Quiz 4

A 30yo female presents w severe acute pain to the left upper quadrant of her abdomen. During your assessment, she tells you that she has sickle cell disease. You should suspect:

her spleen is enlarged bc of red blood cell engorgement.

A 30yo woman w a history of alcoholism has severe upper abdominal pain and is vomiting amounts of bright red blood. Her skin is cool, pale, and clammy; her heart rate is 120 b/m and weak, BP is 70/40. Your most immediate action should be to:

protect her airway from aspiration.

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

provide emotional support en route to the hospital.

A 29yo female has confusion/disorientation. Her respirations are rapid/shallow and her pulse is 120b/m and thready. She is diaphoretic with an O2 sat of 89%. You should:

provide ventilatory support.

A 50yo male was stung by a honeybee ~15mins ago. He has respiratory distress, facial swelling, and hypotension. After placing him on O2 and administering epinephrine, you note his breathing has improved and facial swelling is respolving and his BP is stable. Your next move is:

record the time/dose of injection and transport promptly.

You are dispatched to a 66yo male for a stroke. The patient is unresponsive, apneic, and pulseless. You should:

initiate CPR and attach AED ASAP.

During a primary assessment of a semiconscious 70yo female, you should:

ensure a patent airway and support ventilation as needed.

Young female was sexually assaulted at local motel. She is conscious but confused. She remembers drinking a beer in the night club a night before ad woke up in the bed of a motel room. You should be most suspicious that this patient:

was given flunitrazepam (rophynol).

A 37yo male is have a severe allergic reaction to penicillin. He does not have an epi pen and you can't carry one. How should you proceed with the treatment of this patient?

Administer O2, transport at once, and request a paramedic ambulance.

A 49yo male presents with confusion, sweating, and visual hallucinations. The patient's wife tells you that he is a heavy drinker and possibly had a seizure. They are experiencing:

DTs.

You are caring for a semiconscious man w left-sided paralysis. His airway is patent and respirations are 14b/m with adequate tidal volume. Treatment should include:

O2 via nonrebreathing mask, left lateral recumbent position, transport.

A 75yo male with type 1 diabetes presents w chest pain and weakness. He tells you that he took insulin and ate a meal before. You should treat this patient as though he is experiencing:

a heart attack.

During your assessment of a 50yo male who was found unconscious in an alley, you note that he has slow, shallow respirations, bradycardia, facial cyanosis, and pinpoint pupils. Your partner assists ventilations and shows you arms with needle tracts on them. This patient most likely has:

a heroin overdose.

You are assessing a 49yo man who experienced a sudden, severe headache and passed out. His BP is 190/94 and his pulse rate is 50b/m. He has hypertension and diabetes. He has most likely experienced:

a ruptured cerebral artery.

A 37yo female with a history of diabetes presents w excessive urination/weakness of 2 days duration. You apply 100% O2 and assess blood glucose which reads 320 mg/dL. If this patient's condition is not treated, she'll most likely develop:

acidosis and dehydration.

A 35 yo mildly obese woman is complaining of localized pain the the right upper quadrant with pain in right shoulder. The MOST likely cause of her pain is her:

acute cholecystitis.

a 59yo male presents w a sudden onset of severe lower back pain. He is conscious/alert, but restless and diaphoretic. Your assessment reveals a pulsating mass to the left of his umbilicus. You should:

administer O2 and prepare for immediate transport.

A 19yo female was stung by multiple fire ants, to which she is allergic, but does not have epi. She is conscious/alert and complains of pain. Her BP is 122/70 and pulse is 100b/m and strong, her respirations are 18b/m and unlabored. You should:

administer O2 and transport her to the hospital.

A 4yo male ingested an unknown amount of acetaminophen (Tylenol). The child's mother states that the ingestion occured approximately 20mins ago. The child is conscious/alert and is in no apparent distress. After contacting med control, you should:

administer up to 25g of activated charcoal.

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 BP is 122/64. On his leg is a wheal surrounded by redness. He had a bad reaction last time and carries an epinephrine autoinjector. You should:

apply O2 as needed, clean the area with soap/water or other antiseptic, and transport him to the hospital.

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

applying a nonrebreathing mask at 15L/min.

You respond to a 55yo female with possible allergic reaction to peanuts that she ate ~30mins ago. The patient is conscious/alert and have diffuse urticaria and the feeling that she has a lump in her throat. As your partner applies O2 to the patient, you should:

ask her is she has prescribed epinephrine.

You are dispatched to an apartment complex for a young male with abdominal pain. Your priority upon arriving should be to:

assess the scene for potential hazards.

A 38yo female was bitten by fire ants while at a park with her kids. Your primary assessment reveals she is semiconscious, has labored breathing, and a rapid/thready pulse. She has a red rash on her entire body and face is swollen. You should:

assist her ventilations with 100% O2.

Law enforcement has summoned you to a nightclub, where a 22yo female was found unconscious in an adjacent alley. Your primary assessment reveals her respirations are rapid and shallow and her pulse is rapid and week. She is wearing a medical alert bracelet that identifies her as epileptic. There is an empty bottle of vodka next to her. You should:

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

You and partner are caring for a patient who ingested codein, acetaminophen (tylenol), and propoxyphene (darvon). The patient is unresponsive, his breathing is slow/shallow, and is pulse is slow/weak. Treatment will include:

assisted ventilation, naloxone (Narcan), and rapid transport.

