Module 4

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Which of the following MOST accurately describes what the patient will experience during the postictal state that follows a seizure?

Confusion and fatigue

Function of the Cerebellum

Controls muscle and body coordination responsible for coordinating complex tasks that involve many muscles

Function of the brain stem

Controls the most basic functions of the body, such as breathing, blood pressure, swallowing, and pupil constriction.

In addition to looking for severe bleeding, assessment of circulation in the conscious patient should involve:

checking the radial pulse and noting the color, temperature, and condition of the skin.

When assessing for arm drift of a patient with a suspected stroke, you should:

ask the patient to close his or her eyes during the assessment

When assessing for arm drift of a patient with a suspected stroke, you should:

ask the patient to close his or her eyes during the assessment.

Interruption of cerebral blood flow may result from all of the following, EXCEPT:

cerebral vasodilation

Interruption of cerebral blood flow may result from all of the following, EXCEPT:

cerebral vasodilation.

The three major parts of the brain are the:

cerebrum, cerebellum, and brain stem

The three major parts of the brain are the:

cerebrum, cerebellum, and brain stem.

A 40-year-old patient without a history of seizures experiences a generalized (tonic-clonic) seizure. The LEAST likely cause of this seizure is:

epilepsy

Which of the following is a normal physiologic change that occurs in the mother's respiratory system during pregnancy?

increased respiratory rate and decreased respiratory reserve

Compared to full-term infants, premature infants are at a higher risk for

infection

The amniotic fluid serves to

insulate and protect the fetus.

The leading cause of maternal death during the first trimester of pregnancy is

internal bleeding caused by a ruptured ectopic pregnancy

In contrast to viral hepatitis, toxin-induced hepatitis:

is not a communicable disease

The secondary assessment of a medical patient:

is not practical if the patient is critically ill or your transport time is short.

Chronic renal failure is a condition that

is often caused by hypertension or diabetes.

A 33-year-old woman who is 36 weeks' pregnant is experiencing scant vaginal bleeding. During transport, you note that she suddenly becomes diaphoretic, tachycardic, and hypotensive. In addition to administering 100% oxygen, you should

place her in a left lateral recumbent position.

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

placing the mother supine with her head down and pelvis elevated.

pregnant women are advised to take iron supplements, such as prenatal vitamins, because:

pregnancy causes a decreased number of red blood cells, which predisposes the mother to anemia

A pregnant trauma patient may lose a significant amount of blood before showing signs of shock because

pregnant patients have an overall increase in blood volume.

Functions of the liver include:

production of substances necessary for blood clotting.

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:

protect her airway from aspiration.

Following delivery of a pulseless and apneic infant that has a foul odor, skin sloughing, and diffuse blistering, you should

provide emotional support to the mother

If a newborn's heart rate is less than 60 beats/mins following delivery, you should:

provide ventilations for 30 seconds

Upon delivery of the baby's head, you note that its face is encased in the unruptured amniotic sac. You should

puncture the sac and suction the baby's mouth and nose.

While examining a woman in labor, you see the umbilical cord protruding from the vagina. You should

push the infant's head away from the cord

You are caring for a 68-year-old man with sudden onset of left-sided paralysis and slurred speech. His airway is patent, his respirations are 14 breaths/min with adequate depth, and his oxygen saturation is 98%. Treatment for this patient should include:

recovery position and transport

Which of the following clinical signs is MOST suggestive of a ruptured aneurysm?

sudden severe headache

"PASTE" is an alternate assessment tool for ___________. - respiratory patients - stroke patients - seizure patients - cardiac patients

"PASTE" is an alternate assessment tool for ___________. *- respiratory patients* - stroke patients - seizure patients - cardiac patients

syncope

A fainting spell or transient loss of consciousness, often caused by an interruption of blood flow to the brain

The brain is divided in three major parts

1. The brain stem 2. The Cerebellum 3. The cerebrum

A newborn infant will usually begin breathing spontaneously within _____ seconds following birth.

15-30

A mother who is pregnant with her first baby is typically in the first stage of labor for approximately

16 hours

An abortion occurs when the fetus and placenta deliver before

20 weeks

Stroke Assessment Tools include:

3-Item Stroke Severity Scale (LAG Scale); FAST: and Glasgow Coma Scale

Preeclampsia MOST commonly occurs after the ___ week of gestation.

30th

In which of the following situations would it be MOST appropriate to utilize an air medical transportation service?

61-year-old man with signs and symptoms of a stroke and a ground transport time of 50 minutes

Which of the following patients is at greatest risk for complications caused by the influenza virus?

68-year-old woman with type 2 diabetes

If a baby is born at 7:52 p.m., the second APGAR score should be calculated at

7:57 p.m.

You have just delivered a baby boy. His body is pink, but his hands and feet are blue. His heart rate is approximately 110 beats/min and his respirations are rapid and irregular. He has a weak cry when stimulated and resists attempts to straighten his legs. His APGAR score is

Your patient opens his eyes, moans, and pulls away from you when you pinch his trapezius muscle. You should assign a Glasgow Coma Scale (GCS) score of:

A 49-year-old male presents with an acute onset of crushing chest pain and diaphoresis. You should: Select one: A. assess the adequacy of his respirations. B. administer up to three doses of nitroglycerin. C. administer up to 324 mg of baby aspirin. D. obtain vital signs and a SAMPLE history.

A 59-year-old male with a history of emphysema complains of an acute worsening of his dyspnea and pleuritic chest pain following a forceful cough. Your assessment reveals that he has a barrel-shaped chest, unilaterally diminished breath sounds, and tachycardia. What is the MOST likely cause of this patient's condition? Select one: A. Spontaneous pneumothorax B. Rupture of the diaphragm C. Acute pulmonary embolism D. Exacerbation of his COPD

A 62-year-old man with a history of congestive heart failure presents with severe respiratory distress and with an oxygen saturation of 82%. When you auscultate his lungs, you hear widespread rales. He is conscious and alert, is able to follow simple commands, and can only speak in two- to three-word sentences at a time. You should: Select one: A. apply a CPAP device, monitor his blood pressure, and observe him for signs of improvement or deterioration. B. force fluid from his alveoli by hyperventilating him with a bag-valve mask at a rate of at least 20 breaths/min. C. place him in a position of comfort, deliver oxygen via nasal cannula, and closely monitor his breathing. D. place him in a supine position and assist his ventilations with a bag-valve mask and high-flow oxygen.

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 been 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 includes: Select one: A. placing her in an upright position. B. ventilations with a BVM. C. nitroglycerin for her chest pain. D. oxygen at 2 L/min via nasal cannula.

A dissecting aortic aneurysm occurs when: Select one: A. the inner layers of the aorta become separated. B. the aorta ruptures, resulting in profound bleeding. C. all layers of the aorta suddenly contract. D. a weakened area develops in the aortic wall.

A percutaneous transluminal coronary angioplasty (PTCA) restores blood flow to the ischemic myocardium by: Select one: A. dilating the affected coronary artery with a small inflatable balloon. B. scraping fatty deposits off of the lumen of the coronary artery. C. bypassing the coronary artery with a vessel from the chest or leg. D. placing a stent inside the coronary artery to keep it from narrowing.

A pleural effusion is MOST accurately defined as: Select one: A. fluid accumulation outside the lung. B. a bacterial infection of the lung tissue. C. a unilaterally collapsed lung. D. diffuse collapsing of the alveoli.

Acute coronary syndrome (ACS) is a term used to describe: Select one: A. a group of symptoms that are caused by myocardial ischemia. B. the warning signs that occur shortly before a heart attack. C. a severe decrease in perfusion caused by changes in heart rate. D. the exact moment that a coronary artery is completely occluded.

Acute pulmonary edema would MOST likely develop as the result of: Select one: A. toxic chemical inhalation. B. an upper airway infection. C. severe hyperventilation. D. right-sided heart failure.

Angina pectoris occurs when: Select one: A. myocardial oxygen demand exceeds supply. B. one or more coronary arteries suddenly spasm. C. myocardial oxygen supply exceeds the demand. D. a coronary artery is totally occluded by plaque.

Dyspnea is MOST accurately defined as: Select one: A. shortness of breath or difficulty breathing. B. labored breathing with reduced tidal volume. C. a complete cessation of respiratory effort. D. a marked increase in the exhalation phase.

In contrast to AMI, a dissecting aortic aneurysm: Select one: A. often presents with pain that is maximal from the onset. B. usually presents gradually, often over a period of hours. C. is more commonly associated with pressure in the chest. D. is typically preceded by other symptoms, such as nausea.

In contrast to the sympathetic nervous system, the parasympathetic nervous system: Select one: A. slows the heart and respiratory rates. B. prepares the body to handle stress. C. dilates the blood vessels in the muscles. D. causes an increase in the heart rate.

Major risk factors for AMI include all of the following, EXCEPT: Select one: A. hypoglycemia. B. elevated cholesterol. C. diabetes mellitus. D. hypertension.

Most AEDs are set up to adjust the voltage based on the impedance, which is the: Select one: A. resistance of the body to the flow of electricity. B. direction that the electrical flow takes in the body. C. actual amount of energy that the AED will deliver. D. distance between the two AED pads on the chest.

Prior to attaching the AED to a cardiac arrest patient, the EMT should: Select one: A. dry the chest if it is wet. B. contact medical control. C. perform CPR for 30 seconds. D. assess for a pulse for 20 seconds.

Signs and symptoms of a hypertensive emergency would MOST likely be delayed in patients who: Select one: A. have chronic hypertension. B. are older than 40 years of age. C. have had a stroke in the past. D. regularly take illegal drugs.

The descending aorta divides into the two iliac arteries at the level of the: Select one: A. umbilicus. B. nipple line. C. pubic symphysis. D. iliac crest.

The electrical stimulus that originates in the heart's primary pacemaker is controlled by impulses from the brain that arrive by way of the: Select one: A. autonomic nervous system. B. parietal lobe. C. somatic nervous system. D. pons and medulla.

The iliac arteries immediately subdivide into the: Select one: A. femoral arteries. B. posterior tibial arteries. C. anterior tibial arteries. D. peroneal arteries.

Which of the following cardiac dysrhythmias has the greatest chance of deteriorating into a pulseless rhythm? Select one: A. Ventricular tachycardia B. Sinus tachycardia C. Sinus bradycardia D. Extra ventricular beats

Which of the following conditions would be LEAST likely to result in hypoxia? Select one: A. Severe anxiety B. Pleural effusion C. Narcotic overdose D. Pulmonary edema

Which of the following is LEAST important when obtaining a medical history from a patient complaining of chest discomfort? Select one: A. Family history of hypertension B. History of cigarette smoking C. History of previous heart attack D. Presence of personal risk factors

Which of the following signs is commonly observed in patients with right-sided heart failure? Select one: A. Dependent edema B. Flat jugular veins C. Pulmonary edema D. Labored breathing

Which of the following statements regarding anaphylaxis is correct? Select one: A. Anaphylaxis is characterized by airway swelling and hypotension. B. Patients with asthma are at lower risk of developing anaphylaxis. C. The signs of anaphylaxis are caused by widespread vasoconstriction. D. Most anaphylactic reactions occur within 60 minutes of exposure.

Your patient has a chronic respiratory condition. His stimulus to breathe is triggered by low oxygen levels in the blood. This is known as the ___________. Select one: A. hypoxic drive B. CO2 drive C. alternate drive D. COPD drive

Which of the following patients would MOST likely demonstrate typical signs of infection, such as a fever?

