lc ready app Review exam 1

A 22 year old female is having an asthma attack. She is 31 weeks pregnant. Which one of the following reasons explains why asthma might affect this patient more profoundly than a nonpregnant patient?

Pregnancy increases the consumption of oxygen

A patient who has a history of oral and laryngeal cancer had his laryngeal structures surgically removed as part of the cancer treatment. In its place, a stoma tube has been inserted into the airway on the neck. Currently, this patient is breathing inadequately as evidenced by minimal chest wall movement and no basal breath sounds. Given the patient's history and presentation, what would be the best way to ensure adequate ventilation?

Provide positive pressure ventilation with a pediatric mask and adult bag over the stoma openin

A patient has suffered significant blunt trauma to the chest, resulting in multiple rib fractures and a flail segment. Beyond the impaired ventilation due to thoracic instability, what is a common secondary injury seen with blunt thoracic trauma that can severely hamper normal respiratory efficiency?

Pulmonary contusion

You are addressing a person who is angry at you because his wife was pronounced dead on scene and he thinks you should have started treatment and transport. You are trying to gather specific patient information from him so you can contact appropriate authorities. During this exchange, what patient communication strategy could you possibly employ

Reflection

As you enter an apartment, you observe an alert but anxious woman in her 50s sitting in a chair working to breathe. You see accessory muscle use, shallow respirations, and pale skin. How would you classify this patient's respiratory status?

Respiratory distress

You arrive at the scene of a reported domestic dispute near your station. Due to the rapid response time you arrive before the police. As you cautiously approach the front door you hear loud shouting and what sounds like glass breaking coming from within. What should you do in this instance?

Return to ambulance and stage a few blocks away while waiting for police

Which one of the following medical-legal concepts would best apply to an EMT who chose to illegally perform a paramedic level skill?

Scope of practice

You are treating a 23 year old male for burns sustained when the lawn mower he was working on caught fire due to a gas spill. The patient has reddened skin and blistering to both hands, his right arm, and the anterior right thorax. Given the type and percentage of body surface area burned, how would these burns be categorized?

Severe

You are called to a school for an 8 year old with a nosebleed, which the school nurse is having trouble controlling. When packaging the patient for transport, what is the most appropriate way to position him?

Sitting up and leaning forward

A 43 year old male patient has been shot in the abdomen during a bar fight. Upon your arrival, he appears alert and oriented. You observe a small puncture wound to the LUQ with minimal bleeding and no exit wound. The airway is patent, breathing is rapid but adequate, the peripheral perfusion is intact with good radial pulses. Vitals are P 110, R 26/min, BP 122/86. Given these findings, how would you categorize his physiological status?

Stable, but potentially unstable

During a large-scale incident in your community where multiple people are injured, you have been designated by the Incident Commander to serve the role of EMS Branch Director. As you establish the units under your direction, which one will be responsible for organizing the positioning and flow of ground and air ambulances to and from the scene?

Staging Unit Leader

You are attempting to remove vomitus from the airway of a 3 year old female hit by a car. If you are planning on using a suction machine, what do you know regarding the length of time you should suction the oral cavity?

Suction less than 10 seconds

You are caring for a geriatric patient who is bedridden from a prior stroke and is being cared for by her family. Upon assessment, you note that she has bed sores, dirty underclothes, and the bed smells of dried urine. Upon your arrival at the hospital, what should you report?

The findings that are suggestive of abuse

While performing a scene size-up for a report of workers overcome in a factory, you see a diamond-shaped placard on the building with four numbers. Generally speaking, the higher the number in each quadrant, what can be inferred?

The more dangerous the contents

Which one of the following best describes the pathophysiology of pericardial tamponade?

The sac surrounding the heart fills with blood and limits the heart's ability to fill.

During the management of a female trauma patient who is 8 months pregnant with her second child, you elect to immobilize her on a backboard for suspected spinal injury. When preparing for transport, what important treatment consideration must you provide regarding transport on a backboard?

Tilt the backboard to the left side to avoid potential hypotension.

You and your partner are on a lunch break when you hear a scream from across the room: "My child is choking!" You immediately go to help. The mother quickly tells you she thinks the 10 month old swallowed a coin. You note that the baby is cyanotic with no cough. What is the appropriate way to clear the obstruction?

Use back slaps and chest thrusts.

A 60 year old male complains of chest pain. You decide to use the acronym OPQRST to better investigate the chief complaint. When referring to the "S" of OPQRST, which one of the questions below would be the most appropriate?

What is the severity on a 1-10 scale?

