EMT Mod 4
A transient ischemic attack (TIA) occurs when: Select one: A. a small clot in a cerebral artery causes temporary symptoms. B. signs and symptoms resolve spontaneously within 48 hours. C. medications are given to dissolve a cerebral blood clot. D. a small cerebral artery ruptures and causes minimal damage.
A. a small clot in a cerebral artery causes temporary symptoms.
When administering supplemental oxygen to a hypoxemic patient with a chronic lung disease, you should: Select one: A. adjust the flow rate accordingly until you see symptom improvement, but be prepared to assist his or her ventilations. B. begin with a low oxygen flow rate, even if the patient is unresponsive, because high-flow oxygen may depress his or her breathing. C. avoid positive-pressure ventilation because the majority of patients with chronic lung disease are at increased risk for lung trauma. D. recall that most patients with chronic lung diseases are stimulated to breathe by increased carbon dioxide levels
A. adjust the flow rate accordingly until you see symptom improvement, but be prepared to assist his or her ventilations.
Alkalosis is a condition that occurs when: Select one: A. blood acidity is reduced by excessive breathing. \ B. dangerous acids accumulate in the bloodstream. C. slow, shallow breathing eliminates too much carbon dioxide. D. the level of carbon dioxide in the blood increases
A. blood acidity is reduced by excessive breathing.
Rapid, labored breathing in a patient with signs and symptoms of AMI should make you suspicious for: Select one: A. congestive heart failure. B. significant hypotension. C. right ventricular failure. D. a cardiac arrhythmia
A. congestive heart failure.
A percutaneous transluminal coronary angioplasty (PTCA) restores blood flow to the ischemic myocardium by: Select one: A. dilating the affected coronary artery with a small inflatable balloon. B. placing a stent inside the coronary artery to keep it from narrowing. C. bypassing the coronary artery with a vessel from the chest or leg. D. scraping fatty deposits off of the lumen of the coronary artery.
A. dilating the affected coronary artery with a small inflatable balloon.
After assisting your patient with prescribed nitroglycerin, you should: Select one: A. reassess his or her blood pressure within 5 minutes to detect hypotension. B. avoid further dosing if the patient complains of a severe headache. C. place the patient in a recumbent position in case of fainting\ D. perform a secondary assessment before administering further doses
A. reassess his or her blood pressure within 5 minutes to detect hypotension.
Cardiac output may decrease if the heart beats too rapidly because: Select one: A. there is not enough time in between contractions for the heart to refill completely. B. a rapid heartbeat causes a decrease in the strength of cardiac contractions. C. the volume of blood that returns to the heart is not sufficient with fast heart rates. D. as the heart rate increases, more blood is pumped from the ventricles than the atria
A. there is not enough time in between contractions for the heart to refill completely.
Acute pulmonary edema would MOST likely develop as the result of: Select one: A. toxic chemical inhalation. B. an upper airway infection. C. right-sided heart failure. D. severe hyperventilation.
A. toxic chemical inhalation.
The descending aorta divides into the two iliac arteries at the level of the: Select one: A. umbilicus. B. pubic symphysis. C. nipple line. D. iliac crest
A. umbilicus
When documenting a patient's description of his or her chest pain or discomfort, the EMT should: Select one: A. use the patient's own words. B. document his or her own perception. C. use medical terminology. D. underline the patient's quotes
A. use the patient's own words
Which of the following is a metabolic cause of a seizure? Select one: A. Brain tumor B. Poisoning C. Massive stroke D. Head trauma
B. Poisoning
A 62-year-old man with a history of congestive heart failure presents with severe respiratory distress and with an oxygen saturation of 82%. When you auscultate his lungs, you hear widespread rales. He is conscious and alert, is able to follow simple commands, and can only speak in two- to three-word sentences at a time. You should: Select one: A. place him in a position of comfort, deliver oxygen via nasal cannula, and closely monitor his breathing. B. apply a CPAP device, monitor his blood pressure, and observe him for signs of improvement or deterioration. C. force fluid from his alveoli by hyperventilating him with a bag-valve mask at a rate of at least 20 breaths/min. D. place him in a supine position and assist his ventilations with a bag-valve mask and high-flow oxygen.
B. apply a CPAP device, monitor his blood pressure, and observe him for signs of improvement or deterioration.
Febrile seizures: Select one: A. are also referred to as absence seizures. B. are usually benign but should be evaluated. C. often result in permanent brain damage. D. occur when a child's fever rises slowly
B. are usually benign but should be evaluated.
Nitroglycerin relieves cardiac-related chest pain by: Select one: A. constricting the coronary arteries and improving cardiac blood flow. B. dilating the coronary arteries and improving cardiac blood flow. C. contracting the smooth muscle of the coronary and cerebral arteries. D. increasing the amount of stress that is placed on the myocardium.
