EMT Chapter 12 - Shock

A 70-year-old female was recently discharged from the hospital following a total hip replacement. Today, she presents with restlessness, tachycardia, and a blood pressure of 100/64 mm Hg. Her skin is warm and moist. You should be MOST suspicious that she is experiencing: A. a local infection. B. septic shock. C. decompensated shock. D. pump failure.

B

Which of the following clinical signs is unique to anaphylactic shock?Choose one answer. a. hypotension b. wheezing c. pallor d. dizziness

B

Distributive shock occurs when: A. an injury causes restriction of the heart muscle and impairs its pumping function. B. severe bleeding causes tachycardia in order to distribute blood to the organs faster C. temporary but severe vasodilation causes a decrease in blood supply to the brain D. widespread dilation of the blood vessels cause blood to pool in the vascular beds

D

Anaphylaxis is MOST accurately defined as a:Choose one answer. a. extreme allergic reaction that may affect multiple body systems. b. allergic reaction that causes bronchodilation and vasoconstriction. c. severe allergic reaction that typically resolves without treatment. d. moderate allergic reaction that primarily affects the vasculature.

A

Classic signs and symptoms of hypoglycemia include:Choose one answer. a. cool, clammy skin; weakness; tachycardia; and rapid respirations. b. cold, clammy skin; bradycardia; hunger; and deep, rapid respirations. c. warm, dry skin; irritability; bradycardia; and rapid respirations.

A

Hypothermia occurs when the core body temperature falls below:Choose one answer. a. 95°F (35°C). b. 90°F (32°C). c. 88°F (31°C). d. 98°F (37°C).

A

Hypovolemic shock caused by severe burns is the result of a loss of: A. plasma B. platelets C. whole blood D. red blood cells

A

Most patients who die of anaphylaxis do so within the first __________ following exposure.Choose one answer. a. 30 minutes b. 60 minutes c. 90 minutes d. 5 minutes

A

Neurogenic shock occurs when: A. failure of the nervous system causes widespread vasodilation. B. the spinal cord is severed and causes massive hemorrhaging. C. there is too much blood to fill a smaller vascular container. D. massive vasoconstriction occurs distal to a spinal cord injury.

A

Pale skin in a child indicates that the:Choose one answer. a. blood vessels near the skin are constricted. b. oxygen content in the blood is decreased. c. child is in severe decompensated shock. d. child's core body temperature is elevated.

A

Shock due to severe infection is called ________. A. septic sock B. neurogenic shock C. anaphylactic shock D. hypovolemic shock

A

The principal clinical difference between a stroke and hypoglycemia is that patients with hypoglycemia: Choose one answer. a. usually have an altered mental status or decreased level of consciousness. b. do not present with slurred speech or weakness to one side of the body. c. always take oral medications to maintain normal blood glucose levels. d. are typically alert and attempt to communicate with health care providers.

A

To protect vital organs, the body compensates by directing blood flow away from organs that are more tolerant of low flow, such as: A. the skin B. the heart C. the brain D. the lungs

A

When should nonlifesaving interventions be performed for your multisystem trauma patient? A. en route to the hospital B. prior to transport C. during the primary assessment D. immediately after the injuries are discovered

A

Which of the following MOST accurately describes septic shock? A. bacterial infection of the nervous system with widespread vasodilation B. widespread vasoconstriction and plasma loss due to a severe viral infection C. bacterial damage to the vessel wall, leaking blood vessels, and vasodilation D. viral infection of the blood vessels, vascular damage, and vasoconstriction

A

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: A. determine if she was injured when she fainted. B. provide emotional support regarding her sister. C. advise her that she needs to go to the hospital. D. obtain baseline vital signs and a medical history.

A

Your patient is in shock, but the body's defense mechanisms are currently able to maintain adequate circulation. This is called ___________. A. compensated shock B. decompensated shock C. late shock D. irreversible shock

A

A 20-year-old male has a large laceration to his wrist. He is holding a blood-soaked towel over the wound, but it continues to bleed rapidly. You should: A. apply pressure to the brachial artery B. apply a tourniquet proximal to the wrist C. administer high flow supplemental oxygen D. wrap the towel with pressure bandages

B

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: A. acute myocardial infarction. B. cardiogenic hypoperfusion. C. severe septic hypoperfusion. D. a ruptured aortic aneurysm.

B

A construction worker fell approximately 30 feet. He is semiconscious with rapid, shallow respirations. Further assessment reveals deformity to the thoracic region of his spine. His blood pressure is 70/50 mm Hg, his pulse is 66 beats/min and weak, and his skin is warm and dry. In addition to spinal immobilization and rapid transport, the MOST appropriate treatment for this patient includes:Choose one answer. A) oxygen via nonrebreathing mask, blankets for warmth, and elevation of his head. B) assisted ventilation, thermal management, and elevation of the lower extremities. C) oxygen via nonrebreathing mask, thermal management, and elevation of his legs. D) assisted ventilation, preventing hyperthermia, and elevating his lower extremities.

B

Activated charcoal is given to patients who have ingested certain substances because it:Choose one answer. a. induces vomiting and empties the stomach. b. binds to the substance and prevents absorption. c. is a direct antidote for many toxic substances. d. decreases absorption of poisons into the lungs.

B

As you approach a patient lying at the side of the roadway, you observe severe bleeding from the leg. What should your first action be? A. check for a pulse B. control the bleeding C. open the airway D. administer oxygen

B

Cardiogenic shock may result from all of the following, EXCEPT:Choose one answer. A) increased afterload. B) increased preload. C) heart attack. D) poor contractility

B

Clinical signs of compensated shock include all of the following, EXCEPT: A. cool and clammy skin. B. absent peripheral pulses. C. restlessness or anxiety. D. rapid, shallow breathing.

