of bright red bleeding during a bowel movement. The patient refuses transport, stating he has hemorrhoids and has had similar bleeding in the past. Which of the following statements is most appropriate? A. "This does not sound like hemorrhoids." B. "Similar bleeding can be caused by more serious conditions." C. "Even though this sounds like hemorrhoids, the bleeding may become life-threatening." D. "I'm sure you are right; there is nothing to worry about."
B. "Similar bleeding can be caused by more serious conditions."
Your patient is a 19-year-old female who called EMS because she awoke with "itchy red patches" on her chest, back, and arms that "seem to come and go." As you obtain the history, you learn that she started taking Keflex, an antibiotic, two days ago to prevent infection in a laceration to her hand. In explaining to your patient what is going on, which of the following statements would be the most accurate? A. "It looks like the infection in your hand has spread to the bloodstream. The toxins from the bacteria are causing a rash." B. "These look like hives. They occur during an allergic reaction. You may have developed an allergy to the antibiotic you are taking." C. "I cannot say what this is, but it is not an allergic reaction. Hives do not come and go as you have described." D. "This is a typical side effect of Keflex. It happens in most patients who take it."
B. "These look like hives. They occur during an allergic reaction. You may have developed an allergy to the antibiotic you are taking."
When evaluating a patient with a possible neurologic emergency, which acronym can help you remember the causes? A. ISAL B. AEIOU-TIPS C. AVPU D. TICKLES
B. AEIOU-TIPS
Which of the following correctly pairs a toxin with its antidote? A. Carbon monoxide: amyl nitrite B. Acetaminophen: N-acetylcysteine C. Aspirin: magnesium citrate D. Benzodiazepine: naloxone
B. Acetaminophen: N-acetylcysteine
The most common cause of dementia is: A. Bell's palsy B. Alzheimer's disease C. Stroke D. Korsakoff's psychosis
B. Alzheimer's disease
Which of the following diseases is characterized by hypersecretion of adrenocorticotropic hormone leading to hyperglycemia, obesity, hypertension, and electrolyte imbalances? A. Hashimoto's disease B. Cushing's disease C. Addison's disease D. Gigantism
B. Cushing's disease
Which three mechanisms can produce visceral pain? A. Blunt trauma, penetrating trauma, and medical illness B. Distension, ischemia, and inflammation C. Somatic, referred, and peritonitis D. Peritonitis, cholecystitis, and a ruptured abdominal aorta
B. Distension, ischemia, and inflammation
Which of the following is NOT a potential side effect of oral contraceptives? A. Unintended pregnancy B. Early-onset osteoporosis C. Hypertension D. Thromboembolism
B. Early-onset osteoporosis
Stretch receptors in the lungs send a signal to the inspiratory center of the medulla, inhibiting its stimulation of the phrenic and intercostal nerves. This is called the ________ reflex. A. Cheyne-Stokes B. Hering-Breuer C. Cushing's D. Moro
B. Hering-Breuer
The first medication administered to a patient experiencing an anaphylactic reaction should be: A. Glucagon B. High-concentration oxygen C. Epinephrine D. Diphenhydramine
B. High-concentration oxygen
Your patient is a 76-year-old female who was initially lethargic but responded to verbal stimuli. According to family members, the patient experienced a sudden decrease in responsiveness. She had a left-sided facial droop, aphasia, a dilated and nonreactive right pupil, and a flaccid left arm. Lung sounds are decreased bilaterally. HR = 58, BP = 172/102, RR = 6 and shallow, SaO2 = 88%. As you start to treat her, the patient has a generalized seizure lasting about 30 seconds. She is now unresponsive. Which of the following is most appropriate? A. Hyperventilate by bag-valve mask, IV of normal saline at a keep open rate, diazepam 5 mg IV, intubate if no improvement, transport without delay B. Intubation, IV of normal saline at a keep open rate, cardiac monitor, blood glucose determination, transport without delay C. Hyperventilate by bag-valve mask, IV of normal saline at a keep open rate, check blood glucose level, administer 25 gm of dextrose if needed, administer naloxone and thiamine, intubate if no improvement, transport without delay D. Intubation, IV of normal saline at a keep open rate, cardiac monitor, blood glucose determination, sublingual nitroglycerin spray, transport without delay
B. Intubation, IV of normal saline at a keep open rate, cardiac monitor, blood glucose determination, transport without delay
Which of the following diseases is most likely to cause dementia in the patient? A. Multiple sclerosis B. Pick's disease C. Spina bifida D. Amyotrophic lateral sclerosis
B. Pick's disease
A type of generalized seizure characterized by a rapid loss of consciousness and motor coordination, muscle spasms, and jerking motions is known as a(n): A. Simple partial seizure B. Tonic-clonic seizure C. Complex partial seizure D. Absence
B. Tonic-clonic seizure
What structures may be affected in a urinary tract infection in a female patient? A. Kidney, bladder, fallopian tubes B. Urethra, bladder, kidney C. Vagina, bladder, urethra D. Bladder, ureters, vagina
B. Urethra, bladder, kidney
Your patient is a 56-year-old female who is alert and sitting in a chair. She states that she accidentally took too many of her Cardizem tablets. Which of the following signs or symptoms would you LEAST expect to find? A. Cool, dry skin and mild hypotension B. Warm, dry skin and tachycardia C. Bradycardia and altered mental status D. Cool, diaphoretic skin and profound hypotension
B. Warm, dry skin and tachycardia
The pharmacological effects of administering insulin to a hyperglycemic patient is an example of increased: A. biotransformation. B. carrier-mediated diffusion. C. passive transport. D. transference.
B. carrier-mediated diffusion.
According to Starling's Law, the administration of nitroglycerin will result in ________ preload, ________ stroke volume, and ________ myocardial oxygen demand. A. decreased; decreased; increased B. decreased; decreased; decreased C. decreased; increased; decreased D. increased; increased; decreased
B. decreased; decreased; decreased
Methylphenidate (Ritalin), a drug used to treat attention deficit hyperactivity disorder (ADHD), achieves its therapeutic action by ________ the CNS, thereby causing ________ and allowing for greater concentration and focus. A. depressing; relaxation B. stimulating; heightened awareness and arousal C. depressing; sedation D. stimulating; paradoxical sedation
B. stimulating; heightened awareness and arousal
If a patient were exhibiting pupillary constriction, hypersalivation, bronchial wheezing, and bradycardia, you should suspect ________ of the ________ nervous system. A. blockade; cholinergic B. stimulation; parasympathetic C. blockade; voluntary D. stimulation; sympathetic
B. stimulation; parasympathetic
Paramedic Davis and his partner, EMT-I Smothers, are eating lunch in the hospital cafeteria and discussing the details of a call they ran last week on well-known news anchor Adam Best. Unbeknownst to Davis and Smothers, Mr. Best's co-anchor is sitting directly behind them listening to the details. Which of the following best describes the actions of Davis and Smothers? A.Libel B.Breach of confidentiality C.Negligence D.Slander
B.Breach of confidentiality
A patient is involved in a car crash. When the paramedics arrive, he complains of neck pain but refuses to let the paramedics immobilize his spine. The paramedics explain the risks of refusing treatment and have the patient sign a release-from-liability form. The patient suffers minor neurological damage and later sues, charging negligence on the part of the paramedics. Which of the following best explains why the patient is not likely to be awarded damages? A.There was no violation of the standard of care. B.There was contributory negligence on the part of the patient. C.A monetary award cannot be assigned to the damages. D.The paramedics did not have a duty to act.
B.There was contributory negligence on the part of the patient.
The unilateral termination of the paramedicdash-patient relationship by the paramedic without assurance that an equal or greater level of care will continue is known as: A.battery. B.abandonment. C.misfeasance. D.assault.
B.abandonment.
Most of the laws that OSHA can use to enact regulations and statutes are ________ laws. A.constitutional B.administrative C.legislative D.common
B.administrative
The four elements needed to sustain a charge of negligence against a paramedic are: A.breach of duty, violation of EMS codes, proximate cause, and failure to document the action. B.duty to act, breach of that duty, actual damages, and proximate cause. C.breach of duty, actual damages, malicious intent, and reckless disregard of results. D.duty to act, actual damages, malicious intent, and significant harm.
B.duty to act, breach of that duty, actual damages, and proximate cause.
When a paramedic treats an unconscious patient, the provision of treatment is based on ________ consent. A.expressed B.implied C.primum non nocere D.res ipsa loquitur
B.implied
The type of consent that must be obtained from a conscious, competent adult patient before a paramedic can begin treatment is called ________ consent. A.ex officio B.informed C.implied D.voluntary
B.informed
Legal responsibility for a situation is known as A.res ipsa loquitur. B.liability. C.negligence. D.primum non nocere.
B.liability.
The duties and skills paramedics are allowed and expected to perform while carrying out their jobs are called the: A.treatment guidelines B.scope of practice. C.National Standard Curriculum. D.standing orders.
B.scope of practice.
Injuring a person's name or character through malicious spoken statements is called: A.misfeasance. B.slander. C.libel. D.perjury.
B.slander.
Which of the following solutions is appropriate for the patient needing vascular volume replacement in the prehospital setting? A. 5 percent dextrose in water B. Dextran 40 C. 0.9 percent sodium chloride solution D. 0.45 percent sodium chloride and 5 percent dextrose in water
C. 0.9 percent sodium chloride solution
You are to give your patient 50 mg of ketorolac (Toradol) IM for musculoskeletal pain. Ketorolac is supplied 60 mg/2 mL. What volume of drug (in mL) is to be drawn up for administration? A. 170 B. 0.17 C. 1.7 D. 17
C. 1.7
Which of the following catheters would allow the greatest volume of fluid to be delivered in a given period? A. 16 gauge, 1 1/4′′ B. 14 gauge, 2′′ C. 14 gauge, 1 1/4′′ D. 16 gauge, 2"
C. 14 gauge, 1 1/4′′
Glucose is excreted through the urea above which level? A. 250 mg/dL B. 150 mg/dL C. 180 mg/dL D. 500 mg/dL
C. 180 mg/dL
Once a drug is proven safe and tested on a limited group of people with the disease it is intended to treat, and the therapeutic dose is refined, the drug manufacturer can file a new drug application (NDA) following this phase of human studies. A. 1 B. 4 C. 3 D. 2
C. 3
Gastrointestinal emergencies account for ________ percent of emergency room visits annually. A. 10 B. 2.5 C. 5 D. 7.5
C. 5
Your patient is having a cholecystectomy this evening. To prevent dehydration, she is to receive 5 percent dextrose in 0.45 percent saline solution at a rate of 150 mL/hour. Using 20 drops/mL tubing, what is the drip rate in drops/minute? A. 60 B. 150 C. 50 D. 75
C. 50
After administering a medication by the nasogastric or orogastric tube, how much fluid should you flush with? A. 20 mL B. 10 mL C. 50 mL D. 30 mL
C. 50 mL
Which of the following statements regarding a dialysis fistula is TRUE? A. The fistula is the preferred site of venous access in an emergency situation. B. A fistula uses a dual lumen tube to connect an artery and a vein. C. A fistula is a surgical anastomosis of an artery and a vein. D. The fistula is inserted peripherally, but the end of it is placed near the right atrium.
C. A fistula is a surgical anastomosis of an artery and a vein.
You are examining a newborn and note that the meninges and spinal cord are protruding through an opening over the lower back. This is known as: A. Spina bifida occulta B. Poliomyelitis C. A myelomeningocele D. A meningocele
C. A myelomeningocele
Your patient is a 72-year-old male patient who is conscious but slow to respond to questions and commands. He has become increasingly lethargic, unemotional, and easily fatigued over the past two months. He has had a decreased appetite and has gained weight over the same period. The patient further states, "I'm constipated and always cold." Which of the following additional signs or symptoms would be consistent with this patient presentation? A. Hypothermia, tachycardia, and hypertension B. A "moon-faced" appearance and hyperpigmentation of the skin C. A puffy face, an enlarged tongue, and pale, doughy skin D. Goiter, atrial fibrillation, nausea, and vomiting
C. A puffy face, an enlarged tongue, and pale, doughy skin
The posterior pituitary produces which two hormones? A. Epinephrine and norepinephrine B. Insulin and glucagon C. ADH and oxytocin D. Growth hormone and gonadotropin
C. ADH and oxytocin
An eight-year-old male child is alert and oriented after a brief episode of eyelid fluttering and slight loss of muscle tone, which caused him to slump in his chair. His teacher reports that the child was inattentive for 15 to 20 seconds during the episode but was fine after. This most indicates a(n) ________ seizure. A. Simple partial B. Pseudo C. Absence D. Generalized
C. Absence
A compulsive and overwhelming dependence on a chemical substance is: A. Withdrawal B. Habituation C. Addiction D. Substance abuse
C. Addiction
You are presented with a 25-year-old male complaining of mouth and stomach pain after accidentally ingesting approximately 8 ounces of benzene. Physical examination reveals irritation to the oral mucosa, skin warm and slightly diaphoretic, and lungs clear and equal bilaterally. HR = 100, BP = 118/66, RR = 14, SaO2 = 99%. Based on the clinical exam findings, treatment would consist of all of the following EXCEPT: A. Rapid transportation to an ED for gastric decontamination B. IV of NS KVO C. Administration of activated charcoal D. O2 via nasal cannula 2 lpm
C. Administration of activated charcoal
You are presented with a 25-year-old male complaining of mouth and stomach pain after accidentally ingesting approximately 8 ounces of benzene. Physical examination reveals irritation to the oral mucosa, skin warm and slightly diaphoretic, and lungs clear and equal bilaterally. HR = 100, BP = 118/66, RR = 14, SaO2 = 99%. Based on the clinical exam findings, treatment would consist of all of the following EXCEPT: A. Rapid transportation to an ED for gastric decontamination B. O2 via nasal cannula 2 lpm C. Administration of activated charcoal D. IV of NS KVO
C. Administration of activated charcoal
All of the following are common complications of renal dialysis EXCEPT: A. Bleeding from the needle puncture site B. Dysfunction of the fistula C. Air embolism D. Localized infection at the needle puncture site
C. Air embolism
Which of the following hormones has the greatest effect on blood pressure homeostasis? A. Calcitonin B. Cortisol C. Aldosterone D. Parathyroid hormone
C. Aldosterone
You respond to the aid of a 19-year-old patient who is reported to have taken an overdose of a prescribed medication. She exhibits combativeness and severe tremors. Her blood pressure is 160/100 mmHg, and her pulse is 132. Sinus tachycardia appears on her ECG. Which of the following classification of drugs is most likely to cause these symptoms? A. Opiates B. Barbiturates C. Amphetamines D. Benzodiazepines
C. Amphetamines
Which of the following statements about antibiotics is NOT true? A. Antibiotics typically achieve their therapeutic action by destroying the bacterial cell wall. B. Antibiotics are generally safe and can be prescribed indiscriminately. C. An individual who has developed a resistance to one type of antibiotic will typically respond well to other antibiotics in a similar class. D. Viruses are not susceptible to antibiotics.
C. An individual who has developed a resistance to one type of antibiotic will typically respond well to other antibiotics in a similar class.
The intranasal route of drug administration can be used for which of the following? A. Airway constriction B. Aural application C. Analgesia D. Antiarrhythmic
C. Analgesia
Which of the following is the most important determinant of ventilatory rate? A. Venous PCO2 B. Venous PO2 C. Arterial PCO2 D. Arterial PO2
C. Arterial PCO2
The most important factor in determining the respiratory rate is: A. Alveolar pCO2 B. Alveolar pO2 C. Arterial pCO2 D. Arterial pO2
C. Arterial pCO2
Which of the following statements about hyperglycemic hyperosmolar nonketotic coma (HHNK) is true? A. Paradoxically, the definitive management of HHNK includes the administration of 50 percent dextrose. B. Unlike diabetic ketoacidosis, HHNK is not life-threatening. C. Aside from managing the ABCs, prehospital management is primarily aimed at correcting dehydration. D. Prehospital treatment of HHNK includes correcting metabolic acidosis.
