EMT 16

Which of the following must be assessed in every respiratory patient?

Lung sounds

While auscultating an elderly woman's breath sounds, you hear low-pitched "rattling" sounds at the bases of both of her lungs. This finding is MOST consistent with which of the following conditions?

Aspiration pneumonia

Which of the following is the MOST reliable method of estimating a patient's cardiac output?

Assess the heart rate and strength of the pulse.

Which of the following is NOT a function of the sympathetic nervous system?

Constriction of blood vessels in the muscles

What is the function of the left atrium?

It receives oxygenated blood from the lungs.

Crackles (rales) are caused by _________.

air passing through fluid

The MOST common reason that many people experiencing AMI do not seek immediate medical attention is because they:

are in denial.

The inferior vena cava returns deoxygenated blood to the right side of the heart from all of the following areas, EXCEPT the:

brain.

Which of the following statements regarding the AED and defibrillation is correct?

The AED will not analyze the rhythm of a moving patient.

Blood that is ejected from the right ventricle:

flows into the pulmonary arteries.

In order for efficient pulmonary gas exchange to occur:

oxygen and carbon dioxide must be able to freely diffuse across the alveolar-capillary membrane.

Common signs and symptoms of AMI include all of the following, EXCEPT:

pain exacerbated by breathing.

Cardiac output may decrease if the heart beats too rapidly because:

there is not enough time in between contractions for the heart to refill completely.

When documenting a patient's description of his or her chest pain or discomfort, the EMT should:

use the patient's own words.

Sudden death following AMI is MOST often caused by:

ventricular fibrillation.

Asthma is caused by a response of the:

immune system.

You are assisting an asthma patient with his prescribed metered-dose inhaler. After the patient takes a deep breath and depresses the inhaler, you should:

instruct him to hold his breath for as long as he comfortably can.

While obtaining a 12-lead ECG prior to ALS arrival, you note the presence of artifacts on the tracing. Which of the following is the MOST likely cause of this?

Excessive movement of the patient

Which of the following is LEAST important when obtaining a medical history from a patient complaining of chest discomfort?

Family history of hypertension

Major risk factors for AMI include all of the following, EXCEPT:

hypoglycemia.

Your patient has a chronic respiratory condition. His stimulus to breathe is triggered by low oxygen levels in the blood. This is known as the ___________.

hypoxic drive

Which of the following is MOST characteristic of adequate breathing?

24 breaths/min with bilaterally equal breath sounds and pink skin

In what area of the lungs does respiration occur?

Alveoli

Which of the following is a genetic disorder that predisposes the patient to repeated lung infections?

Cystic fibrosis

A 40-year-old man is in cardiac arrest. Your partner is performing CPR. You are attaching the AED when the patient's wife tells you that he has an automatic implanted cardiac defibrillator (AICD). The AED advises that a shock is indicated. What should you do?

Deliver the shock followed by immediate resumption of CPR.

Which of the following statements regarding nitroglycerin is correct?

Nitroglycerin usually relieves anginal chest pain within 5 minutes.

Which of the following veins is located inferior to the trunk?

Saphenous

Which of the following conditions would be LEAST likely to result in hypoxia?

Severe anxiety

Treatment with continuous positive airway pressure (CPAP) would MOST likely be contraindicated in which of the following situations?

Shortness of breath and a blood pressure of 76/56 mm Hg

A 59-year-old male with a history of emphysema complains of an acute worsening of his dyspnea and pleuritic chest pain following a forceful cough. Your assessment reveals that he has a barrel-shaped chest, unilaterally diminished breath sounds, and tachycardia. What is the MOST likely cause of this patient's condition?

Spontaneous pneumothorax

Which of the following cardiac dysrhythmias has the greatest chance of deteriorating into a pulseless rhythm?

Ventricular tachycardia

Acute coronary syndrome (ACS) is a term used to describe:

a group of symptoms that are caused by myocardial ischemia.

Upon arriving at the residence of a patient with a possible cardiac problem, it is MOST important to:

assess the scene for potential hazards.

You and your EMT partner are the first to arrive at the scene of an unresponsive 70-year-old man. Your assessment reveals that he is apneic and pulseless. A paramedic unit is en route to the scene and will arrive in approximately 5 minutes. You should:

begin CPR, apply the AED, and deliver a shock if it is indicated.

You are dispatched to a residence for a 56-year-old male with an altered mental status. Upon arrival at the scene, the patient's wife tells you that he complained of chest pain the day before, but would not allow her to call EMS. The patient is semiconscious; has rapid, shallow respirations; and has a thready pulse. You should:

begin ventilatory assistance.

The posterior tibial pulse can be palpated:

behind the medial malleolus, on the inside of the ankle.

The head and brain receive their supply of oxygenated blood from the:

carotid arteries.

It would be MOST appropriate for a patient to take his or her prescribed nitroglycerin when experiencing:

chest pain that does not immediately subside with rest.

Rapid, labored breathing in a patient with signs and symptoms of AMI should make you suspicious for:

congestive heart failure.

The myocardium receives oxygenated blood from the __________, which originate(s) from the __________.

coronary arteries, aorta

Ischemic heart disease is defined as:

decreased blood flow to one or more portions of the myocardium.

Cardiogenic shock following AMI is caused by:

decreased pumping force of the heart muscle.

