Exam Chapters 33 - 36
Which of the following questions is of LEAST pertinence when determining whether a mother will deliver her baby within the next few minutes? a. "Have you had a sonogram?" b. "Is this your first baby?" c. "When are you due?" d. "Do you feel the need to push?"
"Have you had a sonogram?"
A mother who is pregnant with her first baby is typically in the first stage of labor for approximately: Select one: a. 16 hours b. 8 hours c. 10 hours d. 4 hours
16 hours
f a baby is born at 7:52, the second Apgar score should be calculated at: a. 7:53 b. 7:57 c. 7:59 d. 8:00
7:57
During your visual inspection of a 25-year-old woman in labor, you see the baby's head crowning at the vaginal opening. What should you do? Select one: a. Apply gentle pressure to the baby's head as it delivers b. Place your fingers in the vagina to assess for a nuchal cord c. Tell the mother not to push and transport her immediately d. Maintain firm pressure to the head until it completely delivers
Apply gentle pressure to the baby's head as it delivers
Under what circumstances is a left ventricular assist device used? Select one: a. To permanently replace the function of one or both of the ventricles b. To ensure that the ventricles contract at an adequate and consistent rate c. As a bridge to heart transplantation while a donor heart is being located d. To reduce ventricular pumping force in patients with aortic aneurysms
As a bridge to heart transplantation while a donor heart is being located
According to the "E" in the DOPE mnemonic, which of the following actions should you perform to troubleshoot inadequate ventilation in a patient with a tracheostomy tube? a. Check the mechanical ventilator for malfunction b. Listen to breath sounds to assess for a pneumothorax c. Attempt to pass a suction catheter into the tube d. Look for blood or other secretions in the tube
Check the mechanical ventilator for malfunction
Which of the following statements regarding interaction with the caregiver of a child or adult with special health care needs is correct? a. In general, the EMT should only speak with a certified home health care provider because he or she is the expert on the patient's illness b. In most cases, it is more appropriate for the EMT to contact medical control prior to speaking with the patient's primary caregiver c. Before performing an assessment of the patient's ABCs, the EMT should ask the caregiver about the patient's medical condition d. Communication with the patient's caregiver or family members is important because they are the most familiar with the patient's condition
Communication with the patient's caregiver or family members is important because they are the most familiar with the patient's condition
Which of the following findings is LEAST suggestive of child abuse? a. Burns to the hands or feet that involve a glove distribution b. An unexplained delay in seeking medical care after the injury c. Evidence of alcohol consumption or drug use at the scene d. Consistency in the method of injury reported by the caregiver
Consistency in the method of injury reported by the caregiver
Which of the following statements regarding sudden infant death syndrome (SIDS) is correct? a. The cause of death following SIDS can be established by autopsy b. Certain cases of SIDS are predictable and therefore preventable c. SIDS is most commonly the result of an overwhelming infection d. Death as a result of SIDS can occur at any time of the day or night
Death as a result of SIDS can occur at any time of the day or night
Which of the following statements regarding autism is correct? a. Impairment of motor activity is a classic sign of autism b. Autism affects females four times greater than males c. Most cases of autism are diagnosed by 3 years of age d. The majority of patients with autism do not speak at all
Most cases of autism are diagnosed by 3 years of age
Which of the following conditions would MOST likely be encountered in a patient with cerebral palsy? a. Paralysis b. Brain tumors c. Seizure disorder d. Type 2 diabetes
Seizure disorder
Which of the following would be the MOST practical method of communicating with a hearing-impaired patient until his or her hearing aids can be located? a. Attempting to use body language to determine the problem b. Using a piece of paper and writing utensil to ask questions c. Contacting dispatch and requesting a sign language interpreter d. Using a high-pitched voice while speaking directly into the ear
Using a piece of paper and writing utensil to ask questions
From what internal female organ is the fetus expelled during delivery? a. Vagina b. Uterus c. Cervix d. Perineum
Uterus
When questioning the parent of a child who ingested a poisonous substance, which of the following questions would be of LEAST pertinence initially? a. Why did your child ingest the poison? b. What time did the ingestion occur? c. Have you noticed any signs or symptoms? d. Do you know what substance was ingested?
Why did your child ingest the poison?
