JBL Medical
A 32-year-old man who was stung by a bee has diffuse hives, facial swelling, and difficulty breathing. When he breathes, you hear audible stridor. What does this indicate? A) Swelling of the upper airway structures B) Swelling of the lower airway structures C) Narrowing of the two mainstem bronchi D) Narrowing of the bronchioles in the lungs
A
A 40-year-old male with a history of depression and schizophrenia appears frightened and tells you that he sees snakes everywhere. You should: A) tell him that you do not see any snakes, but they are obviously scaring him. B) let him know that going to the hospital will keep him safe from the snakes. C) advise him that you suspect he has not been compliant with his medications. D) let him know that it is important for him to be transported as soon as possible.
A
A young woman reports significant weight loss over the last month, persistent fever, and night sweats. When you assess her, you note the presence of dark purple lesions covering her trunk and upper extremities. You should suspect: A) HIV infection. B) tuberculosis. C) rheumatic fever. D) end-stage cancer.
A
Common complaints in a patient with an infectious disease include: A) nausea, rash, fever, and shortness of breath. B) headache, low back pain, and arm numbness. C) chest discomfort, weakness, and vomiting. D) joint pain, muscle aches, and blurred vision.
A
When caring for a patient with an acute behavioral crisis, your primary concern should be: A) ensuring your own and your partner's safety. B) providing safe transport to the hospital. C) gathering all of the patient's medications. D) obtaining a complete past medical history
A
Which of the following is a complication associated with renal failure? A) Uremia B) Cystitis C) Renal calculi D) Low potassium
A
Rapid transport of a patient who ingested a large dose of Tylenol is important because: A) an antidote may prevent liver failure if administered early enough. B) activated charcoal cannot be given to patients who ingested Tylenol. C) it takes only a small dose of Tylenol to cause cardiopulmonary arrest. D) liver failure usually occurs within 6 hours following a Tylenol overdose
A (Acetaminophen [APAP] the active ingredient in Tylenol, is a safe drug if taken as directed. Ingestion of more than 140mg/kg in an adult can cause liver failure and death. Symptoms of APAP OD: can take up to a week before signs of liver failure are apparent; does not present acutely. Antidote for APAP: acetylcysteine [Acetadote, Mucomyst], which is only given at the hospital. Activated charcoal can be given to pts who OD on APAP but it is effective only if the drug is still in the stomach. After 1-2 hours following ingestion, activated charcoal would be ineffective)
You are dispatched to a residence for a 20-year-old male with respiratory distress. When you arrive, you find that the patient has a tracheostomy tube and is ventilator dependent. His mother tells you that he was doing fine, but then suddenly began experiencing breathing difficulty. You should: A) remove him from the mechanical ventilator and ventilate him manually. B) check the settings on the ventilator to ensure that it is functioning properly. C) detach the ventilator, suction the tracheostomy tube, and reassess the patient. D) remove the ventilator tubing and place an oxygen mask over the tracheostomy tube.
A (Begin BVM ventilation after removing the pt from the ventilator. If the pt improves, you will know that the problem was a malfunction with the mechanical ventilator. If a pt does not improve, the tracheostomy tube is likely plugged with thick mucus secretions and requires suctioning)
In general, you should avoid rewarming a frostbitten body part in the field if: A) the affected part could refreeze after rewarming. B) a paramedic is not present to administer analgesia. C) you are unable to obtain water that is at least 120ºF. D) arrival at the emergency department will be delayed.
A (Frostbites: should not be rewarmed if there is a chance that they could refreeze after you have rewarmed them. If an extremity thaws and then refreezes, the amount of tissue and cellular damage may be worse than the damage caused by initial freezing . A delay in getting the pt to the ED warrants rewarming. if rewarmed, the extremities should be immersed in water that is 105 degrees F to 112 degrees F. Analgesia would certainly be a comfort to the pt, although its absence does not negate rewarming a frostbitten body part in the field)
After administering epinephrine to a woman in anaphylactic shock, her condition improves. The EMT should recognize that her clinical improvement is because epinephrine: A) constricts the blood vessels and dilates the bronchioles. B) decreases the heart rate, which improves cardiac output. C) blocks histamine receptors and stops the allergic reaction. D) causes fluid to shift back into the cell, which reduces edema.