A 17-year-old male with anxiety

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 the lung fields. His blood pressure is 90/50 mm Hg and his heart rate is 110 beats/min. In addition to giving him high-flow oxygen, the MOST important treatment for this patient is: - albuterol. - a beta-antagonist. - epinephrine. - an antihistamine.

A 59-year-old male with a history of emphysema complains of an acute worsening of his dyspnea and pleuritic chest pain following a forceful cough. Your assessment reveals that he has a barrel-shaped chest, unilaterally diminished breath sounds, and tachycardia. What is the MOST likely cause of this patient's condition? - Rupture of the diaphragm - Spontaneous pneumothorax - Exacerbation of his COPD - Acute pulmonary embolism

A 59-year-old male with a history of emphysema complains of an acute worsening of his dyspnea and pleuritic chest pain following a forceful cough. Your assessment reveals that he has a barrel-shaped chest, unilaterally diminished breath sounds, and tachycardia. What is the MOST likely cause of this patient's condition? - Rupture of the diaphragm *- Spontaneous pneumothorax* - Exacerbation of his COPD - Acute pulmonary embolism

What is the difference between a stroke and a transient ischemic attack?

A TIA resolves completely within 24 hours of onset.

A ________ is a collection of fluid between the lung and chest wall that may compress the lung. - Pleural effusion - Pulmonary embolism - Pneumothorax - Pulmonary edema

A ________ is a collection of fluid between the lung and chest wall that may compress the lung. *- Pleural effusion* - Pulmonary embolism - Pneumothorax - Pulmonary edema

embolus

A blood clot or other substance in the circulatory system that travels to a blood vessel, where it causes a blockage.

thrombosis

A blood clot, either in the arterial or venous system. When the clot occurs in a cerebral artery, it may result in the interruption of cerebral blood flow and subsequent stroke.

Which of the following statements regarding a breech presentation is MOST correct?

A breech presentation occurs when the buttocks are the presenting part.

Meningitis

A central nervous system infection in which the patient may complain of a headache, stiff neck, fever, and sensitivity to light

status epilepticus

A condition in which seizures recur every few minutes or last longer than 30 minutes.

epilepsy

A disorder in which abnormal electrical discharges occur in the brain, causing seizure and possible loss of consciousness.

atherosclerosis

A disorder in which cholesterol and calcium build up inside the walls of the blood vessels, forming plaque, eventually leading to a partial or complete blockage of blood flow; an accumulation of fat and cholesterol in the arteries.

transient ischemic attack

A disorder of the brain in which brain cells temporarily stop functioning because of insufficient oxygen, causing stroke-like symptoms that resolve completely within 24 hours of onset.

ischemia

A lack of oxygen that deprives tissues of necessary nutrients, resulting from partial or complete blockage of blood flow; potentially reversible because permanent injury has not yet occurred

seizure

A neurologic episode caused by a surge of electrical activity in the brain; can be a convulsion characterized by generalized, uncoordinated muscular activity, and can be associated with loss of consciousness.

A pleural effusion is MOST accurately defined as: - a bacterial infection of the lung tissue. - diffuse collapsing of the alveoli. - fluid accumulation outside the lung. - a unilaterally collapsed lung.

A pleural effusion is MOST accurately defined as: - a bacterial infection of the lung tissue. - diffuse collapsing of the alveoli. *- fluid accumulation outside the lung.* - a unilaterally collapsed lung.

partial (focal) seizure

A seizure affecting a limited portion of the brain.

Which of the following MOST accurately describes a simple partial seizure?

A seizure that begins in one extremity

generalized (tonic-clonic) seizure

A seizure that features rhythmic back-and-forth motion of an extremity and body stiffness, or extreme twitching of all of the body's muscles, that may last several minutes or more; formerly known as a grand mal seizure.

aura

A sensation experienced before a seizure; serves as a warning sign that a seizure is about to occur.

coma

A state of profound unconsciousness from which the patient cannot be roused.

hemorrhagic stroke

A type of stroke that occurs as a result of bleeding inside the brain.

ischemic stroke

A type of stroke that occurs when blood flow to a particular part of the brain is cut off by a blockage (eg, a blood clot) inside a blood vessel.

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 urge to push?"

A"Have you had a sonogram?"

5. Which of the following statements regarding gonorrhea is correct? A. Most men who are infected with gonorrhea do not experience symptoms. B. Painful urination is a common symptom of gonorrhea in men and women. C. Symptoms of gonorrhea usually appear within 3 months after being infected. D. Mild infections with gonorrhea cause abdominal pain, vomiting, and fever.

A. Most men who are infected with gonorrhea do not experience symptoms.

13. You are dispatched to a residence for a 40-year-old female who complains of lower abdominal pain, fever and chills, and a foul-smelling vaginal discharge. Which of the following additional assessment findings would increase your index of suspicion for PID? A. a shuffling gait when walking B. bright red blood in the urine C. a history of ectopic pregnancy D. vaginal passage of blood clots

A. a shuffling gait when walking

21. Which of the following conditions would MOST likely lead to PID if left untreated? A. chlamydia B. ovarian cysts C. genital herpes D. ectopic pregnancy

A. chlamydia

17. Whenever possible, a female sexual assault victim should be: A. given the option of being treated by a female EMT. B. encouraged to take a shower and change her clothes. C. thoroughly assessed, even if no signs of injury exist. D. asked to provide a brief description of the perpetrator.

A. given the option of being treated by a female EMT.

23. When a woman presents with abdominal pain or other vague symptoms, the EMT is often unable to determine the nature of the problem until he or she: A. has gathered patient history information. B. has obtained a complete set of vital signs. C. ascertains if the patient was ever pregnant. D. has formed a general impression of the patient.

A. has gathered patient history information.

9. As a woman approaches menopause: A. her menstrual periods may become irregular and vary in severity. B. she cannot become pregnant because of fluctuating hormone levels. C. she usually experiences abdominal cramping without vaginal bleeding. D. her risk of developing PID lowers significantly.

A. her menstrual periods may become irregular and vary in severity.

6. The physical examination of a sexual assault victim should be: A. limited to a brief survey for life-threatening injuries. B. performed in the presence of at least two police officers. C. as detailed as possible so all injuries can be documented. D. deferred until the patient can be evaluated by a physician.

A. limited to a brief survey for life-threatening injuries.

7. In contrast to bleeding caused by external trauma to the vagina, bleeding caused by conditions such as polyps or cancer: A. may be relatively painless. B. is typically not as severe. C. can be controlled in the field. D. often presents with acute pain.

A. may be relatively painless.

14. Law enforcement personnel request your assistance to assess a 31-year-old female who was sexually assaulted. When you arrive at the scene, you find the patient sitting on a curb outside her apartment. She is conscious, alert, and crying. When you ask her what happened, she tells you that she does not want to be treated or transported to the hospital. She further tells you that all she wants to do is clean up. You should: A. provide emotional support and visually assess her for obvious trauma. B. advise her that she cannot clean herself up because this will destroy evidence. C. ask her if there is anyone you can contact, such as a friend or relative. D. perform a limited hands-on assessment to detect life-threatening injuries.

A. provide emotional support and visually assess her for obvious trauma.

25. When a female has reached menarche: A. she is capable of becoming pregnant. B. she can no longer produce an ovum. C. she usually requires hormone therapy. D. menstrual periods become less frequent.

A. she is capable of becoming pregnant.

aneurysm

An abnormal enlargement of the wall of a blood vessel that results from weakening of the vessel wall.

hypoglycemia

An abnormally low blood glucose level.

cerebrovascular accident (CVA) or Stroke

An interruption of blood flow to the brain that results in the loss of brain function

20. You receive a call to a residence where a man found his wife unconscious on the couch. The patient is unresponsive, her respiratory rate is 8 breaths/min, her breathing is shallow, her heart rate is 40 beats/min, and her pulse is weak. The husband hands you an empty bottle of hydrocodone (Vicodin), which was refilled the day before. You should: A. initiate ventilatory assistance. B. contact the poison control center. C. perform a rapid head-to-toe exam. D. apply oxygen via a nonrebreathing mask.

Answer: A Question Type: Critical Thinking Page: 677

36. During your assessment of a 50-year-old male who was found unconscious in an alley, you note that he has slow, shallow respirations; significant bradycardia; facial cyanosis; and pinpoint pupils. As your partner begins assisting the patient's ventilations, he directs your attention to the patient's arms, which have multiple needle tracks on them. This patient's clinical presentation is MOST consistent with: A. a heroin overdose. B. alcohol intoxication. C. a closed head injury. D. an overdose of diazepam (Valium).

Answer: A Question Type: Critical Thinking Page: 681

3. Heroin is an example of a(n): A. opioid. B. hypnotic. C. cholinergic. D. sympathomimetic.

Answer: A Question Type: General Knowledge Page: 670

9. A poison that enters the body by __________ is the MOST difficult to treat. A. injection B. ingestion C. inhalation D. absorption

Answer: A Question Type: General Knowledge Page: 671

11. Which of the following statements regarding inhaled poisons is correct? A. Lung damage may progress after the patient is removed from the environment. B. Carbon monoxide is very irritating to the upper airway and may cause swelling. C. Burns around the eyes are the most common indication of an inhalation poisoning. D. Chlorine is a colorless and odorless gas that causes hypoxia and pulmonary edema.

Answer: A Question Type: General Knowledge Page: 672

14. Most poisonings occur via the __________ route. A. ingestion B. injection C. inhalation D. absorption

Answer: A Question Type: General Knowledge Page: 674

18. As you enter the residence of a patient who has possibly overdosed, you should: A. be alert for personal hazards. B. look for drug paraphernalia. C. observe the scene for drug bottles. D. quickly gain access to the patient.

Answer: A Question Type: General Knowledge Page: 676

22. Airborne substances are diluted with: A. oxygen. B. syrup of ipecac. C. activated charcoal. D. an alkaline antidote.

Answer: A Question Type: General Knowledge Page: 678

24. Common names for activated charcoal include all of the following, EXCEPT: A. Fructose. B. Actidose. C. LiquiChar. D. InstaChar.

Answer: A Question Type: General Knowledge Page: 679

27. Before giving activated charcoal, you should: A. obtain approval from medical control. B. have the patient drink a glass of milk. C. mix it with an equal amount of water. D. mix the suspension by stirring the bottle.

Answer: A Question Type: General Knowledge Page: 679

32. A hypnotic drug is one that: A. induces sleep. B. prevents amnesia. C. increases the pulse. D. increases the senses.

Answer: A Question Type: General Knowledge Page: 680

44. An overdose on acetaminophen, the active ingredient in Tylenol, will MOST likely cause: A. liver failure. B. gastric ulcers. C. kidney failure. D. central nervous system (CNS) depression.

Answer: A Question Type: General Knowledge Page: 686

37. You and your paramedic partner are caring for a patient who ingested codeine, acetaminophen (Tylenol), and propoxyphene (Darvon). The patient is unresponsive, his breathing is slow and shallow, and his pulse is slow and weak. Treatment for this patient will include: A. assisted ventilation, naloxone (Narcan), and rapid transport. B. oxygen via a nonrebreathing mask and rapid transport. C. assisted ventilation, flumazenil (Romazicon), and rapid transport. D. oxygen via a nasal cannula, atropine, and rapid transport.

Answer: A Question Type: Critical Thinking Page: 681-682

17. In general, injected poisons are impossible to dilute or remove because they: A. are usually absorbed quickly into the body. B. are usually fatal within 30 minutes of exposure. C. absorb slowly into the body, despite their potency. D. react with the blood, which increases their toxicity.

