Chapter 44-52

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51 A key element of the "G" in the GEMS diamond includes: Select one: A. obtaining a complete medical history from the patient. B. assessing the elderly patient's activities of daily living. C. checking the physical condition of the patient's home. D. recalling that elderly patients often present atypically.

Geriatric Patient Assessment, page 2216 The correct answer is: recalling that elderly patients often present atypically.

18 After obtaining an elderly patient's chief complaint, gathering additional information about the history of present illness would MOST likely be complicated because: Select one: A. the patient may ask you to repeat your questions. B. the aging process causes difficulty in understanding. C. most elderly patients take numerous medications. D. chronic problems may affect the acute problem.

Geriatric Patient Assessment, pages 2217-2219 The correct answer is: chronic problems may affect the acute problem.

22 When providing treatment to a patient while he or she is being rescued, it is MOST important to: Select one: A. follow the orders of the person in charge of the rescue. B. provide reassurance to the patient during the rescue effort. C. advise all personnel that they are to follow your directions. D. administer high-flow oxygen throughout the entire rescue.

Guidelines for Rescue Operations, page 2362 The correct answer is: follow the orders of the person in charge of the rescue.

53 Common complications associated with cerebral palsy include all of the following, EXCEPT: Select one: A. cardiovascular disease. B. seizures. C. mental retardation. D. visual impairment.

Other Notable Chronic Medical Conditions, page 2286 The correct answer is: cardiovascular disease.

55 Safe practices when parking your emergency vehicle on a roadway at night include all of the following, EXCEPT: Select one: A. wearing a reflective vest. B. leaving the headlights on. C. using your emergency flashers. D. turning off the strobe lights.

Defensive Emergency Vehicle Driving Techniques, pages 2315-2316 The correct answer is: leaving the headlights on.

60 Components of the environmental assessment of an elderly patient include all of the following, EXCEPT: Select one: A. ensuring that food is adequate and unspoiled. B. assessing for the odor of urine or feces. C. looking for rotted floors or faulty wiring. D. inquiring about any delays in obtaining food.

Geriatric Patient Assessment, page 2216 The correct answer is: inquiring about any delays in obtaining food.

66 Air ambulances are advantageous for all of the following reasons, EXCEPT: Select one: A. more experience of the flight paramedics. B. faster transport to definitive care. C. the ability to access remote areas. D. the availability of specialized equipment.

Air Medical Transport, pages 2320-2321 The correct answer is: more experience of the flight paramedics.

85 After a helicopter lands and continues to keep its rotor blades active, you should: Select one: A. approach the aircraft from the front and keep the pilot in view at all times. B. slowly approach the left side of the aircraft while keeping your head down. C. not approach the aircraft until the pilot or a crew member signals you to do so. D. post a firefighter near the tail rotor to keep bystanders away.

Air Medical Transport, pages 2323-2324 The correct answer is: not approach the aircraft until the pilot or a crew member signals you to do so.

17 Unique dangers associated with confined spaces include: Select one: A. hyperoxic injury. B. sharp metal structures. C. carbon dioxide deficiency. D. limited ventilation.

Additional Specialized Rescue Situations, page 2378 The correct answer is: limited ventilation.

40 In which of the following situations should a helicopter generally NOT be utilized? Select one: A. Spinal injury in which the terrain over which the patient must be carried is rough B. Suspected internal hemorrhage in a hypotensive patient who lives in a rural area C. Motor vehicle crash involving a patient whose extrication will take 45 minutes D. A patient in cardiopulmonary arrest who has been unresponsive to defibrillation

Air Medical Transport, page 2320 The correct answer is: A patient in cardiopulmonary arrest who has been unresponsive to defibrillation

52 The MOST important factor to consider when determining if transport of a trauma patient via helicopter is appropriate is: Select one: A. the patient's hemodynamic status. B. the injury mechanism that was involved. C. delays in ground transport due to traffic. D. the need for definitive airway management.

Air Medical Transport, pages 2319-2322 The correct answer is: the patient's hemodynamic status.

44 Which of the following types of maltreatment involves isolating the victim from others, resulting in a substantial change in the victim's behavior or cognitive function? Select one: A. Neglect B. Emotional abuse C. Abandonment D. Sexual exploitation

Care of Patients When Abuse or Neglect Is Suspected, page 2254 The correct answer is: Emotional abuse

83 Down syndrome is a condition in which: Select one: A. a triplication of chromosome 21 occurs. B. the ovum contains 21 chromosomes. C. chromosome 23 fails to separate. D. the human somatic cell contains 24 chromosomes.

Care of Patients With Cognitive, Sensory, or Communication Impairment, page 2279 The correct answer is: a triplication of chromosome 21 occurs.

89 Intellectual disability is MOST accurately defined as: Select one: A. the inability to provide adequate self-care because of intense emotional abuse during childhood. B. insufficient development of the brain that results in the inability to learn and socially adapt at the usual rate. C. a genetic condition in which the patient is unable to interact normally and acts younger than his or her peers. D. a substandard intelligence quotient secondary to a congenital infection or complications at birth.

