EMT Ch 23 Brady Lab Quiz

You are assessing a patient with abdominal pain. During your​ history, you have determined that the patient receives dialysis three times a​ week, and you note a dialysis shunt in his left arm. How would this knowledge change your assessment of this​ patient's vitals? A. Do not use that arm to obtain a blood pressure. B. Do not evaluate the skin condition in that arm. C. Do not listen to breath sounds on that side of the body. D. Do not assess sensory findings in that arm.

A. Do not use that arm to obtain a blood pressure. Do not obtain a blood pressure in the arm with the shunt. The concern is that the pressure that is generated by the blood pressure cuff may increase the distal venous pressure enough to cause the shunt to rip open. The EMT is permitted to assess sensory findings in that arm and evaluate the skin in that arm. There is no problem with assessing breath​ sounds, as the lungs are in the thoracic cavity.

Within what female reproductive structure does fertilization of the egg with sperm typically​ occur? A. Fallopian tubes B. Ovary C. Vagina D. Uterus

A. Fallopian tubes The fallopian tubes extend from near each of the ovaries to the uterus. The fallopian tubes are typically where fertilization​ occurs, but the egg implants in the uterus to mature after fertilization. The uterus is the​ pear-shaped muscular organ that provides an appropriate site for egg implantation and fetal development during pregnancy. The most inferior portion of the uterus is the cervix. The vagina functions as the birth canal during​ childbirth, receives the penis during sexual​ intercourse, and serves as a passageway for menstrual flow. The ovaries are the primary sex glands and are located on each side of the uterus. They excrete hormones and develop and release eggs that are needed for reproduction.

You are treating a dialysis patient who has missed the last three treatments. The patient currently presents with​ dyspnea, fluid in the​ lungs, and hypertension. During​ transport, how should the patient be positioned on the​ cot? A. Sitting upright B. In a left lateral recumbent position C. In a right lateral recumbent position D. Lying supine

A. Sitting upright During transport of a dialysis patient who has missed one or more treatments and presents with dyspnea and fluid in the​ lungs, the EMT should position the patient in a​ sitting, or​ semi-Fowler's, position to make it easier for the patient to breathe. If the patient is in a supine or lying​ position, this may exacerbate the dyspnea.

You arrive on scene for an elderly patient with suprapubic pain. The patient was discharged yesterday from the hospital with a Foley catheter in place. As you assess the​ equipment, which findings may be contributing to the​ patient's pain? A. You find a kink in the tubing. B. The bag is​ one-third full. C. The fluid in the bag is a pale yellow color. D. The collection bag is located lower than the urethra.

A. You find a kink in the tubing. If the patient has a kink in the drainage​ tubing, the urine that collects in the​ patient's bladder cannot pass into the Foley bag. This can cause urinary retention and enlargement of the bladder from too much trapped urine. This could cause suprapubic pain. A bag that is only​ one-third full is not of​ concern, nor is a pale yellow​ color, as this can be normal.​ Finally, the bag should be located in a position that is lower than the urethra to allow good drainage of urine into the bag.

The structure through which urine passes to be eliminated from the body is​ the: A. urethra. B. ureter. C. loop of Henle. D. calyx.

A. urethra. The ureters are the tubes that carry urine from the kidneys to the urinary bladder. The urinary bladder houses the urine until it is eliminated from the body via a duct called the urethra. In​ women, the urethral opening is anterior to the vagina and excretes​ urine; in​ men, the urethra is located at the tip of the penis and eliminates both urine and male reproductive fluid. The calyx is a specific part of the kidney structure. The loop of Henle is a portion of the nephron.

Sickle cell anemia primarily affects which​ population? A. Children B. African Americans C. ​Middle-aged women D. People of Asian descent

B. African Americans Sickle cell anemia is a hereditary blood disorder that most often afflicts African Americans and black Africans but also people of​ Mediterranean, South and Central​ American, Caribbean, and Middle Eastern ancestry. In sickle cell​ anemia, some red blood cells have abnormal hemoglobin that does not carry adequate oxygen. As a​ result, the cells take on a crescent​ (sickle) shape and become​ fragile, stiff, and rigid. The sickled cells begin to stack​ up, blocking capillary blood flow. Cells and tissues become ischemic and may die. Patients with this disease often suffer infections from damaged red blood cells blocking the spleen. Leukemia is a condition of inadequate white blood​ cells, hematuria is blood in the​ urine, and myoglobin is a protein found in muscle cells.