Your partner tells you that after years of working as an EMT, he has begun to have nightmares. You also notice that he is quite irritable. These findings most likely indicate

a cumulative stress reaction.

A 25 year old male has been involved in a serious motor vehicle crash. During your rapid trauma assessment, you note crepitus when evaluating the pelvis. This finding indicates

a fracture of the pelvis.

A 69 year old female patient complains of difficulty speaking and an inability to move her right arm. She notes the symptoms came on about two hours ago but have since subsided. She is most likely suffering from

a transient ischemic event.

A 74 year old COPD patient complains of difficulty breathing. She has an increased respiratory rate and you note cyanosis around her lips. After ensuring an open airway and adequate breathing, you should

administer high concentration oxygen via non-rebreather mask.

Alveolar ventilation refers to the amount of

air moved in and out of the alveoli per minute.

A 20 year old female has been involved in a minor motor vehicle crash. She is ambulatory on arrival and complains of difficulty breathing. She is alert and vitals are P 110, R 40, and BP 122/80. Her skin is flushed. Considering her respiratory status, you should

apply a non-rebreather mask.

A 48 year old female was recently prescribed an antibiotic. Upon taking her first pill, she noted watery eyes, itching, and now complains of shortness of breath. She is alert, her skin is flushed, and you hear wheezes bilaterally. Her vital signs are P 110, R 30, and BP 112/74. You should first

arrange for ALS to meet you en route to the hospital.

A 44 year old male tells you he is suicidal and plans to hang himself with the rope next to his bed. He does not wish to be transported to the hospital. You should

await law enforcement and transport this patient against his will.

A 55 year old female complains of acute onset palpitations and chest pain. She is alert but pale and diaphoretic. Her vitals are P 220, R 28, BP 88/60. These findings most likely indicate

cardiogenic shock secondary to a cardiac dysrhythmia.

A 31-year-old female has been found unconscious by the side of the road. Bystanders state that they do not know what happened. The patient does not appear to be breathing. After ensuring scene safety, you should next

check her carotid pulse.

A 32 year old male presents with an altered mental status. He is babbling and speaking incoherently. His family states he has a history of psychiatric problems. After ensuring scene safety, you should next

complete a primary and secondary assessment to rule out medical causes of altered mental status.

A 20 year old female complains of severe headache and photophobia. She notes she has had a fever and a stiff neck for the last two days. To manage this patient you should first

don gloves and respiratory protection.

You are caring for a 19 year old female who is complaining of an acute onset of abdominal pain with dizziness. You find the patient to be tachypneic, tachycardic, nervous, and very scared. Skin is pale and diaphoretic. She admits to being sexually active, but "always" uses some type of prophylactic. Her last menstrual cycle was 25 days previously. Abdominal assessment is benign other than slight tenderness to palpation. The most likely reason for the patient's pain is

ectopic pregnancy.

A 7 year old female complains of difficulty swallowing and chills. You notice the child is sitting bolt upright and will not tolerate leaning back. You also note drooling. These findings most likely indicate

epiglottitis.

You are called to evaluate a 2 year old female who has fallen. On your appearance, the child begins to cry and refuses to speak to you. This behavior is

expected in a 2 year old and most likely indicates a normal mental status.

A 15 year old male has been stabbed in the abdomen. As you examine his abdomen, you see a small loop of intestine protruding from the wound. After completing your patient assessment, you should next

initiate rapid transport.

A 7 year old male has crashed his bicycle. He notes he was thrown over the handlebars and complains of only left shoulder pain. His vital signs are P 120, R 24, and BP 102/60. Given this presentation, you should first rule out

internal bleeding from a ruptured spleen.

A patient is found in his apartment sitting in a chair in the tripod position exhibiting noisy respirations, cyanosis around the lips, and restlessness. Vital signs are R 28 (working to breathe), P 100 (slightly irregular), and BP 140/90. Oxygen should be provided to this patient by way of

non-rebreather mask.

A 19 year old patient has a traumatic brain injury and is unconscious. When laid supine, the patient stops breathing. This apnea is most likely caused by

poor airway muscle control.

A 35 year old male police officer has been shot. His bulletproof vest stopped the bullet, but he now complains of pain in his left chest beneath where the bullet was stopped. You should suspect

potential internal injuries from the blunt force trauma.

You are called to assist another crew with lifting a heavy patient. After walking up the stairs to the patient's second-floor bedroom, you realize you do not have gloves. You should

return to the ambulance to retrieve a pair of gloves.

