TEST #8
5. Which of the following statements regarding glucose is correct?
The brain requires glucose as much as it requires oxygen.
17. 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.
23. In contrast to insulin shock, diabetic coma:
can only be corrected in the hospital setting.
3. Muscle control and body coordination are controlled by the:
cerebellum.
8. Interruption of cerebral blood flow may result from all of the following, EXCEPT:
cerebral vasodilation.
1. The three major parts of the brain are the:
cerebrum, cerebellum, and brain stem.
39. A 30-year-old female presents with 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 that:
her spleen is enlarged because of red blood cell engorgement.
2. Chemicals that are responsible for the signs and symptoms of an allergic reaction to a bee sting include:
histamines and leukotrienes.
11. Peritonitis may result in shock because:
fluid shifts from the bloodstream into body tissues.
6. The spinal cord exits the cranium through the:
foramen magnum.
37. Hemoglobin is:
found within the red blood cells and is responsible for carrying oxygen.
51. A patient who is possibly experiencing a stroke is NOT eligible for thrombolytic (fibrinolytic) therapy if he or she:
has bleeding within the brain.
42. 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.
40. An acute accelerated drop in the hemoglobin level, which is caused by red blood cells breaking down at a faster rate than normal, occurs during a(n) __________ crisis.
hemolytic
5. Urticaria is the medical term for:
hives.
26. Which of the following medications is NOT used to treat patients with a history of seizures?
hydromorphone (Dilaudid)
15. Diabetic coma is a life-threatening condition that results from:
hyperglycemia, ketoacidosis, and dehydration.
11. The MOST significant risk factor for a hemorrhagic stroke is:
hypertension.
17. Which of the following conditions would be the LEAST likely to mimic the signs and symptoms of a stroke?
hypovolemia
29. When obtaining a SAMPLE history from a patient with diabetes, it would be MOST important to determine:
if he or she has had any recent illnesses or excessive stress.
23. Status epilepticus is characterized by:
prolonged seizures without a return of consciousness.
30. Immediately after giving an epinephrine injection, you should:
properly dispose of the syringe.
28. 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.
32. An important aspect in the treatment of a patient with severe abdominal pain is to:
provide emotional support en route to the hospital.
26. 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.
41. Patients with thrombophilia are at an increased risk for:
pulmonary embolism.
30. When assessing an unconscious diabetic patient, the primary visible difference between hyperglycemia and hypoglycemia is the:
rate and depth of breathing.
31. 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.
50. When transporting a stable stroke patient with unilateral paralysis, it is best to place the patient in a:
recumbent position with the paralyzed side down.
7. Which of the following conditions would MOST likely affect the entire brain?
respiratory failure or cardiopulmonary arrest
19. Which of the following is characteristic of peptic ulcer disease (PUD)?
burning or pain in the stomach that subsides immediately after eating
33. Which of the following conditions is the diabetic patient at an increased risk of developing?
blindness
27. The adult epinephrine auto-injector delivers ______ mg of epinephrine, and the pediatric auto-injector delivers ______ mg.
0.3, 0.15
33. The effects of epinephrine are typically observed within _________ following administration.
1 minute
29. When administering epinephrine via auto-injector, you should hold the injector in place for:
10 seconds.
12. Most patients who die of anaphylaxis do so within the first __________ following exposure.
30 minutes
48. What Glasgow Coma Scale (GCS) score would you assign to a patient who responds to painful stimuli, uses inappropriate words, and maintains his or her arms in a flexed position?
8
12. The normal blood glucose level, as measured by a glucometer, is between:
80 and 120 mg/dL.
16. 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.
9. Which of the following MOST accurately describes the cause of an ischemic stroke?
blockage of a cerebral artery
21. 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.
14. A transient ischemic attack (TIA) occurs when:
C. the normal body processes destroy a clot in a cerebral artery.
15. A patient who is experiencing aphasia is:
C. unable to produce or understand speech.
16. Which of the following statements regarding diabetic coma is correct?
Diabetic coma typically develops over a period of hours or days.
8. Which of the following statements regarding fire ants is correct?
Fire ants often bite a person repeatedly.
4. Glipizide, a non-insulin-type medication, is another name for:
Glucotrol.
38. 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.