When a​ 25-year-old male patient complains of pain on urination and has a​ fever, nausea, and​ vomiting, he could have a number of conditions. What would make you suspect that it is a kidney​ stone? A. Crushing pain in the back B. Flank or back pain that is colicky and severe C. A sharp pain in the back of the chest on inspiration D. Burning sensation from the center of the chest into the back

B. Flank or back pain that is colicky and severe Common signs and symptoms of kidney stones include abdominopelvic pain or​ tenderness, flank or back pain that is colicky and​ severe, groin​ pain, abnormal urine​ color, pain with​ urination, frequent or urgent need to​ urinate, fever or​ chills, nausea, or vomiting.

What is the name of the urinary catheter that is inserted directly into the bladder via the​ urethra? A. Suprapubic B. Foley C. ​G-tubes D. ​J-tubes

B. Foley As an​ EMT, you may encounter patients who have urinary catheters. Foley or indwelling catheters have a balloon that is inserted into the urinary bladder via the urethra. The urine drains from the bladder into the catheter and is deposited into a bag. Suprapubic catheters work in a similar​ way, but instead of being inserted through the​ urethra, they are placed into the urinary bladder directly through the​ patient's abdominal wall.​ J-tubes and​ G-tubes refer to medical equipment that is inserted through the abdominal wall and into the gastrointestinal system.

Which statement is the BEST explanation as to why the patient may die if the descending abdominal aorta becomes​ perforated? A. The perforation will stop the blood flow to the lower​ extremities, so the patient will build up blood acids that will prove to be fatal. B. It is a large vascular structure. C. The bacteria and chemicals that will be released damage surrounding tissue rapidly. D. If it tears​ open, it also tears open surrounding solid organs.

B. It is a large vascular structure. Vascular structures are the large blood vessels that are found in the abdominal cavity. Portions of the descending aorta and the inferior vena cava are located in the abdominal cavity. Rupture or injury to either vessel will result in major​ bleeding, rapid blood​ loss, and death. Just because the vascular structures are injured does not mean that surrounding organs are injured. Hollow organs such as the gastrointestinal system spill bacterial and chemicals into the​ abdomen, and even though large vascular damage may occur in the​ abdomen, death is caused by blood loss and not by diminished blood flow to the lower extremities.

The pancreas is located in which abdominal​ quadrant? A. Right lower B. Left upper C. Right upper D. Left lower

B. Left upper The left upper quadrant​ (LUQ) contains most of the​ stomach, the​ spleen, the​ pancreas, and part of the large intestine. The left kidney is behind the abdominal lining. The right lower quadrant​ (RLQ) contains the​ appendix, part of the large​ intestine, and the female reproductive organs. The left lower quadrant​ (LLQ) contains part of the large intestine and the female reproductive organs. The right upper quadrant​ (RUQ) contains most of the​ liver, the​ gallbladder, and part of the large intestine. The right kidney is behind the abdominal lining.

What quadrant of the abdomen contains the​ appendix, part of the large​ intestine, and part of the female reproductive​ organs? A. Left lower B. Right lower C. Right upper D. Left upper

B. Right lower The right lower quadrant​ (RLQ) contains the​ appendix, part of the large​ intestine, and the female reproductive organs. The left lower quadrant​ (LLQ) contains part of the large intestine and the female reproductive organs. The right upper quadrant​ (RUQ) contains most of the​ liver, the​ gallbladder, and part of the large intestine. The right kidney is behind the abdominal lining. The left upper quadrant​ (LUQ) contains most of the​ stomach, the​ spleen, the​ pancreas, and part of the large intestine. The left kidney is behind the abdominal lining.

What type of pain is characterized as a dull or aching discomfort that is poorly localized by the​ patient? A. Radicular B. Visceral C. Parietal D. Referred

B. Visceral Visceral pain occurs when an organ itself is involved. Most organs do not have a large number of highly sensitive nerve​ fibers; therefore, the pain is usually less​ severe, is poorly localized​ (the patient cannot point to the pain with one finger - it is more general in​ nature), is dull or aching or​ oppressive, and may be constant or intermittent. Parietal pain is often described as sharp and localized. Referred pain occurs when the patient has a discomfort at a location that is not the source of pain. Radicular pain occurs when pain travels along a nerve dermatome.