Care of Patients With Cognitive, Sensory, or Communication Impairment, page 2279 The correct answer is: insufficient development of the brain that results in the inability to learn and socially adapt at the usual rate.

text Dysarthria is: Select one: A. the inability to make speech sounds correctly. B. a speech disorder that primarily affects adults. C. the loss of ability to communicate in speech or writing. D. caused by damage to the language center of the brain.

Care of Patients With Cognitive, Sensory, or Communication Impairment, page 2283 The correct answer is: the inability to make speech sounds correctly.

77 Assumptions by the paramedic based on stereotypes of a particular communicable disease: Select one: A. will expose the paramedic to legal action. B. are a violation of the patient's privacy. C. will maximize the paramedic's safety. D. serve only to undermine patient care efforts.

Care of Patients With Communicable Diseases, pages 2260-2261 The correct answer is: serve only to undermine patient care efforts.

32 Morbid obesity is defined as a body mass index that is: Select one: A. between 30 and 39.9 kg/m2. B. between 40 and 49.9 kg/m2. C. greater than 50 kg/m2. D. greater than 30 kg/m2.

Care of Bariatric Patients, page 2259 The correct answer is: between 40 and 49.9 kg/m2.

21 A terminal illness is MOST accurately defined as a(n): Select one: A. disease that is fatal in greater than 50% of a given population, even with timely treatment. B. disease process that is expected to cause death within 6 months, verified by a physician. C. disease that will ultimately cause death due to a lack of effective medical treatment. D. disease process that will ultimately require ongoing treatment in order to prevent death.

Care of Patients With Terminal Illness, page 2258 The correct answer is: disease process that is expected to cause death within 6 months, verified by a physician.

47 Unless the fluid level is low, you should NOT uncap the brake fluid reservoir because: Select one: A. air will be drawn into the hydraulic brake lines. B. doing so releases pressure within the brake lines. C. the reservoir is pressurized and may cause burns. D. brake fluid absorbs moisture from the atmosphere.

Checking the Emergency Vehicle, page 2307 The correct answer is: brake fluid absorbs moisture from the atmosphere.

93 Which of the following statements regarding belt noise is correct? Select one: A. Belt noise is a squealing sound related to a load on one of the belt-operated appliances. B. Belt noise is a sign that the engine's alternator or water pump is malfunctioning. C. Belt noise is a low-pitched drone that is synchronous with road speed. D. The noise made from an engine belt is usually harmless and corrects itself.

Checking the Emergency Vehicle, pages 2306-2307 The correct answer is: Belt noise is a squealing sound related to a load on one of the belt-operated appliances.

24 Aging is a linear process, which means that: Select one: A. older adults experience decreased functions faster than younger adults. B. the older we get, the faster our bodies decline in function. C. the rate at which we lose functions does not increase with age. D. older people exhibit the cumulative results of a longer aging process.

Geriatric Anatomy and Physiology, page 2208 The correct answer is: the rate at which we lose functions does not increase with age.

80 When transporting a small child on the stretcher, you should: Select one: A. secure the child as usual, using the adult straps on the stretcher. B. place the child on a backboard, even in the absence of trauma. C. use a pediatric transport securing device whenever possible. D. place the child on a parent's lap and secure them both with straps.

Defensive Emergency Vehicle Driving Techniques, page 2313 The correct answer is: use a pediatric transport securing device whenever possible.

20 As you approach the scene of a car crash, you see two badly damaged vehicles that are off the road to the right. Where should you park the ambulance? Select one: A. 100 feet before the crash site on the right side of the road B. 100 feet past the crash site on the right side of the road C. 100 feet before the crash site on the left side of the road D. 100 feet past the crash site on the left side of the road

Defensive Emergency Vehicle Driving Techniques, page 2315 The correct answer is: 100 feet past the crash site on the right side of the road

23 The paramedic should NOT operate an emergency vehicle if he or she: Select one: A. has worked more than 12 straight hours. B. is taking a cold remedy or an analgesic. C. just finished an intense exercise regimen. D. is a personal acquaintance of the patient.

Defensive Emergency Vehicle Driving Techniques, page 2312 The correct answer is: is taking a cold remedy or an analgesic.

91 When you are dispatched to an emergency, it is MOST important to: Select one: A. take a route that will ensure a fast response time. B. use your lights and siren to warn other motorists. C. determine which route will be used to arrive safely. D. use GPS to ensure accurate navigation to the scene.

Defensive Emergency Vehicle Driving Techniques, page 2313 The correct answer is: determine which route will be used to arrive safely.

57 While responding to an emergency scene, you approach a sharp turn in the road. What should you do? Select one: A. Carefully apply the brakes while cornering the turn at your current speed. B. Slow the vehicle to the posted speed limit and avoid braking during the turn. C. Slow the vehicle's speed and smoothly pump the brakes will making the turn. D. Corner the turn at its widest point, unless you see an oncoming vehicle.

