practice final
A five-year-old child is introduced to you as Robert Smith. The proper way for you to address him is: "Hey, little guy!" "Hi, Robert." "Hi, Bobby." "Hello, Mr. Smith."
"Hi, Robert."
An elderly man is complaining of shortness of breath. You discover pitting edema that is 0.5 to 1 inch deep. This is ________ pitting edema. +4 +1 +2 +3
+3
At standard speed, a 1 mm box on ECG paper represents ________ seconds. 0.08 0.04 0.1 0.12
.04
When the ECG paper is traveling at the standard rate of 25 mm/sec, a large box in the horizontal direction equals: 0.12 seconds. 0.08 seconds. 0.24 seconds. 0.20 seconds.
0.20 seconds.
Reassessment should include which of the following? 1. Assess effects of interventions. 2. Check vital signs. 3. Assess skin condition. 4. Do detailed physical exam. 5. Check airway patency. 1, 3, and 4 2, 4, and 5 1, 2, 3, and 5 1, 2, 4, and 5
1, 2, 3, and 5
There are 15 small boxes between R waves on an ECG tracing. What is the heart rate? 100 120 150 20
100
There are three large boxes between R waves on an ECG tracing. What is the heart rate? 75 100 50 150
100
The normal range of hemoglobin (Hb) levels in the adult male patient would be closest to: 14-17.4 g/dL. 14-17.4 mg/dL. 9.9-14.5 g/dL. 9.9-14.5 mg/dL.
14-17.4 g/dL.
For which of the following patients should you conduct a focused physical exam? 65-year-old male with an altered level of consciousness 22-year-old male with a gunshot wound to the abdomen 35-year-old female roller skater with an ankle fractured after falling 15-year-old female pedestrian who was struck by a motor vehicle traveling at 25 mph
35-year-old female roller skater with an ankle fractured after falling
Which of the following choices is the correct sequence of steps in critical decision making? 1. Interpreting the data 2. Evaluating results 3. Reflecting on the incident 4. Forming a concept 5. Applying the principles 4, 1, 5, 2, 3 1, 2, 4, 5, 3 4, 3, 5, 2, 1 3, 4, 5, 1, 2
4, 1, 5, 2, 3
Which of the following is the correct sequence of cardiac electrical activity? 1. AV node 2. Internodal pathways 3. Bundle of His 4. SA node 5. Purkinje fibers 6. Bundle branches 1, 2, 4, 3, 5, 6 4, 1, 2, 3, 6, 5 1, 2, 4, 3, 6, 5 4, 2, 1, 3, 6, 5
4, 2, 1, 3, 6, 5
A critical patient's vital signs should be reassessed at least every ________ minutes. 15 20 5 10
5
Select the choice below that best describes the sequence of a joint examination. 1. Palpation 2. Passive range of motion 3. Range of motion against resistance 4. Range of motion against gravity 5. Inspection 2, 3, 4, 5, 1 5, 2, 1, 3, 4 5, 1, 2, 4, 3 1, 5, 2, 4, 3
5, 1, 2, 4, 3
Your patient remains unresponsive after a painful stimulus is applied. The family reports that the patient was found unconscious in bed after complaining of a "terrible headache." Which of the following represents the correct sequence of actions in this situation? 1. Obtain a brief history from the family. 2. Conduct a rapid secondary assessment. 3. Perform a detailed exam. 4. Determine vital signs. 5. Perform a primary assessment. 5, 2, 3, 1 5, 2, 1, 4 5, 1, 2, 4 5, 1, 3, 4
5, 2, 1, 4
Which of the following statements concerning Q waves on the ECG is most accurate? The absence of a Q wave is a significant pathophysiological finding. A Q wave is significant only in the presence of chest pain. Q waves are not a normal finding on the ECG. A Q wave is significant if it is 0.04 or more seconds wide.
A Q wave is significant if it is 0.04 or more seconds wide.
