Volume 3 Chapter 1-13

Ace your homework & exams now with Quizwiz!

Damage to organs and systems bodywide is common in patients with sickle cell disease due to which of the following?

Repeated vasoocclusive crises

Which of the following factors that contributes to CVD is not the result of lifestyle choices?

Family genetics

Which of the following is a nonmodifiable risk factor for developing cardiovascular disease?

Family history

A patient you are treating has a PaCO2 of 25 mmHg. If his tidal volume is normal, what would you observe about his ventilations?

Faster than normal

Which of the following is a complication of fibrinolytic reperfusion therapy?

Fatal hemorrhage

Your patient is an elderly female patient that is complaining of bodywide pain. She stated that she was walking at the zoo earlier in the day with her grandson. Her medical history includes lupus and asthma. Vital signs are stable. What treatment may be considered?

Fentanyl

Patients with severe abdominal pathology typically present in which of the following positions?

Fetal position with little movement

Your 92-year-old female patient has been suffering from a urinary tract infection for four days. Assessment reveals she responds to verbal stimuli and has a patent airway, with hot and moist skin. Her heart rate is 116/min and regular, her respiratory rate is 24 breaths/min, her blood glucose is 80 mg/dL, and her blood pressure is 80/52 mmHg. Management should include which of the following?

Fluid administration and consideration for a pressor agent

You analyze a 12 lead and see a negative QRS deflection in lead I and a positive QRS deflection in lead aVf. What is the axis?

Right axis deviation

Which of the following nonstroke disorders could result in a "probability of ischemic stroke" according to the Cincinnati Prehospital Stroke Scale?

Bell's palsy

What is the name of the particular substance released from mast cells and basophils that causesbronchoconstriction?

SRS-A

Signs and symptoms of isolated right ventricular failure include which of the following?

Tachycardia, JVD, hepatic congestion

What is the sensation felt by placing a hand on the chest that vibrates during speech?

Tactile fremitus

Cardiac arrest beyond what time period exceeds the metabolic phase of death?

Ten minutes

What do sickle cell anemia, thalassemia, and glucose-6-phosphate dehydrogenase deficiency have incommon?

They are hereditary diseases.

Which of the following is true of congenital tumors?

They are not neoplasms.

When considering the etiology of most brain tumors, which of the following is correct?

They are often metastasized from elsewhere in the body.

Removal of the TASER darts by emergency personnel should be considered:

after ensuring that the patient is stable and has no other acute medical condition.

The three types of ECG leads are bipolar, augmented, and

precordial.

The most common hereditary hematologic disorder among African Americans is:

sickle cell anemia.

When educating a patient with a history of renal calculi, one of the most important things to impress on him is:

the need to drink large quantities of water.

A patient is stimulated by a vigorous sternal rub and, in response to such stimuli, he flexes his arms and extends his legs. What is this called?

Decorticate posturing

Successful defibrillation depends upon which of the following?

Decreased chest wall resistance to electricity

During the acquisition and interpretation of a 12 lead ECG on a patient with chest pain, you believe the patient may have left ventricular hypertrophy. What finding on the 12 lead may cause you to have that suspicion?

Deep S waves in V1 and V2 and tall R waves in V5 and V6

Your patient has ingested a large amount of iron supplement chewable tablets. Which of the following is the chelating agent that could be given in the hospital to bind the iron and not allow it to be absorbed?

Deferoxamine

Your cardiac arrest patent has an implanted defibrillator that is not functioning, and you see ventricular fibrillation on the ECG. Which of the following is the most appropriate treatment?

Defibrillate the patient using your pads/paddles but avoid placing them on the implanted defibrillator site

Which of the following does not lead to bleeding that is associated with DIC?

Development of neutropenia

What disorder is caused by inadequate ADH secretion relative to blood volume?

Diabetes insipidus

What is the blood disorder in which a clotting factor is missing or defective?

Hemophilia

Which of the following diseases is an inherited disease that causes abnormally low levels of factor VIII?

Hemophilia

A patient in your care is coughing up blood. This is documented as which of the following?

Hemoptysis

What are small masses of swollen veins that occur in the anus or rectum, usually in patients more than 50 years old?

Hemorrhoids

The tenth most common cause of death and most common cause of patients in the intensive care unit is:

sepsis.

You are called to a local high school for a 64-year-old spectator at a sporting event. The patient complains of shortness of breath. The patient identifies a history of COPD and you note absent breath sounds on the patient's left side. Onset of complaint was sudden while the patient was sitting in the stands and no blunt or penetrating trauma occurred. Your immediate concern would be:

spontaneous pneumothorax.

Which of the following descriptors of pain is common in a patient suffering from chest pain secondary to a heart attack?

"Heavy"

What percentage of blood loss can a young, healthy individual sustain before decompensating?

25-30 percent

When implementing therapeutic hypothermia in an ROSC patient, what is the target temperature that is desired?

32-34 degrees Celsius

Which of the following people would be most likely to successfully commit suicide?

60-year-old male

Each year, approximately how many Americans die from complications due to heart disease?

610,000

According to current estimates, how many Americans have some form of cardiovascular disease?

>60 million

Both glucose and large amounts of water are lost via the kidneys in which of the following disorders?

Diabetes mellitus

More than half of all end-stage renal failure cases are caused by which of the following?

Diabetes mellitus and hypertension

How is the children's dosage of epinephrine calculated for anaphylactic shock?

0.01 mg/kg IVP

You are dispatched to the local mall for a 25-year-old female who is seizing. When you arrive you note that she is having a tonic-clonic seizure. A bystander, trained in first aid, tells you that this is the third time she has seized and that she hasn't regained consciousness between events. After controlling her movements you assist her ventilations, administer oxygen, check her vital signs, which are within normal limits, and initiate an IV of D5W TKO. Your patient then starts to seize again. You decide to administer 5 mg diazepam; shortly afterward your patient stops active seizing and you take advantage of the break to reassess her, only to find her respiratory rate has dropped to 6 breaths per minute and she is now hypotensive. While continuing to assist her ventilations, which drug would you consider next?

0.2 mg flumazenil

The ECG shows you a regular rhythm at a rate of 40, no P waves are present, and the QRS complex width is 0.16 seconds. Thepatient's blood pressure is 82/44. Which of the following would be most appropriate?

0.5 mg bolus of atropine sulfate

Epilepsy affects approximately how many Americans per year?

1 percent

Over half of all poisonings that occur to children occur in what age bracket?

1 year to 5 years

You are managing a patient experiencing exacerbation of emphysema with CPAP. To avoid barotrauma, what is the recommended airway pressure?

10 cm/H2O

Looking at an ECG strip, you count 14 QRS complexes in two 3-second marks. Your estimate for the heart rate would be:

140

Approximately what volume of blood in the GI tract will result in recognizable melena?

150 mL

Your patient in cardiac arrest overdosed by ingesting a full bottle of tricyclic antidepressant pills. His rhythm is PEA with a QRS width of 0.18 seconds. Which of the following is a proper treatment?

1 mEq/kg of sodium bicarbonate IV

What time frames do regional poison control centers provide for callers from health care providers?

24 hours a day, 7 days a week

What is the standard speed for ECG paper to move across the stylus when printing out the patient's rhythm?

25 mm/sec

When obtaining a 15 lead ECG on a patient, how many electrodes are placed on the patient's right thorax?

How many poisonings occur annually in the United States, according to the American Association of Poison Control Centers?

3 million

When examining your patient, she tells you that her family physician told her today that she is anemic. If you saw her blood work results, which of the following hematocrit values would confirm this?

30 percent

How many pairs of spinal nerves exit the spinal cord?

Adults typically have how many teeth?

How much oxygen can be transported by a hemoglobin molecule at one time?

4 molecules

You are managing a patient who presents with unresponsiveness, ongoing seizures, heavy secretions in the airway, and a blood glucose level of 38 mg/dL. The patient is a known diabetic who took his insulin but did not eat, due to ongoing nausea from a cold. During a moment when he is not seizing, you establish an IV and start oxygen therapy. Following this, another seizure erupts. What medication should the paramedic administer?

50 percent dextrose IV push

Your patient is postictal from a seizure. He opens his eyes to painful stimulation, makes incomprehensible sounds, and reaches away from the midline when a sternal rub is applied. What is his Glasgow Coma Scale value?

Which of the following persons would be at the highest risk for developing pancreatitis?

A black male

Which of the following is the best definition of a hyphema?

A collection of blood in the anterior chamber of the eye due to trauma

Which of the following treatments would most likely benefit a patient complaining of general weakness and dizziness?

A fluid bolus of normal saline

How does a simple pneumothorax interfere with the body's ability to oxygenate peripheral lung tissues?

A loss of negative pleural space pressure inhibits the lung from expanding properly

What is meant by aberrant conduction?

A single supraventricular beat conducted through the ventricles in a delayed manner

What disease process can lead to the development of cirrhosis of the liver, esophageal varices, andascites?

Hepatitis

Which of the following blood values may be raised if the patient is suffering from congestive heart failure?

ANP

A condition that exists when the pulmonary capillaries have a greater permeability due to a non-cardiogenic cause is called:

ARDS.

When acquiring a 12 lead ECG on a patient for a suspected ischemic episode, what lead tracing on the monitor is not interpreted for waveform changes?

AVR

A patient suffering from excited delirium will always present with which sign or symptom?

Abnormal pain tolerance

The interval that begins at the QRS complex and ends at the apex of the T wave is which of the following?

Absolute refractory period

Individuals engaged in agricultural and food handling industries are most likely to have what type of mechanism behind a toxic exposure?

Absorption

Inflammation of the stomach and intestines with a sudden onset of vomiting and/or diarrhea, and is ahigh-risk complication in individuals that abuse alcohol and tobacco, is the definition for which of thefollowing?

Acute gastroenteritis

What is the general term for a sudden drop in urine output to less than 400-500 mL per day?

Acute renal failure

You are dispatched to an apartment complex, where you find a 25-year-old female with altered mental status and shallow breathing. A neighbor tells you that the patient has been in and out of drug rehab and that she overdosed on narcotics. Which of the following is the most appropriate intervention?

Administer 1 mg of naxalone.

You are dispatched to a restaurant for a male choking victim, in his 30s, sitting at the counter. The location is only two minutes away, and you arrive promptly. After determining that the scene is safe, you proceed inside and up to the counter, where your patient is in obvious respiratory distress with some slight perioral cyanosis, red splotches on his face, and a light rash on both arms. It occurs to you that his face looks "puffy." You note as you approach that you hear wheezing and stridor, and he has a respiratory rate of 26. When you ask the patient if he can speak, he shakes his head "no." You ask him if he is choking, and you again get a "no." While your partner starts the patient on high-flow oxygen via a nonrebreather mask, you get a radial pulse of 128 and thready and a blood pressure of 98/78. The pulse oximeter reads 92 percent on oxygen, and the stridor is worsening. You opt to immediately administer epinephrine IM while your partner sets up and establishes an IV, followed by a second IV. Your next set of vital signs reveals respirations of 22 with reduced effort and stridor, pulse of 132 andthready, blood pressure 92/70 mmHg, and the pulse oximeter indicates 96 on high-flow oxygen. What would your next step be?

Administer a fluid bolus of normal saline

You are dispatched to a soccer field for a referee complaining of shortness of breath. After determining that the scene is safe, you proceed to the sidelines where your patient is in obvious respiratory distress with some significant perioral cyanosis, red splotches on his face and chest, and swelling in his left leg. You note as you approach that you hear wheezing and stridor, and he has a respiratory rate of 34. When you ask the patient if he can speak, he slowly responds to shake his head "no." You ask him if he ischoking, and you again get a "no." While your partner starts the patient on high-flow oxygen via a nonrebreather mask, you get a weak, regular radial pulse of 122 bpm. At that time your patient goes unresponsive. What is your next action?