C. Aside from managing the ABCs, prehospital management is primarily aimed at correcting dehydration.
Which of the following is the most reliable way to differentiate between a hyperglycemic emergency and a hypoglycemic emergency? A. Determine whether the patient is a type I or type II diabetic. B. Determine whether or not the patient took his insulin or oral antihyperglycemic medicines. C. Assess the blood glucose level. D. Follow the conventional wisdom, "Pale, cool, wet: low; red, hot, dry: high."
C. Assess the blood glucose level.
Which of the following is the most reliable way to differentiate between a hyperglycemic emergency and a hypoglycemic emergency? A. Follow the conventional wisdom, "Pale, cool, wet: low; red, hot, dry: high." B. Determine whether the patient is a type I or type II diabetic. C. Assess the blood glucose level. D. Determine whether or not the patient took his insulin or oral antihyperglycemic medicines
C. Assess the blood glucose level.
Your patient is a 48-year-old female who is unconscious with snoring respirations after ingesting an unknown substance. You note cold, peripherally cyanotic skin and a weak, rapid pulse. Her pupils are equal and reactive but constricted. She has no unusual odors, and her blood glucose level is 80 mg/dl. HR = 74, BP = 100/68, RR = 4, SaO2 = 91%. Which of the following is appropriate? A. Intubate, ventilate using supplemental oxygen, IV, 1 mEq/kg sodium bicarbonate B. Assist ventilations using supplemental oxygen, IV, 2 mg naloxone, 100 mg thiamine, 25 gm dextrose C. Assist ventilations using supplemental oxygen, IV, 2 mg naloxone D. Intubate, ventilate using supplemental oxygen, IV, 2 mg naloxone, 100 mg thiamine, 25 gm dextrose
C. Assist ventilations using supplemental oxygen, IV, 2 mg naloxone
Physostigmine (Antilirium) is a useful antidote for which drug overdose? A. Norepinephrine B. Dopamine C. Atropine D. Epinephrine
C. Atropine
You are caring for a 45-year-old male patient who was tending to his fruit orchard when he suddenly developed headache, dizziness, blurred vision, and tremors. You note that he was incontinent of urine, has pupillary constriction, and is salivating excessively. Which of the following medications would be most appropriate to manage this patient? A. Ipratropium bromide B. Diazepam C. Atropine D. Physostigmine
C. Atropine
Your patient is a 32-year-old female who is alert and sitting at her kitchen table complaining of dizziness and near-syncope with exertion. She describes a four-day history of a 104°F fever, nausea, vomiting, and diarrhea unrelieved with over-the-counter medications. Physical examination reveals dry skin and mucous membranes, lung sounds clear and equal bilaterally. HR = 131 and regular, BP = 84/60, RR = 20 and regular, SaO2 = 98%, blood glucose = 58 mg/dL. She has a history of colitis, for which she often takes prednisone, but she has been noncompliant with her prednisone therapy for the past five days because she cannot afford to refill her prescription. The treatment for this patient should include: A. An IV of NS, KVO, 25 g dextrose IV, and 100 mg thiamine IV B. 15 lpm oxygen by nonrebreather, IV of NS, KVO, 25 g dextrose C. A one-liter NS bolus, IV, and 25 g dextrose IV D. A one-liter NS bolus IV
C. A one-liter NS bolus, IV, and 25 g dextrose IV
Restoril and Ativan are examples of: A. Opiates B. Narcotics C. Benzodiazepines D. Barbiturates
C. Benzodiazepines
Hyperglycemia is most likely a result of damage to the pancreatic ________ cells. A. Delta B. Alpha C. Beta D. Acinar
C. Beta
Your patient has ingested cyanide in a suicide attempt. Which of the following is the primary threat to life you should anticipate? A. Liver failure B. Pulmonary edema C. Cellular asphyxia D. Hypotension
C. Cellular asphyxia
Which of the following foods should a patient on MAOIs avoid? A. Chocolate B. Bananas C. Cheese D. White wine
C. Cheese
All of the following contribute to the pathogenesis of diverticulosis EXCEPT: A. Increased colon pressure B. Herniation of mucosa and submucosa through the teniae coli C. Decreased colon motility D. Low-fiber diet
C. Decreased colon motility
Your patient is a 42-year-old male who had surgery four years ago to remove his posterior pituitary gland because of a tumor. He stopped taking replacement hormones because they caused depression. Which of the following is the most likely consequence of the patient's noncompliance with hormone replacement therapy? A. Hypoglycemia B. Hypertension C. Dehydration D. Reduced ability to fight infection
C. Dehydration
Alcohol is classified as a(n): A. Hallucinogen B. Anxiolytic C. Depressant D. Stimulant
C. Depressant
Your partner experiences an itchy, red rash on her hands that stops at the wrists after using a new brand of glove your service purchased. Her skin is warm, dry, and nondiaphoretic; the rash is isolated to her hands; and her lung sounds are clear bilaterally. She has no other complaints. HR = 88, RR = 12, BP = 122/80. Of the following treatments, which is most appropriate? A. Oxygen via nasal cannula 4 lpm, cardiac monitor, IV of NS KVO, epinephrine IV, diphenhydramine IM B. Oxygen via nonrebreather mask 15 lpm, cardiac monitor, IV of NS KVO, epinephrine SC, diphenhydramine IM C. Diphenhydramine IM D. Advise the dispatcher you will be going out of service
C. Diphenhydramine IM
Which of the following medications is NOT used as a first-line drug to counter the physiologic effects of the release of slow-reacting substance of anaphylaxis (SRS-A)? A. Epinephrine 1:10,000 B. Diphenhydramine C. Dopamine D. Albuterol
C. Dopamine
Which of the following is LEAST likely to result in hypoglycemia in a type I diabetic patient? A. Taking insulin as usual but missing a meal B. Increased exercise level C. Eating foods high in sugar D. Inadvertently administering too much insulin
C. Eating foods high in sugar
Your patient has a hormone-secreting tumor of the adrenal medulla. What hormone is most likely to be secreted by this tumor? A. Dopamine B. Cortisol C. Epinephrine D. ACTH
C. Epinephrine
Which treatment would best halt the urticaria associated with an allergic reaction? A. Solu-Medrol B. Dopamine and albuterol C. Epinephrine and diphenhydramine D. Oxygen
C. Epinephrine and diphenhydramine
Which of the following is a contraindication to intraosseous needle placement? A. Development of a pulmonary embolism B. Too large a needle or forceful insertion C. Establishment of a peripheral IV line D. Long-term growth complications and swelling
C. Establishment of a peripheral IV line
In healthy individuals, which of the following is NOT a function of the kidney? A. Excretion of wastes B. Secretion of erythropoietin C. Excretion of glucose D. Regulation of water and electrolyte balance and pH
C. Excretion of glucose
A 34-year-old female, conscious, alert, and oriented, is complaining of a three-week history of increased appetite, weight loss, weakness, insomnia, and inability to tolerate heat. She has recently been frequently agitated and prone to mood swings. Based on these signs and symptoms, which of the following best describes the additional findings you could expect? A. Heart block and hypotension B. Enlarged tongue and cool, puffy skin C. Exophthalmos and goiter D. Hyperpigmentation of the skin and hirsutism
C. Exophthalmos and goiter
Your patient is a 32-year-old female who is alert and complaining of dysuria. She describes a three-day history of pain with urination and urinary urgency and difficulty. She describes the pain as a 5 on a scale of 0 to 10. Physical examination reveals tenderness on palpation of the lower abdomen bilaterally and warm, dry skin. HR = 88, BP = 126/78, RR = 12. The most appropriate action is: A. Oxygen, IV fluids B. Oxygen, IV fluids, morphine C. Expedite transport in position of comfort D. IV fluids, morphine
C. Expedite transport in position of comfort
Which of these procedures does NOT require a constricting band? A. Basilic vein IV insertion B. Cephalic vein IV insertion C. External jugular IV insertion D. Peripheral IV insertion
C. External jugular IV insertion
Your patient is an 18-year-old female college student who is supine in bed and responsive only to painful stimuli. Her roommate states that they went to a party last night. She says the patient only drank soda, but now she thinks a guy who had been following them around might have put something in the patient's drink. Physical examination reveals cool, dry skin and pupils sluggish to light bilaterally. HR = 72, BP = 112/64, RR = 10, SaO2 = 98%. Which of the following drugs was most likely slipped into her drink? A. Amphetamines B. Opium C. Flunitrazepam D. LSD
C. Flunitrazepam
You respond to an ill type 2 diabetic patient. Upon your arrival, the patient complains of not feeling well for a few days, and increasing blood glucose levels. You suspect: A. DKA. B. TPA. C. HHNK. D. TNK.
C. HHNK.
Which of the following is a narcotic? A. Cocaine B. Crack C. Heroin D. Mescaline
C. Heroin
Which of the following is the most direct cause of polyuria in untreated diabetes? A. Too little insulin B. Too much insulin C. Hyperglycemia D. Hypoglycemia
C. Hyperglycemia
You are transporting a male patient to the hospital for an evaluation after a possible seizure when you notice the patient's loss of consciousness. His muscles start to contract so that he is arching his back. This best describes the ________ phase of a generalized seizure. A. Tonic B. Clonic C. Hypertonic D. Postictal
C. Hypertonic
Which of the following most accurately represents the pathophysiological sequence of untreated type I diabetes? A. Glucose is not absorbed through the gastrointestinal tract, resulting in hyposecretion of insulin and hypoglycemia. Lack of glucose results in anaerobic metabolism and acidosis. B. Oversecretion of insulin results in hypoglycemia; cells convert to the use of fats for energy resulting in the production of ketone bodies. C. Hyposecretion of insulin results in inability of glucose to enter cells; blood glucose levels rise, and cells convert to the use of fats for energy, resulting in the production of ketone bodies. D. Hyposecretion of insulin prevents glucose from being broken down in the gastrointestinal tract; too much glucose is absorbed from the gastrointestinal tract resulting in hyperglycemia and ketoacidosis.
C. Hyposecretion of insulin results in inability of glucose to enter cells; blood glucose levels rise, and cells convert to the use of fats for energy, resulting in the production of ketone bodies.
Which of the following assessment findings should you most expect in a patient with chronic pancreatitis? A. Dark-colored urine B. Right lower quadrant pain C. Hypotension D. Clay-colored stool
C. Hypotension
Which class of anti-dysrhythmics characteristically blocks sodium influx during fast potential depolarization? A. II B. III C. I D. IV
C. I
In which class of the Vaughn-Williams classification system of anti-dysrhythmic medications does quinidine belong? A. IC B. II C. IA D. IB
C. IA
Your patient is a conscious and alert 22-year-old female who was stung by a hornet. She states that she has "allergies to bee stings" and has been told that she could die if stung. Your physical examination reveals a 1-cm-diameter, red, edematous area where she was stung on the left forearm. Her skin is warm and dry, and her lung sounds are clear and equal bilaterally. HR = 112 and regular, BP = 122/82, RR = 12 and regular, SaO2 = 98%. The most appropriate treatment for this patient would include: A. 100 percent oxygen via nonrebreather mask 15 lpm, IV of NS 1-2 L, epinephrine 1:1000 0.3 mg SC, diphenhydramine 25 mg IV B. 15 lpm oxygen by nonrebreather, epinephrine 1:1000 0.3 mg SC, diphenhydramine 25 mg IV, transport C. IV of NS KVO D. Transport only
C. IV of NS KVO
Which of the following is LEAST likely to be detrimental when treating a stroke patient? A. Hyperventilation with 100 percent oxygen B. IV of 5 percent dextrose in water C. IV of lactated Ringer's solution D. Administration of 50 percent dextrose, IV push
C. IV of lactated Ringer's solution
All of the following are roles of a poison control center EXCEPT: A. Notifying the receiving hospital and recommending treatment B. Providing information on the most current definitive treatment C. Identifying the toxin or poison D. Determining the potential toxicity of the agent
C. Identifying the toxin or poison
The most common cause of lower back pain is: A. Sciatica B. Osteomyelitis C. Idiopathic D. Arthritis
C. Idiopathic
Which of the following best explains the cause of the histamine and heparin release in response to exposure to an antigen? A. IgG and IgM antibodies have activated basophils and mast cells, resulting in degranulation. B. Humoral cells have initiated a chemical attack on the antigens. C. IgE antibodies have attached themselves to the membranes of basophils and mast cells, resulting in degranulation. D. IgE antibodies have activated the membranes of B and T cells, resulting in release of histamine and heparin
C. IgE antibodies have attached themselves to the membranes of basophils and mast cells, resulting in degranulation.
You are caring for a patient with Guillain-Barré syndrome. The most likely cause of hypoxia in this patient would be: A. Impaired perfusion B. Increased thickness of the respiratory membrane C. Impaired ventilation D. Inadequate lung volume
C. Impaired ventilation
Which of the following is NOT a possible source of cyanide poisoning? A. Long-term sodium nitroprusside therapy B. Fume inhalation from burning plastic, synthetic carpeting, or silk C. Improperly vented heating systems D. Ingestion of apricot, pear, and cherry pits
C. Improperly vented heating systems
A type I diabetic presents with deep, rapid respirations and a fruity odor on her breath. Which of the following would best help correct the underlying physiologic disturbance? A. Oxygen B. Glucagon C. Insulin D. Dextrose
C. Insulin
Which of the following is a parenteral route of drug administration? A. Gastric tube B. Oral C. Intramuscular D. Rectal
C. Intramuscular
Your patient is an 83-year-old male with a fever of 103°F. In addition, the patient is confused and combative. Heart rate = 132, respirations = 20, blood pressure = 100/70, Sp O2 95% on room air, and blood glucose level = 90 mg/dL. During your examination you note that the patient has a Foley catheter and that the collection bag appears not to have been emptied for quite some time. The bag is full of dark, cloudy urine with sediment at the bottom of the bag. Which of the following is most appropriate? A. Furosemide B. Acetaminophen suppository C. Intravenous fluid therapy with normal saline D. BLS transport without intervention
C. Intravenous fluid therapy with normal saline
Which of the following best describes the mechanism of action of activated charcoal? A. It can help patients with unprotected airways and decreased levels of consciousness. B. It neutralizes both acidic and alkaline substances in the stomach. C. It adsorbs toxins in the stomach. D. It prevents substances from ionizing in the small intestine.
C. It adsorbs toxins in the stomach.
Which of the following medications would most likely be considered for emergent treatment in the prehospital management of hypertensive crisis? A. Enalaprilat (Vasotec IV) B. Nifedipine (Procardia) C. Labetalol (Normodyne) D. Nitroglycerin paste (Nitro-Bid)
C. Labetalol (Normodyne)
Your patient is a 31-year-old female complaining of dizziness and difficulty breathing after being stung by a bee. You note that she is extremely anxious, and your physical examination reveals a rapidly developing urticaria to her shoulders, neck, and face. Your partner has administered oxygen via a nonrebreather, initiated IV access, placed the patient on the cardiac monitor, and administered epinephrine SC and diphenhydramine IV. Despite this, you also note that her voice is quickly becoming more hoarse and she has developed expiratory wheezes in all lung fields. HR = 128, BP = 100/70, RR = 20, SaO2 = 99%. What should be your major concern at this point, and what is the most appropriate treatment? A. Hypotension leading to cardiovascular collapse; administer fluids wide open and initiate a dopamine infusion B. Increased bronchospasm leading to respiratory arrest; administer albuterol via nebulizer C. Laryngeal edema leading to total airway occlusion; intubate D. Increased bronchospasm leading to respiratory arrest; administer epinephrine IV
C. Laryngeal edema leading to total airway occlusion; intubate
Which of the following medication combinations is beneficial for a lithium overdose? A. Flumazenil and naloxone B. Haloperidol and furosemide C. Mannitol and sodium bicarbonate D. Narcan and sodium bicarbonate
C. Mannitol and sodium bicarbonate
What is defined as the removal or destruction of disease-causing organisms or infected material by using hygienic measures, cleaning agents, antiseptics and/or disinfectants? A. Standard Precautions B. Cauterization C. Medical asepsis D. Sterilization
C. Medical asepsis
All of the following are assessed during the Cincinnati Prehospital Stroke Screen EXCEPT: A. Facial droop B. Arm drift C. Memory D. Speech
C. Memory
A 32-year-old female is conscious and alert at a group home for recovering alcoholics and states, "I'm having rum fits." Counselors from the home tell you that she is a chronic alcoholic who entered their program three days ago and has not had a drink since. Physical examination reveals cool, diaphoretic skin; dilated pupils bilaterally that are responsive to light; and obvious anxiety. HR = 122, BP = 156/104, RR = 20, SaO2 = 99%, blood glucose = 62 mg/dL. Based on the clinical exam findings, all of the following should be part of your patient management EXCEPT: A. 25 g of D50 IV B. IV of NS C. Metoprolol IV D. Thiamine 100 mg IM
C. Metoprolol IV
A 32-year-old female is conscious and alert at a group home for recovering alcoholics and states, "I'm having rum fits." Counselors from the home tell you that she is a chronic alcoholic who entered their program three days ago and has not had a drink since. Physical examination reveals cool, diaphoretic skin; dilated pupils bilaterally that are responsive to light; and obvious anxiety. HR = 122, BP = 156/104, RR = 20, SaO2 = 99%, blood glucose = 62 mg/dL. Based on the clinical exam findings, all of the following should be part of your patient management EXCEPT: A. 25 g of D50 IV B. Thiamine 100 mg IM C. Metoprolol IV D. IV of NS
C. Metoprolol IV
Where in the body are the parasympathetic ganglia located? A. Near the brainstem B. Near the spinal cord C. Near the target organ D. Near the sacrum
C. Near the target organ
You are caring for a 48-year-old patient with acute onset pulmonary edema secondary to an acute myocardial infarction. He has rales (crackles) in both lung fields and wheezes in the bronchial regions. His blood pressure is 160/90 mmHg, his pulse is 112, and his ventilations are 32. Which of the following medications is indicated FIRST, and why? A. Nitroglycerin (Nitrostat) to vasodilate the coronary vessels to maximize myocardial oxygen supply. B. Furosemide (Lasix) to achieve a diuresis and remove a portion of fluids from the intravascular space. C. Nitroglycerin (Nitrostat) to reduce preload and afterload to redistribute fluids to the periphery. D. Morphine sulfate to decrease anxiety and reduce afterload.
