EMT Chapter 17, 18, 19

___ is complete obstruction of blood circulation in a given organ as a result of compression or entrapment.

Strangulation

Hypoglycemia can mimic conditions such as:

Stroke

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

The normal blood glucose level is between:

80 and 120 mg/dL.

Normal blood glucose levels range from _____ mg/dL.

80 to 120

Acute abdomen

A condition of sudden onset of pain within the abdomen

Peritoneum

A membrane lining the abdomen

Postictal state

A period following a seizure that typically includes labored respirations and altered mental status

When caring for a patient with documented hypoglycemia, you should be MOST alert for:

A seizure

Aura

A sense of warning experienced prior to an event

Aneurysm

A swelling or enlargement of part of an artery resulting from weakness of the arterial wall

Thrombophilia

A tendency to develop blood clots

Severe back pain may be associated with which of the following conditions?

Abdominal aortic aneurysm

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.

Aphasia

An inability to produce or understand speech

When blood flow to a particular part of the brain is cutt off by a blockage inside a blood vessel. The result is:

An ischemic stroke.

When assessing for arm drift of a patient with a suspected stroke, you should:

Ask the patient to close his or her eyes during the assessment.

Which of the following MOST accurately describes a simple partial seizure? A. A seizure that is not preceded by an aura B. A seizure that causes the patient to stare blankly C. A seizure that begins in one extremity D. A generalized seizure without incontinence

C. A seizure that begins in one extremity

Which of the following helps filter the blood and has no digestive function? A. Stomach B. Small intestine C. Spleen D. Large intestine

Spleen

Which of the following conditions would MOST likely affect the entire brain? A. Ruptured cerebral artery in the occipital lobe B. Respiratory failure or cardiopulmonary arrest C. Blocked cerebral artery in the frontal lobe D. Reduced blood supply to the left hemisphere

B. Respiratory failure or cardiopulmonary arrest

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.

Retroperitoneal

Behind the peritoneum

Which of the following conditions is the diabetic patient at an increased risk of developing?

Blindness

The ___ controls the most basic functions of the body, such as breathing, blood pressure, swallowing, and pupil constriction.

Brain stem

You have been dispatched to the home of a 52-year-old woman with severe flank pain. Which of the following would be an appropriate question to ask regarding the pain?

Is the pain constant or intermittent?

Which of the following MOST accurately describes what the patient will experience during the postictal state that follows a seizure? A. A gradually decreasing level of consciousness B. A rapidly improving level of consciousness C. Confusion and fatigue D. Hyperventilation and hypersalivation

C. Confusion and fatigue

Which of the following symptoms would lead the EMT to believe that a patient's headache is caused by sinus congestion? A. There is associated neck stiffness B. There is numbness in the extremities C. The pain is worse when bending over D. The headache began suddenly

C. The pain is worse when bending over

A 54-year-old golfer collapsed on the 17th green at the golf course. His friend said he wasn't feeling well after the eighth hole, but insisted on walking and finishing out the game. His skin is pale, cool, and diaphoretic, and he provides incoherent answers to your questions. An initial blood glucose measurement indicates 65 mg/dL. The patient loses consciousness and a second blood glucose level reads 48 mg/dL. You should:

Call for, or rendezvous with, an ALS unit, ensure a patent airway, provide high-flow oxygen.

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

Cerebral vasodilation

The three major parts of the brain are the:

Cerebrum, cerebellum, and brain stem.

Hormone

Chemical produced by a gland that regulates body organs

_______ commonly produces symptoms about 30 minutes after a particularly fatty meal and usually at night.

Cholecystitis

Type 1 diabetes

Diabetes that usually starts in childhood; requires insulin

Type 2 diabetes

Diabetes with onset later in life; may be controlled by diet and oral medication

Hemophilia

Disorder that causes an inability to develop blood clots

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

Dysarthria.

______ occur(s) when there is excess pressure within the portal system and surrounding vessel and may lead to life-threatening bleeding.

Esophageal varices

Hyperglycemia

Extremely high blood glucose level

Peritonitis may result in shock because:

Fluid shifts from the bloodstream into body tissues.