37. Which of the following statements regarding dialysis is correct?
Patients who miss a dialysis treatment often present with weakness.
35. Which of the following patients would MOST likely demonstrate typical signs of infection, such as a fever?
a 17-year-old male with depression and anxiety
7. Which of the following patients would MOST likely have a delayed onset of an allergic reaction?
a 45-year-old male who ingested penicillin
35. To which of the following diabetic patients should you administer oral glucose?
a confused 55-year-old male with tachycardia and pallor
24. 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.
10. 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.
20. Which of the following MOST accurately describes a simple partial seizure?
a seizure that begins in one extremity
32. When caring for a patient with documented hypoglycemia, you should be MOST alert for:
a seizure.
9. A raised, swollen, well-defined area on the skin that is the result of an insect bite or sting is called:
a wheal.
10. A 37-year-old female with a history of diabetes presents with excessive urination and weakness of 2 days' duration. You apply 100% oxygen and assess her blood glucose level, which reads 320 mg/dL. If this patient's condition is not promptly treated, she will MOST likely develop:
acidosis and dehydration.
14. A 35-year-old mildly 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.
35. A 59-year-old male presents with a sudden onset of 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.
2. The most basic functions of the body, such as breathing, blood pressure, and swallowing, are controlled by the:
brain stem.
35. A 19-year-old female was stung multiple times on the legs by fire ants. She states that she is allergic to fire ants, but does not carry her own epinephrine. The patient is conscious and alert and complains of pain to the area of the bites. Her blood pressure is 122/70 mm Hg, her pulse is 100 beats/min and strong, and her respirations are 18 breaths/min and unlabored. You should:
administer oxygen and transport her to the hospital.
31. Elderly patients with abdominal problems may not exhibit the same pain response as younger patients because of:
age-related deterioration of their sensory systems.
6. The foreign substance responsible for causing an allergic reaction is called a(n):
allergen.
12. An area of swelling or enlargement in a weakened arterial wall is called:
an aneurysm.
16. Pain that is localized to the lower back and/or lower abdominal quadrants is MOST suggestive of:
an aortic aneurysm.
1. Which of the following MOST accurately defines an allergic reaction?
an exaggerated immune system response to any substance
18. Erosion of the protective layer of the stomach or duodenum secondary to overactivity of digestive juices results in:
an ulcer.
20. Pain that radiates to the right lower quadrant from the umbilical area, nausea and vomiting, and anorexia are MOST indicative of:
appendicitis.
13. 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.
28. 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.
27. Febrile seizures:
are usually benign but should be evaluated.
20. You respond to the residence of a 55-year-old female with a possible allergic reaction to peanuts that she ate approximately 30 minutes ago. The patient is conscious and alert, but has diffuse urticaria and the feeling that she has a lump in her throat. As your partner applies oxygen to the patient, you should:
ask her if she has prescribed epinephrine.
43. A 58-year-old male presents with confusion, right-sided weakness, and slurred speech. His wife is present and is very upset. As your partner is applying oxygen, it is MOST important for you to:
ask his wife when she noticed the symptoms.
46. When assessing arm movement of a patient with a suspected stroke, you should:
ask the patient to close his or her eyes during the assessment.
26. 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.
18. A 38-year-old female was bitten by fire ants while at the park with her kids. Your primary assessment reveals that she is semiconscious, has profoundly labored breathing, and has a rapid, thready pulse. She has a red rash on her entire body and her face is very swollen. You should:
assist her ventilations with 100% oxygen.
39. 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.
11. Kussmaul respirations are an indication that the body is:
attempting to eliminate acids from the blood.
33. 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.
22. Assessment of a patient with hypoglycemia will MOST likely reveal:
combativeness.
22. Which of the following MOST accurately describes what the patient will experience during the postictal state that follows a seizure?
confusion and fatigue
36. You are transporting a 49-year-old male with "tearing" abdominal pain. You are approximately 30 miles away from the closest hospital. During your reassessment, you determine that the patient's condition has deteriorated significantly. You should:
consider requesting a rendezvous with an ALS unit.
32. 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. In addition to administering oxygen, you should:
contact medical control and administer oral glucose.
