Quiz 3: Medical

In contrast to a behavioral crisis, a psychiatric emergency occurs when a person:

becomes agitation or violence or becomes a threat to himself or herself, or to others

Chronic renal failure is a condition that:

Is often caused by hypertension or diabetes

To which of the following diabetic patients should you administer oral glucose?

a confused 55-year-old male with tachycardia and pallor

Which of the following conditions or situations would MOST likely make excited delirium worse?

alcohol withdrawal

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

Common side effects of nitroglycerin include all of the following, EXCEPT:

bradycardia

The most basic functions of the body, such as breathing, blood pressure, and swallowing are controlled by the:

brain stem

In addition to ensuring his or her own safety, the EMT's responsibility when caring for a patient with a behavioral emergency is to:

diffuse and control the situation and safely transport the patient

Stimulation of alpha-adrenergic receptors result in:

constriction of the blood vessels

____________ occurs when there is excessive pressure within the portal system and surrounding vessel and may lead to life-threatening bleeding

esophageal varices

When the abdominal muscles become rigid in an effort to protect the abdomen from further irritation, this is referred to as:

guarding

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 MOST important consideration in caring for a patient who has been exposed to an organophosphate insecticide or some other cholinergic agent is to:

avoid exposure yourself

____________ commonly produces symptoms about 30 minutes after a particularly fatty meal and usually at night.

cholecystitis

Signs and symptoms of a sympathomimetic drug overdose include:

tachycardia

Epinephrine is indicated for patients with an allergic reaction when:

wheezing and hypotension are present

Urinary tract infections are more common in:

women

How do poisons typically act to harm the body?

By changing the normal metabolism of cells or by destroying them

the diaphragm and intercostal muscles contract during:

inhalation

You are called to a home and find a 56-year-old woman supine in her bed. She appears alert, but has slurred speech. Her family tells you she has a history of TIAs and hypertension. You ask the patient "what day is it today?" her reply is, "butterfly." Which area of the brain is likely affected?

left hemisphere

Anaphylaxis is not always life threatening, but it typically involves:

multiple organ systems

Angina pectoris occurs when:

myocardial oxygen demand exceeds the supply

You should assess pulse, motor, and sensation in all of the extremities and check for pupillary reactions if you suspect a(n) _____ problem.

neurologic

Symptomatic hypoglycemia will MOST likely develop if a patient:

takes too much of his or her prescribed insulin

A patient with a history of schizophrenia called EMS because he was experiencing abdominal pain. When law enforcement arrived, the patient became violent, necessitating the placement of handcuffs. When you assess the patient, he tells you that killing someone will make his abdominal pain go away. His vital signs are stable. How should you manage this situation?

request a police officer to accompany you in the ambulance

The recommended treatment for absorbed or contact poisons includes __________.

safely removing or diluting the poisonous substance

Functions of the liver include:

secretion of bile and filtration of toxic substances.

Which of the following is NOT considered a sign or symptom of alcohol withdrawal?

seizures

Medical problems that may cause the patient to present as intoxicated can include all of the following, EXCEPT:

syncope

Which of the following statements regarding glucose is correct?

the brain requires glucose as much as it requires oxygen

A dissecting aortic aneurysm occurs when:

the inner layers of the aorta become separated

Organic brain syndrome is defined as:

A dysfunction of the brain caused by abnormal physical or physiological function

The adult epinephrine auto-injector delivers ________ mg of epinephrine, and the infant-child auto-injector delivers ________ mg

0.3; 0.15

Hypoglycemia can mimic conditions such as:

stroke

When administering epinephrine via auto-injector, you should hold the injector in place for:

10 seconds

Normal blood glucose levels range from __________ mg/dL

80 to 120

In cases of sexual assault, it is important to ensure that you do which of the following?

All of these answers are correct: immediately write down your observations of the scene before assessing the patient, call for a female EMT or ALS provider, discuss with law enforcement any suspicions that you may have about the perpetrator

Basic causes of shock include:

All of these answers are correct: poor pump function, blood or fluid loss, blood vessel dilation

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 difibrillator (AICD). The AED advises that a shock is indicated. What should you do?

Deliver the shock followed by immediate resumption of CPR

Which of the following infections, when left untreated may lead to infection of the blood and the brain?

