Critical Care Transport

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A transferring facility administered 3 L of saline over an hour to a patient with a GI bleed who presented with a hemoglobin of 7.4 and a hematocrit of 24. The patients' labs were drawn just prior to your arrival and revealed a hemoglobin of 7.4 and a hematocrit of:

The sudden onset of abdominal pain and vaginal bleeding

A typical presentation of an ectopic pregnancy is:

Sentinel event

A(n) __________ is a patient safety event in which an error reaches a patient and results in death.

Hernia

A(n) __________ is a protrusion of an organ from its tissue lining.

Volvulus

A(n) __________ is a twisting of the intestine onto itself, usually resulting in strangulation.

A pulse check is done every 30 seconds, and compressions stop when the heart rate is greater than 60

Which of the following statements best describes appropriate chest compressions during neonatal resuscitation?

It occurs when the administration of a medication equals the rate of elimination

Which of the following statements best describes the principle of a medications' "steady state"?

Bloody or current jelly stool is typical

Which of the following statements is true regarding intussusception?

It often responds to assisted ventilation

Which of the following statements is true regarding respiratory acidosis?

The primary role of hemoglobin is to address hypoxia in utero

Which of the following statements regarding fetal hemoglobin (HbF) is true?

ACLS medications should be withheld unless the core temperature is above 86 degrees F (30 degrees C)

Which of the following statements should be considered while managing a cardiac arrest in a hypothermic patient?

Abdominal pain

Which of the following symptoms is common in patients with HELLP syndrome?

Ground CCT unit

Which of the following transport modes is safest for the transport of a patient from the scene of a MVC when weather conditions are poor?

Intra-aoritic balloon pump (IABP)

Which of the following will indicate to dispatch that the interfacility transport requires critical care transport?

Obstructions from a hernia

Which of the following would be considered a late complication of bariatric surgery?

Traumatic cardiac arrest

Which of the following would be contraindicated for rotor-wind air medical transport from a scene?

Kidneys

Which organ is the last major line of defense in pH regulation?

Pediatrics

Which population experiences serious burns the most?

Background

Which portion of the SBAR technique is the appropriate time for the CCTP to inform the receiving nurse of the patient's pertinent history?

Vaginal discharge and painful urination

Which set of symptoms most closely identifies pelvic inflammatory disease (PID)?

Beta-blockers

Which standard AMI medication could cause severe hypertension if administered to a person with a cocaine-induced myocardial infarction?

As soon as the first neonate is delivered, double-clamp the cord to prevent bleeding

Which statement is the most appropriate intervention during a multiple-gestation birthing?

Tenecteplace (TNKase)

Which thrombolytic can be administered as a single-dose bolus?

Specialty Care Transport

Which type of transport is the most expensive to operate?

Phenylephrine

Which vasopressor will increase cardiac contractility without significantly increasing the patient's heart rate?

Online medical control

While a CCTP contacts their medical director for additional medication doses, he or she is operating under:

10 mL

While accessing a Hickman catheter on a pediatric patient, which size syringe is safe to aspirate with?

Alpha and beta

While administering labetalol (Trandate) intravenously to a patinet with a hypertensive emergency, the CCTP is aware that it has __________ properties.

Ipsilateral pulse deficits

While assessing the central and peripheral pulses, providers should check one side, release, and then check the other side to evaluate for:

Normal

While auscultating the fetal heart, the heart rate is noted to be 155 beats/min. The rate is:

While calculating a GCS, you notice a motor response with hyperextension of the neck and stiff, extended extremities. What would you rate it?

To determine what antibiotic will best treat the infection

You suspect that your ventilated patient has developed bacterial pneumonia. Sputum cultures have been obtained, and culture and sensitivity testing have been ordered. The purpose of sensitivity testing is:

Sputum culture

You suspect that your ventilated patient has developed bacterial pneumonia. What lab would the hospital order to evaluate the suspicion?

You were only able to view the epiglottis during laryngoscopy. What Comack-Lehane grade do you document for this intubation?

Immediate

You're assigned to a 22-year-old patient with shrapnel present in her head, chest, and arms from an explosion. The patient has a RR of 29, absent radial pulses, and can somewhat follow commands. What triage tag do you assign this patient?

Malignant hyperthermia

__________ is a condition that occurs following administration of succinylcholine or certain inhaled anesthetic agents to genetically susceptible patients.

Necrotizing fascitits

__________ is a life-threatening or limb-threatening infection of the soft tissue that affects the subcutaneous tissue, fat, and fascia but usually spares the skin and the muscle.

Angiodysplasia

__________ is a malformation of submucosal blood vessels in the lower GI tract that leads to thin-walled, winding vessels highly susceptible to rupture.

Polyurea

__________ is a result of the osmotic diuresis that takes place in hyperglycemia or DKA.

Anaphylaxis

__________ is a serious allergic reaction that has a rapid onset of symptoms and, if unrecognized, can lead to respiratory arrest.

Acromegaly

__________ is a syndrome that results from excessive growth hormone secreted by the pituitary gland after the epiphysial plate has closed.

Bariatric surgery

__________ is a type f surgery that reduces a patient's weight in an attempt to improve the patient's overall health.

Lymphdenopathy

__________ is an increase in the size of a lymph node and indicates a high level of immunologic activity.

Cullen sign

__________ is bruising over the umbilicus.

Lactic acid

__________ is maintained when the supply of oxygen is sufficient to meet the cellular demands of the body.

A markedly elevated core temperature

__________ is the cardinal sign of heatstroke.

Osmosis

__________ is the diffusion to fluid across membranes.

False imprisonment

__________ is the intentional and unjustifiable detention of a person without his or her consent or other legal authority.

Convection

__________ is the loss of heat carried away from the body by currents of air or water.

S pneumoniae

__________ is the most common pathogen for all age groups of patients with community-acquired pneumonia.

Aspiration

__________ is the most lethal adverse event from inappropriate administration of ipecac.

Pneumonia

__________ is the number one cause of death as a result of infectious diseases?

Stress

__________ is the reaction of the mind and body to demand for change.

Epidemiology

__________ is the study of how diseases is distributed among populations and the factors that influence that distribution.

Endoscopy

__________ is used to visualize the upper GI tract to locate a source of bleeding or pain.

Septic shock

__________ is/are a leading cause of death in intensive care units (ICUs).

Congenital heart defects

__________ is/are much more likely to be cause of cardiogenic shock than other etiologies.

Laboratory and diagnostic tests

__________ may be disclosed for payment and insurance reasons.

Potassium imbalances

A CCTP should address hyponatremia in the heatstroke patient by giving fluids with caution to prevent what type of problem?

Inferior wall

A 12-lead ECG shows ST segment elevation in leads II, III, and aVF and ST segment depression in leads I and aVL. The location of this patient's suspected MI is in the:

Abrupto placenta

A 19-year-old female that is 32 weeks gestation is involved in a lateral impact MVC in an intersection. She's complaining of abdominal pain and vaginal bleeding, and has developed contractions approximately once every 10-15 minutes. Fetal heart tones are present at 160. What is her likely diagnosis?

Right atrium

A PAC has two pressure transducers that measure pressures at the __________ and pulmonary artery.

neglect

A child who appears unkempt and malnourished is most likely suffering from:

EMTALA

What guidelines determine the appropriate level of care for transportation?

Team STEPPS

A component of __________ allows a CCTP to challenge a physician's order that is unclear or that they feel may cause harm.

Deliveries

A concern of meconium __________ is meconium aspiration.

Estimation of blood glucose levels during the previous 3 to 4 months

A hemoglobin A1C lab test reviews a(n):

Coarctation of the aorta

A newborn who has a narrowing of a portion of the aortic arch will likely be diagnosed with:

Resilience

A person's ability to withstand negative pressure or "bounce back" from difficulties is known as:

Decreased

A rightward shift in the oxyhemaglobin dissociation curve causes __________ affinity for oxygen by hemoglobin.

720 degrees (two full turns)

A rotation of __________ is required to tamponade both the artery and vein and cause full testicular torsion to occur.

A cardiac arrest patient 45 minutes away from the nearest hospital

A rotor-wing aircraft should not be requested for which of the following?

Dehydration

A specific gravity of 1.150 is most likely attributable to which of the following?

Fasciotomy

A surgical incision of the tough, fibrous fasciae that separate compartments to receive pressure is called a(n):

Cardiac output (CO)

A thermistor is used for thermodilution to measure:

Sodium

Aldosterone reduces the amount of __________ lost through the sweat and salivary glands.

Hypertension and hypokalemia

Aldosteronism is a syndrome cause by an excess of aldosterone. It should be suspected in all patients with:

blue; yellow; red

All PAC catheters have standardized coloring of lumens. The right arterial (proximal) port is colored __________, the pulmonary artery (distal) port is colored __________, and the ballon-inflation port is colored __________.

Cushing triad

As ICP rises to the level of arterial pressure, the __________ begins with widened pulse pressure, bradycardia, and abnormal respiratory pattern.

Oxygen paradox

After a rapid decompression in a fixed-wing aircraft, the flight crew becomes hypoxic. After applying high-flow oxygen, they rapidly regain clear cognition followed by a period of dizziness. This condition is known as:

The HEMS crew's clinical capabilities exceed those of ground providers

Air medical transport improves mortality when:

Slow or rapid

Aircraft depressurizations are categorized as either:

A sodium bicarbonate infusion

Although the subject of much controversy, profound acidosis (pH < 7.0) in DKA is usually treated with:

Limb ataxia

All of the following are symptoms of left hemispheric ischemic stroke EXCEPT:

Hypocarbia

All of the following will increase ICP, EXCEPT:

Narcotic overdose

As with adults, a child with bilaterally constricted pupils is most consistent with:

Wolff-Parkinso-White syndrme

As you are managing a patient with palpitations, you notice the presence of slurred upstroke in the QRS complex. What underlying condition do you suspect?

Administer oxytocin after the placenta is delivered

An appropriate measure to manage postpartum hemorrhage is to:

Carboxyhemoglobin

An elevated __________ can cause a falsely evaluated pulse oximetry level.

Carboxyhemoglobin

An elevated __________ can cause falsely elevated pulse oximeter level.

Glucose

Anaerobic metabolism represents the breakdown of __________ to create adenosine triphosphate (ATP) for energy.

Pituitary

Antidiuretic hormone is secreted from the posterior __________ gland.

Buffer

Any substance that can alternately bind or release H+ depending on outside conditions is called a:

Metabolic acidosis

Arterial blood gas (ABG) studies of a patient in the compensatory stage of shock generally show a low pH, which is indicative of:

At 15,000 feet (4.6 km), a healthy person's PaO2 will decrease to approximately __________ mmHg.

Delay the flight until the night pilot is available or turn the flight over to another service

At 6:00 pm on a busy rotor-wing flight shift you receive a request for an interfacility transport of a critically ill patient. The requesting hospital is 186 miles (299 km) distant, and will require approximately 90 minutes of flight time to get to the patient. The pilot shift change is at 7:00 pm. Which of the following is your best option?

Personal safety has been ensured

At a hazardous materials (hazmat) scene, patient assessment and treatment should occur only when:

Warm zone

At a hazmat scene, the zone where decontamination occurs is called the:

Accepting nurse signature on your PCR

At the receiving facility, what documentation is required by the crew?

Carina

At what point does the gum elastic bougie meet resistance during proper airway management?

Decreases

Atmospheric humidity increases as altitude:

30%

Bacterial meningitis is fatal in up to __________ of patients.

During an aircraft's descent from altitude

Barotitis media generally presents:

Transportation of the great vessels

Based on the current classifications of congenital heart disease, which anomaly causes mixed blood flow?

Tetralogy of Fallot

Based on the current classifications of congenital heart disease, which anomaly decreases pulmonary blood flow?

Coarctation of the aorta

Based on the current classifications of congenital heart disease, which anomaly obstructs blood flow from the heart?