In which of the following situations is a significant amount of carboxyhemoglobin most likely to be present? A patient who is being treated with nitrites for cyanide poisoning A patient with COPD who is short of breath with an SpO2 of 90 percent A patient found unresponsive in an apartment in which there is a gas furnace A patient who inhaled anhydrous ammonia fumes
A patient found unresponsive in an apartment in which there is a gas furnace
Which of the following is the most important determinant of ventilatory rate? Arterial PO2 Venous PO2 Arterial PCO2 Venous PCO2
Arterial PCO2
A patient is complaining of abdominal pain, nausea, and vomiting. Which of the following will provide you with the most immediately useful information? Asking about any unusual taste in the mouth Asking about the presence of coffee-grounds emesis Checking for discoloration of the tongue Finding out about any unusual stress in the patient's life
Asking about the presence of coffee-grounds emesis
Which of the following will provide the LEAST information about a patient complaining of abdominal pain? Assessing reaction of the pupils to light Performing a tilt test Looking for Cullen's sign Checking for unusual breath odors
Assessing reaction of the pupils to light
Which of the following is included in an examination of the cardiovascular system Palpate both carotid arteries simultaneously. Palpate to check for Murphy's sign. Auscultate breath sounds. Auscultate for carotid bruits.
Auscultate for carotid bruits.
A 60-year-old man presents with altered mental status. There is no evidence of trauma. Which of the following is most likely to give you specific information about the underlying cause of the patient's condition? A Babinski reflex Pulse oximetry End-tidal carbon dioxide monitoring Blood glucose determination
Blood glucose determination
Which of the following is a traumatic mechanism by which a myocardial injury can be produced? Blunt chest trauma Penetrating chest trauma Traumatic brain injury Rapid deceleration
Blunt chest trauma
Which of the following is affected by a properly working pacemaker? Stroke volume Automaticity Cardiac rhythm Ejection fraction
Cardiac rhythm
Your patient is complaining of numbness and hand pain that wakes him. Of the following, which is most likely? Plantar fasciitis Bursitis Carpal tunnel syndrome Chondromalacia
Carpal tunnel syndrome
While assessing a 23-year-old man with abdominal pain, you note discoloration around the umbilicus. This is known as: ascites. Cullen's sign. Kernig's sign. borborygmi.
Cullen's sign.
Discoloration over the umbilicus, known as ________ sign, is a(n) ________ indicator of intraabdominal bleeding. Cullen's; late Grey Turner's; late Cullen's; early Grey Turner's; early
Cullen's; late
Which of the following findings is NOT a sign of peritoneal irritation? Rebound tenderness DeLorenzo's sign Abdominal pain when the patient coughs Abdominal pain upon light palpation
DeLorenzo's sign
During a musculoskeletal exam, you find redness of the skin over a nontraumatized joint. Which of the following is LEAST likely to be the cause? Dislocation Rheumatic fever Gout Arthritis
Dislocation
Which of the following may indicate either cardiac tamponade or tension pneumothorax? Subcutaneous emphysema Cushing's reflex Distended neck veins Hypertension
Distended neck veins
A 45-year-old man is alert and oriented, complaining of chest pain. He describes a two-day history of worsening pain, described as a burning sensation below his left breast that radiates across his chest. He states that the pain seems to get better right after eating, but then worsens again. Medical history includes myocardial infarction, hypertension, and type 2 diabetes. His medications include Inderal, Vasotech, Glucotrol, and Lopid. Physical examination reveals cool, dry skin; clear lungs; and no JVD or peripheral edema. HR = 102, BP = 132/86, RR = 12, SaO2 = 98%. The patient is on oxygen by nasal cannula at 4 liters per minute. Which of the following should be done next? Do a 12-lead ECG. Give 0.4 mg nitroglycerin sublingually. Start precautionary IV of normal saline and transport. Give 81 mg aspirin by mouth.
Do a 12-lead ECG.
Which of the following guidelines should be observed when examining a one- to three-year-old child? Restrain the child if necessary. Do not distract the toddler with toys. Focus on the vital areas as indicated by the chief complaint. Perform a comprehensive head-to-toe exam on all children in this age group.
Focus on the vital areas as indicated by the chief complaint.
What procedure can you perform to determine additional signs of carpal tunnel syndrome? Hold the patient's wrist in acute extension for 60 seconds. Ask the patient to gently wave his wrists for 60 seconds. Hold the patient's wrist in acute flexion for 60 seconds. Ask the patient to extend his fingers forward for 60 seconds.
Hold the patient's wrist in acute extension for 60 seconds.
ETCO2 is recorded during phase ________ of the capnogram. III IV I II
III
Which of the following can be determined by lead II cardiac monitoring? Presence of a myocardial infarction, but not its location Axis deviation Impulse conduction time Chamber enlargement
Impulse conduction time
Which of the following best describes why a focused history is important in responsive medical patients? It identifies signs of medical complications. It supports diagnostic impression. It helps to formulate a field diagnosis. It allows treatments to be initiated immediately.
It helps to formulate a field diagnosis.
