Ems test 3

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

hypoglycemia

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

it can continue to inject venom for up to 20 minutes.

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.

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

After the AED has delivered a shock, the EMT should:

immediately resume CPR.

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

0.3, 0.15

Your patient answers your questions appropriately, although her eyes remain closed the entire time. She moves each extremity on command, although her left side is weaker than the right. You should assign a Glasgow Coma Scale (GCS) score of:

12

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

A 17-year-old male with anxiety

Which of the following is a major difference between angina pectoris and AMI?

Anginal pain typically subsides with rest.

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.

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

You and your partner have achieved return of spontaneous circulation (ROSC) in a patient who was in cardiac arrest. An ALS unit will arrive in less than 2 minutes. The patient remains unresponsive and has slow, irregular breathing. Further treatment for this patient should include:

BVM ventilation at 10-12 breaths/min and assessment of oxygen saturation.

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 what the patient will experience during the postictal state that follows a seizure?

Confusion and fatigue

A young female is unconscious after intentionally ingesting a large amount of aspirin. You will MOST likely find her respirations:

Deep/ rapid

Which of the following medications blocks the release of histamines?

Diphenhydramine (Benadryl)

Which of the following is the MOST likely cause of artifact on an ECG tracing?

Excessive movement of the patient

Naloxone (Narcan) would reverse the effects of:

Hydromorphone (Dilaudid)

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.

Your patient's symptoms include high fever, cough, vomiting, bloody diarrhea, and shortness of breath. Which of the following should you suspect?

MERS-CoV

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

Mallory-Weiss tear

Which of the following statements regarding gonorrhea is correct?

Painful urination is a common symptom of gonorrhea in men and women.

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. 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, administer oxygen, and place him in a supine position

Which of the following drugs is commonly referred to as "roofies"?

Rohypnol

Treatment with continuous positive airway pressure (CAP) would MOST likely be contraindicated in which of the following situations?

Shortness of breath and a bp of 76/56

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

Take all the meds with you to hospital and document them

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

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

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

a group of symptoms that are caused by myocardial ischemia.

A 35-year-old 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

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.

An area of swelling or enlargement in a weakened arterial wall is called:

an aneurysm

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

aortic aneurysm

A 49-year-old male presents with an acute onset of crushing chest pain and diaphoresis. You should:

assess the adequacy of his respirations.

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.

The ability of cardiac muscle cells to contract spontaneously without a stimulus from a nerve source is called:

automaticity

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

The posterior tibial pulse can be palpated:

behind the medial malleolus, inside of ankle

Activated charcoal is given to patients who have ingested certain substances because it:

binds to the substance and prevents absorption.

In contrast to hypoglycemia, hyperglycemia:

can only be corrected in the hospital setting.

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

carotid arteries

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

congestive heart failure

Ischemic heart disease is defined as:

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

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

In contrast to an automatic implantable cardiac defibrillator (AICD), an external defibrillator vest:

delivers high-energy shocks, similar to an AED.

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

dysarthria

The main legal risk in using the AED is:

failing to deliver a shock when one is needed.

Risk factors for AMI that cannot be controlled include:

family history

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

family history of hypertension

Ketone production is the result of

fat metabolization when glucose is unavailable.

Signs and symptoms of a hypertensive emergency would MOST likely be delayed in patients who:

have chronic hypertension.

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

hypotension

Which of the following signs or symptoms would you NOT expect to encounter in a patient with congestive heart failure?

hypotension and flat jugular veins

Early signs and symptoms of viral hepatitis include all of the following, EXCEPT:

jaundice and abdominal pain.

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

jugular venous distention

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 resolution 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.

Before giving activated charcoal, you should:

obtain approval from medical control.

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

obtain authorization from medical control

The greatest danger in displaying a personal bias or "labeling" a patient who frequently calls EMS is:

overlooking a potentially serious medical condition.

Your EMS team is performing CPR on a 60-year-old male in cardiac arrest. You connect the AED, push the analyze button, and receive a "no shock advised" message. You should:

perform CPR for 2 minutes and reassess

A 29-year-old female presents with confusion and disorientation. Her respirations are rapid and shallow and her pulse is 120 beats/min and thready. She is markedly diaphoretic and has an oxygen saturation of 89%. You should:

provide ventilatory support.

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

severe twitching of all the body's muscles

A 67-year-old female with severe chest pain becomes unresponsive, pulseless, and apneic during transport. You should:

stop the ambulance, begin CPR, and attach the AED as soon as possible

Which of the following conditions often requires transport to a hospital with specialized capabilities that may not be available at the closest hospital?

stroke and heart attack

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.

Ventricular tachycardia causes hypotension because:

the left ventricle does not adequately fill with blood

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.

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

umbilicus

Which of the following physiologic actions does epinephrine produce when given for an allergic reaction?

vasoconstriction and bronchodilation

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

Nitroglycerin is contraindicated in patients:

who have experienced a head injury.

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:

8

Which of the following MOST accurately describes a focal-onset aware seizure?

