Block 5

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A 22-year-old female patient is complaining of dyspnea and numbness and tingling in her hands and feet after an argument with her fiancé. Her respirations are 40 breaths/min. You should: Select one: A. provide reassurance and give oxygen as needed. B. request a paramedic to give her a sedative. C. have her breathe into a paper or plastic bag. D. position her on her left side and transport at once.

A 35-year-old 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: Select one: A. acute cholecystitis. B. acute cystitis. C. pancreatitis. D. appendicitis.

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: Select one: A. be alert for signs and symptoms of shock. B. determine the exact location and cause of his pain. C. transport him in a supine position. D. assess his blood pressure to determine perfusion adequacy.

A 60-year-old male presents with acute respiratory distress. He is conscious and alert, has pink and dry skin, and has respirations of 22 breaths/min with adequate depth. Which of the following treatments is MOST appropriate for this patient? Select one: A. Oxygen via nonrebreathing mask and a focused secondary assessment B. Positive-pressure ventilations and immediate transport to the closest hospital C. Oxygen via a nasal cannula, vital signs, and prompt transport to the hospital D. Assisted ventilation with a bag-valve mask and a head-to-toe exam

A 62-year-old man with a history of congestive heart failure presents with severe respiratory distress and with 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: Select one: A. apply a CPAP device, monitor his blood pressure, and observe him for signs of improvement or deterioration. B. force fluid from his alveoli by hyperventilating him with a bag-valve mask at a rate of at least 20 breaths/min. C. place him in a position of comfort, deliver oxygen via nasal cannula, and closely monitor his breathing. D. place him in a supine position and assist his ventilations with a bag-valve mask and high-flow oxygen.

A patient tells you that he has a left ventricular assist device (LVAD). Which of the following conditions should you suspect that he has experienced? Select one: A. Acute myocardial infarction B. Thoracic aortic aneurysm C. Obstructive lung disease D. Uncontrolled hypertension

A patient who is possibly experiencing a stroke is NOT eligible for thrombolytic (fibrinolytic) therapy if he or she: Select one: A. has bleeding within the brain. B. has a GCS score that is less than 8. C. has had a prior heart attack. D. is older than 60 years of age.

A patient with an altered mental status is: Select one: A. not thinking clearly or is incapable of being aroused. B. completely unresponsive to all forms of stimuli. C. usually able to be aroused with a painful stimulus. D. typically alert but is confused as to preceding events.

A patient with atherosclerotic heart disease experiences chest pain during exertion because: Select one: A. the lumen of the coronary artery is narrowed and cannot accommodate increased blood flow. B. tissues of the myocardium undergo necrosis secondary to a prolonged absence of oxygen. C. the ragged edge of a tear in the coronary artery lumen causes local blood clotting and arterial narrowing. D. the coronary arteries suddenly spasm and cause a marked reduction in myocardial blood flow.

A transient ischemic attack (TIA) occurs when: Select one: A. a small clot in a cerebral artery causes temporary symptoms. B. a small cerebral artery ruptures and causes minimal damage. C. medications are given to dissolve a cerebral blood clot. D. signs and symptoms resolve spontaneously within 48 hours.

An acute myocardial infarction (AMI) occurs when: Select one: A. myocardial tissue dies secondary to an absence of oxygen. B. coronary artery dilation decreases blood flow to the heart. C. the entire left ventricle is damaged and cannot pump blood. D. the heart muscle progressively weakens and dysfunctions.

An area of swelling or enlargement in a weakened arterial wall is called: Select one: A. an aneurysm. B. an embolism. C. atherosclerosis. D. a thrombus.

An index of suspicion is MOST accurately defined as: Select one: A. your awareness and concern for potentially serious underlying and unseen injuries or illness. B. determining the underlying cause of a patient's medical condition based on signs and symptoms. C. the EMT's prediction of the type of illness a patient has based on how the call is dispatched. D. ruling out specific medical conditions based on the absence of certain signs and symptoms.

Angina pectoris occurs when: Select one: A. myocardial oxygen demand exceeds supply. B. myocardial oxygen supply exceeds the demand. C. one or more coronary arteries suddenly spasm. D. a coronary artery is totally occluded by plaque.

Chronic renal failure is a condition that: Select one: A. is often caused by hypertension or diabetes. B. causes dehydration from excessive urination. C. occurs from conditions such as dehydration. D. can be reversed with prompt treatment.

Components of the Cincinnati Prehospital Stroke Scale include: Select one: A. arm drift, speech, and facial droop. B. arm drift, memory, and grip strength. C. facial droop, speech, and pupil size. D. speech, pupil reaction, and memory.

During the primary assessment of a semiconscious 70-year-old female, you should: Select one: A. ensure a patent airway and support ventilation as needed. B. ask family members if the patient has a history of stroke. C. immediately determine the patient's blood glucose level. D. insert a nasopharyngeal airway and assist ventilations.

Early signs and symptoms of viral hepatitis include all of the following, EXCEPT: Select one: A. jaundice and abdominal pain. B. pain in the muscles and joints. C. loss of appetite and a cough. D. vomiting, fever, and fatigue.

Erosion of the protective layer of the stomach or duodenum secondary to overactivity of digestive juices results in: Select one: A. an ulcer. B. cholecystitis. C. appendicitis. D. ileus.

In a healthy individual, the brain stem stimulates breathing on the basis of: Select one: A. increased carbon dioxide levels. B. decreased carbon dioxide levels. C. increased oxygen levels. D. decreased oxygen levels.

In contrast to the assessment of a trauma patient, assessment of a medical patient: Select one: A. is focused on the nature of illness, the patient's chief complaint, and his or her symptoms. B. almost exclusively focuses on physical signs that indicate the patient is experiencing a problem. C. is not as complex for the EMT because most patients typically present with classic symptoms. D. requires a thorough head-to-toe exam that involves a detailed assessment of all body systems.

In contrast to the parietal peritoneum, the visceral peritoneum: Select one: A. is supplied by nerves of the autonomic nervous system, which are less able to localize pain or sensation. B. is less likely to become inflamed or infected because it lines the abdominal organs themselves. C. is supplied by the same nerves from the spinal cord that supply the skin of the abdomen. D. lines the walls of the abdominal cavity and is stimulated when the solid abdominal organs contract.

In contrast to viral hepatitis, toxin-induced hepatitis: Select one: A. is not a communicable disease. B. is a far more transmittable disease. C. can be prevented with a vaccination. D. typically does not cause yellow skin.

Individuals with chronic alcoholism are predisposed to intracranial bleeding and hypoglycemia secondary to abnormalities in the: Select one: A. liver. B. brain. C. pancreas. D. kidneys.

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: Select one: A. assist ventilations, perform a rapid exam, and prepare for immediate transport. B. place a bite block in her mouth in case she has a seizure and transport at once. C. apply oxygen via nonrebreathing mask and transport her for a blood-alcohol test. D. apply oxygen via a nonrebreathing mask, place her on her left side, and transport.

Major risk factors for AMI include all of the following, EXCEPT: Select one: A. hypoglycemia. B. hypertension. C. elevated cholesterol. D. diabetes mellitus.

Most AEDs are set up to adjust the voltage based on the impedance, which is the: Select one: A. resistance of the body to the flow of electricity. B. distance between the two AED pads on the chest. C. actual amount of energy that the AED will deliver. D. direction that the electrical flow takes in the body.

Pain that may be perceived at a distant point on the surface of the body, such as the back or shoulder, is called: Select one: A. referred pain. B. radiating pain. C. visceral pain. D. remote pain.

Patients with tuberculosis pose the greatest risk for transmitting the disease when they: Select one: A. cough. B. have a fever. C. vomit. D. are bleeding.