A (Life-threatening complications of anaphylactic shock: vasodilation which results in hypotension, and bronchoconstriction which results in respiratory failure. Epi stimulates beta and alpha receptors. Alpha receptor stimulation produces vasoconstriction. Beta stimulation produces bronchodilation. Antihistamines [EX: diphenhydramine/Benadryl] binds to histamine receptors which actually terminate the rxn. Antihistamines also reduce the edema)
Which of the following patients with diabetes is the BEST candidate for oral glucose? A) confused patient who has cool, clammy skin B) A confused patient with suspected hyperglycemia C) A semiconscious patient with pale, clammy skin D) An unresponsive patient who took too much insulin
A (Oral glucose is indicated for pts who are in insulin shock [hypoglycemic crisis] and for any pts with symptomatic hypoglycemia [documented by glucometer]. The pt must be conscious and alert enough to be able to swallow the glucose. If the pt is unresponsive or otherwise unable yo swallow the glucose, you should provide rapid transport, proving the appropriate airway management, and consider ALS)
Which of the following is the MOST significant finding in a patient experiencing an allergic reaction? A) Hoarseness B) Headache C) Abdominal cramps D) Widespread rash
A (Signs of allergic rxn: urticaria [rash], headache, abdominal cramps, and hoarseness. Presence of hoarseness is most significant because it indicates upper airway swelling. Other significant findings: swelling of the face, neck, or tongue; wheezing and/or stridor; dyspnea; tachycardia; and hypotension. Death due to severe allergic run is caused by vascular collapse [caused by massive vasodilation] and respiratory failure [caused by upper and/or lower airway swelling]).
You respond to a baseball field for a person who was struck by lightning. When you arrive, you see one patient who appears confused and is ambulatory; a second patient who is conscious, sitting on the ground, and holding his arm; and a third patient who is supine and motionless. After requesting additional responders, you should: A) assess the motionless victim and perform CPR and defibrillation if necessary. B) proceed to the ambulatory patient, sit him down, and assess his mental status. C) treat the conscious patients because the motionless patient is likely deceased. D) assess and begin treating the sitting patient first because he is obviously injured.
A (Those who are conscious following a strike are much less likely to develop delayed respiratory or cardiac arrest since the usually happens immediately after. Those who are not in cardiac or respiratory arrest usually survive. This is reverse triage)
Rapid transport of a patient who ingested a large dose of Tylenol is important because: A) an antidote may prevent liver failure if administered early enough. B) activated charcoal cannot be given to patients who ingested Tylenol. C) it takes only a small dose of Tylenol to cause cardiopulmonary arrest. D) liver failure usually occurs within 6 hours following a Tylenol overdose.
A Acetaminophen (APAP), the active ingredient in Tylenol, is a safe drug if taken as directed. However, ingestion of more than 140 mg/kg in an adult can cause liver failure and death. Symptoms of APAP overdose do not present acutely; it can take up to a week before signs of liver failure are apparent. The antidote for acetaminophen poisoning is acetylcysteine (Acetadote, Mucomyst), which is given only at the hospital. However, it must be given promptly if liver failure is to be avoided. Activated charcoal can be given to patients with APAP overdose; however, it is effective only if the drug is still in the stomach. After 1 to 2 hours following ingestion, activated charcoal would likely be ineffective
Which of the following signs is LEAST suggestive of a diabetic emergency? A) Bradycardia B) Tachycardia C) Combativeness D) Fruity breath odor
A Bradycardia is not commonly associated with either hyperglycemia or hypoglycemia. Tachycardia and combativeness can occur in patients with hyperglycemia or hypoglycemia. A fruity or acetone breath odor, however, is a specific clinical finding in patients with hyperglycemic ketoacidosis (diabetic coma).
