Ch 17,18,19

Which of the following scenarios is most descriptive of an absence seizure?

A 6-year-old male who is conscious, but will not respond to his mother; symptoms subside spontaneously within a few minutes.

Which of the following patients would be least likely to experience the classic signs and symptoms of an acute myocardial infarction (AMI)?

A 67-year-old female with diabetes mellitus

Which of the following conditions would be least likely to result in cerebral hypoxia?

Methamphetamine overdose

Definitive treatment to reduce acute respiratory distress in a patient with a pleural effusion involves:

a fluid thoracentesis.

When defibrillating a 6-month-old infant, you should recall that:

a manual defibrillator is preferred.

Which of the following most accurately describes the correct sequence of events after attaching an AED to a patient in cardiac arrest and pushing the analyze button?

"Shock advised" message, stand clear, defibrillate, immediately resume CPR, reanalyze after 2 minutes

With regard to potential treatment in the hospital, which of the following questions is most important to ask the spouse of a 66-year-old female who presents with signs and symptoms of an acute ischemic stroke?

"When did you first notice the symptoms?"

To minimize the amount of brain-cell damage that occurs following an ischemic stroke, fibrinolytic therapy must be administered within:

3 hours after the onset of symptoms.

What is the approximate cardiac output of a person with a heart rate of 70 beats/min and a stroke volume of 75 mL?

5 L/min

Routine treatment for a patient who has just experienced a generalized tonic-clonic seizure and is postictal includes all of the following, except:

50% dextrose via IV administration.

Which of the following valves of the heart are semilunar valves?

Aortic and pulmonic

What part of the cardiac electrical conduction system initiates electrical impulses at the slowest rate?

Areas below the AV node

In addition to oxygen, which of the following medications would the AEMT be the most likely to administer to a patient who is experiencing acute chest pain, pressure, or discomfort?

Aspirin and nitroglycerin

The interventricular septum is supplied by which artery?

Brachiocephalic artery

You are dispatched to the home of a 64-year-old male patient with lung cancer. The patient complains of acute dyspnea; however, as long as he is sitting upright, his breathing is easier. He denies fever, and his breath sounds are decreased over the base of the left lung. What is the most likely cause of this patient's symptoms?

Collection of fluid outside of the lung

Which of the following is generally not indicated when treating a patient with a tension pneumothorax?

Medication therapy

Which of the following is a common cause of error when operating the AED?

Failure to ensure the batteries are charged

A 30-year-old male presents with a partial seizure to his left arm. His wife denies that he has ever had seizures in the past. Which of the following conditions would be the least likely cause of this patient's seizure?

Idiopathic epilepsy

Which of the following physiologic processes does not occur in patients with COPD?

Increased surfactant production

Which of the following is not a component of the cardiac electrical conduction system?

Interatrial septum

_______ brain cells receive a minimal supply of oxygen and are unable to function normally.

Ischemic

A 45-year-old female is found semiconscious by a neighbor. She is incontinent of urine and is bleeding from her mouth. Which of the following medications found in her residence would lead you to suspect that she experienced a seizure?

Lamictal

Which of the following conditions would most likely mimic the signs and symptoms of an acute ischemic stroke?

Low blood glucose level

Which of the following cardiac dysrhythmias requires immediate defibrillation?

Nonperfusing ventricular fibrillation

Which of the following is the most accurate clinical definition of chronic bronchitis?

Productive cough for 3 months per year for 2 or more consecutive years

A 70-year-old male presents with an acute onset of difficulty breathing that woke him from his sleep. He has a history of hypertension, atrial fibrillation, and several heart attacks. During your assessment, you note dried blood around his mouth. The patient tells you that he cannot lie down because he will "smother." What additional assessment findings will you most likely discover?

Pulmonary rales

Which of the following clinical findings is most consistent with inadequate breathing?