Which of the following statements is FALSE regarding the S3 heart sound? It is a high-pitched sound heard at the end of diastole. It can develop with ventricular failure or ventricular volume overload. It is commonly heard in children. It is the "dee" part of the "lub-dub-dee" cadence.
It is a high-pitched sound heard at the end of diastole.
Which of the following is NOT a reason that a reassessment is important? It allows you to detect trends in the patient's status. It determines changes in the patient's conditions. It allows you to assess the effects of interventions. It reassures the patient you are taking good care of him.
It reassures the patient you are taking good care of him.
Why is a detailed physical exam rarely performed on critical trauma patients in the prehospital setting? It is used only on medical patients. It usually yields little immediately useful information. It produces too much patient anxiety. The rapid trauma assessment performs the same function.
It usually yields little immediately useful information.
After the primary assessment of an unresponsive medical patient with stable vital signs, which of the following is the position in which the patient should be placed? Supine Semi-Fowler's Lateral recumbent Prone
Lateral recumbent
Which of the following arteries supplies blood primarily to the left ventricle and posterior wall? Posterior descending Marginal Left coronary Right coronary
Left coronary
Which of the following is a normal finding when examining a patient's neck? Visible lymph nodes Tracheal tugging Movement of the thyroid gland during swallowing Subcutaneous emphysema
Movement of the thyroid gland during swallowing
Which of the following body systems would you gain the least information about during an abdominal exam? Cardiovascular Digestive Reproductive Musculoskeletal
Musculoskeletal
Your patient is a 62-year-old woman with a history of COPD. She is slightly more short of breath than usual today. She is alert and speaks three to four words between breaths. Her SpO2 is 93 percent on room air. Which of the following devices should be used for the administration of oxygen to this patient? Nonrebreather mask CPAP BVM Nasal cannula
Nasal cannula
What is one way to read the patient? Observe the mechanism of injury. Observe the level of consciousness. Obtain the history from family members. Address life threats.
Observe the level of consciousness.
Which of the following best describes the technique for palpating the abdomen for large or deep masses? One hand pushing deeply in a quick, smooth motion One finger pressing firmly against the abdominal wall One hand over another, pushing down slowly Both hands side by side over the midline of the abdomen
One hand over another, pushing down slowly
Your patient is a 44-year-old woman, alert and oriented, in moderate distress and complaining of difficulty breathing. She gives a one-week history of fever and malaise, with shortness of breath developing three days ago. She also has left-sided chest pain with deep inspiration and a "phlegmy" cough. Physical examination reveals hot, pale, dry skin, and rhonchi and crackles throughout the left lung. The right lung sounds are clear. HR = 134, BP = 88/64, RR = 24, SaO2 = 92%. She has a history of two previous myocardial infarctions and takes nitroglycerin as needed. Which of the following is the best course of prehospital management? Oxygen by nonrebreather mask; IV of NS KVO; and furosemide, 40 mg IV Oxygen via nonrebreather mask and IV of NS with fluid challenge Albuterol via nebulizer with 100 percent oxygen and IV of NS KVO Endotracheal intubation, ventilation with supplemental oxygen, IV of NS KVO, nebulized albuterol and Atrovent, and corticosteroids IV
Oxygen via nonrebreather mask and IV of NS with fluid challenge
Which of the following is LEAST important to the paramedic when evaluating a patient's skin in an emergency situation? Moisture Temperature Pigmentation Color
Pigmentation
Which of the following is LEAST urgent when evaluating a patient suspected of suffering an acute myocardial infarction? Blood pressure ECG Breath sounds Pulse oximetry
Pulse oximetry
Which of the following statements about pulse oximetry is FALSE? Pulse oximetry values can be expected to decrease within seconds in cases of developing hypoxia. Oxygen saturation is the percentage of hemoglobin that is bound with some molecular structure. Pulse oximetry should be used on all patients with respiratory complaints. It may be difficult to obtain a reading in patients experiencing peripheral vasoconstriction.
Pulse oximetry values can be expected to decrease within seconds in cases of developing hypoxia.
The total duration of ventricular depolarization is represented by the ________ on the ECG. QRS duration PQ interval QT interval R-R interval
QRS duration
Your patient is a 16-year-old male who attempted suicide. He is unconscious and apneic, lying supine on a garage floor. The family states that they found the patient unconscious in the front seat of a car that was running in an enclosed garage. HR = 70, BP = 100/60, RR = 0. In addition to an IV of normal saline, which of the following is the most appropriate action? Remove the patient from the garage, initiate BVM ventilations with 100 percent oxygen, intubate, and transport to a hospital with a hyperbaric chamber. Remove the patient from the garage, intubate, and transport to the nearest hospital. Intubate, remove the patient from the garage, and transport to a hospital with a hyperbaric chamber. Remove the patient from the garage, initiate BVM ventilations with 100 percent oxygen, intubate, and transport to the nearest facility.