Unresponsiveness, shallow breathing, and constricted pupils are indicative of which type of drug overdose? A) Narcotic B) Marijuana C) Barbiturate D) Amphetamine
A Signs of a narcotic (opiate/opioid) overdose from drugs such as heroin, morphine (Astromorph, Duramorph), meperidine (Demerol), and codeine include altered mental status; slow, shallow breathing; pupillary constriction (miosis), hypotension; and bradycardia. Narcotics are central nervous system depressants that, when taken in excess, suppress the vital functions necessary for life, such as breathing, heart rate, and blood pressure. Barbiturates produce the same effects; however, the pupils are typically dilated (mydriasis), not constricted. Marijuana and amphetamine drugs are central nervous system stimulants and, therefore, would cause the patient to become restless or even combative.
A 72-year-old woman is found unresponsive in her poorly ventilated home. Her skin is flushed, hot, and dry, and her respirations are rapid and shallow. She is wearing a medical alert bracelet that states she is a diabetic and is allergic to sulfa drugs. What should you suspect? A) Heatstroke B) Anaphylactic shock C) Acute ischemic stroke D) Diabetic complications
A The patient's signs and symptoms are consistent with classic heatstroke. Unlike exertional heatstroke, which usually affects otherwise healthy people who exert themselves in the heat for long periods of time, classic heatstroke commonly affects children and older adults, and it typically occurs when the patient is in a hot, poorly ventilated space for a prolonged period of time. Significant underlying medical problems (eg, hypertension, diabetes, heart disease) increase the patient's risk for classic heatstroke. Both exertional and classic heatstroke present with hot, flushed skin; however, patients with exertional heatstroke may have moist skin, usually from residual perspiration, whereas patients with classic heatstroke typically have dry skin.
A 60-year-old man presents with a right-sided headache and weakness to his left side. He is conscious and alert. His blood pressure is 190/100 mm Hg, pulse is 88 beats/min, and respirations are 14 breaths/min. His past medical history includes diabetes, arthritis, and hypertension. Which of the following should concern you the MOST? A) His blood glucose level B) The presence of hemiparesis C) His current blood pressure D) The location of his headache
B
A woman with type I diabetes presents with deep, rapid breathing; tachycardia, dehydration; and an altered mental status. Which of the following would MOST likely explain her clinical presentation? A) Her blood sugar level is less than 60 mg/dL B) She has not taken her insulin in several days C) She took her insulin but has not eaten today D) She has an infection that lead to dehydration
B
Activated charcoal is contraindicated for a patient who is: A) emotionally upset and has ingested two bottles of aspirin. B) awake and alert and has swallowed a commercial drain cleaner. C) agitated and claims to have ingested a bottle of Tylenol. D) conscious and alert and has ingested a large amount of Motrin.
B
Active rewarming of a patient with moderate or severe hypothermia should be avoided in the field because: A) the risk of inadvertently inducing hyperthermia is too high. B) rewarming too quickly can cause a fatal cardiac dysrhythmia. C) it is painful for the patient and you cannot give analgesic drugs. D) active rewarming has been shown to cause severe hypertension.
B
EMTs are assessing a man who is under the influence of an unknown substance. The patient is agitated, his BP is 180/100 mm Hg, his pulse rate is 150 beats/min, and his skin is hot to the touch. Which of the following drugs would MOST likely cause these signs and symptoms? A) Heroin B) Cocaine C) Alcohol D) Valium
B
Law enforcement requests your assistance to evaluate a young female whom they believe has overdosed. The patient is conscious, is displaying bizarre behavior, and is very restless. Her BP is 170/90 mm Hg and her heart rate is 130 beats/min. You see needle tracks on both of her arms. Which of the following would MOST likely explain her presentation? A) An opioid B) Methamphetamine C) A sedative-hypnotic D) A benzodiazepine
B
The bite of a brown recluse spider is characterized by: A) immediate pain, swelling at the site, and painful muscle spasms. B) delayed onset of pain, swelling, and blister formation at the site. C) two small puncture marks, swelling, and delayed onset of pain. D) rapid swelling within 30 minutes and a decline in mental status.