When the abdominal muscles become rigid in an effort to protect the abdomen from further irritation, this is referred to as:

Guarding

A patient who is possibly experiencing a stroke is NOT eligible for thrombolytic (fibrinolytic) therapy if he or she:

Has bleeding within the brain.

A 30-year-old male experienced a generalized (tonic-clonic) seizure, which stopped before you arrived at the scene. The patient is conscious, is answering your questions appropriately, and refuses EMS transport. Which of the following would be the MOST compelling reason to disagree with his refusal of transport?

He is currently not prescribed any medications

Patients with a subarachnoid hemorrhage typically complain of a sudden severe:

Headache

Insulin

Hormone that enables glucose to enter the cells

Which of the following conditions would be the LEAST likely to mimic the signs and symptoms of a stroke? A. Hypoglycermia B. Hypovolemia C. Intracranial bleeding D. A postictal state

Hypovolemia

For a patient with a gastrointestinal complaint, it is MOST important for the EMT to _________.

Identify whether the patient requires rapid transport.

Which of the following statements regarding sickle cell disease is correct?

In sickle cell disease, the red blood cells are abnormally shaped and are less able to carry oxygen.

___ is a loss of bowel and bladder control and can be due to a generalized seizure

Incontinence

Peritonitis

Inflammation of the peritoneum

Sickle cell disease

Inherited disease that affects red blood cells

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

Is likely to improve over a period of 5 to 30 minutes.

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

___ are solid crystalline masses formed in the kidney, resulting from an excess of insoluble salts or uric acid crystallizing in the urine.

Kidney stones

You are called to a home and find a 56-year-old woman supine in her bed. She appears alert, but has slurred speech. Her family tells you she has a history of TIAs and hypertension. You ask the patient, "What day is it today?" Her reply is, "Butterfly." Which area of the brain is likely affected?

Left hemisphere

Most patients with abdominal pain prefer to:

Lie on their side with their knees drawn into the abdomen.

Which of the following organs would MOST likely bleed profusely if injured?

Liver

Which of the following may help reduce your patient's nausea? A. Oral glucose B. Low-flow oxygen C. Positive-pressure ventilation D. Cricoid pressure

Low-flow oxygen.

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:

Mallowry-Weiss tear.

A patient with an altered mental status is:

Not thinking clearly or is incapable of being aroused.

Referred pain

Pain felt in an area of the body other than where the cause of the pain is located

A patient with hypoglycemia will often present with which of the following signs/symptoms?

Pale, cool, and clammy skin

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.

Which of the following organs lies in the retroperitoneal space? A. Gallbladder B. Liver C. Spleen D. Pancreas

Pancreas.

Ileus

Paralysis of the bowel

Which of the following statements regarding dialysis is correct? A. Hemodialysis is effective but carries a high risk of peritonitis. B. Patients who miss a dialysis treatment often present with weakness. C. Acute hypertension is a common adverse effect of dialysis. D. The purpose of dialysis is to help the kidneys retain salt and water.

Patients who miss a dialysis treatment often present with weakness.

Your patient complains of chronic "burning" stomach pain that improves after eating. You should suspect:

Peptic ulcer disease.

Glucose

Primary fuel, along with oxygen, for cellular metabolism

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.

An important aspect in the treatment of a patient with severe abdominal pain is to:

Provide emotional support en route to the hospital.

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

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: A. Ventilatory assistance and transport. B. Recovery position and transport C. High-flow oxygen and transport D. Oral glucose gel and transport

Recovery position and transport

Pain that may be perceived at a distant point on the surface of the body, such as the back or shoulder, is called:

Referred pain.

At each vertebra in the neck and back, two nerves, called ___ nerves, branch out from the spinal cord and carry signals to and from the body.

Spinal

You are caring for a 70-year-old female with signs and symptoms of an acute stroke. She is conscious, has secretions in her mouth, is breathing at a normal rate with adequate depth, and has an oxygen saturation of 96%. You should:

Suction her oropharynx and transport immediately.

Which of the following statements regarding glucose is correct?

The brain requires glucose as much as it requires oxygen.