C. Nitroglycerin (Nitrostat) to reduce preload and afterload to redistribute fluids to the periphery.
Which of the following is a crystalloid solution? A. Plasmanate B. Hespan C. Normal saline D. Dextran
C. Normal saline
Your patient is a 52-year-old female who is alert but slightly confused after a syncopal episode lasting about 1 minute. She has no complaints, and your physical exam reveals no abnormalities aside from slight confusion. She has had a stroke and has a history of type II diabetes and hypertension. HR = 100, BP = 132/84, RR = 12, SaO2 =99%. Which of the following is the LEAST likely cause of the patient's episode? A. Hypoglycemia B. Transient cerebral ischemia C. Orthostatic hypotension D. Transient cardiac dysrhythmia
C. Orthostatic hypotension
An example of diffusion in the respiratory system is movement of: A. Carbon dioxide from the alveoli into the pulmonary capillaries B. Oxygen from the tissues into the systemic capillaries C. Oxygen from the alveoli into the pulmonary capillaries D. Air from the outside environment into the lungs
C. Oxygen from the alveoli into the pulmonary capillaries
Your patient is a 30-year-old male complaining of pain radiating from the left flank into the groin. He states that it began as a vague pain in his flank, then became very sharp and radiating. Based on his description of his pain, you would also expect him to complain of: A. Purulent urethral discharge B. Inability to urinate C. Painful urination D. Fever
C. Painful urination
A seizure that remains confined to a limited portion of the brain, causing localized dysfunction, is a(n) ________ seizure. A. Absence B. Tonic C. Partial D. Petit mal
C. Partial
Normal exhalation involves all of the following EXCEPT: A. Relaxation of the diaphragm B. Elastic recoil of lung tissue C. Phrenic nerve stimulation D. Decreased intrathoracic volume
C. Phrenic nerve stimulation
Your patient is an alcoholic who stopped drinking three days ago. Which of the following should concern you the most in the care of this patient? A. Hypothermia B. Abdominal cramps C. Potential for seizures D. Command hallucinations
C. Potential for seizures
Your patient is a 20-year-old male who is conscious, alert, and in severe distress. He describes a three-day history of diffuse abdominal pain near his umbilicus that became sharp and migrated to his lower right quadrant this morning. He states that the pain became acutely worse half an hour ago and that he is now lightheaded and nauseated and has vomited numerous times. You believe he may be suffering from appendicitis. Based on his clinical presentation, the most proper treatment, in addition to giving oxygen, would be: A. Provide comfort, expedited transport B. IV of normal saline wide open, Trendelenburg position, rapid transport C. Provide comfort, manage the airway, establish IV access, expedited transport D. IV of normal saline wide open, left lateral recumbent position, phenergan IV, transport
C. Provide comfort, manage the airway, establish IV access, expedited transport
Your patient is a 55-year-old male cab driver who was found unresponsive in the driver's seat of his vehicle, which has been parked in front of a hotel for about 45 minutes. The patient is unresponsive to painful stimulus; has snoring respirations at 12 per minute; is cool, pale, and diaphoretic; and has a heart rate of 58 and a blood pressure of 170/104. Which of the following does NOT help when determining the underlying cause of the patient's condition? A. Scene survey B. Checking the pupils C. Pulse oximetry D. Blood glucose level determination
C. Pulse oximetry
Which of the following is associated with a greater predisposition for hypoglycemia due to decreased gluconeogenesis? A. Pancreatitis B. Cholecystitis C. Renal failure D. Cardiac failure
C. Renal failure
Immediately after birth, an infant is allowed to suckle at the mother's breast. Palpation of the uterus suggests that the uterus is contracting. This finding can be attributed to: A. Inhibition of estrogen and progesterone B. Inhibition of oxytocin C. Secretion of oxytocin D. Secretion of estrogen and progesterone
C. Secretion of oxytocin
The initial exposure of an individual to an antigen is referred to as what? A. Allergy B. Active immunity C. Sensitization D. Hypersensitivity
C. Sensitization
A patient tells you that she experienced an episode of involuntary "shaking" in her arm. She describes a 1- to 2-minute-long episode of muscular jerking and contracting of her entire left arm. She retained consciousness, lacked an aura, and had no pain associated with the episode. This most indicates a(n) ________ seizure. A. Psychosomatic B. Absence C. Simple partial D. Petit mal
C. Simple partial
Pain that is well localized, allowing an examiner to pinpoint the area of irritation is ________ pain. A. Referred B. Visceral C. Somatic D. Parietal
C. Somatic
What neurological problem results in a birth defect in which the fetal vertebrae do not close properly, often resulting in spinal cord dysfunction? A. Creutzfeldt-Jakob disease B. Guillain-Barré syndrome C. Spina bifida D. Multiple sclerosis
C. Spina bifida
A 24-year-old male is supine on the floor and unconscious with snoring respirations. You note a weak, rapid pulse and cool, diaphoretic skin. HR = 124 and regular, BP = 136/88, RR = 12 and regular. Blood glucose is 24 mg/dL. After manually opening the airway and providing oxygen, which of the following should be performed next? A. Intubate the trachea, start an IV, and administer 25 gm dextrose. B. Administer glucagon, 1 mg IM. C. Start an IV and administer 25 gm dextrose, IV. D. Start an IV and administer 0.3 mg glucagon, IV.
C. Start an IV and administer 25 gm dextrose, IV.
Using a pharmaceutical agent for something other than its intended use is called: A. Overdose B. Addiction C. Substance abuse D. Habituation
C. Substance abuse
Your patient is a 60-year-old male complaining of chills, fever, joint pain, and vomiting. He states he was bitten by a spider yesterday morning, and now he thinks the bite might be infected. The patient has an ulcerated wound on his left leg. The best treatment for this patient would include: A. Magnesium sulfate, 2 g B. Diazepam 2.5 mg C. Supportive management D. Calcium gluconate 0.1 mg/kg
C. Supportive management
A patient with speech impairment following a stroke would have involvement in the ________ lobe of the brain. A. Occipital B. Parietal C. Temporal D. Frontal
C. Temporal
Which of the following is the desired physiologic reaction that occurs after the administration of a vaccine that contains live, attenuated viruses? A. The antibodies in the vaccine multiply in the body. B. The viruses in the vaccine act as an antigen, resulting in a nonspecific immune response. C. The immune system will create specific antibodies to the viruses in the vaccine. D. The immune system will create specific antigens to the viruses in the vaccine.
C. The immune system will create specific antibodies to the viruses in the vaccine.
An emergency department physician tells you that the hyperglycemic diabetic you brought in earlier has a pH of 7.40. What is the likeliest explanation of this statement? A. The patient is a type I diabetic who took his insulin and did not eat, resulting in the breakdown of proteins for energy. B. The patient is a type II diabetic who was no longer secreting enough insulin to prevent the use of fats for energy. C. The patient is a type II diabetic who was secreting enough insulin to prevent the use of fats for energy. D. The patient is a type I diabetic who did not take his insulin and is therefore unable to use glucose for energy.
C. The patient is a type II diabetic who was secreting enough insulin to prevent the use of fats for energy.
A male patient presents with a puncture wound to his heel from stepping on a nail. He informs you that he is visiting from El Salvador and has never received a tetanus vaccination. At the emergency room he is administered tetanus immune globulin, as well as a tetanus vaccination. Which of the following best describes the rationale for this treatment? A. The tetanus immune globulin provides IgE antibodies for immediate protection, while the tetanus vaccination provides natural immunity by producing tetanus-specific antibodies. B. The tetanus immune globulin provides IgG and IgM antibodies for immediate protection, while the tetanus vaccination provides passive immunity by producing tetanus-specific antibodies. C. The tetanus immune globulin provides passive immunity, while the tetanus vaccination provides active immunity. D. The tetanus immune globulin provides immediate protection, while the tetanus vaccination provides passive immunity by producing tetanus-specific antibodies.
C. The tetanus immune globulin provides passive immunity, while the tetanus vaccination provides active immunity.
Which of the following provides evidence that a patient is using accessory muscles to breathe? A. The patient is using his diaphragm with inspiration. B. The patient is sitting up, leaning forward to breathe. C. There is noticeable contraction of the intercostal muscles. D. The patient's lips are pursed.
C. There is noticeable contraction of the intercostal muscles.
You have applied a CO-oximeter to your patient, and it is displaying an SpCO of 15 percent. Which of the following is the most appropriate interpretation of this finding? A. This is consistent with a fatal level of carbon monoxide poisoning. B. This is a normal reading for a smoker and nothing to worry about. C. This is consistent with mild carbon monoxide poisoning. D. This is a normal reading for a nonsmoker and nothing to worry about.
C. This is consistent with mild carbon monoxide poisoning.
The need to progressively increase the dose of a drug to reproduce the effect originally achieved at smaller doses is: A. Substance abuse B. Habituation C. Tolerance D. Addiction
C. Tolerance
You are seeing a 69-year-old female patient complaining of fatigue and nausea. She has a history of heart failure and two previous myocardial infarctions. She reports having blurred vision with halos around objects. Her blood pressure is 144/88 mmHg, her pulse is 110 and irregular, and her ventilations are 16. What should you suspect is causing her symptoms? A. Cerebral embolus secondary to atrial fibrillation B. Impaired cerebral perfusion secondary to heart failure C. Toxic blood levels of digoxin D. Acute closed-angle glaucoma
C. Toxic blood levels of digoxin
Which of the following would interfere with urine production? A. Benign prostatic hypertrophy B. Renal calculi C. Toxic damage to the nephrons D. Tumor in the renal pelvis
C. Toxic damage to the nephrons
Your patient is a 16-year-old female who has taken an overdose of phenobarbital. She is unresponsive. Her skin is cool and pale, BP = 92/60, HR = 60, RR = 6. You have intubated the patient and started an IV. Which of the following is appropriate? A. Sodium bicarbonate 100 mEq B. 50 gm activated charcoal through an NG tube en route to the hospital C. Transport without additional pharmacological intervention D. Naloxone 2mg, 25 gm dextrose, transport
C. Transport without additional pharmacological intervention
Your female patient is experiencing sharp, stabbing, right-sided face pain of her upper and lower lips, cheek, and around her orbit. This best describes: A. A cluster headache B. Bell's palsy C. Trigeminal neuralgia D. Temporomandibular joint syndrome
C. Trigeminal neuralgia
Your patient is a 68-year-old female who is being treated for colon cancer. She is conscious and alert, in mild distress, and complaining of progressive weakness over the past three days. Palpation of her abdomen reveals tenderness to the lower right quadrant. Her skin is pale, cool, and dry, and you note the smell and appearance of melena in her stool. HR = 108, BP = 100/60, RR = 12, SaO2 = 97%. Proper treatment of this patient might include: A. Two large-bore IVs of lactated Ringer's solution, wide open B. IV of normal saline with a 250 mL fluid challenge, repeated if necessary C. Two large-bore IVs of normal saline, 20 mL/kg fluid bolus to begin treating hemorrhagic hypovelmia D. IV of 5 percent dextrose solution at 30 mL per hour
C. Two large-bore IVs of normal saline, 20 mL/kg fluid bolus to begin treating hemorrhagic hypovelmia
Administration of medication into the dorsal gluteal muscle must be injected into which quadrant of the muscle? A. Lower inner B. Lower outer C. Upper outer D. Upper inner
C. Upper outer
Which of the following is appropriate for a subcutaneous injection of medication? A. Insertion of the needle at a 90-degree angle B. Up to 2 mL of medication C. Volume of 1 mL or less D. 18 gauge, 3/4′′ needle
C. Volume of 1 mL or less
You have intubated a 66-year-old female who was experiencing an acute exacerbation of her emphysema. What special consideration does this patient, with her specific pathology, require? A. Oxygen flow should be limited to 4 lpm because of the hypoxic drive common in COPD patients. B. She requires hyperventilation to blow off excess CO2. C. While ventilating, you must allow for a prolonged expiratory phase. D. She requires frequent, deep suctioning.
C. While ventilating, you must allow for a prolonged expiratory phase.
You respond to a call of a patient experiencing back pain. Upon your arrival, the patient is curled into the fetal position and feels warm to the touch. You suspect: A. acute renal calculi. B. acute renal failure. C. acute polynephritis. D. acute urinary tract infection.
C. acute polynephritis.
The FDA's pregnancy safety designation of Category A for a drug means: A. fetal risk has been demonstrated, which outweighs any possible benefit to the mother; avoid using in pregnant or potentially pregnant patients. B. animal studies have demonstrated adverse effects, but there are no adequate studies in pregnant women; benefits may be acceptable despite the potential risks. C. adequate studies in pregnant women have not demonstrated a risk to the fetus in the first trimester or later trimesters. D. no adequate animal studies or adequate studies of pregnant women have been done.
C. adequate studies in pregnant women have not demonstrated a risk to the fetus in the first trimester or later trimesters.
Treatment of poisoning emergencies may generally consist of any of the following methods, EXCEPT: A. hemodialysis. B. alkalinizing the urine with sodium bicarbonate. C. administering acid solutions to neutralize alkalis in the stomach. D. emptying the stomach.
C. administering acid solutions to neutralize alkalis in the stomach.
The acronym AVPU is used to quickly assess a patient's: A. mood. B. thought. C. alertness. D. judgment.
C. alertness.
In response to an increase in blood sugar, the pancreas will relase insulin to: A. allow glucose to be wasted in the urine. B. allow glucose to cross the blood-brain barrier. C. allow the glucose to permeate the cell membrane. D. produce more glucose.
C. allow the glucose to permeate the cell membrane.
You respond to a report of a patient with shortness of breath. Upon arrival, you find a patient who has been stung by a bee. The patient is displaying urticaria and wheezing. You suspect: A. ARDS. B. meningitis. C. anaphylaxis. D. asthma.
C. anaphylaxis
The most important determinant of ventilatory rate is: A. arterial PO. B. SpPO C. arterial PCO2. D. arterial NaHCO3.
C. arterial PCO2.
Hypoparathyroidism leads to decreased: A. growth hormone levels. B. metabolic rate. C. calcium levels. D. thyroxine (T4) levels.