Answer: A Question Type: General Knowledge Page: 676

19. Your unit is dispatched to the county jail for an intoxicated inmate. Upon arrival, you find the patient, a 33-year-old male, lying supine in a jail cell. He is responsive to painful stimuli only and has slow, shallow respirations. You should be MOST concerned that this patient: A. might become violent. B. may vomit and aspirate. C. may experience a seizure. D. is severely hypoglycemic.

Answer: B Question Type: Critical Thinking Page: 677

41. You are dispatched to a local nursery for a 39-year-old female who is sick. When you arrive, you find the patient lying on the floor. She is semiconscious, has copious amounts of saliva coming from her mouth, and is incontinent of urine. You quickly feel her pulse and note that it is very slow. Initial management for this patient should include: A. thoroughly suctioning her oropharynx. B. assisted ventilation with a bag-mask device. C. performing a rapid secondary assessment. D. requesting a paramedic to give her atropine.

Answer: B Question Type: Critical Thinking Page: 685

2. The EMT's primary responsibility to the patient who has been poisoned is to: A. administer the appropriate antidote. B. recognize that a poisoning occurred. C. administer 25 g of activated charcoal. D. contact poison control immediately.

Answer: B Question Type: General Knowledge Page: 669

5. Signs and symptoms of a sympathomimetic drug overdose include: A. sedation. B. tachycardia. C. hypotension. D. slurred speech.

Answer: B Question Type: General Knowledge Page: 670

4. Hypotension, hypoventilation, and pinpoint pupils would be expected following an overdose of: A. ecstasy. B. oxycodone (Percocet). C. amphetamine sulfate (Benzedrine). D. crack cocaine.

Answer: B Question Type: General Knowledge Page: 670, 681

12. Your priority in caring for a patient with a surface contact poisoning is to: A. move the patient to a safe area. B. avoid contaminating yourself. C. decontaminate the patient's skin. D. obtain and maintain a patent airway.

Answer: B Question Type: General Knowledge Page: 673

16. Activated charcoal is given to patients who have ingested certain substances because it: A. induces vomiting and empties the stomach. B. binds to the substance and prevents absorption. C. decreases absorption of poisons into the lungs. D. is a direct antidote for many toxic substances.

Answer: B Question Type: General Knowledge Page: 674

28. The major side effect associated with ingestion of activated charcoal is: A. headache. B. black stools. C. abdominal pain. D. ringing in the ears.

Answer: B Question Type: General Knowledge Page: 679

29. After administering activated charcoal to a patient, it is MOST important to: A. call medical control. B. be alert for vomiting. C. reassess the patient's blood pressure. D. document the intervention.

Answer: B Question Type: General Knowledge Page: 679

31. The MOST commonly abused drug in the United States is: A. cocaine. B. alcohol. C. codeine. D. marijuana.

Answer: B Question Type: General Knowledge Page: 680

33. When caring for a known alcoholic patient with severe trauma to the chest and abdomen, you should be concerned that: A. delirium tremens (DTs) are commonly induced by physical trauma and can lead to life-threatening seizures. B. internal bleeding may be profuse because prolonged alcohol use may impair the blood's ability to clot. C. long bone fractures are likely because chronic alcohol consumption weakens the structure of the bones. D. signs and symptoms of shock may be masked by the stimulant effects produced by alcohol.

Answer: B Question Type: Critical Thinking Page: 680-681

43. A patient who presents with rapid breathing, nausea and vomiting, ringing in the ears, and a high fever should be suspected of ingesting a significant quantity of: A. cocaine. B. aspirin. C. Tylenol. D. ibuprofen.

Answer: B Question Type: General Knowledge Page: 685

26. A 4-year-old male ingested an unknown quantity of acetaminophen (Tylenol). The child's mother states that the ingestion occurred approximately 20 minutes ago. The child is conscious and alert and in no apparent distress. After contacting medical control, you should: A. induce vomiting with syrup of ipecac. B. transport the child for definitive care. C. administer up to 25 g of activated charcoal. D. give the child cold milk to absorb the Tylenol

Answer: C Question Type: Critical Thinking Page: 679

38. You respond to a local motel for a young female who was sexually assaulted. The patient is conscious but confused. She tells you that the last thing she remembers was drinking beer at a club with her friends the night before. When she awoke, she was in the bed of the motel room. You should be MOST suspicious that this patient: A. is a heroin abuser. B. is acutely intoxicated. C. was given flunitrazepam (Rohypnol). D. is abusing marijuana.

Answer: C Question Type: Critical Thinking Page: 682

46. A 3-year-old female ingested several leaves from a plant in the living room. The child's mother is not sure what type of plant it is, stating that she bought it simply because it was pretty. After completing your initial assessment of the child, you should: A. administer 25 g of activated charcoal. B. induce vomiting with syrup of ipecac. C. contact the regional poison control center. D. immediately transport the child to the hospital.

Answer: C Question Type: Critical Thinking Page: 689

6. Which of the following drugs is NOT a sedative-hypnotic? A. secobarbital (Seconal) B. diazepam (Valium) C. cocaine D. flunitrazepam (Rohypnol)

Answer: C Question Type: General Knowledge Page: 670

10. The poison control center will be able to provide you with the most information regarding the appropriate treatment for a patient with a drug overdose if the center: A. knows the location of the closest hospital. B. is aware of the patient's age and gender. C. is aware of the substance that is involved. D. knows why the patient overdosed on the drug.

Answer: C Question Type: General Knowledge Page: 671

15. Syrup of ipecac is no longer recommended to treat patients who have ingested a poisonous substance because it: A. has been linked to hypotension. B. does not effectively induce vomiting. C. may result in aspiration of vomitus. D. has toxic effects on the myocardium.

Answer: C Question Type: General Knowledge Page: 674

23. Activated charcoal administration is contraindicated in patients who have ingested: A. ibuprofen. B. acetaminophen (Tylenol). C. acids or alkalis. D. steroid drugs.

Answer: C Question Type: General Knowledge Page: 679

34. DTs is a syndrome associated with withdrawal from: A. cocaine. B. opioids. C. alcohol. D. sedatives.

Answer: C Question Type: General Knowledge Page: 681

42. Atropine sulfate and pralidoxime chloride are antidotes for: A. lysergic acid diethylamide (LSD). B. diphenhydramine (Benadryl). C. nerve gas agents. D. anticholinergic drugs.

Answer: C Question Type: General Knowledge Page: 685

35. A 49-year-old male presents with confusion, sweating, and visual hallucinations. The patient's wife tells you that he is a heavy drinker and she thinks he had a seizure shortly before your arrival. This patient is MOST likely experiencing: A. acute hypovolemia. B. alcohol intoxication. C. acute schizophrenia. D. DTs.

Answer: D Question Type: Critical Thinking Page: 681

39. You respond to a college campus for a young male who is acting strangely. After law enforcement has secured the scene, you enter the patient's dorm room and find him sitting on the edge of the bed; he appears agitated. As you approach him, you note that he has dried blood around both nostrils. He is breathing adequately, his pulse is rapid and irregular, and his blood pressure is 200/110 mm Hg. Treatment for this patient includes: A. requesting a paramedic to administer naloxone (Narcan). B. assisting his ventilations with a bag-mask device. C. asking law enforcement to place handcuffs on the patient. D. attempting to calm him and giving him oxygen if tolerated.

Answer: D Question Type: Critical Thinking Page: 684

40. In an apparent suicide attempt, a 19-year-old female ingested a full bottle of amitriptyline (Elavil). At present, she is conscious and alert and states that she swallowed the pills approximately 30 minutes earlier. Her blood pressure is 90/50 mm Hg, her pulse is 140 beats/min and irregular, and her respirations are 22 breaths/min with adequate depth. When transporting this patient, you should be MOST alert for: A. acute respiratory depression. B. a sudden outburst of violence. C. an increase in her blood pressure. D. seizures and cardiac arrhythmias.

Answer: D Question Type: Critical Thinking Page: 685

1. Substance abuse is MOST accurately defined as: A. knowingly selling illicit drugs in order to buy more drugs. B. willfully using a therapeutic drug to treat a medical illness. C. unwillingly and unknowingly consuming drugs or alcohol. D. knowingly misusing a substance to produce a desired effect.

Answer: D Question Type: General Knowledge Page: 669

7. Your paramedic partner administers atropine to a 49-year-old male with bradycardia. Which of the following side effects would you expect the patient to experience? A. pupillary constriction B. excessive lacrimation C. a fall in blood pressure D. dry mucous membranes

Answer: D Question Type: General Knowledge Page: 670

8. Which of the following questions would be of LEAST pertinence during the initial questioning of a patient who ingested a substance? A. How much of the substance was taken? B. How long ago was it taken? C. What type of substance was taken? D. Why was the substance ingested?

Answer: D Question Type: General Knowledge Page: 670

13. Phosphorus or elemental sodium should be brushed off of the skin instead of irrigated with water because: A. water makes these chemicals impossible to remove. B. severe swelling will occur when mixed with water. C. this will eliminate the chances of you being exposed. D. these chemicals may ignite upon contact with water.

Answer: D Question Type: General Knowledge Page: 674

21. It is MOST important to determine a patient's weight when asking questions pertaining to a toxic ingestion because: A. additional help may be needed at the scene to lift the patient. B. this will allow you to predict if the exposure is lethal. C. this will determine whether or not to give syrup of ipecac. D. activated charcoal is given based on a patient's weight.

Answer: D Question Type: General Knowledge Page: 678

25. The usual dose for activated charcoal is up to ______ for a pediatric patient and up to ______ for an adult patient. A. 5 g, 10 g B. 10 g, 20 g C. 12.5 g, 25 g D. 25 g, 50 g

Answer: D Question Type: General Knowledge Page: 679

30. A person who routinely misuses a substance and requires increasing amounts to achieve the same effect is experiencing a(n): A. addiction. B. dependence. C. withdrawal. D. tolerance.

Answer: D Question Type: General Knowledge Page: 679

45. Which of the following statements regarding the Salmonella bacterium is correct? A. Refrigeration of food will prevent salmonellosis. B. Symptoms of salmonellosis appear within 12 hours. C. The Salmonella bacterium produces toxins that cause food poisoning. D. The Salmonella bacterium itself causes food poisoning.

Answer: D Question Type: General Knowledge Page: 687

You are dispatched to a home where you find a 70-year-old man. He is exhibiting facial drooping and, when you ask him to tell you what day it is, he says "January." Which part of the brain is most likely to have been affected?

Aphasia is the inability to produce or understand speech. This occurs when the left hemisphere of the cerebrum is impacted by a stroke.

You are assessing a 25 year old woman who is 39 weeks pregnant. She is experiencing regular contractions that are approximately 3 minutes apart and states that her amniotic sac broke 2 hours ago. After taking the standard precautions, you should:

Assess her for crowning

You have just delivered a full-term infant. His respirations are rapid and irregular and he has a strong cry. What should you do next?

Assess the brachial or umbilical pulse.

Asthma is caused by a response of the: - endocrine system. - respiratory system. - immune system. - cardiovascular system.

Asthma is caused by a response of the: - endocrine system. - respiratory system. *- immune system.* - cardiovascular system.

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 the lung fields. His blood pressure is 90/50 mm Hg and his heart rate is 110 beats/min. In addition to giving him high-flow oxygen, the MOST important treatment for this patient is: Select one: A. albuterol. B. epinephrine. C. an antihistamine. D. a beta-antagonist.

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? Select one: A. Continue CPR and transport the patient to the closest appropriate hospital. B. Deliver the shock followed by immediate resumption of CPR. C. Contact medical control and request permission to defibrillate. D. Avoid defibrillation as this will damage the patient's AICD.