Administer epinephrine

While gathering the medications a patient with respiratory distress is prescribed, which of the following indicates that he likely has a short-term pulmonary problem?

Antibiotics

You are called to the dialysis center for an ill patient. The technician tells you the patient was a half-hour into her treatment when she suddenly felt light-headed and experienced chest pain. Vital signs: blood pressure 84/60, pulse 114, ventilations 32. What is the best initial management strategy?

Administer high-flow oxygen and transport her on her right side, feet elevated

You are treating a patient with substernal, diffuse chest pain that radiates down his left arm. He is nauseated, has vomited twice, and his skin is pale, cool, and diaphoretic. His blood pressure is 118/60, pulse is 128, showing sinus tachycardia with 3 PVCs per minute, SpO2 on room air is 91 percent. Of the following choices, which is the best initial treatment?

Administer oxygen, titrated to attain a pulse oximetry above 94 percent

You are managing a patient who is a known diabetic. You attempt to obtain a blood glucose level, but the glucometer is failing to provide a reading after two attempts. From the clinical presentation of the patient, you are unsure if the underlying etiology is HHS or DKA. Given this, which of the following interventions should be avoided while transporting the patient to the hospital?

Administration of 50 percent dextrose

Treatment of disseminated intravascular coagulation during the late stages includes which of thefollowing?

Administration of fresh frozen platelets

After 3-4 minutes of cardiac arrest, what physiological process continues in the heart?

Aerobic metabolism

What is the psychological term for an observable expression of emotion?

Affect

During the assessment of a patient complaining of chest pain, when should the paramedic obtain the SAMPLE history?

After the primary assessment

Risk factors for pneumonia include:

Age and immuno-compromising diseases

You are preparing to call the poison control center for a child who has ingested all of his parent's Inderal and Procardia. What other information may the PCC want in order to provide you the most relevantinformation?

Age of the victim, amount of medications and time ingested, and current physical condition

A 20-year-old male runner comes up to you at the finish line of a cross country meet and says he "can't breathe." Physical exam reveals a 6'5", very thin male with acute, sharp pleuritic chest pain, and pale and diminished lung sounds are auscultated in the apex area of the right lung. What has likely happened tohim?

Air has entered in between the visceral and parietal pleura.

You are called to the scene of a 68-year-old female patient. The family told your dispatcher that she was "breathing but wouldn't wake up." On your arrival you find the patient lying in bed with sonorous respirations and decorticate posturing. What is your initialconcern?

Airway maintenance

Your patient is presenting with a fever, a deep cough, dyspnea, and stridor. This has been present for several days and worsened to the point that the family became concerned and called EMS. The patient is now disoriented, struggling to breathe, and has a low pulse ox reading. What would your treatment consist of?

Airway maintenance and ventilation

At the conclusion of your secondary assessment, you have determined that the patient is likely suffering from a thyroid storm. As you prepare your management plan, which of the following interventions would not be appropriate?

Atropine via IVP

Your 15-year-old female presents with fever, chills, a sore throat, and some mild dysphagia that has developed over the past two days. When you examine the oral cavity, you observe pockets of pus in the area around her tonsils. Treatment should focus around which of the following?

Airway protection and treatment of hypoxia as needed

Why does chronic alcoholism lead to the development of pancreatitis?

Alcohol causes platelet plugs in the acinar tissue, which disrupts enzyme flow; the backup of digestive enzymes causes them to activate and autodigest the pancreatic tissue.

What is the leading cause of esophageal varices?

Alcohol consumption

The definitive treatment rationale for the multiple myeloma patient includes which of the following?

All of the above

Which of the following is NOT a cause of behavioral emergencies?

All of the above

Which of these symptoms indicates that a patient might have a roundworm infection?

All of the above

Your patient is a 60-year-old male who has a severe headache, hypoxia, a new pattern of seizures, cognitive changes, vomiting, and a change of sensation in his right arm. You diagnose him with a probable spinal or cerebral neoplasm. Which of the following are appropriate interventions?

All of the above.

A 19-year-old female is complaining of itching on her upper extremities, across her chest, and on her neck. She states that she started taking a new antibiotic for a urinary tract infection about 30 minutes ago, as prescribed. She states she has no allergies but upon physical exam, you do see some diffuse urticaria on her right arm and anterior neck. No wheezing or dypnea is noted. Lung sounds are clear. Pulse is 90 and regular and blood pressure is 130/80. What would you consider as the field diagnosis?

Allergic reaction to the medication

If a suicidal patient begins to tell his story in response to open-ended questions, but grows quiet when recounting a difficult moment, which of the following is the best communication strategy?

Allow the silence to pass and wait until the patient begins speaking.

Which of the following presenting signs may be the only indicator of pneumonia in geriatric patients?

Altered mental status

The 68-year-old patient you are transporting is presenting with hypertension, peripheral edema, and tachycardia in the absence of a significant medical history. You suspect that she may be suffering fromAKI; which of the following can provide you with additional pertinent findings that could support your fielddiagnosis?

An ECG

What is the collective term for processes in the body that build something big by combining individual, smaller parts?

Anabolism

You are called to an outpatient health care facility where a patient was scheduled to undergo imaging studies. The patient received the contrast media approximately one hour ago and now complains of an impending sense of doom, dizziness, and inability to catch her breath. What is your initial concern?

Anaphylactic reaction

Your patient presents to you pale, diaphoretic, dyspneic, hypotensive, and complains of severe abdominal cramping. Inspiratory and expiratory wheezing is auscultated throughout all lung fields, and angioedema is also noted. What do you suspect is this patient's ailment?

Anaphylaxis

You are caring for a patient with severe back pain. You find him sitting, with his back hunched over, and when you try to place him on the cot and lie back, the patient is unable to, as his back has lost its flexibility. Which of the following would be your first field impression of the patient's condition?

Ankylosing spondylitis

Your patient is a known diabetic with a recent history of a laceration to the bottom of his foot. He just noticed it today, but never felt the injury, so he is unaware when it occurred. Now he is having trouble bearing weight on the foot, and there is noticeable swelling and redness over the foot and ankle. Definitive management will involve which of the following?

Antibiotics

Which of the following is a substance that enters the human body and induces an immune response?

Antigen

Which of the following could cause a prolonged QT interval?

Antipsychotic medication administration

What is the abnormal breathing pattern characterized by prolonged inspiration unrelieved by expiration attempts?

Apneustic respirations

Which of the following is appropriate management for a patient bitten on a limb by a pit viper?

Apply a splint to the limb and immobilize in a neutral position

For infectious disease emergencies, which of the following best describes the process of always considering the interaction of the infectious agent, the host, and environment to allow you to determine your likelihood of exposure?

Assessing personal risk

When transporting a patient, who you believe to be having a behavioral emergency as the result of a medical emergency, what is your first concern?

Assessment of the airway, breathing, and circulation

You are called to the home of a patient with a neuromuscular disease that has left him dependent on mechanical ventilation through a stoma for survival. The family summoned EMS due to the ventilator alarming "low minute ventilation." What should the paramedic do regarding management of this patient?

Assure the stoma is patent and begin ventilations with a bag-valve-mask (BVM)

When looking at an ECG, the P wave is representative of what?

Atrial depolarization

The hormone that opposes the effects of the antidiuretic hormone (ADH) is:

Atrial natriuretic hormone (ANH).

When dealing with a child in behavioral crisis, it is important to do which of the following?

Avoid separating the child from his parent

Which one of the following patients is most susceptible to developing cardiovascular disease?

A 64-year-old male, three-pack-per-day smoker

Why is collection of a thorough history important when building a differential diagnosis on the victim of a severe headache?

A severe, acute onset headache or a change in headache pattern indicates the need for immediate attention

Your patient is a 6-year-old female that has developed a sore throat, fever, and drooling over the past three hours. What is most likely the source of her infection?

Bacteria

What is the best technique to calm an agitated patient?

Be calm and professional

Why should the paramedic transport an ROSC patient receiving induced therapeutic hypothermia protocol in the field to an ED that can maintain this therapy?

Because it has been shown that if the patient warms up, survival actually is worse than never starting ITH

Why are females generally at higher risk for urinary tract infections than males?

Because of the comparatively short length of the female urethra

Why is noting acute kidney injury in the field vital to patient care?

Because the condition may be reversible

Why is the use of Lasix or nitroglycerin often of no benefit to the patient suffering from noncardiogenic pulmonary edema (ARDS)?

Because the reason for the pulmonary edema is not related to the cardiac pump (left ventricle)

When evaluating patients complaining of upper gastrointestinal hemorrhage, why is it important to transport expeditiously to an appropriate facility?

Because upper GI hemorrhage carries with it a high mortality rate

A patient you are interviewing suddenly loses consciousness and no pulse is presentdash-ECG reveals ventricular fibrillation. What is your initial action?

Begin CPR immediately, and as soon as the defibrillation pads can be applied, charge the machine and defibrillate the patient

How does significant exposure to carbon monoxide affect normal physiology of the body?

Binds to the hemoglobin sites, preventing the attachment of oxygen and causing cellular anoxia

Your patient has overdosed on his prescribed lithium. What is the medical problem this patient has that would require this medication?

Bipolar disorder

Which of the following patient history findings indicates a more serious cause of low back pain?

Bladder and bowel incontinence

The most common complications of hemodialysis include which of the following?

Bleeding from the needle puncture site and infection

Your patient reports that she has hepatitis C. How might that disease be transmitted to you?

Blood

Your patient who complains their vision is cloudy, diplopia, and sees halo is likely to have which of the following pathologies?

Breakdown of protein within the lens

A patient with a suspected stroke in the brainstem region may display what type of changes to the pulmonary system?

Breathing may become deep and rapid.

What is the underlying pathophysiology that creates the clinical findings consistent with toxic exposure to a caustic substance?

Burn injuries at site of contact

How can the paramedic differentiate acute kidney injury in the prehospital setting?

By clues ascertained by utilizing a focused history

How is a therapeutic level of epinephrine normally maintained in the pediatric patient?

By repeating the calculated boluses every 3-5 minutes as required

What procedure is utilized on a patient that has extensive myocardial disease and/or is not a candidate for percutaneous coronary interventions and has thrombocytopenia?

CABG

What is a common etiology underlying abnormal breathing patterns such as Cheyne-Stokes or central neurogenic hyperventilation?

CNS illness or injury

Your patient was burned by hydrofluoric acid and is complaining of dyspnea and palpitations. Which of the following medications is most appropriate for treating him?

Calcium chloride

During your assessment, you have determined that the patient is likely suffering from deep venous thrombosis. Which of the following clinical signs is least likely to support this field impression?

Calf pain or tenderness

It is the middle of winter and you are called to a scene for a "sick family." As you arrive, the husband meets you at the road and states he has a headache but also that he returned home this morning and found his wife and two children lying on the couch all complaining of nausea/vomiting, headaches, and inability to stand. What would be an appropriate action at this time?

Call the fire department and have them retrieve the family with breathing equipment on.

Along with cigarette smoking, exposure to asbestos, hydrocarbons, radiation, and fumes from metal production have been associated risk factors for what lung disease?

Cancer

It is the middle of winter and you are called to a scene for a "sick family." The husband meets you at the road complaining of a severe headache. He returned home from work this morning and found his wife and two children, drowsy and lying on the coach complaining of nausea/vomiting and headaches. He developed his headache only after entering the residence. What would you suspect in thiscase?

Carbon monoxide poisoning

The ECG monitor shows the following: no rate, no rhythm, P waves that are regular in spacing, no QRS complexes. What would you call this rhythm?

Cardiac standstill

Which monitoring devices are used by the paramedic for a patient anaphylaxis?

Cardiac monitoring, pulse oximetry, end-tidal carbon dioxide detector

If your patient is suffering poor perfusion to the heart muscle that is drastically reducing the ability of the heart to pump blood, this can result in what kind of shock?

