E151 EXAM 2
The respiratory distress that accompanies emphysema is caused by:
chronic stretching of the alveolar walls.
Which of the following statements regarding hepatitis A is correct?
Hepatitis A can only be transmitted by a patient who has an acute infection.
How does positive-pressure ventilation affect cardiac output?
It increases intrathoracic pressure, which decreases venous return to the heart and causes a decrease in cardiac output
You and your partner arrive at the scene of a middle-aged man who collapsed about 5 minutes ago. He is unresponsive, apneic, and pulseless. By standers are present, but have not provided any care. You should:
Perform five cycles of high-quality CPR and then apply the AED
Which to the following statements regarding the hypoxic drive is MOST correct?
The hypoxic drive stimulates a person to breathe on the basis of low oxygen levels.
Which of the following clinical signs is unique to anaphylactic shock?
Wheezing
Which of the following injuries would MOST likely cause obstructive shock?
cardiac tamponade
A 56-year-old male is found semiconscious by his wife. Your assessment reveals that his respirations are rapid and shallow, his pulse is rapid and irregular, and his blood pressure is low. The patient's wife states that he complained of left arm pain and nausea the day before, but would not allow her to call 9-1-1. The MOST likely cause of this patient's present condition is:
cardiogenic hypoperfusion
Several attempts to adequately open a trauma patients airway with the jaw-thrust maneuver have been unsuccessful. You should:
carefully perform the head tilt-chin lift maneuver.
In addition to looking for severe bleeding, assessment of circulation in the conscious patient should involve:
checking the radial pulse and nothing the color, temp, and condition of his or her skin.
Nitroglycerin relieves cardiac-related chest pain by:
dilating the coronary arteries and improving cardiac blood flow.
End-tidal carbon dioxide(ETCO2) is defined as the:
maximal concentration of CO2 at the end of an exhaled breath.
Which of the following statements regarding pulse oximetry is correct?
pulse oximetry measures the percentage of hemoglobin that is saturated with oxygen, but does not measure the actual hemoglobin content of the blood.
Observations made when forming a general impression of a patient would include all of the following, EXCEPT:
pulse strength
The left ventricle has the thickest walls because it:
pumps blood into the aorta and systemic circulation
Prompt transport of a patient with a suspected AMI is important because:
the patient may be eligible to receive thrombolytic therapy.
Which of the following statements regarding the human immunodeficiency virus(HIV) is correct?
the risk of HIV infection is greatest when deposited on a mucous membrane or directly into the bloodstream.
After the patient's airway is intubated during two-rescurer CPR, you should:
Deliver one rescue breath every 6 to 8 seconds.
Which of the following techniques should you use to dislodge a foreign body airway obstruction in a patient who is in an advanced stage of pregnancy or who is very obese?
chest thrusts
Which of the following blood vessels transports oxygenated blood?
pulmonary veins
a 70-year-old female was recently discharged from the hospital following a total hip replacement. Today, she presents with restlessness, tachycardia, and a blood pressure of 100/64 mmHg. Her skin is warm and moist. You should be MOST suspicious that she is experiencing:
septic shock
The electrical impulse generated by the heart originates in the:
sinoatrial (SA) node
What is the correct ratio of compressions to ventilation's when performing two-rescuer child CPR:
15:2
In infants and children, a capillary refill time(CRT) that is greater than ___ second(s) is a sign of poor peripheral perfusion.
2
When testing a mechanical suctioning unit, you should turn on the device, clamp the tubing, and ensure that it generates a vacuum pressure more than:
300mm Hg
What is the minute volume of a patient with a tidal volume of 500mL, a dead space volume of 150mL, and a respiratory rate of 16 breaths/min?
5600mL
After___ minutes without oxygen, brain damage is likely:
6
In which of the following patients would the head tilt-chin life maneuver be the MOST appropriate method of opening the airway?
A 37-year-old female who is found unconscious in her bed.
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 is NOT function of the sympathetic nervous system?
Dilation of blood vessels in the muscles
The two processes that occur during respiration are:
Inspiration and expiration
Which of the following statements regarding methicillin-resistant staphylococcus aureus (MRSA) is correct?
MRSA is a bacterium that causes infections and is resistant to most antibiotics.
As the single EMT managing an apneic patient's airway, the preferred initial method of providing ventilations is the:
Mouth -to-mask technique with a one -way valve.
Angina pectoris occurs when:
Myocardial oxygen demand exceeds the supply.
Albuterol is a generic name for:
Proventil
An index of suspicion is MOST accurately defined as:
Your awareness and concern for potentially serious underlying and unseen injuries or illness.