B

Foods, medications, and insects are common causes of ________. A. septic shock B. anaphylactic shock C. cardiogenic shock D. neurogenic shock b

B

Inadequate circulation of the blood throughout the body is called? A. hypotesion B. shock C. perfusion D. hypoxia

B

Temporary, widespread vasodilation and syncope caused by a sudden nervous system reaction MOST accurately describes:Choose one answer. a. vasovagal shock. b. psychogenic shock. c. neurologic shock. d. neurogenic shock.

B

When assessing a patient with signs and symptoms of shock, it is important to remember that: A.the patient's respirations are deep during the early stages of shock B. blood pressure may be the last measurable factor to change in shock C. multiple fractures are the most common cause of hypovolemic shock D. irreversible shock often responds well to prompt blood transfusion

B

Which of the following injuries would MOST likely cause obstructive shock? A. liver laceration B. Cardiac Tamponade C. Simple Pneumothorax D. spinal cord injury

B

Which of the following would MOST likely result in hemorrhagic shock?Choose one answer. a. severe vomiting b. liver laceration c. excessive sweating d. repeated diarrhea

B

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: A. immediately evaluate his airway. B. apply direct pressure to the wound. C. assess the rate and quality of his pulse. D. administer 100% supplemental oxygen.

B

Your assessment of an unresponsive patient reveals that her breathing is inadequate. Your MOST immediate action should be to: A. administer high-flow oxygen. B. check her airway for obstructions. C. ventilate her with a bag-valve mask. D. move her to the ambulance stretcher.

B

Your patient has a decreased cardiac output and poor myocardial contractility. This will likely lead to ___________. A. hypovolemic shock B. cardiogenic shock C. neurogenic shock D. septic shock

B

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: A. transport him immediately and provide supportive care while en route. B. consider that he may actually be experiencing an acute asthma attack. C. repeat the epinephrine injection after consulting with medical control. D. request a paramedic unit that is stationed approximately 15 miles away.

C

A 59-year-old male presents with severe vomiting and diarrhea of 3 days' duration. He is confused and diaphoretic, and his radial pulses are absent. His blood pressure is 78/50 mm Hg. After applying 100% supplemental oxygen, you should:Choose one answer. A. allow him to drink plain water. B. obtain a repeat blood pressure in 5 minutes. C. prepare for immediate transport. D. perform a head-to-toe exam.

C

Pulmonary edema and impaired ventilation occur during: A.septic shock B. neurogenic shock C. cardiogenic shock D. anaphylactic shock

C

Which of the following is the ONLY action that can prevent eventual death from a tension pneumothorax? A. early administration of high flow oxygen B. rapid administration of intravenous fluids C. decompression of the injured side of the chest D. positive pressure ventilation with bvm

C

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: A. take his vital signs in 15 minutes. B. arrange for an ALS rendezvous. C. reassess his condition in 5 minutes. D. repeat your secondary assessment.

C

You suspect your patient is in shock. You note the patient's skin is pale. This is likely due to ___________. A. an increased heart rate B. peripheral vasodilation C. peripheral vasoconstriction D. hypothermia

C

A 25-year-old unrestrained female struck the steering wheel with her chest when her car hit a tree while traveling at a high rate of speed. She has signs and symptoms of shock, which you suspect are the result of intrathoracic bleeding. Which of the following interventions will provide this patient with the greatest chance for survival? A. High flow oxygen administration B. full mobilization of her spine C. intravenous fluid administration D. rapid transport to a trauma center

D

All of the following conditions would make you suspect shock, EXCEPT: A. severe infection. B. heart attack. C. anaphylaxis. D. tachycardia.

D

Following a stab wound to the left anterior chest, a 25-year-old male presents with a decreased level of consciousness and signs of shock. Which of the following additional assessment findings should increase your index of suspicion for a cardiac tamponade?Choose one answer. a. widening pulse pressure b. diminished breath sounds c. a rapid, irregular pulse d. engorged jugular veins

D

Hypovolemic shock occurs when:Choose one answer. a. at least 10% of the patient's blood volume is lost. b. the clotting ability of the blood is enhanced. c. the patient's systolic blood pressure is less than 100 mm Hg. d. the body cannot compensate for rapid blood loss.

D

In an acute injury setting, neurogenic shock is commonly accompanied by: A. hypovolemia B. tachycardia C. diaphoresis D. hypothermia

D

Shock is the result of:Choose one answer. A. widespread constriction of the blood vessels. B. temporary dysfunction of a major organ. C. the body's maintenance of homeostasis. D. hypoperfusion to the cells of the body.

D

What are the three components of the "perfusion triangle"? A. arteries, veins, capillaries B. plasma, red blood cells, platelets C. heart, brain, lungs D. heart, blood vessels, blood

D

When treating an 80-year-old patient who is in shock, it is important to remember that: A. compensation from the respiratory system usually manifests with increased tidal volume B. the older patients; central nervous system usually reacts more briskly to compensate for shock C. medications older patients take for hypertension often cause and unusually fast heart rate D. changes in gastric motility may delay gastric emptying which increases risk for vominiting

D

Which of the following statements regarding anaphylactic shock is correct? A. Anaphylactic shock occurs immediately after a person is sensitized to an allergen. B. Sensitized people will experience less severe reactions upon subsequent exposure. C. Anaphylactic shock is the result of immune system failure due to a toxic exposure. D. Each subsequent exposure following sensitization often produces a more severe reaction.

D