C. calcium levels.
You respond to an ill patient experiencing flu-like symptoms. Upon your arrival, the patient states that she woke up not feeling well. The patient states that she has been heating her home with wood due to the electric bill being too high. You should suspect: A. hypercarbia. B. hypothermia. C. carbon monoxide poisoning. D. carbon dioxide poisoning.
C. carbon monoxide poisoning.
You respond to an ill male patient. Upon arrival, you note a farmer who is complaining of not feeling well. The patient presents in a tripod position with copious secretions, lacrimation, vomiting, and evidence of urination and defecation. You suspect: A. anticholinergic exposure. B. extrapyramidal syndrome. C. cholinergic exposure. D. sympathomimetic exposure.
C. cholinergic exposure.
Your patient, a known alcoholic, has developed a cardiac arrhythmia that you intend to treat with synchronized cardioversion. Because he is awake, you decide to administer diazepam to ease this experience. However, you find that to induce the desired state you must administer more than twice the normal dose of diazepam. This condition is known as: A. cumulative effect. B. idiosyncrasy. C. cross tolerance. D. tachyphylaxis.
C. cross tolerance.
Loop diuretics achieve their therapeutic effects by: A. enhancing reabsorption throughout the loop of Henle. B. increasing the reabsorption of sodium at the ascending loop of Henle. C. decreasing the reabsorption of sodium at the ascending loop of Henle. D. decreasing the absorption of sodium at the glomerulus.
C. decreasing the reabsorption of sodium at the ascending loop of Henle.
Dopamine is not administered directly to the patient during the treatment of Parkinson's disease because: A. the half-life of dopamine is too short to enable pharmacologic effects in the brain. B. the type of dopamine necessary in the brain is different from the type administered intravenously. C. dopamine cannot cross the blood-brain barrier. D. dopamine is not a therapeutic consideration; only acetylcholine replacement therapy is.
C. dopamine cannot cross the blood-brain barrier.
Teratogenic refers to the: A. likelihood of multiple births as a drug side effect. B. decreased ability of the elderly to metabolize drugs. C. effects of a drug on the developing fetus. D. potential of a drug to cause cancer.
C. effects of a drug on the developing fetus.
Benzodiazepines and barbiturates achieve their sedation effects by ________ in the CNS. A. blocking the dopaminergic receptor sites B. blocking the GABA receptor sites C. enhancing the GABA receptor sites D. depolarizing the neural membranes
C. enhancing the GABA receptor sites
You are caring for a middle-aged male patient who has a long history of psychiatric disorders. During your assessment, you note excessive tremors and uncontrollable spasms in his head, neck, and arms. These are most likely: A. partial (or psychomotor) seizures. B. drug interactions produced by antihypertensive medications and diuretics. C. extrapyramidal side effects of his antipsychotic medication. D. manifestations of his psychotic illness.
C. extrapyramidal side effects of his antipsychotic medication.
In addition to determining potential toxicity based on the type of agent, poison control centers are able to: A. give the paramedic documentation advice. B. determine whether transport is needed. C. guide the paramedic in starting definitive treatment in the field. D. refer the patient to a specialist.
C. guide the paramedic in starting definitive treatment in the field.
You respond to a patient who is complaining of a sudden onset of a severe headache. The patient has a history of hypertension. You should suspect: A. migraine. B. hypertensive urgency. C. hemorrhagic stroke. D. occlusive stroke.
C. hemorrhagic stroke.
According to the classifications of the Controlled Substance Act of 1970, an example of a Schedule I drug would be: A. diazepam. B. atropine sulfate. C. heroin. D. morphine sulfate.
C. heroin
You are called to the home of a patient who suddenly "stopped breathing." The patient has a history of a neoplasm at C3 and C4 You suspect: A. myocardial infarction. B. cervical fractures. C. impingement on the phrenic nerve. D. lung cancer.
C. impingement on the phrenic nerve.
All of the following statements about nonsteroidal anti-inflammatory drugs (NSAIDs) are true EXCEPT that NSAIDs: A. are used as analgesics and antipyretics. B. interfere with the production of prostaglandins, thereby interrupting the inflammatory process. C. include aspirin, acetaminophen, and ibuprofen. D. are prescribed to relieve pain following trauma and surgery.
C. include aspirin, acetaminophen, and ibuprofen.
A tonic-clonic seizure is characterized by: A. flaccidity. B. a period of apnea. C. increased muscle tone and rhythmic jerking. D. movement of one area of the body.
C. increased muscle tone and rhythmic jerking.
Aspirin is beneficial to patients with a history of cardiac disease because it: A. inhibits the clotting cascade. B. causes thrombolysis. C. inhibits platelet aggregation. D. oprovides analgesia.
C. inhibits platelet aggregation.
Digoxin is a paradoxical drug, which means: A. its many effects on the lungs make it an effective bronchodilator. B. its many effects on the lungs make it an ineffective bronchodilator. C. its many effects on the heart make it both an effective antiarrhythmic and a potent pro-dysrhythmic. D. its many effects on the heart make it both an ineffective antiarrhythmic and an anti-dysrhythmic.
C. its many effects on the heart make it both an effective antiarrhythmic and a potent pro-dysrhythmic.
Propranolol (Inderal) causes a ________ effect. A. positive dromotropic B. positive inotropic C. negative chronotropic D. positive chronotropic
C. negative chronotropic
Multiple transmitters are involved in the vomiting reflex, including all of the following, EXCEPT: A. dopamine. B. serotonin. C. norepinephrine. D. acetylcholine.
C. norepinephrine.
The time from when a drug is administered until it reaches the minimum effective concentration is known as the: A. duration of action. B. peak action. C. onset of action. D. therapeutic interval.
C. onset of action.
The cause of esophageal varices can be attributed to: A. pulmonary hypertension. B. pulmonary hypotension. C. portal hypertension. D. portal hypotension.
C. portal hypertension.
The three steps of decontamination are: A. elimination in urine, water, oxygen. B. reduce absorption, reduce metabolism, increase absorption by the kidney. C. reduce intake of the toxin, reduce absorption, enhance elimination. D. water, elimination in urine, atropine.
C. reduce intake of the toxin, reduce absorption, enhance elimination.
Abdominal pain that is originating in a region other than where it is felt is known as: A. Kehr's sign. B. visceral pain. C. referred pain. D. somatic pain.
C. referred pain.
Your first priority in the treatment of an inhaled toxin is to: A. decontaminate the patient. B. deluge with water. C. remove the patient from the source. D. flood with oxygen.
C. remove the patient from the source.
Which of the following medications promotes the conversion of plasminogen to plasmin? A. Heparin B. Coumadin C. rtPA D. Vitamin K
C. rtPA
You are caring for a patient with chronic bronchitis. The patient has an SpO2 of 90%. You should: A. start oxygen therapy, high flow 15 lpm via NRB. B. start oxygen therapy high flow, via CPAP. C. start oxygen therapy low flow, via nasal cannula. D. nothing, as this is an expected reading.
C. start oxygen therapy low flow, via nasal cannula.
You are called to care for a patient with severe shortness of breath. The patient has an SpO2 of 88%, audible wheezing, and a capnography reading of 54 with a shark fin wave form. You are administering albuterol for the second time without relief. You suspect: A. anaphylaxis. B. septic shock. C. status asthmaticus. D. status epilepticus.
C. status asthmaticus.
Benzodiazepines are safer than barbiturates in seizure patients because: A. benzodiazepines cannot cause hypotension or respiratory depression. B. benzodiazepines cause a counteraction by inducing high levels of dopamine in the CNS. C. the effect of benzodiazepines is limited by the amount of endogenous GABA in the CNS. D. the therapeutic dose of barbiturates is very close to the lethal dose.
C. the effect of benzodiazepines is limited by the amount of endogenous GABA in the CNS.
The main purpose of the GI tract is: A. glucogenolysis. B. to expel waste products. C. to convert food into nutrients for the body. D. to facilitate metabolism.
C. to convert food into nutrients for the body.
Obstructive sleep apnea is an example of: A. COPD. B. lower airway obstruction. C. upper airway obstruction. D. CHF.
C. upper airway obstruction.
Your patient is a 40-year-old male who ingested 30 tablets of Lexapro and 24 tablets of Tylenol PM. Which of the following is the most important question you should ask? A. "Do you have a history of depression?" B. "Why did you take these medications?" C. "How long ago did you take these medications?" D. "Have you ever done this before?"
C. "How long ago did you take these medications?"
When dealing with a possible renal emergency, it is imperative to ask: A. "Do you think you can walk?" B. "When was the last time you saw your nephrologist?" C. "How many times have you urinated today?" D. "How much do you weigh?"
C. "How many times have you urinated today?"
Which of the following statements would make you suspicious that your patient has been exposed to cyanide? A. "I think my car has an exhaust leak." B. "I inhaled some fumes when I was fueling my truck." C. "I have been burning carpets and old furniture all day. D. "I think I smoked some bad weed."
C. "I have been burning carpets and old furniture all day.
Your patient is a 19-year-old female who called EMS because she awoke with "itchy red patches" on her chest, back, and arms that "seem to come and go." As you obtain the history, you learn that she started taking Keflex, an antibiotic, two days ago to prevent infection in a laceration to her hand. In explaining to your patient what is going on, which of the following statements would be the most accurate? A. "I cannot say what this is, but it is not an allergic reaction. Hives do not come and go as you have described." B. "This is a typical side effect of Keflex. It happens in most patients who take it." C. "These look like hives. They occur during an allergic reaction. You may have developed an allergy to the antibiotic you are taking." D. "It looks like the infection in your hand has spread to the bloodstream. The toxins from the bacteria are causing a rash."
C. "These look like hives. They occur during an allergic reaction. You may have developed an allergy to the antibiotic you are taking."
When using CPAP in patients with COPD, in general, PEEP should be: A. > 10 cm H2O B. > 10 mm Hg C. < 10 cm H2O D. < 10 mm Hg
C. < 10 cm H2O
The most common cause of dementia in the elderly is: A. Cerebrovascular disease B. Multi-infarct dementia C. Alzheimer's disease D. Parkinson's disease
C. Alzheimer's disease
Which of the following is caused by unilateral paralysis of cranial nerve VII? A. Autonomic dysreflexia B. Myoclonus C. Bell's palsy D. Dystonia
C. Bell's palsy
In the treatment of acute glaucoma, which classifications of drugs are most useful? A. Anticholinergics and beta blockers B. Beta agonists and anticholinergics C. Beta-blockers and cholinergics D. Alpha agonists and anticholinergics
C. Beta-blockers and cholinergics
Which of the following pathologies would necessitate the use of increased care in the preparation of an IV site because of skin fragility and increased risk of infection? A. Graves' disease B. Addison's disease C. Cushing's syndrome D. Myxedema
C. Cushing's syndrome
Your patient is a 39-year-old male with a history of alcoholism. He is unresponsive, with cool, clammy skin and a weak, rapid pulse of 108. BP = 128/92, RR = 12 and regular. Your partner manages the airway and assists ventilations, but you are unable to start an IV after three attempts. Which of the following is most appropriate at this point? A. Glucagon 1.0 mg IM B. Dextrose, 25 g, and thiamine, 100 mg, both IM C. Glucagon, 1.0 mg, and thiamine, 100 mg, both IM D. Reattempt the IV while en route
C. Glucagon, 1.0 mg, and thiamine, 100 mg, both IM
Secretion of glucagon from the pancreas results in ________, which causes a(n) ________ in blood glucose levels. A. Glucogenesis, increase B. Glycogenolysis, decrease C. Glycogenolysis, increase D. Glucogenesis, decrease
C. Glycogenolysis, increase
Your patient is a 48-year-old female who is supine on the floor of a neighborhood health clinic. She became unconscious after receiving 250 mg of IM doxycycline. Clinic staff reports that the patient "broke out in hives and lost consciousness." The patient is being ventilated by bag-valve mask and has an IV of normal saline running wide open. A nurse practitioner on the scene informs you that, before your arrival, he administered 2 doses of 0.5 mg of epinephrine SC, 50 mg of diphenhydramine IV, and 1 L of NS. HR = 138; BP = 84/60; RR = 12/min, assisted with BVM; SaO2 = 94%. Of the following, which is the most appropriate continued treatment of this patient? A. Intubate, Solu-Medrol IV, 250 cc NS fluid challenge, transport B. Continue administering fluids and transport to the nearest facility C. Intubate, administration of dopamine IV infusion, rapid transport D. Initiate a second IV of NS wide open, intubate and hyperventilate, transport
C. Intubate, administration of dopamine IV infusion, rapid transport
You encounter a patient complaining of polyuria, polyphagia, polydipsia, and abdominal pain. Based on these complaints, which of the following would you also expect to find? A. Blood glucose between 80 and 120 mg/dL B. Blood glucose of less than 70 mg/dL C. Kussmaul's respirations and a fruity breath odor D. Complaint of chest pain and shortness of breath
C. Kussmaul's respirations and a fruity breath odor
Upon palpation of your patient's abdomen you note that it is very tender under the right costal margin. This should be documented as a positive ________ sign. A. Cullen's B. McBurney's C. Murphy's D. Grey-Turner's
C. Murphy's
Your patient is a 24-year-old male complaining of a headache for the past two days. He states he has taken aspirin but cannot get rid of the headache. The patient lives in a basement apartment, which you observe is very chilly. The patient states his furnace hasn't been working and he had to use the oven to help heat the apartment. Which other findings and complaints are most likely? A. Nausea, vomiting, decreased hemoglobin saturation B. Rash, nausea, a metallic taste in the mouth C. Nausea, vomiting, confusion, tachypnea D. Pale skin, sluggish pupils, tachycardia
C. Nausea, vomiting, confusion, tachypnea
Your patient is a 24-year-old, 176-pound male who is alert and oriented 12 hours after ingesting thirty 500 mg tablets of Tylenol. Which of the following are the most likely complaints or findings? A. Confusion, lethargy, and hyperthermia B. Abdominal pain and oliguria C. Nausea, vomiting, weakness, and fatigue D. Signs and symptoms of liver failure
C. Nausea, vomiting, weakness, and fatigue
Which of the following diseases is most likely to cause dementia in the patient? A. Spina bifida B. Amyotrophic lateral sclerosis C. Pick's disease D. Multiple sclerosis
C. Pick's disease
The carpopedal spasms that occur due to hyperventilation syndrome are a result of a relative ________, secondary to ________. A. hypocalcemia, decrease in unbound calcium B. hypercalcemia, respiratory alkalosis C. hypocalcemia, increase in bound calcium D. hyponatremia, respiratory alkalosis
C. hypocalcemia, increase in bound calcium
Children under one year of age have a ________ plasma protein concentration than older children. Therefore, medications that bind to plasma proteins will have a ________ effect in them. A. greater; diminished B. lower; diminished C. lower; greater D. greater; greater
C. lower; greater
A document that is signed by a physician and that outlines the life-sustaining measures that may or may not be taken when a patient's heart and respiratory functions have ceased is a: A.power of attorney. B.living will. C.DNR order. D.statement of last rites.
C.DNR order.
Which of the following occurrences is LEAST likely to require mandatory legal reporting by the paramedic? A.Child endangerment B.Abuse of the elderly C.Public intoxication D.Spousal battery
C.Public intoxication
A physician has ordered you to give a medication that you believe will harm your patient. Which of the following should you do? A.Contact a supervisor in the EMS system and request a second opinion. B.Carry out the ordered treatment but note your objection in the patient care report. C.Question the physician, refuse to carry out the order if the physician insists you do so, and document the incident. D.Question the physician but carry out the order if the physician insists.
C.Question the physician, refuse to carry out the order if the physician insists you do so, and document the incident.
Your patient is a competent adult who has given permission for treatment and transport. You have loaded the patient into the ambulance, but just before you are ready to leave the scene, she changes her mind and says she does not want to go to the hospital. Which of the following statements about this situation is true? A.She can now be treated using implied consent. B.She cannot withdraw consent after having given it. C.She can withdraw consent. D.You must obtain an emergency detention order to continue treatment.
C.She can withdraw consent.