Defensive Emergency Vehicle Driving Techniques, pages 2316-2317 The correct answer is: Slow the vehicle to the posted speed limit and avoid braking during the turn.

50 The signs, symptoms, clinical presentation, and treatment for cancer largely depends on: Select one: A. the gender of the patient. B. the present location of the cancer. C. the patient's family history. D. whether or not the patient has diabetes.

Other Notable Chronic Medical Conditions, page 2286 The correct answer is: the present location of the cancer.

86 What entity is responsible for making recommendations regarding infection control practices that include all areas of personal protective equipment, sharps containers, and disinfecting equipment that is carried on an emergency vehicle? Select one: A. United States Department of Transportation B. Occupational Safety and Health Administration C. National Highway Traffic Safety Administration D. Centers for Disease Control and Prevention

Emergency Vehicle Equipment, page 2305 The correct answer is: Occupational Safety and Health Administration

39 In a tiered response EMS system: Select one: A. an ambulance with two paramedics makes the initial response to every EMS call. B. an EMS system attempts to assign ALS ambulances only where they are needed. C. a first response vehicle, BLS ambulance, and ALS ambulance respond to every call. D. every ALS ambulance that responds has at least three paramedics on board.

Emergency Vehicle Staffing and Development, page 2309 The correct answer is: an EMS system attempts to assign ALS ambulances only where they are needed.

68 An increase in blood pressure that commonly occurs with aging is physiologically exacerbated by: Select one: A. the patient's noncompliance with his or her antihypertensive drugs. B. a decrease in stroke volume due to age-induced cardiomyopathy. C. an overproduction of collagen and decreased quantities of elastin. D. a compensatory increase in preload and cardiac ejection fraction.

Geriatric Anatomy and Physiology, page 2209 The correct answer is: an overproduction of collagen and decreased quantities of elastin.

71 Failure of the heart's primary pacemaker and the development of alternate pacemakers in the atria would MOST likely result in: Select one: A. atrial fibrillation. B. ventricular ectopy. C. atrioventricular block. D. junctional rhythms.

Geriatric Anatomy and Physiology, page 2209 The correct answer is: atrial fibrillation.

33 Preparedness in a given area should involve decisions and planning about: Select one: A. major disasters, such as tornadoes and earthquakes. B. the most likely disasters for the area, among other disasters. C. the most common disasters encountered throughout the world. D. international terrorist attacks and catastrophic natural disasters.

EMS Response Within The Incident Command System, page 2340 The correct answer is: the most likely disasters for the area, among other disasters.

34 After ensuring your own safety, you should consider the safety of, in order: Select one: A. your partner, other rescuers, the patient, and any bystanders. B. your partner, the patient, other rescuers, and any bystanders. C. the patient, other rescuers, any bystanders, and your partner. D. the patient, your partner, any bystanders, and other rescuers.

EMS Response Within The Incident Command System, page 2340 The correct answer is: your partner, other rescuers, the patient, and any bystanders.

96 When functioning at the scene of a major incident, communication should: Select one: A. be face to face to minimize radio traffic. B. occur via radio to keep everyone updated. C. incorporate signals for privacy purposes. D. involve the use of codes to limit air time.

EMS Response Within The Incident Command System, page 2341 The correct answer is: be face to face to minimize radio traffic.

63 An elderly person is at increased risk for aspiration, primarily from: Select one: A. atrophy of the epiglottis. B. decreased cough and gag reflexes. C. slowing of the ciliary mechanisms. D. a decreased ability to swallow.

Geriatric Anatomy and Physiology, page 2209 The correct answer is: decreased cough and gag reflexes.

87 MOST age-related visual disturbances are the result of: Select one: A. macular degeneration. B. cataracts or glaucoma. C. retinal artery occlusion. D. diabetic retinopathy.

Geriatric Anatomy and Physiology, page 2210 The correct answer is: cataracts or glaucoma.

98 Aging kidneys have a decreased glomerular filtration rate, which predisposes an older person to all of the following conditions, EXCEPT: Select one: A. profound dehydration. B. hyperkalemia. C. acute volume overload. D. hypernatremia.

Geriatric Anatomy and Physiology, page 2212 The correct answer is: profound dehydration.

10 Aging brings a widespread decrease in bone mass, especially: Select one: A. if the person falls frequently. B. in the presence of hypertension. C. in postmenopausal women. D. in men over 50 years of age.

Geriatric Anatomy and Physiology, page 2213 The correct answer is: in postmenopausal women.

13 Decreased elasticity of the lungs and calcification of the costochondral cartilage results in: Select one: A. a significant increase in vital capacity. B. an increase in residual lung volume. C. a decrease in airway size and resistance. D. a decrease in the total amount of air in the lungs.

Geriatric Anatomy and Physiology, pages 2208-2209 The correct answer is: an increase in residual lung volume.

94 Physiologic age-related decreases in skin elasticity are the result of: Select one: A. decreased collagen and elastin production. B. slower replenishment of epidermal cells. C. chronic use of corticosteroid medications. D. frequent fungal or viral skin infections.