Remove the patient from the garage, initiate BVM ventilations with 100 percent oxygen, intubate, and transport to a hospital with a hyperbaric chamber.
You are en route to a hospital with a patient who appears stable following a motor vehicle collision. To detect changes in the patient's condition, you should do which of the following during transport? Rapid trauma assessment Detailed physical examination Neurological assessment Repeat the primary assessment
Repeat the primary assessment
A patient who loses his balance while standing with his eyes closed and feet together for 20 to 30 seconds is exhibiting a positive: Kehr's sign. tilt test. Romberg test. Babinski's reflex.
Romberg test.
Which of the following sounds is produced when the tricuspid and mitral valves close during systole? S3 S4 S2 S1
S1
Which of the following is an abnormal finding of the pupils? Constriction when focusing on a near object Slow but equal reaction to light Both pupils constricting when a penlight is shone in one eye Less than 2 mm difference in size with normal reaction to light
Slow but equal reaction to light
Your patient is a 73-year-old man who is sitting in a recliner, cyanotic, pulseless, and apneic. The patient's skin is cool and dry. The patient's wife last saw him an hour and a half ago. Which of the following should you do first? Start CPR. Inform the patient's wife that he is dead and nothing can be done for him. Check for rigor mortis. Attach the monitor/defibrillator.
Start CPR.
Which of the following would result in an increased respiratory rate? An increase of cerebrospinal fluid pH Stimulation of chemoreceptors by an increase of PCO2 A decrease of cerebrospinal fluid PO2 Stimulation of baroreceptors by an increase of PCO2
Stimulation of chemoreceptors by an increase of PCO2
Which of the following best describes the technique of evaluating plantar reflexes? Tap the patellar tendon just below the edge of the patella. Stroke the lateral aspect of the sole of the foot from heel to ball, curving medially. Strike the triceps along the posterior aspect of the distal humerus. Have the patient dorsiflex the foot, then strike the Achilles tendon.
Stroke the lateral aspect of the sole of the foot from heel to ball, curving medially.
Which of the following best describes the correct positioning of a patient for an abdominal exam? Lateral recumbent Supine with the head and knees supported by pillows Semi-Fowler's position Supine with the head flat and legs extended
Supine with the head and knees supported by pillows
Ventricular repolarization of the myocardium is represented by the: T wave. isoelectric line. beginning of the QRS complex to the apex of the T wave. ST segment.
T wave.
Which of the following best describes the pulse pressure? The diastolic pressure plus one-third of systolic pressure The sum of systolic and diastolic blood pressures The systolic pressure minus one-third of the diastolic pressure The difference between systolic and diastolic blood pressures
The difference between systolic and diastolic blood pressures
Which of the following characteristics is most similar between the prehospital setting and other medical care environments? The need to establish an airway early in patient care The absence of laboratory results to guide treatment Unpredictable circumstances The variety of uncontrolled environments
The need to establish an airway early in patient care
A 12-lead ECG that reveals slight ST segment elevation; Q waves in leads II, III, and aVF; and ST elevation in V1 and V2 most indicate which of the following? The patient is experiencing myocardial ischemia in her inferior wall that is extending into the septum. The patient is experiencing myocardial injury in her lateral wall. The patient is experiencing ischemia and injury in her left ventricle and septum. The patient has had a myocardial infarction in her inferior wall and is experiencing ischemia extending into the right ventricle.
The patient has had a myocardial infarction in her inferior wall and is experiencing ischemia extending into the right ventricle.
You have applied a CO-oximeter to your patient, and it is displaying an SpCO of 15 percent. Which of the following is the most appropriate interpretation of this finding? This is consistent with a fatal level of carbon monoxide poisoning. This is consistent with mild carbon monoxide poisoning. This is a normal reading for a nonsmoker and nothing to worry about. This is a normal reading for a smoker and nothing to worry about.
This is consistent with mild carbon monoxide poisoning.
You are working in the ED, caring for a 55-year-old female patient with a long history of COPD. She is more short of breath today than usual, and states that she has an increased cough. She has a tympanic temperature of 99.8°F. You have drawn arterial blood gases with the patient on room air; when the report comes back, it shows that the patient has a PaO2 of 92 mmHg. Which of the following is most likely? The lab performed the test incorrectly. The patient is critically hypoxic and requires assisted ventilation. This is the typical value for this patient. You have inadvertently drawn a venous sample.