Which of the following laws is designed to allow the paramedic who has been potentially exposed to an infectious disease access to the medical records of the patient to whom the paramedic was exposed? A.HIPAA B.EMTALA C.The Ryan White CARE Act D.Good Samaritan laws
C.The Ryan White CARE Act
DNR orders, durable powers of attorney, and living wills are forms of: A.protocols. B.standards of care. C.advance directives. D.medical orders.
C.advance directives.
The principle of law that prohibits the release of medical or other personal information about a patient without the patient's permission is known as: A.privilege. B.privacy. C.confidentiality. D.primum non nocere.
C.confidentiality.
In a lawsuit in which a paramedic has been charged with negligence, the paramedic is called the: A.plaintiff B.suspect C.defendant D.magistrate
C.defendant
Protecting those at risk is an example of a paramedic's ________ duty. A.legal B.medicaldash-legal C.ethical D.moral
C.ethical
When a court orders that a prisoner receive treatment the prisoner does not want, the treatment is based on ________ consent. A.proximate B.expressed C.involuntary D.ex parte
C.involuntary
A paramedic performs an intervention on a patient that is contrary to current practices. The patient suffers an injury as a result of that intervention. This is an example of: A.antifeasance. B.nonfeasance. C.malfeasance. D.misfeasance.
C.malfeasance.
There are ethical and societal limits to the interactions between paramedics or other health care personnel and the patients they serve. These are called: A.employment laws. B.scope of practice. C.professional boundaries. D.standard of care.
C.professional boundaries.
The degree of care, skill, and judgment that would be expected of any similarly trained, reasonable paramedic acting under similar circumstances is called the: A.test of prudent actions. B.scope of practice. C.standard of care. D.duty to act.
C.standard of care.
Which of the following would NOT be appropriate for intradermal drug administration? A. 27 gauge, 3/8′′ needle B. 25 gauge, 3/4′′ needle C. 25 gauge, 1′′ needle D. 20 gauge, 3/4′′ needle
D. 20 gauge, 3/4" needle
Your patient is a 68-year-old male who is conscious but confused and lying on his kitchen floor. The patient offers no complaint other than wishing to be helped up from the floor. The patient can tell you that he "slipped a few days ago" and has been on the floor since. Physical examination reveals dry, cool skin; dry mucous membranes; clear lung sounds bilaterally; and no indications of trauma. HR = 112, BP = 98/70, RR = 14, SaO2 = 96%. Your partner finds an appointment card indicating the patient missed a hemodialysis appointment two days ago. Which of the following is the best course for managing this patient? A. Dopamine infusion B. 1,000 mL fluid bolus C. IV of NS at a keep-open rate D. 250 mL fluid bolus
D. 250 mL fluid bolus
Your patient weighs 22 pounds and is to receive 0.02 mg/kg of atropine IV push. You have a multidose vial of atropine containing 20 mL at a concentration of 0.04 mg/mL. What volume (in mL) of medication is to be injected? A. 0.25 B. 2.5 C. 0.5 D. 5
D. 5
Persistent abdominal pain is considered a surgical emergency when lasting longer than: A. 6 days. B. 2 days. C. 2 hours. D. 6 hours.
D. 6 hours.
Which of the following is a natural change the occurs with aging? A. Increased levels of stress which trigger respiratory episodes. B. An increase in lung capacity C. An increase in bronchospasms. D. A decrease in lung compliance.
D. A decrease in lung compliance.
You are examining a newborn and note that the meninges and spinal cord are protruding through an opening over the lower back. This is known as: A. Poliomyelitis B. Spina bifida occulta C. A meningocele D. A myelomeningocele
D. A myelomeningocele
A 19-year-old male has ingested fifty 325 mg aspirin tablets 20 minutes before your arrival. He is alert and complaining of burning abdominal pain. Which of the following is appropriate in the prehospital management of this patient? A. Syrup of ipecac B. Sodium bicarbonate C. N-acetylcysteine D. Activated charcoal
D. Activated charcoal
A 63-year-old female with a history of hypothyroidism presents in a stuporous state, responsive only to pain. Physical exam reveals thin hair, a puffy face, an enlarged tongue, and cold, doughy skin. Her heart rate is 70 and regular, RR is 10 and regular, BP is 90/62, blood glucose level is 60 mg/dL, and temperature is 86°F via a tympanic thermometer. Your treatment of this patient should NOT include: A. IV fluids at a TKO rate B. 50 percent dextrose, IV C. Endotracheal intubation D. Active rewarming
D. Active rewarming
Your patient is a 24-year-old male complaining of a one-week history of abdominal pain. He describes the pain as in the upper right quadrant, dull and reproducible with movement and palpation. He also describes a decreased appetite, weight loss, and clay-colored stool over the same period. Of the following, which is the most likely cause of his clinical condition? A. Pancreatitis B. Cholecystitis C. Colitis D. Acute hepatitis
D. Acute hepatitis
Your patient is a 24-year-old male with a history of type I diabetes. You were called to his place of employment because he was behaving bizarrely. On your arrival he is confused and combative with a blood glucose level of 41 mg/dL. Due to poor vasculature and the patient's combativeness, you have not been able to start an IV. Which of the following is the best course of action? A. Administer half an amp (12.5 g) of 50 percent dextrose, IM. B. Administer 5 mg Valium, IM, and attempt the IV again when the patient is less agitated. C. Use four-point restraints to restrain the patient and transport. Attempt the IV again if the patient becomes unresponsive. D. Administer 1 mg glucagon, IM.
D. Administer 1 mg glucagon, IM.
Your patient was in the building when a fire started at a factory that manufactures plastics. He is complaining of a headache, palpitations, and a burning sensation in his throat. His airway, breathing, and circulation are intact. Heart rate = 128, respirations = 22, blood pressure = 148/84, and SaO2 = 93%. You should immediately: A. Prepare to intubate B. Administer amyl and sodium nitrate C. Apply the cardiac monitor D. Administer high-concentration oxygen
D. Administer high-concentration oxygen
You are called to the home of a 28-year-old male who is complaining of hoarseness, a scratchy sensation in the back of his throat, and palpitations. The symptoms began about 30 minutes ago and have grown steadily worse ever since the patient ingested prescribed penicillin 1 hour ago. Patient management should include all of the following EXCEPT: A. Epinephrine 1:1000 0.3 mg SC B. Supplemental oxygen via nonrebreather mask C. IV of NS KVO D. Administration of an IV beta-blocker
D. Administration of an IV beta-blocker
All of the following are examples of one of the three "principles of decontamination" that are specific to toxicological emergencies EXCEPT: A. Administration of sorbitol B. Removing a patient from a structure that is filled with carbon monoxide C. Administration of N-acetylcysteine D. Administration of an NS fluid challenge
D. Administration of an NS fluid challenge
Which of the following accounts for more than 90 percent of hospital admissions for toxic substance exposure? A. Pediatric accidental poisonings B. Intentional poisoning by another person C. Pediatric overdoses D. Adult poisonings and overdoses
D. Adult poisonings and overdoses
Which of the following should be suspected as a potential cause of syncope? A. Hypovolemia B. Cardiac dysrhythmia C. Vagal stimulation D. All of the above
D. All of the above
Which of the following is least pertinent in the prehospital setting when obtaining the history of a patient with a suspected transient ischemic attack or stroke? A. History of diabetes B. History of cardiovascular disease C. Medications D. Allergies
D. Allergies
In the renin-angiotensin-aldosterone system (RAAS), which element is most responsible for widespread vasoconstriction? A. Angiotensin I B. Angiotensinogen C. Angiotensin-converting enzyme (ACE) D. Angiotensin II
D. Angiotensin II
Your patient is a 38-year-old female with a history of Crohn's disease. She is conscious and alert and complaining of abdominal pain. She describes a one-week history of increasingly diffuse, crampy abdominal pain. She also states that she has had nausea and vomiting, fever, and diarrhea the past two days. Physical examination reveals that her skin is warm and dry and that her abdomen is tender to palpation in all quadrants with no masses or distension noted. HR = 100, BP = 118/78, RR = 14, SaO2 = 99%. Which of the following treatments is appropriate in the prehospital management of this patient? A. Diphenydramine B. Ketorolac (Toradol) C. Methylprednisolone D. Antiemetics
D. Antiemetics
Pain at McBurney's point is associated with: A. Kidney stones B. Cholecystitis C. Pancreatitis D. Appendicitis
D. Appendicitis
Your patient is a 19-year-old male complaining of a two-day history of abdominal pain described as diffuse and colicky, located around his umbilical area. He also states a loss of appetite and a low-grade fever over the same period. Palpation of his abdomen reveals tenderness and guarding to the periumbilical area. Of the following, which is the most likely cause of his clinical condition? A. Cholecystitis B. Bowel obstruction C. Peptic ulcer disease D. Appendicitis
D. Appendicitis
Which of the following statements about hyperglycemic hyperosmolar nonketotic coma (HHNK) is true? A. Unlike diabetic ketoacidosis, HHNK is not life-threatening. B. Paradoxically, the definitive management of HHNK includes the administration of 50 percent dextrose. C. Prehospital treatment of HHNK includes correcting metabolic acidosis. D. Aside from managing the ABCs, prehospital management is primarily aimed at correcting dehydration.
D. Aside from managing the ABCs, prehospital management is primarily aimed at correcting dehydration.
Your patient is a 23-year-old female who is 30 weeks' pregnant. She choked on some cheese while eating a piece of pizza. When asked if she can speak, she replies "yes," although with some difficulty. Your next step should be to: A. Attempt to remove the bolus of cheese with Magill forceps B. Perform a series of abdominal thrusts C. Perform a series of chest thrusts D. Ask the patient to cough as hard as she can
D. Ask the patient to cough as hard as she can
Which of the following medications is a cardioselective beta-blocker? A. Propranolol B. Metaproterenol C. Albuterol D. Atenolol
D. Atenolol
Which of the following is a risk factor for stroke? A. First-degree heart block B. Premature atrial contractions C. Sinus arrhythmia D. Atrial fibrillation
D. Atrial fibrillation
You are presented with a 42-year-old male who is unconscious with snoring respirations after a heroin overdose. HR = 64, BP = 98/50, RR = 6 and shallow, SaO2 = 91%. Which of the following is the most appropriate initial treatment? A. IV access, administer naloxone B. Intubate, ventilate with supplemental oxygen C. IV access, administer a 250 cc fluid bolus D. BLS airway management and ventilation with supplemental oxygen
D. BLS airway management and ventilation with supplemental oxygen
What is the process of chemically converting drugs into metabolites? A. Distribution B. Absorption C. Excretion D. Biotransformation
D. Biotransformation
Your patient is a 44-year-old female with a history of hiatal hernia. She is complaining of diffuse abdominal pain. All four quadrants are tender to palpation. She also states that she has vomited numerous times and describes the presence of bile. You note that her abdomen is slightly distended, and auscultation of her abdomen reveals absent bowel sounds. Of the following, which is the most likely cause of her clinical condition? A. Cholecystitis B. Pancreatitis C. Diverticulitis D. Bowel obstruction
D. Bowel obstruction
Your patient is a 68-year-old female complaining of diffuse abdominal pain. She has a history of intestinal hernias and adhesions from previous abdominal surgery. Your suspicion should be highest for: A. Ulcerative colitis B. Appendicitis C. Diverticulitis D. Bowel obstruction
D. Bowel obstruction
Which of the following statements about chronic renal failure (CRF) is accurate? A. CRF is reversible if the cause is found and treated. B. Hemodialysis can reverse CRF, but CAPD cannot. C. The only treatment for CRF is a kidney transplant. D. CRF is diagnosed when 70 percent of the nephrons are lost and the patient is clinically unstable.
D. CRF is diagnosed when 70 percent of the nephrons are lost and the patient is clinically unstable.
Which of the following statements about chronic renal failure (CRF) is accurate? A. Hemodialysis can reverse CRF, but CAPD cannot. B. CRF is reversible if the cause is found and treated. C. The only treatment for CRF is a kidney transplant. D. CRF is diagnosed when 70 percent of the nephrons are lost and the patient is clinically unstable.
D. CRF is diagnosed when 70 percent of the nephrons are lost and the patient is clinically unstable.
Which of the following antihypertensive medications is an angiotensin-converting enzyme (ACE) inhibitor? A. Clonidine (Catapres) B. Reserpine (Serpalan) C. Labetalol (Normodyne) D. Captopril (Capoten)
D. Captopril (Capoten)
Which of the following is a highly toxic, odorless, tasteless gas that is a by-product of incomplete combustion? A. Cyanide B. Methane C. Carbon dioxide D. Carbon monoxide
D. Carbon monoxide
Which class of hormones is NOT synthesized and secreted by the adrenal cortex? A. Androgens B. Glucocorticoids C. Mineralocorticoids D. Catecholamines
D. Catecholamines
Immunity resulting from a direct attack on a foreign substance by specialized cells in the immune system is: A. Humoral immunity B. Primary immunity C. Secondary response D. Cellular immunity
D. Cellular immunity
A type II diabetic with a blood glucose of 24 mg/dL would most likely be unconscious due to: A. Diabetic ketoacidosis B. Gluconeogenesis C. Insulin shock D. Cerebral hypoglycemia
D. Cerebral hypoglycemia
Which of the following is LEAST likely to be a precipitating factor of thyrotoxic crisis? A. Infection B. Overdose of thyroid hormone C. Trauma D. Cold environment
D. Cold environment
You respond to an ill patient. Upon your arrival, the patient states that she has had an increase in urination, thirst, and general malaise. The patient's finger stick blood glucose reading is 550 mg/dL; her blood pressure is 110/80 mmHg; pulse, 100; respiratory rate 26; ETCO2 29; and you note an acetone odor. You suspect: A. DNK. B. HHNK. C. TNK. D. DKA.
D. DKA.
A 76-year-old patient with acute interstitial nephritis presents with oliguria, altered mental status, and edema to his face, hands, and feet. Of the following, which best describes the pathophysiology behind these clinical findings? A. Na+ and K+ excretion results in diuresis and dehydration. B. H+ excretion results in diuresis and alkalosis. C. Increased GFR results in retention of water, electrolytes, and metabolic waste. D. Decreased GFR results in retention of water, electrolytes, and metabolic waste.
D. Decreased GFR results in retention of water, electrolytes, and metabolic waste.
Which of the following is the therapeutic effect of a cathartic? A. Increased protein binding of drugs B. Alkalinization of the urine C. Vomiting D. Diarrhea
D. Diarrhea
Which of the following is commonly indicated in the management of cocaine overdose? A. Flumazenil B. Narcan C. Thiamine D. Diazepam
D. Diazepam
Which of the following is the generic name of a drug? A. Excedrin B. Motrin C. Tylenol D. Diazepam
D. Diazepam
Your patient is a 42-year-old male with a history of alcohol abuse who is in severe distress with dysphagia and hematemesis. You note that he is becoming lethargic and is having trouble keeping his head up. His skin is cool and clammy. HR = 138, BP = 82/56, RR = 8, SaO2 = 90%. Proper treatment of this patient would include all of the following EXCEPT: A. Aggressive suctioning of the airway and intubation B. IV of NS with fluid challenge C. Placing the patient in shock position D. Dopamine infusion
D. Dopamine infusion
All of the following are considered part of the lower gastrointestinal tract EXCEPT the: A. Jejunum B. Large intestine C. Ileum D. Duodenum
D. Duodenum
Your patient is a 48-year-old female with advanced hepatitis secondary to drug and alcohol abuse. She is confused and is noncompliant with her medications. Which of the following is the most likely cause of her confusion? A. Hyperglycemia B. Anemia C. Hypercoagulative state D. Elevated ammonia levels
D. Elevated ammonia levels
Which of the following chemistry findings would suggest acute renal failure? A. Elevated iron B. Decreased creatinine C. Decreased potassium D. Elevated blood urea nitrogen (BUN)
D. Elevated blood urea nitrogen (BUN)
Which of the following is a prerenal cause of acute renal failure? A. Uretheral obstruction due to renal calculi B. Massive overdose of ibuprofen C. Pyelonephritis D. Embolism of the renal vein
D. Embolism of the renal vein
Which of the following is a property of a reversible cholinesterase inhibitor? A. Blocks sympathetic stimulation for a finite period B. Blocks parasympathetic stimulation for a finite period C. Enables sympathetic stimulation for a finite period D. Enables parasympathetic stimulation for a finite period
D. Enables parasympathetic stimulation for a finite period
Which medication is best for improving hypotension secondary to anaphylactic shock? A. Diphenhydramine B. Hydrocortisone C. Oxygen D. Epinephrine
D. Epinephrine
Capnometry measures the partial pressure of CO2 in: A. Venous blood B. Inspired air C. Arterial blood D. Expired air
D. Expired air
Dislodgement of the catheter from the vein, puncture of the distal vein wall during venipuncture, and/or a poorly secured IV can lead to what? A. Septic shock B. Venous spasm C. Speed shock D. Extravasation
D. Extravasation
Which of the following is the most important intrinsic risk factor for respiratory disease? A. Sedentary lifestyle B. Smoking C. Environment D. Family history
D. Family history
Shortly after starting an IV on your patient, you note that the IV is not dripping. You have removed the constricting band, and all the clamps on the tubing are open. You note that there is minor swelling around the venipuncture site. There is no discoloration of the site, but it is cool and firm to the touch. Which of the following most likely accounts for your findings? A. The tip of the catheter is occluded by a blood clot. B. The tip of the catheter is occluded by a valve in the vein. C. The site has become infected. D. Fluids extravasated into the tissue surrounding the IV site.