Cardiogenic

You are managing a patient with systemic hypotension, alterations in mental status, and poor peripheral perfusion. You have already assessed for and corrected disturbances pertaining to the heart rhythm, vascular volume, and vascular tone. What is the remaining reason for the hypotension?

Cardiogenic shock

You are caring for a patient that upon physical exam, you note that she has a "moon face" appearance, an excessive accumulation of fat on her upper back, and an excessive amount of facial hair. Which of the following will she likely have a higher incidence of developing?

Cardiovascular disease

Found where the trachea divides into the left and right mainstem bronchi, stimulation of the _____ can result in violent coughing.

Carina

What is the most common cause of TIAs?

Carotid artery disease

Your patient presents with tingling, numbness, and weakness in her wrists, hands, and all her fingers. She is a secretary in a fast-paced law office that requires her to type numerous memos, opinions, and other legal paperwork every day during her fifty hours-plus workweek. What is the most likely cause of her discomfort?

Carpal tunnel syndrome

Which of the following patients display findings of respiratory failure?

Central cyanosis, 1-2 word dyspnea, pulse ox of 84 percent

What is the term for a highly-contagious ulcer, more frequently diagnosed in men, caused by Haemophilus ducreyi?

Chancroid

Which of the following is important to consider when assessing and treating infectious diseases in pediatric patients?

Children can quickly develop life-threatening dehydration.

Your patient is complaining of right upper quadrant abdominal pain. He says he just got back home from the all-you-can-eat Friday fish fry and now can't get comfortable. A focused physical exam of the abdomen reveals point tenderness under the right costal margin. Most likely, he is suffering from which of the following?

Cholecystitis

What is the medical term for the formation of gallstones?

Cholelithiasis

Atropine works by antagonizing which of the following?

Cholinergic response

During what phase of a cardiac arrest event will the heart muscle become distressed due to a lack of oxygen in the myocardial cells?

Circulatory phase

You have a patient that was rescued from a burning, smoke-filled home and shows a SpCO reading of 28 percent. He is unconscious and you have to make a transport decision. Which of the following facilities is the most appropriate?

Closest hospital with a hyperbaric chamber

Which of the following is a well-known cause of excited delirium syndrome?

Cocaine

You are called for a "possible overdose." Examination reveals that the patient has a pulse of 112 per minute. Of the following, which is most likely to have caused the tachycardia?

Cocaine

The period when the host may exhibit signs of clinical disease and can transmit the infectious agent to another host is which of the following?

Communicable period

Which of the following disorders is associated with the development of prerenal acute kidney injury (AKI)?

Congestive heart failure

Your patient took a large overdose of citalopram. Which of the following treatment choices is best for her?

Consider benzodiazepines for seizures and external cooling for increased body temperature

Which of the following can cause pathogenesis of fungi that are usually a part of the normal flora?

Consumption of broad-spectrum antibiotics

You are transporting a patient who, after a history and primary exam, you believe to be suffering from hypochondriasis. What should your next action be?

Continue to treat the symptoms until medical conditions have been ruled out

Your patient has a history of mental illness, and he calls you because he has not been able to urinate today. When you question him, he states that he inserted a pencil into his urethra to help the demons get out. You observe the eraser protruding from his penis and slight bleeding as well. Your best course of treatment is which of the following?

Control the external bleeding as best as possible and transport

Which of the following can be caused by pulmonary hypertension?

Cor pulmonale

What condition is said to occur when there is an infection of the cornea by an infectious agent that breaks through the epithelial border of the cornea and it presents with a painful red eye, tearing, andphotophobia?

Corneal ulcer

What form of cardiovascular disease is the single largest killer of Americans each year?

Coronary artery disease

The most important of the glucocorticoids is:

Cortisol

Which of the following is not a cardiovascular cause of chest pain?

Costochondritis

You are called to care for a pyrotechnician who was too close to a firework that exploded prematurely. Although the patient does not have any burns, he is complaining of decreased hearing in one ear with a severe earache, a small amount of bloody discharge from the external canal, and a "buzzing" sound. Given this presentation, what should the paramedic do?

Cover the ear to prevent infection

When evaluating an ECG, you note that in lead III the QRS complex duration is 0.16 seconds. What does this finding imply?

Delayed conduction through the ventricular conduction system

What is the most severe form of ethanol withdrawal manifested by altered mental status and sympatheticoverdrive, which can lead to mortality?

Delirium tremens

Which of the following disorders can result from AIDS, Parkinson's, or drug abuse?

Dementia

The feeling of being different, that the body has taken a different form or that the patient has become someone else, is characteristic of which of the following?

Depersonalization

What is the purpose of defibrillation?

Depolarize the entire mass of the myocardium and allow it to repolarize uniformly

Suicide is 500 times more common among people also suffering from which of the following?

Depression

What mental disorder is normally mistaken for dementia in the elderly patient?

Depression

What type of exam(s) would best assist you in differentiating potential causes for patients complaining of generalized weakness and vertigo?

Detailed history and focused assessment

A dysfunction of the pancreas is most likely to result in which of the following kind of medical emergency?

Diabetic ketoacidosis

Which of the following is most indicative of schizophrenia?

Disorganized speech, distortions of reality, and flat affect

Your patient is complaining of chest pain that is sharp and "ripping," going straight through to his back. He is pale, diaphoretic, and his extremities are mottled. Pulses are weaker on the left arm compared to the right. Blood pressure in the left arm is 80/40 and in the right arm is 170/90. He tells you he has had heart problems in the past, but this doesn't feel like any of his previous heart problems. He has taken four of his nitroglycerin tablets within the last fifteen minutes, with no relief. Based upon this information, what is likely this condition?

Dissecting thoracic aneurysm

Colicky pain and tenderness localized to the lower left quadrant, low grade fever, nausea, and vomiting are the classic presentation for what lower gastrointestinal disorder?

Diverticulitis

Your patient is complaining of colicky left lower quadrant abdominal pain and has a temperature of 100.1 F. When assessing a history, he says he eats a lot of popcorn "for fiber." This all started yesterday, but the pain is terrible today and he is quite nauseated. What does he have?

Diverticulitis

You observe an irregular rhythm on the ECG with a rate of 66 to 80, a normal PR interval, and a regular P wave for every QRS complex. The rate seems to vary with the patient's ventilations. What is your initial action?

Do nothing but observe the patient and transport

Attempted suicides by individuals often involve what type of mechanism?

Drug overdose

Which of the following is one of the listed considerations on the Los Angeles Prehospital Stroke Screen?

Duration of signs and symptoms less than 24 hours

Symptoms that include protruding tongue, twisted neck, deviated gaze, and abdominal rigidity should suggest which diagnosis?

Dystonic reaction

Which of the following statements is most accurate when considering the use of hard restraints?

EMS personnel should avoid using hard restraints.

You and your partner possibly have been exposed to tuberculosis. What is the key intervention to prevent an active TB infection?

Early drug prophylaxis

Which of the following patients would likely have the highest risk for developing cardiovascular disease?

Elderly male who smokes, is obese, and lives a sedentary lifestyle

In terms of contagious diseases, what are the interactions of host, infectious agent, and environment known as?

Elements of disease transmission

Evidence of myocardial injury on a 12 lead ECG will produce an ST segment as which of the following?

Elevated above the baseline, equal to or greater than 1 mm

You are managing an unresponsive patient with a history of type I diabetes. The patient has a low blood glucose level, is tachycardic, normotensive, and has a room air pulse ox reading of 94 percent. Following oxygen therapy, IV initiation, and administration of 50 percent dextrose, the patient is still unresponsive. How should this patient be transported to the hospital?

Emergency traffic speeds with lights and sirens

Your patient is a thin 59-year-old male in respiratory distress. He presents in a tripod position and appears to be working to breathe, pursing his lips. He is on home oxygen at 2 Lpm via nasal cannula and takes Atrovent and Proventil as his medications. You immediately notice his barrel-chested appearance, increased anterior/posterior chest diameter and pink complexion. Most likely, this patient suffers from which of the following?

Emphysema

In which of the following patients who require positive pressure ventilation to maintain oxygenation status would it be most important to ensure you do not deliver high airway pressures?

Emphysema patient

This mechanism is the result behind ectopic foci automatically depolarizing, producing ectopic (abnormal) beats on the ECG.

Enhanced automaticity

Combined with smoking, what complication can develop in a female who is also taking birth control pills?

Enhanced clot formation

Upon arrival to the scene, you observe that your 4-year-old male is having difficulty breathing with audible stridor. He presents in a tripod position sitting on the side of his bed and says his throat hurts. The patient is excessively drooling. Mom states this developed quickly over the past hour and her son hasn't been sick lately. What is the most likely cause?

Epiglottitis

You are managing a patient found in cardiac arrest. Bystander CPR was initiated and the patient was shocked once with an AED. You have determined that the patient is still pulseless and apneic. While one partner is intubating and another is inserting an IO needle into the proximal tibia, what medication should you prepare for administration first via IV push?

Epinephrine

A significant finding in the SAMPLE history that will contraindicate the administration of sublingual nitroglycerine to a patient experiencing myocardial chest pain is which of the following?

Erectile dysfunction medication use within 24 hours

Your patient has been feeling run down for the last day or so and is very weak and thirsty. He states he takes insulin daily, but ran out yesterday morning and hasn't been able to get a refill. ECG shows sinus tachycardia. You perform a finger stick and the portable glucometer reads 480 mg/dL. What would be a beneficial intervention at this time?

Establish an IV and administer boluses of normal saline to rehydrate the patient

You are assessing a male who has just finished running a marathon. He presents with pain in his groin area that occurred just as he crossed the finish line and is very nauseated. You examine the area and it is very painful, tender, and swollen. What is the most appropriate management?

Establish an IV, administer analgesics, and transport immediately

You are called by police to respond to a downtown street corner for an unresponsive man who is bleeding. You arrive and note that the police are already at the scene. Lying face down on the corner is adisheveled, unresponsive man who appears to be in his 60s. As you approach, the officer tells you that he knows the individual as a homeless man who frequently panhandles in the area. The victim then begins to vomit bright red blood. What is your first treatment priority?

Establishing control of the patient's c-spine and airway

Which of the following represents the most appropriate field management of a patient with a blood glucose level of 400 mg/dL, HR of 110, and complaints of being hungry all the time and having to urinateoften?

Establishment of an IV and giving boluses of fluid to rehydrate and maintain pressure

You are accidently stuck with the needle from the IV just initiated on a patient confirmed to have HIV. After washing your hand with warm water and soap, what should be done next?

Evaluation and possible prompt initiation of antiretroviral drugs

During your treatment of a patient with cardiac type chest pain, you have provided oxygen, IV access, nitroglycerin x3, and morphine x1. The patient is now pain free and the 12 lead ECG changes have resolved. At a minimum, how often should you repeat your reassessment phase during transport?

Every 15 minutes

Your patient has been successfully restrained but continues to be agitated, noncompliant, and has very hot skin. What life-threatening condition is the patient developing?

Excited delirium

You arrive at the residence of a 15-year-old male complaining of severe abdominal pain. You establish that the patient is alert and well oriented and his vitals are within normal limits. His father tells you that he has been complaining of a stomach ache for several days but it has recently become much worse. The patient adds that it hurts worse than when he broke his wrist playing baseball. As you perform your focused exam on his abdomen, you palpate the periumbilical area and note guarding followed by a positive test for rebound tenderness in the lower right quadrant. Shortly after palpation, the patient tells you that the pain has subsided to a dull ache; he feels much better and doesn't wish to be taken to the hospital. What is your next action?

Explain to the patient and his father that he could be in grave danger of infection and needs to be transported even though he feels better

What is the risk of infection to health care workers from HIV-positive patients when Standard Precautions are adhered to?