Which of the following is NOT a common sign or symptom associated with malfunction of an implanted cardiac pacemaker? Select one: A. Rapid heart rate B. Syncope or dizziness C. Heart rate less than 60 beats/min D. Generalized weakness

Peritonitis may result in shock because: Select one: A. fluid shifts from the bloodstream into body tissues. B. severe pain causes systemic dilation of the vasculature. C. intra-abdominal hemorrhage is typically present. D. abdominal distention impairs cardiac contractions.

Prompt transport of a patient with a suspected AMI is important because: Select one: A. the patient may be eligible to receive thrombolytic therapy. B. nitroglycerin can only be given in the emergency department. C. many patients with an AMI die within 6 hours. D. 90% of the cardiac cells will die within the first 30 minutes.

Rapid, labored breathing in a patient with signs and symptoms of AMI should make you suspicious for: Select one: A. congestive heart failure. B. significant hypotension. C. right ventricular failure. D. a cardiac arrhythmia.

Risk factors for AMI that cannot be controlled include: Select one: A. family history. B. hyperglycemia. C. lack of exercise. D. excess stress.

Successful treatment of a stroke depends on whether: Select one: A. thrombolytic therapy is given within 3 hours of symptoms beginning. B. medications are given to restore the function of infarcted cells. C. surgical intervention is performed to remove obstructive clots. D. the stroke occurs within the left or right hemisphere of the brain.

The BEST way to prevent infection from whooping cough is to: Select one: A. get vaccinated against diphtheria, tetanus, and pertussis. B. wear a HEPA mask when treating any respiratory patient. C. routinely place a surgical mask on all respiratory patients. D. ask all patients if they have recently traveled abroad.

The MOST common error associated with the use of the AED is: Select one: A. failure of the EMT to ensure the battery is charged. B. inability of the EMT to recognize ventricular fibrillation. C. malfunction of the AED's internal computer processor. D. inappropriately placed adhesive defibrillation electrodes.

The head and brain receive their supply of oxygenated blood from the: Select one: A. carotid arteries. B. brachial arteries. C. subclavian arteries. D. iliac arteries.

The kidneys help to regulate blood pressure by: Select one: A. removing sodium and water from the body. B. eliminating toxic waste products from the body. C. retaining key electrolytes, such as potassium. D. accommodating a large amount of blood volume.

The left ventricle has the thickest walls because it: Select one: A. pumps blood into the aorta and systemic circulation. B. uses less oxygen than other chambers of the heart. C. receives blood directly from the systemic circulation. D. pumps blood to the lungs to be reoxygenated.

The principal clinical difference between a stroke and hypoglycemia is that patients with hypoglycemia: Select one: A. usually have an altered mental status or decreased level of consciousness. B. are typically alert and attempt to communicate with health care providers. C. always take oral medications to maintain normal blood glucose levels. D. do not present with slurred speech or weakness to one side of the body.

The principal symptom in both infectious and noninfectious gastroenteritis is: Select one: A. diarrhea. B. dysuria. C. vomiting. D. high fever.

The three major parts of the brain are the: Select one: A. cerebrum, cerebellum, and brain stem. B. midbrain, cerebellum, and spinal cord. C. brain stem, midbrain, and spinal cord. D. cerebellum, medulla, and occiput.

Three months after returning home from West Africa, a 50-year-old man begins experiencing a fever, cough, and muscle aches. The EMT should suspect: Select one: A. influenza. B. hepatitis. C. Ebola. D. whooping cough.

Treatment with continuous positive airway pressure (CPAP) would MOST likely be contraindicated in which of the following situations? Select one: A. Shortness of breath and a blood pressure of 76/56 mm Hg B. Conscious and alert patient with an oxygen saturation of 85% C. Pulmonary edema, history of hypertension, and anxiety D. Difficulty breathing, two-word dyspnea, and tachycardia

Upon initial contact with a patient who appears to be unconscious, you should: Select one: A. attempt to elicit a verbal response by talking to the patient. B. squeeze the trapezius muscle to see if the patient responds. C. assess breathing depth and determine the respiratory rate. D. direct your partner to apply oxygen via nonrebreathing mask.

When assessing for fluid collection in the lungs during auscultation of lung sounds, you should: Select one: A. start at the lower lung fields and determine at which level you start hearing clear breath sounds. B. auscultate the posterior chest first and compare the apex of one lung to the base of the opposite lung. C. note the presence of a high-pitched whistling sound, which is an indicator of fluid in the lungs. D. pay special attention to the exhalation phase because this is when you will likely hear rales or rhonchi.

When preparing to obtain a 12-lead ECG, the LL and RL electrodes should be placed: Select one: A. on the thighs or ankles. B. on either side of the chest. C. on the lower abdomen. D. anywhere on the arms.

When the level of arterial carbon dioxide rises above normal: Select one: A. respirations increase in rate and depth. B. respirations decrease in rate and depth. C. exhalation lasts longer than inhalation. D. the brain stem inhibits respirations.

Which of the following MOST accurately describes a focal-onset aware seizure? Select one: 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

Which of the following MOST accurately describes the cause of an ischemic stroke? Select one: A. Blockage of a cerebral artery B. Narrowing of a carotid artery C. Rupture of a cerebral artery D. Acute atherosclerotic disease

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

Which of the following is characteristic of peptic ulcer disease (PUD)? Select one: A. Burning or gnawing stomach pain that subsides immediately after eating B. Sharp pain that is typically located in both lower abdominal quadrants C. The passage of bright red blood in the stool or coughing up blood D. Symptom relief after taking nonsteroidal anti-inflammatory drugs

Which of the following medications is commonly given to patients with chest pain to prevent blood clots from forming or getting bigger? Select one: A. Aspirin B. Furosemide (Lasix) C. Oxygen D. Metoprolol (Toprol)

Which of the following questions would be the MOST pertinent to ask a patient who recently returned from Europe and is now ill? Select one: A. Is anyone else in your travel party sick? B. How much time did you spend in Europe? C. Will you be traveling again in the future? D. What was the purpose of your travel?

Which of the following signs is commonly observed in patients with right-sided heart failure? Select one: A. Dependent edema B. Labored breathing C. Flat jugular veins D. Pulmonary edema

Which of the following statements regarding anaphylaxis is correct? Select one: A. Anaphylaxis is characterized by airway swelling and hypotension. B. The signs of anaphylaxis are caused by widespread vasoconstriction. C. Patients with asthma are at lower risk of developing anaphylaxis. D. Most anaphylactic reactions occur within 60 minutes of exposure.

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

Which of the following statements regarding pulse oximetry is correct? Select one: A. Pulse oximetry measures the percentage of hemoglobin that is saturated with oxygen but does not measure the actual hemoglobin content of the blood. B. Caution must be exercised when using the pulse oximeter on a patient with carbon monoxide poisoning because falsely low readings are common. C. The pulse oximeter is a valuable assessment tool that measures the percentage of red blood cells that contain hemoglobin molecules. D. Most otherwise healthy patients can maintain adequate oxygenation and good skin color with oxygen saturation readings as low as 70% to 80%.

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

Which of the following statements regarding the hypoxic drive is correct? Select one: A. The hypoxic drive stimulates a person to breathe on the basis of low oxygen levels. B. Chronic carbon dioxide elimination often results in activation of the hypoxic drive. C. The hypoxic drive serves as the primary stimulus for breathing in healthy individuals. D. 100% supplemental oxygen will always cause apnea in patients with a hypoxic drive.

While auscultating an elderly woman's breath sounds, you hear low-pitched "rattling" sounds at the bases of both of her lungs. This finding is MOST consistent with which of the following conditions? Select one: A. Aspiration pneumonia B. Early pulmonary edema C. Acute asthma attack D. Widespread atelectasis

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: Select one: A. recovery position and transport. B. oral glucose gel and transport. C. high-flow oxygen and transport. D. ventilatory assistance and transport.