Respirations of 16 breaths/min and reduced tidal volume

What acid-base derangement initially occurs in a tachypneic patient without a physiologic demand for increased oxygen?

Respiratory alkalosis

Which of the following statements most accurately describes asthma?

Reversible obstruction caused by bronchospasm, mucus production, and edema

Which of the following represents the correct sequence of electrical conduction through the myocardium?

SA node, AV node, Bundle of His, bundle branches, Purkinje fibers

Which of the following clinical presentations is consistent with a malfunctioning implanted pacemaker?

Syncope and bradycardia

Which of the following statements regarding the 12 cranial nerves is correct?

They arise from the brain and innervate the head and face.

What are the physiologic effects of nitroglycerin when given to a patient with suspected cardiac-related chest pain?

Vascular smooth muscle relaxation and coronary artery dilation

Shortly following acute myocardial infarction, a 55-year-old man collapses and is in cardiac arrest. Which of the following dysrhythmias is he most likely experiencing?

Ventricular fibrillation

Which of the following cardiac rhythms or conditions requires defibrillation?

Ventricular tachycardia without a pulse

When assessing a middle-aged male patient with chest pain, you note a large vertical scar in the center of his chest. This indicates that he has most likely had:

a coronary artery bypass graft.

The Hering-Breuer reflex is defined as:

a feedback loop that inhibits the inspiratory center, which prevents overexpansion of the lungs.

Approximately 2 weeks following a total hip replacement, a 70-year-old female complains of a sudden onset of dyspnea and pleuritic chest pain. Your assessment reveals perioral cyanosis, blood-tinged sputum, and wheezing to the base of her right lung. As your partner applies high-flow oxygen, the patient states that she has a history of hypertension. You should be most suspicious of:

a pulmonary embolism.

Acute epiglottitis in the adult is characterized by:

a severe sore throat.

One of the most common signs of an acute hypertensive emergency is:

a sudden, severe headache.

When assessing a patient using a pulse oximeter, it is important to remember that:

abnormally bound hemoglobin may produce inaccurate readings.

When treating a 56-year-old female with chest pain, you have placed on her oxygen, established IV access, and administered two doses of sublingual nitroglycerin. However, the patient's pain has not improved. You reassess her blood pressure and note that it is 106/66 mm Hg. You should:

administer one more dose of nitroglycerin.

The fifth link in the cardiac chain of survival includes:

advanced cardiovascular care in an intensive care unit.

While treating a patient who is in cardiogenic shock, your paramedic partner makes the comment that the patient needs an inotropic medication. You should recall that this type of medication is intended to:

affect the strength of cardiac contraction.

When assessing a patient for peripheral edema, you should check the sacral area if the patient is:

bedridden

A 20-year-old female presents with acute respiratory distress. Auscultation of her lungs reveals diffuse expiratory wheezing. She is in moderate distress and tells you that she has a prescribed inhaler that she uses when this happens. You should suspect:

an acute asthma attack.

You should be most suspicious that a patient is experiencing an acute myocardial infarction if he or she presents with:

an acute onset of weakness, nausea, and sweating without an obvious cause.

A 55-year-old male with poorly controlled hypertension presents with respiratory distress and difficulty speaking in complete sentences. He is conscious and alert with a blood pressure of 150/90 mm Hg, a pulse rate of 110 beats/min, and respirations of 28 breaths/min and labored. Auscultation of his lungs reveals diffuse coarse crackles. After placing the patient in a comfortable position, you should:

apply the CPAP device.

A 57-year-old female with a history of peripheral vascular disease presents with an acute onset of confusion, aphasia, left-sided hemiparesis, and facial droop. You should suspect an:

arterial blockage in the right cerebral hemisphere.

A 70-year-old male presents with acute aphasia, unilateral weakness, and confusion. You should:

assess his blood glucose level to rule out hypoglycemia.