Geriatric Anatomy and Physiology, pages 2212-2213 The correct answer is: decreased collagen and elastin production.

36 A closed, or contained, multiple-casualty incident is a situation that: Select one: A. involves no more than 10 patients who are critically injured. B. is not expected to produce more patients than initially present. C. does not have the potential to grow in size or complexity. D. does not require mutual aid assistance from other agencies.

Mass-Casualty Incidents, page 2344 The correct answer is: is not expected to produce more patients than initially present.

1 Which of the following is the MOST difficult aspect of being a triage leader? Select one: A. Documenting all the activities that occur in the triage area B. Communicating with the EMS branch on your progress C. Ensuring the movement of all patients to a treatment area D. Not initiating treatment until all patients have been triaged

Medical Incident Command, page 2342 The correct answer is: Not initiating treatment until all patients have been triaged

25 At the present time, the ratio of caregivers to older people is: Select one: A. adequate. B. high. C. low. D. increasing consistently.

Introduction, page 2207 The correct answer is: low.

8 The use of the lights and siren on an ambulance: Select one: A. gives you the legal right-of-way. B. is a request for the right-of-way. C. is statistically the safest mode of transport. D. enables you to exceed the speed limit.

Introduction, page 2304 The correct answer is: is a request for the right-of-way.

4 A mass-casualty incident is MOST accurately defined as an event in which: Select one: A. there are at least 25 patients, more than half of whom are critically injured. B. the number of patients exceeds the resources available to the initial responders. C. mutual aid from other agencies is required to care for numerous patients. D. there are more patients who require advanced life support than patients who do not.

Introduction, page 2333 The correct answer is: the number of patients exceeds the resources available to the initial responders.

67 When determining the optimal method to communicate with, assess, treat, and transport a patient with a special health care challenge, the paramedic should: Select one: A. routinely call medical control before talking to a caregiver. B. demonstrate confidence and enlist the expertise of the patient. C. recall that caregivers are often upset and therefore unreliable. D. remain professional and obtain initial information from a caregiver.

Introduction, pages 2251-2252 The correct answer is: demonstrate confidence and enlist the expertise of the patient.

64 The MOST difficult part of any rescue is: Select one: A. physically moving the patient to a less confined area. B. the simultaneous coordination of rescue and treatment. C. determining which treatment is required immediately. D. accessing the patient so you can provide treatment.

Introduction, pages 2360-2361 The correct answer is: the simultaneous coordination of rescue and treatment.

73 The primary function of the treatment section is to: Select one: A. separate and treat patients based on their triage category. B. treat each patient in the order in which he or she presents. C. expediently move patients to the transportation area. D. rapidly assess each patient to determine injury severity.

Medical Incident Command, page 2342-2343 The correct answer is: separate and treat patients based on their triage category.

88 If an emergency physician is present at the scene of a mass-casualty incident, he or she would be the LEAST likely to: Select one: A. provide on-scene medical direction for paramedics. B. make initial and secondary triage decisions. C. assume control over complex rescuer operations. D. decide which patients require immediate transport.

Medical Incident Command, page 2343 The correct answer is: assume control over complex rescuer operations.

49 The staging area manager is responsible for: Select one: A. requesting additional medical supplies as they are needed. B. coordinating with all incoming and outgoing ambulances. C. supervising all responders who are providing treatment. D. tracking the number of vehicles transporting patients.

Medical Incident Command, page 2343 The correct answer is: coordinating with all incoming and outgoing ambulances.

7 During an incident involving an explosion, you determine that two critically injured patients should be transported to a trauma center by air. After stabilizing the patients' conditions to the best of your ability, you should: Select one: A. contact the incident commander and request permission to utilize air transport. B. call the receiving trauma center and update them on the patients' conditions. C. notify the transportation supervisor and request that he or she establish a landing zone. D. request air transport immediately and determine where you will land the helicopter.

Medical Incident Command, page 2343 The correct answer is: notify the transportation supervisor and request that he or she establish a landing zone.

54 Upon arriving at the scene of a major incident, you can clearly see that there are numerous patients, some of whom are receiving care and others of whom are walking around unattended. Your MOST appropriate action should be to: Select one: A. immediately triage the unattended patients. B. notify dispatch and request air medical transport. C. move the walking patients to a separate area. D. report to the staging area for further instructions.

Medical Incident Command, page 2343 The correct answer is: report to the staging area for further instructions.

16 If a disaster situation requires a morgue unit leader, it is MOST important for the person who is assigned that function to: Select one: A. quickly remove the bodies from the scene, even if a storage and removal plan has not been established. B. leave all of the dead victims in their original locations until a coroner or mortician is at the scene. C. be aware that some mass-casualty incidents involving numerous fatalities may be crime scenes. D. work directly with law enforcement officials to positively identify the deceased as soon as possible.

Medical Incident Command, page 2344 The correct answer is: be aware that some mass-casualty incidents involving numerous fatalities may be crime scenes.