A patient tells you that he has a left ventricular assist device (LVAD). Which of the following conditions should you suspect that he has experienced? Select one: A. Thoracic aortic aneurysm B. Acute myocardial infarction C. Obstructive lung disease D. Uncontrolled hypertension

A patient with atherosclerotic heart disease experiences chest pain during exertion because: Select one: A. the ragged edge of a tear in the coronary artery lumen causes local blood clotting and arterial narrowing. B. the lumen of the coronary artery is narrowed and cannot accommodate increased blood flow. C. the coronary arteries suddenly spasm and cause a marked reduction in myocardial blood flow. D. tissues of the myocardium undergo necrosis secondary to a prolonged absence of oxygen.

After assisting your patient with prescribed nitroglycerin, you should: Select one: A. avoid further dosing if the patient complains of a severe headache. B. reassess his or her blood pressure within 5 minutes to detect hypotension. C. perform a secondary assessment before administering further doses. D. place the patient in a recumbent position in case of fainting.

Blood that is ejected from the right ventricle: Select one: A. enters the systemic circulation. B. flows into the pulmonary arteries. C. has a high concentration of oxygen. D. was received directly from the aorta.

Cardiac output may decrease if the heart beats too rapidly because: Select one: A. a rapid heartbeat causes a decrease in the strength of cardiac contractions. B. there is not enough time in between contractions for the heart to refill completely. C. as the heart rate increases, more blood is pumped from the ventricles than the atria. D. the volume of blood that returns to the heart is not sufficient with fast heart rates.

Common signs and symptoms of AMI include all of the following, EXCEPT: Select one: A. irregular heartbeat. B. pain exacerbated by breathing. C. sudden unexplained sweating. D. shortness of breath or dyspnea.

Rapid, labored breathing in a patient with signs and symptoms of AMI should make you suspicious for: Select one: A. a cardiac arrhythmia. B. congestive heart failure. C. right ventricular failure. D. significant hypotension.

Risk factors for AMI that cannot be controlled include: Select one: A. hyperglycemia. B. family history. C. lack of exercise. D. excess stress.

The EMT should use an AED on a child between 1 month and 8 years of age if: Select one: A. he or she is not breathing and has a weakly palpable pulse. B. pediatric pads and an energy-reducing device are available. C. his or her condition is rapidly progressing to cardiac arrest. D. special pads are used and the child has profound tachycardia.

The MOST common reason that many people experiencing AMI do not seek immediate medical attention is because they: Select one: A. cannot afford it. B. are in denial. C. are elderly. D. do not trust EMTs.

The head and brain receive their supply of oxygenated blood from the: Select one: A. subclavian arteries. B. carotid arteries. C. iliac arteries. D. brachial arteries.

The inferior vena cava returns deoxygenated blood to the right side of the heart from all of the following areas, EXCEPT the: Select one: A. legs. B. brain. C. abdomen. D. kidneys.

The posterior tibial pulse can be palpated: Select one: A. in the fossa behind the knee. B. behind the medial malleolus, on the inside of the ankle. C. between the trachea and the neck muscle. D. on the dorsum of the foot.

The purpose of defibrillation is to: Select one: A. improve the chance of CPR being successful in resuscitation. B. stop the chaotic, disorganized contraction of the cardiac cells. C. cause a rapid decrease in the heart rate of an unstable patient. D. prevent asystole from deteriorating into ventricular fibrillation.

Treatment with continuous positive airway pressure (CPAP) would MOST likely be contraindicated in which of the following situations? Select one: A. Conscious and alert patient with an oxygen saturation of 85% B. Shortness of breath and a blood pressure of 76/56 mm Hg C. Difficulty breathing, two-word dyspnea, and tachycardia D. Pulmonary edema, history of hypertension, and anxiety

When an electrical impulse reaches the AV node, it is slowed for a brief period of time so that: Select one: A. the impulse can spread through the Purkinje fibers. B. blood can pass from the atria to the ventricles. C. the SA node can reset and generate another impulse. D. blood returning from the body can fill the atria.

When documenting a patient's description of his or her chest pain or discomfort, the EMT should: Select one: A. use medical terminology. B. use the patient's own words. C. underline the patient's quotes. D. document his or her own perception.

When preparing to obtain a 12-lead ECG, the V1 and V2 electrodes should be placed: Select one: A. on the left and right arms. B. on either side of the sternum. C. in the midclavicular line. D. in the midaxillary line.

When the myocardium requires more oxygen: Select one: A. the heart contracts with less force. B. the arteries supplying the heart dilate. C. the AV node conducts fewer impulses. D. the heart rate decreases significantly.

When treating a patient with chest pain, you should assume that he or she is having an AMI because: Select one: A. angina and AMI present identically. B. the cause of the pain cannot be diagnosed in the field. C. angina usually occurs after an AMI. D. most patients with chest pain are experiencing an AMI.

Which of the following is MOST characteristic of adequate breathing? Select one: A. 20 breaths/min with shallow movement of the chest wall and pallor B. 24 breaths/min with bilaterally equal breath sounds and pink skin C. 30 breaths/min with supraclavicular retractions and clammy skin D. 22 breaths/min with an irregular pattern of breathing and cyanosis

Which of the following is NOT a function of the sympathetic nervous system? Select one: A. Increases in the heart and respiratory rates B. Constriction of blood vessels in the muscles C. Constriction of blood vessels in the digestive system D. Dilation of blood vessels in the muscles

Which of the following is the MOST reliable method of estimating a patient's cardiac output? Select one: A. Connect the patient to an electrocardiogram. B. Assess the heart rate and strength of the pulse. C. Determine the average diastolic blood pressure. D. Listen to heart sounds with a stethoscope.

Which of the following must be assessed in every respiratory patient? Select one: A. Distal pulse, motor, sensation B. Lung sounds C. Blood glucose levels D. Orthostatic vital signs

Which of the following statements regarding nitroglycerin is correct? Select one: A. A maximum of five nitroglycerin doses should be given to a patient. B. Nitroglycerin usually relieves anginal chest pain within 5 minutes. C. The potency of nitroglycerin is increased when exposed to light. D. Nitroglycerin should be administered between the cheek and gum.

Which of the following statements regarding the AED and defibrillation is correct? Select one: A. CPR should be performed for 5 minutes before using the AED. B. The AED will not analyze the rhythm of a moving patient. C. The AED will shock any rhythm not accompanied by a pulse. D. Defibrillation is the first link in the AHA chain of survival.

Which of the following veins is located inferior to the trunk? Select one: A. Axillary B. Saphenous C. Subclavian D. Cephalic

While obtaining a 12-lead ECG prior to ALS arrival, you note the presence of artifacts on the tracing. Which of the following is the MOST likely cause of this? Select one: A. Incorrect placement of the leads B. Excessive movement of the patient C. Abnormal cardiac electrical activity D. The patient's pulse is irregular.

You are attending to a 54-year-old female patient in a homeless shelter. The patient tells you that she had the flu a couple of weeks ago, and she has not gotten over it. She has been tired and keeps waking up at night, sweating. She has been coughing up green sputum occasionally and has been experiencing episodes of chest pain that get worse when she breathes. Based on this information, your patient is most likely suffering from: Select one: A. pneumonia. B. tuberculosis. C. chronic obstructive pulmonary disease (COPD). D. influenza Type A.

Which of the following statements regarding pelvic inflammatory disease (PID) is correct? A. The most severe cases of PID occur in women who are not sexually active. B. PID can scar the fallopian tubes, which increases the risk of an ectopic pregnancy. C. PID most commonly affects women who have had an ectopic pregnancy in the past. D. The most common presenting symptom of PID is generalized upper abdominal pain.

B. PID can scar the fallopian tubes, which increases the risk of an ectopic pregnancy.

18. Which of the following statements regarding rape is correct? A. The EMT should try to determine if rape occurred. B. Rape is a legal diagnosis, not a medical diagnosis. C. Rape causes more physical harm than emotional harm. D. Only a licensed physician can make a diagnosis of rape.

B. Rape is a legal diagnosis, not a medical diagnosis.

16. During your assessment of a young female with nontraumatic vaginal bleeding, you note that her level of consciousness is decreased, her respirations are rapid and shallow, her skin is cool and moist, and her pulse is rapid and weak. You should: A. perform a rapid secondary assessment. B. assist her ventilations with a bag-mask device. C. assess her blood pressure and elevate her legs. D. perform a visual assessment of her vaginal area.

B. assist her ventilations with a bag-mask device.

19. In anticipation of receiving a fertilized ovum, the lining of the uterine wall: A. thins and begins to separate. B. becomes engorged with blood. C. diverts blood flow to the vagina. D. sheds and is expelled externally.

B. becomes engorged with blood.

24. The onset of menstruation is called menarche and usually occurs in women who are: A. between 12 and 14 years of age. B. between 11 and 16 years of age. C. between 25 and 35 years of age. D. between 45 and 50 years of age.

B. between 11 and 16 years of age.

8. If a woman with vaginal bleeding reports syncope, the EMT must assume that she: A. is pregnant. B. is in shock. C. has an infection. D. has an ectopic pregnancy.

B. is in shock.

Which of the following statements regarding gastrointestinal bleeding is correct?

Bleeding within the gastrointestinal tract is a symptom of another disease, not a disease itself.

Which of the following MOST accurately describes the cause of an ischemic stroke?

Blockage of a cerebral artery

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: Select one: A. request a paramedic to give her a sedative. B. have her breathe into a paper or plastic bag. C. provide reassurance and give oxygen as needed. D. position her on her left side and transport at once.

A patient in cardiac arrest is wearing an external defibrillator vest, which is interfering with effective chest compressions. The EMT should: Select one: A. remove the battery from the monitor and leave the vest in place. B. perform ventilations only and allow the vest device to defibrillate. C. remove the battery from the monitor and then remove the vest. D. leave the battery attached to the monitor and remove the vest.

After the AED has delivered a shock, the EMT should: Select one: A. assess for a carotid pulse. B. re-analyze the cardiac rhythm. C. immediately resume CPR. D. transport the patient at once.

Alkalosis is a condition that occurs when: Select one: A. the level of carbon dioxide in the blood increases. B. blood acidity is reduced by excessive breathing. C. dangerous acids accumulate in the bloodstream. D. slow, shallow breathing eliminates too much carbon dioxide.

Asthma is caused by a response of the: Select one: A. cardiovascular system. B. respiratory system. C. immune system. D. endocrine system.

Common side effects of nitroglycerin include all of the following, EXCEPT: Select one: A. bradycardia. B. hypotension. C. hypertension. D. severe headache.

Common signs and symptoms of acute hyperventilation syndrome include: Select one: A. unilateral paralysis and slurred speech. B. anxiety, dizziness, and severe bradypnea. C. tachypnea and tingling in the extremities. D. altered mental status and bradycardia.

His parents tell you that their son has had a chest infection for the past two days and when they took him to their family doctor, they were told it was likely due to the respiratory syncytial virus (RSV). They have kept him well hydrated, but the infection seems to have gotten worse. On auscultation, you hear decreased air entry bilaterally with fine expiratory wheezes and the occasional coarse wet crackle. Based on this information, your patient is most likely suffering from: Select one: A. epiglottitis. B. pertussis. C. bronchiolitis. D. croup.

Hyperventilation could be associated with all of the following, EXCEPT: Select one: A. a respiratory infection. B. high blood glucose levels. C. a narcotic overdose. D. an overdose of aspirin.

In order for efficient pulmonary gas exchange to occur: Select one: A. the percentage of inhaled carbon dioxide must exceed the percentage of inhaled oxygen. B. the pulmonary capillaries must be completely constricted and the alveoli must be collapsed. C. oxygen and carbon dioxide must be able to freely diffuse across the alveolar-capillary membrane. D. there must be low quantities of pulmonary surfactant to allow for full alveolar expansion.

