Chapter 36-40
You are transporting a female patient who is seven months pregnant. She has been diagnosed with preeclampsia and is currently hypertensive. Which statement made by the patient indicates she may be transitioning from preeclampsia to eclampsia?
"I feel like I am going to have a seizure."
The EMT shows an understanding of newborn resuscitation when she states:
"Interventions in a newborn should be performed for 30 seconds followed by reassessment."
The EMT shows that he understands the seriousness of a prolapsed umbilical cord when he states:
"A prolapsed cord that is pinched can stop the flow of oxygen to the baby and must be addressed immediately."
The father of a developmentally challenged 45-year-old male summoned EMS because his son was "not acting right." The patient is awake, but is nonverbal, which is not typical according the father. Your assessment reveals no abnormalities, and vital signs are normal. When calling the chief complaint into the hospital, you would state that the patient:
"Is not acting normally per his father."
A 25-year-old female presents with abdominal pain. She appears thin and healthy, but in obvious distress. Of the many questions the EMT may ask, which one should the EMT ask early during the patient interview?
"Is there any possibility you are pregnant?"
A 5-year-old boy who is drooling has suspected epiglottitis. His pulse rate is 144 beats/min, respirations are 46 breaths/min, and blood pressure is 110/52 mmHg. The patient is noncompliant with the pulse oximeter, but his skin is normal colored. Which statement made by the EMT indicates proper care of this patient?
"Let's give him some supplemental oxygen."
You are presenting information on emergency care to a class of pregnant women. A participant asks you what the most frequent cause of injury is to a woman during pregnancy. What is the correct response?
"Motor vehicle collisions account for about half of all injuries sustained during pregnancy."
You have just arrived by the side of a 23-year-old female who is 37 weeks pregnant and apneic and pulseless after being shot in the abdomen. Regarding care of this woman, which statement would you provide to other rescuers on scene?
"Waiting for ALS backup is not beneficial; we need to provide CPR and get her to the hospital now!"
All of the following are signs of imminent delivery except
. the patient's water broke
What percentage of minor trauma involving pregnant patients results in fetal loss?
1-3 percent
For infants and children in respiratory distress or respiratory failure, the EMT should provide artificial ventilations at a minimum rate of _______ breaths per minute.
20
What would be an appropriate rate for performing artificial ventilations on an infant or a child who is apneic but still has a pulse?
20 breaths per minute
While examining a pregnant patient who has not received prenatal medical care, you note that you can palpate the uterine fundus at the level of the umbilicus. What is the approximate gestational age of the fetus?
20 weeks
Ectopic pregnancy is most common in women
25-34 years old
By the time a fetus reaches full term, the tidal volume of the female has increased by:
40 percent
During pregnancy, maternal blood volume increases by __________ percent.
45
Postpartum hemorrhage is the loss of ________ milliliters of blood following delivery.
500
When cutting the umbilical cord, it should be cut __________ inches from the infant.
6
The initial Apgar score should be completed at _______ seconds after birth.
60
According to the Centers for Disease Control and Prevention, _____ percent of adults are either overweight or obese.
70
You are treating a 6-month-old patient who was accidentally dropped down a flight of steps, when her mother stumbled at the top of the stairway. The infant will only open her eyes and moan to deep painful stimuli, and tries to withdraw from the pain. Given these findings, you calculate her Pediatric Glasgow Coma Scale score to be:
8
The EMT should recognize a full-term pregnancy has occurred in which patient?
A 21-year-old woman who is 39 weeks pregnant and feeling dizzy
Dementia is typically observed as:
A chronic and irreversible condition
When treating an injured geriatric patient, it is very important to:
Achieve an oxygen saturation of at least 95%
You have been summoned to a grocery store for a 6-year-old girl who has collapsed. On scene, you find the girl lying unresponsive on the floor. You quickly open the patient's airway and determine that she is not breathing. When you try to ventilate her with the bag-valve mask, you are unable to do so. Repositioning the head and reattempting ventilation is not successful in passing air into the lungs. What would your next action be?
Administer 30 chest compressions
You observe a traumatically injured 3-year-old female patient being secured to a long spine board with no padding behind the neck, shoulders, or back during a spine motion restriction intervention. What is the main concern with this oversight?
Airway compromise
At a long-term care facility, a nurse informs you that the patient whom you will be transporting has a peripherally inserted central catheter (PICC) in place. To find this catheter, you should look at the patient's:
Antecubital fossa
You are called to a nursing home for an elderly male patient who is unresponsive. On arrival, you find the patient in a wheelchair with a noticeable hematoma to his forehead and a skin tear to his left wrist. Staff states that the patient had an episode of chest pain just before suddenly passing out and falling to the ground. What should you do immediately?
Apply spine motion restriction precautions
Which of the following findings would best indicate that a patient with a cognitive impairment is able to live alone and care for himself?
Areas of the home in which a fall risk is present have been modified to reduce that risk.
When do most women experience a decrease in the nausea and vomiting associated with hyperemesis gravidarum?