Irregular

Because the respiratory control center in infants is immature, their respiratory pattern is often:

Specific

Beta-2 transferrin is a test performed on drainage or body fluids suspected of being cerebrospinal fluid. It is negative in fluids that do not contain some component of CSF. This test is BEST described as:

Myocardial contusion

Blunt trauma to the anterior chest wall often results in:

Growth hormone

Bromocriptine (Parlodec) is a dopaminergic agonist that is used to decrease the secretion of:

Pharmacokinetics

By understanding the __________ of RSI medications, the CCTP knows that succinylcholine will last for approximately 5-10 minutes. This means that postintubation pharmacological management must be in place before then.

Specialty Care Transport

CMS defines __________ as the use of specialized equipment and specialized training beyond the paramedic scope of practice to manage critically ill patients from facility to facility.

Decrease

Cabin humidity will __________ during a long-range, high altitude, fixed-wing flight lasting more than 4 hours.

Thyroxine

Calcitonin and __________ are secreted by the thyroid gland.

Yes

Can a hospital-owned helipad be utilized by EMS as a pickup point for the transport of a patient to another hospital without EMTALA being triggered?

Poorly defined margins in the scalp

Caput succedaneum is a subcutaneous collection of fluid with:

200 to 270

Carbon monoxide (CO) has an affinity for hemoglobin __________ times greater than that of oxygen.

mL/beat

Cardiac stroke volume (SV) is measured in:

6.8; 7.8

Cell death begins to occur when the pH falls below __________ or above ____________.

Femoral vein

Central venous lines placed in the __________ put the patient at the highest risk of infection.

Right

Chronic obstructive pulmonary disease (COPD) will typically produce a(n) __________ axis deviation.

Sickle cell anemia

Children with which of the following disorders are at an increased risk of cerebrovascular accidents?

Hashimoto

Chronic lymphocyctic throiditis is also known as ___________ disease.

104 F (40 C)

Core body temperatures that exceed __________ result in decreased short-term memory, degraded motor skills, and general decrease in performance.

Completely bind to both receptors to inhibit stimulation

Class II antiarrhythmic medications:

Vasodilation

Class IV antiarrhythmic medications affect the impulse-generating and depolarizing activities of the sinotrial and atrioventricular nodes. As a result, the effects of the medications are negative chronotropy, negative inotropy, negative dromotropy, and:

Altered mental status

Classic symptoms seen in bacterial meningitis include fever, nuchal rigidity, and:

Acidic substances

Coagulation necrosis, which limits the depth and extent of injury, is caused by exposure to:

Is lower

Compared with the pregnant mother, the oxygen content of the fetus:

Preventing an exposure

Concerning human immunodeficiency virus (HIV), the most important method of protection for the CCTP is:

3 to 5 mintues

Cooling is only effective if performed within the first 2 minutes and does not continue for longer than:

102 degrees F (38.8 degrees C)

Cooling of a heatstroke patient should be continued until the rectal temperature falls below:

Crawling is an important development milestone that occurs at approximately __________ months.

Continuous monitoring and drugs of equipment required to sustain life

Critical care is the management of patients with life-threatening conditions that requires:

91 mmHg

What is the cerebral perfusion pressure of a patient with a BP of 160/84 and an ICP of 18?

Murphy's

During an abdominal assessment, you palpate deeply into the right upper quadrant. The patient immediately responds with severe pain during the palpation. This is a positive __________ sign.

During an abdominal exam of a known pregnant patient, the CCTP measures 32 cm from the top of the fundus to the symphysis pubis. Based on this finding, the pregnancy is at least __________ weeks' gestation.

Sodium bicarbonate

During an interfacility transport of a 24-year-old line worker who fell from a telephone pole, you notice a decrease in sensation. His Foley bag has put out 300 mL of tea-colored urine over the last 90 minutes. His ECG is normal sinus without any abnormalities. After administering 2 L of saline, what should be your next management step?

Abdomen

During an interfacility transport of a patient with a resuscitative endovascular balloon occlusion of the aorta in place, you notice on the radiology report that it's placed between the left subclavian and the celiac trunk. Where do you suspect the source of the patient's hemorrhaging is?

Dysphagia, dysphonia, drooling, and distress

Epiglotittis is a medical emergency in the pediatric population. Remember the four D's which stand for:

It affects dopaminergic receptors, causing increased cardiac output

Dopamine is an important catecholamine with many users. Which of the following statements is true regarding dopamine?

Increased work of breathing

Due to their immature immune systems, neonates are at especially high risk for pneumonia. Which of the following symptoms is most likely associated with a pneumonia presentation?

Acetylcholine

During RSI procedures, chemical paralytic agents are used. What neurotransmitter is affected by these agents?

Midazolam

During a dislocation, what medication may help the muscles relax and help facilitate respositioning?

Gastric decompression with an orogastric tube

During a neonate resuscitation, BVM ventilations have been ongoing for 10 minutes. Which of the following should be considered?

During the second trimester

During a normal pregnancy, blood pressure (BP) will decrease as a result of progesterone relaxing the walls around the blood vessels. When will the BP typically reach its lowest point during pregnancy?

Estrogen

During a normal pregnancy, which hormone is continually released in order to support the pregnancy?

Level of consciousness

During the subjective assessment, the patient's general appearance is noted. Which of the following is a component of the general appearance?

Auscultate for bilateral breath sounds

During transport of a mechanically ventilated patient, the high-pressure alarm has continued to sound. You've ensured that there are no obstructions. What should you do next?

IV administration is an approved route

During transport, your patient suddenly has a change in affect and mental state, becoming bizarre, agitated, and restless. In a matter of a few minutes, the patient becomes out of control and necessitates restraints. The most recent vital signs are: blood pressure 144/82 mmHg; heart rate 92 beats/min; respirations 20 breaths/min; SpO2 99%. All other possible causes have been ruled out other than psychosis. Your standing orders call for haloperidol (Haldol), 10 mg intramuscularly. Which of the following statements is true regarding haloperidol?

Clubbed fingers

During your assessment, you note that the angle between the nail and the nail bed is greater than 160-degrees. What is this known as?

Alternation of swallowing and gag reflexes

Dysfunction of cranial nerves IX and X would manifest as:

Increased oxygen demand

Exposure to stressors in aircraft, such as vibration, temperature, noise, and humidity can cause:

80 mL/kg

Estimate __________ of body weight for a child's circulating blood volume.

Hypertension, edema, and proteinuria

Preeclampsia is defined as the presence of:

22, 24

Fetal viability is possible between __________ and __________ weeks' gestation.

Scapula

Flatness on percussions is noted as a normal finding over the:

Calcium gluconate gel

For burns from hydrofluoric acid, what needs to be applied immediately after irrigation?

A chlorhexidine solution

For central line placement, skin decontamination should be accomplished using:

10 breaths/min

For every 1 degree C rise above 37 degrees C, how much does the respiratory rate change in pediatric patients?

Milrinone or dopamine

For treatment of cardiogenic shock in a pediatric patient, which of the following is an acceptable choice?

Furosemide works in the loof of Henle

Furosemide (Lasix) is a commonly used diuretic in the treatment of volume overland. Which of the following statements regarding furosemide is true?

Congenital abdominal wall defects

Gastroschisis and omphalocele are both types of:

1.5 million

Globally speaking, tuberculosis (TB) causes the death of approximately __________ people per year.

Cellular respiration

Glycolysis, Kreb's cycle, and the electron transport chain are the three essential components of which of the following processes?

Cell-mediated

HIV infects CD4+ helper T cells and kills them, resulting in the suppression of __________ immunity.

Sodium loss

Heat cramps are a result of:

80%

Heatstroke has a mortality rate as high as __________ in untreated patients.

Brush it off with gloved hands

How does a CCTP stop the burning process of a dry chemical powder?

Inotropic effect

How does dobutamine (Dobutrex) assist patients in heart failure?

Motor posturing

ICP monitoring may be indicated for patients with severe TBI and a normal CT scan if two or more of the following criteria are present. The criteria include being over the age of 40, __________, and/or a systolic blood pressure less than 90 mmHg.

7 g/dL

In a patient with acute upper GI bleeding, blood administration is indicated when hemoglobin goes below:

The second lumber vertebra

In a patient with normal spine anatomy, the spinal cord ends at the level of:

Over the fourth intercostal space at the midclavicular line

In a school-aged child, where is the best place to auscultate heart sounds?

Cerebral vasodilation from hypoxia

High-altitude cerebral edema (HALE) is thought to be a result of:

A congenital anomaly that results in arrested peristalsis

Hirchsprung disease is:

Utilize positive pressure ventilation

How can a CCTP manage a patient's flail chest segment?

Mandatory competency training

How do critical care transport services ensure that their providers maintain proficiency?

Urine output measurements

How do you evaluate and titrate fluid resuscitation for burn patients?

All of these are correct (sexual contact; exposure to infected blood; perinatal transmission)

Human immunodeficiency virus (HIV), the causative agent of acquired immunodeficiency syndrome (AIDS) can be spread through:

15 to 20 L

Human kidneys can excrete up to __________ of free water each day.

Hydralazine

Hypertension refractory to ACEIs can be treated with:

Oxygen

In aerobic metabolism, the ultimate acceptor of electrons is:

2 to 3 L

In general, an average adult takes in about __________ of fluid throughout an average day.

Compression of the inferior vena cava

In later stages of pregnancy, the peripheral venous pressure risks progressively due to:

60 to 90

If 100% oxygen is administered to a patient with carbon monoxide poisoning, it reduces the CO half-life to __________ minutes.

Inotrope administration

If a CCTP notices a patient with a negative deflection in lead I, lead II, and aVF, what intervention should they prepare to perform?

10 mmHg

If a patient received aggressive fluid resuscitation with 2 liters of saline when they were already hypertensive, what CVP value would you expect to find?

Sacrum

If it were present, where would you find pitting edema of an 85-year-old male patient who is bed confined?

Receiving facility physician

In preparation for transport, the sending facility physician must have identified and communicated with a __________ in order to initiate the patient transfer.

In the 1990s, the Harvard Medical Practice Study reported that almost __________ of hospitalized patients suffered from significant adverse events during their care.

Waxy

In the case of frostbite, the surrounding tissue may appear:

Jimsom weed

What recreational drug can cause a patient to develop anticholenergic syndrome?

Activated charcoal

Initial gastrointestinal decontamination for acetaminophen toxicity is done using:

Blunt

Injuries are generally classified as penetrating or __________ trauma.

Federal Aviation Administration (FAA)

Instrument Flight Rule (IFR) approaches at airports, helipads, and designated landing zones are certified by the:

Two healthcare facilities

Interfacility transport is the transport of a patient between:

Handoff reports

Issues with communication with __________ have resulted in loss of key patient information.

Hypoglycemia

Jitterness is often confused with a seizure. Jitterness is most commonly seen with:

Lactate levels less than __________ mmol/L considered within normal ranges.

Lactate levels less than __________ mmol/L is considered within normal ranges.

Enzyme

Lactose intolerance, or the inability to digest lactose (a sugar found in milk products), is due to a deficiency in lactase. This catalyst lactase, which facilities the biochemical reaction required to transform lactose into glucose and galactose, is known as a(n):

Bradycardia

Late findings consistent with increasing intracranial pressure (ICP) are hypertension, irregular respirations, and:

Intrauterine demise

Loss of the fetus after 20 weeks' gestation is called:

Paresthesias

Major signs and symptoms of compartment syndrome include pain, pallor, paralysis, __________, and pulselessness.

Injection of intramuscular epinephrine

Management of anaphylaxis must include the __________ as a high priority.

Inciting antigen

Management of anaphylaxis must include the removal of the:

Increased pulmonary artery pressure

Mechanically ventilation and/or positive end expiratory pressure (PEEP) will artificially:

Just culture

Medical errors during critical care transport regularly result in harm or potential harm to patients. Viewing these errors as the outcomes of human-error, at-risk behavior, or reckless behavior is a concept designed to differentiate the different types of error, and is also known as:

It has both venous dilating and coronary artery dilating effects

Nitroglycerin (a nitrate) is useful in ischemic heart disease. Which of the following statements is true regarding nitroglycerin?

C1 - C2

Which level of the neck is the most susceptible to injury from a mechanical standpoint?