B. dilating the coronary arteries and improving cardiac blood flow.
A 22-year-old female patient is complaining of dyspnea and numbness and tingling in her hands and feet after an argument with her fiancé. Her respirations are 40 breaths/min. You should: Select one: A. position her on her left side and transport at once. B. provide reassurance and give oxygen as needed. C. have her breathe into a paper or plastic bag. D. request a paramedic to give her a sedative.
B. provide reassurance and give oxygen as needed.
The electrical stimulus that originates in the heart's primary pacemaker is controlled by impulses from the brain that arrive by way of the: Select one: A. somatic nervous system. B. parietal lobe. C. autonomic nervous system. D. pons and medulla.
C. autonomic nervous system.
The most basic functions of the body, such as breathing, blood pressure, and swallowing, are controlled by the: Select one: A. cerebral cortex. B. cerebellum. C. brain stem. D. cerebrum
C. brain stem.
In contrast to AMI, a dissecting aortic aneurysm: Select one: A. is typically preceded by other symptoms, such as nausea. B. is more commonly associated with pressure in the chest. In contrast to AMI, a dissecting aortic aneurysm: Select one: A. is typically preceded by other symptoms, such as nausea. B. is more commonly associated with pressure in the chest. C. often presents with pain that is maximal from the onset. D. usually presents gradually, often over a period of hours
C. often presents with pain that is maximal from the onset.
Acute coronary syndrome (ACS) is a term used to describe: Select one: A. the exact moment that a coronary artery is completely occluded. B. a severe decrease in perfusion caused by changes in heart rate. C. the warning signs that occur shortly before a heart attack. D. a group of symptoms that are caused by myocardial ischemia
D. a group of symptoms that are caused by myocardial ischemia
Upon arriving at the residence of a patient with a possible cardiac problem, it is MOST important to: Select one: A. determine if you need additional help. B. gain immediate access to the patient. C. request a paramedic unit for assistance. D. assess the scene for potential hazards.
D. assess the scene for potential hazards.
Cardiogenic shock following AMI is caused by: Select one: A. a profound increase in the patient's heart rate. B. widespread dilation of the systemic vasculature. C. hypovolemia secondary to severe vomiting. D. decreased pumping force of the heart muscle
D. decreased pumping force of the heart muscle
Common signs and symptoms of acute hyperventilation syndrome include: Select one: A. anxiety, dizziness, and severe bradypnea. B. altered mental status and bradycardia. C. unilateral paralysis and slurred speech. D. tachypnea and tingling in the extremities.
D. tachypnea and tingling in the extremities.
Signs of adequate breathing in the adult include all of the following, EXCEPT: Select one: a. a reduction in tidal volume. b. rhythmic inhalation and exhalation. c. bilaterally clear breath sounds. d. respirations of 20 breaths/min
a. a reduction in tidal volume.
A 66-year-old female with a history of hypertension and diabetes presents with substernal chest pressure of 2 hours' duration. Her blood pressure is 140/90 mm Hg, her pulse is 100 beats/min and irregular, and her respirations are 22 breaths/min with adequate depth. The patient does not have prescribed nitroglycerin, but her husband does. You should: Select one: a. administer oxygen, give her 324 mg aspirin, and assess her further. b. obtain a SAMPLE history and contact medical control for advice. c. give her one nitroglycerin and reassess her systolic blood pressure. d. give her 100% oxygen, attach the AED, and transport immediately
a. administer oxygen, give her 324 mg aspirin, and assess her further.
nterruption of cerebral blood flow may result from all of the following, EXCEPT: Select one: a. cerebral vasodilation. b. a thrombus. c. an embolism] d. an acute arterial rupture
a. cerebral vasodilation.
A 29-year-old male complains of a severe headache and nausea that has gradually worsened over the past 12 hours. He is conscious, alert, and oriented and tells you that his physician diagnosed him with migraine headaches. He further tells you that he has taken numerous different medications, but none of them seem to help. His blood pressure is 132/74 mm Hg, his pulse is 110 beats/min and strong, and his respirations are 20 breaths/min and adequate. In addition to high-flow oxygen, further treatment should include: Select one: a. dimming the lights in the back of the ambulance and transporting without lights and siren. b. assisting him with his migraine medication and transporting without lights and siren. c. applying warm compresses to the back of his neck and transporting with lights and siren. d. placing him in a supine position and transporting with lights and siren to a stroke center
a. dimming the lights in the back of the ambulance and transporting without lights and siren.