A sudden onset of abdominal pain located from the middle of the upper quadrants to the right upper quadrant​ area, presenting at​ night, and associated with a​ low-grade fever and greenish emesis is MOST likely caused​ by: A. a hernia. B. cholecystitis. C. an intestinal obstruction. D. pancreatitis.

B. cholecystitis. ​Cholecystitis, or inflammation of the​ gallbladder, is commonly associated with the presence of gallstones. This condition is more common in women than in men and frequently occurs between the ages of 30 and 50 years. Common signs and symptoms of cholecystitis include a sudden onset of abdominal pain located from the middle of the upper quadrants​ (epigastric area) to the RUQ. The pain is most often present at night and is associated with ingestion of fatty foods. The patient may also complain of tenderness on palpation of the​ RUQ, belching or​ heartburn, and nausea and​ vomiting; the contents of the vomitus may be greenish.

All of the following are signs and symptoms that may accompany a gynecological emergency​ EXCEPT: A. genital​ itching, redness, or swelling. B. hypertension. C. syncope. D. fever and chills.

B. hypertension. Abdominopelvic pain and vaginal bleeding are the two most common signs and symptoms of a gynecological emergency. Others are pain during sexual​ intercourse, urination, or a bowel​ movement; syncope; fever or​ chills; nausea and​ vomiting; and genital​ itching, redness, or swelling. Hypertension is not a cause of abdominopelvic pain or vaginal​ bleeding; typically, hypertension is a cardiovascular disorder.

Your patient with an acute abdomen is found in a guarded position. This position​ is: A. sitting in a chair with the hands on the​ knees, leaning forward. B. in a lying position with knees drawn up and hands over the abdomen. C. flat on the back with legs extended and the hands clenched over the abdomen. D. on the​ knees, leaning​ forward, hands on the floor supporting the body.

B. in a lying position with knees drawn up and hands over the abdomen. A person with an acute abdomen generally appears very ill and will assume a guarded position with knees drawn up and hands clenched over the abdomen. This position helps to decrease the pressure in the abdomen by relaxing the abdominal musculature.

You are treating a patient who you suspect may have a urinary tract infection. He says that he thinks he had blood in his urine this morning. What it the medical term for that​ condition? A. Renal calculi B. Anemia C. Hematuria D. Hematochezia

C. Hematuria Hematuria is a condition in which there is visible blood in the urine. Anemia is a condition of diminished red blood cells in the​ body, renal calculi are kidney​ stones, and hematochezia is visible blood in the stool from a gastrointestinal condition.

What quadrant of the abdomen contains most of the​ stomach, the​ pancreas, part of the large​ intestine, and the​ spleen? A. Right upper B. Right lower C. Left upper D. Left lower

C. Left upper The left upper quadrant​ (LUQ) contains most of the​ stomach, the​ spleen, the​ pancreas, and part of the large intestine. The left kidney is behind the abdominal lining. The right lower quadrant​ (RLQ) contains the​ appendix, part of the large​ intestine, and the female reproductive organs. The left lower quadrant​ (LLQ) contains part of the large intestine and the female reproductive organs. The right upper quadrant​ (RUQ) contains most of the​ liver, the​ gallbladder, and part of the large intestine. The right kidney is behind the abdominal lining.

What is the BEST indicator of your​ patient's status when you are initially assessing a gynecological​ emergency? A. Rate of hemorrhage B. Blood pressure C. Level of consciousness D. Severity of pain

C. Level of consciousness Level of consciousness is the best indicator of your​ patient's status. Vital signs are useful clues to the nature of your​ patient's problem, but the blood pressure typically does not drop until a significant amount of blood has been lost​ (and by​ then, the​ patient's mental status would already have started to​ deteriorate). Significant bleeding will cause increased pulse and respiratory rates as well as narrowing pulse pressures.