Pathogens

Microorganisms capable of causing disease are called:

Right cranial nerve III

On examination of the ocular movements, your patient is unable to look temporally with the right eye. What cranial nerve is affected?

90 degrees F and 95 degrees F (32.2 degrees C and 35 degrees C)

Mild hypothermia, by definition, is a core body temperature between:

An increased inotropic effect (increased cardiac output) occurs without a dromotropic or chronotropic effect

Milrinone (Primacor) is a phosphodiesterase inhibitor. Which of the following statements about the positive effect of increasing cardiac output with milrinone is true?

Emancipated minors

Minors who have assumed most adult responsibilities before reaching the age of majority, such as those who are married, pregnant, in the armed forces, or financially independent and living away from home, are known as:

Motor vehicle collisions

More than 50% of the time, pelvic fractures are the result of:

-3, 9

Most humans can survive forces between __________ g and __________ g.

Primary or secondary

Multiple organ dysfunction syndrome (MODS) can usually be classified as either:

Vecuronium (Norcuron)

Which medication has the longest duration?

Antipsychotics

Neuroceptic malignant syndrome (NMS) is a potentially fatal reaction to what class of medications?

Sympathetic tone

Neurogenic shock is a form of distributive shock caused by loss of:

Spinal fluid

Neurogenic shock results from conditions that impede the ability fo the sympathetic nervous system to control the constriction and dilation of __________ walls.

Distributive

Neurogenic, septic, and anaphylactic shock are classified as what type of shock?

Bends

Nitrogen gas bubbles in the joints or the folds of the intestine tract are often referred to as the:

30%

Nonfunctioning adenomas, which account for __________ of pituitary lesions, are tumors that do not secrete hormones.

Stressors

Nonprescription medications can have an effect on the CCTP's ability to deal with the __________ of aeromedical transport.

Between 70 mg/dL and 100 mg/dL

Normally, blood glucose levels should be:

Whether to accept a flight

One aspect of crew resource management (CRM) in which all members of the crew should hold equal empowerment is the decision of:

Bloodwork analysis

One assessment tool that is available during interfacility transports that may not be available during scene transports is a(n):

Tachycardia

Of the two hyperglycemic states, which of the following is only found in DKA?

2,000 feet (0.6 km)

One ounce (295 mL) of alcohol is the physiologic equivalent of __________ of altitude.

Pericardial tampnade

Patient deterioration secondary to chest trauma that occurs over 24 hours or more may be the only sign of __________ that is seen other than hypoxia.

Vestibular

Organs of equilibrium in the ear provide __________ sensory information.

Efficiency

Overtriage of rotor-wing air medical utilization would go against which IOM Quality Aim?

Slurred speech

Patient's with a subarachnoid hemorrhage will usually present with the worst headache of their life, __________, and hypoxia.

Progressive hoarseness

Patients who have __________ should immediately receive RSI due to airway concersn.

Seizures

Patients with a history of or injury predisposing them to __________ should be protected from the effects of flicker vertigo.

Acetaminophen

Patients with a know oral opioid overdose should also be evaluated for the presence of:

50%

Patients with moderate or severe traumatic brain injury present with some form of AI in approximately __________ of injury cases.

6 to 12

Peak effects from oral ingestion or cardiac glycosides occur in __________ hours.

Succinylcholine (Anectine)

Which medication has the shortest onset of action?

Rhabdomyolysis

Renal dysfunction that results from the mobilization of muscle proteins that impair filtration is a condition known as:

Per the Federal Aviation Regulations (FAR), no person may attempt to operate as a crew member of a civil aircraft until __________ hours after consumption of any alcohol beverage.

86 degrees F (30 degrees C)

Repeated defibrillation in hypothermia-induced ventricular fibrillation is not recommended until the patient has been warmed to a core body temperature of:

Persistence of elevated pressures in pulmonary vasculature after birth

Persistent pulmonary hypertension (PPHN) is:

Decreased cardiac output

Potential hazards of positive-pressure mechanical ventilation are pneumothorax, subcutaneous emphysema, and which of the following?

Preterm labor is defined as the onset of labor before __________ weeks' gestation.

Conn

Primary aldosteronism is usually caused by a tumor of a single adrenal gland that overproduces aldosterone. This is also known as __________ syndrome.

Cardiac output

Primary management cardiogenic shock is focused on enhancing __________ while decreasing left ventricular workload.

Ethanol

Which of the following antibodies can be used for methanol and ethyline glycol toxicity?

Formitic class of invader

Properties of microbes that influence their virolence include all of the following except:

Benchmarking

Providing data from your transport system and participating in a database that compares it to other transport systems is:

On ascent

Pulmonary overpressurization syndrome (POPS) occurs:

Dyne-sec/cm-5

Pulmonary vascular resistance is measured in:

Scope creep

Requiring EMS providers to make decisions they are not trained to make, based on the availability of new procedures, interventions, and diagnostic tools, is known as a type of:

The destruction of muscle tissue

Rhabdomyolysis may release excess potassium from:

Anterior, posterior, and midaxillary

Routine respiratory assessment mandates that the lungs should be auscultated in which areas?

Thyroid storm

Severe thyrotoxicosis is also known as:

Decompensated

Shock will progress to a(n) __________ phase if the underlying cause remains untreated.

It may cause transient muscle fasciculation

Succinylcholine (Anectine) is used during RSI as a neuromuscular blocker. Which of the following statements is true of succinylcholine?

Comorbidity

Susceptibility of disease is determined by all of the following factors except:

Salicylates

Tachypnea and tinnitus are hallmark presumption signs of which of the following toxicologic overdoses?

All of these are correct

Treatment for a vulvular hematoma includes which of the following?

Beta-adrenergic agonists

Treatment for drowning patients who are recovered from the water may include:

Company incident reports

The HIPAA Privacy Rule applies to which of the following?

Brain, blood, and cerebrospinal fluid

The Monro-Kellie doctorine describes the contents of the cranial vault as:

aVR

The P-wave is purely negatively deflected in lead:

600

The United States averages more than __________ heat-related deaths each year.

Bell UH-1

The __________ allowed medical care to be rendered during transport.

Rule of nines

The __________ is the most common formula in the prehospital setting used to estimate body surface area burned.

Sodium

The blood-brain barrier is readily permeable to all of the following EXCEPT:

Thermoregulation

The body's ability to ensure and maintain a balance between heat production and heat elimination is known as:

The fight-or-flight response

The body's response to physical or emotional stress is referred to as:

Prevent fluid overload if the IV pump malfunctions

The buretrol is an intravenous (IV) device that is sometimes used in pediatrics. Its purpose is to:

It is an extracellular cation

The chemical formula for salt is NaCl. NA represents sodium in the equation. What BEST describes the NA ion?

100%

Treatment of necrotizing fascitis with antibodies alone, without surgical intervention, is associated with a nearly __________ morality rate.

Increased appetite

The clinical features of hepatitis A virus (HAV) include all of the following except:

Liver transplantation

The cure for advance cirrhosis is:

Vasospasm

The differential diagnosis from frostbite include cyanosis, __________, and arterial occlusion.

Dantrolene sodium

The drug of choice for treating malignant hyperthermia is:

The time it takes for a medication at the target tissue to reach a minimum effective level

The drug principle of "onset of action" is defined as:

Sleeve gastrectomy

The first part of a biciopancreatic diversion with duodenal switch requires that the patient undergo which surgery?

The value is increased

What happens to the pressure reading if the transducer is placed mid-chest in the eighth intercostal space.

Mean arterial pressure

What helps drive the treatment of a stroke patient?

Henry's Law

The gas law that states that the amount of a gas in a solution varies directly with the partial pressure of a gas over the solution is known as:

The lower limit for cerebral autoregulation in neonates is not known, but it is thought to be near a cerebral perfusion pressure of:

17 to 20 mL/100 mL

The normal arterial oxygen content is:

Endocrine

The pancreas is considered both a(n) __________ and an exocrine gland.

Lower

Utilizing a noninvasive blood pressure (NIBP) cuff hat is too large will result in the measurement being __________ when compared to the patient's actual BP.

Sterile cockpit

What is a potential contraindication for aeromedical transportation?

Percussion

The physical finding of resonance is found during what physical assessment skill?

Transports, diffuses

The physiology of capillary pressure reveals that hydrostatic pressure __________ and osmotic pressure __________.

Liver ciaphosis

What is a root cause of esophageal varices?

Passive

The passing of antibodies from the mother to her infant through breast milk is an example of __________ immunity.

Physiologic derangement and loss of consciousness

The pathophysiology of traumatic brain injury (TBI) emphasizes the importance of which two types of injury?

A near miss

The patient's IV line gets caught on the transferring facility's bed as you're leaving and the RT adjusts the tubing so you can leave without an issue. What is this considered?

January and February

The peak season for respiratory syncytial virus (RSV) in the United States of usually:

Wolf-Parkinson-White (WPW) Syndrome

The people with __________, the bundle of Kent does not have the same ability to slowly conduct electrical impulses as it does through the AV node.

SaO2

The percentage of potential oxygen-binding sites in hemaglobin that are occupied by oxygen molecules is reflected by which of the following values?

5 to 7

The pharmacodynamic principle of "half-life" refers to the amount of time for one-half of the drug to be eliminated. Generally speaking, for most medications the number of half-lives until a drug has no more effect is:

Master gland

The pituitary gland is commonly referred to as the:

Respiration

The placenta, not the lungs, acts as the organ of __________ during fetal gestation.

Hematochezia

The presence of bright red blood in the stool is known as:

Tachycardia

The presence of hypotension, __________, and abnormal temperature in the setting of an infection is clinically indicative of sepsis.

An ectopic pregnancy

The presentation of an ovarian torsion may appear similar to that of:

PEEP

The pressure above ambient pressure that is present in the airway at the end of the respiratory cycle is known as:

Routine hand washing

The prevention of colonization by pathogenic bacteria is attributed to:

Adenosine triphosphate (ATP)

The primary energy-carrying molecule in the body is:

Active

The process of developing antibodies and activating T cells in response to invading agents is called __________ immunity.

Root-cause analysis

What is a systematic approach to understanding the causes of serious adverse events and helps identify system flaws that must be corrected in order to mitigate future incidents?

Working diagnosis

What is an assumed decision on the patient's condition based on available information?

Is the highest priority for all responders

The safety of the transport team and emergency responders is __________ in the approach to a poisoned or overdosed patient.

weather

The single greatest hazard to HEMS operations is:

Acute

The three stages of HIV infection are __________, latent, and late.

Anterior, posterior

The two lobes of the pituitary gland are the __________ and the __________.

Innate

The type of immunity an individual is born with is known as __________ immunity.

Simulation

The use of __________ allows health care providers to hone their skills in a safe environment without risk of patient harm.

Air medical transport

The use of __________ has benefitted critically ill or injured, and those who would have a negative outcome due to prolonged transport.

Coagulation

The zone of __________ comes in direct contact with the heat source and receives the most damage.

Acknowledging that organizations engage in high-risk behavior

What is needed to develop a safety culture?

Verification by two licensed providers

What is often required prior to any blood administration by a CCTP?

Zeroing

What is the CCTP doing when they open the transducer to atmospheric air to obtain a baseline reading?

Ligament of Treitz

What is the anatomic location that demarcates GI bleeds into upper and lower classifications?

Excessive drooling

What is the cardinal sign of epiglotitis?

Open cricothyrotomy

What cricothyroid method requires the CCTP to incise the patient's skin and cricothyroid membrane, this allowing them to place a tracheostomy tube?

Seldinger technique

What cricothyroid method requires the CCTP to insert a catheter and guide-wire, this allowing them to place a tracheostomy tube over the guidewire and into the airway?

Respiratory droplets

Transmission of hepatitis B virus (HBV) can occur by all of the following methods except:

Neuropathy

Tricyclic antidepressants and prescribed as last-resort antidepressants; they are also used in the treatment of chronic pain, __________, and migraines.

Patient volume status

What determines renal failure classification?

Chest radiograph

What diagnostic tool does the ED use to confirm the placement of an ET tube?

Tachycardia and tachypnea

Two o the most common signs and symptoms of compensatory shock are:

Preeclampsia and trauma during prenancy

Two of the leading causes of neonatal mortality are:

Guide wire

What does a CCTP need so they can place a pigtail catheter?

