Block 3

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.

The effects of epinephrine are typically observed within _________ following administration.

1 minute

a newborn will usually begin breathing spontaneously within _____ seconds following birth

15-30

a mother who is pregnant with her first baby is typically in the first stage of labor for approximately

16 hours

Which of the following patients is at highest risk for a pulmonary embolism?

71-year-old male with recent surgery to a lower extremity

If a baby is born at 7:52, the second Apgar score should be calculated at:

7:57.

You have just delivered a baby boy. His body is pink, but his hands and feet are blue. His heart rate is approximately 110 beats/min and his respirations are rapid and irregular. He has a weak cry when stimulated and resists attempts to straighten his legs. His Apgar score is:

8

You are assessing a 76-year-old man complaining of severe tearing pain radiating into his lower back. He is hypotensive and tachycardic. Which of the following should you suspect?

AAA

During your visual inspection of a 19-year-old woman in labor, you see the baby's head crowning at the vaginal opening. What should you do?

Apply gentle pressure to the baby's head as it delivers.

You have just delivered a full-term infant. His respirations are rapid and irregular, and he has a strong cry. What should you do next?

Assess the brachial or umbilical pulse.

Which of the following statements is true about acute renal failure?- Can be reversed with prompt diagnosis and treatment

Can be reversed with prompt diagnosis and treatment

Sickle cell disease is an inherited blood disorder that causes the blood to clot too quickly.

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

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

Kidney

When prioritising care for the victim of a sexual assault, the EMT should focus on _________ first.

Life-threatening injuries

Which of the following statements regarding patients with developmental disabilities is correct?

Patients with developmental disabilities are susceptible to the same disease processes as other patients.

Which of the following processes occurs during ovulation?

The inner lining of the uterus thickens in preparation for implantation.

Which of the following children would benefit the LEAST from a nonrebreathing mask?

Unresponsive 5-year-old male with shallow respirations

Which of the following patients would MOST likely have a delayed onset of an allergic reaction?

a 45-year-old male who ingested penicillin

Spina bifida is MOST accurately defined as:

a birth defect caused by incomplete closure of the spinal column.

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

Spina bifida is a developmental defect in which

a portion of the spinal cord or meninges protrudes outside of the vertebrae

A significant number of patients with cerebral palsy also have:

a seizure disorder

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

A 73-year-old female experienced a syncopal episode while watching TV. She is now conscious, but is diaphoretic, tachycardic, and hypotensive. Your assessment reveals abdominal tenderness and a pulsating mass to the left of her umbilicus. You should be MOST suspicious for:

an aortic aneurysm

A history of pelvic inflammatory disease or tubal ligations increases a woman's risk for:

an ectopic pregnancy.

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.

Upon delivery of an infant's head, you note that the umbilical cord is wrapped around its neck. You should:

attempt to slip the cord gently over the infant's head.

By the 20th week of pregnancy, the uterus is typically at or above the level of the mother's:

belly button

The only indications for placing your gloved fingers in the vagina during delivery are

breech presentations and prolapsed umbilical cord

Syncope in the older patient is:

caused by an interruption of blood flow to the brain

To which of the following diabetic patients should you administer oral glucose?

confused 55-year-old male with tachycardia and pallor

The onset of labor begins with

contractions of the uterus

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.

Common side effects of epinephrine include all of the following, EXCEPT:

drowsiness

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

dysarthria.

. A 6-year-old male presents with acute respiratory distress. His mother states that she saw him put a small toy into his mouth shortly before the episode began. The child is conscious, obviously frightened, and is coughing forcefully. You should:

encourage him to cough, give oxygen as tolerated, and transport

A 6-year-old male presents with acute respiratory distress. His mother states that she saw him put a small toy into his mouth shortly before the episode began. The child is conscious, obviously frightened, and is coughing forcefully. You should:

encourage him to cough, give oxygen as tolerated, and transport.

Proper procedure for administering oral glucose to a patient includes all of the following, EXCEPT:

ensuring the absence of a gag reflex.

Patients with uncontrolled diabetes experience polyuria because:

excess glucose in the blood is excreted by the kidneys.

Ketone production is the result of:

fat metabolization when glucose is unavailable.

Following delivery of a full-term baby, you have properly cared for the baby and have clamped and cut the umbilical cord. During transport, you note that the mother is experiencing moderate vaginal bleeding. You should:

firmly massage the uterine fundus with a circular motion

General communication techniques with the elderly

frequently asking the patient if he or she understands.

A precipitous labor and delivery is MOST common in women who

have delivered a baby before

To minimize distractions and confusion when assessing an older patient, you should:

have only one EMT speak to the patient at a time

An elderly patient may understate or minimize the symptoms of his or her illness because:A. the nervous system has deteriorated.

he or she fears hospitalization.

