Chapter 12: Medical Overview
"Why did you call for EMS today?" helps to determine the: A. chief complaint. B. past medical history. C. medications. D. provocation of pain.
A
A 33-year-old female presents with lower abdominal quadrant pain. She is conscious and alert, but in moderate pain. While your partner is asking her questions about her medical history, you take her vital signs. When you assess her radial pulse, you are unable to locate it. You should: A. assess the rate, regularity, and quality of her carotid pulse. B. immediately take her blood pressure to see if she is hypotensive. C. advise your partner that the patient's blood pressure is low. D. conclude that she is perfusing adequately since she is conscious.
A
After sizing up the scene of a patient with a possible infectious disease, your next priority should be to: A. take standard precautions. B. contact medical control. C. notify law enforcement. D. quickly access the patient.
A
An infectious disease is MOST accurately defined as: A. a medical condition caused by the growth and spread of small harmful organisms within the body. B. any disease that enters the body via the bloodstream and renders the immune system nonfunctional. C. a disease that can be spread from one person or species to another through a number of mechanisms. D. the invasion of the human body by a bacterium that cannot be destroyed by antibiotics or other drugs.
A
Early signs and symptoms of viral hepatitis include all of the following, EXCEPT: A. jaundice and abdominal pain. B. pain in the muscles and joints. C. vomiting, fever, and fatigue. D. loss of appetite and a cough.
A
End-tidal carbon dioxide (ETCO2) monitoring is clearly indicated for patients who present with: A. respiratory distress. B. high blood pressure. C. a headache. D. abdominal pain.
A
If an injury distracts an EMT from assessing a more serious underlying illness, he has suffered from: A. tunnel vision. B. index of suspicion. C. virulence. D. a trauma emergency.
A
Patients with tuberculosis pose the greatest risk for transmitting the disease when they: A. cough. B. have a fever. C. vomit. D. are bleeding.
A
The determination of whether a medical patient is a high-priority or low-priority transport is typically made: A. after the primary assessment has been completed. B. upon completion of a detailed secondary assessment. C. once the patient's baseline vital signs are known. D. as soon as the patient voices his or her chief complaint.
A
Typical chief complaints in patients with an infectious disease include: A. fever, rash, nausea, and difficulty breathing. B. crushing chest pain, vomiting, and weakness. C. joint pain, muscle aches, and blurred vision. D. headache, low back pain, and arm numbness.
A
Upon initial contact with a patient who appears to be unconscious, you should: A. attempt to elicit a verbal response by talking to the patient. B. squeeze the trapezius muscle to see if the patient responds. C. assess breathing depth and determine the respiratory rate. D. direct your partner to apply oxygen via nonrebreathing mask.
A
When assessing a patient with an infectious disease, what is the first action you should perform? A. Size up the scene and take standard precautions. B. Obtain a SAMPLE history. C. Hand the patient off to a paramedic. D. Cover your mouth and nose with your hand.
A
When performing a secondary assessment on a conscious patient with nontraumatic abdominal pain and stable vital signs, you should: A. focus on his or her chief complaint. B. examine him or her from head to toe. C. only palpate tender areas of the abdomen. D. prepare the patient for transport first.
A
Which of the following assessment findings is MOST indicative of a cardiovascular problem? A. jugular venous distention B. palpable pain to the epigastrium C. use of the accessory muscles D. unequal breath sounds
A
Which of the following conditions is NOT categorized as a psychiatric condition? A. substance abuse B. depression C. schizophrenia D. Alzheimer's disease
A
Which of the following statements about tuberculosis is FALSE? A. It is found in open, uncrowded living spaces. B. It can be found in crowded environments with poor ventilation. C. It is spread through the air via droplets. D. The primary infection is typically not serious.
A
Which of the following statements regarding the H1N1 virus is correct? A. It is only one type of influenza among the many other strains of influenza that exist and infect humans. B. H1N1 has caused more deaths worldwide than all of the other strains of influenza combined. C. H1N1, also known as the "swine flu," is a newly discovered strain of influenza for which no vaccine exists. D. Unlike other strains of the influenza virus, H1N1 is primarily transmitted via the fecal-oral route.
A
Which of the following will MOST reliably allow you to determine the nature of a patient's illness? A. asking questions related to the chief complaint B. focusing solely on how the call is dispatched C. trending of the patient's vital signs over time D. refraining from asking open-ended questions
A
You and your EMT partner arrive at the residence of a 50-year-old man who complains of weakness. Your primary assessment reveals that he is critically ill and will require aggressive treatment. The closest hospital is 25 miles away. You should: A. manage all threats to airway, breathing, and circulation and consider requesting an ALS unit. B. perform a detailed secondary assessment, assess his vital signs, and then transport rapidly. C. load him into the ambulance, begin transport, and perform all treatment en route to the hospital. D. administer oxygen via nonrebreathing mask and obtain as much of his medical history as possible.