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: Select one: A. initiate CPR and attach an AED as soon as possible. B. assess the patient for a facial droop and hemiparesis. C. obtain a blood glucose sample to rule out hypoglycemia. D. perform CPR for 5 minutes before applying the AED.

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 valproate (Depakote) for her seizures, but has not taken it in a few days. He also tells you that she has diabetes. In addition to administering oxygen, you should: Select one: A. monitor her airway and breathing status and assess her blood glucose level. B. administer one tube of oral glucose and prepare for immediate transport. C. give her small cups of water to drink and observe for further seizure activity. D. place her in the recovery position and transport her with lights and siren.

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: Select one: A. transport the child to the hospital and reassure the mother en route. B. cover the child with wet towels and give oxygen via nasal cannula. C. call medical control and request permission to give the child aspirin. D. advise the mother to take her child to the doctor the following day.

Your EMS team is performing CPR on a 60-year-old male in cardiac arrest. You connect the AED, push the analyze button, and receive a "no shock advised" message. You should: Select one: A. perform CPR for 2 minutes and reassess. B. re-analyze the patient's cardiac rhythm. C. immediately assess the patient's airway. D. determine if a palpable pulse is present.

Your patient's past medical history includes hypertension, congestive heart failure, diabetes, and seizures. Today, he presents with signs of acute renal failure. Which of his medical problems MOST likely caused this? Select one: A. Heart failure B. Hypertension C. Seizures D. Diabetes

Your patient's symptoms include high fever, cough, vomiting, bloody diarrhea, and shortness of breath. Which of the following should you suspect? Select one: A. MERS-CoV B. Whooping cough C. Hepatitis B D. Influenza

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 high-flow oxygen, the MOST important treatment for this patient is: Select one: A. an antihistamine. B. epinephrine. C. a beta-antagonist. D. albuterol.

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: Select one: A. keep her supine and keep her warm. B. protect her airway from aspiration. C. rapidly transport her to the hospital. D. give her high-flow supplemental oxygen.

A 40-year-old patient without a history of seizures experiences a generalized (tonic-clonic) seizure. The LEAST likely cause of this seizure is: Select one: A. a brain tumor. B. epilepsy. C. a serious infection. D. intracranial bleeding.

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: Select one: A. give her one nitroglycerin and reassess her systolic blood pressure. B. administer oxygen, give her 324 mg of aspirin, and assess her further. C. obtain a SAMPLE history and contact medical control for advice. D. give her high-flow oxygen, attach the AED, and transport at once.

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 94/64 mm Hg and her heart rate is 120 beats/min. Treatment for this patient includes: Select one: A. oxygen at 2 L/min via nasal cannula. B. placing her in an upright position. C. nitroglycerin for her chest pain. D. ventilations with a BVM.

A patient who is experiencing aphasia is: Select one: A. not able to swallow without choking. B. unable to produce or understand speech. C. usually conscious but has slurred speech. D. experiencing a right hemispheric stroke.

A patient whose speech is slurred and difficult to understand is experiencing: Select one: A. dysphasia. B. dysarthria. C. dysphagia. D. aphasia.

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: Select one: A. respiratory difficulty. B. adequate air exchange. C. respiratory insufficiency. D. an obstructed airway.

An important aspect in the treatment of a patient with severe abdominal pain is to: Select one: A. administer analgesic medications to alleviate pain. B. provide emotional support en route to the hospital. C. give 100% oxygen only if signs of shock are present. D. encourage the patient to remain in a supine position.

At the onset of an acute asthma attack, patients commonly experience difficulty breathing and: Select one: A. expiratory wheezing. B. audible stridor. C. profound cyanosis. D. rales and rhonchi.

Dyspnea is MOST accurately defined as: Select one: A. labored breathing with reduced tidal volume. B. shortness of breath or difficulty breathing. C. a complete cessation of respiratory effort. D. a marked increase in the exhalation phase.

Harsh, high-pitched inspiratory sounds are characteristic of: Select one: A. wheezing. B. stridor. C. rhonchi. D. rales.

In addition to obtaining a SAMPLE history and asking questions related to the chief complaint, what else should you specifically inquire about when assessing a patient with a potentially infectious disease? Select one: A. HIV status B. Recent travel C. Sexual practices D. Drug allergies

In the presence of ileus, the only way the stomach can empty itself is by: Select one: A. muscular contraction. B. vomiting. C. spontaneous rupture. D. diarrhea.

Interruption of cerebral blood flow may result from all of the following, EXCEPT: Select one: A. a thrombus. B. cerebral vasodilation. C. an acute arterial rupture. D. an embolism.

It would be MOST appropriate for a patient to take his or her prescribed nitroglycerin when experiencing: Select one: A. difficulty breathing that awakens the patient from sleep. B. chest pain that does not immediately subside with rest. C. sharp chest pain that lasts longer than 10 to 15 minutes. D. an acute onset of dizziness during a period of exertion.

Muscle control and body coordination are controlled by the: Select one: A. brain stem. B. cerebellum. C. cerebral cortex. D. cerebrum.

Pain that radiates to the right lower quadrant from the umbilical area, nausea and vomiting, and lack of appetite are MOST indicative of: Select one: A. cholecystitis. B. appendicitis. C. pancreatitis. D. gastroenteritis.

Prior to defibrillating a patient with an AED, it is MOST important that you: Select one: A. confirm that the patient is in cardiac arrest. B. ensure that no one is touching the patient. C. perform up to 5 minutes of effective CPR. D. properly position the defibrillation pads.

Reassessment of a patient with a medical complaint should begin by: Select one: A. reassessing the nature of illness. B. repeating the primary assessment. C. taking another set of vital signs. D. reviewing all treatment performed.

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: Select one: A. place him in the recovery position and apply oxygen. B. reassess airway and breathing and treat accordingly. C. obtain a blood pressure and apply the pulse oximeter. D. transport at once and re-analyze his rhythm en route.

The MOST important treatment for a patient with severe abdominal pain and signs of shock is: Select one: A. administering high-flow oxygen. B. transporting the patient without delay. C. positioning the patient on his or her side. D. giving oral fluids to maintain perfusion.

The ability of cardiac muscle cells to contract spontaneously without a stimulus from a nerve source is called: Select one: A. impulsivity. B. automaticity. C. excitability. D. contractility.

The inferior vena cava returns deoxygenated blood to the right side of the heart from all of the following areas, EXCEPT the: Select one: A. kidneys. B. brain. C. abdomen. D. legs.

The left cerebral hemisphere controls: Select one: A. breathing and blood pressure. B. the right side of the body. C. heart rate and pupil reaction. D. the right side of the face.

The mental status of a patient who has experienced a generalized seizure: Select one: A. is easily differentiated from that of acute hypoglycemia. B. is likely to improve over a period of 5 to 30 minutes. C. progressively worsens over a period of a few hours. D. typically does not improve, even after several minutes.

The parietal peritoneum lines the: Select one: A. retroperitoneal space. B. walls of the abdominal cavity. C. surface of the abdominal organs. D. lungs and chest cavity.

The posterior tibial pulse can be palpated: Select one: A. on the dorsum of the foot. B. behind the medial malleolus, on the inside of the ankle. C. in the fossa behind the knee. D. between the trachea and the neck muscle.

The spinal cord exits the cranium through the: Select one: A. cauda equina. B. foramen magnum. C. vertebral foramen. D. foramen lamina.

Upon arriving at the residence of a patient with a possible cardiac problem, it is MOST important to: Select one: A. request a paramedic unit for assistance. B. assess the scene for potential hazards. C. determine if you need additional help. D. gain immediate access to the patient.

Ventricular tachycardia causes hypotension because: Select one: A. the right ventricle does not adequately pump blood. B. the left ventricle does not adequately fill with blood. C. the volume of blood returning to the atria increases. D. blood backs up into the lungs and causes congestion.