A 47yo male presents w severe abdominal pain for 3hrs. His abdomen is distended/guarded. Your MOST important consideration for this patient should be to:

be alert for signs and symptoms of shock.

A man finds his 59yo wife unconscious on the couch. She takes medications for type 2 diabetes. He further tells you that his wife has been ill recently that has not eaten for the past 24hrs. Your primary assessment reveals that the patient is unresponsive and not breathing. You should:

check for a carotid pulse for no longer than 10 seconds.

You transport a 49yo male w tearing abdominal pain. You are 30miles from the closest hospital and his condition deteriorates significantly before your reassessment. You should:

consider requesting a rendezvous with an ALS unit.

A 19yo male complains of not feeling right. His insulin/syringe are on a nearby table. The patient says he thinks he took his insulin and doesn't know if he ate. He doesn't know the time or day. The glucometer reads error after several attempts. In addition to O2, you should:

contact medical control and administer oral glucose.

A 73yo man presents w a rash which may be caused by an antibiotic. He has a history of coronary artery diseases, hypertension, and emphysema. He is conscious/alert, his BP is 144/94 and pulse 64 b/m and regular. You auscultate his breath sounds and hear scattered wheezing, although he is not experiencing respiratory distress. In addition to O2, you should:

contact medical control if needed, transport the patient, and monitor him for signs of deterioration.

You receive a call where a man found his wife unconscious on the couch. She is unresponsive, respiratory rate is 8b/m and breathing shallow; her heart rate is 40b/m and pulse weak. The husband hands you an empty bottle of hydrocodone (Vicodin) which was refilled the day before. You should:

initiate ventilatory assistance.

You are treating a 40yo male with blood sugar of 300mg/dL. The patient is semiconscious and breathing shallowly, getting assisted ventilation from your partner. Definitive treatment for this patient includes:

insulin.

When caring for an alcoholic patient with severe trauma to the chest/abdomen, you should be concerned that:

internal bleeding may be profuse bc prolonged alcohol may impair the blood's ability to clot.

A 28yo female patient is found to be responsive to only VS. Her roommate says she has type 1 diabetes and has difficulty controlling her blood glucose level. She tells you the patient has been urinating excessively for 24-36hrs. On the clinical presentation you should suspect she:

is significantly hyperglycemic.

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 wo a 70yo male who complains of weakness/shortness of breath. He has dialysis but has missed two treatments. After high flow O2, you auscultate his lungs and hear ronchi. Though conscious, the patient is confused. His BP is 98/54, pulse 120b/min and irregular, respirations are 24 b/m and labored. You should:

leave him in a sitting position, keep him warm, and prepare for immediate transport.

You arrive at the residence of a 33yo woman who is experiencing a generalized seizure. She has a small amount of vomitus coming from the side of her mouth. After protecting her from further injury you should:

maintain her airway w manual head positioning, suction her airway to remove vomitus, insert nasopharyngeal airway, administer high flow O2.

A 48yo male is found unconscious in the garden. He is unresponsive, has severely labored breathing, and has hives on his entire trunk. You should:

maintain his airway and assist ventilations.

Your unit is dispatched to jail for intoxicated inmate. The 33yo male is lying supine in a jail cell. He is responsive only to PS and has slow, shallow respirations. You should be MOST concerned that this patient:

may vomit and aspirate.

You arrive at a grocery store 5mins after a 21yo female stopped seizing. She is confused/disoriented/thirsty. Her brother tells yo she takes phenytoin (Dilantin) for her seizures, but not recently. She also has diabetes. With O2, you should:

monitor her airway/breathing status and assess her blood glucose level.

After administering .3mg of epi to a 22yo female with an allergic rx, you note improvement of breathing and dissipation of hives. She is still anxious/tachycardic. You should:

monitor her closely, but recall that anxiety and tachycardia are side effects of epi.

While auscultating breathing sounds of a patient who was stung multiple times by a yellow jacket, you her bilateral wheezing over all lung fields. This indicates:

narrowing of the bronchioles in the lungs.

You arrive at a grocery store after a 35yo male stopped seizing. Your assessment reveals that he is confused and incontinent of urine. The patient's GF tells you that he has a history of seizures and takes carbamazepine (Tegretol). When obtaining further medical history from the GF, it is MOST important to:

obtain a description of how the seizure developed.

You have administered one dose of epi to a 40yo female to treat an allergic rx after being stung by a scorpion. She is still having difficulty breathing, descreasing mental status, and a BP of 80/50. You should:

request permission from medical control to administer another dose of epi.

You respond to a residence for a patient with AMS. The 35yo male begins shouting/threatening you with a baseball bat. The man is confused/diaphoretic and is wearing a medical ID bracelet. You should:

retreat at once and call law enforcement.

You are caring for a 70yo female with signs/symptoms of stroke. She is conscious, has mouth secretions, and is breathing normally. You should:

suction her oropharynx and apply 100% O2.

A 42yo male is unresponsive, during assessment there is no signs of trauma and the glucose level is 75mg/dL. His BP is 168/98 and his hr is 45beats/min and bounding, and his respirations are 8breaths/min and irregular. The patient has hemophilia. You should:

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

You respond to a residence for a child who is having a seizure. You enter the residence and find the mother holding the 2yo male. He had a high fever and a seizure that lasted ~5min. You should:

transport the child to the hospital and reassure the mother en route.

The MOST important treatment for a patient w severe abdominal pain and signs of shock includes:

transporting the patient without delay.