A
An index of suspicion is MOST accurately defined as: A. the EMT's prediction of the type of illness a patient has based on how the call is dispatched. B. your awareness and concern for potentially serious underlying and unseen injuries or illness. C. determining the underlying cause of a patient's medical condition based on signs and symptoms. D. ruling out specific medical conditions based on the absence of certain signs and symptoms.
B
Factors that increase the risk for developing methicillin-resistant Staphylococcus aureus (MRSA) include: A. prior exposure to Mycobacterium tuberculosis. B. prolonged hospitalization, especially in an intensive care unit. C. failure to be vaccinated against any strain of hepatitis. D. a history of a respiratory illness within the past 6 to 8 weeks.
B
If you have been exposed to an HIV-positive patient's blood, you should: A. not worry about it, because transmission rates are low. B. seek medical advice as soon as possible. C. wait until your next doctor visit to seek evaluation. D. wash the area thoroughly and get an updated tetanus shot.
B
In addition to looking for severe bleeding, assessment of circulation in the conscious patient should involve: A. palpating the carotid pulse to determine the approximate rate and checking capillary refill time. B. checking the radial pulse and noting the color, temperature, and condition of his or her skin. C. applying a pulse oximeter probe to the finger to determine if peripheral perfusion is adequate. D. taking a blood pressure and determining if the patient is alert and oriented or confused.
B
In addition to obtaining a SAMPLE history and asking questions related to the chief complaint, what else should you inquire about when assessing a patient with a potentially infectious disease? A. HIV status B. recent travel C. drug allergies D. sexual practices
B
It is especially important to assess pulse, sensation, and movement in all extremities as well as pupillary reactions in patients with a suspected ___________ problem. A. endocrine B. neurologic C. cardiac D. respiratory
B
Reassessment of a patient with a medical complaint should begin by: A. taking another set of vital signs. B. repeating the primary assessment. C. reassessing the nature of illness. D. reviewing all treatment performed.
B
The _______ is your awareness and concern for potentially serious underlying and unseen injuries or illnesses. A. nature of illness B. index of suspicion C. general impression D. clinical impression
B
The primary prehospital treatment for most medical emergencies: A. focuses on definitive care because a diagnosis can usually be made. B. addresses the patient's symptoms more than the actual disease process. C. involves transport only until treatment can be performed at the hospital. D. typically does not require the EMT to contact medical control.
B
What should you do if you are exposed to a patient who is found to have pulmonary tuberculosis? A. Get the BCG vaccine. B. Get a tuberculin skin test. C. Undergo serious therapy. D. No precautions need to be taken.
B
When caring for a patient who takes numerous medications, it is best to: A. send the patient's medications to the hospital with a family member or other person who will safeguard them. B. take all of the patient's medications with you to the hospital and document them on your patient care report. C. let the hospital staff retrieve the patient's medical records, which should show a list of his or her current medications. D. document the medications on your patient care report, but leave them at home so they do not get misplaced.
B
When palpating the chest and abdomen, you are attempting to identify areas of: A. bruising. B. tenderness. C. crepitus. D. nausea.
B
Which statement regarding HIV is FALSE? A. It is not easily transmitted in your work environment. B. It is not considered a hazard when deposited on mucous membranes. C. You should always wear gloves when treating a patient with HIV. D. Many patients with HIV do not show symptoms.
B
Your patient is having respiratory difficulty and is not responding to your treatment. What is the best method of transport? A. Without lights and sirens, to the closest hospital B. With lights and sirens, to the closest hospital C. Air transport, to a special facility located 30 miles away D. The patient does not need to be transported.
B
Your patient is complaining of fever, headache, stiffness of the neck, and red blotches on his skin. He most likely has: A. tuberculosis. B. hepatitis B. C. SARS. D. meningitis.
D
A patient suffering from a heart attack should be transported to: A. a local clinic, 5 minutes away. B. a community hospital with no catheterization lab, 10 minutes away. C. a university hospital with a catheterization lab, 15 minutes away. D. a trauma center, 20 minutes away.
C
A seizure patient is having what kind of medical emergency? A. Respiratory B. Cardiovascular C. Neurologic D. Immunologic
C
If a "frequent flier" calls 9-1-1 because of a suspected head injury, you should NEVER: A. take the call seriously; don't waste your time or resources on such a caller. B. perform a primary assessment; he called for a head injury last week, and it wasn't serious. C. assume you know what the problem is; every case is different, and you don't want to miss a potentially serious problem. D. treat the patient with respect; he is probably lying.