You are assessing a 28-year-old patient and you notice he has pinpoint pupils. You suspect a drug overdose. What drug is the likely cause of this phenomenon?

heroin

Which of the following conditions would be the LEAST likely to mimic the signs and symptoms of a stroke?

hypovolemia

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.

Which of the following is a normal physiologic change that occurs in the mother's respiratory system during pregnancy?

increased respiratory rate and decreased respiratory reserve

The amniotic fluid serves to:

insulate and protect the fetus.

By placing one hand on top of your head and the other hand over your abdomen, you are asking a hearing-impaired patient if he or she:

is sick

A nuchal cord is defined as an umbilical cord that:

is wrapped around the baby's neck.

Because the stinger of a honeybee remains in the wound following a sting:

it can continue to inject venom for up to 20 minutes

You have just delivered a premature baby. Your assessment reveals that he is breathing adequately; however, his heart rate is 90 beats/min. You should:

keep him warm and provide ventilatory assistance.

Individuals with chronic alcoholism are predisposed to intracranial bleeding and hypoglycemia secondary to abnormalities in the:

liver

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.

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.

After administering 0.3 mg of epinephrine via auto-injector to a 22-year-old woman 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.

When preparing a pregnant patient for delivery, you should position her:

on a firm surface with her elevated 2"to 4"

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

Which of the following organs lies in the retroperitoneal space?

pancreas

A 33-year-old woman who is 36 weeks pregnant is experiencing scant vaginal bleeding. During transport, you note that she suddenly becomes diaphoretic, tachycardic, and hypotensive. In addition to administering 100% oxygen, you should:

place her in a left lateral recumbent position.

Common interventions used to stimulate spontaneous respirations in the newborn include all of the following, EXCEPT:

positive-pressure ventilations.

A pregnant trauma patient may lose a significant amount of blood before showing signs of shock because:

pregnant patients have an overall increase in blood volume.

Immediately after giving an epinephrine injection, you should:

properly dispose of the syringe.

Law enforcement personnel request your assistance to assess a 31-year-old female who was sexually assaulted. When you arrive at the scene, you find the patient sitting on a curb outside her apartment. She is conscious, alert, and crying. When you ask her what happened, she tells you that she does not want to be treated or transported to the hospital. She further tells you that all she wants to do is clean up. You should:

provide emotional support and visually assess her for obvious trauma.

Following delivery of a pulseless and apneic infant who has a foul odor, skin sloughing, and diffuse blistering, you should:

provide emotional support to the mother.

If a newborn's heart rate is less than 60 beats/min following delivery, you should:

provide ventilations for 30 seconds

While examining a woman in labor, you see the umbilical cord protruding from the vagina. You should:

push the infant's head away from the cord.

Which of the following does NOT usually contribute to or cause obesity?

rapid metabolism

When caring for an elderly patient who is hearing-impaired, you should:

recall that elderly patients have difficulty hearing high-frequency sounds.

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

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.

General care for a patient with a tracheostomy tube includes all of the following, EXCEPT:

removing the tube if the area around it appears to be infected.

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:a) instruct the patient to keep her eyes open and then repeat the arm drift test.b) repeat the arm drift test and ensure that her palms are facing downward.c) defer this part of the test and assess her for facial droop and slurred speech.d) repeat the arm drift test, but move the patient's arms into position yourself.

repeat the arm drift test, but move the patient's arms into position yourself.

When enlisting the help of an interpreter who signs, it is important for you to ask the interpreter to

report exactly what the patient signs and not to add any commentary.

Eclampsia is MOST accurately defined as

seizures that result from severe hypertension.

A tube from the brain to the abdomen that drains excessive cerebrospinal fluid is called

shunt

When determining the frequency of contractions, you should time the contractions from the:

start of one to the start of the next.

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.

Which of the following signs/symptoms is considered particularly significant in gynecological emergencies?

syncope

When caring for a geriatric patient with a traumatic injury, it is important to consider that:

the injury may have been preceded by a medical condition.

A 77-year-old female presents with an acute onset of altered mental status. Her son is present and advises that she has a history of hypertension, atrial fibrillation, type 2 diabetes, and glaucoma. He further advises that she takes numerous medications and that she is normally alert. When you assess this patient, it is important to note that:

the patient is experiencing delirious behavior, which suggests a new health problem.

When caring for patients with cerebral palsy, it is important to remember that:

their limbs are often underdeveloped and are prone to injury.

PID typically does NOT affect the:

urinary bladder

Which of the following physiologic actions does epinephrine produce when given for an allergic reaction?

vasoconstriction and bronchodilation

The tip of a central venous catheter rests in the:

vena cava