This is the typical value for this patient.
Which of the following patient conditions requires immediate transport? Unresponsiveness to painful stimuli after ALS interventions Neck pain following a motor vehicle collision Wrist fracture with diminished distal sensation Narcotic overdose
Unresponsiveness to painful stimuli after ALS interventions
The anterior surface of the heart is best viewed by ECG leads: II, III, aVF. I, aVL. V1-V4. aVR, aVL, aVF.
V1-V4.
The lead to the left of the sternum at the fourth intercostal space is: V4. V3. V1. V2.
V2
When you ask the patient to puff out her cheeks, show her upper and lower teeth, and raise her eyebrows, which cranial nerve are you evaluating? V VI VII IX
VII
Which of the following findings is abnormal in a cardiovascular assessment? Splitting of the S2 heart sound in children Visible pulsation of the PMI at the fifth intercostal space, medial to the left midclavicular line Jugular venous distension in the supine position Vibrations when palpating the carotid artery
Vibrations when palpating the carotid artery
All of the following are signs of inadequate breathing in an infant EXCEPT: use of accessory muscles. altered mental status. cyanosis. a respiratory rate of 32 breaths per minute.
a respiratory rate of 32 breaths per minute.
An important aspect of the reassessment is to monitor and evaluate all of the following EXCEPT the: transport priority. accumulation of charges for care. vital signs. effectiveness of interventions.
accumulation of charges for care.
Artifacts such as muscle tremors can make assessment of cardiac rhythm difficult because: an artifact can cause the pacer to fire prematurely. the QRS complexes may be obscured by the pacer spikes. an artifact can obscure the underlying rhythm. the pacemaker may confuse the artifact with an electrical impulse and not fire.
an artifact can obscure the underlying rhythm.
The fourth heart sound, S4, is: an atrial gallop sound. a ventricular gallop sound. a high-pitched sound at the base of the heart. the "dub" of "dee-lub-dub."
an atrial gallop sound.
Lung perfusion depends on all of the following EXCEPT: intact pulmonary capillaries. an intact alveolar membrane. adequate blood volume. efficient pumping of blood by the heart.
an intact alveolar membrane.
Critical thinking is a thought process used to: establish credibility with an emergency physician. defend one's actions in a CQI review process. focus on a situation's most important aspect. analyze and evaluate.
analyze and evaluate.
With your field diagnosis in mind, you develop a treatment plan for your patient. This part of the critical decision-making process is called: interpreting the data. forming a concept. evaluating the results. applying principles.
applying principles.
Your 23-year-old female patient presents with relatively normal vital signs and is fully alert and oriented. Her only complaint is lower abdominal pain. If you assume she is pregnant, you are: applying principles. overgeneralizing. evaluating. interpreting the data.
applying principles.
The most important factor in determining the respiratory rate is: alveolar pCO2. arterial pO2. alveolar pO2. arterial pCO2.
arterial pCO2.
Most carbon dioxide from cellular metabolism reaches the alveoli by being transported: as carbonic anhydrase. bound to hemoglobin. dissolved in plasma. as bicarbonate ion.
as bicarbonate ion.
In an infant, the heart rate is best detected by either palpating the brachial artery or: auscultating the carotid pulse. palpating the carotid pulse. palpating the femoral pulse. auscultating the apical pulse.
auscultating the apical pulse.
A 23-year-old female patient is complaining of lower abdominal and genital pain. Upon examination you find a white, curdlike vaginal discharge. This is most typical of: Gardnerella. gonorrhea. herpes simplex. candidiasis.
candidiasis.
To assess an infant's airway, you should: hyperextend the head and lift the chin. carefully extend the head and neck. perform a tongue-jaw lift. perform a jaw-thrust maneuver.
carefully extend the head and neck.
During the cardiac cycle, the S2 heart sound indicates the ________ of the ________ valves. closing; aortic and pulmonic opening; mitral and tricuspid opening; aortic and pulmonic closing; mitral and tricuspid
closing; aortic and pulmonic
A patient experienced a brief loss of consciousness following a blow to the head. During your questioning, she describes a series of events that do not match what observers had noted before the trauma. This might be an example of: incoherence. delusion. confabulation. mania.
confabulation.