Extremely rare

How does chronic bronchitis cause the development of pulmonary hypertension?

Gas exchange is decreased because of lowered alveolar ventilation, resulting in hypercarbia, which causes pulmonary vasoconstriction.

Which of the following will likely not produce occult lower gastrointestinal bleeding?

Gastroenteritis

The most important intrinsic risk factor leading to respiratory disease development is:

Genetic predisposition

A patient with an airway obstruction between which two anatomical points will be unable to ventilate atall?

Glottis opening and carina

What is the term for the synthesis of glucose molecules from nonsugar sources?

Gluconeogenesis

What is the form of inflammatory arthritis that occurs when uric acid accumulates in the joints?

Gout

Your elderly patient is complaining of a sudden onset of pain in his left foot. Light touch of his great toe causes excruciating pain. Which of the following joint disorders is the most likely cause of the patient's pain?

Gout

Ecchymosis observed along the flank areas of the abdomen and is evidence of abdominal bleeding is described by which of the following?

Grey Turner's sign

Which one of the following histamine receptor types is located in the central nervous system?

Which of the following is a complication of type 2 diabetes due to sustained hyperglycemia and water intake that is inadequate to replace lost fluids?

HHS

You are transporting a patient from a nursing home into the emergency room for violent behavior. Along with a urinary tract infection, what other set of signs/symptoms would lead to a sepsis diagnosis?

HR >90 bpm and tachypnea

Eighty percent of the persons who successfully commit suicide have done what in the past?

Had a previous suicide attempt

Skin exposure to which of the following toxins may be decontaminated by use of water immersion mixed with magnesium sulfate, calcium salts, or benzethonium chloride?

Hydrofluoric acid

What is the proper sequence for removing a TASER dart?

Have TASER turned off, cut the dart wire, pull dart out, and cover wound with dressing

What should be the primary action when dealing with a patient sprayed with a pesticide that contains anorganophosphate?

Have the patient remove all clothing; then use copious amounts of water to flush the patient clear of any more toxin before attempting to touch the patient

You are dispatched to the home of a male with a history of kidney failure. On arrival, the patient informs you that he receives four hours of dialysis, three days per week and his shunt is swollen and painful. What could you conclude about this patient?

He has chronic kidney disease.

What is the medical term for coughing up or vomiting blood?

Hematemesis

What is a blood test that measures the percentage of the volume of whole blood that is made up of red blood cells?

Hematocrit

The process of developing the cellular components of blood is which of the following?

Hematopoesis

You are called for a 59-year-old female with chest pain. Her only medical history she tells you is that she was in the hospital once for an allergic reaction to Novocaine after dental surgery. Pulse is 90 and irregular, ventilations 20, blood pressure is 130/80. She takes no medications and her ECG shows sinus rhythm with numerous, multifocal PVCs. What is the most appropriate action?

High flow oxygen therapy

In an allergic reaction, what substance released by mast cells and basophils causes bronchoconstriction, increased intestinal motility, vasodilation, and increased vascular permeability?

Histamine

Which of the following factors contributes to the high mortality rate of upper gastrointestinal bleeds?

Home treatment of symptoms with over-the-counter drugs

What is the term for the chemical attack staged by the immune system in response to invading substances by immunoglobulins?

Humoral immunity

You are assessing an emphysema patient with respiratory distress and sharp localized chest pain to the left hemithorax. The patient states that he normally has trouble breathing, but it suddenly became much worse after a "coughing spell." You note absent breath sounds to the left apical and mid lung fields, and diminished sounds on the right side. Given these findings, what would you anticipate finding when you percuss the thorax?

Hyperresonance

What is the term for an unexpected and exaggerated reaction to a particular antigen?

Hypersensitivity

Which of the following is a modifiable risk factor for developing cardiovascular disease?

Hypertension

Which of the following risk factors has NOT been proven to increase the risk of cardiovascular disease?

Hypocholesterolemia

What gland of the body connects the endocrine system with the nervous system?

Hypothalamus

Which of the following is most likely caused by permanent loss or atrophy of functional thyroid tissue or insufficient stimulation of a normal thyroid gland as a result of hypothalamic or pituitary disease?

Hypothyroidism

Regardless of the type of anemia, or the cause, significant anemia always results in which of thefollowing?

Hypoxia

Which of the following acronyms provides a screening mnemonic for major depression?

INSADCAGES (The mnemonic represents Interest, Sleep, Appetite, Depressed mood, Concentration, Activity, Guilt, Energy, and Suicide.)

In which of the following arrest situations should the paramedic withhold resuscitation?

If the arrested patient displays dependent lividity

Which of the following is the most abundant class of antibodies found in blood serum and lymph?

IgG

A person receiving a blood transfusion experiences a sudden onset of fever, headache, and generalized itching. You verify the patient is receiving the correct blood type (the label on the bag matches thepatient's chart). What is the appropriate action?

Immediately stop the transfusion, remove and save the tubing, and substitute saline with a 10 drop set at the hub of the intravenous catheter

During your assessment of a patient with CHF, what position should he be in prior to the paramedic evaluating for the presence or absence of JVD?

In a sitting-up position of about 45 degrees

Which of the following findings for a patient complaining of dyspnea is of greatest concern?

Inability to speak in full sentences

While transporting a pediatric patient with rhinitis, the parents ask if there is anything they can do at home to help alleviate the patient's symptoms. What bit of advice could the paramedic offer the parents?

Increase the water vapor in the air via a room humidifier

What appears to be the main reason why excited delirium emerges within a patient?

Increased brain dopamine levels

What is the underlying pathophysiological change to the lungs that causes the patient to develop adult respiratory distress syndrome (ARDS)?

Increased fluid accumulation in the perialveolar interstitial spaces

You have just regained pulses on a cardiac arrest patient. As of right now, the heart rate is 38/min with sinus bradycardia showing on the monitor with multifocal PVCs, the patient is being ventilated at 10/min with oxygen via ET tube, and the palpable blood pressure is 68/palpation. Given these findings, what should the paramedic focus the next interventions on?

Increasing the heart rate

What is the term for the individual identified as the person who first introduces an infectious agent to apopulation?

Index case

Which of the following parameters is not a way that a population is identified?

Index case

Which of the following types of immunity provides protection from exposure to an antigen by getting avaccination?

Induced active

What postarrest treatment intervention has been shown to be beneficial in improving neurological outcome by slowing metabolism and minimizing oxidative stress?

Induced therapeutic hypothermia

A term for describing permanently damaged myocardial tissue that will not heal and may cause the appearance of a pathological Q wave on a 12 lead ECG is which of the following?

Infarct

What is the pathophysiological difference between someone experiencing chest pain from an ischemic episode versus an infarctionepisode?

Infarction is commonly from a totally occluded coronary blood vessel.

What is the underlying pathology of a patient with an upper respiratory infection?

Inflammation of upper airway structures from a virus or bacteria

What is the most common route of toxin exposure in the pediatric population?

Ingestion

Which of the following routes of toxic exposure is most common?

Ingestion

You are called to a remote campsite for a patient who is unresponsive. According to family members, the patient came back to the camp from walking through the woods looking for some wild onions to cook with, and was complaining of severe abdominal pain. The patient then vomited, and went in his tent to lie down. Later he was found unresponsive. Given the presentation, what would be the type of toxicexposure?

Ingestion of wild mushrooms

Although toxic exposures can have immediate and delayed effects, what type of exposure mechanism would likely start out with pulmonary findings such as tachypnea, wheezing, or inspiratory crackles?

Inhalation

Which of the following is a route of toxic exposure that results in rapid absorption of a toxic agent across the alveolar-capillary membrane?

Inhalation

During your management of a spontaneously breathing patient with suspected ARDS who is failing to oxygenate adequately with oxygen via NRB, what other intervention can the paramedic attempt to increase the oxygenation status of the patient?

Initiate CPAP

Your patient presents with continuous vomiting and diarrhea after eating at the local restaurant two hours earlier. He complains of severe abdominal pain and starting to feel very weak. Which of the following is the best treatment option?

Initiate IV fluids; replace at a rate sufficient to maintain blood pressure

Anaphylaxis most rapidly develops during what type of antigen exposure?

Injection

Your patient is exhibiting signs and symptoms of an allergic reaction with dyspnea and wheezing. The blood pressure is still acceptable, but the pulse oximeter is dropping despite high-flow oxygen. What should the paramedic consider administering next?

Intramuscular epinephrine

During your management of a patient suspected to be suffering from Cushing's syndrome, which of the following interventions should be part of the prehospital management?

Intravenous therapy

Your elderly female patient is complaining of steadily increasing, dull abdominal pain over the past two days. It does not radiate, but drawing up her knees helps a little to relieve the pain. She has been vomiting greenish-tinged material quite often. Her skin is pale, cool, and diaphoretic; pulse is 100 and blood pressure is 104/70. What is most likely the cause of her presentation?

Intussusception

After administering epinephrine and a 1000 ml bolus of 0.9 percent saline, you are ordered to administer 300 mg of Tagamet slow IV push to your patient that is experiencing an anaphylactic reaction. What is the benefit of Tagamet in this scenario?

In theory, it can block the H2 receptors in the peripheral blood vessels and reverse some vasodilation.

The ECG shows a rhythm with regularly-irregular groups of QRS complexes. There are more P waves than QRSs and the PR intervals become progressively longer until a P wave is not followed by a QRS complex. Which of the following would you suspect?

Ischemia at the AV junction

What is the term for the inability to concentrate or dilute urine?

Isosthenuria

Which of the following statements is true regarding hemophilia B?

It causes abnormally low levels of factor IX.

How does the brain attempt to compensate for the acidosis associated with DKA?

It increases the rate and depth of ventilations.

In terms of public health, patients that present with clinical findings pertaining to a particular infectious disease should alert the paramedic to what possibility?

It may not be an isolated incident.

How does chronic anemia relate to end-stage renal failure?

It occurs secondarily to disruption of renal hormone production.

Identify the correct statement regarding a stroke.

It occurs when the normal blood flow to an area of the brain is compromised due to partial or total blockage of a cerebral artery.

What is the benefit to transport a patient experiencing a myocardial infarction to a center with a catheter lab that performs percutaneous coronary intervention?

It provides the possibility of rapid reperfusion to distal myocardium by dilating the lumen of a blocked coronary artery with a balloon.

The process in which ketone bodies accumulate to biologically significant levels in the bloodstream is known as:

Ketosis

What condition is typically associated or the result of a middle ear infection or upper respiratory infection?

Labyrinthitis

You are called to treat a patient, post-dialysis, for acute stomach discomfort. Airway is clear, breathing is 22 and regular, clear lung sounds, pulse is 88 and weak-skin is cool and slightly diaphoretic. Blood pressure is 106/68 in right arm (left has a shunt). When asked, she tells you she is diabetic (glucose is 90), has a heart history (12 lead shows only an old myocardial infarct) and is on dialysis 3 times a week. When you try to stand her up, she immediately becomes very pale, lightheaded, and dizzy. What should be done next?

Lay her supine on your cot, establish an IV, and prepare to give fluids to maintain peripheral perfusion.

Which of the following lead patterns showing evidence of myocardial ischemia in a patient with chest pain would be indicative of obtaining right precordial leads?

Leads II, III, and AVF

What area(s) of the heart is/are directly observed by the precordial leads on a 12 lead ECG?

Left ventricle and septum

A patient with a long-standing history of systemic hypertension would most likely produce which of the following waveforms on a 12 lead ECG?

Left ventricular hypertrophy

Where is lead V5 placed on a patient's chest?

Left thorax, fifth intercostal space, anterior axillary line

The majority of out-of-hospital deaths attributed to coronary artery disease are due to what sudden event?