B
Which of the following conditions would be the LEAST likely to be present in a patient who was submerged in water? A) Spinal injury B) Hyperglycemia C) Laryngospasm D) Gastric distention
B
Which of the following drugs can cause or worsen excited delirium? A) Heroin B) Cocaine C) Ketamine D) Marijuana
B
Which of the following patient presentations would MOST likely require the EMT to don a high-efficiency particular air (HEPA) respirator? A) Fever, weight loss, and jaundice B) Fever, a cough, and night sweats C) Jaundice, vomiting, and weakness D) Nuchal rigidity, fever, and headache
B
Which of the following statements regarding lightning-related injuries is correct? A) The majority of patients who are struck by lightning die, even if CPR is provided immediately. B) The cardiovascular and nervous systems are most commonly injured during a lightning strike. C) Because of the high electrical energy associated with lightning, full-thickness burns are a common finding. D) Multiple fractures, including those of the cervical spine, are the most common cause of lightning-related deaths.
B (Cardiovascular and nervous systems are most commonly injured during a lightning strike; therefore, respiratory or cardiac arrest is the most common cause of lightning-related deaths. A lightening strike typically induces asystole [cardiac standstill]; however, this spontaneously resolves in some people or with high-quality CPR. Skin burns are superficial because duration of the strike is short. Lightning causes massive contraction of all the body's muscles, potentially resulting in long bone and spinal fx)
Which of the following signs or symptoms would you MOST likely encounter in a patient with an inflamed gallbladder? A) Vomiting dark red blood B) Pain in the right shoulder C) Bruising around the umbilicus D) Pain to the right lower quadrant
B (Cholecystitis: inflammation of the gallbladder. Symptoms: right upper quadrant pain, usually after a meal, and referred pain to the right shoulder; nausea and vomiting may occur. Hematemesis is a sign of GI bleed. Bruising around the umbilicus [Cullen sign] indicates blood in the peritoneal cavity)
You are called to a local park for an ill person. It is a hot day and the humidity is high. When you arrive, a bystander directs you to the patient, a young male who is semiconscious. His skin is flushed, hot, and moist. Your FIRST action in the management of this patient should be to: A) ensure an open airway. B) move him to a cool area. C) administer high-flow oxygen. D) begin rapid cooling measures.
B (Heatstroke: after moving the pt to a better environment, ensuring airway potency, adequate breathing, and adequate circulation, you should proceed with rapid cooling measures)
A woman with type I diabetes presents with deep, rapid breathing; tachycardia, dehydration; and an altered mental status. Which of the following would MOST likely explain her clinical presentation? A) Her blood sugar level is less than 60 mg/dL B) She has not taken her insulin in several days C) She took her insulin but has not eaten today D) She has an infection that led to dehydration
B (Hyperglycemic ketoacidosis: without insulin, glucose cannot enter the cell to make energy, so it pools in the blood to excessive levels [hyperglycemia]. Hyperglycemia cause the body to eliminate large amounts of water via the kidneys, resulting in dehydration. In the absence of glucose, the cell will metabolize fat. which produces ketoacids. The respiratory system will try to eliminate these ketoacids from the body by increasing the rate and depth of breathing [Kussmaul respirations]. Had she taken her insulin, but did not eat, you would have her blood glucose levels lower than normal)
A 24-year-old female presents with a rash to her left leg and swollen, painful knee joints. She tells you that she and her friends returned from a hiking trip in the mountains a week ago. She is conscious and alert with a blood pressure of 112/62 mm Hg, a pulse of 84 beats/min, and respirations of 14 breaths/min. What should you suspect? A) Tetanus B) Lyme disease C) An allergic reaction D) Rocky Mountain spotted fever
B (Lyme disease: result of tick bites. Ticks can Lyme disease and Rocky Mountain spotted fever which are spread through the tick's saliva. First symptom of Lyme: rash [begins about 3 days after the bite of an infected tick] which may represent a target bull's-eye pattern in 1/3 of pts. After a few more days/weeks symptoms: painful swelling of the joints particularly in the knees. Rocky Mountain spotted fever: occurs within 7-10 days after being bitten. Symptoms: nausea, vomiting, headache, weakness, paralysis, and possibly cardiopulmonary failure. Tetanus: muscle spasms [tetany])
A patient who overdosed on methamphetamine would be expected to have all of the following clinical signs, EXCEPT: A) agitation. B) bradycardia. C) hypertension. D) dilated pupils.