A seizure that begins in one extremity

EMTs are dispatched for a teenage male who is "not acting right." When they arrive, they are informed that the patient was huffing. Several cans of Freon are found near the patient. Which of the following is unique consideration for this patient?

A sudden adrenaline release can cause a fatal dysrhythmia.

A patient with a left ventricular assist device (LVAD) tells you that the device's pump flow is continuous. Which of the following should you expect to encounter during your assessment?

Absence of a palpable pulse

A sign of respiratory distress seen in the neck is:

Accessory muscle use

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.

Which of the following represents the MOST appropriate method of assisting a patient with his or her prescribed nitroglycerin tablet or spray?

Administer the medication sublingually and allow it to dissolve or absorb.

A 58-year-old male presents with confusion, right-sided weakness, and slurred speech. His airway is patent, and his breathing is adequate. His wife is present and is very upset. Which of the following has the MOST immediately priority?

Asking his wife when she noticed the symptoms

The myocardium receives oxygenated blood from the ____ which originates from the ____

Coronary arteries, aorta

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

Deliver the shock followed by immediate resumption of CPR.

During your assessment of a 50-year-old male who was found unresponsive in an alley, you note that he has slow, shallow respirations, 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. Which of the following would most likely explain the patient's presentation?

Heroin overdose

Which of the following statements regarding the human immunodeficiency virus (HIV) is correct?

The risk of HIV infection is greatest when deposited on a mucous membrane or directly into the bloodstream.

Common signs and symptoms of a hypertensive emergency include:

a bounding pulse, a severe headache, and dizziness.

You are assessing a 49-year-old man who, according to his wife, experienced a sudden, severe headache and then passed out. He is unresponsive and has slow, irregular breathing. His blood pressure is 190/94 mm Hg, and his pulse rate is 50 beats/min. His wife tells you that he has hypertension and diabetes. He has MOST likely experienced:

a ruptured cerebral artery.

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

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?

acute myocardial infarction

You are dispatched to a residence for a 67-year-old female who was awakened by shortness of breath and sharp chest pain. Her husband tells you that she was recently discharged from the hospital after having hip surgery. Your assessment reveals dried blood around her mouth, facial cyanosis, and an oxygen saturation of 88%. You should suspect:

acute pulmonary embolism

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

administer 15 g of activated charcoal.

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 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:

administer oxygen, give her 324 mg of aspirin, and assess her further.

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.

You are assessing a young male who was stung on the leg by a scorpion. He is conscious and alert, his breathing is regular and unlabored, and his blood pressure is 122/64 mm Hg. Assessment of his leg reveals a wheal surrounded by an area of redness. He states that he had a "bad reaction" the last time he was stung by a scorpion, and carries his own epinephrine auto-injector. You should:

apply oxygen as needed, clean the area with soap and water or a mild antiseptic, and transport him to the hospital.

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.

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

are usually absorbed quickly into the body.

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?

aspiration pneumonia

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:

assist her ventilations with a bag-mask device.

You receive a call for a 70-year-old female with respiratory distress. Her husband tells you that she has congestive heart failure, however, he does not think that she has been taking her medications as prescribed. The patient is laboring to breathe, appears tired, and has cyanosis around her lips. You should:

assist her ventilations with a bag-mask device.

A 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.

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 ventilations, perform a rapid exam, and prepare for immediate transport.

You and your paramedic partner are caring for a patient who ingested codeine, acetaminophen (Tylenol), and hydrocodone (Vicodin). The patient is unresponsive, his breathing is slow and shallow, and his pulse is slow and weak. Treatment for this patient should include:

assisted ventilation and naloxone (Narcan).

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:

attempting to calm him and giving him oxygen if tolerated.

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

be alert for personal hazards.

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.

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.

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:

begin high-quality CPR and apply the AED as soon as possible.

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

begin ventilatory assistance.

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

blood returning from the body can fill the atria

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

brain

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

cerebral vasodilation

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

The respiratory distress that accompanies emphysema is caused by:

chronic stretching of the alveolar walls.

A 19-year-old male complains of "not feeling right." His insulin and a syringe are on a nearby table. The patient says he thinks he took his insulin and cannot remember whether he ate. He is also unable to tell you the time or what day it is. The glucometer reads "error" after several attempts to assess his blood glucose level. You should:

contact medical control and administer oral glucose.

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 primary assessment of the child, you should:

contact the regional poison control center.

A 50-year-old man with diabetes has an altered mental status and is unable to tell you when he last ate or took his insulin. Your glucometer keeps malfunctioning and you are unable to determine his blood glucose level. Which of the following clinical signs would MOST likely lead you to the correct diagnosis?

deep rapid breathing

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

dilating the affected coronary artery with a small inflatable balloon.

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 seems 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.