Lethal cardiac rhythm disturbance

You are called for a male patient with general illness. The patient complains of fatigue and fever. Physical exam reveals swollen lymph nodes and enlarged liver, bilateral weak grip strength, and pain within the sternum (non-cardiac). Which of the following is most likely the patient's condition?

Leukemia

Any patient with a history of diabetic ketoacidosis, bacterial infection, and/or rheumatoid arthritis can be at risk for which of the following?

Leukocytosis

The ECG shows a regular rhythm at a rate of 30, QRS is 0.18 seconds, and no P waves are present. Which of the following treatments is NOT appropriate?

Lidocaine

Toxic overdoses of acetaminophen can cause damage and necrosis to what organ of the body?

Liver

Which of the following is a cause for artifact appearing on the ECG?

Loose electrodes/wires

Which of the following is a symptom rather than a musculoskeletal disorder?

Myalgia

You are called to a residence to transport a 24-year-old female complaining of frequent and painful urination for the past 24 hours. She appears to be restless and continuously moves about; her vitals are pulse 94, respirations 20, blood pressure 104/76. Her skin is pale, cool, and moist. With this information, what would your field diagnosis be and what is your transport mode?

Lower urinary tract infection, expedite transport to an appropriate facility

When approaching a patient during your scene size-up and primary assessment, if you determine the potential for violence, you should do which of the following?

Maintain a safe distance and call police

Prehospital treatment of priapism consists of which of the following?

Making the patient comfortable and transporting him immediately

An 80-year-old, bed-confined patient has ankylosing spondylitis. She has fallen out of bed, isunconscious,and EMTs have been called. What should EMTs do when they arrive?

Manage the airway using devices that do not require visualization, adequately pad underneath the patient's head, neck and upper back with sheets or pillows, and determine how to transport in a non-jarring manner

The portion of the brainstem that is located between the diencephalon (interbrain) and the pons that is responsible for motor coordination and control of eye movement is which of the following?

Mesencephalon (midbrain)

You are called to examine a middle-aged female patient. She is not responsive to verbal commands, but tries to withdraw from and brush away painful stimulus. As you perform a physical exam, you find an insulin pump attached to her. Among the following possible causes, which one would be least likely?

Metabolic alkalosis

Your patient is complaining of difficulty breathing and dizziness. You can hear audible stridor and wheezing. Which of the following will be least beneficial?

Methylprednisolone (Solu-Medrol)

What is the primary cause of chronic gastroenteritis?

Microbial infection

You respond to a patient who experienced sudden vision loss in her left eye. She has a history of diabetes and hypertension. Regarding treatment, which of the following is correct?

Most patients regain vision without treatment, although it rarely returns to normal.

What is the term for cancer in the plasma cells of the immune system?

Multiple myeloma

As you approach your patient, you can see she has a very flat affect, a very puffy face, thinned hair, and doughy-looking, pale skin. From this general impression, what might be the underlying pathology with thispatient?

Myxedema

The presentation of which of the following findings in a patient with hypothyroidism would require emergent transport to the closest emergency department?

Myxedema coma

You arrive on scene for a patient who has purposely overdosed via ingestion. The empty prescription pill bottle reads "ibuprofen, 800 mg/tab." What drug class would this be?

NSAID

You are transporting a patient with severe joint pain secondary to a degenerative mechanism. What can the paramedic consider administering to make the patient feel more comfortable and decrease the pain while en route?

Narcotic

You are treating a 38-year-old male with a painful, closed right tibia fracture. There was no traumaticmechanism, but the patient says he was recently diagnosed with a chondrosarcoma. Which of the following is the most likely cause of the fracture?

Neoplasm

Damage to the kidneys from diabetes mellitus, resulting in chronic kidney disease, primarily occurs in which renal structure?

Nephrons

Which of the following cell types is primarily tasked with fighting infection?

Neutrophils

Your patient tells you he was cutting down brush in the woods behind his house today and when hefinished, he noticed a large rash developing on his arms and legs. He is in no outward respiratory or cardiovascular distress, but the majority of his anterior arms and legs are covered with urticaria. He lets you assess his vital signs, and they are all within normal limits. What is the best treatment option for thispatient?

Observe the patient and consider an IM injection of Benadryl or Tagamet

Synchronized cardioversion delivers energy during which part of the cardiac cycle?

On the peak of an R wave

Which of the following patients is at the highest risk of committing suicide?

One in possession of a gun

What is an organism that exists harmlessly as part of the normal human body environment and does not become a health threat until the body's immune system fails?

Opportunistic pathogen

What is the name of the membranous structure that separates the anterior aspect of the eye from the posterior aspect?

Orbital septum

What is the term for large amounts of water loss due to the presence of excessively high levels of glucose in the tubules of the kidney?

Osmotic diuresis

Which of the following pathologies is not secondary to a repetitive motion etiology?

Osteoarthritis

What condition occurs when the bone itself becomes inflamed or infected?

Osteomyelitis

What is the medical term for an infection of the bone?

Osteomyelitis

Which of the following is most likely to occur in a bedridden 65-year-old female alcoholic with a history of rheumatoid arthritis and a vitamin D deficiency?

Osteoporosis

The application of physical and chemical restraints to a patient must be performed with whatunderstanding?

Overstepping the boundaries of proper restraint may be perceived as battery, assault, or false imprisonment.

You are called for a 24-year-old woman with a rash. You find her sitting in a chair, alert and oriented and states she itches all over. She states she has been ill with a cold and saw her physician yesterday. She was given a prescription for an antibiotic and took the first dose last night and a second about 1/2 hour ago. Auscultation of the chest reveals clear lung sounds. The patient's blood pressure is 108/64, pulse110, ventilations 18. Initial management of this patient should include which of the following?

Oxygen by nonrebreather mask and administration of 0.3-0.5 mg of 1:1,000 epinephrine IM

When examining a patient with abdominal pain, which of the following is most likely to produce somatic pain?

Pancreas

When a patient tries to commit suicide by ingesting something, why could the signs and symptoms be inconsistent with a single diagnosis?

Patients will have ingested more than one toxin to try to kill themselves.

What is the most common underlying etiology for upper GI hemorrhage?

Peptic ulcer disease

Which of the following is not cause/risk for the development of cholecystitis?

Peptic ulcer disease

Your patient is a 28-year-old male who works in a fast-paced, high stress job environment. He is complaining of acute abdominal pain and presents lying supine and very still. He takes no meds and has no medical history. His skin is cool to the touch, pulse is 108, and blood pressure is 96/60. What is he most likely suffering from?

Peptic ulcer rupture

The 15-month-old you are treating is in respiratory arrest. Pulse still present at 108, skin is cyanotic. Mom states the baby was fine a minute ago and when she came back, her daughter wasn't breathing. You open the airway and make an attempt to ventilate but no air goes in. You reposition the child with padding under her shoulders and reattempt ventilations, but still no air entry is achieved. What is your course of action now?

Perform a series of 5 back blows and 5 chest thrusts

Which of the following is the principal treatment for polycythemia?

Phlebotomy

You are called to a residence for nausea and vomiting. You make your way through the house noting multiple liquor bottles on the floor. This patient is a 45-year-old male with shirt and mouth covered inblood, vomiting large quantities of dark, coffee grounds emesis. The patient's radial pulse is thready and weak at 114 bpm and he has cool, diaphoretic skin. Your initial priorities for this patient include which of the following?

Place patient in the left lateral recumbent position on your cot, suction as needed, and administer oxygen

Which of the following guidelines is recommended for questioning patients who have behavior problems?

Place yourself at the patient's level and listen to what the patient says.

Maintenance of oncotic pressure, clotting of blood, and transporting hormones are the responsibility of which of the following?

Plasma proteins

What is the type of respiratory problem that occurs when the patient develops an infectious process in one part of a lung that continues to spread throughout adjacent alveoli, which ultimately decreases ventilation and oxygenation?

Pneumonia

You are caring for an elderly female experiencing respiratory distress. Currently you find her seated upright in bed with accessory muscle use. Audible rales can be heard; she is diaphoretic and warm to the touch, has a temperature of 102 degrees F, and her respiratory rate is 32. The patient tells you that her breathing has been getting worse all night. You auscultate the chest and hear rales and rhonchi in all fields of her left lung and rhonchi in her right base, but her right middle and upper lobes sound clear. What do you suspect her problem to be?

Pneumonia

Your patient presents with shortness of breath and chest pain. Physical exam reveals some mild intercostal retractions with hot, flushed skin. Auscultation of the chest reveals diffuse rhonchi in the apex of the left lung. You also notice several tissues with yellowish sputum streaked with blood. She says she's never had this before and has been coughing for a day now. What do you suspect?

Pneumonia

Which of the following statements about the epidemiology of toxic exposures is true?

Poisonings have been constantly increasing in incidence and severity over the past several years.

Which of the following risk factors are thought to increase the risk of cardiovascular disease?

Poor diet

Which of the following assessment tools can provide an accurate differential diagnosis for a patient with altered mental status?

Portable glucometer

During your exam of a known CHF patient, you auscultate some minor lung congestion, observe peripheral edema to her anklesbilaterally, and a small amount of JVD while sitting upright. The family states these findings are normal for her. The patient complains of a slight headache. What should be your course of treatment?

Position of comfort, venous access, 12 lead ECG, oxygen to maintain SpO2 greater than 94 percent

Your patient has overdosed on multiple drugs in an attempted suicide. The patient presents with an open airway with an intact gag reflex, clear breath sounds over the trachea, but no breath sounds over the lung periphery due to a diminished tidal volume, and a pulse ox reading of 84 percent. What intervention should the paramedic provide first?

Positive pressure ventilation

Which of the following statements regarding a patient with ROSC is most accurate?

Postarrest care is almost as important as prearrest care.

You have a patient who was exposed to cyanide. During your management of this patient, which of the following drugs would not be part of the cyanide antidote kit?

Pralidoxime

The patient you are treating for palpitations and chest pain has a noticeable goiter and exophthalmos. When you ask her about her medical history, she says she has had a long-standing thyroid problem but never any cardiac, respiratory, or neurological issues. Pulse is 140 and regular (sinus tachycardia on theECG), ventilations 22 with clear lung sounds, and a blood pressure of 158/80. Which of the following medications would best treat her current condition?

Propranolol

You are dining at a restaurant, off-duty, when you notice a slender man at another table who appears to be in severe distress and clutching his throat. He pushes himself away from the table; you ask him what is wrong, but he cannot speak. What is your first action?

Provide abdominal thrusts in a rapid, upward fashion

A history of traumatic childhood incidents, neglect, dysfunctional families, abusive parents, and parental alcohol or drug abuse frequently combines with genetic predisposition to produce which of the following kinds of disorders?

Psychosocial

You are transporting a behavioral patient with a history of parental neglect. This person is likely suffering from which of the following forms of behavioral conditions?

Psychosocial

What is the condition characterized by a raised, wedge-shaped growth of the conjunctiva?

Pterygium

What is the underlying pathophysiology that is largely responsible for causing pulmonary dysfunction in a patient with any of the four major types of lung cancer?

Pulmonary cell growth and reproduction are altered due to the cancer

Your patient has recently come home after a bed-ridden 2-week stay in the local hospital. Earlier thisweek, he had experienced some bilateral lower leg pains with swelling and redness. Skin is pale with some expiratory wheezing auscultated in the area of his upper right thorax, where he complains of chest pain. Most likely, what is he suffering?

Pulmonary embolism

Which of the following is NOT a good practice for the paramedic to help prevent disease prevention?

Put all equipment back in the squad, restock, make the cot, then wash your hands

What is the term for an infectious inflammation of the nephrons, renal interstitial tissue, or both?

Pyelonephritis

Your patient tells you she is having terrible abdominal pain. She says that she was diagnosed three days ago with a urinary tract infection, but is on a fixed income and couldn't afford the antibiotics she was prescribed. She is very restless and has noticeable tenderness when you palpate her flank area. What is the likely cause of her distress?

