EMT Mid Term

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

A rapid heart rate

Which of the following statements regarding anaphylaxis is correct?

Anaphylaxis is characterized by airway swelling and hypotension.

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

Constriction of blood vessels in the muscles

Which of the following signs is commonly observed in patients with right-sided heart failure?

Dependent edema

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?

Engorged jugular veins

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

Family history of hypertension

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

Mallory-Weiss tear

Which of the following is NOT a pertinent negative to note during your assessment of a patient with chest trauma?

No heart murmurs

Albuterol is a generic name for:

Proventil

At 0500 hours, you respond to the home of a 76-year-old man complaining of chest pain. Upon arrival, the patient states that he had been sleeping in the recliner all night due to indigestion, when the pain woke him up. He also tells you he has taken two nitroglycerin tablets. His vital signs are as follows: respirations, 16 breaths/min; pulse, 98 beats/min; pulse oximeter of 92%, blood pressure 92/76 mm Hg. He is still complaining of chest pain. What actions should you take to intervene?

Provide high-flow oxygen.

Dyspnea is MOST accurately defined as:

Shortness of breath or difficulty breathing.

Which of the following helps filter the blood and has no digestive function?

Spleen

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

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

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.

On inhalation, which of the following does NOT occur?

The pressure inside the chest increases.

Which of the following is correct about the secondary assessment for a high-priority patient?

You may not have time to complete a secondary assessment.

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

a group of symptoms that are caused by myocardial ischemia.

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

a narcotic overdose.

A flail chest occurs when

a segment of the chest wall is detached from the thoracic cage causing paradoxical motion

Pneumothorax is defined as:

accumulation of air in the pleural space

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 and has been unable to ambulate well. Your assessment reveals dried blood around her mouth, facial cyanosis, and an oxygen saturation of 88%. This patient's presentation is MOST consistent with: *

acute pulmonary embolism.

An alert patient presents with a regular pattern of inhalation and exhalation and breath sounds that are clear and equal on both sides of the chest. These findings are consistent with:

adequate air exchange.

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

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

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.

While jogging, a 19-year-old male experienced an acute onset of shortness of breath and pleuritic chest pain. He is conscious and alert with stable vital signs. Your assessment reveals that he has diminished breath sounds over the left side of the chest. You should:

administer oxygen and transport to the hospital

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.

A 37-year-old male was pinned between a flatbed truck and a loading dock. On exam, you find bruising to the chest, distended neck veins, bilaterally diminished breath sounds, and bilateral scleral hemorrhaging. You should:

aggressively manage his airway.

An open pneumothorax occurs when:

air enters the pleural space from outside the body.

Subcutaneous emphysema is an indication that:

air is escaping into the chest wall from a damaged lung

In what area of the lungs does respiration occur?

alveoli

Erosion of the protective layer of the stomach or duodenum secondary to overactivity of digestive juices results in:

an ulcer

Which of the following is most likely to cause immediate death?

aortic rupture

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

appendicitis

Following blunt trauma to the chest, an 18-year-old female presents with respiratory distress, reduced tidal volume, and cyanosis. Her blood pressure is 80/50 mm Hg and her pulse is 130 beats/min and thready. You should:

apply 100% oxygen and immediately transport.

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 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 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.

His parents tell you that their son has had a chest infection for the past two days and when they took him to their family doctor, they were told it was likely due to the respiratory syncytial virus (RSV). They have kept him well hydrated, but the infection seems to have gotten worse. On auscultation, you hear decreased air entry bilaterally with fine expiratory wheezes and the occasional coarse wet crackle. Based on this information, your patient is most likely suffering from:

bronchiolitis.

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.

Your patient is an obese 49 y/o female who complains of abdominal pain that occurs mostly at night or after eating fatty foods. You should suspect ____________.

cholecystitis

Signs and symptoms of a tension pneumothorax include all of the following, EXCEPT:

collapsed jugular veins.

A sudden onset of sever shortness of breath at night , course rales, and dependent edema (ankle edema) are clinical indicators of:

congestive heart failure.

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

coronary arteries, aorta

Hemoptysis is defined as

coughing up blood

Ischemic heart disease is defined as:

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

Cardiogenic shock following AMI is caused by:

decreased pumping force of the heart muscle

The respiratory distress that accompanies emphysema is caused by:

destruction of the alveoli by chronic stretching of the alveolar walls.

A conscious and alert 29-year-old female with a history of asthma complains of difficulty breathing that began after her morning jog. The temperature outside is 40°F (5°C). On exam, you hear bilateral expiratory wheezing. After providing 100% oxygen, you should: *

determine if she has been prescribed a beta-agonist inhaler.

The thoracic cavity is separated from the abdominal cavity by the:

diaphragm

A 30-year-old male presents with acute shortness of breath, widespread hives, and facial swelling. He denies any past medical history and takes no medications. During your assessment, you hear wheezing over all lung fields. His blood pressure is 90/50 mm Hg and his heart rate is 110 beats/min. In addition to giving him 100% oxygen, the MOST important treatment for this patient is:

epinephrine

At the onset of an acute asthma attack, patients commonly experience difficulty breathing and:

expiratory wheezing.

Peritonitis may result in shock because:

fluid shifts from the bloodstream into body tissues.

A 62-year-old man with a history of congestive heart failure presents with severe respiratory distress and an oxygen saturation of 82%. When you auscultate his lungs, you hear widespread rales. He is conscious and alert, is able to follow simple commands, and can only speak in two- to three-word sentences at a time. You should:

force fluid from his alveoli by hyperventilating him with a bag-mask device at a rate of at least 20 breaths/min.