Nitroglycerin is contraindicated in patients: Select one: A. with a systolic blood pressure less than 120 mm Hg. B. with a history of an ischemic stroke. C. who have experienced a head injury. D. who have taken up to two doses.

Nitroglycerin relieves cardiac-related chest pain by: Select one: A. increasing the amount of stress that is placed on the myocardium. B. contracting the smooth muscle of the coronary and cerebral arteries. C. dilating the coronary arteries and improving cardiac blood flow. D. constricting the coronary arteries and improving cardiac blood flow.

The MOST common error associated with the use of the AED is: Select one: A. malfunction of the AED's internal computer processor. B. inability of the EMT to recognize ventricular fibrillation. C. failure of the EMT to ensure the battery is charged. D. inappropriately placed adhesive defibrillation electrodes.

The electrical impulse generated by the heart originates in the: Select one: A. bundle of His. B. atrioventricular node. C. sinoatrial node. D. coronary sinus.

Upon arriving at the residence of a patient with a possible cardiac problem, it is MOST important to: Select one: A. gain immediate access to the patient. B. determine if you need additional help. C. assess the scene for potential hazards. D. request a paramedic unit for assistance.

When auscultating the lungs of a patient with respiratory distress, you hear adventitious sounds. This means that the patient has: Select one: A. diminished breath sounds. B. normal breath sounds. C. abnormal breath sounds. D. an absence of breath sounds.

When preparing to obtain a 12-lead ECG, the "LL" and "RL" electrodes should be placed: Select one: A. on either side of the chest. B. on the lower abdomen. C. on the thighs or ankles. D. anywhere on the arms.

Which of the following statements regarding the hypoxic drive is correct? Select one: A. Chronic carbon dioxide elimination often results in activation of the hypoxic drive. B. The hypoxic drive serves as the primary stimulus for breathing in healthy individuals. C. The hypoxic drive stimulates a person to breathe on the basis of low oxygen levels. D. 100% supplemental oxygen will always cause apnea in patients with a hypoxic drive.

Which of the following statements regarding the pain associated with AMI is correct? Select one: A. It often fluctuates in intensity when the patient breathes. B. Nitroglycerin usually resolves the pain within 30 minutes. C. It can occur during exertion or when the patient is at rest. D. It is often described by the patient as a sharp feeling.

You and your EMT partner are the first to arrive at the scene of an unresponsive 70-year-old man. Your assessment reveals that he is apneic and pulseless. A paramedic unit is en route to the scene and will arrive in approximately 5 minutes. You should: Select one: A. perform CPR only and wait for the manual defibrillator to arrive. B. apply the AED while your partner provides rescue breathing. C. begin CPR, apply the AED, and deliver a shock if it is indicated. D. begin CPR and have your partner update the responding paramedics.

You are assisting an asthma patient with his prescribed metered-dose inhaler. After the patient takes a deep breath and depresses the inhaler, you should: Select one: A. advise him to exhale forcefully to ensure medication absorption. B. allow him to breathe room air and assess his oxygen saturation. C. instruct him to hold his breath for as long as he comfortably can. D. immediately reapply the oxygen mask and reassess his condition.

You are dispatched to a convenience store for a patient who passed out. Upon arriving at the scene, you find two off-duty EMTs performing CPR on the patient, a 58-year-old male. Your initial action should be to: Select one: A. request a paramedic unit and quickly attach the AED. B. have the EMTs stop CPR and assess for a pulse. C. feel for a pulse while compressions are ongoing. D. quickly attach the AED and push the analyze button.

You are dispatched to a residence for a 56-year-old male with an altered mental status. Upon arrival at the scene, the patient's wife tells you that he complained of chest pain the day before, but would not allow her to call EMS. The patient is semiconscious; has rapid, shallow respirations; and has a thready pulse. You should: Select one: A. attach the AED immediately. B. obtain baseline vital signs. C. begin ventilatory assistance. D. apply a nonrebreathing mask.

10. A 26-year-old female presents with heavy vaginal bleeding. She is conscious, but restless. Her blood pressure is 84/54 mm Hg, her pulse is 120 beats/min and weak, and her respirations are 22 breaths/min with adequate depth. She tells you that she inserted a tampon about 2 hours ago. You should: A. administer high-flow oxygen, ask her to remove the tampon, perform a detailed secondary assessment, and transport promptly. B. administer high-flow oxygen, perform a detailed assessment of her vaginal area for signs of trauma, place her on her side, and transport. C. administer high-flow oxygen, place a sterile pad over her vagina, keep her warm, elevate her lower extremities, and transport without delay. D. assist her ventilations with a bag-mask device, place one sterile dressing into her vagina, perform a rapid secondary assessment, and transport.

C. administer high-flow oxygen, place a sterile pad over her vagina, keep her warm, elevate her lower extremities, and transport without delay.

3. General treatment for a woman with vaginal bleeding and shock following sexual assault includes all of the following, EXCEPT: A. supplemental oxygen and lower extremity elevation. B. refraining from placing any dressings into the vagina. C. carefully removing any foreign bodies from the vagina. D. treating external lacerations with moist, sterile compresses.

C. carefully removing any foreign bodies from the vagina.

It is not uncommon for young females who experience their first menstrual period to: A. have a falsely positive home pregnancy test result. B. lose up to 500 mL of blood within the first 24 hours. C. experience abdominal cramping, which may be misinterpreted. D. become so emotionally distraught that they contemplate suicide.

C. experience abdominal cramping, which may be misinterpreted.

11. Which of the following conditions does NOT typically present with vaginal discharge? A. chlamydia B. gonorrhea C. genital herpes D. PID

C. genital herpes

15. When caring for a woman who is experiencing a gynecologic emergency, the EMT's main focus should be to: A. determine the underlying cause of her problem. B. ask questions related to her gynecologic history. C. maintain her ABCs and transport without delay. D. keep assessment and treatment to a minimum.

C. maintain her ABCs and transport without delay.

CPAP is generally used for which condition? - Acute pulmonary edema - Hyperventilation - Pleural effusion - Spontaneous pneumothorax

CPAP is generally used for which condition? *- Acute pulmonary edema* - Hyperventilation - Pleural effusion - Spontaneous pneumothorax *CPAP is a noninvasive means of providing ventilatory support for patients experiencing respiratory distress associated with obstructive pulmonary disease and acute pulmonary edema.*

Tension headaches

Caused by muscle contractions in the head and neck Attributed to stress

Sinus headaches

Caused by pressure that is the result of fluid accumulation in the sinus cavities

Crackles (rales) are caused by _________. - severe bronchoconstriction - narrowing of the upper airways - air passing through fluid - mucus in the larger airways

Crackles (rales) are caused by _________. - severe bronchoconstriction - narrowing of the upper airways *- air passing through fluid* - mucus in the larger airways

Which of the following is an indication of imminent birth?

Crowning of the baby's head

"PASTE" is an alternate assessment tool for ___________. Select one: A. cardiac patients B. seizure patients C. stroke patients D. respiratory patients

A 66-year-old female with a history of hypertension and diabetes presents with substernal chest pressure of 2 hours' duration. Her blood pressure is 140/90 mm Hg, her pulse is 100 beats/min and irregular, her respirations are 22 breaths/min, and her oxygen saturation is 92%. The patient does not have prescribed nitroglycerin, but her husband does. You should: Select one: A. obtain a SAMPLE history and contact medical control for advice. B. give her one nitroglycerin and reassess her systolic blood pressure. C. give her high-flow oxygen, attach the AED, and transport at once. D. administer oxygen, give her 324 mg of aspirin, and assess her further.

An alert patient presents with a regular pattern of inhalation and exhalation and breath sounds that are clear and equal on both sides of the chest. These findings are consistent with: Select one: A. respiratory insufficiency. B. respiratory difficulty. C. an obstructed airway. D. adequate air exchange.

Cardiogenic shock following AMI is caused by: Select one: A. widespread dilation of the systemic vasculature. B. a profound increase in the patient's heart rate. C. hypovolemia secondary to severe vomiting. D. decreased pumping force of the heart muscle.

Crackles (rales) are caused by _________. Select one: A. narrowing of the upper airways B. severe bronchoconstriction C. mucus in the larger airways D. air passing through fluid

Deoxygenated blood from the body returns to the: Select one: A. left atrium. B. left ventricle. C. right ventricle. D. right atrium.

In what area of the lungs does respiration occur? Select one: A. Trachea B. Capillaries C. Bronchi D. Alveoli

Ischemic heart disease is defined as: Select one: A. absent myocardial blood flow due to a blocked coronary artery. B. death of a portion of the heart muscle due to a decrease in oxygen. C. decreased blood flow to the heart muscle due to coronary dilation. D. decreased blood flow to one or more portions of the myocardium.

Most patients are instructed by their physician to take up to _______ doses of nitroglycerin before calling EMS. Select one: A. two B. four C. five D. three

Prior to assisting a patient with his or her prescribed nitroglycerin, the EMT must: Select one: A. ensure the medication is in tablet form. B. wait at least 5 minutes after assessing the blood pressure. C. determine who prescribed the nitroglycerin. D. obtain authorization from medical control.

The myocardium receives oxygenated blood from the __________, which originate(s) from the __________. Select one: A. aorta, inferior vena cava B. coronary sinus, vena cava C. vena cava, coronary veins D. coronary arteries, aorta

The right coronary artery supplies blood to the: Select one: A. left ventricle and posterior wall of the right ventricle. B. right atrium and posterior wall of the right ventricle. C. left ventricle and inferior wall of the right atrium. D. right ventricle and inferior wall of the left ventricle.

Ventricular tachycardia causes hypotension because: Select one: A. blood backs up into the lungs and causes congestion. B. the volume of blood returning to the atria increases. C. the right ventricle does not adequately pump blood. D. the left ventricle does not adequately fill with blood.

What is the function of the left atrium? Select one: A. It receives blood from the pulmonary arteries. B. It receives oxygenated blood from the vena cava. C. It ejects oxygenated blood into the aorta. D. It receives oxygenated blood from the lungs.

Which of the following is NOT a common sign or symptom associated with malfunction of an implanted cardiac pacemaker? Select one: A. Heart rate less than 60 beats/min B. Generalized weakness C. Syncope or dizziness D. A rapid heart rate

Which of the following is a genetic disorder that predisposes the patient to repeated lung infections? Select one: A. Celiac sprue B. Multiple sclerosis C. Severe acute respiratory syndrome D. Cystic fibrosis

While auscultating an elderly woman's breath sounds, you hear low-pitched "rattling" sounds at the bases of both of her lungs. This finding is MOST consistent with which of the following conditions? Select one: A. Acute asthma attack B. Widespread atelectasis C. Early pulmonary edema D. Aspiration pneumonia

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. Bystanders are present, but have not provided any care. You should: Select one: A. perform two-rescuer CPR for 5 minutes and request ALS backup. B. immediately apply the AED pads and analyze his cardiac rhythm. C. have your partner perform CPR while you question the bystanders. D. begin high-quality CPR and apply the AED as soon as possible.

You are assessing a 49-year-old man who complains of chest pressure that began the night before. He is conscious, but anxious, and tells you he has a history of angina and hypertension. After applying high-flow oxygen, you expose his chest to auscultate his lungs and note that he has a nitroglycerin patch on his right upper chest. His skin is cool and pale, his blood pressure is 78/50 mm Hg, and his pulse is 110 beats/min and irregular. You should: Select one: A. immediately remove the nitroglycerin patch, apply the AED in case he develops cardiac arrest, and transport to the closest hospital. B. ask him if the nitroglycerin patch he is wearing has improved his chest pressure, complete your secondary assessment, and transport promptly. C. move the nitroglycerin patch to the other side of his chest in case you need to apply the AED, keep him warm, and transport without delay. D. remove the nitroglycerin patch, place him in a supine position and elevate his lower extremities, and prepare for immediate transport.