Between 14 and 20 weeks
A type of machine that delivers a high pressure on inhalation and a lower pressure on exhalation is called
BiPAP.
When assessing the patient, which sign would raise your suspicion that the shunt is occluded?
Blood pressure of 260/126 mmHg
You are in the process of performing a field delivery and have just delivered the baby's head. What should you do next?
Check the neck for the umbilical cord
A patient who requires ongoing home medical oxygen complains of generalized weakness. Assessment indicates a patent airway and adequate respirations. His radial pulse is strong and regular, and his skin is warm and dry. Vital signs are pulse, 92 beats/min; respirations, 18 breaths/min; blood pressure, 156/88 mmHg; and SpO2, 95%. The patient is currently on 2 lpm of oxygen via an oxygen concentrator positioned bedside. What would be appropriate care in the management of this patient?
Continue oxygen administration at 2 lpm via nasal cannula during transport
You have been called to assist another crew with the birth of a baby. On scene, another EMT informs you that the mother's perineum tore and is bleeding heavily. You would:
Place a sterile dressing between the mother's vagina and rectum
Assessment of a pregnant patient in labor reveals what appears to be the baby's buttocks presenting at the vaginal opening. The EMT would immediately:
Place the patient in supine, head-down position, with hips elevated, and administer supplemental oxygen
Your patient is a 28-year-old woman in her third trimester who complains of vaginal bleeding with no pain. What is the most likely cause?
Placenta previa
The family of an 87-year-old female has called 911. The patient is confused and exhibiting improper and out-of-character behavior. The family informs you that the patient has diabetes, but takes pills and not insulin. They also state that she has been complaining of dizziness and has been drinking water nonstop as well as urinating. Assessment reveals adequate breathing, skin that is cool, and a radial pulse that is rapid and weak. The glucometer is malfunctioning and not providing a glucose reading. Based on her history, you should be suspicious of and treat the patient for:
Elevated blood sugar
In an unstable multitrauma patient, when should minor musculoskeletal injuries be splinted?
En route to the hospital if time perm
You have been called to a geriatric extended care facility for a 91-year-old female with pneumonia. The patient is to be transported to a local hospital for further treatment. When asked, the staff confirms and then produces the patient's Do Not Resuscitate (DNR) order. The patient's airway is patent, respirations labored, and skin warm, with an intact radial pulse. The vital signs are pulse, 124 beats/min; respirations, 20 breaths/min; blood pressure, 104/58 mmHg; SpO2, 91%; and temperature, 101.2°F. The patient also complains of chest discomfort and has a cough. Given this situation, the focus of your care should be:
Ensuring adequate oxygenation
Which disease or illness would you suspect when confronted with a pediatric patient exhibiting an acute onset of respiratory distress and an audible inspiratory stridor sound, but no cough?
Epiglottitis
When should the EMT instruct his partner to cut the umbilical cord?
Following delivery and after the baby has been dried off
You are assessing a 29-year-old pregnant female who has signs of imminent delivery. Her past medical history includes HIV infection. Compared to a patient with no infectious disease, how will standard precautions differ for this patient?
Gloves, a gown, and eye protection should be worn for both the patient with HIV and the noninfectious patient
Which single assessment finding is most consistent with a stable newborn?
Heart rate of 140 beats per minute
When treating a patient whom you believe has an ectopic pregnancy, you know that the primary threat to the patient's life is:
Hemorrhage
What is the most common reason for an EMS response to a patient with an implanted VAD?
Infection
Which statement regarding pediatric injury prevention is most accurate?
Injury prevention and accident prevention are not the same
Assessment of a 79-year-old female with a long history of medical complaints reveals tenderness and deformity to her left hip. Staff at the personal care home state that she slipped in some water and fell onto her buttocks. Currently, she is alert and oriented and describes the pain as 10/10. Regarding care of her leg, what is most appropriate care?
Maintain the leg in the position found and transfer the patient to a long spine board
What is the best location for assessing breath sounds in the pediatric patient?
Midaxillary region of the lungs
You have been called for a 2-week-old baby who is sick. Assessment reveals him to have a fever and rhonchi that is audible with a stethoscope over the lungs. Which of the additional assessment findings would be most concerning to you given the age of this patient?
Nasal passages occluded by mucus
A frantic mother has contacted EMS because she believes that her 4-year-old daughter got into her blood pressure medications and ate three or four pills. The patient presents as awake and oriented, with pale skin that is cool and diaphoretic. Her pulse is rapid and respirations adequate. Vital signs are pulse, 116 beats/min; respirations, 22 breaths/min; blood pressure, 82/44 mmHg; and SpO2, 99%. After completing the primary assessment, what would your immediate action be?
Obtain the name and dosage of the medication, and then call the poison control center
Which action demonstrates that the EMT is correctly performing uterine massage?
