EMT Exam 4 Chap 19-23 (JBL)
1. Kussmaul respirations are an indication that the body is: A) attempting to eliminate acids from the blood. B) trying to generate energy by breathing deeply. C) severely hypoxic and is eliminating excess CO2. D) compensating for decreased blood glucose levels.
A
16. Epinephrine is indicated for patients with an allergic reaction when: A) wheezing and hypotension are present. B) the patient is anxious and tachycardic. C) a paramedic is present at the scene. D) the reaction produces severe urticarial.
A
18. Which of the following statements regarding epinephrine administration via the intramuscular (IM) route is correct? A) The 1:1000 concentration should be used. B) The preferred injection site is the upper arm. C) The IM route should not be used in children. D) The maximum single adult dose is 0.15 mg.
A
3. When obtaining a SAMPLE history from a patient with diabetes, it would be MOST important to determine: A) if he or she has had any recent illnesses or excessive stress. B) approximately how much water the patient drank that day. C) if there is a family history of diabetes or related conditions. D) the name of the physician who prescribed his or her insulin.
A
31. You are dispatched to a local nursery for a 39-year-old female who is sick. When you arrive, you find the patient lying on the floor. She is semiconscious, has copious amounts of saliva coming from her mouth, and is incontinent of urine. You quickly feel her pulse and note that it is very slow. Immediate management for this patient should include: A) thoroughly suctioning her oropharynx. B) assisted ventilation with a BVM. C) performing a rapid secondary assessment. D) requesting a paramedic to give her atropine.
A
36. In general, injected poisons are impossible to dilute or remove because they: A) are usually absorbed quickly into the body. B) are usually fatal within 30 minutes of exposure. C) absorb slowly into the body, despite their potency. D) react with the blood, which increases their toxicity.
A
39. If the victim of a toxicologic emergency vomits, an EMT should _________. A) use appropriate personal protective equipment and examine the vomitus for pill fragments or other clues for patient care. B) have the patient enclose the vomitus in a container and take it to the emergency department. C) safely dispose of the vomitus as soon as possible and decontaminate the vehicle as necessary. D) not approach the vomitus.
A
42. Most poisonings occur via the __________ route. A) ingestion B) injection C) inhalation D) absorption
A
43. As you enter the residence of a patient who has possibly overdosed, you should: A) be alert for personal hazards. B) look for drug paraphernalia. C) observe the scene for drug bottles. D) quickly gain access to the patient.
A
46. You receive a call to a residence where a man found his wife unresponsive on the couch. The patient's respiratory rate is 8 breaths/min, her breathing is shallow, her heart rate is 40 beats/min, and her pulse is weak. The husband hands you an empty bottle of hydrocodone (Vicodin), which was refilled the day before. You should: A) ventilate her with a BVM. B) contact the poison control center. C) perform a rapid head-to-toe exam. D) apply oxygen via a nonrebreathing mask.
A
47. A 22-year-old male with a history of clinical depression called 9-1-1 and stated that he has attempted to kill himself. Your unit and law enforcement officers arrive at the scene simultaneously. You find the patient lying supine on the living room floor. He is unresponsive and cyanotic. An empty bottle of hydromorphone (Dilaudid) is found on an adjacent table. You should: A) open the patient's airway and assess his respirations. B) ask the police to handcuff the patient for safety purposes. C) provide care after determining what Dilaudid is used for. D) wait for the police to examine him before providing care.
A
50. People at a higher risk for suicide include all of the following, EXCEPT: A) married males older than 30 years. B) those with a recent diagnosis of a serious illness. C) children with parents addicted to alcohol. D) substance abusers.
A
55. The single most significant factor that contributes to suicide is: A) depression. B) drug abuse. C) advanced age. D) a chronic illness.
A
56. You are assessing a 45-year-old female who is severely depressed. She states that it seems as though her entire world is crashing down around her. She further states that she has had frequent thoughts of suicide, but is not sure if she can actually go through with it. How should you manage this situation? A) Ask the patient if she has developed a suicidal plan. B) Leave the scene and have a neighbor check in on her. C) Have law enforcement place her in protective custody. D) Encourage the patient to remain quiet during transport.