Gonorrhea

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

"nerve gases" overstimulate normal body functions that are controlled by parasympathetic nerves, causing:

Increased salivation

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

Liver

a 29-year-old pregnant woman has severe vomiting for the last 2 days. Today, she is vomiting large amounts of blood. Her skin is cool and pale and she is tachycardiac. The EMT should suspect:

Mallory-Weiss tear

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

A patient with atherosclerotic heart disease experiences chest pain during exertion because:

The lumen of the coronary artery is narrowed and cannot accommodate increased blood flow

You receive a call to a residence where a man found his wife unresponsive on the couch. The patient's 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:

Ventilate her with a BVM

A 75-year-old male with type 1 diabetes presents with chest pain and a general feeling of weakness. He tells you that he took his insulin today and ate a regular meal approximately 2 hours ago. You should treat this patient as though is experiencing:

a heart attack

Which of the following is an example of a psychiatric emergency?

a person violently attacking family members

A raised, swollen, well-defined area on the skin that is the result of an insect bite or sting is called:

a wheal

Severe back pain may be associated with which of the following conditions?

abdominal aortic aneurysm

A 4-year-old, 15-kg male ingested an unknown quantity of acetaminophen (tylonel). The child's mother states that she does not know when the ingestion occurred. the child is conscious, alert and in no apparent distress. The EMT should:

administer 15g of activated charcoal

You arrive at a local grocery store approximately 5 minutes after a 21-year-old female stopped seizing. She is confused and disoriented; she keeps asking you what happened and tells you that she is thirsty. Her brother, who witnessed the seizure, tells you that she takes phenytoin (Dilantin) for her seizures, but has not taken it in a few days. He also tells you that she has diabetes. In addition to applying high-flow oxygen, you should:

administer her airway and breathing status and assess her blood glucose level

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:

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

A 59-year-old male presents with sudden-onset 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

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

A 37-year-old male is having a severe allergic reaction to penicillin. He does not have an epinephrine auto-injector and your protocols do not allow you to carry epinephrine on the ambulance. How should you proceed with the treatment of this patient?

administer oxygen, transport at once, and request a paramedic intercept

During gynecologic emergencies, in addition to the standard SAMPLE questions, the EMT should attempt to determine which of the following?

all of the above: The amount of time since of the patient's last menstrual cycle, the possibility that the patient may be pregnant, if the patient is sexually active

Epinephrine, whether made by the body or by a drug manufacturer, works rapidly to:

all of the above: raise the pulse rate and blood pressure, inhibit an allergic reaction, relieve bronchospasm

A 54-year-old golfer collapsed on the 17th green at the golf course. His friend said he wasn't feeling well after the eighth hole, but insisted on walking and finishing out the game. His skin is pale, cool, and diaphoretic, and he provides incoherent answers to your questions. An initial blood glucose measurement indicates 65 mg/dL. the patient loses consciousness and a second blood glucose level reads 48 mg/dL. You should:

all of these answers are correct: call for, or rendezvous with, an ALS unit, ensure a patent airway, provide high flow oxygen

Patients may experience allergic reactions to which of the following?

all of these answers are correct: food and medications, plant material, insect or animal bites and stings

the foreign substance responsible for causing an allergic reaction is called an:

allergen

Which of the following conditions or factors would be the LEAST likely to result in a change in behavior?

antihypertensive medications

A 60-year-old female presents with a tearing sensation in her lower back. Her skin is sweaty and she is tachycardiac. the EMT should suspect:

aortic aneurysm

A 20-year-old male has a large laceration to his wrist. He is holding a blood-soaked towel over the wound, but it continues to bleed rapidly. You should:

apply a tourniquet proximal to the wrist

Care for a victim of an immunologic emergency who is severely hypotensive should include which of the following?

apply high-flow oxygen therapy, place the patient in a shock position, and help maintain the patient's body temperature

A 66-year-old male presents with bizarre behavior. His daughter states that he did not seem to recognize her and was very rude to her. The patient is conscious, and has a patent airway and adequate breathing. You should:

ask the daughter how her father normally behaves

You are assessing a 45-year-old female who is severely depressed. She states that it seems as though her entire world is crashing down around her. She further states that she has had frequent thoughts of suicide, but is not sure if she can actually go through with it. How should you manage this situation?

ask the patient if she has developed a suicidal plan

you respond to a college campus for a young male who is acting strangely. after law enforcement has secured the scene, you enter the patients 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. treatment for this patient includes

attempting to calm him and giving him oxygen if tolerated

Kussmaul respirations are an indication that the body is:

attempting to eliminate acids from the blood

As you enter the residence of a patient who has possibly overdosed, you should:

be alert for personal hazards

Dean, a man in his 50s, is acting irrationally. His wife states that he thinks he is the dictator of a small country, and he is wearing nothing but a baseball cap and a belt with a small handgun attached to it. What is your best course of action?