Allen test

What does a provider need to do prior to performing an arterial puncture in the radial artery?

RIght-sided heart failure

What does distension of the external jugular veins indicate?

Tone, interactiveness, consolability, look (gaze), speech (cry)

What does the acronym TICLS stand for?

NCLEX-RN

What exam must candidates pass in order to obtain nursing licensure?

Aldosterone and cortisol

Underproduction of __________ caused by decreased functioning of the adrenal cortex is called adrenal insufficiency (AI).

Diabetic ketoacidosis

Untreated hyperglycemia in a patient with type I diabetes will progress to:

Increased alcohol consumption

Unusual or unexpected physical activity, not eating enough food, and __________ can cause hypoglycemia in diabetics.

Jejunostomy (J)

What gastrointestinal tube has the lowest aspiration risk for the patient?

Bicarbonate

Venous CO2 levels measure the amount of __________ in a venous sample.

Ventilator-associated pneumonia (VAP) is a type of hospital-acquired pneumonia (HAP) that appears more than __________ hours after endotracheal intubation.

Titrating ventilations to a CO2 level of 30 - 35 mmHg

Ventilatory management with an advanced airway for a patient with increased ICP includes:

Gum elastic bougie

What 60-cm tool has a 30-degree bend at the distal tip and can be used during intubation, allowing the CCTP to feel clicks as it passes tracheal rings?

ST elevation in V4R

What ECG finding may cause you to withhold nitroglycerin from a chest pain patient?

When the body's head enters the birth canal

What action signals the start of the second stage of labor?

Surgical airway kit

What additional airway equipment must the CCTP have ready while intubating a patient with inhalation burns?

Medications are rarely needed because infants can be resuscitated with effective ventilatory support

What should the CCTP consider during neonatal resuscitation?

Bulging fontanelles

What sign of meningococcal infection is found only in infants and young children (not older children)?

Efficiency

When a clinician utilizes premixed infusions instead of mixing their own infusion, they are meeting the Institution of Medicine's __________ Quality Aim.

Side effects may be expected based on how the medication works

When administering any medication, the CCTP should be aware of medication side effects. Which of the following statements best reflects the concept of medication side effects?

Phagocytized

When an antibody opsonizes a microorganism, the microorganism becomes more easily:

Ectopic pregnancy

When considering the presence of an ovarian cyst in a woman with abdominal pain, which of the following should also be kept on the differential diagnosis list?

At any point the CCTP is present

When does an adult patient of sound mind have the right to refuse treatment by a CCTP?

Lead misplacement

When evaluating a chest pain patient's 12-lead ECG, you not that lead aVR is positively deflected. What is the most likely cause for this?

When flying under visual flight rules without a flight plan on file, the fixed-wing pilot must update air traffic control or the communications center with the current position every __________ minutes, at a minimum.

15 degrees head-down

When inserting a subclavian central line, position the patient in a __________ position.

When a patient arrives on hospital property

When is a hospital bound by EMTALA regulations?

Inability to locate landmarks

When is a surgical cricothyrotomy contraindicated?

The sending facility cannot perform the needed interventions

When is it acceptable to transfer an unstable patient from a facility?

VIII

When managing a patient with hemophilia who has experienced a moderate injury with bleeding, what factor must be administered promptly to promote clotting?

Intravascular

When patients have burns over large areas of their body, their __________ fluid drastically decreases.

Sensitivity

While transferring a patient on a transvenous pacemaker, what setting you need to obtain from the transferring facility beyond rate, milliamperes, and mode?

Abruptio placento

While transporting a 36-week pregnant patient from a motor vehicle collision, she tells you that she has excruciating abdominal pain on top of her contractions that just started. She suffered no visible trauma, but you note vaginal bleeding. What do you suspect?

Administer chewable PO aspirin

You arrive on a scene flight for a STEMI patient. Due to your response time, the only interventions done by the 911 crew were IV access and a 12-lead with ST elevation in V1 - V4. What is your initial intervention?

Carboxyhemoglobin

You are caring for a 35-year-old female who was the victim of an inhalational smoke injury during a house fire. She was intubated due to respiratory comprise. Currently, she is being ventilated with a capital tidal volume of 500 mL, a respiratory rate of 12 breaths/min, and an FiO2 of 10. What lab value would you expect to be elevated?

Working diagnosis

You are caring for a 50-year-old male who has presented with an acute onset of chest pain. After obtaining a 12-lead ECG you note elevation in leads v3 - v6. Your __________ is an anteriolateral MI.

Biot respirations

You are caring for a critical patient following a closed head injury. The patient is responsive to painful stimuli, pupils are R 8 mm L 3 mm, and vital signs are HR 52, BP 186/114, RR unable to assess due to irregularity. What respiratory pattern is the patient presenting with?

Full-thickness

__________ burns involve the epidermis through subcutaneous fat layers.

Drug antagonism

__________ occurs when one medication blocks the body's response to another medication.

Immunodeficiency

__________ occurs when one or more of the components of the immune system is damaged or nonfunctioning.

Unstable angina

__________ occurs when the supply of oxygen to the myocardium is insufficient to meet demand.

Aerobic metabolism

__________ results in the production of lactic acid.

Cholinergic

__________ syndrome can occur following exposure to organophosphate and carbamate insecticides.

Gangrene

__________, a result of permanent cell death, may set in within a few days of deep frostbite, requiring amputation of the affected limb.

Naloxone (Narcan)

___________ is the antidote for acute opioid overdose.

A reduced mean arterial pressure (prerenal)

acute kidney injury/renal failure in shock is most often caused by:

Master thermostate

the hypothalamus serves as the __________ by using negative feedback to help regulate body temperature.

I:E 1:3

you are transporting a 70-kg, mechanically ventilated COPD patient. The ventilator settings are assist-control mode, Vt 420 mL, RR 14, I:E 1:2, FIO2 0.6. What change would the CCTP consider making due to the pathophysiology of the underlying condition?

Acute myocardial infarction

Which of the following signs and symptoms is associated with pheochromocytoma?

Dilated pupils

Which of the following signs and symptoms is produced by nicotinic receptor toxicity?

Toxidrome

A __________ is a readily identifiable pattern of clinical signs and symptoms that result from certain classes of chemicals and medications.

Informed consent

What type of consent is obtained after you discuss the treatment and transport plan with the patient and patient's family?

Jejunostomy tube

What type of feeding tube is placed directly into the small intestine due to absorption complications?

Gastric tube

What type of feeding tube passes through the nose or mouth?

Maxillary fractures

What type of head injuries are classified with LeFort criteria?

This patient does not meet criteria for TBI

A patient presents following a head injury. He had a brief (less than five minute) loss of consciousness at onset. Currently he is opening his eyes spontaneously and follow commands, but is slightly disoriented when asked to state the year. His brain injury is best described as:

Magnesium sulfate

A 24-year-old female was involved in a boating accident that caused numerous fractures on her lower extremities. You are transporting her via flight from the scene. Her ECG shows a PRI of 80 ms, QRS of 115 ms, and QTc of 504 ms. What prophylactic medication should be administered?

The level I trauma center

A 24-year-old patient is stabbed multiple times in the abdomen. He has a GCS of 15, SBP of 80 mmHg, and RR of 34. Where should this patient be transported to?

Fixed-wing transport

A 3-month old patient in Louisville, Kentucky, has a unique heart condition that requires an intervention that is currently only performed at the Children's Hospital of Philadelphia. What is the best mode of transportation for this patient?

Mixed alkalosis

A 38-year-old septic patient has the following laboratory values: pH, 7.54; PCO2, 28 mmHg; PO2, 91 mmHg; HCO3-, 32 mEq/L. What classification would the patient be in?

Respiratory alkalosis

A 42-year-old female had a syncopal episode after being notified that her son died while serving in the Army. She has the following laboratory values: pH, 7.49; PCO2, 19 mmHg; PO2, 83 mmHg; HCO3-, 26 mEq/L. What classification would she be in?

Respiratory acidosis

A 52-year-old CHF patient has the following laboratory values: pH, 7.05; PCO2, 86 mmHg; PO2, 52 mmHg; HCO3-, 29 mEq/L. What classification would the patient be in?

Potassium

A 58-year-old male patient has missed his last two dialysis sessions. He went to the ED with difficulty breathing and presented to the staff with V-tach. What lab study was likely elevated?

Hyperkalemia

A 68-year-old female patient has missed her last two dialysis sessions. She went to the ED with difficulty breathing, and her ECG showed peaked T-waves. What complication does this patient have?

Digitalis toxicity

A 72-year-old male patient arrived at the ED with nausea, vomiting, and near-syncopal episodes. He has a history of AMI, CHF, GERD, and hypertension. He takes digitalis, omeprazole, and lisinopril. His electrolyte panel shows Na 138 mEq/L, K 52 mEq/L, Mg 2.0 mEq/L, and Ca 9.1 mg/dL. The ECG shows sinus rhythm at 62 with a first-degree heart block. What is the underlying complication for this patient?

Central cord syndrome

A 75-year-old male presents following an MVC. He is complaining of neck pain and has profound weakness in both upper extremities. His lower extremities are strong on a gross motor exam. He has spotty temperature sensation in all extremities. What type of spinal cord injury BEST describes this constellation of findings?

Difficult airway

A CCTP is having problems ventilating a patient with a face mask, establishing an endotracheal tube, and/or placing a supraglottic airway. How would the CCTP document this?

The officer responsible for ordering should try to order the same brand

A CCTP reports a medical error where he administered midazolam instead of fentanyl. When the incident was investigated, the crew member claimed responsibility and stated that he didn't realize the label for the fentanyl had changed to brown after the last supply order. How should this incident be managed?

Rotor-wing transport

A STEMI patient with three vasoactive medications infusing in a community hospital that is 10 miles away, 45 minutes with current traffic, would be a candidate for which mode of transportation?

HICKMAN

A __________ central catheter is a semitransparent catheter that is placed with the proximal end exiting from the lower chest via a subcutaneous tunnel.

GROSHONG

A __________ central catheter is thin, flexible, can have up to three lumens, and is equipped with a subcutaneous cuff. A pressure-sensitive two-way valve allows for the catheter tip to be closed. Clamping and heparin flushing are not necessary, although a normal saline flush is needed after each use.

Subdural

A hemorrhage located in the dura-arachnoid junction is best described as:

Immediately (within 24 hours)

A huddle to determine what happened, to address staff concerns, and to ensure the patient is stabilized should take place within what timeline after a serious adverse event?

Increased

A leftward shift in the oxyhemoglobin dissociation curve causes __________ for oxygen by hemoglobin.

Peritonitis

A major concern with hollow organ injury is:

Agonist

A medication that attaches to a receptor site and stimulates it to cause the response it normally does is called a(n):

80 mL/kg/day

A neonate with a birth weight of 1,300 g (very low birth weight) requires how much fluid for normal physiologic function?

27%

A patient fell into a fire pit and experienced partial-thickness burns across his chest, full-thickness burns around both of his arms, and superficial burns on his face. What is the total body surface area of his burns according to the rule of nines?

Increased pH

A patient in compensatory shock will increase his or her respiratory rate to bring about which of the following changes?

30 kg/m2

A patient must have a body mass index (BMI) greater than __________ in order to be considered obese.

Ultrasound

A patient presents to a trauma bay after a high-velocity MVC in which there was airbag deployment. The patient was the unrestrained driver and is complaining of pain in the abdomen. There is bruising around the umbilicus. Which of the following would be the fastest confirming modality to confirm bleeding in the abdomen?

Respiratory assessment

A patient presents with a cervical fracture at C3 from a high velocity injury. Which of the following is the most important initial intervention?

Subarachnoid hemorrhage

A patient presents with complains of the worse headache of his life with abrupt onset. He has nuchal rigidity on exam. What is the most likely diagnosis?