Spina bifida is defined as: a. a birth defect caused by incomplete closure of the spinal column b. chronic pressure on the brain caused by excess cerebrospinal fluid c. a birth defect in which the child is born without spinal vertebrae d. congenital inflammation of the spinal cord, usually in the neck
a birth defect caused by incomplete closure of the spinal column
During the natural process of aging, the number of functional cilia in the respiratory system decreases, resulting in: a. air-trapping within the alveoli b. baseline respiratory distress c. an increased risk of COPD d. a decreased ability to cough
a decreased ability to cough
Down syndrome is a genetic defect that occurs as the result of: a. a triplication of chromosome 21 b. an extra pair of chromosomes c. a sperm that contains 24 chromosomes d. a separation of chromosome 21
a triplication of chromosome 21
An infant with severe dehydration would be expected to present with: a. moist oral mucosa b. excessive tearing c. bulging fontanelles d. absent urine output
absent urine output
You are dispatched to a residence for a child with respiratory distress. The patient, an 18-month-old female, is tachypneic, has sternal retractions, and is clinging to her mother. Her skin is pink and dry, and her heart rate is 120 beats/min. The MOST appropriate treatment for this child includes: a. separating the child from her mother and providing ventilatory assistance b. requesting a paramedic ambulance to insert an advanced airway device c. allowing the child to remain with her mother and applying a nasal cannula d. administering blow-by oxygen and transporting the child with her mother
administering blow-by oxygen and transporting the child with her mother
A specific legal document that directs relatives and caregivers regarding the medical treatment that may be given to patients who cannot speak for themselves is called a(n): a. advance directive b. statute of care c. power of attorney d. physician directive
advance directive
According to the Emergency Medical Treatment and Active Labor Act (EMTALA): Select one: a. all health care facilities are legally obligated to provide assessment and care only if the patient is critically ill or injured b. a health care facility has the right to refuse assessment and treatment to a patient, but only if his or her condition is not deemed critical c. all health care facilities must provide a medical assessment and required treatment, regardless of the patient's ability to pay d. a patient maintains the legal right to recant his or her consent to emergency treatment, even after signing in to the emergency department
all health care facilities must provide a medical assessment and required treatment, regardless of the patient's ability to pay
The purpose of the pediatric assessment triangle (PAT) is to: a. facilitate a rapid head-to-toe assessment of the child by visualization only b. gather critical data by performing a rapid hands-on assessment of the child c. determine if the child's vital signs are within the age-appropriate limits d. allow you to rapidly and visually form a general impression of the child
allow you to rapidly and visually form a general impression of the child
A history of pelvic inflammatory disease or tubal ligations increases a woman's risk for: a. an ectopic pregnancy b. placenta previa c. preeclampsia d. gestational diabetes
an ectopic pregnancy
Unless he or she is critically ill or injured, you should generally begin your assessment of a toddler: a. at the head b. at the feet c. in the ambulance d. en route to the hospital
at the feet
You are assessing a 440-lb man who complains of shortness of breath and lower back pain. The patient is conscious and alert, his blood pressure is 148/98 mm Hg, and his heart rate is 120 beats/min. Your MOST immediate action should be to: a. ask a member of your team to locate the best route to move him to the ambulance b. avoid placing him in a supine position if possible and administer oxygen c. notify the receiving facility and advise them of the patient's weight and status d. perform a secondary assessment, focusing on his respiratory system and back
avoid placing him in a supine position if possible and administer oxygen
By the 20th week of pregnancy, the uterus is typically at or above the level of the mother's: a. pubic bone b. xiphoid process c. superior diaphragm d. belly button
belly button
Pale skin in a child indicates that the: a. blood vessels near the skin are constricted b. child is in severe decompensated shock c. oxygen content in the blood is decreased d. child's core body temperature is elevated
blood vessels near the skin are constricted
Cerebral palsy is characterized by poorly controlled ________ movement. a. eye b. extremity c. neck d. body
body
Clouding of the lenses of the eyes is called: a. cataracts b. glaucoma c. conjunctivitis d. retinitis
cataracts
A surgical procedure that creates an opening between the intestine and the surface of the body that allows for elimination of waste products is called a(n): a. gastrostomy b. colostomy c. gastric stoma d. intestinal shunt
colostomy