Pyelonephritis

Which of the following statements is true regarding pyelonephritis?

Pyelonephritis is much more common in pregnant and sexually active females.

The total duration of ventricular depolarization is known as the:

QT interval.

A patient with a history of Crohn's disease will frequently present with which of the following?

Recent weight loss

What is the therapeutic endpoint for reducing the blood pressure in a patient with a hypertensive emergency with a severely elevated blood pressure and evidence of end-organ dysfunction?

Reduce MAP by no more than 25 percent initially

How does the respiratory membrane change in patients with emphysema?

Reduction of the total surface area available for gas exchange

What mechanism of abnormal impulse formation is responsible for sustaining rapid rhythms such as paroxysmal supraventriculartachycardia?

Reentry

During the management of a patient in PEA cardiac arrest, you have already intubated and ventilated the patient, you are performing ongoing compressions, and you have administered four doses of epinephrine and a fluid bolus. Prior to termination of the arrest, you elect to give 1 mEq/kg of sodium bicarbonate. However, the IV was just pulled out accidentally by your partner prior to the bicarbonate administration. What should you do next?

Reestablish the IV or initiate an IO

Why do reflex movements lack the fine motor control of conscious movement?

Reflex impulses come from the spinal cord.

What is the term for a chronic pain condition characterized by diffuse pain, swelling, and limitation of movement that follows an injury to an arm or a leg?

Reflex sympathetic dystrophy

Which of the following can be obtained from a single-lead ECG tracing?

Regularity of heartbeat

Chief strategies for supportive care in the chronic kidney disease patient include which of the following?

Regulation of fluid volume and cardiovascular function

You arrive on scene for an unresponsive male patient with a suspected airway obstruction. Without performing any other assessment on this patient other than knowing he is an adult male, what is the most common reason for an upper airway obstruction?

Relaxed tongue

You are called to an auto parts store for an "agitated person who appears to be confused." When youarrive, the patient is standing in front of the store yelling at two teenagers who appear to be antagonizing him. What should your first goal be?

Remove the antagonizers

You are led to a back bedroom where you find the patient lying in bed in a supine position. You immediately notice that she is ashen with shallow, unlabored respirations. While your partner begins administration of high-flow oxygen via a bag-valve unit, you perform a quick check of the radial pulse and find it present, with a rate of 130 and thready but regular. Your partner sizes her for and places an oropharyngeal airway, but discovers a gag reflex is still present and inserts a nasal airway instead. As you continue your rapid assessment, you fold the blankets back and discover that your patient is lying in a large pool of blood with no apparent source. The daughter shrieks and starts sobbing uncontrollably while violently shaking her mother's shoulders and screaming for her to wake up. What is your next step?

Remove the daughter from the area

What is the first priority when dealing with a patient suffering from a toxic inhalation?

Remove the patient from the source as soon as it is safe to do so

Upon arrival to the residence of a 32-year-old male, you are told by the patient that he is in extreme pain today. The pain started in his lower back area and now radiates into his lower abdominal area and groin. He is very restless and feels nauseated. He also explains to you that he noticed a "little bit of blood in mypee." What is the most likely conclusion?

Renal calculi

Which of the following urinary system disorders tends to occur more often in males than in females?

Renal calculi formation

In terms of patient privacy, what should paramedics reporting a potential incident of a patient with an infectious disease need to understand?

Reporting incidents of infectious disease may be done without fear of violating patient privacy.

During the care of a patient, her arterial bleeding results in blood splashing onto your face and eyes. Besides stopping care to immediately flush your face, what should you do?

Request that you and the patient both be tested for communicable diseases

When the walls of the alveoli and small bronchioles are destroyed, as occurs in emphysema, vital capacity remains relatively the same while what increases?

Residual volume

You are transferring a schizophrenic patient from the local hospital to a specialty hospital for continuing treatment. Despite your encouragement, he begins to exhibit aggressive behavior while en route to the specialty hospital. Your next action should be to do which of the following?

Restrain the patient

Why should patients not be restrained in the prone position?

Restraint in a prone position has been associated with positional asphyxia.

You arrive at the scene of a potential psychiatric emergency at the local library; the patient, a female in her 40s, appears to be hallucinating, yelling for "them" to leave her alone, and throwing books at patrons and bookshelves. The police, who were dispatched at the same time, have not arrived yet. What should you do next?

Retreat to a safe location, encouraging bystanders to do so also, and await assistance

You have a patient with severe lower right abdominal pain, sharp in characteristic. Although the paramedic should assess the abdomen, what may result if you repeatedly palpate for rebound tenderness in the area of McBurney's point?

Rupture of the vermiform appendix

What federal law provides that neither you nor your employer can force a patient to be tested for a communicable disease?

Ryan White Act

What is the disease that develops from a coronavirus and has an incubation period anywhere from 2-14 days?

SARS

During the assessment of a 12 lead ECG on a patient with chest pain, what type of waveform change is the paramedic assessing for that indicates possible damage?

ST segment elevation

What should be included in the care and treatment of most gastrointestinal disorder patients who are acutely deteriorating?

Secure airway, provide ongoing monitoring, initiate a large-bore IV, and transport gently in a position of comfort

What is the term for the initial exposure of an individual to an antigen?

Sensitization

Your patient experiencing an MI has ST segment elevation in V1 and V2, with ST depression and T wave inversion in V5 and V6. Given this, what should be your first suspicion as to the ventricular wall injured?

Septal wall

How many days are needed following exposure to a new antigen so that the cellular and humoral components of the immune systems will respond to a response-inducing antigen?

Several days

You are called to treat a 26-year-old African American male with an acute onset of severe joint and abdominal pain. He presents lying on the couch in the fetal position and states the pain is a "10." Pulse is 110, ventilations 20, and blood pressure is 140/90. Physical exam reveals left upper quadrant abdominal tenderness to palpation. What is the most likely cause for his illness?

Sickle cell crisis

Which of the following is most indicative of mood disorders?

Significant weight loss and feelings of worthlessness

You are called to a residence for a 7yearold male subject not acting appropriately. On scene the patient appears to be unaware of your arrival and responsive to verbal stimuli from his mother. ABC's appear to be intact and no life threats are immediately present. The mother reports that the child was watching television and noticed the child's fingers began to twitch. As she continues to describe the course of events leading up to calling for EMS, the patient becomes unresponsive and exhibits hyperextension of the back. Which of the following describes the evolution of the patient's current condition?

Simple partial to tonic-clonic

What pacemaker site in the heart serves as the primary pacemaker?

Sinoatrial node

A phasic variation of the R-R interval that is related to the respiratory cycle and changes in intrathoracic pressure produces which of the following rhythms on the ECG?

Sinus arrhythmia

When a patient experiences a sudden increase in cholinergic tone or has intrinsic SA node disease, this may lead to the development of which of the following ECG rhythms?

Sinus bradycardia

You are looking at an ECG that displays normal P waves at 80/min with a 1:1 relationship with the QRS, a PRI with a 0.24 secondconduction, and the width of the QRS is 0.14 seconds. The T wave is positively deflected. What is the most likely name of thisrhythm?

Sinus rhythm with a first-degree AV block and a bundle branch block

Your 19-year-old patient admits to drinking a six pack of Red Bull, two Monster drinks, and six Cokes in order to pull an all-nighter. Which of the following rhythms are you most likely to see on an ECG?

Sinus tachycardia with multiple PACs

If a patient with an acute coronary syndrome presents to EMS, and the ALS providers are able to resolve all pain through the use of nitrates and narcotics, why should this patient still be taken to a hospital capable of percutaneous coronary interventions?

So that the cause of the MI can be more permanently resolved within a very narrow and time-sensitive window of opportunity

What is the disorder that is characterized by physical symptoms that have no apparent physiologiccause?

Somatoform

You are managing a patient with suspected CO poisoning from using a kerosene heater in his home during a cold winter night. What is the lowest SpCO reading considered to be objective for initiating treatment for the exposure?

SpCO >10 percent

A 62-year-old male with a history of emphysema states an acute onset of pleuritic chest pain after a bout of coughing. He appears mildly dyspneic with ventilations of 26/min. When you auscultate the lungs, you note that breath sounds are diminished somewhat in the right thorax. You strongly suspect the patient has which of the following?

Spontaneous pneumothorax

You are treating a 40-year-old male for a sudden onset of chest pain during his daily run. He presents sitting on a park bench in no outward distress. He says the pain started in his chest about 10 minutes ago, but when he stopped his run and sat down, it went away. What do you suspect the underlying problem to be?

Stable angina attack

You receive a phone call at your EMS station from a mother who tells you that her 12-year-old son has been sick for several days. She took him to the doctor that morning and was told that the infection wasviral, and antibiotics would not be effective against it; she wants to know what you would do. What would you tell her?

State you understand how she feels, but viral infections are usually self-limiting and treated according to their symptoms. Suggest that she contact his doctor.

What is the physiological action of dopamine?

Stimulates alpha and beta receptors

What is the mechanism of glucagon?

Stimulates breakdown of glycogen

Which of the following findings for a patient complaining of dyspnea is of greatest concern?

Stridor on inspiration

Which of the following is the third most common cause of death and, in middle-aged and older patients, is a frequent cause of disability each year in the U.S.?

Stroke

Neurologic disorders that display symptoms of unilateral hemispheric involvement are generally the result of which of the following mechanisms?

Structural lesions

You are called for a 67-year-old male who "passed out." You find the patient unconscious, lying supine in the bathroom next to a toilet full of bright red blood and vomit. The patient's skin is cool, pale, and diaphoretic. His blood pressure is 60/30, pulse 140 and weak, ventilations 6/min and shallow. What is your initial management action?

Suction the airway and assist his ventilations with 100 percent oxygen and a BVM

Your patient responds only to your voice. He is diaphoretic, pale, and cool, blood pressure is 80/50, ventilations 28, and pulse is 34. The ECG monitor shows a rhythm that has regular, but independent atrial and ventricular rhythms with no consistent PR interval and a QRS width of 0.14 seconds. Select the most appropriate treatment.

Supine position, IV, oxygen, externally pace at a rate greater than 60

You are caring for an elderly female experiencing respiratory distress that worsened throughout the night. Currently, you find her seated upright in bed with accessory muscle userespiratory rate of 32 and labored. She is diaphoretic, very warm to the touch, and has a temperature of 102 degrees F. You auscultate her chest and hear rales and rhonchi in most of her upper and middle left lung. What is the most appropriate treatment plan for her?

Support adequate ventilation and oxygenation

For the paramedic, regardless of the mechanism by which a patient is exposed to a toxin, what should be the most important focus?

Supporting any lost vital function secondary to the poisoning

You are examining a 6-year-old female who is in respiratory distress and has a weak, seal-bark-like cough. She complains that her throat is very sore and she has trouble swallowing. Care should include which of the following?

Supportive care and humidified oxygen, as needed

Your patient presents with purulent drainage and erythema of his left eye. The conjunctiva appears inflamed but the cornea is clear. He also complains of excessive tearing and slight photophobia. What is the best course of action for this patient?

Supportive care for the patient, crew hand washing, and not touching your eyes

You are called to transport an elderly male to the hospital for evaluation of his colicky, left-sided parietal pain. The nurse informs you that the patient has had some alternating bouts of constipation and diarrhea over the last few days, but didn't call you until he noticed scant, bright red blood in his stool this morning. When you examine the abdomen, no scarring or distention, Cullen's, or Grey Turner's sign are noted. Tenderness is only noted over the affected area of the left lower abdominal quadrant. What will be your course of treatment?

Supportive care, establish an IV, and monitor SpO2

The patient you are examining complains of an acute onset of severe nausea, dizziness, vertigo, and tinnitus in his right ear. When asked, he states he is a one-pack-a-day smoker that just got over a bout of bronchitis and is a diagnosed alcoholic. During your physical exam, you detect some nystagmus in the right eye. What is the best course of treatment?