27 Because extrication and rescue are medically complex: Select one: A. anyone who requires extrication or rescue should be triaged and receive basic lifesaving care before being extricated or rescued. B. no lengthy extrication or rescue operation should commence until an emergency physician is present at the scene. C. the position of extrication or rescue officer should always be assumed by an experienced EMT or paramedic. D. the officers responsible for these functions usually function under a speciality branch of the incident command system.

Medical Incident Command, pages 2343-2344 The correct answer is: the officers responsible for these functions usually function under a speciality branch of the incident command system.

78 The majority of current hemodynamic monitoring involves placement of different types of catheters into areas within the: Select one: A. cardiovascular system. B. brain and spinal cord. C. central nervous system. D. pulmonary circulation.

Medical Technology Used During Interfacility Transport, page 2275 The correct answer is: cardiovascular system.

45 The inner cannula of a tracheostomy tube: Select one: A. is the larger tube that passes directly into the patient's trachea. B. has a 15-mm port that can be attached to a ventilator circuit. C. should be equipped with a cuff if used in pediatric patients. D. should only be removed during tracheostomy tube replacement.

Medical Technology in the Prehospital Setting, page 2262 The correct answer is: has a 15-mm port that can be attached to a ventilator circuit.

35 The fistula used for hemodialysis is a surgical connection between: Select one: A. two large arteries. B. two large veins. C. a vein and the peritoneum. D. an artery and a vein.

Medical Technology in the Prehospital Setting, page 2273 The correct answer is: an artery and a vein.

6 Hydrocephalus may occur if: Select one: A. too much cerebrospinal fluid is forced into the spinal canal. B. the brain produces less than 500 mL of cerebrospinal fluid per day. C. bleeding in the brain causes an increase in intracranial pressure. D. cerebrospinal fluid absorption into the bloodstream is reduced.

Medical Technology in the Prehospital Setting, page 2274 The correct answer is: cerebrospinal fluid absorption into the bloodstream is reduced.

69 Following removal of an ostomy device and cleansing the stoma, you should: Select one: A. apply the new device over the stoma. B. cover the stoma with the provided wafer. C. flush the inside of the stoma with saline. D. place a clean gauze pad over the stoma.

Medical Technology in the Prehospital Setting, pages 2269-2270 The correct answer is: place a clean gauze pad over the stoma.

19 Multiple sclerosis is: Select one: A. most often secondary to a diffuse axonal brain injury and causes neuromuscular disability due to stretching or tearing of the axons. B. chronic in most cases, and is the result of degenerative changes in the muscle that results in muscle atrophy and decreased bone density. C. a chronic central nervous system disease caused by destruction of the myelin and nerve axons within the brain and spinal cord. D. a progressive disease in 90% of patients who have it, and is characterized by unrelenting pain, weakness, and visual impairment.

Other Notable Chronic Medical Conditions, pages 2287-2288 The correct answer is: a chronic central nervous system disease caused by destruction of the myelin and nerve axons within the brain and spinal cord.

26 Spina bifida occurs when: Select one: A. hydrocephalus causes a significant increase in pressure within the spinal canal, resulting in chronic compression of the spinal cord. B. the fetus's spinal column does not close properly or completely and vertebrae do not develop, leaving a portion of the spinal cord exposed. C. growth of the fetus's spinal column stops at the thoracic vertebrae, which leaves the lumbar portion of the spinal cord completely unprotected. D. trauma during birth causes distracting injuries to the cervical and thoracic vertebrae, resulting in partial or complete paralysis below the injury.

Other Notable Chronic Medical Conditions, pages 2289-2290 The correct answer is: the fetus's spinal column does not close properly or completely and vertebrae do not develop, leaving a portion of the spinal cord exposed.

31 Hypertensive emergencies in the geriatric population: Select one: A. require a controlled decline in blood pressure that often cannot be achieved in the prehospital setting. B. can cause a ruptured cerebral or aortic aneurysm and should be treated in the field with antihypertensives. C. are typically treated in the prehospital setting with beta-blocker medications or a slow nitroglycerin infusion. D. are relatively uncommon owing to increased elasticity of the blood vessels, which facilitates vasodilation.

Pathophysiology, Assessment, and Management of Cardiovascular Conditions, page 2222 The correct answer is: require a controlled decline in blood pressure that often cannot be achieved in the prehospital setting.

59 The MOST common risk factor for the development of type 2 diabetes in people over 65 years of age is: Select one: A. frequent infections that do not heal properly. B. hypertension of longer than 5 years' duration. C. poor dietary habits and a sedentary lifestyle. D. the presence of more than one chronic disease.

Pathophysiology, Assessment, and Management of Endocrine Conditions, page 2230 The correct answer is: the presence of more than one chronic disease.

81 The relatively high use of nonsteroidal anti-inflammatory drugs by older patients predisposes them to: Select one: A. mesenteric ischemia. B. cholelithiasis. C. peptic ulcer disease. D. constipation.

Pathophysiology, Assessment, and Management of Gastrointestinal Conditions, page 2227 The correct answer is: peptic ulcer disease.