B (Meth: an upper, stimulates the CNS causing it to release excessive amounts of adrenaline (epinephrine). Epi increases HR and BP; therefore, the pt would experience tachycardia and hypertension. Other signs: papillary dilation, agitation, and hyperthermia. Bradycardia is more common in pts who OD'd on narcotics, benzodiazepines, barbiturates)
Which of the following signs and symptoms would the EMT expect to encounter in a patient with organophosphate poisoning? A) Flushed skin, blurred vision, and tachycardia B) Excessive salivation, bradycardia, and vomiting C) Dilated pupils, jaundice, dry mouth, and nausea D) Hyperthermia, hypertension, and combativeness
B (Organophosphates: found in industrial pesticides and insecticides; class of chemicals called cholinergics. Parasympathetic NS (AKA cholinergic nervous system) is responsible for slowing of the HR, and other resting functions. Pt would be expected to present with bradycardia, hyper salivation, and other clinical signs of increased parasympathetic [cholinergic] activity. SLUDGEM: salivation/sweating; lacrimation; urination; defecation, drooling, and diarrhea; gastric upset and cramps; emesis; muscle twitching and miosis [pinpoint pupils]. DUMBELS: defecation; urination; miosis; bradycardia; emesis; lacrimation; salivation)
Immediately following a generalized tonic-clonic seizure, most patients are: A) apneic. B) confused. C) hyperactive. D) awake and alert.
B (Pts are typically confused, sleepy, or sometimes combative after a tonic-clonic seizure. This is the postictal phase. The pts LOC improves within 30 min. Pts will most likely by tachypneic because this is the body's attempt to eliminate excess CO2 that accumulated during the seizure. Tachycardia is also common immediately following a generalized tonic-clonic seizure)
Which of the following signs or symptoms would you MOST likely encounter in a patient with an inflamed gallbladder? A) Vomiting of dark red blood B) Pain in the right shoulder C) Bruising around the umbilicus D) Pain to the right lower quadrant
B Inflammation of the gallbladder is called cholecystitis. Classic symptoms include right upper quadrant pain, usually shortly after a meal, and referred pain to the right shoulder. Nausea and vomiting may also occur. Hematemesis (vomiting blood) is a sign of gastrointestinal bleeding, not cholecystitis. Bruising around the umbilicus (Cullen sign) indicates blood in the peritoneal cavity. Pain in the lower right abdominal quadrant is common in patients with appendicitis, not cholecystitis
A 48-year-old male became acutely hypoxic, experienced a seizure, and is now postictal. The MOST effective way to prevent another seizure is to: A) place him in the recovery position. B) give him oral glucose if he can swallow. C) administer high-flow supplemental oxygen. D) dim the lights in the back of the ambulance.
C
A 50-year-old woman complains of a rash and itching to her trunk and arms that began a day after she started taking penicillin. Her breath sounds are clear to auscultation, she denies shortness of breath, her oxygen saturation is 96%, and her BP is 132/74 mm Hg. Treatment should include: A) high-flow oxygen and transport. B) epinephrine and rapid transport. C) transport only with close monitoring. D) warm compresses to relieve the itching.
C
In contrast to a patient with a blood glucose level of 25 mg/dL, a patient with a blood glucose level of 800 mg/dL would be expected to present with: A) profuse diaphoresis and pallor. B) an acute alteration in mentation. C) tachycardia and poor skin turgor. D) a rapid, shallow breathing pattern.
C
When treating an unresponsive man who was struck by lightning, you should: A) begin CPR at once if he is apneic and pulseless. B) apply full spinal precautions before moving him. C) ensure that you and the patient are in a safe place. D) manually stabilize his head and open his airway.