D. Fluids extravasated into the tissue surrounding the IV site.
Your patient is a 66-year-old female who is conscious and alert, complaining of a one-week history of progressive "lightheadedness" with exertion. She also complains of mild nausea; dark, sticky stools; and pain in her lower abdomen. Which of the following is the most likely cause of this patient's condition? A. Ingestion of an iron or a bismuth-containing medication B. Diverticulosis C. Acute cholecystitis D. Gastrointestinal bleeding
D. Gastrointestinal bleeding
You suspect your patient is experiencing a hemorrhagic stroke. He is confused, has a respiratory rate of 20, and a blood pressure of 178/88. Which of the following additional findings would most increase your suspicion of increased intracranial pressure? A. Anterograde amnesia B. Hallucinations C. Slurred speech D. Heart rate of 50
D. Heart rate of 50
Which of the following should occur with the administration of insulin? A. Gluconeogenesis B. Lipolysis C. Glycogenolysis D. Hepatic glycogen synthesis
D. Hepatic glycogen synthesis
Which of the following is NOT associated with chronic alcohol ingestion? A. Decreased sensation in hands and feet B. Esophageal varices C. Thiamine deficiency D. Hyperactivity
D. Hyperactivity
You arrive to find an unresponsive patient inside a running vehicle in his garage. Your destination should include a hospital with what capability? A. Neurosurgical capabilities B. Any hospital C. Hypobaric oxygen D. Hyperbaric oxygen
D. Hyperbaric oxygen
Your patient is experiencing profuse hives, itching, dyspnea, coughing, tachycardia, and dizziness after eating seafood 5 minutes ago. You might also expect to see all of the following additional signs EXCEPT: A. Bronchospasm B. Laryngeal edema C. Cyanosis D. Hypertension
D. Hypertension
Which of the following should not be a part of the general management of a patient with altered mental status? A. Thiamine B. IV of NS KVO C. 50 percent dextrose D. Hyperventilation with 100 percent oxygen
D. Hyperventilation with 100 percent oxygen
Your patient is unresponsive after removal from a home in which four family members were found unconscious after having "flulike symptoms." The patient has snoring respirations at 10 per minute; a weak, rapid radial pulse; and an SaO2 of 100%. Your treatment should consist of all of the following EXCEPT: A. Endotracheal intubation B. IV of normal saline C. Considering transport to a hospital with hyperbaric oxygen treatment facilities D. Hyperventilation with 100 percent oxygen
D. Hyperventilation with 100 percent oxygen
Your patient is unresponsive after removal from a home in which four family members were found unconscious after having "flulike symptoms." The patient has snoring respirations at 10 per minute; a weak, rapid radial pulse; and an SaO2 of 100%. Your treatment should consist of all of the following EXCEPT: A. IV of normal saline B. Considering transport to a hospital with hyperbaric oxygen treatment facilities C. Endotracheal intubation D. Hyperventilation with 100 percent oxygen
D. Hyperventilation with 100 percent oxygen
If a patient being treated for hypoparathyroidism stopped taking the medications prescribed for his condition, which of the following would be most likely to occur? A. Hypokalemia B. Hypercalcemia C. Hyperkalemia D. Hypocalcemia
D. Hypocalcemia
Epinephrine administration results in all of the following EXCEPT: A. Increased cardiac contractile force B. Increased peripheral vasoconstriction C. Tachycardia D. Hypotension
D. Hypotension
Which of the following assessment findings should you most expect in a patient with chronic pancreatitis? A. Clay-colored stool B. Dark-colored urine C. Right lower quadrant pain D. Hypotension
D. Hypotension
ETCO2 is recorded during phase ________ of the capnogram. A. IV B. II C. I D. III
D. III
In which class of the Vaughn-Williams classification system of antidysrhythmic medications does amiodarone belong? A. IB B. II C. IV D. III
D. III
In which class of the Vaughn-Williams classification system of anti-dysrhythmic medications does verapamil belong? A. IB B. IA C. II D. IV
D. IV
Which of the following is the best route for administering epinephrine to patients in severe anaphylactic shock refractory to initial interventions? A. SC B. ET C. IM D. IV
D. IV
Your patient is a conscious and alert 22-year-old female who was stung by a hornet. She states that she has "allergies to bee stings" and has been told that she could die if stung. Your physical examination reveals a 1-cm-diameter, red, edematous area where she was stung on the left forearm. Her skin is warm and dry, and her lung sounds are clear and equal bilaterally. HR = 112 and regular, BP = 122/82, RR = 12 and regular, SaO2 = 98%. The most appropriate treatment for this patient would include: A. 100 percent oxygen via nonrebreather mask 15 lpm, IV of NS 1-2 L, epinephrine 1:1000 0.3 mg SC, diphenhydramine 25 mg IV B. 15 lpm oxygen by nonrebreather, epinephrine 1:1000 0.3 mg SC, diphenhydramine 25 mg IV, transport C. Transport only D. IV of NS KVO
D. IV of NS KVO
Your patient is a 34-year-old male who is alert and oriented after an intentional overdose of ten Wellbutrin tablets 30 minutes ago. He denies ingestion of any other drugs or alcohol. Physical examination reveals warm, dry skin; PEARL; and a slight tremor to his hands. HR = 100, BP = 128/84, RR = 14, SaO2 = 99%. Which of the following is most appropriate? A. IV of normal saline, KVO; sodium bicarbonate 1 mEq/kg, IV B. IV of normal saline, KVO; flumazenil, IV C. IV of normal saline, KVO; activated charcoal, PO or via NG tube D. IV of normal saline, KVO
D. IV of normal saline, KVO
Your patient is a 43-year-old female with a history of peanut allergy. She is complaining of dizziness after eating a casserole that she later discovered contained peanuts. Your physical examination reveals warm, diaphoretic skin; a blotchy, red rash covering her chest and arms; and lung sounds that are clear and equal bilaterally. HR = 122, BP = 124/76, RR = 15 and regular, SaO2 = 97%. In addition to providing oxygen, appropriate treatment for this patient includes: A. IV with crystalloid solution such as lactated Ringer's or normal saline. B. IV with crystalloid solution such as lactated Ringer's or normal saline, epinephrine 1:1000 SC, diphenhydramine IV, nebulized albuterol. C. IV of NS wide open, epinephrine 1:1000 SC, diphenhydramine IV. D. IV with crystalloid solution such as lactated Ringer's or normal saline, epinephrine 1:1000 SC, diphenhydramine IV.
D. IV with crystalloid solution such as lactated Ringer's or normal saline, epinephrine 1:1000 SC, diphenhydramine IV.
If a drug were to block the nicotinic receptors at the neuromuscular junction, what symptomatic effect might this have on the patient? A. Increase in gastric motility B. Pupillary constriction C. Decrease in heart rate D. Inability to move voluntary and involuntary muscles
D. Inability to move voluntary and involuntary muscles
An increased hydrogen ion concentration in the cerebrospinal fluid results in a(n) ________ respiratory rate. A. Erratic B. Decreased C. Unchanged D. Increased
D. Increased
When treating patients with suspected hypoglycemia, which of the following should be of greatest concern regarding the administration of 50 percent dextrose in water? A. The administration of oxygen before any other therapies B. Confirming the patient has a history of diabetes C. Ensuring that a blood glucose specimen is obtained before administering the drug D. Infiltration of the IV during the drug administration
D. Infiltration of the IV during the drug administration
All of the following may cause a transient ischemic attack EXCEPT: A. A small embolus B. Hypotension C. Cerebrovascular spasm D. Intracranial hemorrhage
D. Intracranial hemorrhage
By which of the following routes will medication have the quickest onset of action? A. Intradermal B. Subcutaneous C. Oral D. Intramuscular
D. Intramuscular
Which of the following is a disadvantage of pulmonary drug administration via nebulizer or metered dose inhaler? A. Pulmonary absorption is a slow route for drug administration. B. Side effects are more likely with pulmonary drug administration. C. It requires a larger dose than other routes. D. It requires the patient to have adequate ventilation.
D. It requires the patient to have adequate ventilation.
When assessing a fistula used for hemodialysis, which of the following should concern you? A. Pulsation with each heartbeat B. A bruit on auscultation C. Bruising around the fistula D. Lack of a palpable vibration
D. Lack of a palpable vibration
Your patient is a 31-year-old female complaining of dizziness and difficulty breathing after being stung by a bee. You note that she is extremely anxious, and your physical examination reveals a rapidly developing urticaria to her shoulders, neck, and face. Your partner has administered oxygen via a nonrebreather, initiated IV access, placed the patient on the cardiac monitor, and administered epinephrine SC and diphenhydramine IV. Despite this, you also note that her voice is quickly becoming more hoarse and she has developed expiratory wheezes in all lung fields. HR = 128, BP = 100/70, RR = 20, SaO2 = 99%. What should be your major concern at this point, and what is the most appropriate treatment? A. Hypotension leading to cardiovascular collapse; administer fluids wide open and initiate a dopamine infusion B. Increased bronchospasm leading to respiratory arrest; administer epinephrine IV C. Increased bronchospasm leading to respiratory arrest; administer albuterol via nebulizer D. Laryngeal edema leading to total airway occlusion; intubate
D. Laryngeal edema leading to total airway occlusion; intubate
A patient with no prior history of renal disease is experiencing restlessness, agitation, dysuria, and flank pain radiating into the groin. Appropriate treatment for this patient would consist of all of the following EXCEPT: A. Morphine B. IV fluid therapy C. Fentanyl D. Lasix IV
D. Lasix IV
Which of the following is NOT characteristic of a migraine? A. Throbbing headache B. Vomiting C. Photosensitivity D. Low back pain
D. Low back pain
Which of the following is NOT part of the respiratory status assessment? A. Respiratory effort B. Color C. Mental status D. Lung compliance
D. Lung compliance
What is the most common cause of chronic gastroenteritis? A. Elevated cortisol B. Use of NSAIDs C. Floral infection D. Microbial infection
D. Microbial infection
Narcan acts as an antagonist to all of the following medications EXCEPT: A. Heroin B. Methadone C. Codeine D. Midazolam
D. Midazolam
Your patient is a 45-year-old female who became hypertensive after eating some cheese and drinking wine. Which type of medication would most likely account for this reaction? A. Phenothiazines B. Tricyclic antidepressants C. Selective serotonin reuptake inhibitors D. Monoamine oxidase inhibitors
D. Monoamine oxidase inhibitors
Which of the following diseases involves inflammation followed by demyelination of the brain and spinal cord nerve fibers? A. Myasthenia gravis B. Muscular dystrophy C. Alzheimer's disease D. Multiple sclerosis
D. Multiple sclerosis
Fifty percent dextrose solution is placed on side A of a membrane, and 25 percent dextrose is placed on side B of a membrane. Assuming the membrane is permeable to water, but not solutes, what will happen? A. Water may move freely in both directions, but there will be no net movement of water. B. Net movement of water from side A to side B will occur. C. Water will not move in either direction. D. Net movement of water from side B to side A will occur.
D. Net movement of water from side B to side A will occur.
Administration of a medication to the right eye would be documented medically as: A. o.g. B. o.u. C. o.s. D. o.d.
D. O.d
Which of the following is NOT typically associated with type 1 diabetes mellitus? A. Inadequate insulin release from the beta cells of the pancreatic islets B. Juvenile onset C. Insulin dependence D. Obesity
D. Obesity
Which of the following medications is a proton-pump inhibitor? A. Cimetidine (Tagamet) B. Pirenzepine (Gastrozepine) C. Ranitidine (Zantac) D. Omeprazole (Prilosec)
D. Omeprazole (Prilosec)
Tenderness associated with pyelonephritis is best evaluated by percussing: A. Laterally, just superior to the superior iliac crest B. In the midline, just superior to the symphysis pubis C. Just lateral to the spine slightly superior to the sacroiliac joint D. Over the pubis in lower UTI and at the flank in upper UTI.
D. Over the pubis in lower UTI and at the flank in upper UTI.
What is the MOST common catheter used in prehospital IV starts? A. Butterfly set B. Plastic C. Hollow-needle D. Over-the-needle
D. Over-the-needle
All of the following symptoms are consistent with urinary tract infection EXCEPT: A. Frequent urge to urinate B. Tenderness over one or both flanks C. Difficulty beginning and continuing to void D. Passing hard, granular material in the urine
D. Passing hard, granular material in the urine
Which of the following statements concerning Africanized honeybees is accurate? A. The venom of Africanized honeybees causes acute renal failure. B. Envenomation by Africanized honeybees requires treatment with specific antivenin. C. The venom of Africanized honeybees is more toxic than that of other types of bees. D. Patients stung by Africanized honeybees tend to have more stings than patients stung by other types of bees.
D. Patients stung by Africanized honeybees tend to have more stings than patients stung by other types of bees.
To relieve nasal congestion, which of the following medications would be most effective when administered intranasally? A. Propranalol B. Physostigmine C. Epinephrine D. Phenylepherine
D. Phenylepherine
Which of the following intravenous solutions would remain in the vascular system the longest? A. 5 percent dextrose in water B. 0.9 percent sodium chloride C. Lactated Ringer's solution D. Plasmanate
D. Plasmanate
Which of the following is LEAST likely to lead to acute renal failure? A. Urethral obstruction B. Heart failure with hypotension C. Interstitial nephritis D. Pneumonia
D. Pneumonia
Which of the following infectious childhood diseases would most likely result in paralysis? A. Rubella B. German measles C. Spina bifida D. Poliomyelitis
D. Poliomyelitis
You are preforming a physical exam on a patient with emphysema. You note that the patient has a pink hue to her skin. You should suspect: A. Carboxyhemoglobinemia. B. Methahemoglobinemia. C. Cor pulmonale. D. Polycythemia.
D. Polycythemia.
Which of the following most accurately describes the rationale for monitoring the cardiac rhythm in the hyperglycemic patient? A. Hyperglycemia causes ventricular irritability and increases the risk of ventricular fibrillation. B. All ALS patients must be monitored. C. The increased viscosity of the blood makes myocardial ischemia very likely. D. Polyuria can lead to electrolyte disturbances, resulting in cardiac dysrhythmias.