38 After falls, _______________ is/are the second leading cause of accidental death among elderly people. Select one: A. thermal burns B. drug interactions C. motor vehicle crashes D. submersion injury

Pathophysiology, Assessment, and Management of Geriatric Trauma Emergencies, page 2237 The correct answer is: motor vehicle crashes

3 Heat gain or loss in response to environmental changes is delayed in elderly people for all of the following reasons, EXCEPT: Select one: A. impaired circulation. B. chronic hyperthyroidism. C. atherosclerotic vessels. D. decreased sweat production.

Pathophysiology, Assessment, and Management of Geriatric Trauma Emergencies, page 2238 The correct answer is: chronic hyperthyroidism.

82 An 82-year-old man presents with confusion that has worsened progressively over the past 2 weeks. Because of his confusion and the fact that he is hearing impaired, you obtain the majority of your medical history information from his daughter. She tells you that her father has high blood pressure but refuses to take medication for it. She also tells you that she thinks he fell about 3 weeks ago, although he denies falling. The patient's blood pressure is 168/98 mm Hg, pulse rate is 60 beats/min and occasionally irregular, and respirations are 22 breaths/min and regular. This patient MOST likely: Select one: A. has an acute onset of dementia. B. has normal age-related physiologic changes. C. is experiencing a subdural hematoma. D. had a stroke secondary to atrial fibrillation.

Pathophysiology, Assessment, and Management of Geriatric Trauma Emergencies, page 2238 The correct answer is: is experiencing a subdural hematoma.

9 Cervical spondylosis is a degenerative change in the cervical spine that causes: Select one: A. fracture of the odontoid process of the second cervical vertebra. B. lateral curvature of the cervical spine with cord impingement. C. destruction of the intervertebral discs and vertebral fractures. D. narrowing of the spinal canal and pressure on the spinal cord.

Pathophysiology, Assessment, and Management of Geriatric Trauma Emergencies, page 2238 The correct answer is: narrowing of the spinal canal and pressure on the spinal cord.

37 Kyphosis is characterized by: Select one: A. a hunchback appearance. B. vertebral disc compression. C. lateral curvature of the spine. D. cartilage degeneration.

Pathophysiology, Assessment, and Management of Musculoskeletal Conditions, page 2236 The correct answer is: a hunchback appearance.

15 Correct 1.00 points out of 1.00 Flag question A. an acute alteration in mentation that indicates an underlying condition. B. an altered mental status that is caused by structural damage to the brain. C. a pattern of disorganized thinking that progresses over several weeks. D. any alteration in cognitive function that may or may not be reversible.

Pathophysiology, Assessment, and Management of Neurologic Conditions, pages 2223-2224 The correct answer is: an acute alteration in mentation that indicates an underlying condition.

48 Untreated depression in people over 65 years of age: Select one: A. usually goes unrecognized because it is often mistaken for delirium. B. is associated with a higher suicide rate than in any other age group. C. causes homicidal behavior in as much as 50% of this age group. D. is often recognized by the patient, who subsequently asks for help.

Pathophysiology, Assessment, and Management of Psychologic Conditions, page 2234 The correct answer is: is associated with a higher suicide rate than in any other age group.

62 Which of the following is the MOST common respiratory infection that causes death in the elderly population? Select one: A. Mycobacterium tuberculosis B. Pneumocystis carinii C. Respiratory syncytial virus D. Pneumococcus bacteria

Pathophysiology, Assessment, and Management of Respiratory Conditions, page 2220 The correct answer is: Pneumococcus bacteria

72 A 71-year-old man with a history of emphysema, coronary artery disease, and hypertension presents with increased shortness of breath and fatigue. His oxygen saturation is 80% on home oxygen at 2 L/min via nasal cannula. His blood pressure is 140/76 mm Hg, pulse rate is 104 beats/min, and respirations are 28 breaths/min and labored. His medications include an albuterol inhaler, prednisone, hydrochlorothiazide, and lisinopril. Auscultation of his lungs reveals scattered wheezing in all fields. Which of the following prehospital interventions is NOT indicated for this patient? Select one: A. Nebulized ipratropium B. Continuous positive airway pressure C. High-flow oxygen therapy D. Subcutaneous epinephrine

Pathophysiology, Assessment, and Management of Respiratory Conditions, page 2220 The correct answer is: Subcutaneous epinephrine

58 Adverse drug reactions in elderly people are the result of: Select one: A. changes in drug metabolism due to diminished hepatic function. B. changes in body composition and an increase in body water. C. increased drug elimination due to decreased antidiuretic hormone. D. partial digestion secondary to delayed gastric emptying.

Pathophysiology, Assessment, and Management of Toxicologic Conditions, page 2232 The correct answer is: changes in drug metabolism due to diminished hepatic function.

30 Hypotension and orthostatic vital sign changes would MOST likely occur in elderly people who take: Select one: A. beta-blockers. B. antidepressants. C. diuretics. D. ACE inhibitors.