You are dispatched for a patient who has been assaulted. On arrival, you note a crowd gathered around two men fighting. One of the men has blood on his shirt. You should

stage a safe distance away and await law enforcement.

A 55 year old male dropped a container at work and was sprayed with a dry powder that is burning him. The patient is now unconscious and you note that the powder still covers his chest and arms. His coworkers state that he complained of severe pain and burning before losing consciousness. You should

stage away from the patient until hazardous materials technicians arrive.

A 71 year old female presents with a new onset of right-sided facial droop and a lethargic mental status. As you load her onto a stair chair for extrication, she exhibits snoring respirations. You should

stop movement and reposition her airway.

A two-car motor vehicle crash has occurred at the bottom of a steep hill. As you approach the crash site, you can see the severely damaged vehicles, but the ambulance begins to slide on the ice. You should

stop the ambulance and proceed on foot.

You are transporting a 67 year old female patient who is complaining of chest pain. Your partner is driving in nonemergency mode while you are administering oxygen and monitoring vital signs. Suddenly the patient stops breathing and goes into cardiac arrest. You should next

stop the ambulance first and then attach the AED.

You are caring for an elderly female patient who has not been acting normally for the past few hours. The family reports she has been acting confused, forgetful, and she has trouble walking. Her medical history includes hypertension and thyroid problems. Vitals are P 86, R 18, and BP 168/78. The most likely medical problem to explain this presentation is

stroke.

You and your partner are completing your pre-shift ambulance inspection. You notice that the driver's seat belt is not functioning. You should

take the ambulance out of service and notify maintenance.

You respond to a severe motor vehicle crash that requires technical extrication. Rescue crews have begun readying to use power tools. A rescue team member asks you to climb in the car and hold manual cervical immobilization while they extricate the patient. You do not have proper protective equipment. You should

tell him you cannot enter the car because you are not properly equipped.

You and your partner are preparing to transport a 56 year old man with hand pain. The patient states he does not wish to sit on the stretcher and "just wants to sit on the bench." Your partner says, "Sure, that's fine." You should

tell your partner you are uncomfortable with transporting a patient on the bench seat.

You are about to transport a pediatric cardiac arrest. A police officer asks you if you would like an escort. You should

thank him but decline because an escort can cause a safety hazard.

You should begin multi-casualty procedures when

the demands of the event overwhelm your available resources.

A 21 year old male has been involved in a serious motor vehicle crash. You begin your primary assessment in the vehicle as rescue crews prepare for mechanical extrication. After checking airway and breathing, you find spurting blood coming from a laceration on his leg. Your jump kit is outside the car. You should

use your gloved hand to initiate direct pressure.

After checking your ambulance, you notice your hands have been soiled by an unknown substance. The most effective way to protect yourself against disease would be to

wash your hands with warm soapy water.

You are caring for a baby that was just delivered in the mother's home. After cutting the cord you complete your initial APGAR scoring. You find the baby displays a strong cry, has cyanotic hands and feet with a pink core, is actively moving, the heart rate is 140 per minute, and the newborn grimaces and cries with stimulation. What is the calculated APGAR score?

9

Early signs of hypoperfusion in a pregnant female patient may be lost due the physiological changes caused by pregnancy. Which of the following vital signs is one such example of this?

Blood pressure

A 45 year old female is complaining of trouble breathing. The patient is sitting in a tripod position, has nasal flaring, rapid breathing, accessory muscle use, and diminished alveolar breath sounds. Of these findings, which one is more indicative of difficulty breathing rather than heightened respiratory efforts due to the pulmonary problem?

Diminished alveolar sounds

What term is used to describe the exchange of respiratory gases between the alveoli and the pulmonary capillary bed?

External respiration

A 21 year old patient collided with another player while playing soccer. Bystanders note he briefly lost consciousness. He is awake, but cannot remember where he is. He states he does not wish to be transported to the hospital. Which one of the following reasons best describes why this patient cannot refuse care?

His mental status is altered.

A 17 year old male complains of lower quadrant abdominal pain. How should you properly assess his abdomen?

Palpate four quadrants and the affected area last

A 12 year old male is having an asthma attack. He appears tired and pale. During your primary assessment, you note his respiratory rate to be 40. However, you have difficulty hearing his lung sounds. What is the most likely reason for the difficulty in hearing lung sounds?

There is little air moving

A 66 year old male patient with a stoma is found in respiratory arrest. Which one of the following would be the most appropriate method for delivering positive pressure ventilations to this patient?

Use a pediatric mask to ventilate the stoma directly.