You are attending to a 23-year-old female patient who is 16 weeks pregnant with her second child. The patient has apparently fallen and sustained an injury to her upper right arm. When you ask about the incident history, the patient is reluctant to explain what happened and becomes very quiet. Based on this information, you should: a. contact police and remain at the scene until they arrive and escort you to the hospital b. continue your care in a private area, document any details regarding the scene and the incident, and reassure her as you provide care c. immediately remove the patient from the environment and transport d. ask more detailed questions and press the issue until you have a more detailed understanding of the incident
continue your care in a private area, document any details regarding the scene and the incident, and reassure her as you provide care
A 2-year-old female has experienced a seizure. When you arrive at the scene, the child is conscious, crying, and clinging to her mother. Her skin is hot and moist. The mother tells you that the seizure lasted approximately 5 minutes. She further tells you that her daughter has no history of seizures, but has had a recent ear infection. You should: a. cool the child with tepid water and transport to the hospital b. place the child in cold water to attempt to reduce her fever c. suspect that the child has meningitis and transport at once d. allow the mother to drive her daughter to the hospital
cool the child with tepid water and transport to the hospital
A viral infection that may cause obstruction of the upper airway in a child is called: a. bronchitis b. epiglottitis c. croup d. asthma
croup
A 13-year-old child is on a home ventilator. The parents called because the mechanical ventilator is malfunctioning and the child has increasing respiratory distress. You should: a. reset the ventilator by unplugging it for 30 to 60 seconds b. attempt to troubleshoot the mechanical ventilator problem c. disconnect the ventilator and apply a tracheostomy collar and use a BVM d. place a call to the home health agency treating this patient
disconnect the ventilator and apply a tracheostomy collar and use a BVM
Infection should be considered a possible cause of an airway obstruction in an infant or child, especially if he or she presents with: a. extreme restlessness b. skin that is cool and dry c. acute respiratory distress d. drooling or congestion
drooling or congestion
Following delivery of a full-term baby, you have properly cared for the baby and have clamped and cut the umbilical cord. During transport, you note that the mother is experiencing moderate vaginal bleeding. You should: a. place her legs together and position her on her left side b. carefully insert a sterile trauma dressing into her vagina c. elevate her legs 6 to 8 inches and cover her with a blanket d. firmly massage the uterine fundus with a circular motion
firmly massage the uterine fundus with a circular motion
When caring for a female child who has possibly been sexually abused, you should: a. immediately report your suspicions to the parents b. have a female EMT remain with her if possible c. carefully examine the genitalia for signs of injury d. encourage the child to urinate and take a shower
have a female EMT remain with her if possible
To minimize distractions and confusion when assessing an older patient, you should: a. elevate your voice and speak directly to the patient b. dismiss the family members from the room or area c. have only one EMT speak to the patient at a time d. perform a physical exam and then talk to the patient
have only one EMT speak to the patient at a time
The leading cause of death in the geriatric patient is: a. hypertension b. heart disease c. arthritis d. altered mental status
heart disease
Common causes of seizures in children include all of the following, EXCEPT: a. infection b. poisonings or ingestion c. electrolyte imbalances d. hyperglycemia
hyperglycemia
You are assessing a 70-year-old female who complains of intense thirst, frequent urination, and dizziness. She has a history of type 2 diabetes, heart disease, rheumatoid arthritis, and gout. Her blood glucose reads "high." She is conscious, but confused. Her blood pressure is 92/52 mm Hg, her pulse rate is 130 beats/min and weak, and her respirations are 22 breaths/min and shallow. This patient's clinical presentation is MOST consistent with: a. hyperglycemia with moderate dehydration b. diabetic ketoacidosis c. hyperosmolar hyperglycemic nonketotic syndrome d. acute renal failure with associated hyperglycemia
hyperosmolar hyperglycemic nonketotic syndrome
The amniotic fluid serves to: a. assist in fetal development b. insulate and protect the fetus c. transfer oxygen to the fetus d. remove viruses from the fetus
insulate and protect the fetus
A nuchal cord is defined as an umbilical cord that: Select one: a. is lacerated due to a traumatic delivery b. has separated from the placenta c. is wrapped around the baby's neck d. has abnormally developed blood vessels
is wrapped around the baby's neck
The first month of life after birth is referred to as the: a. toddler period. b. premature phase. c. start of infancy. d. neonatal period.
neonatal period.