15. A 73-year-old man presents with a generalized rash, which he thinks may have been caused by an antibiotic that he recently began taking. He has a history of coronary artery disease, hypertension, and emphysema. He is conscious and alert, his blood pressure is 144/94 mm Hg, and his pulse is 64 beats/min and regular. You auscultate his breath sounds and hear scattered wheezing, although he is not experiencing respiratory distress. In addition to administering oxygen, you should:
contact medical control if needed, transport the patient, and monitor him for signs of deterioration.
17. Common signs and symptoms of diabetic coma include all of the following, EXCEPT:
cool, clammy skin.
21. Classic signs and symptoms of hypoglycemia include:
cool, clammy skin; weakness; tachycardia; and rapid respirations.
23. Which of the following conditions is more common in women than in men?
cystitis
18. The signs and symptoms of insulin shock are the result of:
decreased blood glucose levels.
49. 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 seem 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 and adequate. In addition to high-flow oxygen, further treatment should include:
dimming the lights in the back of the ambulance and transporting without lights and siren.
21. Which of the following medications blocks the release of histamines?
diphenhydramine (Benadryl)
1. Diabetes is MOST accurately defined as a(n):
disorder of carbohydrate metabolism.
22. Esophageal varices MOST commonly occur in patients who:
drink a lot of alcohol.
34. Common side effects of epinephrine include all of the following, EXCEPT:
drowsiness.
22. Common signs and symptoms of an allergic reaction include all of the following, EXCEPT:
drying of the eyes.
16. A patient whose speech is slurred and difficult to understand is experiencing:
dysarthria.
5. The anterior aspect of the cerebrum controls:
emotion.
6. Insulin functions in the body by:
enabling glucose to enter the cells.
36. During the primary assessment of a semiconscious 70-year-old female, you should:
ensure a patent airway and support ventilation as needed.
36. Proper procedure for administering oral glucose to a patient includes all of the following, EXCEPT:
ensuring the absence of a gag reflex.
44. A patient without a history of seizures experiences a sudden convulsion. The LEAST likely cause of this seizure is:
epilepsy.
7. Patients with uncontrolled diabetes experience polyuria because:
excess glucose in the blood is excreted by the kidneys.
3. Anaphylaxis is MOST accurately defined as a(n):
extreme allergic reaction that may affect multiple body systems.
9. Ketone production is the result of:
fat metabolization when glucose is unavailable.
37. 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 cardiopulmonary resuscitation (CPR) and attach an automated external defibrillator (AED) as soon as possible.
13. Diabetic ketoacidosis occurs when:
insulin is not available in the body.
31. You are treating a 40-year-old male with a documented blood sugar reading of 300 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.
2. Type 1 diabetes:
is a condition in which no insulin is produced by the body.
21. The mental status of a patient who has experienced a typical seizure:
is likely to improve over a period of 5 to 30 minutes.
24. Chronic renal failure is a condition that:
is often caused by hypertension or diabetes.
14. A 28-year-old female patient is found to be responsive to verbal stimuli only. Her roommate states that she was recently diagnosed with type 1 diabetes and has had difficulty controlling her blood sugar level. She further tells you that the patient has been urinating excessively and has progressively worsened over the last 24 to 36 hours. On the basis of this patient's clinical presentation, you should suspect that she:
is significantly hyperglycemic.
12. In contrast to the parietal peritoneum, the visceral peritoneum:
is supplied by nerves of the autonomic nervous system, which are less able to localize pain or sensation.
10. Because the stinger of a honeybee remains in the wound following a sting:
it can continue to inject venom for up to 20 minutes.
15. 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
28. When using an auto-injector to give epinephrine, the primary injection site is the:
lateral portion of the thigh.
4. Injury to a hollow abdominal organ would MOST likely result in:
leakage of contents into the abdominal cavity.
38. 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 high-flow 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.
27. Most patients with abdominal pain prefer to:
lie on their side with their knees drawn into the abdomen.
2. Which of the following organs would MOST likely bleed profusely if injured?
liver
34. Individuals with chronic alcoholism are predisposed to intracranial bleeding and hypoglycemia secondary to abnormalities in the:
liver.
25. A strangulated hernia is one that:
loses its blood supply due to compression by local tissues.
41. You arrive at the residence of a 33-year-old woman who is experiencing a generalized 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.