D. Polyuria can lead to electrolyte disturbances, resulting in cardiac dysrhythmias.
A patient has accidentally ingested about 4 ounces of drain cleaner. Your primary concern should be: A. Internal bleeding B. Metabolic alkalosis C. Decreased level of consciousness D. Potential airway compromise
D. Potential airway compromise
Your patient is an alcoholic who stopped drinking three days ago. Which of the following should concern you the most in the care of this patient? A. Abdominal cramps B. Command hallucinations C. Hypothermia D. Potential for seizures
D. Potential for seizures
Diphenhydramine is administered in anaphylaxis because it: A. Blocks histamine receptors B. Possibly reduces peripheral vasodilation C. Reduces histamine release from mast cells and basophils D. Produces all of the above
D. Produces all of the above
A 36-year-old female is conscious and alert and complaining of palpitations. She denies chest pain, difficulty breathing, or loss of consciousness but becomes "dizzy" with exertion. She states that she has been experiencing agitation, insomnia, intolerance to heat, and weight loss. Physical exam reveals exophthalmos and an enlarged thyroid gland. HR = 142 and regular, BP = 110/70, RR = 14 and regular. Which of the following would be most effective in treating this patient? A. 50 percent dextrose IV B. Synchronized cardioversion C. 250 cc fluid challenge D. Propranolol
D. Propranolol
Your patient is a 57-year-old male who is alert and oriented and complaining of a slight headache. His coworker states the patient "fainted." The patient describes feeling weak and lightheaded before the incident and "came to" lying on the floor. Medical history includes cardiovascular disease with a history of angina and hypertension. Medications include clopidogrel (Plavix), nitroglycerin, and metoprolol. Which of the following is LEAST helpful when formulating a field impression for this patient? A. Neurological exam B. Orthostatic vital signs C. Cardiac monitoring D. Pulse oximetry
D. Pulse oximetry
Your patient, who has a history of cholecystitis, is experiencing pain in her right shoulder. She is most likely experiencing ________ pain. A. Peritoneal B. Somatic C. Visceral D. Referred
D. Referred
Your patient is a 16-year-old male who attempted suicide. He is unconscious and apneic, lying supine on a garage floor. The family states they found the patient unconscious in the front seat of a car that was running in an enclosed garage. HR = 70, BP = 100/60, RR = 0. In addition to an IV of normal saline, which of the following is the most appropriate? A. Intubate, remove the patient from the garage, and transport to a hospital with a hyperbaric chamber. B. Remove the patient from the garage, initiate BVM ventilations with 100 percent oxygen, intubate, and transport to the nearest facility. C. Remove the patient from the garage, intubate, and transport to the nearest hospital. D. Remove the patient from the garage, initiate BVM ventilations with 100 percent oxygen, intubate, and transport to a hospital with a hyperbaric chamber.
D. Remove the patient from the garage, initiate BVM ventilations with 100 percent oxygen, intubate, and transport to a hospital with a hyperbaric chamber.
Which of the following is most likely to affect elimination of a medication? A. Metabolic alkalosis B. Hemorrhage C. Burns on more than 30 percent of the body surface area D. Renal disease
D. Renal disease
Which of the following structures FIRST allows gas exchange as air enters the lungs? A. Alveolar sacs B. Alveolar ducts C. Terminal bronchioles D. Respiratory bronchioles
D. Respiratory bronchioles
Prozac, Paxil, and Zoloft are all examples of: A. Monoamine oxidase inhibitors B. Phenothiazines C. Tricyclic antidepressants D. Selective serotonin reuptake inhibitors
D. Selective serotonin reuptake inhibitors
Prozac, Paxil, and Zoloft are all examples of: A. Monoamine oxidase inhibitors B. Tricyclic antidepressants C. Phenothiazines D. Selective serotonin reuptake inhibitors
D. Selective serotonin reuptake inhibitors
The primary goal in the prehospital care of a patient who has been bitten by a pit viper is to: A. Induce diuresis B. Alkalinize the urine C. Remove the venom from the surrounding tissue D. Slow absorption of the venom
D. Slow absorption of the venom
Which of the following statements about cough suppressants is TRUE? A. They may include mucolytics that greatly diminish sputum production. B. Non-opioid medications are available by prescription only. C. They often include expectorants that reduce the amount of sputum produced. D. Some cough suppressants contain opioid antitussives that can be habit forming.
D. Some cough suppressants contain opioid antitussives that can be habit forming.
Your patient is a 19-year-old female who is exhibiting generalized seizure activity. Her roommate states that she had a seizure that lasted about 3 minutes. She remained unresponsive, then started having another seizure about 5 minutes after the first. The patient has peripheral cyanosis and copious oral secretions. Which of the following is of HIGHEST priority for this patient? A. Starting an IV, administering succinylcholine, and intubation B. Starting an IV and administering 5 mg of diazepam C. Suctioning the airway, applying 15 liters per minute of oxygen by nonrebreathing mask D. Suctioning the airway, assisting ventilations with a bag-valve-mask device
D. Suctioning the airway, assisting ventilations with a bag-valve-mask device
Your patient is a 55-year-old male with a history of seizures who is on the floor and experiencing tonic-clonic motor activity. His jaw is clenched, he has peripheral cyanosis, and there are frothy secretions in his airway. HR = 130, RR = 4 and shallow, SaO2 = 88%. Which of the following is MOST appropriate? A. An IV of normal saline at a keep open rate, check blood glucose level, administer 3 mg of lorazepam, IV B. An IV of normal saline at a keep open rate, check blood glucose level, administer 5 mg of diazepam, IV C. Immediate nasal intubation and hyperventilation with 100 percent oxygen D. Suctioning the airway, inserting a nasopharyngeal airway, assisting respirations by bag-valve mask device with 100 percent oxygen
D. Suctioning the airway, inserting a nasopharyngeal airway, assisting respirations by bag-valve mask device with 100 percent oxygen
Which of the following findings would be atypical in a patient with a history of Cushing's syndrome? A. Blood glucose level of 190 mg/dL B. Bruising of the extremities C. Blood pressure of 154/86 mmHg D. Temperature of 101°F
D. Temperature of 101°F
A 35-year-old male complains of a "pressure"-type headache to the back of his head and neck. He states that he woke up with the discomfort this morning, and the pain has steadily gotten worse through the day. He denies any radiation of the pain and denies photophobia but states that he is slightly nauseated. Based on this clinical presentation, the paramedic should be suspicious of what type of headache? A. Cluster B. Vascular C. Migraine D. Tension
D. Tension
Your patient is complaining of pain secondary to epididymitis. Where should you expect the pain to be located? A. Flank B. Suprapubic region C. Lower left or right quadrant, depending on which side is affected D. Testes
D. Testes
In order for hemodialysis to be effective in ridding the body of excess electrolytes, which of the following statements must be true? A. The dialysate must contain electrolytes in a concentration higher than in the patient's blood. B. The dialysate must contain electrolytes in the same concentration as in the patient's blood. C. The dialysate must not contain electrolytes. D. The dialysate must contain electrolytes in a concentration lower than in the patient's blood.
D. The dialysate must contain electrolytes in a concentration lower than in the patient's blood.
Which of the following statements best explains why urinary tract infections are more common in females than in males? A. Bacteria from the vagina commonly enter the female urethra. B. The presence of estrogen in the lining of the female reproductive tract makes the mucous membranes more prone to infection. C. Males have more acidic urine, which is effective in eliminating bacteria from the urinary tract. D. The female urethra is shorter than those in males, more easily allowing bacteria to enter the rest of the urinary tract.
D. The female urethra is shorter than those in males, more easily allowing bacteria to enter the rest of the urinary tract.
Which of the following properly accounts for the differences between visceral and somatic pain? A. The nerves that carry somatic pain impulses enter the spinal column at various levels, while the nerves that carry visceral impulses enter the spinal column via specific nerve routes. B. Visceral pain originates in the walls of hollow organs, while somatic pain originates in skeletal muscle. C. Spilled organ contents and bacteria can result in visceral pain, while somatic pain is caused by organ distension. D. The nerves that carry visceral pain impulses enter the spinal column at various levels, while the nerves that carry somatic impulses enter the spinal column via specific nerve routes.
D. The nerves that carry visceral pain impulses enter the spinal column at various levels, while the nerves that carry somatic impulses enter the spinal column via specific nerve routes.
You have been called to treat a patient complaining of difficulty breathing. Which of the findings should concern you the most? A. The patient can speak only one to two words between breaths. B. The patient is sitting in the "tripod" position. C. The patient has a heart rate of 126. D. The patient is confused, agitated, and angry that you are trying to help him.
D. The patient is confused, agitated, and angry that you are trying to help him.
You have administered 25 g of 50 percent dextrose to a patient who was initially unresponsive with a blood glucose level of 23 mg/dL. Which of the following is the best indication that the patient's condition is improving? A. The heart rate decreases from 112 to 96 per minute. B. The patient seems less diaphoretic. C. The respiratory rate decreases from 24 to 16 per minute. D. The patient opens his eyes but is confused.
D. The patient opens his eyes but is confused.
Your patient is a 15-year-old asthmatic who has been having difficulty breathing for 45 minutes but does not have his Xopenex inhaler with him. Capnography shows an ETCO2 of 45 mmHg. The best way to interpret this finding is: A. This is a normal ETCO2, indicating that this is a mild asthma attack B. This is a high ETCO2, and the patient requires immediate ventilatory assistance to prevent respiratory arrest C. This is a low ETCO2 indicating that the patient is hyperventilating and thus in the early stages of an asthma attack D. The patient's ETCO2 first dropped as he began to hyperventilate but now is rising again and may continue to rise to dangerous levels
D. The patient's ETCO2 first dropped as he began to hyperventilate but now is rising again and may continue to rise to dangerous levels
Which of the following is NOT associated with the parasympathetic division of the autonomic nervous system? A. Vagal tone B. Cholinergic C. Craniosacral D. Thoracolumbar
D. Thoracolumbar
A finding of exophthalmos and goiter should increase your suspicion for a problem with the: A. Anterior pituitary gland B. Parathyroid gland C. Posterior pituitary gland D. Thyroid gland
D. Thyroid gland
A patient has a fever of 105°F, irritability, delirium, tachycardia, vomiting, and hypotension. These signs and symptoms are most consistent with: A. Myxedema B. Hypothyroidism C. Graves' disease D. Thyrotoxic crisis
D. Thyrotoxic crisis
The amount of air moved in and out of the lungs during a normal, quiet respiration is called: A. Dead space volume B. Functional reserve capacity C. Inspiratory capacity D. Tidal volume
D. Tidal volume
You are transporting a male patient with the complaint of expressive aphasia and right upper extremity paralysis to the hospital. When calling the hospital, which of the following pieces of information is it most critical to convey? A. SaO2 94% despite oxygen B. History of hypertension C. Blood pressure 168/82 mmHg D. Time of symptom onset
D. Time of symptom onset
Your patient is a 62-year-old female who is alert and oriented and sitting at her kitchen table. Her husband describes an episode of slurred speech and facial drooping that lasted about 10 minutes and resolved just before your arrival. Physical examination is unremarkable. She has no significant medical history and takes no medications. HR = 78, BP = 134/78, RR = 12, SaO2 = 99%. Which of the following is most likely? A. Stroke B. Méniére's disease C. Absence seizure D. Transient ischemic attack
D. Transient ischemic attack
Your patient is a 19-year-old male who ingested thirty 500 mg tablets of Tylenol 25 minutes ago. Police officers on the scene are requesting that you "check him out" before they transport him for psychiatric evaluation. The patient denies ingesting other drugs or alcohol and has no complaints. HR = 94, BP = 116/74, RR = 12, SaO2 = 98%. Which of the following would be most appropriate? A. Transport to the emergency department and administer sodium bicarbonate B. Release the patient to law enforcement custody C. Transport to the emergency department and administer activated charcoal D. Transport to the emergency department and start an IV of normal saline
D. Transport to the emergency department and start an IV of normal saline
Obstructive sleep apnea is a problem of the: A. Phrenic nerve B. Larynx and vocal cords C. Medulla oblongata D. Upper airway
D. Upper airway
Which of the following would most increase the likelihood of a urinary tract infection? A. Male gender B. Lack of sexual activity C. Prior history of renal calculi D. Urinary stasis
D. Urinary stasis
Which of the following is the appropriate method for preparing a site for venipuncture or injection? A. Use of a sanitizer B. Chemical sterilization C. Use of a disinfectant D. Use of an antiseptic
D. Use of an antiseptic
Which of the following cranial nerves is NOT part of the parasympathetic system? A. III B. VII C. IX D. VI
D. VI
Which of the following is NOT a source of a drug? A. Mineral B. Microorganism C. Animal D. Vegetable
D. Vegetable
Air entering and leaving the lungs via inspiration and expiration is known as: A. Oxygenation B. Perfusion C. Respirations D. Ventilation
D. Ventilation
What distinguishes verapamil (Calan, Isoptin) and diltiazem (Cardizem) from nifedipine (Procardia)? A. Verapamil and diltiazem are calcium channel blockers, whereas nifedipine is not. B. Nifedipine can be used only to treat anginal episodes. C. Only nifedipine causes smooth muscle relaxation. D. Verapamil and diltiazem reduce SA and AV node conductivity.
D. Verapamil and diltiazem reduce SA and AV node conductivity.
A plastic or glass container with a self-sealing rubber top is known as a(n): A. blister pack B. ampule C. prefilled syringe D. vial
D. Vial
What is a small, sterile glass or plastic container that usually contains a single dose of a solution? A. MDI B. Mix-O-Vial C. Ampule D. Vial
D. Vial
The order Hymenoptera includes: A. Jellyfish B. Spiders C. Scorpions D. Wasps
D. Wasps
An important distinction between analgesics and anesthetics is: A. analgesics are reversible, whereas anesthetics are not. B. anesthetics can be administered only intravenously. C. analgesics produce unconsciousness in high doses. D. anesthetics block all sensations.
D. anesthetics block all sensations.
Naloxone is an ________ to opioid receptors. A. analgesic B. agonist-antagonist C. agonist D. antagonist
D. antagonist
Medications instilled directly into the auditory canal to treat ear problems include all of the following, EXCEPT: A. ceruminolytic agents. B. topical anesthetics. C. antibacterial agents. D. anticholinergic agents.
D. anticholinergic agents.
You respond to an ill patient experiencing flu-like symptoms. Upon your arrival, the patient states that she woke up not feeling well. The patient states that she has been heating her home with wood due to the electric bill being too high. You should suspect: A. hypercarbia. B. hypothermia. C. carbon dioxide poisoning. D. carbon monoxide poisoning.
D. carbon monoxide poisoning.
Inhaled toxins: A. are eliminated by first-round metabolism. B. are immediately absorbed into the bloodstream. C. permeate the blood-brain barrier more quickly. D. cause damage and edema in the lungs.
D. cause damage and edema in the lungs.
Nicotinic receptors are found on all of the following, EXCEPT: A. cholinergic and adrenergic postganglionic neurons. B. skeletal muscle. C. spinal cord neurons. D. cholinergic and adrenergic preganglionic neurons.
D. cholinergic and adrenergic preganglionic neurons.
The endocrine system differs from the nervous system in the fact that it: A. directly regulates the brain. B. doesn't regulate anything in the body. C. controls the body without nerve impulses. D. controls the body with specialized chemical mediators.
D. controls the body with specialized chemical mediators.
The primary neurotransmitter of the sympathetic nervous system is: A. dopamine. B. acetylcholine. C. reteplase. D. epinephrine.
D. epinephrine.
Paradoxical movement is associated with: A. hemothorax. B. simple pneumothorax. C. tension pneumothorax. D. flail chest.
D. flail chest.
Your patient is complaining of "coughing up blood," or, in medical terms: A. hemopulmonary spasm. B. hemothorax. C. neoplasm. D. hemoptysis.
D. hemoptysis.
Following exposure to an allergen in which IgE antibodies are released, mast cells degranulate, releasing: A. insulin. B. T cells. C. epinephrine. D. histamine.
D. histamine.
Which of the following is an extrinsic risk factor that would increase the likelihood of a patient developing a respiratory disease? A. genetic disposition B. cardiac problems C. asthma D. history of cigarette use
D. history of cigarette use
A similarity all laxatives share is that they: A. increase bulk in the intestines. B. increase peristalsis via direct stimulation. C. reduce the molecular bonds of colon contents. D. increase the water content in the colon
D. increase the water content in the colon
Histamine causes the all of the following EXCEPT: A. vasodilation. B. increased permeability. C. bronchoconstriction. D. increased intracranial pressure.
D. increased intracranial pressure.
A tonic-clonic seizure is characterized by: A. a period of apnea. B. movement of one area of the body. C. flaccidity. D. increased muscle tone and rhythmic jerking.
D. increased muscle tone and rhythmic jerking.
Glucagon will affect blood glucose levels by: A. inducing the storage of glucose into the liver and skeletal muscle through glycogenesis. B. enabling the rapid absorption of glucose into the cells. C. enhancing the absorption of glucose from the gastrointestinal tract. D. inducing glycogenolysis and gluconeogenesis.