Most prehospital cardiac arrests occur as the result of:
a cardiac arrhythmia
An infectious disease is MOST accurately define as:
a medical condition caused by the growth and spread of small harmful organisms within the body.
Which of the following is NOT a common sign or symptom associated with malfunction of an implanted cardiac pacemaker?
a rapid heart rate
Clinical signs of compensated shock include all of the following, EXCEPT:
absent peripheral pulses.
You are dispatched to a residence for a 67-year-old female who was awakened by shortness of breath and sharp chest pain. Her husband tells you that she was recently discharged from the hospital after having hip surgery. Your assessment reveals dried blood around her mouth, facial cyanosis, and an oxygen saturation of 88%. This patients presentation is MOST consistent with:
acute pulmonary embolism
Which of the following is the MOST reliable indicator of adequately performed bad-mask ventilations in an apenic adult with a pulse?
adequate rise of the chest when squeezing the bag.
A 51-year-old female presents with a sudden onset of difficulty breathing. She is conscious and alert and able to speak in complete sentences. Her respirations are 22 breaths/min and regular. You should:
administer 100% oxygen via a nonrebreathing mask
Your primary assessment of an elderly woman reveals that she is conscious and alert, but is experiencing difficulty breathing. She has a history of emphysema, hypertension and congestive heart failure. As you assess the patients circulatory status, you should direct your partner to:
administer oxygen with the appropriate device.
The MOST appropriate treatment for a patient with a mild upper airway obstruction includes:
administering oxygen and transporting immediately
In the presence of oxygen, the mitochondria of the cells convert glucose into energy through a process called:
aerobic metabolism
An elderly patient has fallen and hit her head. You assess her level of consciousness as unresponsive using the AVPU scale. Your initial care should focus on:
airway, breathing, and circulation
In what area of the lungs does respiration occurs?
alveoli
You respond to a residence for a patient with a severe leg injury following an accident with a chainsaw. When you arrive, you find the patient, a 44-year-old male, lying supine in the backyard. He has a partial amputation of his right lower leg that is actively bleeding. The patient is conscious and breathing adequately; however, he is restless and his skin is diaphoretic. You should:
apply direct pressure to the wound
The ability of cardiac muscle cells to contract spontaneously without a stimulus from a nerve source is called:
automaticity
Initial treatment to dislodge a severe foreign body airway obstruction in a responsive infant involves:
back slaps
Paroxysmal nocutrnal dyspnea(PND), rales, and dependent edema are clinical indications of:
congestive heart failure
The myocardium receives oxygenated blood from the ____, which originate(s) from the _____.
coronary arteries, aorta
A crackling sound produced by air bubbles under the skin is called:
crepitus
Ishemic heart disease is MOST accurately defined as:
decreased blood flow to one or more portions of the myocardium.
Which of the following is considered an obvious sign of death and would not require the initiation of CPR?
dependent blood pooling
You are dispatched to a residence for a 40-year-old female who fainted. Upon your arrival, the patient is conscious and alert, and states that she is fine. Her husband tells you that she fainted after receiving news that her sister was killed in a car crash. You offer oxygen to the patient, but she refuses to accept it. At this point, your primary concern should be to:
determine if she was injured when she fainted.
Inhalation occurs when the:
diaphragm and intercostal muscles contract and cause a decrease in the intrathoracic pressure.
A 66-year-old woman presents with a stabbing pain in the middle of her chest that radiates to her back. She tells you that the pain suddenly began about 30 minutes ago and has been severe since the onset. She has a history of hypertension, but admits to being noncompliant with her antihypertensive medications. When you assess her, you find that her blood pressure is significantly higher in her left arm than it is in her right arm. what are her signs and symptoms most indicative of?
dissecting aortic aneurysm
Which of the following statements regarding anaphylactic shock is MOST correct?
each subsequent exposure following sensitization often produces a more severe reaction.
Upon arriving at a potentially unsafe scene, you should:
ensure that you are safe.
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 lung fields. His blodd pressure is 90/50 mmHg and his heart rate is 110 beats/min. In addition to giving him 100% oxygen, the MOST important treatment for this patient is:
epinephrine
At the onset of an acute asthma attack, patients commonly experience difficulty breathing and:
expiratory wheezing
The process of exchanging oxygen and carbon dioxide between the alveoli and the blood of the capillaries is called:
external respiration
When assessing a patient with a medical complaint, which of the following would MOST likely reveal the cause of his or her problem?
history taking
Shock is the result of:
hypoperfusion to the cells of the body
The goal of the primary assessment is to:
identify and rapidly treat all life-threating conditions
In a healthy individual, the brain stem stimulates breathing on the basis of:
increased carbon dioxide levels
Cardiogenic shock may result from all of the following, EXCEPT:
increased preload
When palpating a patient's pulse, you note that there is a short interval between pulsations. This indicates the the pulse is:
irregular
The secondary assessment of a medical patient:
is not practical if the patient is critically ill or your transport time is short.