A complete neurologic exam includes assessment of mental status and speech, the motor and sensory systems, reflexes, and the: visual acuity. speed of peripheral nervous conduction. tympanic membrane. cranial nerves.
cranial nerves.
Areas of a neurologic exam include all of the following EXCEPT: reflexes. cranium. cranial nerves. mental status and speech.
cranium.
The crunching sound that is made when unlubricated skeletal parts rub against each other is called: a pleural friction rub. crepitus. a synovial rub. bursal friction.
crepitus.
Normal pediatric respiratory and heart rates ________ as children grow older. stay the same decrease increase increase, then decrease
decrease
While speaking, your patient shifts rapidly from topic to topic without realizing that his thoughts are not connected. This might be a sign of any of the following conditions EXCEPT: manic episodes. psychosis. schizophrenia. depression.
depression.
You are examining a 70-year-old female patient with altered mental status. She is awake and can speak. You detect an odor of acetone and suspect that the patient is suffering from: cyanide poisoning. bowel obstruction. diabetic ketoacidosis. alcohol poisoning.
diabetic ketoacidosis.
The mitral valve is open during: repolarization. diastole. systole. cardiac standstill.
diastole.
Palpation and inspection of the point of maximal impulse can reveal certain conditions, such as: pneumothorax. coronary insufficiency. cardiac tamponade. enlarged right ventricle.
enlarged right ventricle.
An ECG monitor is useful for: determining stroke volume. evaluating the effectiveness of cardiac contractions. determining cardiac output. evaluating the heart's electrical conduction system for abnormalities.
evaluating the heart's electrical conduction system for
You can test the oculomotor, trochlear, and abducens nerves by: shining a light into the pupils and observing constriction of the pupils. conducting a visual acuity test. closing one nostril while presenting a strong smell under the other nostril. evaluating the patient's extraocular movements.
evaluating the patient's extraocular movements.
During the reassessment of a stable patient, you should recheck vital signs every 15 minutes. This is an example of: reviewing. evaluating. applying principles. reflecting.
evaluating.
Capnometry measures the partial pressure of CO2 in: inspired air. expired air. venous blood. arterial blood.
expired air.
The loss of muscle tone results in: flaccidity. rigidity. paresthesia. spasticity.
flaccidity.
When evaluating dorsiflexion, you should instruct the patient to point his: foot upward. hand upward. foot downward. hand downward.
foot upward.
The first step in critical thinking is to: ascertain the chief complaint. determine statistically significant conditions. form a concept. conduct a focused exam.
form a concept.
As you survey the scene, you are gathering information about your patient and the scene. This step in the critical decision-making process is called: interpreting the data. reflecting on the incident. forming a concept. evaluating results.
forming a concept.
A patient who is experiencing dysphonia: has defective language caused by neurological damage. is speaking clearly and normally. has voice changes secondary to vocal cord problems. has defective speech caused by motor deficits.
has voice changes secondary to vocal cord problems.
The precordial leads provide a view of the: inferior portion of the heart, including the entire right ventricle. lateral plane of the heart, including part of the right ventricle, most of the left ventricle, and the septum. horizontal plane of the heart, including the right ventricle and right atrium. horizontal plane of the heart, including the left ventricle and septum.
horizontal plane of the heart, including the left ventricle and septum.
During a neurologic exam, you ask your patient to stick out his tongue. It deviates to the right. This may indicate a lesion to the patient's ________ nerve. facial glossopharyngeal hypoglossal vagus
hypoglossal
A patient who is misinterpreting what is happening is experiencing a(n): hallucination. paresthesia. delusion. illusion.
illusion.
An increased hydrogen ion concentration in the cerebrospinal fluid results in a(n) ________ respiratory rate. unchanged decreased increased erratic
increased
A 12-lead ECG that reveals ST elevation in all of the precordial leads most indicates myocardial: injury to the right ventricle, left ventricle, and septum. ischemia to the left ventricle and septum. injury to the right ventricle and septum. infarction to the left and right ventricles.
injury to the right ventricle, left ventricle, and septum.
You respond to a patient complaining of lower abdominal pain. Upon your arrival, you find a 25-year-old man who also complains of groin pain. After inspecting the penis and scrotum, your next step would be to: take a urine sample. lift the scrotum and inspect for swelling or lumps. inspect the glans. palpate the testicles.
inspect the glans.
The standard sequence for examining the chest is: palpate, percuss, auscultate, inspect. inspect, palpate, percuss, auscultate. inspect, auscultate, percuss, palpate. inspect, palpate, auscultate, percuss.
inspect, palpate, percuss, auscultate.
