Chapter 12-17 EMT

Alkalosis is a condition that occurs when:

blood acidity is reduced by excessive breathing.

Which of the following is the MOST reliable method of estimating a patient's cardiac output?

Assess the heart rate and strength of the pulse.

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:

Begin CPR, apply the AED, and deliver a shock if it is indicated

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

Ibuprofen

Which of the following statements regarding the pain associated with AMI is correct?

It can occur during exertion or when the patient is at rest.

What is the function of the left atrium?

It receives oxygenated blood from the lungs.

Which of the following statements regarding anaphylactic shock is correct?

Subsequent exposure after sensitization often produces a more severe reaction.

Which of the following statements regarding the hypoxic drive is correct?

The hypoxic drive stimulates a person to breathe on the basis of low oxygen levels.

Your assessment of an unresponsive patient reveals that her breathing is inadequate. Your MOST immediate action should be to:

check her airway for obstructions.

Which of the following is NOT a function of the sympathetic nervous system?

constriction of blood vessels in the muscles

Febrile seizures:

are usually benign but should be evaluated.

The electrical stimulus that originates in the heart's primary pacemaker is controlled by impulses from the brain that arrive by way of the:

autonomic nervous system

Which of the following MOST accurately describes septic shock?

bacterial damage to the vessel wall, leaking blood vessels, and vasodilation

When an electrical impulse reaches the AV node, it is slowed for a brief period of time so that:

blood can pass from the atria to the ventricles.

The inferior vena cava returns deoxygenated blood to the right side of the heart from all of the following areas, EXCEPT the:

brain

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

brain stem

Which of the following statements regarding the AED and defibrillation is correct?

The AED will not analyze the rhythm of a moving patient.

Blood that is ejected from the right ventricle:

flows into the pulmonary arteries.

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.

The spinal cord exits the cranium through the:

foramen magnum

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.

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

jugular venous distention

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

pain exacerbated by breathing

A 22-year-old female patient is complaining of dyspnea and numbness and tingling in her hands and feet after an argument with her fiancé. Her respirations are 40 breaths/min. You should:

provide reassurance and give oxygen as needed.

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.

When documenting a patient's description of his or her chest pain or discomfort, the EMT should:

use the patient's own words.

Sudden death following AMI is MOST often caused by:

ventricular fibrillation

Which of the following cardiac dysrhythmias has the greatest chance of deteriorating into a pulseless rhythm?

ventricular tachycardia

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?

Excessive movement of the patient

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

poisoning

The iliac arteries immediately subdivide into the:

femoral arteries

Which of the following statements regarding anaphylaxis is correct?

Anaphylaxis is characterized by airway swelling and hypotension.

A 40-year-old man is in cardiac arrest. Your partner is performing CPR. You are attaching the AED when the patient's wife tells you that he has an automatic implanted cardiac defibrillator (AICD). The AED advises that a shock is indicated. What should you do?

Deliver the shock followed by immediate resumption of CPR.

Which of the following statements regarding methicillin-resistant Staphylococcus aureus (MRSA) is correct?

MRSA is a bacterium that causes infections and is resistant to most antibiotics.

Which of the following statements regarding nitroglycerin is correct?

Nitroglycerin usually relieves anginal chest pain within 5 minutes.

The AED has delivered a shock to an elderly male in cardiac arrest. Following 2 minutes of CPR, you re-analyze the patient's cardiac rhythm and receive a "no shock advised" message. After further resuscitation, you restore a palpable carotid pulse. Your next action should be to:

Reassess airway and breathing and treat accordingly

During your treatment of a woman in cardiac arrest, you apply the AED, analyze her cardiac rhythm, and receive a "no shock advised" message. This indicates that:

She is not in ventricular fibrillation

Dyspnea is MOST accurately defined as:

Shortness of breath or difficulty breathing.

Acute coronary syndrome (ACS) is a term used to describe:

a group of symptoms that are caused by myocardial ischemia.

A transient ischemic attack (TIA) occurs when:

a small clot in a cerebral artery causes temporary symptoms.

Clinical signs of compensated shock include all of the following, EXCEPT:

absent peripheral pulses.

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:

adequate air exchange.

When administering supplemental oxygen to a hypoxemic patient with a chronic lung disease, you should:

adjust the flow rate accordingly until you see symptom improvement, but be prepared to assist his or her ventilations.

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 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:

apply a CPAP device, monitor his blood pressure, and observe him for signs of improvement or deterioration.