C
Which of the following signs or symptoms is MOST suggestive of a systemic reaction following ingestion of a poison? A) Nausea and vomiting B) Burns around the mouth C) Tachycardia and hypotension D) Painful or difficult swallowing
C
Which part of the assessment process would MOST likely provide clues as to the possible underlying cause of a medical patient's chief complaint? A) Vital signs B) Mental status C) Medical history D) Primary assessment
C
You receive a call for a 54-year-old female who is having a seizure. When you arrive at the scene, the patient is actively seizing. Her husband tells you that she has a history of seizures, and that she has been seizing continuously for 20 minutes. It is MOST important for you to recognize that: A) her seizure could be the result of a low blood glucose level. B) the patient may have stopped taking her seizure medication. C) the patient is hypoxic and needs oxygen as soon as possible. D) her husband's description is consistent with status epilepticus.
C
The MOST obvious way to reduce heat loss from radiation and convection is to: A) move away from a cold object. B) wear a thick wind-proof jacket. C) move to a warmer environment. D) increase metabolism by shivering.
C (Radiation: transfer of heat by radiant energy. The body loses heat by radiation when a person stands in a cold room. Convection: when heat is transferred to a circulating air such as when cool air moves across the body's surface. A person standing in windy cold weather, wearing lightweight clothing is losing heat to the environment mostly by convection. Shivering increases the body's metabolism and is a mechanism for generating heat, not reducing heat loss. Conduction: direct transfer of heat from a part of the body to a colder object by direct contract, as when a warm hand touches cold metal or ice)
A 31-year-old man presents with uncontrolled twitching of his left arm that began shortly after he experienced an odd taste in his mouth. He denies loss of consciousness and states that this has happened to him before. What should you suspect? A) Absence seizure B) Generalized seizure C) Simple partial seizure D) Complex partial seizure
C (Seizures are classified as being generalized or partial. Generalized seizures: tonic-clonic [grand Mal] or absence [petit Mal] seizures. Gen tonic-clonic: result from abnormal electrical discharges from large areas of the brain, usually involving both hemispheres; characterized by unconsciousness and generalized severe twitching and last several minutes or longer. Absence: brief lapse of consciousness in which the pt stares and does not respond; do no involve any changes in motor activity. Partial [focal] seizures: begin in one part of the brain and are classified as simple or complex. Simple partial: no change occurs in the pt's LOC; may report numbness, weakness, or dizziness; the senses may also be involved and the pt may report visual changes and unusual smells or tastes; may also cause twitching of the extremity muscles that spreads slowly from one part of the body to another. Complex partial: pt has an altered mental status and does not interact normally with his or her environment; results from abnormal discharges from the temporal lobe; signs: lip smacking, eye blinking, and isolated convulsions or jerking of the body or one part of the body; pt may experience unpleasant smells and visual hallucinations, exhibit uncontrollable fear, or exhibit repetitive physical behavior such as content sitting or standing)
A 23-year-old female with sickle cell disease complains of a sudden onset of severe pain in her lower extremities. Which of the following is the MOST likely cause of her symptoms? A) Red blood cells are being destroyed at an abnormal rate B) Spontaneous bleeding is occurring within the muscles C) Blood flow is diminished because of vascular occlusion D) Blood clots have formed because of excessive platelets
C (Vasoocclusive crisis)
Which of the following is a physiologic effect of epinephrine when used to treat anaphylactic shock? A) As a vasodilator, it increases the blood pressure. B) As a vasoconstrictor, it lowers the blood pressure. C) As a bronchodilator, it improves the patient's breathing. D) As an antihistamine, it blocks chemicals that cause the reaction.
C Epinephrine possesses dual effects. As a bronchodilator, it relaxes the smooth muscle of the bronchioles and improves the patient's breathing. As a vasoconstrictor, it constricts the blood vessels and increases the patient's blood pressure. Diphenhydramine (Benadryl) is an antihistamine; it blocks H1 histamine receptor sites, which blocks the release of the chemicals (histamines) that are causing the allergic reaction
Patients who abuse opioids by injecting them are also at risk for: A) hepatitis A. B) tuberculosis. C) hepatitis C. D) schizophrenia.