You are called to the county jail for a 50-year-old male who is "drunk." When you assess him, you note the smell of alcohol on his breath and a decreased level of consciousness. The sheriff's deputy tells you that this patient is a "regular." On the basis of the information that you have obtained, you should:

assess the patient's blood glucose and suspect intracranial bleeding.

A 60-year-old female is in possible cardiogenic shock. She is semiconscious with shallow respirations, an irregular pulse, and hypotension. Appropriate treatment for this patient should include:

assisted ventilation with a bag-mask device, thermal management, 250-mL fluid boluses, and transport.

Approximately 20 minutes after receiving a penicillin injection at the doctor's office, a 41-year-old female presents with acute respiratory distress, facial swelling, and intense itching to her entire body. Her level of consciousness is decreased and her breathing is labored with minimal chest rise. The most appropriate treatment for this patient should include:

assisted ventilations, IV of normal saline, and epinephrine.

Characteristics of adequate breathing in an adult include all of the following, except:

asymmetrical chest movement.

The tricuspid and mitral valves of the heart are referred to as:

atrioventricular valves.

You are assessing a 59-year-old male with an altered mental status. You should suspect an acute ischemic stroke versus hypoglycemia if the patient:

attempts to communicate with you.

You are assessing a 62-year-old female who has an automatic implantable cardiac defibrillator (AICD). As you are applying oxygen to her, she becomes unconscious, pulseless, and apneic. You should:

begin CPR and apply the AED as soon as possible.

You are dispatched to an assisted-living center for a 67-year-old male with "mental status changes." You arrive at the scene and begin to assess the patient. He is responsive to painful stimuli only, has rapid and shallow breathing, and a slow radial pulse. You should:

begin assisting the patient's ventilations.

After defibrillating an adult patient in cardiac arrest with the AED, you should:

begin or resume CPR starting with chest compressions.

An ischemic stroke is most often the result of a(n):

blocked cerebral artery.

Chronic carbon dioxide retention, as seen in patients with certain lung diseases, may cause the patient to:

breathe on the basis of decreased oxygen.

Patients with emphysema:

breathe through pursed lips and may develop polycythemia.

A 56-year-old male complains of difficulty breathing. His wife tells you that he complained of chest discomfort a few days prior, but would not allow her to call EMS. Your assessment reveals rales in the apices and bases of both lungs. This patient's clinical presentation is most consistent with:

cardiogenic pulmonary edema.

The spinal nerves branch out from the spinal cord and:

carry signals to and from the body.

Located just behind the brainstem, the _______ controls muscle and body coordination.

cerebellum

Migraine headaches are thought to be caused by:

changes in blood vessel size within the base of the brain.

You receive a call to a local grocery store for a possible heart attack. Upon arrival at the scene, you find two bystanders performing CPR on the patient, a 49-year-old male. You should:

confirm that the patient is in cardiac arrest.

Cystic fibrosis is a genetic disorder that results in:

excess sodium loss and thick pulmonary secretions.

A 61-year-old female called EMS after suddenly being awakened in the middle of the night with a feeling that she was "smothering." You arrive to find the patient, very apprehensive and restless, sitting on the living room couch in obvious respiratory distress. Her BP is 160/90 mm Hg, pulse is 110 beats/min and irregular, and respirations are 24 breaths/min and labored. Auscultation of her lungs reveals diffuse rhonchi in all fields. Treatment for this patient should include:

continuous positive airway pressure and an IV line set to keep the vein open.

According to the Starling law of the heart:

contractility increases as the myocardial walls are stretched.

The _______ arteries arise from the aorta shortly after they leave the left ventricle.

coronary

Prinzmetal angina is caused by:

coronary vasospasm.

When using the Cincinnati Stroke Scale to assess a 59-year-old female with a suspected stroke, you note a left-sided facial droop when you ask her to smile. You should:

determine if the patient has dysarthria or is unable to speak.

The coronary arteries of a person with arteriosclerotic heart disease:

develop plaque deposits from cholesterol and fatty substances.