Which of the following statements regarding the acute abdomen is correct? A. The parietal peritoneum is typically the first abdominal layer that becomes inflamed or irritated. B. The most common cause of an acute abdomen is inflammation of the gallbladder and liver. C. The initial pain associated with an acute abdomen tends to be vague and poorly localized. D. An acute abdomen almost always occurs as the result of blunt trauma to solid abdominal organs.

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

The left cerebral hemisphere controls:

The right side of the body.

___ may reverse stroke symptoms and even stop the stroke if given within 3 to 6 hours of onset of symptoms

Thrombolytic therapy

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.

___ describes severe kidney failure resulting in the buildup of waste products within the blood.

Uremia

Hemiparesis

Weakness of one side of the body

Which of the following signs or symptoms would the EMT MOST likely encounter in a patient with new-onset type 1 diabetes?

Weight loss and polyuria

When you are obtaining medical history from the family of a suspected stroke patient, it is MOST important to determine:

When the patient last appeared normal.

Urinary tract infections are more common in ___.

Women

Which of the following is correct about the secondary assessment for a high-priority patient? A. You may not have time to complete a secondary assessment. B. Never contact medical direction before completing the secondary assessment. C. The secondary assessment must be performed prior to transport. D. Never perform a secondary assessment on a high-priority patient.

You may not have time to complete a secondary assessment.

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:

a heart attack

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

Febrile seizures:

are usually benign but should be evaluated

Kussmaul respirations are an indication that the body is:

attempting to eliminate acids from the blood.

Type 1 diabetes is considered to be a(n) ___ problem, in which the body becomes allergic to its own tissues and literally destroys them.

autoimmune

The EMT should assess for hypoglycemia in small children with a severe illness or injury because:

children cannot store excess glucose as effectively as adults.

Your patient complains of abdominal pain that occurs mostly at night or after eating fatty foods. You should suspect ____________.

cholecystitis

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

cool, clammy skin.

Classic signs and symptoms of hypoglycemia include:

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

A patient with an altered mental status; high blood glucose levels; and deep, rapid breathing may have a condition known as __________.

diabetic ketoacidosis

The accumulation of ketones and fatty acids in blood tissue can lead to a dangerous condition in diabetic patients known as:

diabetic ketoacidosis.

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

ensure a patient airway and support ventilation as needed.

Proper procedure for administering oral glucose to a patient includes all of the following, EXCEPT: A. checking the medication's expiration date. B. ensuring the absence of a gag reflex. C. assessing the patient's mental status. D. requesting permission from medical control.

ensuring the absence of a gag reflex.

The two main types of cells contained in blood are called _________.

erythrocytes and leukocytes

The spinal cord exits the cranium through the:

foramen magnum.

During your assessment of a 19-year-old male, you are told that he is being treated with factor VIII. This indicates that:

he has hemophilia A.

A(n) ___ is the protrusion of a loop of an organ or tissue through an abnormal body opening.

hernia

The MOST significant risk factor for a hemorrhagic stroke is:

hypertension

Headache, vomiting, altered mental status, and seizures are all considered early signs of:

increased intracranial pressure.

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.

A 37-year-old female with a history of diabetes presents with excessive urination and weakness of 2 days' duration. Her blood glucose level reads 320 mg/dL. If this patient's condition is not promptly treated, she will MOST likely develop:

irreversible renal failure.

In contrast to type 1 diabetes, type 2 diabetes:

is caused by resistance to insulin at the cellular level.

Chronic renal failure is a condition that:

is often caused by hypertension or diabetes

Injury to a hollow abdominal organ would MOST likely result in:

leakage of contents into the abdominal cavity.

The main function of the endocrine system is to _________.

maintain homeostasis

The principal difference between a patient who has a stroke and a patient with hypoglycemia almost always has to do with the:

mental status

Blood glucose levels are measured in:

milligrams per deciliter.

The onset of hypoglycemia can occur within:

minutes.

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.

Excessive eating caused by cellular "hunger" is called:

polyphagia.

Symptomatic hypoglycemia will MOST likely develop if a patient:

takes too much of his or her prescribed insulin.

The MOST important treatment for a patient with severe abdominal pain and signs of shock is:

transporting the patient without delay.