5. Functions of the liver include:
production of substances necessary for blood clotting.
19. 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 severely labored breathing, and has hives over his entire trunk. You should:
maintain his airway and assist his ventilations.
45. Which of the following is NOT an assessment parameter included in the Cincinnati Prehospital Stroke Scale?
memory
33. 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 phenytoin (Dilantin) for her seizures, but has not taken it in a few days. He also tells you that she has diabetes. In addition to applying high-flow oxygen, you should:
monitor her airway and breathing status and assess her blood glucose level.
36. 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 dissipation 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.
24. While auscultating breath sounds of a patient who was stung multiple times by a yellow jacket, you hear bilateral wheezing over all lung fields. This indicates:
narrowing of the bronchioles in the lungs.
30. A patient with an altered mental status is:
not thinking clearly or is incapable of being aroused.
29. 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 carbamazepine (Tegretol). When obtaining further medical history from the girlfriend, it is MOST important to:
obtain a description of how the seizure developed.
27. 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.
34. Glutose is a trade name for:
oral glucose.
38. You are caring for a semiconscious man with left-sided paralysis. His airway is patent and his respirations are 14 breaths/min with adequate tidal volume. Treatment for this patient should include:
oxygen via a nonrebreathing mask, left lateral recumbent position, and transport.
30. 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.
3. Which of the following organs lies in the retroperitoneal space?
pancreas
9. The MOST common and significant complication associated with an acute abdomen is:
peritonitis.
19. An absence seizure is also referred to as a:
petit mal seizure.
25. Which of the following is a metabolic cause of a seizure?
poisoning
8. Excessive eating caused by cellular "hunger" is called:
polyphagia.
13. 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.
7. The kidneys help to regulate blood pressure by:
removing sodium, and thus water, from the body.
47. 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.
32. 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.
25. 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.
11. The stinger from a honeybee should be:
scraped away from the skin.
24. Which of the following conditions is NOT a common cause of seizures?
severe hypovolemia
18. A generalized seizure is characterized by:
severe twitching of all the body's muscles.
6. Which of the following organs assists in the filtration of blood, serves as a blood reservoir, and produces antibodies?
spleen
1. Solid abdominal organs include the:
spleen, kidneys, and pancreas.
23. Which of the following sounds indicates swelling of the upper airway?
stridor
29. Patients with acute abdominal pain should not be given anything to eat or drink because:
substances in the stomach increase the risk of aspiration.
40. 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, and is breathing at a normal rate with adequate depth. You should:
suction her oropharynx and apply 100% oxygen.
13. Which of the following clinical signs is MOST suggestive of a ruptured cerebral artery?
sudden, severe headache
3. Patients with type 2 diabetes usually control their disease with all of the following, EXCEPT:
supplemental insulin.
43. 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.
19. Insulin shock will MOST likely develop if a patient:
takes too much of his or her prescribed insulin.
14. Which of the following would MOST likely provide clues regarding the source of a patient's allergic reaction?
the environment in which the patient is found
4. The left cerebral hemisphere controls:
the right side of the body.
20. Hypoglycemic crisis tends to develop more often and more severely in children because:
they do not always eat correctly and on schedule.
52. Successful treatment of a stroke depends on whether:
thrombolytic therapy is given within 3 hours after symptoms began.
28. 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.
34. The MOST important treatment for a patient with severe abdominal pain and signs of shock includes:
transporting the patient without delay.
17. Which of the following negative effects of anaphylaxis will be the MOST rapidly fatal if not treated immediately?
upper airway swelling
31. The principal clinical difference between a stroke and hypoglycemia is that patients with hypoglycemia:
usually have an altered mental status or decreased level of consciousness.
25. Which of the following physiologic actions does epinephrine produce when given for an allergic reaction?
vasoconstriction and bronchodilation
10. In the presence of ileus, the only way the stomach can empty itself is by:
vomiting.
8. The parietal peritoneum lines the:
walls of the abdominal cavity.
26. Epinephrine is indicated for patients with an allergic reaction when:
wheezing and hypotension are present.
4. The two MOST common signs of anaphylaxis are:.
wheezing and widespread urticaria.
42. When obtaining medical history information from the family of a suspected stroke patient, it is MOST important to determine:
when the patient last appeared normal.