Supportive measures, establish an IV, and give ondansetron for the nausea

Discharge of which branch of the autonomic nervous system causes increased heart rate and blood pressure, pupillary dilation, a rise in the blood sugar, and bronchodilation?

Sympathetic nervous system

You respond to a call for a male patient experiencing chest pain. He has an altered level of consciousness, blood pressure of 80/60, carotid pulse of 200, cold, diaphoretic skin, and the ECG shows ventricular tachycardia. What is your best treatment option for him?

Synchronized cardioversion

What is the neurologic condition characterized by a sudden, temporary loss of consciousness that can be caused by hypovolemia, hypoglycemia, a heart arrhythmia, and/or TIA?

Syncope

Your 21-year-old female patient calls 911 for general weakness. When you assess her, she complains of multiple joint aches, fatigue, recent hair loss, and sensitivity to light. She noticed just today that when she came home, there was a rash that developed over her cheeks and the bridge of her nose. What does she suffer from?

Systemic lupus erythematosus

Your patient is presenting with earache, dull facial pain, and a headache. No trauma is noted and the patient states that she is also having difficulty chewing due to pain. Based on these symptoms, you would suspect that the patient is suffering from:

TMJ syndrome.

You are transporting a patient with ECG changes and a clinical presentation consistent with an acute coronary event. Assuming that all of the following receiving facilities are roughly the same distance from your location, which receiving facility would you transport to?

The hospital with PCI capability

During the management of a patient found in cardiac arrest without a known downtime, which of the following factors should not be considered as either inclusionary or exclusionary criteria for terminating efforts?

The downtime before EMS arrival

Which of the following best describes cellular respiration?

The exchange of the respiratory gases between the red blood cells and the various tissues.

Which of the following conditions, if present during the management of a patient in cardiac arrest, is not sufficient cause to terminate the resuscitative efforts in the field by the paramedic?

The patient has a rescue airway in place.

As you question a patient who has recovered from a complex partial seizure, which of the following is he likely to mention?

The patient has a very bad metallic taste in his mouth.

Why should the use of chemical restraint by paramedics be considered whenever a physically restrained patient struggles excessively?

The patient may be suffering from excited delirium syndrome.

You are called to the residence of a 16-year-old male complaining of a low-grade fever and a body-wide rash. After determining the safety of the scene, you opt to enter the residence, where you find the patient in the living room. You immediately recognize the rash as chickenpox. What are the treatment recommendations for chickenpox?

The patient should remain at home until the lesions are crusted and dry

Which of the following is true regarding the vital signs of a patient experiencing the onset severe allergic and anaphylactic reactions?

The patient will experience an increase in heart rate.

Which of the following is the definition of decontamination?

The process of reducing the amount of toxin absorbed into the body

The infectious disease control officer (IDCO) will maintain records of all infectious disease exposures as required by law. Who can these records be released to without the employee's written permission?

The records cannot be released without the employee's written consent.

Which of the following best describes afterload?

The resistance against which the ventricle must contract

Severe pain associated with the movement of a kidney stone through the ureter is the result of which of the following?

The thin muscle layer surrounding the microscopic ureter and the nerve distribution

Why does a patient with hepatitis present with jaundice and scleral icterus?

The virus damages the hepatocytes and tissue that is responsible for processing and removing bilirubin.

You are evaluating a 52-year-old male complaining of facial drooping on his left side upon awakening this morning. You have established that he has no prior medical history, vital signs were all within normal ranges, and his blood glucose level was 98. You have determined that he has left-sided facial droop, is slurring his words slightly, has equal grip, and has equal arm drift. What screening result would you determine according to the Cincinnati Prehospital Stroke Scale?

There is a 72 percent or higher probability of an ischemic stroke.

If a patient has a PR interval that is 7 mm (7 small boxes) in duration, what can be said about the overall ECG?

There is a conduction delay in the AV node.

Why are benign neoplasms of the central nervous system potentially harmful?

They can easily result in elevated intracranial pressures.

Which of the following statements is most accurate about poison control centers and the types of health care providers who staff them?

They employ physicians, nurses, paramedics, and toxicologists.

Which of the following statements is true regarding the causes of behavioral emergencies?

They most frequently involve biological conditions or substance abuse.

In order for a paramedic to honor an advance directive presented to him at the side of a patient that has just arrested, whose signature MUST appear on the written document?

The patient's physician

You are dispatched to the scene of a "belligerent man" who is ranting at passersby. As you approach, you note that police have already arrived at the convenience store, and your victim, who appears to be in his 50s, is standing between them talking loudly, and appears to be confused. The store owner is telling the officers that your patient frequently panhandles in front of the store and then purchases wine, but today he just started "carrying on" in a loud voice. The police would like him transported to the ED, and one of the officers has volunteered to accompany you. His vital signs are all within normal limits and your exam is unremarkable except for yellowing of the conjunctiva. You initiate an IV and contact the ED while en route. Of the following medications, which one might your protocol indicate administering given this specific presentation?

Thiamine

What is one of the major causes behind Wernicke's syndrome or Korsakoff's psychosis?

Thiamine deficiency

Your patient is an 85-year-old male who is experiencing a septal wall AMI. Which of the following rhythms would you expect to see on the ECG?

Third degree heart block

You are assessing a patient with chronic kidney disease and a recent creation of a fistula in her right arm. As you assess the fistula, you palpate a vibration over the area. What do you conclude about this finding?

This is normal and should be present.

Which of the following endocrine glands is larger and more active in the child as compared to the adult?

Thymus

During your assessment of a patient with a reported "psychological problem," you note that he is extremely agitated, tachycardic, hypotensive, occasionally delirious, and has a high fever and normal blood glucose level. Which of the following endocrine problems would be most likely?

Thyrotoxic crisis

Which of the following is generally caused by Graves' disease?

Thyrotoxicosis

Which of the following is not a typical cause of altered mental status?

Tinnitus

When dealing with the victim of a stroke, why is it imperative to establish the exact time of onset while rapidly delivering the patient to the ED?

To determine the patient's fibrinolytic candidacy

What is the basic purpose of poison control centers (PCC)?

To provide information about poisonings and treatment recommendations for health care providers

You see ST segment elevation in leads II, III, and aVf. Why do you switch the precordial leads to the right side of the chest and take another 12 lead?

To rule in or rule out a right ventricular AMI

Of the following pathologies, which is likely to produce diffuse depression of both hemispheres?

Toxic metabolic states

What is a group of signs and symptoms and/or characteristic effects associated with exposure to a particular substance or class of substance called?

Toxidrome

You are called to a house for a pediatric patient with increased work of breathing. When you walk into the room you see the patient being held by her father, nonproductive hoarse cough, and flushed. As you get closer you can audibly hear some stridor. What is your immediate concern?

Tracheitis

Which of the following would be a reason to continue a cardiac resuscitation?

Transient return of a pulse

What is the most common etiology of sudden eye emergencies that EMS is summoned to care for?

Trauma

Which troponin isoform value is most specific for cardiac injury?

Troponin I

While it can be present in cases of hypokalemia, this wave can also be a normal and non-pathological ECG characteristic:

U wave

What is an idiopathic syncopal episode usually caused by?

Undetermined cause

After being bitten by an unknown spider, the patient is now in acute pain with severe muscle contraction, hypotension, and labored breathing. How should the paramedic categorize the patient's stability in order to make a transport priority determination?

Unstable

Hematemesis is typically indicative of a hemorrhage to what GI location?

Upper gastrointestinal

What is the term for incomplete urination with urine remaining in the bladder?

Urinary stasis

You are transporting a child with Osgood-Schlatter disease to the hospital for severe pain. Duringtransport, the parents ask you if you know of anything that could help decrease the pain while at home. What advice could you offer them?

Use local measures such as rest and ice application

Which of the following ECG leads would best indicate the presence of a right ventricular myocardial infarction?

V4R

Which of the following vascular disorders would probably require the least amount of prehospital intervention by the paramedic?

Varicose veins

When looking at an ECG, the QRS complex is representative of what?

Ventricular depolarization

Which of the following rhythms has an indication for defibrillation as part of its treatment?

Ventricular fibrillation

What is the most effective method for preventing disease transmission?

Vigorous hand washing with soap and warm water

Which infectious microorganism must rely on a host cell to both grow and reproduce?

Virus

If a patient were to suffer a hemorrhagic stroke in the occipital cortex of the cerebrum, what would the patient complain about most?

Vision disturbances

You are transporting an elderly female patient who displays symptoms of early dementia to the local hospital for routine testing. The patient expresses concern that you are in a rush and she can't locate her glasses. How should you respond?

We have plenty of time, Mrs. Jones. I'll help you look for them.

Which of the following best describes the identification of left atrial enlargement on the 12 lead ECG?

Widened P wave of 2.5 mm

Your patient states "I...can't...breathe...it feels...like...I...am...suffocating!" Physical examination reveals cyanosis, diaphoresis, and bilateral rales in the lung bases. Patient has 2+ pitting edema bilaterally to the ankles as well as mild ascites. A productive cough is noted with pink-tinged sputum and pulses/movement are present in all four extremities. Which of the following conditions is most likely for this patient?

Worsening left heart failure

Which of the following is true when treating young children and infants for seizures or any other neurologic disorder?

You should rely on parents for the patient history and assistance with the primary exam.

A brain abscess can be described as:

a localized collection of pus in the brain.

When dealing with either geriatric or pediatric patients in behavioral crisis, it is better to:

allow a family member to remain with them whenever possible.

You are called for a female patient in respiratory distress. The patient reports an allergy to cats and bees; however, she is not aware of recent exposure to either. She states her current complaint is similar to previous episodes but the symptoms are much worse this time and developed much quicker than usual. Your primary concern would be:

an anaphylactic reaction despite the inability to identify the antigen.

The principal chemical agents of the humoral immunity attack are:

antibodies.

An agent that inhibits growth or multiplication of bacteria is known as _______.

bacteriostatic.

A person's observable conduct and activity is simply known as their:

behavior.

Non-cancerous enlargement of the prostate is known as:

benign prostatic hypertrophy.

It is 6:30 a.m. and you are preparing to get off duty when you are dispatched to a residence for a71-year-old female patient. The daughter stated to your dispatcher that the patient went to bed at about 10 p.m. as usual, but now, while she is breathing, she won't wake up. You arrive at the home, located in amiddle-class neighborhood, decide that the scene is safe, and enter the residence. You are led to a back bedroom where you find the patient lying in bed in a supine position. You immediately notice that she is ashen with shallow, unlabored respirations. While your partner begins administration of high-flow oxygen, assisting with a bag-valve unit, you perform a quick check of the radial pulse and find it present, with a rate of 130 and thready but regular. Your partner sizes her for and places an oropharyngeal airway, but discovers a gag reflex is still present and inserts a nasal airway instead. As you continue your rapidassessment, you fold the blankets back and discover that your patient is lying in a large pool of blood with no apparent source. While you begin to collect some history from the daughter, you should also:

call dispatch to send an additional unit.

You are assessing a small child who was found unresponsive and apneic. The patient is surrounded by Lego® toys. Considering your scene size-up, your primary differential diagnosis would be:

choking.

When the administration of epinephrine increases the heart rate, this is called a positive ________ effect.

chronotropic

As anaphylaxis progresses for an unresponsive and intubated patient, you would expect end tidal dioxide levels may:

climb due to the development of both respiratory and metabolic acidosis.

When responding to a patient with a known a degenerative nervous disorder, it is necessary for the paramedic to:

conduct a primary assessment and patient history to determine the chief complaint.