A percutaneous transluminal coronary angioplasty (PTCA) restores blood flow to the ischemic myocardium by:

dilating the affected coronary artery with a small inflatable balloon.

Nitroglycerin relieves cardiac-related chest pain by:

dilating the coronary arteries and improving cardiac blood flow.

A 30-year-old male presents with acute shortness of breath, widespread hives, and facial swelling. He denies any past medical history and takes no medications. During your assessment, you hear wheezing over all the lung fields. His blood pressure is 90/50 mm Hg and his heart rate is 110 beats/min. In addition to giving him high-flow oxygen, the MOST important treatment for this patient is:

epinephrine

The MOST common error associated with the use of the AED is

failure of the EMT to ensure the battery is charged.

Common side effects of nitroglycerin include all of the following, EXCEPT:

hypertension.

Prior to assisting a patient with his or her prescribed nitroglycerin, the EMT must:

obtain authorization from medical control.

In contrast to AMI, a dissecting aortic aneurysm:

often presents with pain that is maximal from the onset.

When preparing to obtain a 12-lead ECG, the V1 and V2 electrodes should be placed:

on either side of the sternum.

A 67-year-old female presents with difficulty breathing and chest discomfort that awakened her from her sleep. She states that she has congestive heart failure, has had two previous heart attacks, and has been prescribed nitroglycerin. She is conscious and alert with adequate breathing. Her blood pressure is 94/64 mm Hg and her heart rate is 120 beats/min. Treatment for this patient includes:

placing her in an upright position

The AED has delivered a shock to an elderly male in cardiac arrest. Following 2 minutes of CPR, you re-analyze the patient's cardiac rhythm and receive a "no shock advised" message. After further resuscitation, you restore a palpable carotid pulse. Your next action should be to:

reassess airway and breathing and treat accordingly.

After assisting your patient with prescribed nitroglycerin, you should:

reassess his or her blood pressure within 5 minutes to detect hypotension.

"PASTE" is an alternate assessment tool for ___________.

respiratory patients

The right coronary artery supplies blood to the:

right ventricle and inferior wall of the left ventricle.

During your treatment of a woman in cardiac arrest, you apply the AED, analyze her cardiac rhythm, and receive a "no shock advised" message. This indicates that:

she is not in ventricular fibrillation.

In contrast to the sympathetic nervous system, the parasympathetic nervous system:

slows the heart and respiratory rates.

The purpose of defibrillation is to:

stop the chaotic, disorganized contraction of the cardiac cells.

Ventricular tachycardia causes hypotension because:

the left ventricle does not adequately fill with blood.

When the myocardium requires more oxygen:

the arteries supplying the heart dilate.

When treating a patient with chest pain, you should assume that he or she is having an AMI because

the cause of the pain cannot be diagnosed in the field.

Most patients are instructed by their physician to take up to _______ doses of nitroglycerin before calling EMS.

three

The descending aorta divides into the two iliac arteries at the level of the:

umbilicus.

Which of the following statements regarding the pain associated with AMI is correct?

It can occur during exertion or when the patient is at rest.

When auscultating the lungs of a patient with respiratory distress, you hear adventitious sounds. This means that the patient has:

abnormal breath sounds.

The electrical stimulus that originates in the heart's primary pacemaker is controlled by impulses from the brain that arrive by way of the:

autonomic nervous system.

When an electrical impulse reaches the AV node, it is slowed for a brief period of time so that:

blood can pass from the atria to the ventricles.

His parents tell you that their son has had a chest infection for the past two days and when they took him to their family doctor, they were told it was likely due to the respiratory syncytial virus (RSV). They have kept him well hydrated, but the infection seems to have gotten worse. On auscultation, you hear decreased air entry bilaterally with fine expiratory wheezes and the occasional coarse wet crackle. Based on this information, your patient is most likely suffering from:

bronchiolitis.

You are dispatched to a convenience store for a patient who passed out. Upon arriving at the scene, you find two off-duty EMTs performing CPR on the patient, a 58-year-old male. Your initial action should be to:

feel for a pulse while compressions are ongoing.

The iliac arteries immediately subdivide into the:

femoral arteries.

A pleural effusion is MOST accurately defined as:

fluid accumulation outside the lung

You are assessing a 49-year-old man who complains of chest pressure that began the night before. He is conscious, but anxious, and tells you he has a history of angina and hypertension. After applying high-flow oxygen, you expose his chest to auscultate his lungs and note that he has a nitroglycerin patch on his right upper chest. His skin is cool and pale, his blood pressure is 78/50 mm Hg, and his pulse is 110 beats/min and irregular. You should:

remove the nitroglycerin patch, place him in a supine position and elevate his lower extremities, and prepare for immediate transport.

You are attending to a 54-year-old female patient in a homeless shelter. The patient tells you that she had the flu a couple of weeks ago, and she has not gotten over it. She has been tired and keeps waking up at night, sweating. She has been coughing up green sputum occasionally and has been experiencing episodes of chest pain that get worse when she breathes. Based on this information, your patient is most likely suffering from:

tuberculosis.

You are attending to a 3-year-old male patient who is presenting with severe shortness of breath. His parents report that he has had a cough and cold with a low grade fever for the past two days. They became worried today, as his level of distress has increased dramatically. On assessment, the patient is sitting upright and making high-pitched noises with each breath. Based on this information, the patient is most likely suffering from:

viral infection of the upper respiratory tract.