The gallbladder is located in which abdominal​ quadrant? A. Left upper B. Right lower C. Right upper D. Left lower

C. Right upper The right upper quadrant​ (RUQ) contains most of the​ liver, the​ gallbladder, and part of the large intestine. The right kidney is behind the abdominal lining. The left upper quadrant​ (LUQ) contains most of the​ stomach, the​ spleen, the​ pancreas, and part of the large intestine. The left kidney is behind the abdominal lining. The right lower quadrant​ (RLQ) contains the​ appendix, part of the large​ intestine, and the female reproductive organs. The left lower quadrant​ (LLQ) contains part of the large intestine and the female reproductive organs.

What surrounds some solid organs such as the liver and​ spleen, but does not surround hollow and vascular​ structures? A. Large network of capillary beds B. Parietal peritoneum C. Thick fibrous capsule D. Layer of fatty tissue

C. Thick fibrous capsule Solid organs are very vascular​ (contain a large amount of vessels and​ blood). Some of these organs​ (liver and​ spleen) are covered by a thick fibrous capsule. This capsule helps to protect the organ and occasionally will help to tamponade a bleed that has occurred when the solid organ is perforated for some reason. Most organs are surrounded also by fatty tissue for​ protection, and they all have capillary beds within them. The parietal peritoneum is a layer of tissue that surrounds the entire abdominal cavity.

When you conduct a focused history and physical examination of your patient with abdominal​ pain, remember​ to: A. palpate the abdomen several times to determine if the pain is getting worse or not. B. palpate the area of the abdomen that is most painful first to get it out of the way. C. ask what color the​ patient's last stool was. D. give the patient milk or an​ over-the-counter antacid for pain relief.

C. ask what color the​ patient's last stool was. Depending on the answer to this​ question, the EMT may be able to discern whether there has been bleeding into the gastrointestinal​ system, or in the absence of any bowel movement for some​ time, a constipation issue that is causing the pain. The EMT should never give the patient anything by​ mouth, and the abdomen should be palpated by starting at a quadrant most distant from the site of pain. Repeating the palpation will not likely provide any additional​ information, and the repeated palpation may increase the​ patient's pain.

Your patient is complaining of severe abdominal pain that is sharp in character and can be easily localized by pointing to it with one hand. That type of pain is known​ as: A. radicular. B. visceral. C. parietal. D. referred.

C. parietal. Parietal​ pain, also​ called somatic pain, is associated with irritation of the peritoneal lining. Remember that the peritoneum has a larger amount of highly sensitized nerve endings.​ Thus, one would expect the pain to be more severe and more localized​ (easier to point to with one​ finger). Parietal pain is more localized and is​ intense, usually found on one side or the​ other, sharp, and typically constant. Visceral pain is dull and poorly localized. Referred pain occurs when the patient has a discomfort at a location that is not the source of pain. Radicular pain occurs when pain travels along a nerve dermatome.

Which disease is an inherited disorder that causes abnormally slow blood​ clotting? A. Endometriosis B. Sickle cell anemia C. Stage 4 anemia D. Hemophilia

D. Hemophilia Hemophilia is a blood disorder that affects clotting. When a person with hemophilia is​ injured, it takes longer for the bleeding to stop because clots cannot form properly. Bleeding that would be considered minor for a​ non-hemophiliac, such as a​ nosebleed, is a major emergency for the hemophiliac. Normal bleeding control procedures should be applied to the​ hemophiliac; however, stopping the blood loss will be more​ difficult, and your attempts to do will be so less effective. Sickle cell anemia is a disease that alters the shape of the red blood cell. Endometriosis is a condition in which endometrial tissue grows outside the uterus. Stage 4 anemia is a fictitious term.

When should you administer oxygen to a patient with a genitourinary complaint and no pulmonary​ complaints? A. If the heart rate is above​ 90/minute B. If you need to place the patient in​ Fowler's position for comfort C. If the patient rates the pain as moderate or higher D. If the pulse ox reading is less than 94 percent

D. If the pulse ox reading is less than 94 percent If the SpO2​ is greater than 94 percent and no other signs of respiratory​ distress, hypoxia,​ hypoxemia, or poor perfusion are​ present, there may be no need to administer supplemental oxygen. If the SpO2​ is less than 94 percent or if signs of respiratory​ distress, hypoxia,​ hypoxemia, or poor perfusion are​ present, administer oxygen via a nasal cannula to maintain an SpO2​ reading of at least 94 percent. If signs of severe hypoxia are​ present, a nonrebreather mask at 15 lpm could be used.