Treatment for a conscious and alert patient who is experiencing a migraine headache includes:

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

The movement and utilization of oxygen in the body is dependent on all of the following, except:

effective alveolar-capillary osmosis.

The percentage of blood pumped from the heart is called:

ejection fraction.

You are assessing the arm drift of an elderly male with a suspected stroke and note that both of his arms drift toward the ground. You should:

ensure the patient understood your instructions and repeat the test.

Treatment for a patient experiencing a cardiovascular emergency begins by:

ensuring airway patency and adequate breathing.

The visceral pericardium, which lies closely against the heart, is also called the:

epicardium.

In contrast to bronchitis, pneumonia typically presents with:

fever and chills.

In cases of pulmonary edema, diffusion is impaired primarily because of:

fluid-filled alveoli.

More carbon dioxide diffuses out of the bloodstream when:

fresh oxygen diffuses into the alveoli.

The most significant risk associated with ventilating a patient too rapidly is:

gastric distention and regurgitation.

When assisting a patient with his or her prescribed inhaler, it is important to:

have the patient exhale deeply prior to inhaling the medication.

A patient with acute chest discomfort took two of his prescribed nitroglycerin tablets and is now experiencing a pounding headache. However, he tells you that he is still experiencing chest discomfort. You should suspect that:

he is experiencing ongoing myocardial ischemia.

The two processes that occur during respiration are:

inspiration and expiration.

A 30-year-old male presents with respiratory distress that began within minutes of being exposed to an unknown chemical at an industrial site. When caring for this patient, it is most important to remember that:

he must be properly decontaminated first.

If a patient has a ventricular assist device (VAD) that provides continuous blood flow:

he or she will not have any palpable pulses.

When assessing the severity of nocturnal dyspnea in a patient with a chronic respiratory disease, you should determine:

how many pillows he or she sleeps with at night.

You are treating a 2-year-old boy who is experiencing respiratory distress. During your assessment, you note that the child has mild inspiratory stridor, a barking cough, and a low-grade fever. The child is otherwise conscious, is acting appropriate for his age, and has strong radial pulses. Treatment should include:

humidified oxygen.

Stimulation of the sympathetic nervous system results in:

increased blood pressure and heart rate.

Patients with a hemorrhagic stroke typically experience a rapidly declining level of consciousness because of:

increasing intracranial pressure.

All of the following are commonly prescribed medications for patients with a respiratory disease, except:

inderal

A patient experiencing status epilepticus:

is having a prolonged generalized motor seizure.

An acute myocardial infarction is more apt to occur in the left ventricle because:

it is large and thick and demands more oxygen than the right ventricle.

The left main coronary artery rapidly divides into the:

left anterior descending and circumflex arteries.

In most people, speech is controlled by the:

left hemisphere.

Effectively performed CPR is a crucial treatment for a patient in cardiac arrest because it:

maintains myocardial and cerebral perfusion.

A 59-year-old female with a history of poorly controlled hypertension becomes acutely dyspneic, develops profound cyanosis to the upper chest, and becomes unresponsive. She is pulseless and apneic upon your arrival. As you and your partner are performing the appropriate treatment interventions, you discuss the possible cause of her condition, which is most likely a(n):

massive pulmonary embolism.

Most of the heart lies within the:

mediastinum

You are dispatched for an elderly male with dyspnea. When you arrive, you find the patient sitting in a chair. He is semiconscious and unable to effectively communicate with you. As you perform a primary survey, your partner applies 100% oxygen and a pulse oximeter, which reads 85%. The most reliable indicator of cerebral hypoxia in this patient is his:

mental status alteration.

Damage to the _______ valve may cause blood to regurgitate into the lungs.

mitral

The clonic phase of a generalized motor seizure is characterized by:

muscle contraction and relaxation occurring in rapid succession.

The middle, muscular layer of the heart is called the:

myocardium

A transient ischemic attack (TIA) occurs when:

neurological abnormalities resolve within 36 to 48 hours.