C Patients who abuse opioids by injecting them often share needles with other people. This significantly increases their risk for contracting bloodborne pathogens such as hepatitis C and human immunodeficiency virus (HIV). Hepatitis A is spread by the fecal-oral route; it is not a bloodborne pathogen. Tuberculosis is spread by the droplet (aerosolization) route; it is not a bloodborne pathogen. Schizophrenia is a spectrum of psychiatric illnesses; there is no correlation between opioid abuse and schizophrenia.
A 73-year-old man presents with confusion; cool, pale, clammy skin; absent radial pulses; and a blood pressure of 70/40 mm Hg. The patient's wife tells you that he has had abdominal pain for a week and began vomiting a coffee-ground substance yesterday. His past medical history includes hypertension and gastric ulcer disease. Your MOST immediate concern should be that: A) his blood glucose level is probably too high. B) he is bleeding from his gastrointestinal tract. C) he is in shock and requires prompt transport. D) his condition requires surgery within 2 hours.
C The patient is likely bleeding from his gastrointestinal (GI) tract. Although this is a serious condition, it is not a condition you can treat; internal bleeding cannot be controlled in the field. You can, however, treat his signs and symptoms of shock by administering high-flow oxygen and keeping him warm by covering him with a blanket. Therefore, this should be your most immediate concern. Furthermore, the patient requires prompt transport to the hospital where he can receive definitive care, which may or may not involve surgery. It is highly unlikely that his blood glucose level is too high; he does not have a history of diabetes.
A patient with a core body temperature of 94°F would MOST likely present with: A) decreased muscle activity. B) an altered mental status. C) joint and muscle stiffness. D) shivering and pale skin.
D
The signs and symptoms of an allergic reaction to a bee sting are caused by: A) failure of the immune system to produce antibodies that render the bee's venom inactive. B) an inability of the immune system to recognize the bee's venom as being a foreign substance. C) the direct toxic effects of the bee's venom on the cardiovascular and respiratory systems. D) an exaggerated immune system reaction in which chemicals are released in response to the venom.
D
When assessing a patient with an apparent behavioral crisis, the MOST important initial observation the EMT should make is whether or not: A) the patient is oriented to person, place, and time. B) the patient's residence is well kept or in disarray. C) there is any drug paraphernalia near the patient. D) the patient seems aggressive or verbally abusive.
D
When you arrive at a residence for a man who is "not acting right," you enter the house and find him sitting on his couch. Which of the following findings would be MOST indicative of an altered mental status? A) Odor of alcohol B) Closed eyes C) Tired appearance D) Slurred speech
D
Which of the following complications would MOST likely occur if a patient with end-stage renal disease missed several dialysis treatments? A) Severe dehydration B) Potassium depletion C) Bacterial infection D) Pulmonary edema
D
Activated charcoal may be indicated following an ingestion of: A) lithium. B) gasoline. C) antifreeze. D) ibuprofen.
D (Activated charcoal: binds [absorbs] to specific toxins and prevents their absorption by the body. The toxins are then carries out of the body in the stool. This is not indicated for those who have ingested alkali poisons, cyanide, ethanol [gasoline], iron, lithium, methanol [wood alcohol], mineral acids, organic solvents, and ethylene glycol [antifreeze]. Pts who have ingested large quantities of ibuprofen, ACAP, and aspirin would be candidates provided that they are conscious and alert and can protect their own airway)
Which of the following conditions would place the patient at greatest risk for complications after receiving epinephrine? A) Asthma B) Bradycardia C) Hypovolemia D) Heart disease
D (Epinephrine could cause complications in pts with heart disease or acute coronary syndrome. It increases HR which increases cardiac O2 demand and consumption. This could exacerbate underlying cardiac disease)
You are at the scene where a man panicked while swimming in a small lake. Your initial attempt to rescue him should include: A) throwing a rope to the victim. B) rowing a small raft to the victim. C) swimming to the victim to rescue him. D) reaching for the victim with a long object.
D (General rules for attempting to rescue a pt from the water: reach, throw, row, and then go. Going into the water to retrieve the victim is the last resort)
A 29-year-old man with abdominal pain tells the EMT that he has hemophilia A. This means that: A) his red blood cells break down rapidly. B) he will lose blood at a much faster rate. C) his risk for a pulmonary embolism is high. D) he will bleed for a longer period of time.