Grade 2 hyphema

A patient sustains a direct blow to her right eye. On ophthalmological examination, you find blood filling one-third of the space between her iris and cornea. This injury is a:

Decreased osmolality

A patient who is intubated and unresponsive following a high-velocity MVC is noted to have increased urine outputs. Her urine is clear and colorless. When tested, you would expect the patient's urine to show:

The 3-3-2 rule

A patient with a dental abscess is having difficulty opening her mouth. Her airway would be considered a difficult airway because of __________ from the LEMON mnemonic.

Myocardial contusion

A patient with a pleural rub and regular PVCs after chest trauma may have suffered a(n):

Osmosis

A patient with a severe TBI is receiving 3% saline boluses via central line to increase his serum sodium levels to >150. The concept that increased sodium concentration in the vascular system will draw off fluid from the brain tissue is called:

Cherry-red

A patient with carbon monoxide poisoning will present with __________ skin.

An apparent obstruction

A patient with copious amounts of vomit in their upper airway would be considered a difficult airway because of __________ from the LEMON mnemonic.

Concentration

A patient's BMP comes back with a sodium value of 143 mmol/dL. This measurement describes:

A pilot is required to don supplemental oxygen if flying at 10,000 feet ( 3 km) to 12,000 (3.7 km) for greater than __________ minutes.

Remain clear of clouds

A pilot operating under visual flight rules (VFR) must:

20%

A systemic inflammatory response is initiated in burns greater than __________ TBSA.

A highly reliable organization

What type of organization focuses on managing its inevitable failures, helping to reduce their effects on patient care?

Kussmaul

What type of respiratory pattern is common for patients with excited delirium syndrome?

Hypovolemic

What type of shock results from inadequate blood volume?

Pediatric assessment triangle

All pediatric assessments should begin with forming a general impression using the:

Although succinylcholine (Anectine) is the drug of choice in rapid sequence intubation (RSI), it is contraindicated in patients with burn injuries greater than __________ hours old.

The middle meningeal artery

An epidural hematoma is often the result of a blow to the temporal region of the skull that involves:

Fomite

An inanimate object what can transmit infectious organisms from one individual to another is known as a(n):

Distributive

What type of shock would you anticipate if a patient's cardiac output is increased and the afterload is decreased?

The hospital formulary

As a CCTP on a MICU of a large healthcare system, what reference would you utilize to check the health system's standard concentration of epinephrine infusions for a pediatric patient in septic shock?

Septic

What type of shock would you anticipate if a patient's preload and afterload were decreased?

Cardiogenic

What type of shock would you anticipate if a patient's preload and afterload were increased?

Hypovolemic

What type of shock would you anticipate if a patient's preload was decreased and the afterload was increased?

Benign pituitary tumor

What usually causes acromegaly and gigantism?

Nitroprusside

What vasoactive medication can benefit patients in left ventricular heart failure by reducing preload and afterload?

Hot air balloon

What vehicle was utilized in 1870 during the Prussian Siege of Paris as the first documented case of air medical transport?

Battery failure

What would require the entire implanted pacemaker to be replaced?

Mechanical lift device

Which of the following devices utilizes a harness to secure the patient while transferring them within a skilled nursing facility?

Sodium (Na+)

Which of the following electrolytes flows into the cell to initiate depolarization?

LeFort III

Which of the following facial fractures is most commonly associated with leakage of CSF?

Congenital heart defects are classified as either cyanotic or acyanotic

Which of the following statements about congenital heart defects is true?

Most are benign and asymptomatic

Which of the following statements about ovarian cysts is most accurante?

An increased metabolic rate, fewer glycogen stores, and an immature liver

Which of the following factors contribute to an infants' increased risk of hypoglycemia?

Intercostal retractions

Which of the following indicates a labored work of breathing?

CPP should be maintained between 50 and 70 mmHg

Which of the following is FALSE concerning CPP?

Regulates water intake

Which of the following is NOT a function of a hypothalamus?

Insertion of a lumbar drain via lumbar puncture

Which of the following is NOT a way to assess intracranial pressure int he setting of an acute traumatic brain injury?

Altered mental status

Which of the following is NOT one of the common symptoms of pulmonary TB?

Hypotension

Which of the following is a cardiovascular complication of selective serotonin reuptake inhibitor (SSRI) overdose?

Breech presentation

Which of the following is a cause or risk factor for birth injuries to the neonate?

Oropharyngeal perforation

Which of the following is a complication of endotracheal intubation in the neonate?

Sodium-depleted heat exhaustion

Which of the following is a form of heat exhaustion?

Failure of the thermoregulatory system

Which of the following is a key feature of myxedema coma?

Temperature regulation is not fully developed

Which of the following is a major factor that makes children susceptible to hypothermia?

RH incompatibility

Which of the following is a potential cause of anemia in the neonate?

Torsades de pointes

Which of the following is a potential complication of tricyclic antidepressant overdose?

Enzyme

Which of the following is a protein that acts as a catalyst for biochemical reactions?

Gestational diabetes

Which of the following is a risk factor for pregnancy-induced hypertension (PIH)?

Extremes of age

Which of the following is a risk factor that predisposes people to environmental emergencies?

Muscle weakness

Which of the following is a sign and symptom of hypothyroidism?

Central hypothermia

Which of the following is a sign of spinal shock?

Headache

Which of the following is a sign or symptom of heat exhaustion?

Proper handling of sharps

Which of the following is a work practice control that reduces the risk of transmission and contamination of infectious agents?

Tetralogy of Fallot

__________ consists of a ventricular septal defect, pulmonary stenosis, overriding aorta, and right ventricular hypertrophy.

Helicobacter bycori

__________ has a causative association with peptic ulcer disease.

Meconium staining is present and there is marked respiratory distress.

Which of the following is an indication for endotracheal intubation in the neonate?

Labetalol

Which of the following is considered a Class II antiarrhythmic?

Ketorolac

Which of the following is considered an NSAID?

Use of narcotics within 4 hours of delivery

Which of the following is considered an intrapartum risk factor?

Immerse in ice water

Which of the following is indicated for a patient with heat exhaustion?

Mitigate the etiology

Which of the following is not an objective of epidemiology?

Mixed alkalosis

__________ involves elevated pH, a low PCO2 level, and a high HCO3- level.

Emergency Medical Services

Which of the following is recognized as a medical subspecialty by the American Board of Emergency Physicians?

Penetrating trauma

Which of the following is the MOST common cause of injury to both the large and small intestines?

Footling breech

During fetal delivery, the CCTP sees that both fetal feet are presenting first in the birth canal. What is the name of this type of presentation?

All of these are correct (ensure that the patient is securely fastened to the stretcher; remain seated and secured with seatbelt applied as much as possible; and, ensure all loose equipment is secured and equipment lockers are closed)

During ground transport of a critically injured patient, a CCTP should be mindful to:

Placental wall

During intrauterine life, the fetus receives oxygenated blood from the:

During laryngoscopy, you identified that atenoid cartilages. What Cormack-Lehane grade do you document for this intubation?

An increase in tidal volume

During pregnancy, the minute ventilation increases due to:

Negative

During spontaneous ventilations, the patient takes a breath that creates __________ intrathoracic pressure and causes air to rush into the cavity.

Round, oval, keyhole

During the assessment of the pupils, notation is made as a their size and shape. Which of the following are the terms used to describe pupillary shape?

Aspiration

During the decontamination process, the main risk to the patient when performing gastric lavage is:

Perform basic resuscitation, then seek clarification

During the hand-off report from the transferring nurse, he tells you that the patient has a DNR and only wants comfort measures performed. En-route, the patient codes but you are unable to find the patient's DNR in the chart. How do you manage the cardiac arrest?

Serum creatinine

Which of the following is the best indicator of renal function?

Chest compressions, PPV, epinephrine

Which of the following is the correct sequence of steps in neonatal resuscitation?

It acts as an agonist at the dopamine D2 receptors in the medula

Which of the following is true regarding prochlorperazine (Compazine)?

Ears

Which of the following may experience an injury from barotramua?

Salicylates

Which of the following medication classifications is currently without an FDA-approved antidote?

Hydrazaline

Which of the following medications is most appropriate for use on the PIH patient?

Lorazepam

Which of the following medications should be stored in a refrigerator?

Intense aerobic exercise

Which of the following nonphysiologic conditions can elevate cortisol production?

Transcutaneous pacing

How do you manage a patient on a transcutaneous pacemaker if the pulse generator fails en-route?

Contact the receiving facilities physician

How do you manage a patient when a sending physician refuses to allow you to treat a patient appropriately according to your protocols?

Obtain written orders to transport the medication infusion

How do you manage the ground transport of a patient on an infusion unaddressed in your protocols but that you received education on during the recruit academy?

Check for an inflated distal balloon

How do you troubleshoot a patient's pressure waveform that appears to be continuously wedged?

Pads with A-P placement

How does a CCTP provide electrical therapy to a patient who has an ICD in place?

120 - 160 beats/min

How fast is a normal fetal heart rate?

Cardiac output x Systemic vascular resistance

How is blood pressure calculated?

30 minutes

How long after administration does mannitol reach its maximum effect?

How many arteries are typically in an umbilical cord?

Pressurized aircraft cabin

How many passengers and crew members protected from increased barometric pressures during fixed-wing aircraft transports?

Anisocoria

How may a physician note the unequal pupils of a critical stroke patient?

Acquired

Humoral and cell-mediated immunity are types of __________ immunity.

Staphylcoclus aureus and Streptococcus pyrogensis

Which of the following pathogens are most commonly responsible for toxic shock syndrome (TSS)?

Begin sterile cockpit procedures

If a pilot declares a flight emergency while en-route to the receiving hospital, the medical crew should immediately:

Just above the nipple

If an emergent needle decompression for a possible tension pneumothorax is indicated, what area most closely approximates the second intercostal space?

Decrease its rate

If the heart of the fetus does not receive enough oxygen, the fetal heart will:

Absorption

If the surrounding environment is hotter than the body, the body gains heat through:

Stomach

If you elicit tympany on percussion during a normal assessment, what may you be percussing?

To be palpated below the costal margin

In a child, it may be normal for the liver and spleen:

14 to 21 days

In a chronic subdural, symptoms generally appear how long after the initial trauma?

Colorless

In a patient with a urine specific gravity of 1.001, the specimen will be clear, __________, and odorless.

Two to three

In the adult population, beta-adrenergic blockers have the potential to be fatal in as little as __________ times the therapeutic dose.

An active drug may be changed into an inactive metabolite

In the liver, drugs undergo the process of biotransformation. This process can result in one of four events. Which of the following statements is true regarding biotransformation?

Severe infection

In the patient with chronic AI, signs and symptoms of Addisonian crisis may appear suddenly as a result of:

2 to 3 days

In the primary immune response, antibodies usually do not appear until __________ after the initial encounter.

Objective

In your ePCR, you document that a patient has a potassium level of 5.4 mmol/L. What type of information is this considered?

Mixed acidosis

__________ involves low pH, an elevated PCO2 level, and a low HCO3- level.

Asthma patietns

Which of the following patient populations would likely require high inspiratory pressures to adequately achieve gas exchange?

A preterm neonate treated with 100% O2 and positive-pressure ventilation

Which of the following patients is most likely to develop bronchopulmonary dysphlasia (BPD)?

22-year-old with circumferential partial thickness burn on his right arm from a campfire

Which of the following patients should be transported to a burn center?

KG = 50 + (2.3 x height in inches over 5 feet)

Many drugs are formulated for the average adult, which is generally accepted to be a 70-kg person. Thus, the individual's body weight should be considered when selecting an appropriate dose. More specifically, the patient's ideal body weight may be used. What is the calculation to determine the ideal body weight of an adult male?

31-year-old with a palm-sized partial-thickness burn on his arm from sulfuric acid at a factory

Which of the following patients should be transported to a burn center?

A patient who has an endotracheal tube inserted through a tracheostomy

Which of the following patients would be able to have an MRI?

A patient in late-stage diabetic ketoacidosis (DKA)

Which of the following patients would most likely present in metabolic alkalosis?

The dispatcher

What is the first point of contact for the rotor-wing critical care team?

Renal funciton

What is the glomerular filtration rate (GFR) used to benchmark?

Self-digestion of pancreatic tissue

What is the inflammatory response in pancreatitis reacting to?