A
60. When caring for a patient experiencing excited delirium, the EMT should remember that: A) sudden death can occur if the patient's violence is not controlled. B) lights and siren are effective in redirecting the patient's behavior. C) most patients will have low blood pressure and hyperglycemia. D) excited delirium is worsened by nervous system depressant drugs.
A
66. Whenever possible, a female sexual assault victim should be: A) given the option of being treated by a female EMT. B) encouraged to take a shower and change her clothes. C) thoroughly assessed, even if no signs of injury exist. D) asked to provide a brief description of the perpetrator.
A
71. The physical examination of a sexual assault victim should be: A) limited to a brief survey for life-threatening injuries. B) performed in the presence of at least two police officers. C) as detailed as possible so all injuries can be documented. D) deferred until the patient can be evaluated by a physician.
A
72. The __________ and _________ are folds of tissue that surround the urethral and vaginal openings. A) labia majora; labia minora B) perineum; anus C) vagina; cervix D) fallopian tubes; uterus
A
74. A patient with pelvic inflammatory disease will typically complain of _________. A) abdominal pain associated with menstruation B) nausea and vomiting associated with intercourse C) aches and fever associated with urination D) bleeding associated with stress
A
76. Patient complaints of pain during intercourse, lower abdominal discomfort, and nausea may be indicative of which of the following? A) Pelvic inflammatory disease B) Chlamydia C) Bacterial vaginosis D) Gonorrhea
A
8. Which of the following conditions is the diabetic patient at an increased risk of developing? A) Blindness B) Depression C) Alcoholism D) Hepatitis B
A
10. A patient with an altered mental status; high blood glucose levels; and deep, rapid breathing may have a condition known as __________. A) hyperosmolar hyperglycemic nonketotic coma B) diabetic ketoacidosis C) hypoglycemic crisis D) hyperglycemic crisis
B
12. The EMT should assess for hypoglycemia in small children with a severe illness or injury because: A) a child's cells do not uptake glucose as rapidly as adults' do. B) children cannot store excess glucose as effectively as adults. C) illness or injury causes the pancreas to produce less insulin. D) children overproduce insulin during severe illness or injury.
B
14. The normal blood glucose level is between: A) 60 and 80 mg/dL. B) 80 and 120 mg/dL. C) 30 and 150 mg/dL. D) 160 and 200 mg/dL.
B
2. Common signs and symptoms of severe hyperglycemia include all of the following, EXCEPT: A) warm, dry skin. B) cool, clammy skin. C) rapid, thready pulse. D) acetone breath odor.
B
20. When administering epinephrine via auto-injector, you should hold the injector in place for: A) 5 seconds. B) 10 seconds. C) 15 seconds. D) 20 seconds.
B
21. The stinger from a honeybee should be: A) left in place and covered. B) scraped away from the skin. C) squeezed with tweezers and removed. D) irrigated with copious amounts of water.
B
23. Anaphylaxis is MOST accurately defined as a(n): A) moderate allergic reaction that primarily affects the vasculature. B) extreme allergic reaction that may affect multiple body systems. C) severe allergic reaction that typically resolves without treatment. D) allergic reaction that causes bronchodilation and vasoconstriction.
B
24. The effects of epinephrine are typically observed within _________ following administration. A) 30 seconds B) 1 minute C) 30 minutes D) 1 hour
B
26. A 37-year-old male is having a severe allergic reaction to penicillin. He does not have an epinephrine autoinjector and your protocols do not allow you to carry epinephrine on the ambulance. How should you proceed with the treatment of this patient? A) Ask the patient if he has any diphenhydramine tablets that you can administer. B) Administer oxygen, transport at once, and request a paramedic intercept. C) Remain at the scene with the patient and request a paramedic ambulance. D) Quickly determine if there are any bystanders who may carry epinephrine.
B
33. A 25-year-old man overdosed on heroin and is unresponsive. His breathing is slow and shallow and he is bradycardic. He has track marks on both arms. The EMT should: A) administer naloxone via the intranasal route. B) insert a nasal airway and ventilate with a BVM. C) position the patient on his side and transport. D) administer naloxone via the intramuscular route.
B
34. Your priority in caring for a patient with a surface contact poisoning is to: A) move the patient to a safe area. B) avoid contaminating yourself. C) decontaminate the patient's skin. D) obtain and maintain a patent airway.