When caring for a patient with an altered mental status and signs of circulatory compromise, you should: Select one: A. perform a detailed secondary assessment prior to transporting the patient. B. limit your time at the scene to 10 minutes or less, if possible. C. transport immediately and begin all emergency treatment en route to the hospital. D. have a paramedic unit respond to the scene if it is less than 15 minutes away.

When caring for a patient with documented hypoglycemia, you should be MOST alert for: Select one: A. an acute stroke. B. a seizure. C. respiratory distress. D. a febrile convulsion.

When documenting a patient's description of his or her chest pain or discomfort, the EMT should: Select one: A. underline the patient's quotes. B. use the patient's own words. C. document his or her own perception. D. use medical terminology.

When the myocardium requires more oxygen: Select one: A. the AV node conducts fewer impulses. B. the arteries supplying the heart dilate. C. the heart rate decreases significantly. D. the heart contracts with less force.

When you are obtaining medical history from the family of a suspected stroke patient, it is MOST important to determine: Select one: A. if there is a family history of a stroke. B. when the patient last appeared normal. C. the patient's overall medication compliance. D. if the patient has been hospitalized before.

Which of the following assessment findings is MOST indicative of a cardiovascular problem? Select one: A. Unequal breath sounds B. Jugular venous distention C. Palpable pain to the epigastrium D. Use of the accessory muscles

Which of the following conditions is more common in women than in men? Select one: A. Hepatitis B. Cystitis C. Cholecystitis D. Pancreatitis

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

Which of the following is MOST characteristic of adequate breathing? Select one: A. 22 breaths/min with an irregular pattern of breathing and cyanosis B. 24 breaths/min with bilaterally equal breath sounds and pink skin C. 20 breaths/min with shallow movement of the chest wall and pallor D. 30 breaths/min with supraclavicular retractions and clammy skin

Which of the following is NOT a function of the sympathetic nervous system? Select one: A. Constriction of blood vessels in the digestive system B. Constriction of blood vessels in the muscles C. Dilation of blood vessels in the muscles D. Increases in the heart and respiratory rates

Which of the following is characteristic of a focal-onset aware seizure? Select one: A. Generalized twitching of all muscles B. Normal level of consciousness C. Absence of breathing D. No change in vision, smell, or taste

Which of the following organs assists in the filtration of blood, serves as a blood reservoir, and produces antibodies? Select one: A. Liver B. Spleen C. Pancreas D. Kidneys

Which of the following patients is at greatest risk for complications caused by the influenza virus? Select one: A. 50-year-old woman with moderate obesity B. 68-year-old woman with type 2 diabetes C. 12-year-old child with a fractured arm D. 39-year-old man with mild hypertension

Which of the following statements regarding hepatitis A is correct? Select one: A. Hepatitis A is primarily transmitted via contact with blood or other body fluids. B. Hepatitis A can only be transmitted by a patient who has an acute infection. C. Infection with hepatitis A causes chronic illness with a high mortality rate. D. Although there is no vaccine against hepatitis A, treatment is usually successful.

Which of the following statements regarding methicillin-resistant Staphylococcus aureus (MRSA) is correct? Select one: A. Most cases of MRSA transmission occur following an accidental needlestick. B. MRSA is a bacterium that causes infections and is resistant to most antibiotics. C. The communicable period for MRSA is 10 days to 2 weeks after being infected. D. Studies have shown that fewer than 1% of health care providers are MRSA carriers.

Which of the following statements regarding nitroglycerin is correct? Select one: A. The potency of nitroglycerin is increased when exposed to light. B. Nitroglycerin usually relieves anginal chest pain within 5 minutes. C. Nitroglycerin should be administered between the cheek and gum. D. A maximum of five nitroglycerin doses should be given to a patient.

Which of the following statements regarding the AED and defibrillation is correct? Select one: A. Defibrillation is the first link in the AHA chain of survival. B. The AED will not analyze the rhythm of a moving patient. C. CPR should be performed for 5 minutes before using the AED. D. The AED will shock any rhythm not accompanied by a pulse.

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

Which of the following veins is located inferior to the trunk? Select one: A. Subclavian B. Saphenous C. Axillary D. Cephalic

Which of the following will MOST reliably allow you to determine the nature of a patient's illness? Select one: A. Focusing solely on how the call is dispatched B. Asking questions related to the chief complaint C. Refraining from asking open-ended questions D. Trending of the patient's vital signs over time

You and your partner have achieved return of spontaneous circulation (ROSC) in a patient who was in cardiac arrest. An ALS unit will arrive in less than 2 minutes. The patient remains unresponsive and has slow, irregular breathing. Further treatment for this patient should include: Select one: A. oxygen via nonrebreathing mask at 15 L/min and immediate transport. B. bag-mask ventilation at 10 breaths/min and assessment of oxygen saturation. C. elevation of his lower extremities and covering him with warm blankets. D. insertion of an oropharyngeal airway and positioning him on his side.

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. 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: Select one: A. move the nitroglycerin patch to the other side of his chest and administer oxygen. B. remove the nitroglycerin patch, administer oxygen, and place him in a supine position. C. complete your secondary assessment and reassess his blood pressure in 5 minutes. D. remove the nitroglycerin patch and apply the AED in case he develops cardiac arrest.

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: Select one: A. assist her ventilations with a bag-valve mask. B. suction her oropharynx and transport immediately. C. administer one tube of oral glucose and transport. D. insert an oral airway, apply oxygen, and transport.

You are dispatched to an apartment complex for a young male with abdominal pain. Your priority upon arriving at the scene should be to: Select one: A. quickly gain access to the patient. B. assess the scene for potential hazards. C. place a paramedic ambulance on standby. D. notify the dispatcher of your arrival.

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 topiramate (Topamax). When obtaining further medical history from the girlfriend, it is MOST important to: Select one: A. determine when he was last seen by his physician. B. obtain a description of how the seizure developed. C. ask her how long the patient has been taking his medication. D. determine if the patient is a known alcohol abuser.

You arrive at the residence of a 33-year-old woman who is experiencing a generalized (tonic-clonic) seizure. She has a small amount of vomitus draining from the side of her mouth. After protecting her from further injury, you should: Select one: A. place a bite block in between her teeth, apply high-flow oxygen via a nonrebreathing mask, and consider inserting a nasopharyngeal airway. B. maintain her airway with manual head positioning, suction her airway to remove the vomitus, insert a nasopharyngeal airway, and administer high-flow oxygen. C. wait for the seizure to stop, manually open her airway, insert an oropharyngeal airway, and assess her oxygen saturation with the pulse oximeter. D. restrain her extremities to prevent her from injuring herself, suction her airway to remove the vomitus, and assist her ventilations with a bag-mask device.

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 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: Select one: A. perform a detailed secondary assessment and then transport him to a dialysis center. B. leave him in a sitting position, keep him warm, and prepare for immediate transport. C. place him in a supine position, elevate his lower extremities, and transport at once. D. treat for shock and request a paramedic unit to respond to the scene and assist you.

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: Select one: A. 7 B. 8 C. 6 D. 9

Your primary assessment of an elderly woman reveals that she is conscious and alert, but is experiencing difficulty breathing. She has a history of emphysema, hypertension, and congestive heart failure. As you assess the patient's circulatory status, you should direct your partner to: Select one: A. assess her oxygen saturation and blood pressure. B. administer oxygen with the appropriate device. C. perform a head-to-toe secondary assessment. D. retrieve the stretcher and prepare for transport.

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: Select one: A. vigorously palpate the abdomen to establish pain severity. B. place the patient in a sitting position and transport at once. C. administer oxygen and prepare for immediate transport. D. request a paramedic unit to give the patient pain medication.

In contrast to an automatic implantable cardiac defibrillator (AICD), an external defibrillator vest: Select one: A. does not warn when a shock is about to be delivered. B. will only deliver a shock if ventricular fibrillation occurs. C. delivers high-energy shocks, similar to an AED. D. does not require the EMT to stand clear when it shocks.