A 17 year old male has been stabbed in the groin. He presents with bright red, spurting blood. This bleeding is most likely from a(n)

artery.

A 77 year old female resident of a nursing home complains of difficulty breathing. She has a history of mild dementia. The most appropriate way to evaluate the mental status of this patient would be to

ask staff members what her baseline mental status is.

A 21 year old female states that she has taken 25 Librium capsules approximately 30 minutes ago. After completing a primary assessment and initiating transport, you should next

contact poison control.

A 59 year old male complains of acute onset chest pain. He is alert and diaphoretic. His vitals are P 110, R 24, and BP 188/80. The patient states he has a history of heart problems and takes nitroglycerin occasionally. The only other medication he takes is Viagra. You should

determine whether he has taken his Viagra before assisting with nitroglycerin.

A 68 year old female complains of abdominal pain and vertigo. She notes a three-day history of dark, black stools. She is pale, slightly diaphoretic, and her vital signs are P 118, R 20, and BP 88/64. Those findings indicate

hypotensive shock caused by a GI bleed.

A 22 year old, 38-week pregnant female requires transport to the hospital after a fall. There is no indication of spine injury. The most appropriate position to transport her in would be

left lateral recumbent.

A 16 year old male has been struck by a car. He is confused and complains of abdominal pain. His vital signs are P 120, R 30, BP 100/72. A detailed assessment should be completed on this patient

only after transport has been initiated.

A 4 month old male is in respiratory arrest. Before initiating positive pressure ventilations, you should

pad behind his shoulders to account for his large occiput.

A closed soft tissue injury implies that

the soft tissue has not been broken or penetrated.

You respond to a serious motor vehicle crash where it is apparent that a young woman has been killed. Her family arrives on scene. When speaking with them, you should tell them

their daughter has died.

Approaching the scene of a single-car crash, you observe smoke in the vicinity of the vehicle. You are concerned that there may be someone still inside. As the first emergency responder on scene, where should you position your vehicle?

100 feet upwind from the vehicle

You and your partner are checking your ambulance prior to your shift. Which one of the following oxygen cylinder pressures would be the minimum safe residual pressure for operational use?

200 psi

You are assisting in the management of four injured patients in a remote area of the county. You have at your disposal one helicopter capable of transporting one critical patient, and two more ground ambulances that will handle the other three patients. Please select the patient below that you would elect to receive transport by the helicopter.

39 year old patient with head injury, and signs of herniation

Of the following traumatized patients, which one would most likely suffer critical injuries and require transport to a trauma center based on a significant mechanism of injury?

A child who fell five feet from a fence top who had a loss of consciousness

Which one of the following best describes the National Incident Management System?

A system designed to be used by federal, state, and local governments to prepare for and manage emergencies in the United States

A 26 year old, 36-week pregnant female has been involved in a car crash. She complains of tearing, steady abdominal pain and vaginal bleeding. She is alert and her vital signs are P 116, R 24, and BP 100/68. Given this presentation, what is her most likely problem?

Abruptio placentae

An adult patient who is extremely allergic to bee stings was attacked when he accidentally dislodged a beehive while cutting a tree down. He has multiple stings all over his body and currently presents with stridor, tachycardia, coarse bilateral wheezing, falling blood pressure, and unresponsiveness. Given the pathophysiologic changes in an anaphylactic reaction, which of the below would be the greatest contributor to the rapid death of this patient?

Airway closure

You are en route to a motor vehicle crash where you will back up an EMS unit already on scene. They advise you by radio that you will be picking up an unresponsive female patient with a head injury. They add that she is currently breathing spontaneously at 34/minute, pulses are present, all active bleeding has been managed, and the vitals are stable. Given this, what vital aspect of the primary survey did they not advise you of?

Airway patency

A 17 year old was slashed in the abdomen during a knife fight. When you arrive, you observe that part of the patient's large intestine is eviscerated. Which one of the following is the most appropriate way to care for the protruding intestine?

Apply a moistened dressing and then an occlusive covering.

You arrive first on the scene of a car that has struck a tree. Moderate damage has occurred. You ensure the scene safety, don appropriate personal protective equipment, and request additional resources. You note the patient is not responding and you are unable to gain access through the front doors. What should you do next?

Attempt to open a rear door and enter the car.

During the management of a patient with respiratory distress, you elect to assist in the administration of a metered dose inhaler (MDI). This drug causes smooth muscle relaxation at what level of the patient's respiratory tree?

Bronchioles

Given any type of cellular, digital, or radio communication between the EMS providers and dispatch, what is one consistent limitation across these technologies the EMT must be aware of and try to avoid in order to ensure smooth communication occurs?