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

have chronic hypertension.

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

hypoglycemia

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

identify whether the patient requires rapid transport

You respond to a residence for a 40-year-old female who was assaulted by her husband; the scene has been secured by law enforcement. Upon your arrival, you find the patient lying supine on the floor in the kitchen. She is semiconscious with severely labored breathing. Further assessment reveals a large bruise to the left anterior chest, jugular venous distention, and unilaterally absent breath sounds. As your partner is supporting her ventilations, you should:

immediately request ALS support.

Asthma is caused by a response of the:

immune system

You are assisting an asthma patient with his prescribed metered-dose inhaler. After the patient takes a deep breath and depresses the inhaler, you should:

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

Chronic renal failure is a condition that:

is often caused by hypertension or diabetes.

You arrive at the scene of a major motor vehicle crash. The patient, a 50-year-old female, was the driver and removed from her vehicle prior to your arrival. Bystanders who removed her state that she was not wearing a seatbelt. The patient is unresponsive, tachycardic, and diaphoretic. Your assessment reveals bilaterally clear and equal breath sounds, a midline trachea, and collapsed jugular veins. There is no radial pulse and the carotid pulse is weak and rapid. You should be MOST suspicious that this patient has experienced a:

laceration of the aorta.

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

leakage of contents into the abdominal cavity.

Most patients with abdominal pain prefer to:

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

If a person's tidal volume decreases, but his or her respiratory rate remains unchanged:

minute volume will decrease.

If a patient with a chest injury is only able to inhale small amounts of air per breath, he or she:

must increase his or her respiratory rate to maintain adequate minute volume.

Angina pectoris occurs when:

myocardial oxygen demand exceeds the supply

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?

pancreas

-You have sealed the open chest wound of a 40-year-old male who was stabbed in the anterior chest. Your reassessment reveals that he is experiencing increasing respiratory distress and tachycardia, and is developing cyanosis. You should:

partially remove the dressing, reassess then provide bag-valve-mask ventilation if indicated

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

peptic ulcer disease.

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 88/64 mm Hg and her heart rate is 120 beats/min and oxygen saturation is 95%. Treatment for this patient includes:

placing her in an upright position.

In order to avoid exacerbating a patient's injury, it is especially important to use extreme caution when providing positive-pressure ventilation to patients with a:

pneumothorax

A 28-year-old male was struck in the chest with a baseball bat during an altercation. He is conscious and alert and complains of severe chest pain. Your assessment reveals a large area of ecchymosis over the sternum and a rapid, irregular pulse. In addition to providing supplemental oxygen, you should:

prepare 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.

A man called EMS 12 hours after injuring his chest. Your assessment reveals a flail segment to the right side of the chest. The patient is experiencing respiratory distress and his oxygen saturation is 78%. His breath sounds are equal bilaterally and his jugular veins are normal. You should suspect:

pulmonary contusion.

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.

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

You are assessing a 49-year-old man who complains of chest pressure that began the night before. He is conscious, but anxious, and tells you he has a history of angina and hypertension. After applying high-flow oxygen, you expose his chest to auscultate his lungs and note that he has a nitroglycerin patch on his right upper chest. His skin is cool and pale, his blood pressure is 78/50 mm Hg, and his pulse is 110 beats/min and irregular. You should:

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

The kidneys help to regulate blood pressure by:

removing sodium, and thus water, from the body.

A patient who presents with profound cyanosis following a chest injury:

requires prompt ventilation and oxygenation.

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.

Which of the following conditions would LEAST likely result in hypoxia?

severe anxiety

The electrical impulse generated by the heart originates in the:

sinoatrial node.

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

slows the heart and respiratory rates.

A 59-year-old male with a history of emphysema complains of an acute worsening of his dyspnea and pleuritic chest pain following a forceful cough. Your assessment reveals that he has a barrel-shaped chest, diminished breath sounds on the left side, and tachycardia. What is the MOST likely cause of this patient's condition?

spontaneous pneumothorax

The purpose of defibrillation is to:

stop the chaotic, disorganized contraction of the cardiac cells.

Harsh, high-pitched inspiratory sounds are characteristic of:

stridor

Common signs and symptoms of acute hyperventilation syndrome include:

tachypnea and tingling in the extremities.

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.

A dissecting aortic aneurysm occurs when:

the inner layers of the aorta become separated.

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

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

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.

You are attending to a 54-year-old female patient in a homeless shelter. The patient tells you that she had the flu a couple of weeks ago, and she has not gotten over it. She has been tired and keeps waking up at night, sweating. She has been coughing up green sputum occasionally and has been experiencing episodes of chest pain that get worse when she breathes. Based on this information, your patient is most likely suffering from:

tuberculosis.

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

use the patient's own words.

Sudden death following AMI is MOST often caused by:

ventricular fibrillation

A 19-year-old male is unresponsive, apneic, and pulseless after being struck in the center of the chest with a softball. Based on the mechanism of injury, what MOST likely occurred?

ventricular fibrillation when the impact occurred during a critical portion of the cardiac cycle

In the presence of ileus, the only way the stomach can empty itself is by:

vomiting

Nitroglycerin is contraindicated in patients:

who have taken an erectile dysfunction medication in the past 12 hours

Urinary tract infections are more common in ____________.

women