A 66-year-old woman presents with a stabbing pain in the middle of her chest that radiates to her back. She tells you that the pain suddenly began about 30 minutes ago and has been severe since the onset. She has a history of hypertension, but admits to being noncompliant with her antihypertensive medications. When you assess her, you find that her blood pressure is significantly higher in her left arm than it is in her right arm. What do these signs and symptoms MOST likely indicate?

dissecting aortic aneurysm

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?

dry mucous membranes

Insulin functions in the body by:

enabling glucose to enter the cells.

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

ensure a patent airway and support ventilation as needed.

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.

Peritonitis may result in shock because:

fluid shifts from the bloodstream into body tissues.

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 he is experiencing:

heart attack

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

hypertension

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

hypovolemia

When obtaining a 12-lead ECG, the patient should be:

in a supine position with legs uncrossed.

Which of the following would cause the greatest increase in cardiac output?

increased heart rate and increased stroke volume

Three months after returning home from West Africa, a 50-year-old man begins experiencing a fever, cough, and muscle aches. The EMT should suspect:

influenza

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.

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

insert a nasal airway and ventilate with a BVM.

You are dispatched to an apartment complex where a 21-year-old female has apparently overdosed on several narcotic medications. She is semiconscious and has slow, shallow respirations. You should:

insert a nasopharyngeal airway and begin assisted ventilation.

You are assisting an asthma patient with his prescribed metered-dose inhaler. After the patient exhales, and before inhaling, the patient should put his or her lips around the inhaler, take a deep breath, and depress the inhale. You should:

instruct him to hold his breath for as long as he comfortably can.

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

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

is in shock

In contrast to viral hepatitis, toxin-induced hepatitis:

is not a communicable disease

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 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.

Which of the following clinical presentations is MOST consistent with pelvic inflammatory disease (PID)?

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

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

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

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.

A 48-year-old male is found unconscious in the garden by his wife. When you arrive at the scene and assess the man, you find that he is unresponsive, has labored breathing, and has hives over his entire trunk. You should:

maintain his airway and assist his ventilations.

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.

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:

may vomit and aspirate

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.

An acute myocardial infarction (AMI) occurs when:

myocardial tissue dies secondary to an absence of oxygen.

Bacterial vaginosis is a condition that occurs when:

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

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

In contrast to AMI, a dissecting aortic aneurysm:

often presents with pain that is maximal from the onset

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

on either side of the sternum

A man finds his 59-year-old wife unconscious on the couch. He states that she takes medications for type 2 diabetes. He further tells you that his wife has been ill recently and has not eaten for the past 24 hours. Your assessment reveals that the patient is unresponsive. You should:

open and maintain her airway and assess breathing.

A 60-year-old male presents with acute respiratory distress. He is conscious and alert, has pink and dry skin, and has respirations of 22 breaths/min with adequate depth. Which of the following treatments is MOST appropriate for this patient?

oxygen via nonrebreathing mask and a focused secondary assessment

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

pain exacerbated by breathing

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.

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.

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

poisoning

You have just completed your primary assessment of a 48-year-old man with crushing chest pain and difficulty breathing. The patient has been given 324 mg of aspirin and is receiving supplemental oxygen. As you begin your secondary assessment, you note that his mental status has deteriorated and he is now bradycardic. You should:

prepare the patient for immediate transport.

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.

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.

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

The left ventricle has the thickest walls because it:

pumps blood into the aorta and systemic circulation

Which of the following is NOT a common sign or symptom associated with malfunction of an implanted cardiac pacemaker?

rapid heart rate

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

After assisting your patient with prescribed nitroglycerin, you should:

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

A 50-year-old male was stung by a honeybee approximately 15 minutes ago. He presents with respiratory distress, facial swelling, and hypotension. After placing him on oxygen and administering his epinephrine via auto-injector, you note that his breathing has improved. Additionally, his facial swelling is resolving and his blood pressure is stable. Your next action should be to:

record the time and dose of the injection, and transport promptly.

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

A patient in cardiac arrest is wearing an external defibrillator vest, which is interfering with effective chest compressions. The EMT should:

remove the battery from the monitor and then remove the vest

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.

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.

Most AEDs are set up to adjust the voltage based on the impedance, which is the

resistance of the body to the flow of electricity.

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.

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

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.

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 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 42-year-old male is found unresponsive on his couch by a neighbor. During your assessment, you find no signs of trauma and the patient's blood glucose level is 75 mg/dL. His blood pressure is 168/98 mm Hg, his heart rate is 45 beats/min and bounding, and his respirations are 8 breaths/min and irregular. The patient is wearing a medical alert bracelet that states he has hemophilia. You should:

suspect that he has intracranial bleeding, assist his ventilations, and transport rapidly to an appropriate hospital.

Prompt transport of a patient with a suspected AMI is important because:

the patient may be eligible to receive thrombolytic therapy.

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. Immediate management for this patient should include:

thoroughly suctioning her oropharynx

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.

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 suspect that this patient:

was given flunitrazepam (Rohypnol).

Defibrillator pads are placed on the patient's chest:

with one pad to the right of the upper sternum and the other pad to the left lower chest below the armpit.

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.