Pathophysiology, Assessment, and Management of Toxicologic Conditions, page 2233 The correct answer is: diuretics.

61 In contrast to a 30-year-old man, if a 70-year-old man were to consume an excessive amount of alcohol: Select one: A. the alcohol would be eliminated from his body much faster unless he is taking an antihypertensive drug. B. he would experience a lower blood alcohol concentration secondary to a decrease in total body water. C. he would experience a higher blood alcohol concentration due to decreases in body mass and total body water. D. it would take longer for him to develop alcohol toxicity secondary to decreased metabolism in the liver.

Pathophysiology, Assessment, and Management of Toxicologic Conditions, page 2233 The correct answer is: he would experience a higher blood alcohol concentration due to decreases in body mass and total body water.

29 In rescues that involve lengthy entrapment in a confined space, especially with cave-ins and trench rescues, the paramedic should be especially concerned about the potential for: Select one: A. femur fractures. B. spinal cord injury. C. crush syndrome. D. severe alkalosis.

Patient Care, pages 2387-2388 The correct answer is: crush syndrome.

92 Recognizing hazards, securing the scene, and calling for appropriate assistance are characteristic of the ______________ level of technical rescue. Select one: A. operations B. technician C. awareness D. command

Rescue Training, page 2361 The correct answer is: awareness

95 If your department has its own technical rescue team: Select one: A. it should have only one designated incident commander. B. there is generally not a need to call in an outside agency. C. technical rescue protocols should be established. D. the rescue team should respond on every EMS call.

Steps in Special Rescue, page 2363 The correct answer is: technical rescue protocols should be established.

28 After the warm zone has been established: Select one: A. it should be demarcated with orange police or fire line tape. B. only entry and rescue teams are allowed to function within it. C. law enforcement officials should identify it with red tape. D. a rescuer should be posted there to prevent unauthorized entry.

Steps in Special Rescue, pages 2364-2365 The correct answer is: it should be demarcated with orange police or fire line tape.

42 The National Incident Management System is designed to: Select one: A. provide a consistent template to enable state, federal, and local governments to respond safely to any act of terrorism. B. prepare for, prevent, respond to, and recover from domestic incidents, regardless of cause, size, or complexity. C. educate state, federal, and local governments, as well as private-sector organizations, to effectively prevent a domestic incident. D. maximize the capabilities of each state in the United States to manage a large-scale disaster effectively, regardless of the cause.

The NIMS, page 2334 The correct answer is: prepare for, prevent, respond to, and recover from domestic incidents, regardless of cause, size, or complexity.

5 During an incident involving a building collapse, a paramedic is assigned eight rescuers to function under his authority. However, as the incident progresses, the paramedic finds that he is unable to effectively manage the personnel assigned to him. He should: Select one: A. send two of the rescuers to the triage section since this is where they will most likely be needed. B. release half of the rescuers assigned to him and instruct them to report directly to the incident commander. C. transfer authority to one of the rescuers assigned to him and then follow that person's directions. D. divide tasks and delegate supervision of some tasks to one or more of the rescuers assigned to him.

The Incident Command System, page 2335 The correct answer is: divide tasks and delegate supervision of some tasks to one or more of the rescuers assigned to him.

99 Which of the following duties is NOT a responsibility of the incident commander? Select one: A. Developing a plan to manage the incident B. Authorizing medical treatment interventions C. Establishing strategic objectives and priorities D. Assessing the entire incident scene

The Incident Command System, page 2336 The correct answer is: Authorizing medical treatment interventions

84 A single command system is one in which: Select one: A. one person is in charge, unless multiple agencies respond. B. the incident commander assumes all functional roles. C. one person from each responding agency assumes command. D. one person is in charge, even if multiple agencies respond.

The Incident Command System, page 2336 The correct answer is: one person is in charge, even if multiple agencies respond.

75 Command functions include all of the following, EXCEPT the: Select one: A. liaison officer. B. triage officer. C. public information officer. D. safety officer.

The Incident Command System, page 2336 The correct answer is: triage officer.

90 Broadly speaking, the finance section chief is responsible for: Select one: A. determining what impact the incident will have on the economy of the affected area. B. documenting all expenditures at an incident and seeking reimbursement. C. predetermining how much a major incident would affect the system's finances. D. tracking all personnel overtime and ensuring that they are compensated.

The Incident Command System, page 2337 The correct answer is: documenting all expenditures at an incident and seeking reimbursement.

14 At a very large incident, the operations section is responsible for: Select one: A. ensuring that there is ample lighting and functional communications equipment during the incident. B. locating food, shelter, and health care for you and the other responders present at the incident. C. obtaining data regarding problems that may arise at the incident and revising the plan to solve the problem. D. managing the tactical operations job usually handled by the incident commander on routine EMS calls.

The Incident Command System, page 2337 The correct answer is: managing the tactical operations job usually handled by the incident commander on routine EMS calls.

2 Multiple-casualty equipment and supplies needed for airway control include all of the following, EXCEPT: Select one: A. rigid and flexible suction catheters and suction devices. B. oral and nasal airways, ET tubes, and Combitubes. C. large-bore IV catheters for thoracic decompression. D. gloves, face shields, and a HEPA or N-95 mask.

