EMS

Which of the following patients is at highest risk for a pulmonary embolism?

71-year-old male with recent surgery to a lower extremity

Your patient's past medical history includes hypertension, congestive heart failure, diabetes, and seizures. Today, he presents with signs of acute renal failure. Which of his medical problems MOST likely caused this?

heart failure

As a woman approaches menopause:

her menstrual periods may become irregular and vary in severity.

When caring for a patient who is visually impaired, it is important to:

tell him or her what is happening, identify noises, and describe the situation and surroundings.

The tip of a central venous catheter rests in the:

vena cava

Which of the following patients would MOST likely have a delayed onset of an allergic reaction?

A 45-year-old male who ingested penicillin

Which of the following statements regarding rebound tenderness is correct?

It is often discovered when the patient is jarred or moved suddenly.

Which of the following sets of vital signs would the EMT most likely encounter in a patient with acute cocaine overdose?

BP, 200/100 mm Hg; pulse, 150 beats/min

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

Burning or gnawing stomach pain that subsides immediately after eating

According to the "E" in the DOPE mnemonic, which of the following actions should you perform to troubleshoot inadequate ventilation in a patient with a tracheostomy tube?

Check the mechanical ventilator for malfunction.

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

Chlamydia

Which of the following statements regarding interaction with the caregiver of a child or adult with special health care needs is correct?

Communication with the patient's caregiver or family members is important because they are the most familiar with the patient's condition.

A 66-year-old male presents with dark red rectal bleeding and abdominal pain. He is conscious and alert; however, his skin is cool and clammy and his pulse is rapid. Further assessment reveals that his blood pressure is 112/60 mm Hg. Which of the following questions would be most pertinent to ask him?

Have you experienced recent abdominal trauma?

Which of the following is not a reason why the exact extent and prevalence of elder abuse is unknown?

Human resource agencies fail to investigate.

While assessing a 21-year-old female who struck a tree head-on with her small passenger car, you note that her airbag deployed. You should:

Lift the airbag and look for deformity to the steering wheel

Which of the following statements regarding inhaled poisons is correct?

Lung damage may progress after the patient is removed from the environment.

You are dispatched to a residence for a young female who is sick. The patient complains of a rash to her lower extremities and truncal area. Your assessment reveals a small, painful blister on her inner thigh. As your partner is taking the patient's vital signs, she states that she and her family returned from a camping trip two days ago. On the basis of this patient's presentation, you should suspect:

Lyme disease

Which of the following statements regarding suicide in the older patient is correct?

Older patients tend to use more lethal means than younger patients.

Which of the following statements regarding pelvic inflammatory disease (PID) is correct?

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

Which of the following statements regarding dialysis is correct?

Patients who miss a dialysis treatment often present with weakness.

Which of the following statements regarding the Salmonella bacterium is correct?

The Salmonella bacterium itself causes food poisoning.

Which of the following statements regarding the acute abdomen is correct?

The initial pain associated with an acute abdomen tends to be vague and poorly localized.

Which of the following statements regarding abdominal eviscerations is correct?

The protruding organs should be kept warm and moist.

Which of the following questions would be least pertinent during the initial questioning of a patient who ingested a substance?

Why was the substance ingested?

A specific legal document that directs relatives and caregivers regarding the medical treatment that may be given to patients who cannot speak for themselves is called a(n):

advance directive

Characteristic anatomic features of Down syndrome include:

a round head with a flat occiput.

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 pelvic inflammatory disease?

a shuffling gait when walking

Down syndrome is a genetic defect that occurs as the result of:

a triplication of chromosome 21

It is most important to determine a patient's weight when asking questions pertaining to a toxic ingestion because:

activated charcoal is given based on a patient's weight.

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.

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

age-related deterioration of their sensory systems

Delirium tremens (DTs) is a syndrome associated with withdrawal from:

alcohol

Common causes of depression in the elderly include all of the following, except:

an acute onset of dementia.

A 73-year-old female experienced a syncopal episode while watching TV. She is now conscious but diaphoretic, tachycardic, and hypotensive. Your assessment reveals abdominal tenderness and a pulsating mass to the left of her umbilicus. You should suspect:

an aortic aneurysm.

The normal blood glucose level is between:

and 120 mg/dL.

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

aortic aneurysm

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

appendicitis

You respond to a movie theater for a 70-year-old male who is confused. His wife tells you he has type 2 diabetes but refuses to take his pills. Your assessment reveals that the patient is diaphoretic, tachycardic, and tachypneic. Initial management for this patient should include:

applying a nonrebreathing mask at 15 L/min.

A 54-year-old male experienced an avulsion to his penis when his foreskin got caught in the zipper of his pants. He was able to unzip his pants and remove the foreskin prior to your arrival. Your assessment reveals that he is in severe pain and that the avulsion is bleeding moderately. The most appropriate treatment for this patient includes:

applying direct pressure with a dry, sterile dressing.

In general, injected poisons are impossible to dilute or remove because they:

are usually absorbed quickly into the body.