The principal clinical difference between a stroke and hypoglycemia is that patients with hypoglycemia: Select one: a. usually have an altered mental status or decreased level of consciousness b. do not present with slurred speech or weakness to one side of the body. c. always take oral medications to maintain normal blood glucose levels. d. are typically alert and attempt to communicate with health care providers
a. usually have an altered mental status or decreased level of consciousness
When auscultating the lungs of a patient with respiratory distress, you hear adventitious sounds. This means that the patient has: Select one: a. an absence of breath sounds. b. abnormal breath sounds. c. normal breath sounds. d. diminished breath sounds
b. abnormal breath sounds.
While auscultating an elderly woman's breath sounds, you hear low-pitched "rattling" sounds at the bases of both of her lungs. With which of the following conditions is this finding MOST consistent? Select one: a. early pulmonary edema b. aspiration pneumonia c. acute asthma attack d. widespread atelectasis
b. aspiration pneumonia
A 49-year-old male presents with an acute onset of crushing chest pain and diaphoresis. You should: Select one: a. obtain vital signs and a SAMPLE history. b. assess the adequacy of his respirations. c. administer up to 324 mg of baby aspirin. d. administer up to three doses of nitroglycerin
b. assess the adequacy of his respirations.
Which of the following conditions would LEAST likely result in hypoxia? Select one: a. pleural effusion b. pulmonary edema c. severe anxiety d. prolonged seizures
c. severe anxiety
You receive a call for a 70-year-old female with respiratory distress. Her husband tells you that she has congestive heart failure; however, he does not think that she has been taking her medications as prescribed. The patient is laboring to breathe, appears tired, and has cyanosis around her lips. You should: Select one: a. administer oxygen via a nonrebreathing mask. b. assist her ventilations with a bag-mask device. c. apply a pulse oximeter and obtain vital signs. d. obtain a complete list of all of her medications
b. assist her ventilations with a bag-mask device.
The three major parts of the brain are the: Select one: a. midbrain, cerebellum, and spinal cord. b. cerebrum, cerebellum, and brain stem. c. cerebellum, medulla, and occiput. d. brain stem, midbrain, and spinal cord
b. cerebrum, cerebellum, and brain stem.
A pleural effusion is MOST accurately defined as: Select one: a. a bacterial infection of the lung tissue. b. fluid accumulation outside the lung. c. a unilaterally collapsed lung. d. diffuse collapsing of the alveoli.
b. fluid accumulation outside the lung.
Which of the following medications is NOT used to treat patients with a history of seizures? Select one: a. carbamazepine (Tegretol) b. hydromorphone (Dilaudid) c. phenobarbital d. phenytoin (Dilantin)
b. hydromorphone (Dilaudid)
Which of the following conditions would be the LEAST likely to mimic the signs and symptoms of a stroke? Select one: a. a postictal state b. hypovolemia c. intracranial bleeding d. hypoglycemia Feedback
b. hypovolemia
The two processes that occur during respiration are: Select one: a. oxygenation and ventilation. b. inspiration and expiration. c. ventilation and diffusion. d. diffusion and oxygenation
b. inspiration and expiration.
Harsh, high-pitched inspiratory sounds are characteristic of: Select one: a. wheezing. b. stridor. c. rhonchi. d. rales
b. stridor
Which of the following clinical signs is MOST suggestive of a ruptured cerebral artery? Select one: a. confusion and weakness b. sudden, severe headache c. unilateral hemiparesis d. nasal discharge of blood
b. sudden, severe headache
In what area of the lungs does respiration occur? Select one: a. bronchi b. capillaries c. alveoli d. trachea
c. alveoli
When assessing arm movement of a patient with a suspected stroke, you should: Select one: a. expect to see one arm slowly drift down to the patient's side. b. ask the patient to hold his or her arms up with the palms down. c. ask the patient to close his or her eyes during the assessment. d. observe for approximately 5 minutes
c. ask the patient to close his or her eyes during the assessment.
The backup system of respiratory control, which is based on low concentrations of oxygen in the blood, is called the: Select one: a. hypocarbic drive. b. oxyhemoglobin drive. c. hypoxic drive. d. pneumotaxic drive
c. hypoxic drive.
In a healthy individual, the brain stem stimulates breathing on the basis of: Select one: a. decreased oxygen levels. b. increased oxygen levels. c. increased carbon dioxide levels. d. decreased carbon dioxide levels.
c. increased carbon dioxide levels.
When afterload increases: Select one: a. the blood pressure falls because of significant dilation of the blood vessels. b. the volume of venous blood that returns to the right atrium increases. c. it becomes harder for the ventricle to push blood through the blood vessels. d. the amount of resistance that the ventricle must beat against decreases
c. it becomes harder for the ventricle to push blood through the blood vessels.