Shortly after administering a second nitroglycerin dose to a 44-year-old male with chest pain, he becomes lightheaded. You take his blood pressure, and it reads 80/50 mm Hg. You have already established IV access and are administering oxygen. You should:

place him supine and reassess his BP.

Typical signs and symptoms of pneumonia include:

pleuritic chest pain, fever, and rhonchi.

Nitroglycerin is contraindicated in patients who:

possibly have a head injury.

When assessing a female patient with chest pain and shortness of breath, you note that her blood pressure is 80/50 mm Hg, her heart rate is 120 beats/min, and she has cyanosis around her mouth. In addition to supporting her ventilations, you should:

prepare for immediate transport.

As with angina, the pain associated with acute myocardial infarction is often described as:

pressure

Afterload is defined as the:

pressure against which the left ventricle must pump.

A middle-aged male presents with classic signs and symptoms of a dissecting aortic aneurysm. The most important intervention that you can perform for this patient is:

prompt transport.

Cheyne-Stokes respirations are characterized by:

rapid and slow breathing with alternating apneic periods.

Asystole has an exceedingly high mortality rate because it:

reflects a prolonged period of myocardial ischemia.

The exchange of oxygen and carbon dioxide, at the cellular level or in the lungs, is called:

respiration

A 50-year-old female is in cardiac arrest. You attach the AED and receive a "no shock advised" message. You should:

resume CPR and reanalyze her cardiac rhythm after 2 minutes.

After applying the AED to your cardiac arrest patient, you receive a "shock advised" message. You should:

resume CPR as the defibrillator is charging.

After defibrillating a patient in cardiac arrest with the AED, you should:

resume chest compressions.

A 60-year-old male with a history of poorly controlled hypertension complains of a sudden, severe headache. Within a few minutes, his level of consciousness rapidly deteriorates. This is most suggestive of a(n):

ruptured cerebral artery.

During your assessment of a woman with chronic shortness of breath and fatigue, you ask her how many pillows she sleeps with at night. You are asking her this question to determine if:

she has left-sided heart failure and how severe it may be.

The normal site of origin of electrical impulses in the heart is the _______, which generates _______ impulses per minute.

sinoatrial node, 60 to 100

Your 23-year-old female patient complains of pain to the superior portion of her face. She tells you that the pain has persisted for the past few days and gets worse when she bends down to pick something up. This is most consistent with a:

sinus headache.

The primary function of the atrioventricular (AV) node is to:

slow conduction from the atria to the ventricles to allow for ventricular filling.

When the parasympathetic nervous system is stimulated, it:

slows the heart rate by decreasing SA node discharge.

Past brain trauma is an example of a(n) _______ cause of a seizure.

structural

You respond to a residence for a 27-year-old male with an altered mental status. As you are assessing him, his girlfriend tells you that he does not have any medical problems that she is aware of; however, he did fall two days ago and struck his head. These clinical and historical findings should make you most suspicious for:

subdural hemorrhaging.

The _______, which is present wherever a nerve cell terminates, connects to the next cell via _______.

synapse, neurotransmitters

The hypertension that is commonly observed in patients with an intracerebral hemorrhage is usually the result of:

the body's attempt to shunt blood to the brain.

During a seizure, neurons are in a hypermetabolic state. This means that:

they are using large amounts of glucose and producing lactic acid.

Patients with COPD are highly susceptible to pneumonia because:

they cannot effectively expel infected pulmonary secretions.

An anaphylactic reaction impairs effective breathing secondary to:

upper airway swelling.

An external defibrillator vest:

uses high-energy shocks similar to an AED.

Blood enters the right atrium through the:

vena cavae and coronary sinus.

The process of moving air into and out of the lungs is called:

ventilation

Cardiac asthma is a condition in which a patient:

with congestive heart failure experiences wheezing due to constricted bronchi.