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, unilaterally diminished breath sounds, and tachycardia. What is the MOST likely cause of this patient's condition? Select one: A. Rupture of the diaphragm B. Exacerbation of his COPD C. Spontaneous pneumothorax D. Acute pulmonary embolism

A 66-year-old woman presents with a stabbing pain in the middle of her chest that radiates to her back. She tells you that the pain suddenly began about 30 minutes ago and has been severe since the onset. She has a history of hypertension, but admits to being noncompliant with her antihypertensive medications. When you assess her, you find that her blood pressure is significantly higher in her left arm than it is in her right arm. What do these signs and symptoms MOST likely indicate? Select one: A. Acute myocardial infarction B. Unstable angina C. Dissecting aortic aneurysm D. Hypertensive emergency

A 67-year-old female with severe chest pain becomes unresponsive, pulseless, and apneic during transport. You should: Select one: A. defibrillate with the AED while continuing transport to the hospital. B. perform CPR for 1 to 2 minutes and then analyze her rhythm with an AED. C. stop the ambulance, begin CPR, and attach the AED as soon as possible. D. alert the receiving hospital and perform CPR for the duration of the transport.

A dissecting aortic aneurysm occurs when: Select one: A. the aorta ruptures, resulting in profound bleeding. B. all layers of the aorta suddenly contract. C. the inner layers of the aorta become separated. D. a weakened area develops in the aortic wall.

A generalized (tonic-clonic) seizure is characterized by: Select one: A. unconsciousness for greater than 30 minutes. B. a blank stare and brief lapse of consciousness. C. severe twitching of all the body's muscles. D. a core body temperature of greater than 103°F (40°C).

A patient who presents with a headache, fever, confusion, and red blotches on his or her skin should be suspected of having: Select one: A. MERS-CoV. B. tuberculosis. C. meningitis. D. hepatitis.

A pleural effusion is MOST accurately defined as: Select one: A. diffuse collapsing of the alveoli. B. a unilaterally collapsed lung. C. fluid accumulation outside the lung. D. a bacterial infection of the lung tissue.

A strangulated hernia is one that: Select one: A. is reducible if surgical intervention occurs within 2 hours. B. can be pushed back into the body cavity to which it belongs. C. loses its blood supply due to compression by local tissues. D. spontaneously reduces without any surgical intervention.

A young female is unconscious after intentionally ingesting a large amount of aspirin. You will MOST likely find her respirations: Select one: A. rapid and shallow. B. slow and shallow. C. deep and rapid. D. slow and deep.

After sizing up the scene of a patient with a possible infectious disease, your next priority should be to: Select one: A. notify law enforcement. B. quickly access the patient. C. take standard precautions. D. contact medical control.

Albuterol is a generic name for: Select one: A. Singulair. B. Alupent. C. Ventolin. D. Atrovent.

Alkalosis is a condition that occurs when: Select one: A. the level of carbon dioxide in the blood increases. B. slow, shallow breathing eliminates too much carbon dioxide. C. blood acidity is reduced by excessive breathing. D. dangerous acids accumulate in the bloodstream.

An infectious disease is MOST accurately defined as: Select one: A. any disease that enters the body via the bloodstream and renders the immune system nonfunctional. B. a disease that can be spread from one person or species to another through a number of mechanisms. C. a medical condition caused by the growth and spread of small, harmful organisms within the body. D. the invasion of the human body by a bacterium that cannot be destroyed by antibiotics or other drugs.

Blood that is ejected from the right ventricle: Select one: A. has a high concentration of oxygen. B. was received directly from the aorta. C. flows into the pulmonary arteries. D. enters the systemic circulation.

Cardiac output may decrease if the heart beats too rapidly because: Select one: A. a rapid heartbeat causes a decrease in the strength of cardiac contractions. B. as the heart rate increases, more blood is pumped from the ventricles than the atria C. there is not enough time in between contractions for the heart to refill completely. D. the volume of blood that returns to the heart is not sufficient with fast heart rates.

Common signs and symptoms of a hypertensive emergency include: Select one: A. tachycardia, pain behind the eyes, and weakness. B. pallor, cool skin, and a temporary loss of hearing. C. a bounding pulse, a severe headache, and dizziness. D. syncope, a weak pulse, and bleeding from the ears.

Common signs and symptoms of acute hyperventilation syndrome include: Select one: A. altered mental status and bradycardia. B. anxiety, dizziness, and severe bradypnea. C. tachypnea and tingling in the extremities. D. unilateral paralysis and slurred speech.

Esophageal varices MOST commonly occur in patients who: Select one: A. have a history of esophagitis. B. have uncontrolled diabetes. C. consume a lot of alcohol. D. have weak immune systems.

Factors that increase the risk for developing methicillin-resistant Staphylococcus aureus (MRSA) include: Select one: A. prior exposure to Mycobacterium tuberculosis. B. failure to be vaccinated against any strain of hepatitis. C. prolonged hospitalization, especially in an intensive care unit. D. a history of a respiratory illness within the past 6 to 8 weeks.

Febrile seizures: Select one: A. are also referred to as absence seizures. B. occur when a child's fever rises slowly. C. are usually benign but should be evaluated. D. often result in permanent brain damage.

Functions of the liver include: Select one: A. absorption of nutrients and toxins. B. release of amylase, which breaks down starches into sugar. C. secretion of bile and filtration of toxic substances. D. production of hormones that regulate blood sugar levels.

Injury to a hollow abdominal organ would MOST likely result in: Select one: A. profound shock due to severe internal bleeding. B. pain secondary to blood in the peritoneum. C. leakage of contents into the abdominal cavity. D. impairment in the blood's clotting abilities.

Older patients with abdominal problems may not exhibit the same pain response as younger patients because of: Select one: A. progressive deterioration of abdominal organ function. B. chronic dementia, which inhibits communication. C. age-related deterioration of their sensory systems. D. interactions of the numerous medications they take.

Pain that is localized to the lower back and/or lower abdominal quadrants is MOST suggestive of: Select one: A. acute pancreatitis. B. a kidney infection. C. an aortic aneurysm. D. acute appendicitis.

Prior to attaching the AED to a cardiac arrest patient, the EMT should: Select one: A. contact medical control. B. assess for a pulse for 20 seconds. C. dry the chest if it is wet. D. perform CPR for 30 seconds.

Ten days after treating a 34-year-old patient with tuberculosis, you are given a tuberculin skin test, which yields a positive result. This MOST likely indicates that: Select one: A. the disease is dormant in your body, but will probably never cause symptoms. B. you contracted the disease by casual contact instead of exposure to secretions. C. you were exposed to another infected person prior to treating the 34-year-old patient. D. you are actively infected with tuberculosis and should be treated immediately.

The AED is MOST advantageous to the EMT because: Select one: A. it delivers an unlimited number of shocks with the same amount of energy. B. its use does not require the presence of advanced life support personnel. C. it delivers prompt defibrillation to patients with ventricular fibrillation. D. it is lightweight, easy to use, and safe for the EMT who is using it.

The MOST common and significant complication associated with an acute abdomen is: Select one: A. internal bleeding. B. high fever. C. peritonitis. D. severe pain.

The determination of whether a medical patient is a high-priority or low-priority transport is typically made: Select one: A. once the patient's baseline vital signs are known. B. as soon as the patient voices his or her chief complaint. C. after the primary assessment has been completed. D. upon completion of a detailed secondary assessment.

The electrical stimulus that originates in the heart's primary pacemaker is controlled by impulses from the brain that arrive by way of the: Select one: A. parietal lobe. B. somatic nervous system. C. autonomic nervous system. D. pons and medulla.

The frontal lobe of the brain controls: Select one: A. vision. B. touch. C. emotion. D. movement.

