EMT CH 18

A difference in pulse strength or blood pressure in each arm indicates possible _________.

abdominal aortic aneurysm

Which of the following conditions is more common in women than in men? A. cystitis B. hepatitis C. pancreatitis D. cholecystitis

A. cystitis

Which of the following organs lies in the retroperitoneal space? A. Pancreas B. Liver C. Gallbladder D. Spleen

A. Pancreas

Which of the following statements regarding the acute abdomen is correct? A. The initial pain associated with an acute abdomen tends to be vague and poorly localized. B. An acute abdomen almost always occurs as the result of blunt trauma to solid abdominal organs. C. The most common cause of an acute abdomen is inflammation of the gallbladder and liver. D. The parietal peritoneum is typically the first abdominal layer that becomes inflamed or irritated.

A. The initial pain associated with an acute abdomen tends to be vague and poorly localized.

Your patient complains of abdominal pain that occurs mostly at night or after eating fatty foods. You should suspect ____________. A. cholecystitis B. a hernia C. kidney stones D. appendicitis

A. cholecystitis

Esophageal varices MOST commonly occur in patients who: A. drink a lot of alcohol. B. have severe diabetes. C. have a history of esophagitis. D. have weak immune systems.

A. drink a lot of alcohol.

Your partner notes blood in a patient's vomit. The medical term for this is: A. hematemesis. B. melena. C. hematochezia. D. steratorrhea.

A. hematemesis.

You respond to the residence of a 70-year-old male who complains of weakness and severe shortness of breath. His wife tells you that he is a dialysis patient, but has missed his last two treatments. After applying high-flow oxygen, you auscultate his lungs and hear diffuse rhonchi. The patient is conscious, but appears confused. His blood pressure is 98/54 mm Hg, his pulse rate is 120 beats/min and irregular, and his respirations are 24 breaths/min and labored. You should: A. leave him in a sitting position, keep him warm, and prepare for immediate transport B. place him in a supine position, elevate his lower extremities, and transport at once. C. treat for shock and request a paramedic unit to respond to the scene and assist you. D. perform a detailed secondary assessment and then transport him to a dialysis center.

A. leave him in a sitting position, keep him warm, and prepare for immediate transport

Most patients with abdominal pain prefer to: A. lie on their side with their knees drawn into the abdomen. B. sit in a semi-Fowler position with their knees slightly bent. C. lie in a supine position with their knees in a flexed position. D. sit fully upright because it helps relax the abdominal muscles.

A. lie on their side with their knees drawn into the abdomen.

The MOST common and significant complication associated with an acute abdomen is: A. peritonitis. B. high fever. C. severe pain. D. internal bleeding.

A. peritonitis.

A 30-year-old woman with a history of alcoholism presents with severe upper abdominal pain and is vomiting large amounts of bright red blood. Her skin is cool, pale, and clammy; her heart rate is 120 beats/min and weak; and her blood pressure is 70/50 mm Hg. Your MOST immediate action should be to: A. protect her airway from aspiration. B. rapidly transport her to the hospital. C. give her high-flow supplemental oxygen. D. keep her supine and keep her warm.

A. protect her airway from aspiration.

A 30-year-old woman with a history of alcoholism presents with severe upper abdominal pain and is vomiting large amounts of bright red blood. Her skin is cool, pale, and clammy; her heart rate is 120 beats/min and weak; and her blood pressure is 70/50 mm Hg. Your MOST immediate action should be to: A. protect her airway from aspiration. B. keep her supine and elevate her legs. C. rapidly transport her to the hospital. D. give her high-flow supplemental oxygen

A. protect her airway from aspiration.

An important aspect in the treatment of a patient with severe abdominal pain is to: A. provide emotional support en route to the hospital. B. administer analgesic medications to alleviate pain. C. encourage the patient to remain in a supine position. D. give 100% oxygen only if signs of shock are present.