You are caring for a patient with a gynecological emergency. The patient presents with a diminished​ orientation, tachypnea and​ tachycardia, and pale skin. The pulse oximeter reads 90 percent on room air. Which intervention should you perform to increase the pulse ox​ reading? A. Insert an oropharyngeal airway. B. Insert a nasopharyngeal airway. C. Put the patient in a supine position with the legs elevated 12 inches. D. Place the patient on oxygen.

D. Place the patient on oxygen. If the SpO2 is 94 percent or more and no other signs of respiratory​ distress, hypoxia,​ hypoxemia, or poor perfusion are​ present, there may be no need to administer supplemental oxygen. If the SpO2 is 94 percent or more or signs of respiratory​ distress, hypoxia,​ hypoxemia, or poor perfusion are​ present, administer oxygen via a nasal cannula to maintain an SpO2 reading of 94 percent or more. If signs of severe hypoxia are​ present, a nonrebreather mask at 15 lpm could be used.

How many kidneys does the body​ have? A. Three B. Four C. One D. Two

D. Two The kidneys are a pair of organs located in the retroperitoneal space of the abdominal cavity. Their basic role is to filter blood and create urine to carry the waste out of the body. They also play a role in​ acid-base balance by buffering hydrogen and bicarbonate ions.

What are two common problems that are seen in patients who miss dialysis​ treatments? A. Altered mental status and strokes B. Fluid depletion and congestive heart failure C. Gastrointestinal bleeding and electrolyte shifts D. Weakness and pulmonary edema

D. Weakness and pulmonary edema Beyond the typical complications of​ dialysis, a patient who misses one or several sessions is more likely to start experiencing general weakness and pulmonary edema. Missing one or more treatments is unlikely to cause gastrointestinal​ bleeding; the patient is also unlikely to become fluid depleted.

Your patient has a history of alcohol​ abuse, is vomiting large amounts of bright red​ blood, and has a rapid pulse but no pain or tenderness to the abdomen. You​ suspect: A. cholecystitis. B. an ulcer. C. an abdominal aortic aneurysm. D. esophageal varices.

D. esophageal varices. Esophageal varices are a​ bulging, engorgement, or weakening of the blood vessels in the lining of the lower part of the esophagus. These abnormalities are common in heavy alcohol drinkers or patients with liver disease and are caused by increased pressure in the venous blood supply system of the​ liver, stomach, and esophagus. The patient typically does not complain of pain associated with the vomiting of blood.​ Ulcers, abdominal aortic​ aneurysms, and cholecystitis are all associated with moderate to severe abdominal pain.

Until it has been proven​ otherwise, you should assume that a missed or late menstrual period is due​ to: A. stress. B. IUD use. C. menopause. D. pregnancy.

D. pregnancy. Until it has been proven​ otherwise, you should assume that any missed or late period is due to pregnancy even if your patient denies it. Direct questions such as​ "Could you be​ pregnant?" may not get an accurate response. Inquire about other​ signs, including a late or missed​ period, breast​ tenderness, bloating, urinary​ frequency, or nausea and vomiting.​ Stress, menopause, and IUD use may cause vaginal bleeding or alter its​ characteristics; however, these rarely cause the absence of a menstrual cycle.

The female reproductive structure that houses the fetus during development is​ the: A. fallopian tube. B. ovary. C. cervix. D. uterus.

D. uterus. The uterus is the​ pear-shaped muscular organ that provides an appropriate site for egg implantation and fetal development during pregnancy. The most inferior portion of the uterus is the cervix. The vagina functions as the birth canal during​ childbirth, receives the penis during sexual​ intercourse, and serves as a passageway for menstrual flow. The ovaries are the primary sex glands and are located on each side of the uterus. They excrete hormones and develop and release eggs that are needed for reproduction. The fallopian tubes extend from near each of the ovaries to the uterus. The fallopian tubes are typically where fertilization​ occurs, but the egg implants in the uterus to mature after fertilization.