D. inducing glycogenolysis and gluconeogenesis.
All of the following statements about hormone replacement therapy (HRT) with estrogen are true EXCEPT that HRT: A. is often used to treat postmenopausal symptoms and osteoporosis. B. may increase the risk of breast cancer and stroke. C. has side effects that include nausea, fluid retention, and breast tenderness. D. ineffectively delays the onset of senile dementia in many patients.
D. ineffectively delays the onset of senile dementia in many patients.
You are evaluating a patient complaining of having a productive cough. The patient states the sputum is green to brown. You suspect: A. allergies. B. inflammation. C. hemoptysis. D. infection.
D. infection.
You are called to the scene of a patient who has just attempted suicide by ingestng detergent. You notice that the patient is coughing and has a hoarse voice. You suspect: A. subcutaneous emphysema. B. nothing, this is a normal finding for this patient. C. tracheal rupture. D. laryngeal edema.
D. laryngeal edema.
The entire nervous system is covered by the: A. pia mater. B. peritoneum. C. dura mater. D. meninges.
D. meninges.
Current treatment regimens for peptic ulcer disease may include all of the following, EXCEPT: A. proton pump inhibitors B. H2 receptor antagonists C. antacids D. nonsteroidal anti-inflammatory drugs (NSAIDs)
D. nonsteroidal anti-inflammatory drugs (NSAIDs)
One important distinction with potassium-sparing diuretics over other forms of diuretics is that potassium-sparing diuretics: A. exert their effects early in the nephritic process. B. are so potent that they are rarely used with other diuretics. C. are more efficient than loop diuretics in sodium and water reabsorption. D. not only decrease sodium reabsorption, they increase potassium reabsorption.
D. not only decrease sodium reabsorption, they increase potassium reabsorption.
The FDA's classification of a drug's treatment or therapeutic potential as "P" means that the drug: A. is an orphan drug. B. is indicated for AIDS and HIV-related disease. C. is similar to drugs already on the market. D. offers an important therapeutic gain.
D. offers an important therapeutic gain.
Two drugs that augment or replace posterior pituitary hormones are: A. glucagon and vasopressin. B. adenosine and vasopressin. C. insulin and glucagon. D. oxytocin and antidiuretic hormone.
D. oxytocin and antidiuretic hormone.
The acronym SLUDGE helps identify the effects of ________ drugs on the autonomic nervous system. A. sympatholytic B. sympathomimetic C. parasympatholytic D. parasympathomimetic
D. parasympathomimetic
Monoamine oxidase inhibitors (MAOIs) achieve their therapeutic effects by: A. blocking the norepinephrine receptor sites in the CNS. B. enhancing degradation of monoamine neurotransmitters at the synapses. C. enhancing the effects of monoamine oxidase at the synapse. D. preventing the breakdown of neurotransmitters, such as norepinephrine, in the CNS.
D. preventing the breakdown of neurotransmitters, such as norepinephrine, in the CNS.
A sudden disruption of pulmonary perfusion caused by a blood clot is known as: A. pulmonary diffusion. B. pulmonary edema. C. pulmonary occlusion. D. pulmonary embolism.
D. pulmonary embolism.
Beta-adrenergic antagonists reduce hypertension through all of the following effects, EXCEPT: A. diminishing reflex tachycardia as a compensatory response. B. suppressing renin release from the kidneys. C. a negative inotropic effect. D. reduction of peripheral vascular resistance through vasodilation.
D. reduction of peripheral vascular resistance through vasodilation.
ATIA typically: A. is caused by intracranial hemorrhage. B. can be reversible with tPA. C. never resolves. D. resolves within 24 hours.
D. resolves within 24 hours.
A prolonged deficiency of vitamin C may result in: A. kwashiorkor. B. increased bleeding. C. pernicious anemia. D. scurvy.
D. scurvy.
Initial exposure to an antigen is referred to as: A. anaphylaxis. B. allergy. C. desensitization. D. sensitization.
D. sensitization.
Ventilation is: A. the diffusion of the gas at the cellular level. B. the diffusion of gases at the alveoli. C. done to allow the gas to escape the chest wall. D. the mechanical process of moving air in and out of the lungs.
D. the mechanical process of moving air in and out of the lungs.
The hallmark treatment of ARDS is to: A. perform renal dialysis to remove the fluid. B. administer corticosteroids. C. treat the increased fluid with diuretics. D. treat the underlying condition.
D. treat the underlying condition.
All of the following changes in the geriatric patient affect the pharmacokinetics of a medication, EXCEPT: A. depressed liver function that may prolong drug action. B. decreased gastrointestinal motility. C. increased body fat and decreased muscle mass. D. uncompromised renal function.
D. uncompromised renal function.
You respond to a call of an ill person. Upon arrival, you find your patient complaining of diffuse abdominal pain and hematemesis. When asked, the patient states that the emesis was "coffee ground" in nature. You suspect: A. lower GI bleed. B. esophageal varices. C. melena. D. upper GI bleed.
D. upper GI bleed.
You respond to an ill patient. You note that the patient appears jaundiced and has a white frosty dust on his skin. You suspect: A. renal frost. B. scabies. C. eczema. D. uremic frost.
D. uremic frost.
Decreasing PaCO2 will cause: A. vasodilation. B. hyperventilation syndrome. C. ataxic respirations. D. vasoconstriction.
D. vasoconstriction.
Increasing PaCO2 will cause: A. hyperventilation syndrome. B. ataxic respirations. C. vasoconstriction. D. vasodilation.
D. vasodilation.
Your patient is a 48-year-old female who is alert and oriented after a possible seizure. Her friends state they witnessed her slump to the floor and "shake" for about 15 seconds. She awoke in less than 1 minute and was "a bit groggy" for a few minutes. She does not believe she had a seizure but thinks she may have fainted. Which of the following questions is LEAST important when differentiating seizure and syncope? A. "What happened just before the event?" B. "What kind of medications do you take?" C. "Do you have a history of seizures?" D. "Are you allergic to any medications?"
D. "Are you allergic to any medications?"
Your patient is a 22-year-old female in mild distress that is complaining of left lower quadrant abdominal pain and nausea. Which of the following questions would be LEAST helpful when determining the etiology of her abdominal pain? A. "Are you having any vomiting or diarrhea?" B. "When did the pain start?" C. "When did your last menstrual period start?" D. "Have you ever had a sexually transmitted disease?"
D. "Have you ever had a sexually transmitted disease?"
Your diabetic patient asks you why diabetics need to take insulin. Which of the following answers is most accurate? A. "Insulin breaks down glucose into proteins so it can be used by the cells for energy." B. "Insulin helps the body eliminate excess glucose through the kidneys." C. "Without insulin glucose is converted to ketone bodies, which are toxic in large quantities." D. "Insulin helps glucose enter the cells of the body so it can be used for energy."
D. "Insulin helps glucose enter the cells of the body so it can be used for energy."
Your diabetic patient asks you why diabetics need to take insulin. Which of the following answers is most accurate? A. "Insulin breaks down glucose into proteins so it can be used by the cells for energy." B. "Without insulin glucose is converted to ketone bodies, which are toxic in large quantities." C. "Insulin helps the body eliminate excess glucose through the kidneys." D. "Insulin helps glucose enter the cells of the body so it can be used for energy."
D. "Insulin helps glucose enter the cells of the body so it can be used for energy."
Which of the following questions would best help you determine if the pathology of a patient's complaint has been progressing? A. "When did your pain first start?" B. "Have you ever felt this pain before?" C. "On a scale of 1 to 10, with 10 being the worst pain possible, how would you rate this pain?" D. "On a scale of 0 to 10, with 10 being the worst pain possible, how would you have rated the pain when it started? How would you rate the pain now?"
D. "On a scale of 0 to 10, with 10 being the worst pain possible, how would you have rated the pain when it started? How would you rate the pain now?"
Your 43-year-old male patient is alert and oriented and complaining of abdominal pain. He states that he is experiencing nausea and has vomited twice. Which of the following is the most appropriate follow-up question? A. "What were you doing when the vomiting started?" B. "Did you become dizzy or faint while you were vomiting?" C. "Do you drink more than three alcoholic beverages a day?" D. "What did the material you vomited look like?"
D. "What did the material you vomited look like?"
Epilepsy affects roughly: A. 15% of the population. B. 10% of the population. C. 5% of the population. D. 1% of the population.
D. 1% of the population.
Which of the following patients are at risk for the most common cause of upper airway obstruction? A. 5-year-old female with epiglottitis B. 4-year-old male with croup C. 22-year-old female stung by a wasp D. 21-year-old female unconscious and supine on the floor
D. 21-year-old female unconscious and supine on the floor
You are examining a patient who was recently involved in a traumatic incident. You notice that the patient is now exhibiting periumbilical ecchymosis. This is known as: A. Grey Turner's sign. B. rigidity sign. C. Edwards sign. D. Cullen's sign.
D. Cullen's sign.
Which of the following treatment regimens for anaphylaxis lists the medications in the correct order of administration following oxygen? A. Dexamethasone, diphenhydramine, epinephrine B. Diphenhydramine, epinephrine, dexamethasone C. Epinephrine, dexamethasone, diphenhydramine D. Epinephrine, diphenhydramine, dexamethasone
D. Epinephrine, diphenhydramine, dexamethasone
You have administered glucagon to a diabetic patient. Which of the following should occur? A. Glycogenesis, resulting in a decreased blood glucose level B. Stimulation of the pancreatic alpha cells, resulting in lipolysis C. Stimulation of the pancreatic beta cells, resulting in a decreased blood glucose level D. Glycogenolysis, resulting in an increased blood glucose level
D. Glycogenolysis, resulting in an increased blood glucose level
Which of the following statements about the epidemiology of Graves' disease is TRUE? A. Graves's disease typically manifests late in adulthood. B. Obesity and poor dietary habits increase the risk of Graves' disease. C. Heredity does not predispose people to Graves' disease. D. Graves' disease is about six times more common in women than in men.
D. Graves' disease is about six times more common in women than in men.
What is the term for the time the body takes to clear one-half of a drug from the body? A. Therapeutic level B. Optimum dose C. Duration of action D. Half-life
D. Half-life
Your patient is a 52-year-old male complaining of shortness of breath. He is sitting up, alert, and oriented and appears to be in moderate respiratory distress. He states that he "always gets a chest cold in the winter" and describes a three-week history of productive cough and increasing shortness of breath. Physical examination reveals coarse rhonchi to the upper lobes bilaterally, air movement is decreased in the bases, and his skin is cool with peripheral cyanosis. You note that he is overweight and describes an 18-pack-a-year smoking history. Based on these clinical exam findings, the most clinically relevant finding you might also expect is: A. Barrel chest and increased anterior/posterior chest diameter B. Pulmonary edema and hypotension C. Pursed-lipped breathing D. JVD, pedal edema, and hepatic congestion
D. JVD, pedal edema, and hepatic congestion
Your patient is a 24-year-old male complaining of a headache for the past two days. He states he has taken aspirin but cannot get rid of the headache. The patient lives in a basement apartment, which you observe is very chilly. The patient states his furnace hasn't been working and he had to use the oven to help heat the apartment. Which other findings and complaints are most likely? A. Rash, nausea, a metallic taste in the mouth B. Pale skin, sluggish pupils, tachycardia C. Nausea, vomiting, decreased hemoglobin saturation D. Nausea, vomiting, confusion, tachypnea
D. Nausea, vomiting, confusion, tachypnea
You should most highly suspect that a patient with tremors, periodic muscular rigidity, slowed movement, and impaired balance and coordination suffers from: A. Amyotrophic lateral sclerosis B. Autonomic dysreflexia C. Peripheral neuralgia D. Parkinson's disease
D. Parkinson's disease
A condition seen in chronic alcoholics that causes ataxia, eye muscle weakness, and mental derangement is known as: A. Korsakoff's psychosis. B. Brugada syndrome. C. Wolff-Parkinson-White syndrome. D. Wernicke's syndrome.
D. Wernicke's syndrome.
At the cellular level, the treatment of seizures is generally accomplished by ________ the influx of ________ ions into the neural cells. A. enhancing; potassium B. enhancing; sodium and calcium C. inhibiting; potassium D. inhibiting; sodium and calcium
D. inhibiting; sodium and calcium
You are called to a scene for a report of "an unconscious man." When you arrive at the scene, the patient is conscious and alert, sitting on the front stairs with neighbors around him. He says he doesn't know what happened but is "Okay now, just a little woozy." You ask if you can assess him, but he refuses. You make several attempts to get him to change his mind, pointing out possible causes of the problem and possible consequences of refusing. He still says no, and you ask the neighbors if they can help the patient change his mind. Finally, you get the patient to sign a release from liability form and have it witnessed by one of the neighbors. As you leave, you document the call and your efforts to convince the patient to accept assessment/care. What else should you have done with this patient before leaving the scene? A.Consulted with medical direction online B.Urged the patient's neighbors to stay with him C.Advised the patient that he could call EMS again if the problem recurs D.All of the above
D.All of the above
Which of the following is best described as the unlawful touching of another individual without the individual's consent? A.Negligence B.Assault C.Malpractice D.Battery
D.Battery
Which of the following is NOT a component of a civil suit? A.Incident B.Investigation C.Discovery D.Imprisonment
D.Imprisonment
Which of the following is an example of good documentation? A.Vital information is kept secret between you and your partner. B.It is done prior to patient care. C.You use as many abbreviations as possible. D.It is thorough.
D.It is thorough.
_____________ often occurs in patients who have used CNS depressants and results from the patient being in a physical position that interferes with his airway or with ventilation. A.Res ipsa loquitur B.Excited delirium C.Defamation D.Restraint asphyxia
D.Restraint asphyxia
Which of the following is NOT one of the common elements of Good Samaritan laws offering protection to people who assist at scenes of medical emergencies? A.The person was not grossly negligent. B.The person accepted no payment for his services. C.The person acted in good faith. D.The person attempted to contact qualified emergency personnel.
D.The person attempted to contact qualified emergency personnel.
Which of the following statements about civil suits regarding torts is generally true? A.Guilt must be proven beyond a shadow of a reasonable doubt. B.The burden of proof rests on the defendant. C.Intent to harm must be proven. D.The plaintiff seeks to recover damages from the defendant.
D.The plaintiff seeks to recover damages from the defendant.
Which of the following is true in the event that off-duty paramedics provide advanced life-support interventions at an emergency scene? A.It is permissible as long as they have valid certification or licensure in that state. B.They will be granted immunity from negligence as long as they follow the standard of care. C.They are protected by Good Samaritan laws in all states. D.They may be charged with practicing medicine without a license.
D.They may be charged with practicing medicine without a license.
Your patient is a 16-year-old male with a reported history of ingesting 8 to 10 beers over the preceding 2 hours. He fell while jumping on a trampoline, striking his head on the metal framing of the trampoline. There was no reported loss of consciousness, but the patient has a laceration to the occipital area of the head. The patient is alert and oriented to person, time, and place but fails to show appropriate concern for his injury and has slurred speech. The parents are unavailable. Which of the following is the best course of action? A.Use the doctrine of res ipsa loquitur to support your decision to either treat and release or treat and transport. B.Have the patient arrested for underage drinking, and obtain the consent of law enforcement to treat the patient. C.Treat the patient as an emancipated minor and allow him to decide whether he wants treatment and transport. D.Treat the patient under the doctrine of implied consent of the parents.
D.Treat the patient under the doctrine of implied consent of the parents.
A written statement of a patient's preference for future medical care is a(n): A.power of attorney. B.deposition. C.patient narrative. D.advance directive.
D.advance directive.
The granting of permission by a governmental body for a qualified individual to engage in a particular profession or occupation is known as: A.reciprocity. B.registration. C.certification. D.licensure.
D.licensure.
When faced with unruly or violent patients who pose threats to themselves, paramedics, or others, the paramedic may control the patients by using: A.handcuffs. B.pepper spray. C.a taser. D.reasonable physical force.
D.reasonable physical force.
A civil wrong committed by one individual against another is a: A.breach of duty. B.felony. C.misdemeanor. D.tort.
D.tort.