Unconsciousness

What is the initial clinical presentation of a patient with a diffuse axomal injury (DAI)?

Maintaining maternal perfusion

What is the key to a viable fetus in a critically ill pregnant patient?

Trauma

What is the leading cause of death of children from 6 months of age through young adulthood?

A catastrophic event

What is the long-term concern of utilizing the Swiss cheese model?

Systolic

On an aortic pressure waveform, the uppermost point of the waveform indicates the __________ pressure.

60; 70

On arrival at a referring intensive care unit (ICU) to transfer a patient with a Swan-Ganz catheter in place, the CCTP notes that the first visible marking on the catheter is one thick black line with two then lines. The CCPT knows that the catheter is inserted to a depth between __________ and __________ cm.

A universal time-out

Once everything is in place for an RSI, what can be done to improve team communication prior to performing the RSI?

Lund-Browder chart

What is the most accurate method for calculating the body surface area burned?

Chest pain

What is the most common adverse event from cocaine intoxication?

Diverticulosis

What is the most common cause of lower GI bleeding?

Cholecistitas

What is the most common cause of pancreatitis?

Roux-en-Y gastric bypass

What is the most common type of bariatric surgery?

Acute tubular necrosis

What is the most frequent cause of intrarenal acute renal failure?

Sickle cell crisis

What is the most likely cause of a veno-occlusive priapism?

Osmolality

What is the physiologic measurement of osmotic pressure in humans?

Nerve damage

What is the potential complication of improper technique during an escharotomy?

Escharotomy

What is the procedure in which an incision is made through stiff, edematous, burned skin to allow the patient to be ventilated adequately?

Generate data and improve the service provided

What is the purpose of a quality assurance and improvement (QA&I) program?

Surgery-associated stress

Which of the following physiologic conditions cause increased cortisol production?

Off-label use

What is the term used for medication administration of a drug that is supported for a condition according to research, but the manufacturer has not attempted to obtained FDA approval for its use for that condition?

What is usually the first value to consider when interpreting an arterial blood gas (ABG)?

Ultrasonagraphy

What lab measure sound waves as they travel through body tissue?

Lactate level

What lab test will be run when you draw blood into a gray tube?

Breech

Which of the following presents the highest risk for spinal injury to the neonate during vaginal childbirth?

Activated partial thromboplastin time

What lab value becomes elevated in patients with DIC, with hemophilia, or receiving anticoagulation prophylaxis?

Sputum culture

What lab would be obtained in order to identify the causative organism of a septic, vent-dependent, tracheostomy patient?

These measures can promote thermogenesis

Rubbing alcohol and water-soaked sheets should be avoided when treating heatstroke because:

90 degrees F (32.2 degrees C)

Severe hypothermia begins as the core body temperature drops below:

Traumatic asphyxia

Severe, sudden crushing injury to the chest and abdomen that leads to the appearance of extreme cyanosis describes:

Accessory

Shrugging the shoulders and turning the head are motor functions of the __________ nerve.

Macintosh

What laryngoscope blade applies pressure on the hyoepiglottic ligament in order to view the vocal cords?

Miller

What laryngoscope blade can be used to lift up the patient's epiglottis in order to view the vocal cords?

Abliximab (ReoPro)

What medication is commonly administered during and after PCI as an antiplatelet agent?

Ketamine

What medication is optimal for induction due to its onset of action?

High-dose insulin

What medication may be administered in conjunction with glucose as part of the management of calcium channel blocker overdoses?

The American College of Surgeons Committee on Trauma classifies hypovolemic shock caused by hemorrhagic trauma into __________ classes.

Informed

The CCTP has an obligation to obtain __________ consent for air medical transport, including a written statement that the patient understands the risks and benefits of transport.

Posterior

The CCTP uses leads V7, V8, and V9 to evaluate patients for a(n) __________ wall MI.

Handoff report

The CCTP will always be allowed time to __________ during every scene transport.

Initial

The __________ stage of shock begins as blood flow in the microcirculation is challenged by an inability to meet the demands of normal aerobic function.

SvO2

The ability of the body's tissues to extract and use oxygen that is bound to hemoglobin is reflected by which of the following values?

Milrinone

What medication will provide the greatest increase in cardiac contractility?

Fixed-wing aircraft

What mode of transport is optimal for a patient being transported 236 miles?

Complete utilization of the facilities available resources

What must a transferring facility do in order to stabilize a patient prior to transport, according to EMTALA?

Physician notes

What objective source can be utilized on ever interfacility transport to help guide the CCTP's bedside assessment with the most information?

A medical error

What occurs when a planned action fails to be completed as intended?

Cortex

What part of the adrenal gland produce hormones?

Brain

What part of the body is best evaluated with magnetic resonance imaging (MRI)?

Y connection

What part of the ventilator circuit helps manage the dry oxygen as it exits the cylinder?

Postural hypotension

Which of the following signs and symptoms can manifest during heat stroke?

Physiologic zone

The area of the atmosphere that contains the oxygen and barometric pressure needed for a normal, healthy person to live is the:

60 to 70

The average basal metabolic rate (BMR) of a 70-kg adult is around __________ kcal/h.

Congestive heart failure

What pathology does a CCTP suspect from a patient with a CVP of 18 mmHg, MAP of 118 mmHg, and PCWP of 26 mmHg?

Computed tomography

What radioactive study is an ED likely to utilize when evaluating a potential stroke patient?

Computed tomography

What radiologic study provides a cross-sectional image of the body part in question?

16 to 18 months

The anterior fontanelle closes at approximately __________ of age.

Calcium gluconate or calcium carbonate

The antidote for hydrogen fluoride (HF) skin exposure poisoning is:

Cellular respiration

The components of __________ can work together in either aerobic or anaerobic metabolism to produce energy in the form of ATP.

1 week of age

The creatinine level of a newborn initially reflects that of the mother; creatinine results reflect that neonate's renal function at about:

White blood cell count

The criteria included in most basic tools for early detection of systemic inflammatory response syndrome (SIRS) are heart rate, respiratory rate, temperature, and:

Crackles

What sound would a CCTP likely auscultate in a patient with acute left-side CHF exacerbation?

Melena

What symptom suggests that a patient may have an upper GI bleed?

Basal metabolic rate

The heat produced at rest from normal metabolic functions is referred to as the:

Buckling rather than fracturing

The immature bones of children are more porous than those of adults and tend to respond to trauma by:

Pressurizing an aircraft cabin

The isobaric control system and differential control method are methods of:

70%

The kidneys are able to comensate to maintain adequate function with nephron losses of up to:

8 and 23 mg/dL

The laboratory values for BUN should remain between:

Brain

The last organ to be affected by hypoperfusion is the:

24 - 96 hours

The late signs and symptoms of acetaminophen toxicity generally present over:

Physiologically deficient zone

The layer of the atmosphere above 10,000 feet is known as the:

Addison disease is a chronic process

The main difference between all other AI conditions and Addison disease is that:

A "sterile cockpit" environmnt

The majority of air medical crashes occur during:

Nitrogent

The most abundant gas in the atmosphere is:

Succinylcholine (Anectine)

The most common anesthetic trigger for malignant hyperthermia is:

Myocardial infarction

The most common cause of cardiogenic shock is:

Hypotension and bradycardia

The most common signs and symptoms of overdose with calcium channel blockers are:

Hypotension and bradycardia

The most common signs of overdose with calcium channel blockers are:

Anterior tibia

The most common site for intraosseous (IO) insertion in children is the:

Alternating

The most common source of electrical injury is a(n) __________ current.

The Seldinger technique

The most common technique for central line insertion is:

Acetaminophen (Tylenol)

The most commonly ingested drug resulting in overdose is:

Rewarming followed by refreezing

The most serious complication of frostbite is seen when the patient experiences:

60% to 80%

The normal SvO2 level measured in the pulmonary artery by a pulmonary artery (PA) catheter is:

31 to 186 U/L

The normal laboratory value range for serum lipase is:

2 to 6 mmHg

The normal range for a CVP measurement in a critically ill patient is:

4 to 12 mmHg

The normal range for a PCWF measurement is:

23 to 30 mmol/L

The normal range for a VBG HCO3- (bicarbonate) is:

40 mmHg

The normal range for a VBG PO2 is:

4 to 8 L/min

The normal range for a cardiac output measurement is:

60% to 80%

The normal range for a mixed venous oxygen saturation (SvO2) measurement is:

40 to 60 mmHg

The normal range for a pulse pressure measurement is:

Delivery of the neonate

The only true treatment for eclampsia is:

Free hydrogen ions (H+)

The pH value represents the concentration of __________ present in the body.

The signs and symptoms of malignant hyperthermia may begin up to __________ hours after administration fo a triggering agent.

Rubrospinal tracts

The spinal tracts responsible for carrying voluntary motor commands from the brain to the muscles are the:

Get an understanding of the underlying issue

The three steeps of the QA&I process are to define quality, collect and gather data, and:

The thyroid glad is the largest gland in the neck. It is found in the __________ part of the neck, below the muscle layers.

Radiation

The transfer of heat through electromagnetic waves is known as:

The physician assistant

The transferring neonatal orders a neonatal physician assistant to your transport team for the transfer of an 1,800-g neonate with an intraventricular hemorrhage and hydrocephalus. What dictates the management of the patient's care during this transport?

Just culture

What system encourages self-reporting of errors that will be free from disciplinary action and aid in corrections of the overall system?

Pediatric

Trauma is the leading cause of death in the __________ population.

Aortic rupture

Traumatic __________ is the most common cause of immediate death in motor vehicle collisions.

130,000

Traumatic injuries account for over __________ fatalities in the United States annually.

Hyperglycemia

Which of the following signs and symptoms is associated with Cushing syndrome?

Failure mode and effect analysis

What system requires someone to develop a risk matrix for each potential failure that incorporates the likelihood of that failure, the ability to detect failure, and the potential harm in order to assign a risk score to the environment?

Opiates

What toxidrome is suspected in a patient with pinpoint pupils, CNS depression, and respiratory depression?

Acyanotic

What type of congenital heart defects lead to low oxygen saturations?

Acyanotic

What type of congenital heart defects shunt blood from the left heart to the right heart?

Implied

What type of consent is granted for a patient found unresponsive and seizures?

Perfusionist

What additional healthcare provider may become part of the transport team during the transport of a patient receiving extracorporeal membrane oxygenation (ECMO)?

The state agency responsible for licensure

What agency dictates CCTPs' scope of practice?

Placing a nasopharyngeal airway

What airway intervention is contraindicated in patients with significant facial trauma?

Patient rights

What allows individuals to accepts or refuse treatment, to receive appropriate care, and to receive care without interruption?

Pneumonia, congenital heart disease, and hypoglycemia

What are some possible causes of apnea at birth?

Vomiting and excessive thirst

What are the two hallmark signs associated with diabetic ketoacidosis (DKA)?

Exotoxins and endotoxins

What are the two types of toxins produced by bacteria?

Midazolam

What benzodiazepine is the first-line for seizures in prehospital and critical care transport?

Hemoglobin

What binds the majority of oxygen found in the arterial blood?

Place a magnet on the ICD

What can be done to stop an ICD from sensing and treating arterial tachycardias?

Urinary tract infection

What can cause detectable hematuria in a urinalysis?

Checklists

What can help reduce the risk of adverse events and errors of omission during IABP transports?

Frostbite

What can occur when ice packs are applied to burned hands or feet?

Keep the patient warm

What can the CCTp do to help mitigate coagulopathy complication in trauma patients?

Lactic acid

What cellular byproduct causes septic patients to go into metabolic acidosis?

Ileus

What condition may be present in burn patient with abdominal distention and vomiting?

Kehr sign

What could a patient present with if they suffered in injury to heir spleen?

Magnetic resonance imaging

What diagnostic tool is used in the ED to clear a patient's cervical, thoracic, and lumbar spines?

Battery

What did you witness if you see a patient's spouse strike the patient's face with an open hand across the cheak?

Urine output

What do the ABA guidelines say should be used to manage fluid resuscitation?

Finger probe

What do you need to attach to the patient and monitor in order to obtain a carboxyhemoglobin reading?