A. provide emotional support en route to the hospital.

Urinary tract infections are more common in ____________. A. women B. active adults C. sedentary adults D. men

A. women

What is the last vital sign to change in the setting of shock? A. Heart rate B. Blood pressure C. Respiratory rate D. Pulse oximetry reading

B. Blood pressure

Which of the following may help reduce your patient's nausea? A. Positive-pressure ventilation B. Low-flow oxygen C. Oral glucose D. Cricoid pressure

B. Low-flow oxygen

A 29-year-old pregnant woman has had severe vomiting for the last 2 days. Today, she is vomiting large amounts of blood. Her skin is cool and pale and she is tachycardic. The EMT should suspect: A. esophageal varices. B. Mallory-Weiss tear. C. esophagitis. D. acute pancreatitis.

B. Mallory-Weiss tear.

Which of the following statements regarding dialysis is correct? A. Acute hypertension is a common adverse effect of dialysis. B. Patients who miss a dialysis treatment often present with weakness. C. The purpose of dialysis is to help the kidneys retain salt and water. D. Hemodialysis is effective but carries a high risk of peritonitis.

B. Patients who miss a dialysis treatment often present with weakness.

Which of the following helps filter the blood and has no digestive function? A. Small intestine B. Spleen C. Stomach D. Large intestine

B. Spleen

You suspect upper gastrointestinal bleeding. All of the following fit into this category, EXCEPT? A. Esophageal varices B. Ulcerative colitis C. Esophagitis D. Mallory-Weiss tear

B. Ulcerative colitis

A 35-year-old mildly obese woman is complaining of localized pain in the right upper quadrant with referred pain to the right shoulder. The MOST likely cause of her pain is: A. acute cystitis. B. acute cholecystitis. C. appendicitis. D. pancreatitis.

B. acute cholecystitis.

A 59-year-old male presents with a sudden onset of severe lower back pain. He is conscious and alert, but very restless and diaphoretic. Your assessment reveals a pulsating mass to the left of his umbilicus. You should: A. vigorously palpate the abdomen to establish pain severity. B. administer oxygen and prepare for immediate transport. C. place the patient in a sitting position and transport at once. D. request a paramedic unit to give the patient pain medication.

B. administer oxygen and prepare for immediate transport.

A 59-year-old male presents with sudden-onset severe lower back pain. He is conscious and alert, but very restless and diaphoretic. Your assessment reveals a pulsating mass to the left of his umbilicus. You should: A. request a paramedic unit to give the patient pain medication. B. administer oxygen and prepare for immediate transport. C. vigorously palpate the abdomen to establish pain severity. D. place the patient in a sitting position and transport at once.

B. administer oxygen and prepare for immediate transport.

A 47-year-old male presents with severe abdominal pain of 3 hours' duration. His abdomen is distended and guarded. Your MOST important consideration for this patient should be to: A. transport him in a supine position. B. be alert for signs and symptoms of shock. C. assess his blood pressure to determine perfusion adequacy. D. determine the exact location and cause of his pain.

B. be alert for signs and symptoms of shock.

Peritonitis may result in shock because: A. intra-abdominal hemorrhage is typically present. B. fluid shifts from the bloodstream into body tissues. C. abdominal distention impairs cardiac contractions. D. severe pain causes systemic dilation of the vasculature.

B. fluid shifts from the bloodstream into body tissues.

For a patient with a gastrointestinal complaint, it is MOST important for the EMT to _________. A. determine the cause of the patient's complaint B. identify whether the patient requires rapid transport C. perform all interventions prior to transport D. avoid transporting the patient if the condition is minor

B. identify whether the patient requires rapid transport

A young female presents with costovertebral angle tenderness. She is conscious and alert with stable vital signs. Which of the following organs is MOST likely causing her pain? A. liver B. kidney C. pancreas D. gallbladder

B. kidney

Your patient complains of chronic "burning" stomach pain that improves after eating. You should suspect: A. pneumonia. B. peptic ulcer disease. C. aortic aneurysm. D. kidney stones.

B. peptic ulcer disease.

An important aspect in the treatment of a patient with severe abdominal pain is to: A. give 100% oxygen only if signs of shock are present. B. provide emotional support en route to the hospital. C. encourage the patient to remain in a supine position. D. administer analgesic medications to alleviate pain.