B
40. Activated charcoal is given to patients who have ingested certain substances because it: A) induces vomiting and empties the stomach. B) binds to the substance and prevents absorption. C) decreases absorption of poisons into the lungs. D) is a direct antidote for many toxic substances.
B
41. Hypotension, hypoventilation, and pinpoint pupils would be expected following an overdose of: A) ecstasy. B) oxycodone (Percocet). C) amphetamine sulfate (Benzedrine). D) crack cocaine.
B
49. A 66-year-old male presents with bizarre behavior. His daughter states that he did not seem to recognize her and was very rude to her. The patient is conscious, and has a patent airway and adequate breathing. You should: A) conclude that the patient has Alzheimer disease. B) ask the daughter how her father normally behaves. C) carefully restrain the patient and transport at once. D) advise the patient that his behavior is unacceptable.
B
51. You are assessing a conscious 55-year-old male with a sudden change in behavior. Which of the following clinical findings would be MOST suggestive of dysfunction of this patient's central nervous system? A) An irregular pulse B) Rapid eye movement C) Excessive tearing or crying D) Consistent eye contact
B
52. Which of the following conditions or factors would be the LEAST likely to result in a change in behavior? A) Low blood glucose levels B) Antihypertensive medications C) Exposure to excess heat or cold D) Inadequate blood flow to the brain
B
53. A functional disorder is a: A) psychological disorder caused by a structural abnormality. B) physiological disorder in the absence of a structural abnormality. C) psychological disorder in the absence of a structural abnormality. D) physiological disorder caused by a structural abnormality.
B
58. A general impression of the patient is formed by an EMT: A) when the patient is in the ambulance. B) at a distance when the patient is first seen. C) speaking with family members or bystanders first. D) speaking privately with the patient.
B
61. Which of the following is an example of a psychiatric emergency? A) A person going on a week-long "bender" after losing a job B) A person violently attacking family members C) A person who is depressed and no longer caring for himself D) A person who is experiencing a panic attack
B
64. Which of the following is considered an organic brain syndrome? A) Schizophrenia B) Alzheimer dementia C) Anxiety conditions D) Depression
B
7. A patient with hypoglycemia will often present with which of the following signs/symptoms? A) Hypertension B) Pale, cool, and clammy skin C) Warm, red, and dry skin D) Deep, rapid respirations
B
70. If a woman with vaginal bleeding reports syncope, the EMT should assume that she: A) is pregnant. B) is in shock. C) has an infection. D) has an ectopic pregnancy.
B
73. While the ages can vary, women typically experience menstruation from approximately _________ to ____________ years of age. A) 10; 40 B) 11; 50 C) 20; 60 D) 10; 70
B
75. In anticipation of receiving a fertilized ovum, the lining of the uterine wall: A) thins and begins to separate. B) becomes engorged with blood. C) diverts blood flow to the vagina. D) sheds and is expelled externally.
B
80. The _____________ connect(s) each ovary with the uterus. A) egg B) fallopian tubes C) abdomen D) cervix
B
9. Classic signs and symptoms of hypoglycemia include: A) warm, dry skin; irritability; bradycardia; and rapid respirations. B) cool, clammy skin; weakness; tachycardia; and rapid respirations. C) warm, dry skin; hunger; abdominal pain; and deep, slow respirations. D) cold, clammy skin; bradycardia; hunger; and deep, rapid respirations.
B
19. After administering 0.3 mg of epinephrine via auto-injector to a 22-year-old female with an allergic reaction, you note improvement in her breathing and resolution of her hives. However, she is still anxious and tachycardic. You should: A) contact medical control and obtain authorization to administer another 0.3 mg of epinephrine. B) transport her rapidly, as it is obvious that she is having a severe reaction to the epinephrine. C) monitor her closely but recall that anxiety and tachycardia are side effects of epinephrine. D) consider administering 0.15 mg of epinephrine to completely resolve her allergic reaction.
C
35. The poison control center will be able to provide you with the most information regarding the appropriate treatment for a patient with a drug overdose if the center: A) knows the location of the closest hospital. B) is aware of the patient's age and gender. C) is aware of the substance that is involved. D) knows why the patient overdosed on the drug.