Disease duration

What factor differentiates acute kidney injury from chronic renal failure?

Right arterial pressure

What hemodynamic pressure does CVP monitor?

Current diagnosis and interventions

What information must be sent with a patient during all interfacility patient transfers?

Ocular globe rupture

What injury presents with blood in the anterior chamber of the eye?

NG tube insertion

What intervention can the CCTP perform for the patient with a diaphragmatic rupture?

Elevated cabin temperature for hypothermia

What intervention is most effective in mitigating the lethal triad during trauma management?

Slip

What is a lapse in concentration that occurs in the face of distraction?

Crackles

What is an example of an adventitious breath sound?

Diastolic murmurs

What is considered a normal, and benign, finding in an older patient's cardiac assessment?

Medical command physician orders

What is necessary for a CCTP to act outside of his or her protocols?

Target cells do not react to the arrival of insulin

What is the cause of insulin resistance?

17.5 mmHg

What is the corrected PCWP reading for a patient who is mechanically ventilated with a PEEP of 15 cm H2O and a PCWP reading of 22 mm?

Contamination may be spread by people and materials

What is the difference between irradiation and contamination with respect to radioactive materials?

The posterior lobe does not produce hormones

What is the differences between the anterior and the posterior pituitary lobes?

Effectiveness

When a CCTP transports a patient from a scene to the appropriate facility, they are meeting the Institute of Medicine's __________ Quality Aim?

Left axis deviation (LAD)

When analyzing a 12-lead ECG, you note that lead I is positively deflected and lead aVF is negatively deflected. This would indicate a(n):

Peptic ulcers

When are proton pump inhibitors indicated?

Chronotropic, inotropic, and dromotropic

When caring for a patient with cardiac concerns or issues, the CCTP should focus on three areas of concern with regard to cardiac pharmacology. These areas are:

At least 1.5 inches

When caring for a pregnant patient in cardiac arrest, how deep should providers perform chest compressions?

Renal output

When performing a circulation assessment for the neonate, which of the following is/are assessed?

45 degrees

When placing a femoral artery line, the needle should be inserted at a __________ angle.

When placing leads for a 12-lead ECG, the __________ lead is placed in the fifth intercostal space at the midclavicular line.

Will most likely have a significant latex allergy

When taking a patient history, you learn from the parents that the infant has a neutral tube defect. You know know that this child:

Not to use an extremity with a fistula for BP measurement, venipuncture, or IV access.

When transporting a patient with a history of renal failure who has been disconnected from their device, it is important for the CCTP to remember:

1869

When was the United States' first city ambulance service established?

The 11th century, during the Crusades

When was the movement of injured patients first recorded?

When circumferential burns to the thorax are present

When would a CCTP need to perform an escharotomy?

Spleen

Where are encapsulated bacteria encountered and destroyed?

Baltimore, Maryland

Where did the first public services medevac program start?

Small intestine

Where does an ileostomy originate?

Forearm or thigh

Where is a hemodialysis patient likely to have their AV shunt placed?

Urethra

Where is the most likely initial infection for a urinary tract infection (UTI)?

Foramen of Monro

Where is the zero point of an EVD placed?

Denver, Colorado

Where was the first hospital-based air ambulance program developed?

10.5 mg/dL

Which calcium level would cause the thyroid gland to secrete calcitonin directly into the bloodstream?

Aortic stenosis

Which congenital anomaly causes narrowing of the aortic value?

III

Which cranial nerve may result in the hippus phenomenon when compressed?

Ethanol

Which of the following antidotes can be used for methanol and ethylene glycol toxicity?

Tissue hypoxia and hypovolemia

Which of the following are common pathologic causes for tachycardia?

Posture, balance, and equilibrium

Which of the following are functions of the cerebellum?

Cyanotic congenital heart disease and cardiomyopathy

Which of the following are possible causes of cyanosis?

The way a medication produces the intended response

Which of the following best described a drug's mechanism of action?

Neurosurgery

Which of the following can cause central diabetes insipidus?

Unequal pupils

Which of the following changes most likely represents a serious neurological pathology and should be reported immediately?

Gestational diabetes

While caring for a 33-year-old mother at 40 weeks' gestation, you assist in delivering her newborn. You notice meconium-stained amniotic fluid. The mother had adequate prenatal care and well-controlled gestational diabetes. Which of the following is considered an antepartum risk factor?

The CK is elevated from a variety of muscle damage

While caring for a 50-year-old male has just been diagnosed with an acute myocardial infarction, you notice that his creatinine kinase (CK) levels are evaluated outside of the normal range. You know that the CK level may be elevated for reasons other than an acute myocardial infarction. Which of the following statements best explains the usefulness of the CK level in diagnosing his condition?

A neonate at 36 weeks' gestation would require a MAP of 36 mmHg

While caring for a neonate with profound diarrhea, the assessment reveals that the patient is in a shock-like state. IV fluid resuscitation initiated. One goal of resuscitative fluid therapy is to aim for an adequately perfusing mean arterial pressure (MAP). Which of the following statements is true?

Sepsis secondary to pneumonia

While caring for a neonate with respiratory distress syndrome, you recall that the differential diagnosis list for RDS includes:

Maintaining airway and adequate ventilation

While caring for and transporting a patient who is being mechanically ventilated, which of the following is of the highest priority?

Serum creatinine

While caring fro your trauma patient with crush injuries, the ED attending informs you that the patient is having decreased renal function and tells you to closely monitor the patients output. What lab study did she reference for this information?

Intercostal retractions

While evaluating the need to RSI a patient, what sign would suggest that the patient has an increased work of breathing?

Left anterior hemiblock

While evaluating your patient's 12-lead, you identify a negative deflection in leads I and II along with an axis of -76 degrees. What is the diagnosis for this patient?

Right ventricular hypertrophy

While evaluating your patient's 12-lead, you notice a large R-wave in V1 and V2 along with a pronounced S-wave in V6. The axis is 132 degrees. What is the patient's diagnosis based on these findings?

High-pressure alarm

While in transport with your mechanically ventilated patient, one of the alarms begins to signal. It resolves after suctioning the endotracheal tube. Which alarm was activated?

Near miss

While landing at a scene for a PR event, a firefighter walked directly beneath the helicopter across the LZ. What type of incident occurred?

Pneumothorax

While managing a child with a tracheostomy tube, your high pressure alarm goes off as the patient becomes hypoxic. You notice pronounced JVD. What do you suspect occurred?

Displacement

While managing a child with a tracheostomy tube, your low pressure alarm goes off. What do you suspect occurred?

Equipment issue

While managing a child with a tracheostomy tube, your low pressure alarm goes off. You are able to ventilate the patient well with a BVM, and your capnography waveform is adequate. What do you suspect occurred?

Mean arterial pressure of 65 mmHg

While managing a septic patient, what is the target value guiding fluid resuscitation and vasopressor therapy?

Moving away from his aircraft

While on a night flight, the CCTP sees another aircraft showing a red light on the left, white light in the middle, and green light on the right. This aircraft is:

Consolidate as many infusion lines as possible

While packaging the patient for transport, the CCTP should __________ before moving the patient to their stretcher.

Rebound tenderness

While performing an abdominal assessment, you palpate deeply against the abdomen and then quickly release the pressure. As you release the pressure, the patient grimaces. This is documented as:

Myoclonic muscle movements

While preparing drugs for administration for rapid-sequence intubation (RSI), you select etomidate. Although you know that etomidate has no absolute contraindications, you do know that it has a high incidence of:

Midazolam (Versed) is a unique benzodiazepine in that it has both sedative and amnesic properties

While preparing to administer a benzodiazepine, you review the drug's product information. Which of the following is a true statement regarding benzodiazepines?

Ask the physician to adjust the order or to send appropriate personnel

While reviewing the physician's written orders, you notice PRN interventions that exceed your scope of practice. How do you manage the transport?

Tidal Volume

While reviewing the ventilator parameters, you notice that the patient is being ventilated with 440 mL for each breath. What parameter are you looking at?

Right atrial hypertrophy

While reviewing your COPD patient's ECG before transport, you notice the patient has __________ present, which often accompanies pulmonary disorders.

Uterine rupture

While transporting a 34-year-old pregnant patient from a motor vehicle collision, she tells you that she has excruciating abdominal pain on top of her contractions that just started. She is a scheduled for a C-section in 2 weeks because she was concerned about having a vaginal delivery after her last C-section. What is the concern with the patient having a vaginal delivery?

Administer 50 mcg of fentanyl

While transporting a 45-year-old, 280-lb, male patient with burns on his upper and lower back, he tells you that the medicine (25 mcg of fentanyl) that the paramedic gave him 15 minutes ago didn't help at all. He rates his pain as a 10/10. What will you do to manage his pain?

Increase RR to 16

While transporting a 57-kg, mechanically ventilated patient, you notice that he begins to become hypoxic (SPO2 86%). His current ventilator settings are Assist Control Mode, Vt 400 mL, RR 14 per min., FIO2 1.0, PEEP 5 cm H2O, and I:E 1:2. What is the most beneficial change you could make to improve the patient's hypoxia?

Imaging results and report

While transporting a 74-year-old male with a subdural hematoma, you find demographics, transfer orders, PRN and standing orders, an H&P, physician notes, nursing notes, medication administration record, lab values, physiologic scoring methods, and advanced directives in the PCR. What else would you like to transport with the PCR?

Eclampsia

While transporting a patient who just gave birth 6 hours ago, the patient begins to seize. What do you suspect?

1:2

While transporting a patient with a balloon pump on a ___________ ratio, the CCTP would expect to see the balloon inflate every other beat.

4 - 5 minutes

While transporting a patient with circumferential burns on their right arm, what is an appropriate amount of time to irrigate the burns?

30 degrees

While transporting a pediatric patient with hydrocephaly, what angle should the head to the bed be adjusted to?

It provides both anesthetic and amnesic effects

While transporting your mechanically ventilated patient, you will be maintaining an already established infusion of propofol (Diprivan). Which of the following statements is true regarding this drug?

Transcutaneous pacing

While transporting your patient with a left bundle branch block and a left anterior hemiblock, she becomes near syncopal. Your serial ECG shows a STEMI. What intervention will the patient need?

Bellevue Hospital

Who initiated the first ambulance service in a US major metropolitan area?

Igor Sikorsky

Who invented the helicopter?

The plaintiff

Who is responsible for the burden of proof in an negligence case filed against a CCTP?

Dispatch center

Who is responsible for the initial triage process of calls involving critical care transport patients?

The patient's spouse

Who must receive a privacy statement prior to transport of a chemically sedated and paralyzed patient if no power of attorney has been made and numerous family members are present?

Arab and Greek Physicians

Who taught the Knights of St. John first aid procedures?

To look for the presence of microorganisms

Why are blood, urine, and sputum cultures drawn?

Esophageal varices bleeding

Why does a physician place a Sengstaken-Blakemore tube?

Biventricular

With a(n) __________ pacemaker, the CCTP can see the left and right ventricles paced together.

Sympathomimetic syndrome

__________ involves overstimulation of the adrenergic nervous system, resulting in tachycardia, hypertension, agitation, dilated pupils, and diaphoresis.

Glucose

You are caring for a patient who develops a sudden altered level of consciousness. Which of the following is a point-of-care laboratory test that would be appropriate to run for this patient and available in any MICU or aircraft?

The intracranial pressure is increasing

You are caring for a patient who has sustained a significant head injury. During a routine neurologic assessment, you pay close attention to the patient's GCS. During the examination, you note that the previous GCS score was 13 and now it is 9. Based on this finding, you might suspect which of the following?

One; level II trauma center

You are flying an 18-year-old female with multiple gunshot wounds from a scene. Her SBP is 72 mmHg, and her GCS is currently 3T after you've preformed an RSI. She is a level __________ trauma patient, so she should be transported to:

PaCO2

You are preparing to transport a critical patient who is being mechanically ventilated. As part of your patient assessment, you note that the most recent arterial blood gas (ABG) results were: pH 7.42; PaO2 88 mmHg; PaCO2 40 mmHg; and SaO2 98 mmHg. Which of the following is an indicator of the effectiveness of ventilation?