D (Hemophilia A: rare disease caused by a deficiency of Factor VII, which is an essential component of blood clotting. The body relies upon an intact clotting system in order to spontaneous stop bleeding [hemostasis]. This impairs the process of hemostasis because the pt's ability to create a clot following an injury is decreased. This also increases the risk of spontaneous bleeding, including in the brain. Pts bleed longer, not faster. Pts whose blood clots too quickly are at risk for a pulmonary embolism. Hemophilia does not affect the RBCs, or how quickly they break down [hemolysis]).
You receive a call to a restaurant where a 34-year-old man is experiencing shortness of breath. When you arrive, you immediately note that the man has urticaria on his face and arms. He is conscious, but restless, and is in obvious respiratory distress. You should: A) ask the patient if he has an epinephrine auto-injector. B) remove the patient's shirt to inspect his chest for urticaria. C) obtain vital signs and a SAMPLE history. D) administer supplemental oxygen at 12 to 15 L/min.
D (Initial management of a pt with a severe allergic rxn is to ensure a patent airway and administer supplemental O2. After ensuring respiratory is okay, ask whether the pt has a prescribed Epi-Pen. If so, contact medical control and obtain permission)
In the patient with diabetes, insulin shock typically presents with: A) dry skin and a slow onset. B) dry skin and a rapid onset. C) clammy skin and a slow onset. D) clammy skin and a rapid onset.
D (Insulin shock [hypoglycemic crisis]: presents with cool, clammy skin and a rapid onset. The brain is critically dependent on glucose and responds quickly when the body is in short supply. Diabetic coma [hyperglycemic crisis]: presents with warm, dry skin and a slow onset. sometimes occurring over a period of days)
When insulin levels in the blood remain high: A) a fruity odor can be detected on the patient's breath. B) the cells starve for glucose and begin to metabolize fat. C) the patient urinates excessively and becomes dehydrated. D) glucose is rapidly taken out of the blood to fuel the cells.
D (Insulin: a hormone that promotes the cellular uptake of glucose from the bloodstream. If insulin levels remain high, such as when a diabetic takes too much insulin, glucose is rapidly taken out of the blood to fuel the cells. This leads to low circulating blood glucose levels [hypoglycemia] and a condition called insulin shock. If insulin levels are too low, such as when a diabetic forgets to take their insulin, glucose cannot enter the cells and pools in the bloodstream [hyperglycemia]. In the absence of glucose. the ells begin to metabolize fat which produces ketooacids [DKA]. The respiratory system attempts to eliminate ketoacids from the blood with an increased rate and depth of breathing [Kussmaul] that is accompanied by a fruity or acetone breath odor. Hyperglycemia causes the pt to eliminate excess water from the body through urination [diuresis], resulting in dehydration)
You are transporting a 35-year-old male who has a history of alcoholism. He stopped drinking 4 days ago and is now disoriented, diaphoretic, and tachycardic. This patient is at risk for: A) schizophrenia. B) hypothermia. C) hyperglycemia. D) tonic-clonic seizures.
D (Pt with alcohol withdrawal: frightening hallucinations [delirium tremens/DT], a syndrome characterized by restlessness, fever, disorientation, sweating, and agitation. In severe cases, gen tonic-clonic seizures may occur. About 1-7 days after a person stops drinking or when alcohol consumption levels are suddenly decreased, DTs may develop. Pts with DTs are often dehydrated due to sweating, fluid loss, insufficient fluid intake, or vomiting, and their hallucination can be extremely frightening. Alcoholic pts would more likely be hypoglycemic)
After moving a hypothermic patient to a warmer area, your primary focus should be to: A) provide rapid rewarming. B) give warm, humidified oxygen. C) assess his or her body temperature. D) prevent further body heat loss.
D (Rapid rewarming may induce a lethal cardiac dysrhythmia and cardiac arrest. Assessing a hypothermic pt's core body temp requires a special hypothermia thermometer, which many EMS may not carry)