After considering the information you have collected, you determine the most likely cause of your patient's condition. This step in the critical decision-making process is called: applying the principles. reflecting on the incident. forming a concept. interpreting the data.
interpreting the data.
Using knowledge and experience to diagnose patients and plan their treatment is called clinical: practice. judgment. intuition. reflection.
judgment.
During the abdominal exam, areas that are known to be painful or tender should be examined: first. only by a physician. last. at the beginning and end of the exam.
last
To inspect and examine the anus, a paramedic should place the patient in the ________ position. supine left lateral recumbent prone kneeling
left lateral recumbent
A condition marked by exaggerated lumbar concavity is called: lordosis. scoliosis. kyphosis. spondylosis.
lordosis.
When evaluating any patient's genitalia, a paramedic must always: be of the same gender as the patient. perform a rectal exam, as well. maintain privacy. use a lubricant.
maintain privacy.
You are evaluating a patient who was a restrained driver of a motor vehicle that crashed into the median barrier at 40 mph. He is awake, alert, and oriented, complaining of neck and back pain. There is a bruise across his upper abdomen in the shape of the seat belt. Based on this information, you should assume he is a ________ trauma patient, and transport him to ________. minor; the closest hospital minor; the patient's hospital of choice major; the closest hospital major; a trauma center
major; a trauma center
You are sent to the home of an insulin-dependent diabetic female patient. You ask her to state her name, the month, and her address. This would be an example of assessing the patient's: judgment. mood. memory and attention. general fund of knowledge.
memory and attention.
When oxygen is not bound to the iron molecule of hemoglobin, the iron molecule is in the ferrous (Fe2+) charge state, rather than when oxygen changes the charge of iron to the ferric (Fe3+) state. A dangerous form of hemoglobin that is unable to oxidize is: oxyhemoglobin (OxHb). methemoglobin (MetHb). deoxyhemoglobin (DeoHb). carboxyhemoglobin (COxHb).
methemoglobin (MetHb).
When responding to calls involving two-vehicle collisions, you must always suspect: multiple patients. flail chest. patients with altered mental status. severe lower extremity injuries.
multiple patients.
An elevation of the ST segment is associated with: left ventricular hypertrophy. hyperkalemia. slowed conduction through the AV node. myocardial injury.
myocardial injury.
The presence of inverted T waves on an ECG indicates: myocardial instability. myocardial infarction. myocardial necrosis. myocardial ischemia.
myocardial ischemia.
A 45-year-old patient presents with abdominal pain in the right lower quadrant. Upon auscultation of bowel sounds, you hear high-pitched gurgles and clicks lasting around 10 seconds. This patient may have: borborygmi. paralytic ileus. normal sounds. hyperperistalsis.
normal sounds.
You arrive at a location and begin to read the scene by: observing the immediate surroundings. addressing life threats. approaching the patient. conducting a focused exam.
observing the immediate surroundings.
To detect life-threatening cardiac dysrhythmias, the paramedic must view the ECG in ________ lead(s). twelve two one three
one
Components of a scene size-up include all of the following EXCEPT: mechanism of injury. number of patients. patient's chief complaint. dangers to bystanders.
patient's chief complaint.
Paramedics treat patients with the same techniques as other clinicians, EXCEPT that they: are far less trained than other practitioners. are not allowed to make independent decisions. perform these procedures in uncontrollable and unpredictable environments. treat life-threatening emergencies only.
perform these procedures in uncontrollable and
During your focused physical exam of a patient with a suspected myocardial infarction, you should examine: deep tendon reflexes. extraocular movements. range of motion in joints. peripheral perfusion status.
peripheral perfusion status.
Rebound tenderness in the abdomen is a sign of potential: peritoneal irritation. full urinary bladder. kidney stone. food poisoning.
peritoneal irritation.
Devices for maintaining airway patency in a five-year-old patient include all of the following EXCEPT a(n): pharyngotracheal lumen airway. oropharyngeal airway. suction unit. endotracheal tube.
pharyngotracheal lumen airway.
While you are assessing for Babinski's response, the patient's big toe dorsiflexes and the other toes fan out. This indicates a ________ response, which is ________. positive; abnormal negative; abnormal positive; normal negative; normal
positive; abnormal
One sign of gonorrhea in males is a(n): white, curdlike discharge. scant, clear discharge. profuse, yellow discharge. external pustule.
profuse, yellow discharge.