B. provide emotional support en route to the hospital.

In the presence of ileus, the only way the stomach can empty itself is by: A. diarrhea. B. vomiting. C. muscular contraction. D. spontaneous rupture.

B. vomiting.

A young female presents with costovertebral angle tenderness. She is conscious and alert with stable vital signs. Which of the following organs is MOST likely causing her pain? A. Pancreas B. Gallbladder C. Kidney D. Liver

C. Kidney

Which of the following is correct about the secondary assessment for a high-priority patient? A. Never contact medical direction before completing the secondary assessment. B. Never perform a secondary assessment on a high-priority patient. C. You may not have time to complete a secondary assessment. D. The secondary assessment must be performed prior to transport.

C. You may not have time to complete a secondary assessment.

Which of the following organs lies in the retroperitoneal space? A. liver B. spleen C. gallbladder

C. gallbladder

Chronic renal failure is a condition that: A. can be reversed with prompt treatment. B. occurs from conditions such as dehydration. C. is often caused by hypertension or diabetes. D. causes dehydration from excessive urination.

C. is often caused by hypertension or diabetes.

Most patients with abdominal pain prefer to: A. sit fully upright because it helps relax the abdominal muscles. B. sit in a semi-Fowler position with their knees slightly bent. C. lie on their side with their knees drawn into the abdomen. D. lie in a supine position with their knees in a flexed position.

C. lie on their side with their knees drawn into the abdomen.

When assessing a patient with abdominal pain, you should: A. observe for abdominal guarding, which is characterized by sudden relaxation of the abdominal muscles when palpated. B. ask the patient to point to the area of pain or tenderness and assess for rebound tenderness over that specific area. C. palpate the abdomen in a clockwise direction, beginning with the quadrant after the one the patient indicates is painful. D. visually assess the painful area of the abdomen, but avoid palpation because this could worsen his or her condition.

C. palpate the abdomen in a clockwise direction, beginning with the quadrant after the one the patient indicates is painful.

Pain that may be perceived at a distant point on the surface of the body, such as the back or shoulder, is called: A. visceral pain. B. radiating pain. C. referred pain. D. remote pain.

C. referred pain.

Which of the following organs assists in the filtration of blood, serves as a blood reservoir, and produces antibodies? A. liver B. kidney C. spleen D. pancreas

C. spleen

Patients with acute abdominal pain should not be given anything to eat or drink because: A. it will create referred pain and obscure the diagnosis. B. food will rapidly travel through the digestive system. C. substances in the stomach increase the risk of aspiration. D. digestion prevents accurate auscultation of bowel sounds.

C. substances in the stomach increase the risk of aspiration.

The parietal peritoneum lines the: A. retroperitoneal space. B. lungs and chest cavity. C. walls of the abdominal cavity. D. surface of the abdominal organs.

C. walls of the abdominal cavity.

Elderly patients with abdominal problems may not exhibit the same pain response as younger patients because of: A. chronic dementia, which inhibits communication. B. interactions of the numerous medications they take. C. progressive deterioration of abdominal organ function. D. age-related deterioration of their sensory systems.

D. age-related deterioration of their sensory systems.

A 47-year-old male presents with severe abdominal pain of 3 hours' duration. His abdomen is distended and guarded. Your MOST important consideration for this patient should be to: A. determine the exact location and cause of his pain. B. transport him in a supine position. C. assess his blood pressure to determine perfusion adequacy. D. be alert for signs and symptoms of shock.

D. be alert for signs and symptoms of shock.

Peritonitis may result in shock because: A. severe pain causes systemic dilation of the vasculature. B. intra-abdominal hemorrhage is typically present. C. abdominal distention impairs cardiac contractions. D. fluid shifts from the bloodstream into body tissues.

D. fluid shifts from the bloodstream into body tissues.

A strangulated hernia is one that: A. spontaneously reduces without any surgical intervention. B. can be pushed back into the body cavity to which it belongs. C. is reducible if surgical intervention occurs within 2 hours. D. loses its blood supply due to compression by local tissues.

D. loses its blood supply due to compression by local tissues.

Pain that is localized to the lower back and/or lower abdominal quadrants is MOST suggestive of:

an aortic aneurysm