You are attending to a 3-year-old male patient who is presenting with severe shortness of breath. His parents report that he has had a cough and cold with a low grade fever for the past two days. They became worried today, as his level of distress has increased dramatically. On assessment, the patient is sitting upright and making high-pitched noises with each breath. Based on this information, the patient is most likely suffering from: Select one: A. inflammation of the bronchioles. B. inflammation of the lower respiratory tract and bronchospasm. C. bacterial infection of the epiglottis. D. viral infection of the upper respiratory tract.

When documenting a call in which a female was sexually assaulted, you should: A. only use quotation marks when recording any statements made by witnesses. B. translate the patient's words or statements using proper medical terminology. C. record your opinion only if you have reasonable proof to justify the statement. D. keep the report concise and record only what the patient stated in her own words.

D. keep the report concise and record only what the patient stated in her own words.

20. Which of the following clinical presentations is MOST consistent with PID? A. left lower quadrant pain, referred pain to the left shoulder, and fever B. pain around the umbilicus, low-grade fever, and generalized weakness C. upper abdominal cramping, severe headache, and heavy vaginal bleeding D. lower abdominal pain, fever, general malaise, and foul-smelling vaginal discharge

D. lower abdominal pain, fever, general malaise, and foul-smelling vaginal discharge

2. Potentially life-threatening consequences of PID include: A. ovarian cysts and gonorrhea. B. bacterial vaginosis and chlamydia. C. uterine rupture with severe bleeding. D. ovarian abscess and ectopic pregnancy.

D. ovarian abscess and ectopic pregnancy.

4. When caring for a female patient who has been sexually assaulted, you should: A. ask the patient for a concise, detailed report of what happened to her. B. allow law enforcement to take her statement before you begin treatment. C. advise her that she will not be allowed to shower or change her clothes. D. place any bloodstained clothing or other articles in separate paper bags.

D. place any bloodstained clothing or other articles in separate paper bags.

Which of the following statements regarding gestational diabetes is correct: A. Diet and exercise are typically ineffective in controlling gestational diabetes. B. The onset of gestational diabetes typically manifests with hypoglycemia. C. Gestational diabetes results in permanent diabetes mellitus after delivery. D. In some cases, women with gestational diabetes require insulin injections.

D. In some cases, women with gestational diabetes require insulin injections.

After the fetus has descended into the pelvis at the end of the third trimester, many mother experience:

Easier breathing

Which of the following is NOT a component of the APGAR score? A.activity B.grimace C.pulse D.body size

D. body size

Most medical models base a pregnant woman's due date: A. two weeks after her last menstrual cycle. B. two weeks before her last menstrual cycle. C. on the last day of her last menstrual cycle.D. on the first day of her last menstrual cycle.

D. on the first day of her last menstrual cycle.

Common interventions used to stimulate spontaneous respirations in the newborn include all of the following, EXCEPT: A.thorough drying with a towel. B.suctioning of the upper airway. C.some form of tactile stimulation. D.positive-pressure ventilations.

D.positive-pressure ventilations

When you are assessing for a stroke, which of the following neurologic tests should be included in the assessment as a minimum?

Facial movement, arm movement, and speech

(T/F) Decreased, absent, or abnormal breath sounds are also called vesicular breath sounds.

False. Decreased, absent, or abnormal breath sounds are also known as *adventitious* breath sounds.

(T/F) Snoring sounds are indicative of a partial lower airway obstruction, usually in the bronchioles.

False. Snoring sounds are indicative of a partial *upper* airway obstruction, usually in the oropharynx.

All of the following questions are pertinent to ask a mother when determining whether or not her baby will deliver within the next few minutes, EXCEP

Have you had a sonogram?

A 30-year-old male experienced a generalized (tonic-clonic) seizure, which stopped before you arrived at the scene. The patient is conscious, is answering your questions appropriately, and refuses EMS transport. Which of the following would be the MOST compelling reason to disagree with his refusal of transport?

He is currently not prescribed any medications

Signs and symptoms of preeclampsia include:

Headache and edema

His parents tell you that their son has had a chest infection for the past two days and when they took him to their family doctor, they were told it was likely due to the respiratory syncytial virus (RSV). They have kept him well hydrated, but the infection seems to have gotten worse. On auscultation, you hear decreased air entry bilaterally with fine expiratory wheezes and the occasional coarse wet crackle. Based on this information, your patient is most likely suffering from: - pertussis. - epiglottitis. - bronchiolitis. - croup.

His parents tell you that their son has had a chest infection for the past two days and when they took him to their family doctor, they were told it was likely due to the respiratory syncytial virus (RSV). They have kept him well hydrated, but the infection seems to have gotten worse. On auscultation, you hear decreased air entry bilaterally with fine expiratory wheezes and the occasional coarse wet crackle. Based on this information, your patient is most likely suffering from: - pertussis. - epiglottitis. *- bronchiolitis.* - croup.

Which of the following mimics a stroke and also causes a seizure?

Hypoglycemia

Which of the following is a metabolic cause for a seizure?

Hypoglycemia is a metabolic cause of seizures.

Causes of altered mental status

Hypoglycemia, Delirium, unrecognized head injury, sever alcohol intoxication, psychologic disorders and medication, infections (in brain), drug overdose, and/or poisoning

Which of the following conditions would be the LEAST likely to mimic the signs and symptoms of a stroke?

Hypovolemia

Which of the following medications would the EMT be LEAST likely to administer to a patient with a medical complaint?

Ibuprofen

In addition to asthma, which of the following conditions is associated with wheezing? - Croup - Epiglottitis - Pulmonary embolism - Bronchitis

In addition to asthma, which of the following conditions is associated with wheezing? - Croup - Epiglottitis - Pulmonary embolism *- Bronchitis*

In order for efficient pulmonary gas exchange to occur: - oxygen and carbon dioxide must be able to freely diffuse across the alveolar-capillary membrane. - there must be low quantities of pulmonary surfactant to allow for full alveolar expansion. - the pulmonary capillaries must be completely constricted and the alveoli must be collapsed. - the percentage of inhaled carbon dioxide must exceed the percentage of inhaled oxygen.

In order for efficient pulmonary gas exchange to occur: *- oxygen and carbon dioxide must be able to freely diffuse across the alveolar-capillary membrane.* - there must be low quantities of pulmonary surfactant to allow for full alveolar expansion. - the pulmonary capillaries must be completely constricted and the alveoli must be collapsed. - the percentage of inhaled carbon dioxide must exceed the percentage of inhaled oxygen.

In the mnemonic PASTE, what does the "S" stand for? - Symptoms - Severity - Sputum - Syncope

In the mnemonic PASTE, what does the "S" stand for? - Symptoms - Severity *- Sputum* - Syncope

In what area of the lungs does respiration occur? - Alveoli - Trachea - Capillaries - Bronchi

In what area of the lungs does respiration occur? *- Alveoli* - Trachea - Capillaries - Bronchi

When caring for a patient with documented hypoglycemia, you should be MOST alert for:

a seziure

Two main type of stroke

Ischemic and Hemorrhagic Stroke

What happens when blood flow to a particular part of the brain is cut off by a blockage, resulting in tissue damage?

Ischemic stroke

Which of the following assessment findings is MOST indicative of a cardiovascular problem?

Jugular venous distention

Which of the following medications would indicate that a patient has a history of seizures?

Levetiracetam (Keppra)

Medications used most often to treat seizures include:

Levetiracetam (Keppra) Phenytoin (Dilantin) Phenobarbital Carbamazepine (Tegretol) Valproate (Depakote) Topiramate (Topamax) Clonazepam (Klonopin)

incontinence

Loss of bowel and/or bladder control; may be the result of a generalized seizure.

________ affect(s) the entire brain, often causing anxiety, restlessness, and confusion.

Low oxygen levels in the bloodstream will affect the entire brain, often causing anxiety, restlessness, and confusion.

Which of the following is bacterium resistant to most antibiotics and causes skin abscesses?

MRSA

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.

When assessing a patient with a medical complaint, which of the following would MOST likely reveal the cause of the problem?

Medical history

Which of the following statements regarding twins is MOST correct?

Most twins are born within 45 minutes of each other.

What is the name of the condition when the patient forgets about the injured side after a stroke?

Neglect

Which of the following statements regarding dialysis is correct?

Patients who miss a dialysis treatment often present with weakness.

Which of the following conditions would MOST likely affect the entire brain?

Respiratory failure or cardiopulmonary arrest

Eclampsia is MOST accurately defined as

Seizures that result from severe hypertension

febrile seizures

Seizures that result from sudden high fevers; most often seen in children.

What is dyspnea?

Shortness of breath

dysarthria

Slurred speech

Which of the following conditions is NOT categorized as a psychiatric condition?

Substance abuse

APGAR

Summarizes the health of a newborn. A=Appearance P=Pulse G=Grimace A=Activity R=Respirations

Most common types of headaches are:

Tension headache, migraines, and sinus headaches

You are treating a patient who is exhibiting slurred speech, facial droop, and an inability to move his left arm. Which neurologic examination emphasizes these possible stroke signs?

The Cincinnati Prehospital Stroke Scale looks at facial droop, arm lift, and speech.

Hemorrhagic stroke (bleeding in the brain)

The blood from a ruptured blood vessel irritates the tissues of the brain and can cause increased intracranial pressure.

aphasia

The inability to understand and/or produce speech.

Which of the following processes occurs during ovulation?

The inner lining of the uterus thickens in preparation for implantation.

The most common form of COPD is ________. - Asthma - Bronchitis - Emphysema - Pneumonia

The most common form of COPD is ________. - Asthma - Bronchitis *- Emphysema* - Pneumonia

Which of the following symptoms would lead the EMT to believe that a patient's headache is caused by sinus congestion?

The pain is worse when bending over

A 58-year-old male presents with confusion, right-sided weakness, and slurred speech. His wife is present and is very upset. As your partner is applying oxygen, it is MOST important for you to:

ask his wife when she noticed symptoms

postictal state

The period following a seizure that lasts 5 to 30 minutes; characterized by labored respirations and some degree of altered mental status.

Which of the following statements regarding the placenta is MOST correct?

The placenta allows oxygen, carbon dioxide, and other products to transfer between the mother and fetus but does not allow blood to mix between the mother and fetus.

Migraines

Thought to be caused by changes in blood-vessel size in the base of the brain; often associated with nausea and vomiting and may be preceded by visual warning signs such as flashing lights or partial vision loss.

Treatment with continuous positive airway pressure (CPAP) would MOST likely be contraindicated in which of the following situations? - Pulmonary edema, history of hypertension, and anxiety - Shortness of breath and a blood pressure of 76/56 mm Hg - Difficulty breathing, two-word dyspnea, and tachycardia - Conscious and alert patient with an oxygen saturation of 85%

Treatment with continuous positive airway pressure (CPAP) would MOST likely be contraindicated in which of the following situations? - Pulmonary edema, history of hypertension, and anxiety *- Shortness of breath and a blood pressure of 76/56 mm Hg* - Difficulty breathing, two-word dyspnea, and tachycardia - Conscious and alert patient with an oxygen saturation of 85%

(T/F) Adult patients breathing more than 20 breaths/min or fewer than 12 breaths/min should receive high-flow oxygen.

True.

Which of the following occurs during true labor?