call for police backup

The exchange of oxygen and nutrients for waste products of metabolism occurs at the cellular level in the:

capillaries

A 56-year-old male is found semiconscious by his wife. Your assessment reveals that his respirations are rapid and shallow, his pulse is rapid and irregular, and his blood pressure is low. The patient's wife states that he complained of left arm pain and nausea the day before, but would not allow her to call 9-1-1. the MOST likely cause of this patient's present condition is:

cardiogenic hypoperfusion

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

cerebral vasodilation

Common side effects of epinephrine include all of the following, EXCEPT:

drowsiness

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 a trauma emergency

Often the most important intervention for a sexual assault patient is _____ and transport to a facility with a staff specially trained to deal with this scenario.

comforting reassurance

As you approach a patient lying at the side of the roadway, you observe severe bleeding from the leg. What should your first action be?

control the bleeding

Common signs and symptoms of severe hyperglycemia include all of the following, EXCEPT:

cool, clammy skin

Cardiogenic shock following AMI is caused by:

decreased pumping force of the heart muscle

A patient with an altered mental status; high blood glucose levels; and deep, rapid breathing may have a condition known as __________.

diabetic ketoacidosis

Oxygen and carbon dioxide pass across the alveolar membrane in the lungs through a process called:

diffusion

Nitroglycerin relieves cardiac-related chest pain by:

dilating the coronary arteries and improving cardiac blood flow

Which of the following medications blocks the release of histamines?

diphenhydramine (Benadryl)

Which of the following conditions would MOST likely lead to pelvic inflammatory disease if left untreated?

ectopic pregnancy

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

ensure a patent airway and support ventilation as needed

the first step in assessing a patient with a behavioral emergency is to:

ensure your safety

Anaphylaxis is MOST accurately defined as an:

extreme allergic reaction that may affect multiple body systems

Ketone production is the result of:

fat metabolization when glucose is unavailable

The atlas is the:

first cervical vertebra, which articulates with the skull

Blood that is ejected from the right ventricle:

flows into the pulmonary arteries

The spinal cord exits the cranium through:

foramen magnum

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:

has gathered patient history information

You have responded to the home of a 26-year-old woman who has reportedly taken a large number of pills in an attempt to commit suicide. As you enter the living room, you see her sleeping in her chair, and several empty alcohol containers present. She is breathing heavily. You are able to arouse her to consciousness for a short period of time. Which course of action takes priority?

have her take activated charcoal while she is conscious

Patients with a subarachnoid hemorrhage typically complain of sudden severe:

headache

Urticaria is the medical term for:

hives

the body's backup system of respiratory control, which is based on low concentrations of oxygen in the blood, is called the:

hypoxic drive

Headache, vomiting, altered mental status, and seizures are all considered early signs of:

increased intracranial pressure

You are dispatched to a residence for a 66-year-old male who, according to family members, has suffered a massive stroke. Your primary assessment reveals that the patient is unresponsive, apneic, and pulseless. You should:

initiate CPR and attach an AED ass soon as possible

Of the four avenues of poisoning, generally ___________ is the most worrisome in terms of treatment to the EMS provider.

injection

A 25-year-old man overdosed on heroin and is unresponsive. His breathing is slow and shallow and he is bradycardiac. He has track marks on both arms. The EMT should:

insert a nasal airway and ventilate with a BVM

In contrast to type 1 diabetes, type 2 diabetes:

is caused by resistance to insulin at the cellular level.

The mental status of a patient who has experienced a generalized seizure:

is likely to improve over a period of 5 to 30 minutes

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

You have been dispatched to the home of a 52-year-old woman with severe flank pain. Which of the following would be an appropriate question to ask regarding the pain?

is the pain constant or intermittent?

Because the stinger of a honeybee remains in the wound following a sting:

it can continue to inject venom for up to 20 minutes

Most patients with abdominal pain prefer to:

lie on their side with their knees drawn into the abdomen

Individuals with chronic alcoholism are predisposed to intracranial bleeding and hypoglycemia secondary to abnormalities in the:

liver

a strangulated hernia is one that:

loses its blood supply due to compression by local tissues

Which of the following signs or symptoms would the EMT MOST likely encounter in a patient with new-onset type 1 diabetes?

low blood glucose level

you arrive at the residence of a 33-year-old woman who is experiencing a generalized seizure. she has a small amount of vomitus draining from the side of her mouth. after protecting her from further injury, you should:

maintain her airway with manual head positioning, suction her airway to remove vomitus, insert a nasopharyngeal airway, and administer high-flow oxygen

The main function of the endocrine system is to:

maintain homeostasis

The principle difference between a patient who has had a stroke and a patient with hypoglycemia almost always has to do with the:

mental status

Blood glucose levels are measured in:

milligrams per deciliter

After administering 0.3 mg of epinephrine via auto-injector to a 22-year-old female with an allergic reaction, you note improvement in her breathing and dissipation of her hives. However, she is still anxious and tachycardic. You should:

monitor her closely but recall that anxiety and tachycardia are side effects of epinephrine

A patient with an altered mental status is:

not thinking clearly or is incapable of being aroused.