C
38. Which of the following sets of vital signs would the EMT MOST likely encounter in a patient with acute cocaine overdose? A) BP, 60/40 mm Hg; pulse, 140 beats/min B) BP, 190/90 mm Hg; pulse, 40 beats/min C) BP, 200/100 mm Hg; pulse, 150 beats/min D) BP, 180/100 mm Hg; pulse, 50 beats/min
C
48. The first step in assessing a patient with a behavioral emergency is to: A) take vital signs. B) restrain the patient. C) ensure your safety. D) obtain proper consent.
C
5. You are treating a 40-year-old male with a documented blood sugar reading of 480 mg/dL. The patient is semiconscious and breathing shallowly, and is receiving assisted ventilation from your partner. You should recognize that definitive treatment for this patient includes: A) oxygen. B) glucagon. C) insulin. D) dextrose.
C
59. A 38-year-old male with a history of schizophrenia is reported by neighbors to be screaming and throwing things in his house. You are familiar with the patient and have cared for him in the past for unrelated problems. Law enforcement officers escort you into the residence when you arrive. The patient tells you that he sees vampires and is attempting to ward them off by screaming and throwing things at them. He has several large lacerations to his forearms that are actively bleeding. The MOST appropriate way to manage this situation is to: A) try to gain the patient's trust by telling him that you see the vampires too. B) request that the police officers arrest him and take him to the hospital. C) restrain the patient with appropriate force in order to treat his injuries. D) approach the patient and calm him by placing your hand on his shoulder.
C
6. A man finds his 59-year-old wife unconscious on the couch. He states that she takes medications for type 2 diabetes. He further tells you that his wife has been ill recently and has not eaten for the past 24 hours. Your assessment reveals that the patient is unresponsive. You should: A) assess for the presence of a medical identification tag. B) administer 100% oxygen via a nonrebreathing mask. C) open and maintain her airway and assess breathing. D) administer oral glucose between her cheek and gum.
C
62. When a psychiatric emergency arises, a patient is most likely to exhibit which of the following behaviors? A) Disruptions to activities of daily living B) Any behaviors unacceptable to the patient, family, or community C) Any behaviors that are a violent threat to the patient, EMTs, or others D) Visual or auditory hallucinations
C
63. Which of the following is a good guideline for physical examination of any patient? A) Always work toe-to-head. B) Examine extremities first. C) Avoid touching without permission. D) Complete the physical exam first, then check the ABCs.
C
67. Pelvic inflammatory disease (PID) typically does NOT affect the: A) uterus. B) ovaries. C) urinary bladder. D) fallopian tubes.
C
68. When caring for a woman who is experiencing a gynecologic emergency, the EMT's main focus should be to: A) determine the underlying cause of her problem. B) ask questions related to her gynecologic history. C) maintain her ABCs and transport without delay. D) keep assessment and treatment to a minimum.
C
11. A 75-year-old male with type 1 diabetes presents with chest pain and a general feeling of weakness. He tells you that he took his insulin today and ate a regular meal approximately 2 hours ago. You should treat this patient as though he is experiencing: A) hypoglycemia. B) an acute stroke. C) hyperglycemia. D) a heart attack.
D
13. The main function of the endocrine system is to _________. A) produce glandular secretions B) regulate glucose and calcium C) regulate blood flow D) maintain homeostasis
D
15. A raised, swollen, well-defined area on the skin that is the result of an insect bite or sting is called: A) a pustule. B) purpura. C) urticaria. D) a wheal.
D
17. Because the stinger of a honeybee remains in the wound following a sting: A) the stinger should quickly be removed with tweezers. B) the body's immune system deactivates the bee's venom. C) the toxicity of the venom decreases within 10 minutes. D) it can continue to inject venom for up to 20 minutes.
D
22. When a foreign substance invades the body, the body will __________. A) protect itself B) go on alert C) attempt to inactivate the foreign substance D) All of these answers are correct.
D
25. Anaphylaxis caused by stinging insects is typically an allergic reaction to ____________ rather than the bite or sting itself. A) injected poison B) irritating toxin C) deadly venom D) All of these answers are correct.