The greatest danger in displaying a personal bias or "labeling" a patient who frequently calls EMS is: Select one: A. discouraging the patient from calling EMS in the future. B. making the entire EMS system look unprofessional. C. overlooking a potentially serious medical condition. D. demeaning or humiliating the patient and his or her family.

The most basic functions of the body, such as breathing, blood pressure, and swallowing, are controlled by the: Select one: A. cerebrum. B. cerebral cortex. C. brain stem. D. cerebellum.

The primary prehospital treatment for most medical emergencies: Select one: A. focuses on definitive care because a diagnosis can usually be made. B. typically does not require the EMT to contact medical control. C. addresses the patient's symptoms more than the actual disease process. D. involves transport only until treatment can be performed at the hospital.

The respiratory distress that accompanies emphysema is caused by: Select one: A. repeated exposure to cigarette smoke. B. acute fluid accumulation in the alveoli. C. chronic stretching of the alveolar walls. D. massive constriction of the bronchioles.

The two processes that occur during respiration are: Select one: A. oxygenation and ventilation. B. diffusion and oxygenation. C. inspiration and expiration. D. ventilation and diffusion.

When administering supplemental oxygen to a hypoxemic patient with a chronic lung disease, you should: Select one: A. recall that most patients with chronic lung diseases are stimulated to breathe by increased carbon dioxide levels. B. avoid positive-pressure ventilation because the majority of patients with chronic lung disease are at increased risk for lung trauma. C. adjust the flow rate accordingly until you see symptom improvement, but be prepared to assist his or her ventilations. D. begin with a low oxygen flow rate, even if the patient is unresponsive, because high-flow oxygen may depress his or her breathing.

When auscultating the lungs of a patient with respiratory distress, you hear adventitious sounds. This means that the patient has: Select one: A. diminished breath sounds. B. normal breath sounds. C. abnormal breath sounds. D. an absence of breath sounds.

When caring for a patient who takes numerous medications, it is best to: Select one: A. send the patient's medications to the hospital with a family member or other person who will safeguard them. B. let the hospital staff retrieve the patient's medical records, which should show a list of his or her current medications. C. take all of the patient's medications with you to the hospital and document them on your patient care report. D. document the medications on your patient care report, but leave them at home so they do not get misplaced.

When forming your general impression of a patient with a medical complaint, it is important to remember that: Select one: A. it is during the general impression that assessment of the ABCs occurs. B. the majority of medical patients you encounter are also injured. C. the conditions of many medical patients may not appear serious at first. D. most serious medical conditions do not present with obvious symptoms.

When obtaining a 12-lead ECG, the patient should be: Select one: A. in a semi-Fowler's position with legs crossed B. in a supine position with legs elevated. C. in a supine position with legs uncrossed. D. in a semi-Fowler's position with arms raised.

When preparing to obtain a 12-lead ECG, the V1 and V2 electrodes should be placed: Select one: A. in the midclavicular line. B. in the midaxillary line. C. on either side of the sternum. D. on the left and right arms.

When transporting a stable stroke patient with a paralyzed extremity, place the patient in a: Select one: A. sitting position with the head at a 45° to 90° angle. B. recumbent position with the paralyzed side up. C. recumbent position with the paralyzed side down. D. supine position with the legs elevated 6″ to 12″.

Which of the following blood vessels transports oxygenated blood? Select one: A. Inferior vena cava B. Superior vena cava C. Pulmonary veins D. Pulmonary arteries

Which of the following cardiac dysrhythmias has the greatest chance of deteriorating into a pulseless rhythm? Select one: A. Sinus tachycardia B. Sinus bradycardia C. Ventricular tachycardia D. Extra ventricular beats

Which of the following clinical signs is MOST suggestive of a ruptured aneurysm? Select one: A. Nasal discharge of blood B. Confusion and weakness C. Sudden, severe headache D. Unilateral hemiparesis

Which of the following conditions is NOT categorized as a psychiatric condition? Select one: A. Schizophrenia B. Alzheimer's disease C. Substance abuse D. Depression

Which of the following conditions often requires transport to a hospital with specialized capabilities that may not be available at the closest hospital? Select one: A. Cardiac arrest and shock B. Diabetes and migraines C. Stroke and heart attack D. Seizures and infection

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

Which of the following findings should concern the EMT the MOST when assessing a patient who complains of a headache? Select one: A. Sinus congestion B. History of migraines C. Neck stiffness or pain D. Slow onset of symptoms

Which of the following is LEAST important when obtaining a medical history from a patient complaining of chest discomfort? Select one: A. History of cigarette smoking B. Presence of personal risk factors C. Family history of hypertension D. History of previous heart attack

Which of the following is the MOST likely cause of artifact on an ECG tracing? Select one: A. Irregular patient pulse B. Abnormal cardiac electrical activity C. Excessive movement of the patient D. Incorrect placement of the leads

Which of the following is the MOST reliable method of estimating a patient's cardiac output? Select one: A. Listen to heart sounds with a stethoscope. B. Connect the patient to an electrocardiogram. C. Assess the heart rate and strength of the pulse. D. Determine the average diastolic blood pressure.

Which of the following medications would indicate that a patient has a history of seizures? Select one: A. Hydromorphone (Dilaudid) B. Metformin (Glucophage) C. Levetiracetam (Keppra) D. Enalapril (Vasotec)

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

Which of the following patients would MOST likely demonstrate typical signs of infection, such as a fever? Select one: A. An 88-year-old male with chronic renal problems B. A 35-year-old female in the later stages of AIDS C. A 17-year-old male with anxiety D. A 3-month-old female who was born prematurely

Which of the following statements regarding the human immunodeficiency virus (HIV) is correct? Select one: A. Most patients who are infected with HIV experience chronic symptoms that vary in duration and severity. B. HIV is far more contagious than hepatitis B and is easily transmitted in the health care setting. C. The risk of HIV infection is greatest when deposited on a mucous membrane or directly into the bloodstream. D. The risk of HIV infection is high, even if an infected person's blood comes in contact with your intact skin.

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: Select one: A. an occluded cerebral artery. B. a complex partial seizure. C. a ruptured cerebral artery. D. acute hypoglycemia.

You are assessing a patient with respiratory distress and are unsure if the cause is congestive heart failure or chronic obstructive pulmonary disease (COPD). Which of the following clinical signs would be the MOST helpful in determining whether the patient has chronic heart failure or COPD? Select one: A. Altered mental status B. Cyanosis of the skin C. Jugular vein distention D. Rapid breathing

Your patient answers your questions appropriately, although her eyes remain closed the entire time. She moves each extremity on command, although her left side is weaker than the right. You should assign a Glasgow Coma Scale (GCS) score of: Select one: A. 15 B. 14 C. 12 D. 13

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 seems 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. Treatment should include: Select one: A. placing him in a supine position and transporting with lights and siren to a stroke center. B. applying warm compresses to the back of his neck and transporting with lights and siren. C. assisting him with his migraine medication and transporting without lights and siren. D. dimming the lights in the back of the ambulance and transporting without lights and siren. Feedback

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: Select one: A. esophagitis. B. acute pancreatitis. C. esophageal varices. D. Mallory-Weiss tear.

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? Select one: A. He has experienced seizures since he was 20. B. His Glasgow Coma Scale (GCS) score is 15. C. His wife states that this was his "usual" seizure. D. He is currently not prescribed any medications.

A 40-year-old man is in cardiac arrest. Your partner is performing CPR. You are attaching the AED when the patient's wife tells you that he has an automatic implantable cardiac defibrillator (AICD). The AED advises that a shock is indicated. What should you do? Select one: A. Avoid defibrillation because this will damage the patient's AICD. B. Contact medical control and request permission to defibrillate. C. Continue CPR and transport the patient to the closest appropriate hospital. D. Deliver the shock followed by immediate resumption of CPR.