Dead spots

A 58-year-old male was found confused and stumbling by his family. Which one of the following questions would be most important to ask as part of obtaining the patient's history?

Does the patient have any past medical problems?

A patient has a gastrointestinal bleed that is resulting in a drop in his circulating blood volume. In order for the body to try and compensate for this volume loss while attempting to maintain adequate peripheral perfusion, what might the negative feedback systems of the body employ?

Enhancing vasomotor tone

Injury to which of the following skeletal structures carries with it the highest likelihood of fatal complications?

Femur

You are departing the scene of a two-car MVC from which you are transporting a critical trauma patient. Your partner is in the back and you are going to drive the ambulance to the hospital. As you conceptualize the route you wish to take to the hospital, which of the factors below is LEAST important to the actual route you'll take?

Freeway versus city road

You have been dispatched to a local college dormitory for an unresponsive male. Bystanders on scene state he was drinking alcohol heavily, passed out and fell to the floor. As you approach the patient you see large amounts of vomitus on his face and around his head. What clinical finding would you observe if you suspect the patient is aspirating the vomitus?

Gurgling airway sounds with each breath

Upon turning a patient over to hospital staff, a nurse advises you that your patient is a known injectable drug abuser. Of the numerous work practice controls to keep you safe from cross-contamination, which of the below is best in protecting your safety as an EMT?

Hand washing

You arrive on scene for a male patient in his mid-30s who, according to family, is acting strangely. As you enter the house you find the patient standing with his face to the corner with aluminum foil wrapped around the top of his head to keep the "evil radio waves" from entering his head. The patient is not aggressive, and allows you to complete your physical exam. Of the following conditions, which is most likely NOT his problem?

Heart attack

A 4 year old sustained an accidental impact to the chest and is conscious with some respiratory distress. While performing the physical assessment, you observe bruising on the chest. When palpating the chest bilaterally, no deformity is felt. Auscultation identifies diminished sound on one side. Based on the information from the assessment, which one of the following is most likely to have occurred?

Hemothorax

An insulin-dependent diabetic has completed a large meal and afterward reports that he is not feeling well. For the past few hours, he has been extremely thirsty with frequent urination. You notice that he is breathing rapidly and has breath that smells like acetone. During the SAMPLE history, he tells you that he has taken his insulin regularly. What is this patient's most likely underlying problem?

Hyperglycemia

An 18 year old male diabetic patient has been sick for one week. His family states he has complained of nausea and vomiting but has been taking his insulin properly. Today they note he is "acting drunk." You note the patient is pale and diaphoretic and his vital signs are P 116, R 28, and BP 132/80. What is the most likely cause of his condition?

Hypoglycemia

A mother states her 7 week old infant has not been feeding well and may have had a fever over the last four days. The baby is listless, and when you examine his head, you notice his fontanels are sunken. What does this finding most likely indicate?

Hypovolemia

You are caring for a 2 year old female patient with a recent history of bronchitis. The patient is being held by her mother, but you notice that the child seems very limp. The airway is patent, breathing is spontaneous but rapid and shallow. The pulse is rapid and the skin is ashen in color. Breath sounds are markedly diminished with both inspiratory and expiratory wheezing bilaterally. Given this situation, you should perform what intervention first?

Initiate PPV with oxygen supplementation.

Which one of the following best describes why activated charcoal is administered to treat an ingested toxin?

It absorbs toxins in the stomach

A 32 year old male has been stabbed in the upper right quadrant of his abdomen. The knife used was seven inches long. What is the organ most likely damaged by this wound?

Liver

A 31 year old male jumped from a fourth-floor window and landed feet first onto the pavement below. Based on this mechanism of injury, you should suspect which one of the following areas to sustain the most damage?

Lumbar spine

While managing a patient with cardiac chest pain, you elect to assist them in the administration of their nitroglycerin. After two doses the chest pain is still not relieved. Per your clinical protocols, you must contact medical control prior to the administration of a third nitro. This is an example of what type of medical authorization?

Online medical direction

While obtaining a SAMPLE history from a 58 year old suspected cardiac patient with severe chest pain and diaphoresis, you are informed that the patient had open heart surgery three years ago. Under which "letter" of the acronym SAMPLE should this information be placed?

P

While ventilating a patient with a bag-valve mask, you squeeze the bag in order to ventilate the patient. Now that the lungs have been filled, by what process does the air (oxygen) leave the lungs before the next ventilation is provided?

Passive