A patient with an altered mental status is: Select one: a. usually able to be aroused with a painful stimulus. b. typically alert but is confused as to preceding events. c. not thinking clearly or is incapable of being aroused. d. completely unresponsive to all forms of stimuli.
c. not thinking clearly or is incapable of being aroused.
A generalized seizure is characterized by: Select one: a. a core body temperature of greater than 103°F (40°C). b. unconsciousness for greater than 30 minutes. c. severe twitching of all the body's muscles d. a blank stare and brief lapse of consciousness
c. severe twitching of all the body's muscles
A dissecting aortic aneurysm occurs when: Select one: a. a weakened area develops in the aortic wall. b. the aorta ruptures, resulting in profound bleeding. c. the inner layers of the aorta become separated. d. all layers of the aorta suddenly contract.
c. the inner layers of the aorta become separated.
The left cerebral hemisphere controls: Select one: a. the right side of the face. b. heart rate and pupil reaction. c. the right side of the body. d. breathing and blood pressure.
c. the right side of the body.
When obtaining medical history information from the family of a suspected stroke patient, it is MOST important to determine: Select one: a. if there is a family history of a stroke. b. the patient's overall medication compliance. c. when the patient last appeared normal. d. if the patient has been hospitalized before
c. when the patient last appeared normal.
An area of swelling or enlargement in a weakened arterial wall is called: Select one: a. a thrombus. b. atherosclerosis. c. an embolism. d. an aneurysm
d. an aneurysm
Muscle control and body coordination are controlled by the: Select one: a. cerebrum. b. cerebral cortex. c. brain stem. d. cerebellum
d. cerebellum
Paroxysmal nocturnal dyspnea (PND), rales, and dependent edema are clinical indicators of: Select one: a. severe pneumonia. b. bronchitis or asthma. c. emphysema. d. congestive heart failure
d. congestive heart failure
A 66-year-old woman presents with a stabbing pain in the middle of her chest that radiates to her back. She tells you that the pain suddenly began about 30 minutes ago and has been severe since the onset. She has a history of hypertension, but admits to being noncompliant with her antihypertensive medications. When you assess her, you find that her blood pressure is significantly higher in her left arm than it is in her right arm. What are her signs and symptoms MOST indicative of? Select one: a. AMI b. hypertensive emergency c. unstable angina d. dissecting aortic aneurysm
d. dissecting aortic aneurysm
A patient who is possibly experiencing a stroke is NOT eligible for thrombolytic (fibrinolytic) therapy if he or she: Select one: a. has had a prior heart attack. b. is older than 60 years of age. c. has a GCS score that is less than 8. d. has bleeding within the brain.
d. has bleeding within the brain.
Asthma is caused by a response of the: Select one: a. endocrine system. b. respiratory system. c. cardiovascular system. d. immune system
d. immune system
The diaphragm is a unique muscle because it: Select one: a. does not have striations like skeletal muscle. b. is the exclusive muscle of breathing. c. does not receive impulses from the brain. d. is both a voluntary and involuntary muscle
d. is both a voluntary and involuntary muscle
A patient with atherosclerotic heart disease experiences chest pain during exertion because the: Select one: a. coronary arteries suddenly spasm and cause a marked reduction in myocardial blood flow. b. tissues of the myocardium undergo necrosis secondary to a prolonged absence of oxygen. c. ragged edge of a tear in the coronary artery lumen causes local blood clotting and arterial narrowing. d. lumen of the coronary artery is narrowed and cannot accommodate increased blood flow.
d. lumen of the coronary artery is narrowed and cannot accommodate increased blood flow.
Angina pectoris occurs when: Select one: a. a coronary artery is totally occluded by plaque. b. one or more coronary arteries suddenly spasm. c. myocardial oxygen supply exceeds the demand. d. myocardial oxygen demand exceeds the supply
d. myocardial oxygen demand exceeds the supply
A 59-year-old male with a history of emphysema complains of an acute worsening of his dyspnea and pleuritic chest pain following a forceful cough. Your assessment reveals that he has a barrel-shaped chest, unilaterally diminished breath sounds, and tachycardia. What is the MOST likely cause of this patient's condition? Select one: a. rupture of the diaphragm b. acute pulmonary embolism c. exacerbation of his COPD d. spontaneous pneumothorax
d. spontaneous pneumothorax
Successful treatment of a stroke depends on whether: Select one: a. the stroke occurs within the left or right hemisphere of the brain. b. surgical intervention is performed to remove obstructive clots. c. medications are given to restore the function of infarcted cells. d. thrombolytic therapy is given within 3 hours after symptoms began
d. thrombolytic therapy is given within 3 hours after symptoms began