C
If your patient is alone and unresponsive, in order to obtain some form of medical history, you should: A. ask people in the neighborhood. B. go through the patient's wallet. C. search the scene for medication containers or medical devices. D. search through the patient's bedroom drawers for hidden illegal drugs.
C
In which of the following situations would it be MOST appropriate to utilize an air medical transportation service? A. 43-year-old man experiencing a heart attack, and the closest appropriate hospital is 15 minutes away B. 29-year-old woman who is 18 weeks pregnant, has light vaginal bleeding, and stable vital signs C. 61-year-old man with signs and symptoms of a stroke and your ground transport time is 50 minutes D. 50-year-old conscious woman with severe nausea and vomiting, fever, and chills of 3 days' duration
C
Patients who are being treated with penicillin for a syphilis infection are considered: A. communicable for the rest of their life. B. noncommunicable in about 4 weeks. C. noncommunicable within 28 to 48 hours. D. noncommunicable right from the initial infection.
C
Syphilis is a: A. high-risk disease to the EMT, especially through a needlestick. B. bacterial infection that is typically resistant to antibiotic medications. C. bloodborne disease that can successfully be treated with penicillin. D. sexually transmitted disease that is only found in vaginal secretions.
C
The incubation period for hepatitis B is typically: A. 1 to 2 weeks. B. 5 to 10 weeks. C. 4 to 12 weeks. D. 1 to 10 weeks.
C
The most important aspect of the scene size-up is: A. determining the number of patients. B. calling for additional resources. C. ensuring scene safety. D. determining the nature of illness.
C
Vaccinations are NOT available for which form of hepatitis? A. Hepatitis A B. Hepatitis B C. Hepatitis C D. None of the above
C
Which of the following conditions often requires transport to a hospital with specialized capabilities that may not be available at the closest hospital? A. cardiac arrest and shock B. diabetes and migraines C. stroke and heart attack D. seizures and infection
C
Which of the following statements regarding severe acute respiratory syndrome (SARS) is correct? A. Although SARS can cause pneumonia and other respiratory infections, it rarely causes death, even in immuno compromised patients. B. Most cases of SARS are caused by a bacterium that is spread from person to person via direct contact with infected blood. C. SARS is caused by a virus and usually starts with flulike symptoms that deteriorate to pneumonia and respiratory failure. D. SARS is caused by a virus that occurs naturally in the bird population, although it usually does not cause illness in humans.
C
You have just completed your primary assessment of a 48-year-old man with crushing chest pain. The patient has been given 324 mg of aspirin and is receiving high-flow oxygen via nonrebreathing mask. As you begin your secondary assessment, you note that his mental status has deteriorated and he is now bradycardic. You should: A. continue with your secondary assessment. B. insert a nasal airway and assist his breathing. C. prepare the patient for immediate transport. D. request an ALS unit to respond to the scene.
C
You should assess pulse, motor, and sensation in all of the extremities and check for pupillary reactions if you suspect a _______ problem. A. cardiovascular B. endocrine C. neurologic D. psychological
C
Your patient believes he has hepatitis and is now exhibiting signs of cirrhosis of the liver. He most likely has: A. hepatitis A. B. hepatitis B. C. hepatitis C. D. hepatitis D.
C
A 58-year-old man complains of chest discomfort and nausea. He is conscious and alert; his blood pressure is 140/90 mm Hg, his pulse is 104 beats/min, and his respirations are 16 breaths/min. Your partner has applied supplemental oxygen. Prior to assisting the patient with one of his prescribed nitroglycerin tablets, you ask him if he takes medication to treat erectile dysfunction and he tells you that he does. You should: A. administer his nitroglycerin and then reassess his blood pressure. B. avoid giving him nitroglycerin and transport him at once. C. recall that erectile dysfunction drugs can cause hypertension if given with nitroglycerin. D. ask him what he takes, how much, and when he last took it.
D
A patient who presents with a headache, fever, confusion, and red blotches on his or her skin should be suspected of having: A. hantavirus. B. hepatitis. C. tuberculosis. D. meningitis.
D
A patient who was bitten by a mosquito and presents with signs and symptoms of illness should be suspected of having: A. hantavirus. B. avian flu. C. lyme disease. D. West Nile virus.
D
All of the following are factors that increase the risk for developing MRSA, EXCEPT: A. antibiotic therapy. B. prolonged hospital stays. C. exposure to an infected patient. D. close contact with wild birds.
D
Hepatitis B is more virulent than hepatitis C, which means that it: A. is less resistant to treatment. B. is a more contagious type of disease. C. leads to chronic infection after exposure. D. has a greater ability to produce disease.