You are working at the triage desk in the ED when a young man on crutches approaches the desk. He appears moderately short of breath. He states he had a cast put on his left leg seven days ago after surgery for a ruptured Achilles tendon. This morning, while he was watching television, he suddenly became short of breath. He has a history of asthma, for which he takes Xopenex as needed, and is taking Tylenol with codeine for pain related to his surgery. The patient's lung sounds are clear and equal, SpO2 is 90 percent on room air, heart rate is 100 and regular, respirations are 24 and slightly labored, blood pressure is 128/88 mmHg, and the patient is afebrile. These findings are most consistent with: allergic reaction to codeine. asthma exacerbated by recent anesthesia. pneumonia secondary to recent anesthesia. pulmonary embolism associated with immobilization of the lower extremity.
pulmonary embolism associated with immobilization of the lower extremity.
Blood entering the left atrium arrives via the: superior and inferior vena cava. pulmonary artery. bicuspid valve. pulmonary vein.
pulmonary vein.
A fast, systematic assessment designed to identify other life-threatening injuries after the primary assessment is the: 1-minute exam. focused physical exam. rapid secondary assessment. detailed physical exam.
rapid secondary assessment.
Asking your patient to recall what he had for a meal earlier in the day would test: long-term memory. immediate memory. remote memory. recent memory.
recent memory.
After a call you discuss the patient with the ED physician, comparing diagnoses and care plans. This is an example of: putting it all together. applying principles. reflecting. evaluating.
reflecting.
Your three-year-old patient opens her eyes and responds when you speak to her. Her mental status is best described as: responsive to tactile stimuli. lethargic. alert. responsive to verbal stimuli.
responsive to verbal stimuli.
Changing or stopping interventions that are NOT working is an example of: reviewing your performance. revising the management plan. reading the patient. reevaluating.
revising the management plan.
Jugular venous pressure approximates the patient's ________ pressure. right ventricular left ventricular left atrial right atrial
right atrial
The SA and AV nodes are perfused by the ________ artery. circumflex coronary right coronary anterior descending left coronary
right coronary
Heart sound S2 may be heard at the end of systole by auscultating over the ________ intercostal space. first second sixth fifth
second
The careful, thorough process of eliciting a patient's history and conducting a physical exam is known as the: ongoing assessment. rapid medical assessment. primary survey. secondary assessment.
secondary assessment.
QUESTION 43 For you to assess for jugular venous distention, your patient should be ________ at a ________-degree angle. standing; 90 supine; 45 sitting; 90 sitting; 45
sitting; 45
The ability to critically evaluate a patient's condition and formulate a treatment plan rests on all of the following EXCEPT: identifying and dealing with medical ambiguity. the ability to focus on large amounts of data. an excellent working knowledge of anatomy and physiology. strictly following protocols.
strictly following protocols.
Trending vital signs is best accomplished by: taking multiple sets of vital signs. estimating any values that are missing on the prehospital care record. having each set of vital signs verified by a second EMS provider. comparing the prehospital vital signs to the patient's normal vital signs.
taking multiple sets of vital signs.
On a properly calibrated ECG machine, 1 mV is equivalent to a height of ________ boxes. four large one large five small ten small
ten small
To avoid the carotid sinus, you should palpate for a carotid pulse at the level of: carotid bifurcation. the sternocleidomastoid muscle. the cricoid cartilage. Terry's point.
the cricoid cartilage.
Patterns of deterioration in patient condition may include all of the following EXCEPT: skin becomes cool, pale, and moist. the respiratory rate significantly increases or decreases. the level of consciousness increases. the heart rate significantly increases or decreases.
the level of consciousness increases.
The valve between the right atrium and right ventricle is the ________ valve. bicuspid pulmonic aortic tricuspid
tricuspid
During ventricular systole, the ventricles contract while the: tricuspid and mitral valves open. tricuspid and mitral valves close. foramen ovale opens. pulmonic and aortic semilunar valves close.
tricuspid and mitral valves close.
To test an extremity for pain sensation, you should: use a sharp object, and have the patient tell you if he feels a sharp or dull sensation. briskly tap the tendon of the elbow or knee. firmly pinch a fold of skin over the most sensitive part of the extremity. stroke the extremity in a distal-to-proximal direction.
use a sharp object, and have the patient tell you if he feels a sharp or dull sensation.
Slowing of the electrical impulse at the AV node is necessary to allow time for the ________ to fill with blood. atria coronary arteries ventricles coronary sinus
ventricles
The QRS complex represents: ventricular depolarization. ventricular repolarization. atrial depolarization. atrial repolarization.
ventricular depolarization.