Pericarditis

You are transporting a 26-year-old febrile patient with sharp chest pain and shortness of breath that increases when lying flat. The 12-lead shows a 2-mm ST elevation in V1 - V6, II, III, and aVF. What is the patient's diagnosis based on these findings?

Ventilation-perfusion mismatch

You are transporting a 64-year-old female patient on a mechanical ventilator for CHF exacerbation. She has an ETCO2 of 80 mmHg. How would you classify the inadequate gas exchange?

Vomiting occurred during the rescue

You are transporting a patient following a near-drowning/submersion injury. What likely was the cause of the most recent serum magnesium level being 1.0 mEq/L?

Potassium

You are transporting a patient who recently sustained major crush injuries to both legs. The cardiac monitor shows peaked T waves. What electrolyte would you suspect to be elevated?

Monitor his urine output closely

You are transporting a patient who was assaulted at a bar. The patient is intubated, sedated, and unresponsive. He has two peripheral large-bore IVs in place and is receiving a propofol and fentanyl infusion. He is being transferred to a facility with neurosurgical capabilities. His most recent sodium level is 155 mmol/dL. Which of the following is the BEST intervention?

It is therapeutic

You are transporting a patient with a known mechanical heart valve from a community care center to a tertiary care center for definitive care. His INR result is 2.3. Which of the following statements best describes the warfarin therapy efficiently for this patient?

Lactate level

You are transporting a trauma patient to a tertiary care facility for definitive care. Prior to transport, this patient underwent a prolonged resuscitation effort at the sending hospital. Based on the prolonged resuscitation, which of the following would be the most specific test to reflect organ perfusion?

Purkinje fibers

You arrive at the ED to find a semiresponsive patient. The ECG has no P-wave or T-waves, just wide QRS complexes at a rate of 25/min. What is the primary pacemaker hat firing?

Administer 1 L of normal saline

You arrive to transfer a septic patient who is currently on a dopamine infusion a 5 mcg/kg/min and oxygen by nasal cannula at 2 lpm. She has received 500 mL of saline and 1 g of vancomycin prior to arrival. Vital signs are HR 110, RR 26, BP 76/44, and SpO2 94%, CVP i. What is your next intervention?

Balloon has clotted

You decide to inflate the balloon on your PAC but no not see a waveform change indicating a wedge. You are unable to withdraw the air from the balloon. You should suspect that the:

Check the patient's capnography

You have just orally intubated your patient. You're having difficulty auscultating on-scene due to the noise. What should you do next?

Left ventricular failure

You note an abnormally large decrease in systolic blood pressure. Which of the following is the most likely cause?

Serious arrhythmias

You receive a report that an ICU patient is in acute renal failure. You inquire as to the most recent ionized calcium level result. You are told that 1 hour ago it was 4.40 mg/dL. Which of the following are you concerned about occurring due to these levels?

Delayed

You're assigned to a 46-year-old patient with bilateral leg fractures and a pelvic fracture after being extricated from a building collapse. The patient has an RR of 26, palpable radial pulses, and is able to follow commands. What triage tag do you assign this patient?

The laws of motion

You're responding to a patient who suffers from a splenic rupture as a restrained driver in a high-speed frontal collision. The patient had no external abdominal trauma. What principle can explain what happed to the patient?

Employ BiPAP and facemask

You're transporting a 54-year-old female patient with chest pain and difficulty breathing. Cardiac enzymes and 12-lead are unremarkable. You note crackles bilaterally and pitting edema around her ankles. The hospital initiated a nitroglycerin infusion at 60 mcg/min and O2 by nasal cannula at 2 lpm. Her current vital signs are BP 154/91, HR 88, RR 18, SpO2 94%, and EtCO2 68. How do you manage this patient?

Diltiazem

You're transporting a 64-year-old female patient with chest pain and difficulty breathing. Her ECG shows atrial fibrillation with rapid ventricular response. How do you manage this patient?

Bundle branch block

You're transporting a chest pain patient who has a QRS measurement of 150 milliseconds, which is different from his ECG taken last month. What is the diagnosis?

Implanted pacemaker

You're transporting a patient who has had three syncopal episodes this afternoon. The 12-lead ECG has a QRS measurement of 180 milliseconds that presents with a small R-wave followed by a long, deep S-wave. What intervention will this patient receive at the receiving facility?

Kussmaul respirations

You're transporting a semiresponsive hyperglycemic patient. You notice a fruity odor in your unit as the patent rapidly breaths. What respiratory pattern is this patient in?

Apply calcium gluconate gel to the burns

You're treating a 24-year-old, 99-lb, female patient with hydrofluoric acid burn throughout her abdomen and proximal half of her anterior thigh. The 911 crew has established vascular access and irrigated the burns. What is your initial treatment?

Pat the area dry and apply dry, sterile dressings

You're treating a patient with burns on his anterior left leg. After irrigating the burn, what treatment will help protect the burn and reduce pain?

Adverse drug event

You've administered vecoronium and realized you forgot to administer midazolam. Your partner pushes the midazolam but the patient's heart rate continues to rise. You notice the line was clamped and the bolus went into the bag. What type of incident occurred?

Hypoxic hypoxia

You've just transported a patient from an MVC with Gray Turner sign present. His pulse oximetry is not able to get a signal. What type of hypoxia is he experiencing?

You've responded to a 24-year-old patient in a minibike accident without a helmet. He has a GCS of 9, SBP of 62 mmHg, and RR of 8> what revised trauma score would you assign this patient?

You've responded to a 30-year-old patient with an amputation of the right leg from factory machinery. He has a GCS of 14, SBP of 143 mmHg, and RR of 34. What revised trauma score would you assign this patient?

Alarm fatigue

Your CCTP partner is checking ventilator settings while the infusion pump immediately beside her continues to go off. Why is your partner not addressing the pump alarm?

332.5 mL/hr

Your MICU arrived at a regional ED to pick-up a 22-year-old, 209-lb, male patient with thermal burns bilaterally on his anterior legs, genitals, and abdomen. The burn center ordered fluids according to the ABA 2010 guidelines. The patient has been in the ED for 2 hours and his urine output has been 50 mL. As you transfer the patient to your equipment, what rate will you infuse the lactated Ringer's at?

III

Your MICU is en-route to an interfacility transfer of a 26-year-old male patient with unstable pelvic fracture. The transferring facility is 90 minutes away from the university medical center that has accepted the patient. What level trauma center is the regional medical center that's transferring the patient?

Diaphragmatic rupture

Your aircraft arrived on scene of a 6-year-old patient tat struck his chest and abdomen while on a trampoline. During your assessment, you auscultate bowel sounds in the chest cavity. What injury do you suspect?

709 mL/hr

Your aircraft arrived on scene to a 34-year-old, 231-lb, female patient with thermal burns on her bilateral posterior legs and lower back. The burn center prefers fluids according to the ABA 2010 guidelines, and your protocols use the rule of nines. At what rate will you infuse the lactated Ringer's?

675 mL/hr

Your aircraft arrives to find an ALS crew that just obtained vascular access on a 75 kg woman. The patient has burns on her head, left arm, chest, and thoracic region. Your service's protocols utilize the Parkland formula and the rule of nines. At what rate should you infuse your isotonic solution?

Your aircraft is en-route to an interfacility transfer to a 22-year-old female patient with an unstable cervical spine fracture. The transferring facility's neurosurgeons did not have the capability to mange cervical fractures, so they called the university medical center. What level trauma center is the regional medical center that's transferring the patient?

Applying a pelvic binder

Your aircraft is picking up a 32-year-old female who was the driver of a vehicle that struck a telephone pole. The dash had to be rolled off of her legs, so she was entrapped for a while. The ground unit informs you that she's hypotensive, has hip deformities, and has bilateral compound ankle fractures. What is your initial treatment for the hypotension?

High doses of IV fentanyl have been reportedly associated with chest wall "rigidity"

Your critical care transport team is carrying a 35-year-old male who has sustained bilateral femur fractures in a rollover motor vehicle collision to a tertiary care facility. The patient never required resuscitation and remained hemodynamically stable through his entire stay at the community hospital from which you are transporting him. During his care there, he had bilateral traction splints applied, two large-bore IVs established, blood type crossed-matched, and supplemental oxygen administered by 100% nonrebreathing mask. The physical exam reveals a patient who is in moderate/severe pain and in distress secondary to the fractures. He is alert and oriented times 3, restless, and anxious. Lungs are clear bilaterally. Heart sounds are good. Both traction splints are in place with good distal dorsalis pedis and posterior tibialis pulses, good distal sensory checks, and range of motion of the feet and toes. Most recent vital signs are blood pressure, 122/68 mmHg; heart rate, 102 beats/min; respirations, 22 breaths/min; SpO2, 100%. Your standing orders call for administration of fentanyl (Sublimaze) 1 mcg/kg, which is 100 mcg for this patient. Which of the following statement is true regarding this medication for this patient?

Acute gastritis

Your patient has ingested a large amount of caustic substance, causing a large GI bleed. How would this bleed be categorized?

A troponin valve of 0.12 ng/mL

Your patient has sustained a myocardial infarction. In addition to the 12-lead showing significant ST elevations in II, III, and AVF, which of the following accurately reflects current myocardial damage?

Epidural hematoma

Your patient has visible trauma to the right temporal area. There was initial report of LOC, but he was AAOx3 on your arrival. He is becoming more lethargic, and his right pupil is now nonreactive and increasing from 3 mm to 5 mm. This is a classic presentation of:

Tachycardic/hypotension

Your patient is a 2-day-old neonate born at 36 4/7 weeks' gestation. His HR is 174, and his systolic blood pressure is 67 mmHg. Which of the following best describes the cardiovascular status of this patient?

Insulin administration

Your patient is being treated for diabetic ketoacidosis. The most recent chemistry panel for this patient reveals a serum potassium of 2.5 mEq/L. What caused this value?

Lipase = 452 U/L

Your patient is complaining of severe left-upper-quadrant pain, nausea, and vomiting and is moderately hypotensive. Which of the following laboratory values most closely reflects acute pancreatitis as the possible cause?

Tidal volume as set on ventilator

Your patient is currently paralyzed, sedated, and being mechanically ventilated with the ventilator set to control mode. What ventilator parameter is terminating the inspiratory phase of the patient's ventilations?

IV oxytocin

Your patient is experiencing significant postpartum hemorrhaging despite fundal massage. Appropriate treatment for this includes:

Obtunded

Your patient is responding minimally to verbal ques and falls asleep quickly in the absence of verbal or tactile stimulation. His mental status is best described as:

Your patient is responsive to painful stimuli, withdraws from pain, and speaks with inappropriate words. What is the patient's Glascow Coma Scale (GCS)?

Pericarditis

Your patient is short of breath and complaining of chest pain. He is seated in a tripod position, which he says improves his condition. When analyzing his 12-lead ECG, you note that all complexes are low voltage, with ST segment elevation and T-wave inversion in all leads. You suspect:

Broca area

Your patient is showing symptoms of expressive aphasia. Which area of the brain is most likely damaged?

Contrecoup injury

Your patient reportedly feel backwards from a chair, striking the back of her head. There is visible occipital trauma. Imaging shows bilateral frontal hemorrhages. This constellation of findings is BEST described as:

Your patient responds to verbal stimuli, speaks with nonsensical words, and withdraws from pain. What is the patient's GCS?

Discuss the concerns with the family and sending physician

Your pediatric CCT unit arrives at a regional hospital to transport a 3-day old infant with atrioventricular septal defect that is extremely unstable. As you enter the room of the level I NICU, the parents are alarmed and agitated. Uninformed and confused about the transport, the father says, "This hospital is the best in the state," and declines the transport. How do you manage this patient?

III

Your physical assessment of the airway reveals that the base of the uvula is the only structure identifiable. What classification Mallampati would you identify this patient as?

Your physical assessment reveals that the posterior pharynx is partially exposed. What classification Mallampati would you identify this patient as?

Opportunistic infections

__________ are disease caused by normally nonpathogenic agents in patient with an abnormally functioning immune system.

Critical Care Transport

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