A 49-year-old male presents with an acute onset of crushing chest pain and diaphoresis. You should: Select one: A. administer up to 324 mg of baby aspirin. B. administer up to three doses of nitroglycerin. C. obtain vital signs and a SAMPLE history. D. assess the adequacy of his respirations.

A 58-year-old male presents with confusion, right-sided weakness, and slurred speech. His airway is patent, and his breathing is adequate. His wife is present and is very upset. Which of the following has the MOST immediately priority? Select one: A. Documenting all of his current medications B. Administering glucose to rule out hypoglycemia C. Obtaining a complete set of baseline vital signs D. Asking his wife when she noticed the symptoms

A 58-year-old man complains of chest discomfort and nausea. He is conscious and alert; his blood pressure is 140/90 mm Hg, his pulse is 104 beats/min, and his respirations are 16 breaths/min. Your partner has applied supplemental oxygen. Prior to assisting the patient with one of his prescribed nitroglycerin tablets, you ask him if he takes medication to treat erectile dysfunction (ED), and he tells you that he does. You should: Select one: A. administer his nitroglycerin and then reassess his blood pressure. B. recall that erectile ED drugs can cause significant hypertension. C. avoid giving him nitroglycerin and transport him at once. D. ask him what he takes, how much, and when he last took it.

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: Select one: A. strangulated hernia. B. acute pancreatitis. C. kidney stones. D. aortic aneurysm.

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 supplemental oxygen, you should: Select one: A. contact medical control and administer an antihistamine. B. call medical control and ask how to proceed with treatment. C. place her in a recumbent position to facilitate breathing. D. determine if she has been prescribed a beta-agonist inhaler.

A patient in cardiac arrest is wearing an external defibrillator vest, which is interfering with effective chest compressions. The EMT should: Select one: A. perform ventilations only and allow the vest device to defibrillate. B. leave the battery attached to the monitor and remove the vest. C. remove the battery from the monitor and leave the vest in place. D. remove the battery from the monitor and then remove the vest.

A sign of respiratory distress seen in the neck is: Select one: A. muscular atrophy. B. muscular definition. C. muscular twitches. D. accessory muscle use.

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? Select one: A. Pancreas B. Liver C. Gallbladder D. Kidney

Acute coronary syndrome (ACS) is a term used to describe: Select one: A. a severe decrease in perfusion caused by changes in heart rate. B. the exact moment that a coronary artery is completely occluded. C. the warning signs that occur shortly before a heart attack. D. a group of symptoms that are caused by myocardial ischemia.

Acute pulmonary edema would MOST likely develop as the result of: Select one: A. an upper airway infection. B. severe hyperventilation. C. right-sided heart failure. D. toxic chemical inhalation.

Assessment of a patient's blood pressure with an automatic BP cuff reveals that it is 204/120 mm Hg. The patient is conscious and alert and denies any symptoms. The EMT should: Select one: A. reassess her blood pressure in 5 minutes. B. conclude that she has hypertension. C. prepare for immediate transport. D. obtain a manual blood pressure.

Asthma is caused by a response of the: Select one: A. respiratory system. B. endocrine system. C. cardiovascular system. D. immune system.

Cardiogenic shock following AMI is caused by: Select one: A. hypovolemia secondary to severe vomiting. B. widespread dilation of the systemic vasculature. C. a profound increase in the patient's heart rate. D. decreased pumping force of the heart muscle

Common signs and symptoms of AMI include all of the following, EXCEPT: Select one: A. shortness of breath or dyspnea. B. sudden unexplained sweating. C. irregular heartbeat. D. pain exacerbated by breathing.

Deoxygenated blood from the body returns to the: Select one: A. right ventricle. B. left atrium. C. left ventricle. D. right atrium.

During your treatment of a woman in cardiac arrest, you apply the AED, analyze her cardiac rhythm, and receive a "no shock advised" message. This indicates that: Select one: A. the AED has detected asystole. B. the AED detected patient motion. C. she has a pulse and does not need CPR. D. she is not in ventricular fibrillation.

Hepatitis B is more virulent than hepatitis C, which means that it: Select one: A. is less resistant to treatment. B. leads to chronic infection after exposure. C. is a more contagious type of disease. D. has a greater ability to produce disease.

Hyperventilation could be associated with all of the following, EXCEPT: Select one: A. high blood glucose levels. B. an overdose of aspirin. C. a respiratory infection. D. a narcotic overdose.

In addition to looking for severe bleeding, assessment of circulation in the conscious patient should involve: Select one: A. applying a pulse oximeter probe to the finger to determine if peripheral perfusion is adequate. B. palpating the carotid pulse to determine the approximate rate and checking capillary refill time. C. taking a blood pressure and determining if the patient is alert and oriented or confused. D. checking the radial pulse and noting the color, temperature, and condition of the skin.

In order for efficient pulmonary gas exchange to occur: Select one: A. there must be low quantities of pulmonary surfactant to allow for full alveolar expansion. B. the percentage of inhaled carbon dioxide must exceed the percentage of inhaled oxygen. C. the pulmonary capillaries must be completely constricted and the alveoli must be collapsed. D. oxygen and carbon dioxide must be able to freely diffuse across the alveolar-capillary membrane.

In what area of the lungs does respiration occur? Select one: A. Trachea B. Bronchi C. Capillaries D. Alveoli Feedback

It is especially important to assess pulse, sensation, and movement in all extremities as well as pupillary reactions in patients with a suspected ___________ problem. Select one: A. endocrine B. respiratory C. cardiac D. neurologic

Most patients are instructed by their physician to take up to _______ doses of nitroglycerin before calling EMS. Select one: A. five B. two C. four D. three

Most patients with abdominal pain prefer to: Select one: A. lie in a supine position with their knees in a flexed position. B. sit in a semi-Fowler position with their knees slightly bent. C. sit fully upright because it helps relax the abdominal muscles. D. lie on their side with their knees drawn into the abdomen.

Narrowing of the coronary arteries caused by a buildup of fatty deposits is called: Select one: A. arteriosclerosis. B. angina pectoris. C. acute ischemia. D. atherosclerosis.

Nitroglycerin relieves cardiac-related chest pain by: Select one: A. constricting the coronary arteries and improving cardiac blood flow. B. contracting the smooth muscle of the coronary and cerebral arteries. C. increasing the amount of stress that is placed on the myocardium. D. dilating the coronary arteries and improving cardiac blood flow.

Patients with acute abdominal pain should not be given anything to eat or drink because: Select one: A. digestion prevents accurate auscultation of bowel sounds. B. food will rapidly travel through the digestive system. C. it will create referred pain and obscure the diagnosis. D. substances in the stomach increase the risk of aspiration.

Prior to assisting a patient with his or her prescribed nitroglycerin, the EMT must: Select one: A. determine who prescribed the nitroglycerin. B. wait at least 5 minutes after assessing the blood pressure. C. ensure the medication is in tablet form. D. obtain authorization from medical control.

Signs and symptoms of a hypertensive emergency would MOST likely be delayed in patients who: Select one: A. have had a stroke in the past. B. regularly take illegal drugs. C. are older than 40 years of age. D. have chronic hypertension.

Solid abdominal organs include the: Select one: A. stomach and small intestine. B. gallbladder and large intestine. C. urinary bladder, colon, and ureters. D. spleen, kidneys, and pancreas.

Status epilepticus is characterized by: Select one: A. generalized seizures that last less than 5 minutes. B. profound tachycardia and total muscle flaccidity. C. an absence seizure that is not preceded by an aura. D. prolonged seizures without a return of consciousness.

The EMT should use an AED on a child between 1 month and 8 years of age if: Select one: A. his or her condition is rapidly progressing to cardiac arrest. B. special pads are used and the child has profound tachycardia. C. he or she is not breathing and has a weakly palpable pulse. D. pediatric pads and an energy-reducing device are available.