A patient who presents with rapid breathing, nausea and vomiting, ringing in the ears, and hyperthermia should be suspected of ingesting a significant quantity of:

aspirin

Activated charcoal may be indicated for a patient who ingested:

aspirin

31-year-old male with a history of diabetes had a seizure that stopped prior to EMS arrival. He is unresponsive and has rapid, shallow breathing. His pulse is rapid and weak, and his skin is cyanotic. The EMT should:

assist the patient's ventilations with a bag-valve mask.

Because of the complexity of the older patient and the vagueness of his or her complaint, you should:

attempt to differentiate between chronic and acute problems.

When documenting a case of suspected elder abuse, it is most important for the EMT to:

avoid documenting any unsupported opinions

When documenting a call involving a female patient who was sexually assaulted, the EMT should:

avoid speculation and document only factual data.

When assessing or providing care to a patient with an intellectual disability, you should:

be observant for signs of fear or reluctance from the patient.

A football player was struck by another player in the right flank area just below the posterior rib cage. He complains of severe pain and point tenderness to the area. Your assessment reveals that there is a small amount of blood in his underwear. You should be most suspicious for:

blunt injury to the kidney.

In anticipation of receiving a fertilized ovum, the lining of the uterine wall:

becomes engorged with blood.

General treatment for a woman with vaginal bleeding and shock following sexual assault includes all of the following, EXCEPT:

carefully removing any foreign bodies from the vagina.

Vagus nerve stimulators may be an alternative treatment to medication for patients with:

chronic seizure disorders.

A surgical procedure that creates an opening between the intestine and the surface of the body that allows for elimination of waste products is called a(n):

colostomy

Assessment of a patient with hypoglycemia will MOST likely reveal:

combativeness

Esophageal varices MOST commonly occur in patients who:

consume a lot of alcohol

Your presence is requested by law enforcement to assess a 33-year-old female who was sexually assaulted. The patient is conscious and obviously upset. As you are talking to her, you note an impressive amount of blood on her clothes in the groin area. Her blood pressure is 98/58 mm Hg, her pulse is 130 beats/min, and her respirations are 24 breaths/min. You should:

control any external bleeding, administer oxygen, and transport at once.

The transfer of heat to circulating air, such as when cool air moves across the body's surface, is called:

convection

Classic signs and symptoms of hypoglycemia include:

cool, clammy skin; weakness; tachycardia; and rapid respirations.

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

cystitis

During your assessment of a 70-year-old woman, she tells you that she takes blood-thinning medication and has to wear compression stockings around her legs. This information should make you suspect that she has:

deep vein thrombosis.

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 that he might have had a seizure shortly before your arrival. This patient is most likely experiencing:

delirium tremens

Which of the following medications increases a person's risk of a heat-related emergency?

diuretics

Insulin functions in the body by:

enabling glucose to enter the cells.

Proper procedure for administering oral glucose to a patient includes all of the following, EXCEPT:

ensuring the absence of a gag reflex

High humidity reduces the body's ability to lose heat through:

evaporation

The body's natural cooling mechanism, in which sweat is converted to a gas, is called:

evaporation

Patients with uncontrolled diabetes experience polyuria because:

excess glucose in the blood is excreted by the kidneys

It is common for young females who experience their first menstrual period to:

experience abdominal cramping, which may be misinterpreted.

EMTs are dispatched to a residence for an 80-year-old woman who is ill. The patient's daughter states that her mother almost fainted after going to the bathroom, and that her pulse was very slow. The patient's pulse rate is 80 beats/min and irregular and she is conscious and alert. The EMTs should suspect that the patient:

experienced a vasovagal response.

Each ovary produces an ovum in alternating months and releases it into the:

fallopian tube

Peritonitis may result in shock because:

fluid shifts from the bloodstream into body tissues.

All of the following terms refer to a body part that is cold but not frozen, except:

frostbite

Whenever possible, a female sexual assault victim should be:

given the option of being treated by a female EMT.

Contraction or tensing of the abdominal muscles to ease pain is called:

guarding

A service dog is easily identified by its:

harness

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.

An elderly patient might understate or minimize the symptoms of his or her illness because:

he or she fears hospitalization.

The reduction in brain weight and volume increases an older person's risk for:

head trauma

As many as 40% of patients with Down syndrome have:

heart condition

Peritonitis usually occurs when:

hollow abdominal organs are damaged and spill their contents into the peritoneal cavity.

Which of the following conditions would be the least likely to increase a person's risk of hypothermia?

hyperglycemia

You are assessing a 70-year-old female who complains of intense thirst, frequent urination, and dizziness. She has a history of type 2 diabetes, heart disease, rheumatoid arthritis, and gout. Her blood glucose reads "high." She is conscious but confused. Her blood pressure is 92/52 mm Hg, her pulse rate is 130 beats/min and weak, and her respirations are 22 breaths/min and shallow. This patient's clinical presentation is most consistent with:

hyperosmolar hyperglycemic nonketotic syndrome.

When obtaining a SAMPLE history from a patient with diabetes who has an altered mental status, it would be MOST important to determine:

if he or she has had any recent illnesses or excessive stress.