Uterine contractions become more regular

hemiparesis

Weakness on one side of the body

What is atelectasis? - Collapse of the alveolar air spaces of the lungs - The buildup of excess acid in the blood or body tissues that results from a primary illness - The buildup of excess base (lack of acids) in the body fluids - An extreme, life-threatening, systemic allergic reaction that may include shock and respiratory failure

What is atelectasis? *- Collapse of the alveolar air spaces of the lungs* - The buildup of excess acid in the blood or body tissues that results from a primary illness - The buildup of excess base (lack of acids) in the body fluids - An extreme, life-threatening, systemic allergic reaction that may include shock and respiratory failure

What is the most appropriate method for oxygen delivery to an adult patient experiencing breathing difficulty? - Nasal cannula at 2 to 6 L/min - Nonrebreathing mask at 15 L/min - Venturi mask at 8 L/min - BVM at 15 L/min

What is the most appropriate method for oxygen delivery to an adult patient experiencing breathing difficulty? - Nasal cannula at 2 to 6 L/min *- Nonrebreathing mask at 15 L/min* - Venturi mask at 8 L/min - BVM at 15 L/min

When assisting an asthmatic patient with a small-volume nebulizer attached to oxygen, what is the appropriate flow rate for the oxygen? - 2 L/min - 4 L/min - 6 L/min - 10 L/min

When assisting an asthmatic patient with a small-volume nebulizer attached to oxygen, what is the appropriate flow rate for the oxygen? - 2 L/min - 4 L/min *- 6 L/min* - 10 L/min

When auscultating the lungs of a patient with respiratory distress, you hear adventitious sounds. This means that the patient has: - normal breath sounds. - an absence of breath sounds. - abnormal breath sounds. - diminished breath sounds.

When auscultating the lungs of a patient with respiratory distress, you hear adventitious sounds. This means that the patient has: - normal breath sounds. - an absence of breath sounds. *- abnormal breath sounds.* - diminished breath sounds.

Which of the following conditions would be LEAST likely to result in hypoxia? - Severe anxiety - Pleural effusion - Pulmonary edema - Narcotic overdose

Which of the following conditions would be LEAST likely to result in hypoxia? *- Severe anxiety* - Pleural effusion - Pulmonary edema - Narcotic overdose

Which of the following is MOST characteristic of adequate breathing? - 24 breaths/min with bilaterally equal breath sounds and pink skin - 30 breaths/min with supraclavicular retractions and clammy skin - 20 breaths/min with shallow movement of the chest wall and pallor - 22 breaths/min with an irregular pattern of breathing and cyanosis

Which of the following is MOST characteristic of adequate breathing? *- 24 breaths/min with bilaterally equal breath sounds and pink skin* - 30 breaths/min with supraclavicular retractions and clammy skin - 20 breaths/min with shallow movement of the chest wall and pallor - 22 breaths/min with an irregular pattern of breathing and cyanosis

Which of the following is a genetic disorder that predisposes the patient to repeated lung infections? - Severe acute respiratory syndrome - Multiple sclerosis - Cystic fibrosis - Celiac sprue

Which of the following is a genetic disorder that predisposes the patient to repeated lung infections? - Severe acute respiratory syndrome - Multiple sclerosis *- Cystic fibrosis* - Celiac sprue

Which of the following medications can be used for the treatment of an acute asthma attack? - Cromolyn - Albuterol - Fluticasone - Salmeterol

Which of the following medications can be used for the treatment of an acute asthma attack? - Cromolyn *- Albuterol* - Fluticasone - Salmeterol

Which of the following must be assessed in every respiratory patient? - Orthostatic vital signs - Distal pulse, motor, sensation - Blood glucose levels - Lung sounds

Which of the following must be assessed in every respiratory patient? - Orthostatic vital signs - Distal pulse, motor, sensation - Blood glucose levels *- Lung sounds*

Which of the following statements is true regarding asthma? - Asthma involves accumulation of air in the pleural space. - Asthma involves a collection of fluid in the pleural space. *- Asthma involves excessive mucus production.* - Asthma involves a collection of fluid in the alveoli. *Asthma is an acute spasm of the smaller air passages, called bronchioles, associated with excessive mucus production and with swelling of the mucous lining of the respiratory passages.*

Which type of breath sound are you more likely to hear in a person with congestive heart failure? - Decreased/absent - Rhonchi - Crackles - Stridor

Which type of breath sound are you more likely to hear in a person with congestive heart failure? - Decreased/absent - Rhonchi *- Crackles* - Stridor

While auscultating an elderly woman's breath sounds, you hear low-pitched "rattling" sounds at the bases of both of her lungs. This finding is MOST consistent with which of the following conditions? - Early pulmonary edema - Aspiration pneumonia - Acute asthma attack - Widespread atelectasis

While auscultating an elderly woman's breath sounds, you hear low-pitched "rattling" sounds at the bases of both of her lungs. This finding is MOST consistent with which of the following conditions? - Early pulmonary edema *- Aspiration pneumonia* - Acute asthma attack - Widespread atelectasis

You are assisting an asthma patient with his prescribed metered-dose inhaler. After the patient takes a deep breath and depresses the inhaler, you should: - instruct him to hold his breath for as long as he comfortably can. - allow him to breathe room air and assess his oxygen saturation. - advise him to exhale forcefully to ensure medication absorption. - immediately reapply the oxygen mask and reassess his condition.

You are assisting an asthma patient with his prescribed metered-dose inhaler. After the patient takes a deep breath and depresses the inhaler, you should: *- instruct him to hold his breath for as long as he comfortably can.* - allow him to breathe room air and assess his oxygen saturation. - advise him to exhale forcefully to ensure medication absorption. - immediately reapply the oxygen mask and reassess his condition.

You are attending to a 3-year-old male patient who is presenting with severe shortness of breath. His parents report that he has had a cough and cold with a low grade fever for the past two days. They became worried today, as his level of distress has increased dramatically. On assessment, the patient is sitting upright and making high-pitched noises with each breath. Based on this information, the patient is most likely suffering from: - viral infection of the upper respiratory tract. - inflammation of the bronchioles. - inflammation of the lower respiratory tract and bronchospasm. - bacterial infection of the epiglottis.

You are attending to a 3-year-old male patient who is presenting with severe shortness of breath. His parents report that he has had a cough and cold with a low grade fever for the past two days. They became worried today, as his level of distress has increased dramatically. On assessment, the patient is sitting upright and making high-pitched noises with each breath. Based on this information, the patient is most likely suffering from: *- viral infection of the upper respiratory tract.* - inflammation of the bronchioles. - inflammation of the lower respiratory tract and bronchospasm. - bacterial infection of the epiglottis.

You are attending to a 54-year-old female patient in a homeless shelter. The patient tells you that she had the flu a couple of weeks ago, and she has not gotten over it. She has been tired and keeps waking up at night, sweating. She has been coughing up green sputum occasionally and has been experiencing episodes of chest pain that get worse when she breathes. Based on this information, your patient is most likely suffering from: - pneumonia. - tuberculosis. - influenza Type A. - chronic obstructive pulmonary disease (COPD).

You are attending to a 54-year-old female patient in a homeless shelter. The patient tells you that she had the flu a couple of weeks ago, and she has not gotten over it. She has been tired and keeps waking up at night, sweating. She has been coughing up green sputum occasionally and has been experiencing episodes of chest pain that get worse when she breathes. Based on this information, your patient is most likely suffering from: - pneumonia. *- tuberculosis.* - influenza Type A. - chronic obstructive pulmonary disease (COPD).

You arrive at a residence where you find a woman in her early 60s. She is anxious, tachycardic, and her fingertips and lips are blue. As you assess her, she coughs up frothy sputum, and you hear crackles and some wheezing as you check for breath sounds. What condition do these findings indicate? - Spontaneous pneumothorax - Emphysema - Bronchitis - Congestive heart failure

Your patient has a chronic respiratory condition. His stimulus to breathe is triggered by low oxygen levels in the blood. This is known as the ___________. - hypoxic drive - CO2 drive - COPD drive - alternate drive

Your patient has a chronic respiratory condition. His stimulus to breathe is triggered by low oxygen levels in the blood. This is known as the ___________. *- hypoxic drive* - CO2 drive - COPD drive - alternate drive

Most patients with an infectious disease will have _________.

a fever

An infectious disease is MOST accurately defined as:

a medical condition caused by the growth and spread of small, harmful organisms within the body

When the cervix begins to dilate

a mucus plug is expelled from the vagina

Spina bifida is a developmental defect in which:

a portion of the spinal cord or meninges protrudes outside of the vertebrae

When caring for a patient with documented hypoglycemia, you should be MOST alert for:

a seizure

Fetal complications associated with drug- or alcohol-addicted mothers include all of the following, EXCEPT: a) profound tachycardia b) premature delivery c) low birth weight d) respiratory depression

a) profound tachycardia

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:

acute cholecystitis.

Most treatments provided in the prehospital setting are intended to _________.

address the patient's symptoms

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:

administer oxygen and prepare for immediate transport.

You are assessing a 30-year-old woman who is 35 weeks' pregnant. She tells you that her amniotic sac has not ruptured, but she is experiencing irregular contractions that "come and go." Upon visual inspection, you note a small amount of brown mucus draining from her vagina. You should

administer oxygen and transport.

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 patient's circulatory status, you should direct your partner to:

administer oxygen with the appropriate device.

The determination of whether a medical patient is a high-priority or low-priority transport is typically made:

after the primary assessment has been completed.

Elderly patients with abdominal problems may not exhibit the same pain response as younger patients because of:

age-related deterioration of their sensory systems.

Braxton-Hicks contractions are characterized by

alleviation of pain with movement or changing positions

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

an aortic aneurysm.

A 26-year-old woman complains of a stabbing pain in the right lower quadrant of her abdomen. She states that her last menstrual period was 7 weeks ago and that she had pelvic inflammatory disease approximately 3 months ago. You should be MOST suspicious that this patient is experiencing

an ectopic pregnancy

A history of pelvic inflammatory disease or tubal ligations increases a woman's risk for

an ectopic pregnancy

Erosion of the protective layer of the stomach or duodenum secondary to overactivity of digestive juices results in:

an ulcer.

Pain that radiates to the right lower quadrant from the umbilical area, nausea and vomiting, and anorexia are MOST indicative of:

appendicitis.

During your visual inspection of a 19-year-old patient in labor, you see the baby's head crowning at the vaginal opening. What should you do?

apply gentle pressure to the baby's head as it delivers.

Components of the Cincinnati Prehospital Stroke Scale include:

arm drift, speech, and facial droop.

You are assessing a 25-year-old woman who is 39 weeks' pregnant. She is experiencing regular contractions that are approximately 3 minutes apart and states that her amniotic sac broke 2 hours ago. After taking the appropriate BSI precautions, you should

assess her for crowning.

You are dispatched to an apartment complex for a young male with abdominal pain. Your priority upon arriving at the scene should be to:

assess the scene for potential hazards.

Law enforcement has summoned you to a nightclub, where a 22-year-old female was found unconscious in an adjacent alley. Your primary assessment reveals that her respirations are rapid and shallow and her pulse is rapid and weak. She is wearing a medical alert bracelet that identifies her as an epileptic. There is an empty bottle of vodka next to the patient. You should:

assist ventilation perform a rapid exam, and prepare for immediate transport.

Upon delivery of an infant's head, you note that the umbilical cord is wrapped around its neck. You should

attempt to slip the cord gently over the infant's head

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:

be alert for signs and symptoms of shock.