When afterload increases:
it becomes harder for the ventricle to push blood through the blood vessels.
Hypotension in a child with blunt or penetrating trauma is particularly significant because:
it often indicates the loss of half of his or her blood volume.
Which of the following maneuvers should be used to open a patients airway when a spinal injury is suspected?
jaw-thrust
Which of the following assessment findings is MOST indicative of a cardiovascular problem?
jugular venous distension
The impedance threshold device(ITD) may improve circulation during CPR by:
limiting the amount of air that enters the lungs during the recoil phase between chest compressions, which results in negative intrathoracic pressure and improved cardiac filling.
The hypoxic drive-the primary stimulus to breathe for patients with certain chronic respiratory distress-is influenced by:
low blood oxygen levels.
A patient with atherosclerotic heart disease experiences chest pain during exertion because the:
lumen of the coronary artery is narrowed and cannot accommodate increase blood flow
An acute myocardial infarction(AMI) occurs when:
myocardial tissue dies secondary to an absence of oxygen.
Which of the following medications would the EMT LEAST likely administer to a patient with a medical complaint?
naloxone(Narcan)
An injured patient is assigned a total score of 9 on the GCS. He is assigned a score of 2 for eye opening, a score of 3 for verbal response, and a score of 4 for motor response. Which of the following clinical findings is consistent with his GCS score?
opens eyes in response to pain, uses inappropriate words, withdraws from pain
In order for efficient pulmonary gas exchange to occur:
oxygen and carbon dioxide must be able to freely diffuse across the alveolar capillary membrane.
a 60-year-old male presents with acute respiratory distress. He is conscious and alert, has pink and dry skin, and has respirations of 24 breaths/min with adequate depth. Which of the following treatments modalities is MOST appropriate for this patient?
oxygen via nonrebreathing mask and a focused secondary assessment.
You and your partner arrive at the side of a 60-year-old woman who suddenly collapsed about 7 minutes ago. She is unresponsive, apneic, and pulseless. You should:
perform cardiopulmonary resuscitation (CPR) for about 2 minutes and then apply the AED.
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 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 include:
placing her in an upright position.
Hypovolemic shock cause by severe burns is the result of a loss of:
plasma
You have just completed your primary assessment of a 48-year-old man with crushing chest pain. The patient has been given 324mg of aspirin and is receiving high-flow oxygen via nonrebreathing mask. As you begin you secondary assessment, you note that his mental status has deteriorated and he is now bradycardic. You should:
prepare the patient for immediate transport.
You are dispatched to the county jail for an inmate who is "sick". When you arrive, you find the patient, a 33-year-old male, unresponsive. His airway is patent and his respirations are rapid and shallow. Your initial action should be to:
provide assisted ventilation
A 22-year-old female patient is complaining of dyspnea and numbness and tingling in her hands and feet after an argument with her fiancé. Her respirations are 40 breaths/min. You should:
provide reassurance and give oxygen as needed.
Temporary,widespread vasodilation and syncope caused by a sudden nervous system reaction MOST accurately describes:
psychogenic shock.
You are ventilating a 40-year-old uninjured man who is apenic but has a pulse. When your partner reassesses his blood pressure, he notes that it has decreased significantly from previous readings. You elevate the patient's legs, but this action has no effect. You should:
reevaluate the rate and volume of your ventilations.
a 19-year-old female is found unconscious by her roommate. Your primary assessment reveals that her breathing in inadequate. As you insert an oropharyngeal airway, she begins to gag violently, you should:
remove the airway and be prepared to suction her oropharynx
When performing a reassessment of your patient, you should first:
repeat the primary assessment
A 67-year-old female with severe chest pain become unresponsive, pulseless, and apneic during transport. You should:
stop the ambulance, begin CPR, and attach the AED as soon as possible.
The pressure exerted against the walls of the artery when the left ventricle contracts is called the:
systolic pressure
All of the following conditions would make you suspect shock, EXCEPT:
tachycardia
When the body senses a state of hypo perfusion, the sympathetic nervous system releases epinephrine, the effects of which include:
tachycardia
Common signs and symptoms of acute hyperventilation syndrome include:
tachypnea and tingling in the extremities
Which of the following statements regarding the AED and defibrillation is correct?
the AED will not analyze the rhythm of a moving patient.
During an EMS call, you should take standard precautions :
upon exiting the ambulance, but before actual patient contact.