The Incident Command System, page 2338 The correct answer is: large-bore IV catheters for thoracic decompression.

70 You are caring for a patient with non-life-threatening injuries in the treatment section of a multiple-casualty incident when you are approached by several TV reporters who are seeking details regarding the incident. You should: Select one: A. firmly tell the reporters to leave the scene immediately. B. provide a brief overview of the current situation. C. direct the reporters to the public information officer. D. ignore the reporters' questions and continue patient care.

The Incident Command System, page 2339 The correct answer is: direct the reporters to the public information officer.

41 The ______________ has the authority and responsibility to stop an emergency operation if he or she believes a rescuer is in danger. Select one: A. rescue officer B. safety officer C. logistics chief D. triage officer

The Incident Command System, page 2339 The correct answer is: safety officer

11 Prior to implementing any plans or operations at the scene of a multiple-casualty incident, you should FIRST: Select one: A. move any unnecessary personnel away from the area. B. acquire the assistance of at least seven other rescuers. C. notify your supervisor or the incident commander. D. make sure the assigned safety officer is present.

The Incident Command System, pages 2337-2338 The correct answer is: notify your supervisor or the incident commander.

74 The goal of doing the greatest good for the greatest number of people mandates that: Select one: A. every victim should receive a detailed physical exam during triage. B. there should be one triage officer for every 10 victims of a disaster. C. life-threatening injuries should be treated during the triage phase. D. triage assessment is brief and patient condition categories are basic.

Triage, page 2345 The correct answer is: triage assessment is brief and patient condition categories are basic.

65 While triaging patients at a multiple-casualty incident, you rapidly assess a patient and determine that she is conscious and alert, but cannot feel or move anything below her umbilicus. You should: Select one: A. conduct a more in-depth neurologic exam of the patient. B. categorize her as an immediate patient and continue triage. C. apply full spinal motion restriction precautions at once. D. place a yellow tag on her and move on to the next patient.

Triage, pages 2346-2347 The correct answer is: place a yellow tag on her and move on to the next patient.

76 According to the START triage system, a nonbreathing patient should be triaged as immediate if: Select one: A. the airway is completely blocked by swelling. B. he or she does not respond to two rescue breaths. C. a manual airway maneuver restores breathing. D. he or she is in need of immediate intubation.

Triage, pages 2348-2349 The correct answer is: a manual airway maneuver restores breathing.

97 Upon arriving at the scene of a multiple vehicle crash, you call for additional resources and begin triaging patients using the START triage system. The first patient you assess is a young male who is unconscious and apneic. After manually opening his airway, you note that he starts breathing shallowly. You should: Select one: A. assess the rate and quality of his radial pulse. B. categorize him as an immediate patient. C. place a yellow tag on him and continue triage. D. secure his airway with an ET tube.

Triage, pages 2348-2349 The correct answer is: categorize him as an immediate patient.

79 According to the JumpSTART triage system, if an infant or child is not breathing, you should: Select one: A. manually open the patient's airway. B. immediately assess for a pulse. C. deliver five rescue breaths. D. categorize the patient as expectant.

Triage, pages 2349-2350 The correct answer is: immediately assess for a pulse.

12 A man stormed into a daycare center and opened fire with a semiautomatic rifle. The scene has been secured by law enforcement, and you are in the process of triaging the injured children. The first child you assess, a 4-year-old boy, is unresponsive and apneic but has a pulse. After manually opening his airway, he remains apneic. You should: Select one: A. assist his ventilations while closely monitoring his pulse rate. B. consider him nonsalvageable and place a black tag on him. C. provide five rescue breaths and reassess his respiratory status. D. categorize him as an immediate patient and continue triaging.

Triage, pages 2349-2350 The correct answer is: provide five rescue breaths and reassess his respiratory status.

46 In contrast to a platform vehicle frame, a unibody frame: Select one: A. is most commonly found in trucks and sport utility vehicles. B. is more structurally sound and is rarely found in small vehicles. C. combines the vehicle body and frame into a single component. D. uses a beam to fabricate the load-bearing frame of the vehicle.

Vehicle Extrication, page 2369 The correct answer is: combines the vehicle body and frame into a single component.

56 Which of the following statements regarding vehicle air bags is correct? Select one: A. Air bags can deploy any time after an accident and must be deactivated even if the vehicle's power supply has been disconnected. B. If the air bags on the passenger's and driver's sides have not deployed by the time you arrive at the scene, there is no need to deactivate them. C. Vehicle air bags serve as the primary protective mechanism to protect the front seat passengers of a vehicle involved in a frontal crash. D. Vehicles equipped with air bags have a built-in safety sensor that causes all the air bags in the vehicle to deactivate upon impact.

Vehicle Extrication, pages 2375-2376 The correct answer is: Air bags can deploy any time after an accident and must be deactivated even if the vehicle's power supply has been disconnected.


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