The MOST common reason that many people experiencing AMI do not seek immediate medical attention is because they: Select one: A. do not trust EMTs. B. cannot afford it. C. are elderly. D. are in denial.

The MOST significant risk factor for a hemorrhagic stroke is: Select one: A. heavy exertion. B. diabetes mellitus. C. severe stress. D. hypertension. Feedback

The iliac arteries immediately subdivide into the: Select one: A. peroneal arteries. B. posterior tibial arteries. C. anterior tibial arteries. D. femoral arteries.

The main legal risk in using the AED is: Select one: A. failure of the AED's internal computer chip. B. not assessing for a pulse after a shock is delivered. C. negligence on the part of the manufacturer. D. failing to deliver a shock when one is needed.

The purpose of defibrillation is to: Select one: A. improve the chance of CPR being successful in resuscitation. B. prevent asystole from deteriorating into ventricular fibrillation. C. cause a rapid decrease in the heart rate of an unstable patient. D. stop the chaotic, disorganized contraction of the cardiac cells. Feedback

The right coronary artery supplies blood to the: Select one: A. right atrium and posterior wall of the right ventricle. B. left ventricle and inferior wall of the right atrium. C. left ventricle and posterior wall of the right ventricle. D. right ventricle and inferior wall of the left ventricle.

The secondary assessment of a medical patient: Select one: A. should be performed at the scene, especially if the patient is critically ill. B. is typically limited to a focused exam for patients who are unconscious. C. should routinely include a comprehensive examination from head to toe. D. is not practical if the patient is critically ill or your transport time is short.

Typical chief complaints in patients with an infectious disease include: Select one: A. joint pain, muscle aches, and blurred vision. B. crushing chest pain, vomiting, and weakness. C. headache, low back pain, and arm numbness. D. fever, rash, nausea, and difficulty breathing.

When assessing a patient with a medical complaint, which of the following would MOST likely reveal the cause of the problem? Select one: A. Index of suspicion B. Primary assessment C. Baseline vital signs D. Medical history

When assessing a patient with abdominal pain, you should: Select one: A. observe for abdominal guarding, which is characterized by sudden relaxation of the abdominal muscles when palpated. B. ask the patient to point to the area of pain or tenderness and assess for rebound tenderness over that specific area. C. visually assess the painful area of the abdomen, but avoid palpation because this could worsen his or her condition. D. palpate the abdomen in a clockwise direction, beginning with the quadrant after the one the patient indicates is painful.

When assessing for arm drift of a patient with a suspected stroke, you should: Select one: A. observe movement of the arms for approximately 2 minutes. B. ask the patient to hold his or her arms up with the palms down. C. expect to see one arm slowly drift down to the patient's side. D. ask the patient to close his or her eyes during the assessment.

When performing a secondary assessment on a conscious patient with nontraumatic abdominal pain and stable vital signs, you should: Select one: A. examine the patient from head to toe. B. only palpate tender areas of the abdomen. C. prepare the patient for transport first. D. focus on his or her chief complaint.

When treating a patient with chest pain, you should assume that he or she is having an AMI because: Select one: A. angina usually occurs after an AMI. B. angina and AMI present identically. C. most patients with chest pain are experiencing an AMI. D. the cause of the pain cannot be diagnosed in the field.

Which of the following conditions is NOT a common cause of seizures? Select one: A. Poisoning or overdose B. Acute alcohol withdrawal C. Acute hypoglycemia D. Hypotension

Which of the following conditions would be LEAST likely to result in hypoxia? Select one: A. Narcotic overdose B. Pleural effusion C. Pulmonary edema D. Severe anxiety Feedback

Which of the following is a metabolic cause of a seizure? Select one: A. Massive stroke B. Head trauma C. Brain tumor D. Poisoning

Which of the following medications would the EMT be LEAST likely to administer to a patient with a medical complaint? Select one: A. Oral glucose B. Albuterol C. Aspirin D. Ibuprofen

Which of the following organs would MOST likely bleed profusely if injured? Select one: A. Gallbladder B. Stomach C. Appendix D. Liver

Which of the following statements regarding gastrointestinal bleeding is correct? Select one: A. Chronic bleeding within the gastrointestinal tract is usually more severe than bleeding that occurs acutely. B. In the majority of cases, bleeding within the gastrointestinal tract occurs acutely and is severe. C. Lower gastrointestinal bleeding results from conditions such as Mallory-Weiss syndrome. D. Bleeding within the gastrointestinal tract is a symptom of another disease, not a disease itself.

Which of the following statements regarding the pain associated with AMI is correct? Select one: A. It often fluctuates in intensity when the patient breathes. B. It is often described by the patient as a sharp feeling. C. Nitroglycerin usually resolves the pain within 30 minutes. D. It can occur during exertion or when the patient is at rest.

You and your EMT partner arrive at the residence of a 50-year-old man who complains of weakness. Your primary assessment reveals that he is critically ill and will require aggressive treatment. The closest hospital is 25 miles away. You should: Select one: A. load him into the ambulance, begin transport, and perform all treatment en route to the hospital. B. administer oxygen via nonrebreathing mask and obtain as much of his medical history as possible. C. perform a detailed secondary assessment, assess his vital signs, and then transport rapidly. D. manage all threats to airway, breathing, and circulation and consider requesting an ALS unit.

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: Select one: A. repeat the arm drift test and ensure that her palms are facing downward. B. instruct the patient to keep her eyes open and then repeat the arm drift test. 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.

You are assisting an asthma patient with his prescribed metered-dose inhaler. After the patient exhales, and before inhaling, the patient should put his or her lips around the inhaler, take a deep breath, and depress the inhale. You should: Select one: A. immediately reapply the oxygen mask and reassess his condition. B. allow him to breathe room air and assess his oxygen saturation. C. advise him to exhale forcefully to ensure medication absorption. D. instruct him to hold his breath for as long as he comfortably can.

You are dispatched to a convenience store for a patient who passed out. Upon arriving at the scene, you find two off-duty EMTs performing CPR on the patient, a 58-year-old male. Your initial action should be to: Select one: A. have the EMTs stop CPR and assess for a pulse. B. request a paramedic unit and quickly attach the AED. C. quickly attach the AED and push the analyze button. D. feel for a pulse while compressions are ongoing.

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. Your assessment reveals dried blood around her mouth, facial cyanosis, and an oxygen saturation of 88%. You should suspect: Select one: A. acute pulmonary edema. B. right-sided heart failure. C. spontaneous pneumothorax. D. acute pulmonary embolism.

You are dispatched to an apartment complex where a 21-year-old female has apparently overdosed on several narcotic medications. She is semiconscious and has slow, shallow respirations. You should: Select one: A. apply oxygen via a nonrebreathing mask and transport at once. B. place her in the recovery position and monitor for vomiting. C. insert an oropharyngeal airway and perform oral suctioning. D. insert a nasopharyngeal airway and begin assisted ventilation.

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: Select one: A. continue transporting and alert the receiving hospital. B. assist his ventilations with a bag-valve mask. C. immediately perform a rapid physical examination. D. consider requesting a rendezvous with an ALS unit.

You have just completed your primary assessment of a 48-year-old man with crushing chest pain and difficulty breathing. The patient has been given 324 mg of aspirin and is receiving supplemental oxygen. As you begin your secondary assessment, you note that his mental status has deteriorated and he is now bradycardic. You should: Select one: A. insert a nasal airway and assist his breathing. B. request an ALS unit to respond to the scene. C. continue with your secondary assessment. D. prepare the patient for immediate 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: Select one: A. obtain a complete list of all of her medications. B. administer oxygen via a nonrebreathing mask. C. apply a pulse oximeter and assess her vital signs. D. assist her ventilations with a bag-mask device

The electrical impulse generated by the heart originates in the: Select one: A. atrioventricular node. B. coronary sinus. C. sinoatrial node. D. bundle of His.

Block 5

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