D
If your medical patient is not in critical condition, how long should you spend on scene? A. 10 minutes or less B. 30 minutes C. 2 hours D. However long it takes to gather as much information as possible
D
In contrast to the assessment of a trauma patient, assessment of a medical patient: A. is not as complex for the EMT because most patients typically present with classic symptoms. B. requires a thorough head-to-toe exam that involves a detailed assessment of all body systems. C. almost exclusively focuses on physical signs that indicate the patient is experiencing a problem. D. is focused on the nature of illness, the patient's chief complaint, and his or her symptoms.
D
In contrast to viral hepatitis, toxin-induced hepatitis: A. can be prevented with a vaccination. B. typically does not cause yellow skin. C. is a far more transmittable disease. D. is not a communicable disease.
D
Patients with altered mental status should be considered _______ when determining transport options. A. nonemergency B. low priority C. moderate priority D. high priority
D
Ten days after treating a 34-year-old patient with tuberculosis, you are given a tuberculin skin test, which yields a positive result. This MOST likely indicates that: A. you contracted the disease by casual contact instead of exposure to secretions. B. the disease is dormant in your body, but will probably never cause symptoms. C. you are actively infected with tuberculosis and should be treated immediately. D. you were exposed to another infected person prior to treating the 34-year-old patient.
D
The greatest danger in displaying a personal bias or "labeling" a patient who frequently calls EMS is: A. demeaning or humiliating the patient and his family. B. discouraging the patient from calling EMS in the future. C. making the entire EMS system look unprofessional. D. overlooking a potentially serious medical condition.
D
The secondary assessment of a medical patient: A. should be performed at the scene, especially if the patient is critically ill. B. is typically limited to a focused exam for patients who are unconscious. C. should routinely include a comprehensive examination from head to toe. D. is not practical if the patient is critically ill or your transport time is short.
D
When assessing a patient with a medical complaint, which of the following would MOST likely reveal the cause of his or her problem? A. rapid body scan B. primary assessment C. baseline vital signs D. history taking
D
When caring for a patient with an altered mental status and signs of circulatory compromise, you should: A. transport immediately and begin all emergency treatment en route to the hospital. B. perform a detailed secondary assessment prior to transporting the patient. C. have a paramedic unit respond to the scene if it is less than 15 minutes away. D. limit your time at the scene to 10 minutes or less, if possible.
D
When forming your general impression of a patient with a medical complaint, it is important to remember that: Choose one answer. A. most serious medical conditions do not present with obvious symptoms. B. the majority of medical patients you encounter are also injured. C. it is during the general impression that assessment of the ABCs occurs. D. the conditions of many medical patients may not appear serious at first.
D
Which of the following medications would the EMT LEAST likely administer to a patient with a medical complaint? A. albuterol B. oral glucose C. aspirin D. naloxone (Narcan)
D
Which of the following statements regarding hepatitis A is correct? A. Hepatitis A is primarily transmitted via contact with blood or other body fluids. B. Infection with hepatitis A causes chronic illness with a high mortality rate. C. Although there is no vaccine against hepatitis A, treatment is usually successful. D. Hepatitis A can only be transmitted by a patient who has an acute infection.
D
Which of the following statements regarding methicillin-resistant Staphylococcus aureus (MRSA) is correct? A. The communicable period for MRSA is 10 days to 2 weeks after being infected. B. Most cases of MRSA transmission occur following an accidental needlestick. C. Studies have shown that less than 1% of health care providers are MRSA carriers. D. MRSA is a bacterium that causes infections and is resistant to most antibiotics.
D
Which of the following statements regarding the human immunodeficiency virus (HIV) is correct? A. The risk of HIV infection is high, even if an infected person's blood comes in contact with your intact skin. B. HIV is far more contagious than hepatitis B and is easily transmitted in the health care setting. C. Most patients who are infected with HIV experience chronic symptoms that vary in duration and severity. D. The risk of HIV infection is greatest when deposited on a mucous membrane or directly into the bloodstream
D
Your primary assessment of an elderly woman reveals that she is conscious and alert, but is experiencing difficulty breathing. She has a history of emphysema, hypertension, and congestive heart failure. As you assess the patient's circulatory status, you should direct your partner to: A. retrieve the stretcher and prepare for transport. B. assess her oxygen saturation and blood pressure. C. perform a head-to-toe secondary assessment. D. administer oxygen with the appropriate device.
D
_______ is a bacterium that causes infections and is resistant to most antibiotics. A. Meningitis B. Tuberculosis C. Hepatitis C D. MRSA
D