When preparing a pregnant patient for delivery, you should position her: a. on her left side with the right leg elevated b. in a supine position with her legs spread c. in a sitting position with her hips elevated 12 inches d. on a firm surface with her hips elevated 2 to 4 inches
on a firm surface with her hips elevated 2 to 4 inches
When immobilizing a patient with a kyphotic spine to a long backboard, the EMT would MOST likely have to: a. place blankets behind the patient's head b. force the head into a neutral alignment c. secure the patient's head before the torso d. use a scoop stretcher instead of a log roll
place blankets behind the patient's head
A 26-year-old female who is 34 weeks pregnant is experiencing a seizure. Her husband tells you that her blood pressure has been high and that she had been complaining of a headache for the past few days. You should: Select one: a. insert an oral airway and ventilate her with a bag-valve mask b. administer oral glucose for presumed hypoglycemia and transport c. place her on her side, administer high-flow oxygen, and transport d. elevate her legs to improve brain perfusion and keep her warm
place her on her side, administer high-flow oxygen, and transport
Your 22-year-old patient is in active labor. Upon visual inspection, you note that the infant's leg is protruding from the vagina. Appropriate management of this situation includes: a. carefully attempting to push the infant's leg off of the umbilical cord b. placing the mother supine with her head down and pelvis elevated c. gently pulling on the infant's leg in an attempt to facilitate delivery d. placing the mother in a recumbent position and rapidly transporting
placing the mother supine with her head down and pelvis elevated
Sedentary behavior while healing from a hip fracture would MOST likely predispose the older patient to: a. heart failure b. pneumonia c. ischemic stroke d. osteoporosis
pneumonia
Common interventions used to stimulate spontaneous respirations in the newborn include all of the following, EXCEPT: a. suctioning of the upper airway b. thorough drying with a towel c. positive-pressure ventilations d. some form of tactile stimulation
positive-pressure ventilations
A pregnant trauma patient may lose a significant amount of blood before showing signs of shock because: a. pregnant patients can dramatically increase their heart rate b. pregnancy causes vasodilation and a lower blood pressure c. blood is shunted to the uterus and fetus during major trauma d. pregnant patients have an overall increase in blood volume
pregnant patients have an overall increase in blood volume
Three days after delivering her baby, a 30-year-old woman complains of a sudden onset of difficulty breathing. Her level of consciousness is decreased and she is tachycardic. The EMT should suspect: a. acute pulmonary edema b. pulmonary embolism c. spontaneous pneumothorax d. intrauterine bleeding
pulmonary embolism
Blood levels of medications may rise in the elderly, sometimes to toxic levels. This is MOST likely due to: a. renal insufficiency b. intentional overdose c. splenic dysfunction d. pancreatic failure
renal insufficiency
You and your partner are both male and are attending to a 28-year-old female patient complaining of diffuse abdominal pain. The patient is 34 weeks pregnant with her first child. The patient refuses to allow you to examine her, and her husband informs you that their culture does not allow males to examine or care for pregnant women. You should: a. insist that the patient requires proper care and that requires an adequate physical assessment and that you cannot be responsible for the outcome b. inform the patient that by calling for an ambulance, she is agreeing to the care provided and continue with your assessment and management c. respect the patient's wishes, ensure that the appropriate documentation is completed, and transport the patient d. call for the police to ensure that patient assessment is carried out
respect the patient's wishes, ensure that the appropriate documentation is completed, and transport the patient
Common complications associated with central venous catheters include all of the following, EXCEPT: a. clotting of the line b. bleeding around the line c. a local infection d. rupture of a central vein
rupture of a central vein
Signs and symptoms of meningitis in the infant or child include all of the following, EXCEPT: a. headache and fever b. altered mental status c. a stiff or painful neck d. sunken fontanelles
sunken fontanelles
When assessing an 8-year-old child, you should: a. talk to the child, not just the caregiver b. rely solely on the parent for information c. use a toe-to-head assessment approach d. refrain from taking a blood pressure
talk to the child, not just the caregiver
When caring for a patient who is visually impaired, it is important to: a. tell him or her what is happening, identify noises, and describe the situation and surroundings b. stand to the side of the patient when speaking if his or her peripheral vision is impaired c. allow a service dog to remain with the patient at all times, even if the patient is critically ill d. leave items such as canes and walkers at the residence if the patient will be carried on a gurney
tell him or her what is happening, identify noises, and describe the situation and surroundings
The presence of meconium in the amniotic fluid indicates: a. an expected finding in full-term infants b. that the fetus is at least 4 weeks premature c. that the baby's airway may be obstructed d. that full newborn resuscitation will be needed
that the baby's airway may be obstructed
In contrast to younger patients, older patients are more prone to a decrease in blood pressure (BP) upon standing because: a. any change in position causes blood to be shunted to the brain b. the aging process results in an overall increase in blood volume c. their red blood cells are destroyed at a faster than normal rate d. the body is less able to adapt the BP to rapid postural changes
the body is less able to adapt the BP to rapid postural changes