You arrive on scene to find a middle-aged male pulseless and apenic. Downtime is unknown. Your partner immediately begins CPR and you attach your defibrillator. Your next action should be to:

continue and support high quality CPR for at least 90 seconds.

The initial phase of an asthma reaction includes:

contraction of the bronchial smooth muscle and leakage of fluid from peribronchial capillaries.

A degenerative disease of connective tissue often associated with hypertension and aging is known as:

cystic medial necrosis.

The effect of histamine on the gastrointestinal system includes

diarrhea.

The time period between the onset of signs and symptoms of a disease and the resolution of symptoms or death of the organism is called the:

disease period.

You are going in to check on a patient that came into the hospital for general weakness. Her red blood cell count was measured to be 10 million/mm3. The patient is at risk for:

epistaxis.

The most durable type of cartilage is:

fibrinocartilage.

The spinal cord leaves the brain at the medulla and proceeds through an opening called the:

foramen magnum.

The majority of adult poisonings and overdoses are:

intentional.

The most common method of differentiating bacteria is:

gram staining.

The two major components of the cardiovascular system are the:

heart and peripheral blood vessels.

The knee is a:

hinge joint.

The chemical attack of an invading substance is:

humoral immunity.

When differentiating hyperglycemia from hypoglycemia, a notable difference when gathering history is:

hypoglycemia can develop within minutes to an hour, while hyperglycemia may take hours to a day to manifest.

The period of time between the contraction of a disease and the appearance of symptoms is known asthe:

incubation period.

You arrive on scene of a male complaining of malaise, headache, fever, chills, and sore throat. His wife reports that his symptoms began yesterday but got significantly worse today. The only events leading up to the illness was an incident in which the patient was chasing a raccoon out from under the deck on their house a few days ago; though no bite was specifically recalled, he was in close contact with the animal. If you did suspect rabies, your treatment would include:

initiate IV fluids; administer antiemetic.

The electric shock delivered to the body by a TASER:

is considerably less than needed to affect the heart.

The male urethra is considered a significant entry point for sexually transmitted diseases because:

it carries both urine and male reproductive fluid.

If you believe that your unresponsive patient suffered a syncopal episode, but he didn't regain consciousness within a few moments, then:

it is likely something more serious than a syncopal episode.

According to Einthoven's triangle, lead I is characterized by:

left arm positive, right arm negative.

You are treating a 22-year-old female complaining of a worsening headache and fever after being diagnosed with "strep throat" three days ago. She woke up early in the morning with an increased fever and an extremely stiff neck. She prefers you keep the lights off because they severely hurt her eyes. She may have contracted:

meningitis.

Following exposure to an antigen, the body will create antibodies specific for that antigen. This process is known as:

naturally acquired immunity.

A TASER patient who has normal vital signs and no other injuries can be released to law enforcement after being:

observed by the paramedic for 15 minutes.

Characteristics that distinguish whether a patient is suffering from hyperosmolar hyperglycemic state(HHS) and diabetic ketoacidosis (DKA) are:

often difficult to distinguish in the prehospital context and should be treated the same.

The upper portion of the oral cavity is the:

palate.

The first and second most common causes of fatal anaphylactic reactions are (respectively):

parenteral penicillin injections and insect stings.

Some blood delivered to the lungs via the pulmonary arteries does not participate in gas exchange. Under normal conditions, this is referred to as:

physiologic shunt.

You are responding to a homeless man that you regularly transport for alcohol abuse. In your assessment his primary complaint is foot pain. He reports a history of "sugar in my blood," but he denies taking any medications. After taking his shoe off, you identify two ulcers with redness, swelling, and very warm to the touch. The best treatment for him would include:

preventing further damage, bracing if necessary during transport.

Which of these disease-producing agents are particles of protein, folded in such a way that proteases (enzymes that break down proteins) cannot act on them?

prions.

The right semilunar valve, or pulmonic valve, connects the right ventricle to the:

pulmonary artery.

Animals, humans, insects, and the environment are all types of:

reservoirs.

Your patient is complaining of flashes of light to her peripheral vision associated with blurred vision secondary to a traumatic eye injury. The likely condition is:

retinal detachment.

A woman has brought her daughter to the emergency department. The girl is 4 years old and has had a worsening, "hacking" cough for several days. As you evaluate the child, her temperature is 104 degrees F, her eyelids appear swollen, her eyes are red with a crusty discharge, and she has reddish spots on her forehead, lips, and in her mouth. You quickly identify this patient as having:

rubeola.

The oily substance secreted onto the eyelids is:

sebum.

When the sinus node fails to discharge for a brief period, resulting in short periods of cardiac standstill that persists until pacemaker cells lower in the conduction system discharge, this is called:

sinus arrest.

The primary muscles, along with the abdominal muscles, used in periods of heavy respiratory demand are the

sternocleidomastoid and scalene muscles.

An esophageal varix is a(n):

swollen vein of the esophagus.

The two functional divisions of the autonomic nervous system are the:

sympathetic and the parasympathetic.

The whole-body inflammatory state which may result in septicemia is called:

systemic inflammatory response syndrome.

Venous access is typically difficult in older patients with sickle cell disease due to:

the high number of previous IV starts the patient has had.

Intracardiac pressures are higher on the left than on the right because

the lungs offer less resistance to blood flow than the systemic circulation.

Any condition that results in immobility of the extremities can increase the risk of _____.

thromboembolism.

The need for an increased amount of a drug to obtain effects previously attained from a lower dose of the same drug is called:

tolerance.

The study of toxins (drugs and poisons) and antidotes and their effects on living organisms is:

toxicology.

When a coronary artery is blocked completely and the result is damage to the full thickness of the myocardium, this is known as a______infarction.

transmural

Bleeding within the gastrointestinal tract proximal to the ligament of Treitz is categorized as:

upper gastrointestinal bleeding.

The safest method of patient restraint is:

verbal deescalation.

An organism's ability to overcome the body's defenses is known as:

virulence.

You respond to the residence of a 64-year-old male who is "having a stroke," according to his wife. On arrival you ensure the scene is safe and proceed inside; your patient is sitting at the kitchen table, obviously upset but not in distress, and his face displays the traditional "sag" on the right side consistent with a stroke. As you begin your primary exam, you begin gathering history from your patient. He tells you that the problem began as a headache behind his right ear the previous night and he awoke unable to move the muscles on the right side of his face. Your exam reveals normal vitals, feeling and strength of arms and legs are equal on both sides, and he has feeling on the right side of his face, but little or no muscle control; he is also apparently unable to close his right eye. What would be your field diagnosis?

Bell's palsy

What condition is associated with excess levels of self-administered glucocorticoids or internal overproduction of cortisol due to a tumor in the pituitary gland?

Cushing's syndrome

An increase in intracranial pressure that results in increased blood pressure, decreased pulse, and irregular ventilations is known aswhat?

Cushing's triad

Your patient is a 63-year-old male complaining of chest pain, stating his pain is an "8" on the 1-10 scale. His skin is cool and diaphoretic; he is confused and has a productive cough with pink-tinged sputum. ECG shows sinus tachycardia at a rate of 110 and his blood pressure is 74/40, ventilations are 24. What is the most appropriate pharmacological intervention?

Dopamine, titrated to maintain blood pressure

You arrive on scene to find a 28-year-old male who is very depressed since the loss of his fiancé from a single-car motor vehicle crash in which he was driving. You find him sitting in a chair in his bedroom, and he informs you he hasn't slept well in weeks and has constant nightmares. He expresses extreme remorse and responsibility over the loss. What is the best course of treatment?

Empathy, emotional support, and transportation for hospital evaluation

What is the "triad of signs" which indicates respiratory distress secondary to an infectious process in pediatric patients?

Fever, tachypnea, and retractions

Which of the following is the best definition of necrotizing fasciitis?

Flesh-eating bacterial infection that can rapidly destroy the skin, muscles, and surrounding tissues

You are called to the residence of a 42-year-old female, known to be HIV positive, complaining of fever, nausea, vomiting, and generalized weakness. On your arrival you determine that the scene is safe and enter the residence. What personal protective equipment have you put on prior to entering?

Gloves, mask, and eye protection

What nervous tissue disease results in a progressive loss of the myelin sheath covering nerve axons and causes a relative loss of nerve impulse conduction?

Guillain-Barre syndrome

Which of the following is a disease process caused by a genetic defect specific to chromosome 4?

Huntington's disease

When you arrive on scene to help an ill female, you notice a pole with a clear bag of fluid hanging from it that you can see is dialysate. What can you conclude before meeting her in person?

Hypotension, dyspnea, and/or seizure may be possible patient presentations.

What level of disinfection is provided by the use of 1:10 to 1:100 dilution of water and chlorine bleach orEPA-registered disinfectants or germicides?

Intermediate-level disinfection

Your patient presents lying in bed, unconscious to painful stimulation, and very cold to the touch. Pulse is 48 (low amplitude sinus bradycardia on the ECG), ventilations 12, and a blood pressure of 90/50. Exhaled CO2 is 55 mmHg, and you notice a vial of Synthroid on her nightstand. What is the most appropriate management for this patient?

Intubate, ventilate to maintain a CO2 between 35-45 mmHg

You have a patient lie down and flex her hips. Then you try to straighten the knee, but you are unable to fully extend it. What is this test called?

Kernig's sign

What is the order of progression of phases from the initial infection through resolution of the diseaseprocess?

Latent, communicable, then disease

What is the name given to a severe form of cellulitis of the submaxillary and sublingual spaces, usually from a dental abscess or trauma to the floor of the mouth?

Ludwig's angina

The rhythm on your ECG shows a rate of 74, PR interval of 0.28 seconds, QTC interval of 0.35 seconds, and QRS width of 0.08 seconds. What is your best course of action?

Observe, address, and treat any other chief complaints

What approximate portion of patients who experience a TIA is likely to soon after experience a stroke?

One-third

The general protocol for treatment of patients with a field diagnosis of sepsis would include which of the following?

Oxygenation, ventilation, fluid resuscitation, and vasopressor administration

Approximately 50,000 people are newly diagnosed in the United States each year with what nervous system disorder?

Parkinson's disease

Which of the following is an indicator of potential danger with a person experiencing a behavioralemergency?

Patient's posture and body language

The blood flow through a blood vessel is directly proportional to the fourth power of the vessel's radius. This is the definition of:

Poiseuille's law.

While listening to breath sounds on a dyspneic patient, you note a crackling sound over the peripheral lung fields. This breath sound is also known as __________ and refers to ____________.

Rales; fluid in the smaller airways

A fourteen-year-old boy comes to you with Osgood-Schlatter disease. What are treatment measures do you take?

Rest, ice, and nonsteroidal anti-inflammatory medications

You are dispatched to the home of a 54-year-old male with a history of chronic kidney disease. He called 9-1-1 because his shunt is painful and red at the access site. You assess it and believe there is a high possibility that the shunt is occluded. Management of this would include which of the following?

Transport, this requires surgical intervention

When obtaining an 18 lead ECG on a patient with chest pain, which lead locations would likely show the ST elevation from a posterior wall infarction?

V7, V8, V9

The _____ pleura covers the lungs while the _____ pleura lines the thoracic cavity.

Volume 3 Chapter 1-13

Related study sets

Chapter 40 quiz

Ch. 8

Chapter 39: Incident Management

Research Methods Literacy Modules

Ch. 7 Production Costs

Science study Guide

ACCT423 Final - FS Analysis

Databases Final

3106: EXAM #1 MULTIPLE CHOICE (SPRING 2021)

Speech chapter 10

Concept of Globalization

(2) Advantages and Disadvantages of Sole Proprietorship

ISMN 6750 Exam 1 Questions

Fed. Govt Exam 4

The four stages of general anesthesia and related nursing intervention

Orgo Lab

Managerial acct. ch.5

Chapter 8 Reading Question 1

Customer Accounts

FI 302 Exam 2