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

Febrile seizures:

occur when a child's fever rises slowly

A patient with hypoglycemia will often present with which of the following signs/symptoms?

pale, cool, and clammy skin

Which of the following organs lies in the retroperitoneal space:

pancreas

A functional disorder is a:

physiological disorder in the absence of a structural abnormality

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 breaths/min. Treatment for this patient includes:

placing her in an upright position

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

poisoning

Excessive eating caused by cellular "hunger" is called:

polyphagia

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:

provide emotional support and visually assess her for obvious trauma

At 0500 hours, you respond to the home of a 76-year-old man complaining of chest pain. Upon arrival, the patient states that he had been sleeping in the recliner all night due to indigestion, when the pain woke him up. He also tells you that he has taken two nitroglycerin tablets. His vital signs are as follows: respirations, 16 breaths/min; pulse, 98 beats/min; blood pressure, 92/76 mm Hg. He is still complaining of chest pain. What actions should you take to intervene?

provide high-flow oxygen

A 66-year-old woman experienced a sudden onset of difficulty breathing. She has a history of type 2 diabetes and deep vein thrombosis (DVT). On the basis of her medical history, which of the following should the EMT suspect?

pulmonary embolism

A 25-year-old unrestrained female has struck the steering wheel with her chest when her car hit a tree while traveling at a high rate of speed. She has signs and symptoms of shock, which you suspect are the result of intrathoracic bleeding. Which of the following interventions will provide this patient with the greatest chance for survival

rapid transport to a trauma center

When assessing an unresponsive diabetic patient, the primary visible difference between hyperglycemia and hypoglycemia is the:

rate and depth of breathing

A technique used to gain insight into a patient's thinking, which involves repeating in question form what the patient has said, is called:

reflective listening

The kidneys help to regulate blood pressure by:

removing sodium and water from the body

You are assessing the arm drift component of the Cincinnati Prehospital Stroke Scale on a 60-year-old woman. When she holds both of her arms out in front of her and closes her eyes, both of her arms immediately fall to her sides. You should:

repeat the arm drift test, but move the patient's arms into position yourself

A 19-year-old male was stung multiple times by fire ants. He is experiencing obvious signs and symptoms of anaphylactic shock. You administer high-flow oxygen and give him epinephrine via intramuscular injection. Upon reassessment, you determine that his condition has not improved. You should:

repeat the epinephrine injection after consulting with medical control

You have administered one dose of epinephrine to a 40-year-old female to treat an allergic reaction that she developed after being stung by a scorpion. Your reassessment reveals that she is still having difficulty breathing, has a decreasing mental status, and has a blood pressure of 80/50 mm Hg. You should:

request permission from medical control to give another dose of epinephrine

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

respiratory distress

You respond to a residence for a patient who is "not acting right." As you approach the door, the patient, a 35-year-old male, begins shouting profanities at you and your partner while holding a baseball bat. The man is confused and diaphoretic, and is wearing a medical identification bracelet. You should:

retreat at once and call law enforcement

Deoxygenated blood from the body returns to the:

right atrium

Which of the following helps filter blood and has no digestive function?

spleen

Which of the following organs assists in the filtration of blood, serves as a blood reservoir and produces antibodies?

spleen

Solid abdominal organs include the:

spleen, kidney, and pancreas

You are attending to a 27-year-old patient with a history of depression. The patient's family tells you that she has been openly talking about harming herself and suicide, and they got scared when she tried to overdose on some medications. the patient did not take the pills and is alert and oriented. Despite all of your best efforts to convince her, the patient refuses to go to the hospital for treatment. Bases on this information, you should:

stay with the patient while you arrange for other transport options as a potentially life-threatening emergency exits

Cardiac output may decrease if the heart beats too rapidly because:

there is not enough time in between contractions for the heart to refill completely

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 slow. Immediate management for this patient should include:

thoroughly suctioning her oropharynx

Which of the following signs/symptoms are indicative of respiratory involvement of an allergic reaction?

tightness in the chest or throat

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

transporting the patient without delay

Which of the following negative effects of anaphylaxis will be the MOST rapidly fatal if not treated immediately?

upper airway swelling

Which of the most negative effects of anaphylaxis will be the MOST rapidly fatal if not treated immediately?

upper airway swelling

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

Nitroglycerin is contraindicated in patients:

who have experienced a head injury.