You are treating a 40-year-old male with a documented blood sugar reading of 480 mg/dL. The patient is semiconscious and breathing shallowly, and is receiving assisted ventilation from your partner. You should recognize that definitive treatment for this patient includes:

insulin

Type 1 diabetes:

is a condition in which no insulin is produced by the body

If a woman with vaginal bleeding reports syncope, the EMT should assume that she:

is in shock

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.

When documenting a call in which a female was sexually assaulted, you should:

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

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 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.

When caring for a woman who is experiencing a gynecologic emergency, the EMT's main focus should be to:

maintain her ABCs and transport without delay.

In contrast to bleeding caused by external trauma to the vagina, bleeding caused by conditions such as polyps or cancer:

may be relatively painless.

Placing a pregnant patient in a supine position during the third trimester of pregnancy:

may decrease the amount of blood that returns to the heart.

In contrast to conductive hearing loss, sensorineural hearing loss is caused by:

nerve damage

Bacterial vaginosis is a condition that occurs when:

normal bacteria in the vagina are replaced by an overgrowth of other bacterial forms.

Heroin is an example of a(n):

opioid

An older woman with osteoporosis presents with pain and deformity to her left hip after she shifted her weight onto her other foot. She has most likely experienced a(n):

pathologic fracture

When a hollow organ is punctured during a penetrating injury to the abdomen:

peritonitis may not develop for several hours.

Excessive eating caused by cellular "hunger" is called:

polyphagia

General techniques for communicating with hearing-impaired patients include:

positioning yourself approximately 18 inches directly in front of the patient.

The purpose of a ventricular peritoneum shunt is to:

prevent excess cerebrospinal fluid from accumulating in the brain.

Because the depth of an open abdominal wound is often difficult to determine:

prompt transport to the hospital is essential.

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.

You are transporting a 28-year-old man with a frostbitten foot. The patient's vital signs are stable, and he denies any other injuries or symptoms. The weather is treacherous, and your transport time to the hospital is approximately 45 minutes. During transport, you should:

protect the affected part from further injury.

A 20-year-old male was pulled from cold water by his friends. The length of his submersion is not known and was not witnessed. You perform a primary assessment and determine that the patient is apneic and has a slow, weak pulse. You should:

provide rescue breathing, remove his wet clothing, immobilize his entire spine, keep him warm, and transport carefully.

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

rate and depth of breathing

An EMT's primary responsibility to the patient who has been poisoned is to:

recognize that a poisoning occurred.

In contrast to an automated implanted cardioverter/defibrillator, an internal cardiac pacemaker:

regulates the patient's heart rate if it falls below a preset value.

You are assessing a man with suspected hypothermia. The patient is conscious, alert, and actively shivering. His respiratory rate is increased, but his breathing is unlabored, and the pulse oximeter reads 72%. The pulse oximetry reading is most likely:

secondary to decreased perfusion in the extremities.

Functions of the liver include:

secretion of bile and filtration of toxic substances.

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:

seizures and cardiac arrhythmias

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

spleen

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

substances in the stomach increase the risk of aspiration.

You respond to a local lake where a diver complains of difficulty breathing that occurred immediately after rapidly ascending from a depth of approximately 30 feet. On assessment, you note that he has cyanosis around his lips and pink froth coming from his nose and mouth. You should:

suction his mouth and nose, apply high-flow oxygen, monitor the patient's breath sounds for a pneumothorax, and contact medical control regarding transport to a recompression facility. Yea

A 31-year-old male was bitten on the leg by an unidentified snake. The patient is conscious and alert and in no apparent distress. Your assessment of his leg reveals two small puncture marks with minimal pain and swelling. In addition to administering oxygen and providing reassurance, further care for this patient should include:

supine positioning, splinting the leg, and transporting.

The two most efficient ways for the body to eliminate excess heat are:

sweating and vasodilation

An 84-year-old male fell a week ago and has been bedridden since then. Today, he presents with an altered mental status. His skin is pale and cold, and his respirations are rapid and shallow. The EMT should suspect:

systemic infection

Heatstroke occurs when:

the body's heat-eliminating mechanisms are overwhelmed.

In contrast to a living will, a "do not resuscitate" (DNR) order becomes valid when:

the patient develops cardiac arrest.

A person who routinely misuses a substance and requires increasing amounts to achieve the same effect is experiencing:

tolerance

Most of the serious injuries associated with scuba diving are caused by:

too rapid of an ascent.

A 22-year-old male was kicked in the abdomen several times. You find him lying on his left side with his knees drawn up. He is conscious and alert and complains of increased pain and nausea when he tries to straighten his legs. His blood pressure is 142/82 mm Hg, his pulse rate is 110 beats/min and strong, and his respirations are 22 breaths/min and regular. In addition to administering high-flow oxygen, you should:

transport him in the position in which you found him.

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 organs is at most risk for injury as the result of a pelvic fracture?

urinary bladder

Epinephrine is indicated for patients with an allergic reaction when:

wheezing and hypotension are present