One hand cups the top of the uterus, with one of the hands positioned just above the symphysis pubis
An 85-year-old male with a history of heart attacks has called 911 for chest discomfort. He states that the pain started 2 hours ago when he was sitting on his porch. When asked, he states that it feels similar to his last heart attack, only this time he is also dizzy. The primary assessment indicates no life threats, and the Emergency Medical Responder on scene reports the following vital signs: pulse, 92 beats/min; respirations, 18 breaths/min; blood pressure, 88/52 mmHg; and SpO2, 92% on room air. The patient has nitroglycerin, but has not taken it yet (you have a standing order to administer nitroglycerin without calling medical direction). After applying oxygen, you should:
Perform the secondary exam
Which process introduces fluid into the peritoneal cavity via a port?
Peritoneal dialysis
Why are premature uterine contractions of concern in the pregnant trauma victim?
Premature contractions can cause the release of oxytocin, which can start labo
Which one of the following should be performed for an elderly trauma patient regardless of the severity of the mechanism of injury or level of responsiveness?
Rapid trauma assessment
The mother of a 2-year-old has called EMS because her son has an axillary temperature of 103.2°F. On scene, your assessment reveals the boy to be confused and lethargic, with a rectal temperature of 104.1°F. When caring for this child, you would:
Remove the child's clothes and sponge his body with tepid water
You have been dispatched to a residence for a female patient who is dizzy and "passing out." An Emergency Medical Responder meets you at the door and reports that the patient is lying in bed and is nine months pregnant. Her pulse rate is 112 beats per minute and her blood pressure is 84/50 mmHg. Respirations are 24 breaths per minute and she has a room air pulse oximetry reading of 97%. What should you do as soon as you reach the patient's side?
Roll her onto her left side
You have been called to a home for a female in labor. On scene, the family tells you that the 37-year-old patient is 42 weeks pregnant and wanted to have her baby at home naturally. The patient has been in labor for more than 24 hours, but suddenly began complaining of severe and tearing abdominal pain. Which condition should the EMT suspect?
Ruptured uterus
A 6-year-old male is in severe respiratory distress with inspiratory stridor. He has pale, moist skin, with cyanosis noted around his mouth. The patient is very lethargic and cannot hold his head up. His mother is panicked and reports that he has a history of asthma. Breath sounds are diminished and his vital signs are pulse, 162 beats/min; respirations, 40 breaths/min; blood pressure, 122/66 mmHg; and SpO2, 81%. What would your immediate action be?
Start positive pressure ventilation
A patient with a history of arteriosclerosis has:
Stiffened arteries
While assessing a patient with altered mental status, you note a catheter-like device projecting from the center of the patient's pelvic area. This is most likely a(n):
Suprapubic catheter
When you form an initial impression for a pediatric patient based on consciousness, breathing, and color, you are following:
The Pediatric Advanced Life Support (PALS) method
Assessment of a patient who complains of the sudden onset of chest discomfort reveals a central intravenous catheter to his right upper chest. While assessing this piece of medical equipment, which finding related to the catheter should be of greatest concern to the EMT?
The line is unclamped and without a cap
You are preparing to transport an 86-year-old female with an altered mental status who complains of nausea and vomiting. During transport, the occurrence of aspiration pneumonia would be best prevented by:
Transporting the patient in a semi-Fowler's position
Which finding is of greatest concern when assessing a 33-year-old female who is eight months pregnant?
Vaginal bleeding not associated with pain
A 36-year-old pregnant woman was the driver of a car that struck a tree while traveling at a slow speed. The patient is complaining of severe tearing abdominal pain and vaginal bleeding. The most likely injury to this patient is
abruptio placentae.
Patients with hydrocephalus have an excess accumulation of ________ in the cranial vault.
cerebrospinal fluid
The third stage of labor begins following
delivery of the baby.
A normal developmental characteristic of toddlers is that they
do not like to be touched
When assessing an elderly patient in a nursing home or extended-care facility who shows signs and symptoms of a respiratory disorder, the EMT should
don a HEPA or N-95 respirator.
The first step in emergency care for a pediatric patient in shock is
ensuring an open airway.
Paraplegia refers to paralysis
from the waist down.
_______ refers to the number of times a woman has been pregnant.
gravida
When dealing with a prolapsed cord, you should position the patient in the ______ position.
knee chest
Blood pressure readings in children ______ are unreliable due to their ability to compensate.
less than 3 years old
In assessing a toddler, the EMT knows that the rib cage is
much more pliable than the rib cage in adults.
The best place to check for signs of dehydration in the elderly patient is the
mucous membranes of the eyes and mouth.
_____is the area of skin between the vagina and the anus.
perineum
Fluid that has leaked into the space between the capillaries and alveoli of the lung may cause
pulmonary edema
When dealing with multisystem trauma, spine motion restriction
should be initiated as soon as possible if warranted.
If a tracheostomy opening is to be permanent, it is referred to as a
stoma.
Emergency care for an elderly patient experiencing a seizure includes
suctioning the airway as necessary.
When placing a patient in her third trimester in the supine position, the EMT must elevate the right hip 4 to 6 inches to prevent
supine hypotensive syndrome
The most common cause of hypoxia in the unconscious pediatric patient with a head injury is
the tongue
Vascular access devices are typically embedded in the ______ right side of the _____.
upper, abdomen