By the 20th week of pregnancy, the uterus is typically at or above the level of the mother's

belly button

The vagina and the neck of the uterus comprise the

birth canal

Signs and symptoms of pregnancy-induced hypertension (preeclampsia) include all of the following, EXCEPT

blood in the urine

The ONLY indications for placing your gloved fingers in the vagina during delivery are:

breech presentation and prolapsed umbilical cord

The ONLY indications for placing your gloved fingers in the vagina during delivery are

breeched presentation and prolapsed umbilical cord

Which of the following is characteristic of peptic ulcer disease (PUD)?

burning or pain in the stomach that subsides immediately after eating

The umbilical cord

carries oxygen to the baby via the umbilical vein.

Muscle control and body coordination are controlled by the:

cerebellum

You are attending to a 27-year-old male driver of a car. According to his passenger, the patient had been acting strangely while driving, then slumped forward against the steering wheel, apparently unconscious. The car drove off the road and struck a telephone pole. The patient remains unconscious, and physical assessment reveals only a large hematoma on his right forehead with no other physical signs. Your patient is a diabetic who had been under a lot of stress lately and may have missed meals. This is an example of a:

combination of a medical and trauma emergency.

You are examining a patient whose signs include lip smacking, jerking of the left arm, and agitation. Based on these signs, what type of seizure is this patient experiencing?

complex partial seizure.

The onset of labor begins with

contractions of the uterus

Patients with tuberculosis pose the greatest risk for transmitting the disease when they:

cough

Which of the following conditions is more common in women than in men?

cystitis

A placenta previa is MOST accurately defined as

development of the placenta over the cervical opening

A 29-year-old male complains of a severe headache and nausea that has gradually worsened over the past 12 hours. He is conscious, alert, and oriented and tells you that his physician diagnosed him with migraine headaches. He further tells you that he has taken numerous different medications, but none of them seem to help. His blood pressure is 132/74 mm Hg, his pulse is 110 beats/min and strong, and his respirations are 20 breaths/min. Treatment should include:

dimming the lights in the back of the ambulance and transporting without lights and siren.

Esophageal varices MOST commonly occur in patients who:

drink a lot of alcohol.

A patient whose speech is slurred and difficult to understand is experiencing:

dysarthria

A patient whose speech is slurred and difficult to understand is experiencing:

dysarthria.

The anterior aspect of the cerebrum controls:

emotion

During the primary assessment of a semiconscious 70-year-old female, you should:

ensure a patent airway and support ventilation as needed

During the primary assessment of a semiconscious 70-year-old female, you should:

ensure a patent airway and support ventilation as needed.

After a baby is born, it is important to

ensure it is thoroughly dried and warm

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

firmly massage the uterine fundus with a circular motion

Peritonitis may result in shock because:

fluid shifts from the bloodstream into body tissues.

When performing a secondary assessment on a conscious patient with nontraumatic abdominal pain and stable vital signs, you should:

focus on his or her chief complaint.

If a newborn has gasping respirations after being dried and suctioned

further stimulation is not likely to improve ventilation.

Which of the following organs lies in the retroperitoneal space?

gallbladder

The BEST way to prevent infection from whooping cough is to:

get vaccinated against diphtheria, tetanus, and pertussis.

A 30-year-old pregnant female is gravida-3 and para-2. This means that she has

given birth to 2 live babies

Hepatitis B is more virulent than hepatitis C, which means that it:

has a greater ability to produce disease.

in contrast to a full-term infant, a premature infant:

has an even proportionately larger head

A patient who is possibly experiencing a stroke is NOT eligible for thrombolytic (fibrinolytic) therapy if he or she:

has bleeding within the brain

A patient who is possibly experiencing a stroke is NOT eligible for thrombolytic (fibrinolytic) therapy if he or she:

has bleeding within the brain.

The term primipara refers to a woman who

has had only one live birth.

A precipitous labor and delivery is MOST common in women who

have delivered a baby before

Which of the following findings should concern the EMT the MOST when assessing a patient who complains of a headache?

history of migraines

The MOST significant risk factor for a hemorrhagic stroke is:

hypertension

The MOST significant risk factor for a hemorrhagic stroke is:

hypertension.

Which of the following conditions is NOT a common cause of seizures?

hypotension

Which of the following conditions would be the LEAST likely to mimic the signs and symptoms of a stroke?

hypovolemia

In contrast to the parietal peritoneum, the visceral peritoneum

is supplied by nerves of the autonomic nervous system, which are less able to localize pain or sensation.

A nuchal cord is defined as an umbilical cord that

is wrapped around the baby's neck.

You have just delivered a premature baby. Your assessment reveals that he is breathing adequately; however, his heart rate is 90 beats/min. You should

keep him warm and provide ventilatory assistance.

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?

kidney

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:

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

Most patients with abdominal pain prefer to:

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

When caring for a patient with an altered mental status and signs of circulatory compromise, you should:

limit your time at the scene to 10 minutes or less, if possible.

Which of the following organs would be MOST likely to bleed profusely if injured?

liver

A strangulated hernia is one that

loses its blood supply due to compression by local tissues.

You and your EMT partner arrive at the residence of a 50-year-old man who complains of weakness. Your primary assessment reveals that he is critically ill and will require aggressive treatment. The closest hospital is 25 miles away. You should:

manage all threats to airway, breathing, and circulation and consider requesting an ALS unit.

When assessing a patient with abdominal pain, you should:

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

In 2009, the H1N1 virus accounted for over 200,000 deaths worldwide in the form of the swine flu. In 1919, a similar outbreak of the H1N1 occurred in the form of the Spanish flu. Starting in Kansas City, the virus spread rapidly worldwide, claiming up to 50 million lives. These are both examples of:

pandemics.

The MOST common and significant complication associated with an acute abdomen is

peritonitis.

Assessment of the medical patient is usually focused on the _________.

nature of illness

It is especially important to assess pulse, sensation, and movement in all extremities as well as pupillary reactions in patients with a suspected ___________ problem.

neurologic

A patient with an altered mental status is:

not thinking clearly or is incapable of being aroused

A patient with an altered mental status is

not thinking clearly or is incapable of being aroused.

You arrive at a grocery store shortly after a 35-year-old male stopped seizing. Your assessment reveals that he is confused and incontinent of urine. The patient's girlfriend tells you that he has a history of seizures and takes topiramate (Topamax). When obtaining further medical history from the girlfriend, it is MOST important to:

obtain a description of how the seizure developed

Assessment of a patient's blood pressure with an automatic BP cuff reveals that it is 204/120 mm Hg. The patient is conscious and alert and denies any symptoms. The EMT should:

obtain a manual blood pressure.

When preparing a pregnant patient for delivery, you should position her

on a firm surface with her hips elevated 2" to 4"

The brain is most sensitive to changes in ________, _________, and ________levels

oxygen; glucose; temperature

Pain that may be perceived at a distant point on the surface of the body, such as the back or shoulder, is called:

referred pain.

The kidneys help to regulate blood pressure by:

removing sodium, and thus water, from the body.

Reassessment of a patient with a medical complaint should begin by:

repeating the primary assessment.

End-tidal carbon dioxide (ETCO2) monitoring is clearly indicated for patients who present with:

respiratory distress.

Which of the following is NOT generally considered an obstetrical emergency?

return of contractions following delivery of the baby

An important aspect in the treatment of a patient with severe abdominal pain is to:

rovide emotional support en route to the hospital.

What criteria must be met for a patient to have status epilepticus?

seizures that recur every few minutes or last longer than 30 minutes.

A generalized (tonic-clonic) seizure is characterized by:

severe twitching of all the body's muscles.

Solid abdominal organs include the:

spleen, kidneys, and pancreas.

Patients with acute abdominal pain should not be given anything to eat or drink because:

substances in the stomach increase the risk of aspiration.

During delivery of the baby's head, you should suction the mouth before the nose because

suctioning the nose first may cause the baby to gasp and aspirate fluid.

When caring for a patient who takes numerous medications, it is best to:

take all of the patient's medications with you to the hospital and document them on your patient care report.

When the mother is experiencing a contraction, you should instruct her to:

take quick short breaths

After sizing up the scene of a patient with a possible infectious disease, your next priority should be to:

take standard precautions.

The presence of thick meconium in the amniotic fluid indicates

that the baby's airway may be obstructed.

The third stage of labor begins when the

the baby is expelled from the vagina

When forming your general impression of a patient with a medical complaint, it is important to remember that:

the conditions of many medical patients may not appear serious at first.

During delivery, it is MOST important to position your partner at the mother's head because

the mother may become nauseated and vomit.

Abruprio placenta occurs when:

the placenta prematurely separates from the uterine wall

In contrast to a placenta previa, a placenta abruptio occurs when

the placenta prematurely separates from the uterine wall.

A 35-year-old woman who is 30 weeks' pregnant presents with a severe headache and swelling in her hands and feet. She is conscious and alert with a blood pressure of 148/94 mm Hg, a pulse of 100 beats/min, and respirations of 24 breaths/min. During transport, you should be MOST concerned with

the possibility that she may experience a seizure

Supine hypotensive syndrome occurs when

the pregnant uterus compresses the inferior vena cava

The left cerebral hemisphere controls:

the right side of the body

The left cerebral hemisphere controls:

the right side of the body.

The term "bloody show" is defined as:

the small amount of pink-tinged mucus that is discharged from the vagina after expulsion of the mucous plug

Vigorous suctioning of a newborn's airway is indicated if:

there is meconium in the amniotic fluid

Successful treatment of a stroke depends on whether:

thrombolytic therapy is given within 3 hours of symptoms beginning.

When determining the frequency of contractions, you should

time the contractions from the start of one to the start of the next

You respond to a residence for a child who is having a seizure. Upon arrival at the scene, you enter the residence and find the mother holding her child, a 2-year-old male. The child is conscious and crying. According to the mother, the child had been running a high fever and then experienced a seizure that lasted approximately 3 minutes. You should:

transport the child to the hospital and reassure the mother en route

transport the child to the hospital and reassure the mother en route.

The MOST important treatment for a patient with severe abdominal pain and signs of shock includes:

transporting the patient without delay.

General treatment guidelines when caring for a woman with traumatic vaginal bleeding includes

transporting to an appropriate facility

A patient who is experiencing aphasia is:

unable to produce or understand speech.

The principal clinical difference between a stroke and hypoglycemia is that patients with hypoglycemia:

usually have an altered mental status or decreased level or consciousness

From what internal female organ is the fetus expelled during delivery?

uterus

In the presence of ileus, the only way the stomach can empty itself is by:

vomiting.

An infant is considered to be premature if it

weighs less than 5 pounds or is born before 36 weeks' gestation.

When you are obtaining medical history from the family of a suspected stroke patient, it is MOST important to determine:

when the patient last appeared normal

When you are obtaining medical history from the family of a suspected stroke patient, it is MOST important to determine:

when the patient last appeared normal.

Ten days after treating a 34-year-old patient with tuberculosis, you are given a tuberculin skin test, which yields a positive result. This MOST likely indicates that:

you were exposed to another infected person prior to treating the 34-year-old patient.

Module 4

संबंधित स्टडी सेट्स

ECON1123-CH14-MONOPOLY

Exam 3

Lecture 16

Respiratory Review - A&P2

OB exam 2

BRAHIM

TIME ZONES - UNIT 2

Millwright Red Seal Study 1

Angiogenesis

EV 19

Chapter 7 Law

INFS 1010- Excel Ch. 2

PSY290 Final exam

Questions

Nutrition: Chap 10 & 11

MS prepu 49: Management of Patients with Urinary Disorders

Strategic Management - Chapter 7

Background/"Why Now" Info

AZ-104: Configure Virtual Machine Extensions

E115