D
27. The adult epinephrine auto-injector delivers ______ mg of epinephrine, and the infant-child auto-injector delivers ______ mg. A) 0.1; 0.01 B) 0.01; 0.1 C) 0.03; 0.3 D) 0.3; 0.15
D
28. Which of the following medications blocks the release of histamines? A) Albuterol (Ventolin) B) Epinephrine (Adrenalin) C) Acetaminophen (Tylenol) D) Diphenhydramine (Benadryl)
D
29. You respond to a college campus for a young male who is acting strangely. After law enforcement has secured the scene, you enter the patient's dorm room and find him sitting on the edge of the bed; he appears agitated. As you approach him, you note that he has dried blood around both nostrils. He is breathing adequately, his pulse is rapid and irregular, and his blood pressure is 200/110 mm Hg. Treatment for this patient includes: A) requesting a paramedic to administer naloxone (Narcan). B) assisting his ventilations with a bag-valve mask device. C) asking law enforcement to place handcuffs on the patient. D) attempting to calm him and giving him oxygen if tolerated.
D
30. Substance abuse is MOST accurately defined as: A) knowingly selling illicit drugs in order to buy more drugs. B) willfully using a therapeutic drug to treat a medical illness. C) unwillingly and unknowingly consuming drugs or alcohol. D) knowingly misusing a substance to produce a desired effect.
D
32. Your paramedic partner administers atropine to a 49-year-old male with bradycardia. Which of the following side effects would you expect the patient to experience? A) Pupillary constriction B) Excessive lacrimation C) A fall in blood pressure D) Dry mucous membranes
D
37. A person who routinely misuses a substance and requires increasing amounts to achieve the same effect is experiencing: A) addiction. B) dependence. C) withdrawal. D) tolerance.
D
4. To which of the following diabetic patients should you administer oral glucose? A) An unconscious 33-year-old male with cool, clammy skin B) A conscious 37-year-old female with nausea and vomiting C) A semiconscious 40-year-old female without a gag reflex D) A confused 55-year-old male with tachycardia and pallor
D
44. A 49-year-old male presents with confusion, sweating, and visual hallucinations. The patient's wife tells you that he is a heavy drinker and she thinks he had a seizure shortly before your arrival. This patient is MOST likely experiencing: A) acute hypovolemia. B) alcohol intoxication. C) acute schizophrenia. D) delirium tremens.
D
45. Of the four avenues of poisoning, generally ___________ is the most worrisome in terms of treatment to the EMS provider. A) inhalation B) absorption C) ingestion D) injection
D
54. General guidelines for managing a patient with a behavioral emergency include: A) firmly identifying yourself as an EMS provider. B) placing the patient between yourself and an exit. C) allowing the patient to be alone if he or she wishes. D) being prepared to spend extra time with the patient.
D
57. Which of the following terms applies to a state of delusion in which the patient is out of touch with reality? A) Agitated delirium B) Schizophrenia C) Suicidal D) Psychosis
D
65. You receive a call for a domestic dispute. When you arrive at the scene, you find a young male standing on the front porch of his house. You notice that an adjacent window is broken. The patient has a large body, is clenching his fists, and is yelling obscenities at you. Which of the following findings is LEAST predictive of this patient's potential for violence? A) His clenched fists B) The broken window C) His shouting of obscenities D) His large body size
D
69. Which of the following clinical presentations is MOST consistent with pelvic inflammatory disease (PID)? A) Left lower quadrant pain, referred pain to the left shoulder, and fever B) Pain around the umbilicus, low-grade fever, and generalized weakness C) Upper abdominal cramping, severe headache, and heavy vaginal bleeding D) Lower abdominal pain, fever, general malaise, and foul-smelling vaginal discharge
D
77. In cases of sexual assault, it is important to ensure that you do which of the following? A) Immediately write down your observations of the scene before assessing the patient. B) Call for a female EMT or ALS care provider. C) Discuss with law enforcement any suspicions that you may have about the perpetrator. D) All of these answers are correct.
D
78. Which of the following infections, when left untreated, may lead to infection of the blood and brain? A) Pelvic inflammatory disease B) Chlamydia C) Bacterial vaginosis D) Gonorrhea
D
79. Causes of vaginal bleeding include which of the following? A) Ectopic pregnancy B) Vaginal trauma C) Spontaneous abortion D) All of these answers are correct.
D