You respond to a residence for a patient with a severe leg injury following an accident with a chainsaw. When you arrive, you find the patient, a 44-year-old male, lying supine in the backyard. He has a partial amputation of his right lower leg that is actively bleeding. The patient is conscious and breathing adequately; however, he is restless and his skin is diaphoretic. You should:

apply direct pressure to the wound

The MOST common reason that many people experiencing AMI do not seek immediate medical attention is because they:

are in denial

Upon arriving at the residence of a patient with a possible cardiac problem, it is MOST important to:

assess the scene for potential hazards.

The posterior tibial pulse can be palpated:

behind the medial malleolus, on the inside of the ankle

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

The head and brain receive their supply of oxygenated blood from the:

carotid arteries

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 his or her skin

It would be MOST appropriate for a patient to take his or her prescribed nitroglycerin when experiencing:

chest pain that does not immediately subside with rest

Rapid, labored breathing in a patient with signs and symptoms of AMI should make you suspicious for:

congestive heart failure

The myocardium receives oxygenated blood from the __________, which originate(s) from the __________.

coronary arteries, aorta

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

cough

Ischemic heart disease is defined as:

decreased blood flow to one or more portions of the myocardium.

Cardiogenic shock following AMI is caused by:

decreased pumping force of the heart muscle

You are dispatched to a residence for a 40-year-old female who fainted. Upon your arrival, the patient is conscious and alert, and states that she is fine. Her husband tells you that she fainted after receiving news that her sister was killed in a car crash. You offer oxygen to the patient, but she refuses to accept it. At this point, your primary concern should be to:

determine if she was injured when she fainted.

A percutaneous transluminal coronary angioplasty (PTCA) restores blood flow to the ischemic myocardium by:

dilating the affected coronary artery with a small inflatable balloon.

Nitroglycerin relieves cardiac-related chest pain by:

dilating the coronary arteries and improving cardiac blood flow.

When preparing to obtain a 12-lead ECG, the V1 and V2 electrodes should be placed:

either side of the sternum

The MOST common error associated with the use of the AED is:

failure of the EMT to ensure the battery is charged

Neurogenic shock occurs when:

failure of the nervous system causes widespread vasodilation.

Which of the following is LEAST important when obtaining a medical history from a patient complaining of chest discomfort?

family history of hypertension

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:

feel for a pulse while compressions are ongoing.

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

hypertension

Major risk factors for AMI include all of the following, EXCEPT:

hypoglycemia

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 as soon as possible

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

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

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

liver

You arrive at the residence of a 33-year-old woman who is experiencing a generalized (tonic-clonic) 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 the vomitus, insert a nasopharyngeal airway, and administer high-flow oxygen

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 valproate (Depakote) for her seizures, but has not taken it in a few days. He also tells you that she has diabetes. In addition to administering oxygen, you should:

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

Hyperventilation could be associated with all of the following, EXCEPT:

narcotic overdose

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.

Prior to assisting a patient with his or her prescribed nitroglycerin, the EMT must:

obtain authorization from medical control

In contrast to AMI, a dissecting aortic aneurysm:

often presents with pain that is maximal from the onset

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:

placing her in an upright position.

You are transporting a 33-year-old male who was involved in a major motor vehicle crash. You have addressed all immediate and potentially life-threatening conditions and have stabilized his condition with the appropriate treatment. With an estimated time of arrival at the hospital of 20 minutes, you should:

reassess his condition in 5 minutes.

After assisting your patient with prescribed nitroglycerin, you should:

reassess his or her blood pressure within 5 minutes to detect hypotension.

When transporting a stable stroke patient with a paralyzed extremity, place the patient in a:

recumbent position with the paralyzed side down

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:

remove the nitroglycerin patch, place him in a supine position and elevate his lower extremities, and prepare for immediate transport.

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.

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

repeating the primary assessment.

When the level of arterial carbon dioxide rises above normal:

respirations increase in rate and depth.

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

respiratory distress

The right coronary artery supplies blood to the:

right ventricle and inferior wall of the left ventricle.

Which of the following veins is located inferior to the trunk?

saphenous

In contrast to the sympathetic nervous system, the parasympathetic nervous system:

slows the heart and respiratory rates.

Ventricular tachycardia causes hypotension because:

the left ventricle does not adequately fill with blood

The purpose of defibrillation is to:

stop the chaotic, disorganized contraction of the cardiac cells.

Common signs and symptoms of acute hyperventilation syndrome include:

tachypnea and tingling in the extremities.

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 myocardium requires more oxygen:

the arteries supplying the heart dilate.

When treating a patient with chest pain, you should assume that he or she is having an AMI because:

the cause of the pain cannot be diagnosed in the field.

Most patients are instructed by their physician to take up to _______ doses of nitroglycerin before calling EMS.

three

Acute pulmonary edema would MOST likely develop as the result of:

toxic chemical inhalation.

The descending aorta divides into the two iliac arteries at the level of the:

umbilicus