14, 15 quiz Flashcards
After assessing a patient with her EpiPen, she tells you that it is much easier for her to breathe. However, her heart rate has increased from 92 to 118 beats per minute. Regarding the epinephrine, the EMT recognizes the increased heart rate as a(n):
A) side effect
B) therapeutic effect
C) allergy
D) contraindication
A) side effect
The AED should never be applied to a patient who is not in cardiac arrest because some patients in:
A) ventricular tachycardia may have a pulse
B) ventricular fibrillation may have a pulse
C) asystole may have a pulse
D) ventricular fibrillation may be conscious and alert
A) ventricular tachycardia may have a pulse
You are transporting a patient in cardiac arrest. The AED is being used and a shock has been advised. Prior to administering the shock, what should you do?
A) stop the ambulance and have all rescuers exit prior to using the AED
B) withhold all shocks because metal will conduct the shock into the ambulance
C) move the patient from the metal stretcher to a nonmetal surface
D) ensure that no rescuer is touching the stretcher
D) ensure that no rescuer is touching the stretcher
Which of the following medications should be administered by the EMT only if the patient has a prescription for it?
A) Oxygen
B) Aspirin
C) Oral Glucose
D) Nitroglycerin
D) Nitroglycerin
A patient in shock with abdominal pain indicates he noticed alot of blood in the toilet after having a bowel movement this morning. The EMT should suspect what type of shock?
A) Hemorrhagic hypovolemic
B) Hypoxic hypovolemic
C) Nonhemorrhagic hypovolemic
D) Septic hypovolemic
A) Hemorrhagic hypovolemic
A beta 2 medication benefits a patient by:
A) diminishing the need for oxygen
B) eliminating chest pain
C) slowing the respiratory rate
D) dilating the small airways
D) dilating the small airways
You have been called for an elderly male patient who suddenly collapsed. On scene you find an 82-year-old man lying on the garage floor. Assessment reveals him to be unresponsive and not breathing. Which one of the following should you do immediately?
A) Determine the “down time”
B) Check for a carotid pulse
C) Start cardiopulmonary resuscitation
D) Apply the AED
B) Check for a carotid pulse
When should the EMT transport the cardiac arrest patient?
A) before delivering the first shock when a “Shock Advised” message is received
B) immediately upon determining that the patient is in cardiac arrest
C) after one shock has been delivered and the patient remains in cardiac arrest
D) after three “No Shock Advised” messages are received
D) after three “No Shock Advised” messages are received
The EMT knows that the cause of underlying distributive shock is:
A) dilation of the blood vessels
B) poor fluid intake
C) damaged heart with poor contractility
D) loss of blood volume
A) dilation of the blood vessels
A patient with chest pain tells you that he feels the same as when he had a heart attack two years ago. He is diaphoretic, nauseated, vomiting, and has a pulse of 84, respirations of 16, and a blood pressure of 78/50 mmHg. He is allergic to aspirin. He asks you to assist him in taking one of his nitroglycerin pills. Which one of the assessment findings that follows represents a contraindication to the nitroglycerin?
A) Heart rate below 100
B) Allergy to aspirin
C) Blood pressure of 78/50
D) Nausea and vomiting
C) Blood pressure of 78/50
A 67-year-old female with severe chest pain becomes unresponsive, pulseless, and apneic during transport. You should:
stop the ambulance, begin CPR, and attach the AED as soon as possible.
You are assessing a 49-year-old man who, according to his wife, experienced a sudden, severe headache and then passed out. He is unresponsive and has slow, irregular breathing. His blood pressure is 190/94 mm Hg and his pulse rate is 50 beats/min. His wife tells you that he has hypertension and diabetes. He has MOST likely experienced:
a ruptured cerebral artery.
The mental status of a patient who has experienced a typical seizure:
is likely to improve over a period of 5 to 30 minutes.
What is myocardial Ischemia?
Poor blood supply
What are some signs and symptoms of congestive heart failure (CHF)?
JVD pulmonary edema pedal Edema, dyspnea, Orthopnea
what is the blood pressure for hypertension?
Systolic pressure above 140 MMHG or diastolic above 90
After analyzing the heart rhythm of a patient in cardiac arrest, the AED provides a “deliver shock” message. After clearing the patient, the EMT’s next step should be to:
A.
Press the shock button, and then perform CPR for 2 minutes
B.
Press the shock button, and then check for the return of a pulse
C.
Press the shock button, and then allow the AED to analyze the heart rhythm
D.
Check for a pulse, and then press the shock button if a pulse is not present
A.
Press the shock button, and then perform CPR for 2 minutes
because of a shortage of paramedics at your ambulance service, it has been announced that there will be AEDs placed on every ambulance for use by EMT crews. Which of these statements indicates an understanding of how this policy will affect the EMTs?
A.
”The AED will let us know whether to shock the patient.”
B.
”EMTs will have to learn how to interpret ECG tracings.”
C.
”Cardiopulmonary resuscitation will no longer be needed.”
D.
”EMTs will now be able to shock all patients in cardiac arrest.”
A.
”The AED will let us know whether to shock the patient.”
A 44-year-old male patient has been shot in the abdomen. Which assessment findings would lead you to believe that the patient is in compensated shock?
A.
Slightly confused, pulse 116, BP 102/56 mmHg, warm skin that is flushed
B.
Confused and anxious, pulse 144, BP 82/palpation, cool skin that is mottled
C.
Alert and anxious, pulse 102, BP 114/88 mmHg, pale and cool skin
D.
Confused, pulse 44, BP 110/68 mmHg, cool and cyanotic skin
C.
Alert and anxious, pulse 102, BP 114/88 mmHg, pale and cool skin
A patient in cardiac arrest has regained a pulse after two shocks, but is still apneic. Which action would be appropriate next?
A.
Reanalyze the patient’s heart rhythm with the AED every 5 minutes
B.
Cancel the ALS assistance request and proceed directly to the hospital
C.
Transport the patient supine and secured to a long spine board as treatment is continued
D.
Remove the AED once it is determined that a pulse has returned and initiate transport
C.
Transport the patient supine and secured to a long spine board as treatment is continued
An unrestrained female driving a small car is involved in a rollover-type collision. Why is her risk for serious injury and death significantly increased?
a. Rollovers are the result.
b. Smaller and lighter cars tend to roll multiple times.
c. The risk for ejection is lessened, increasing injuries suffered in the car.
d. There are more impacts in a rollover.
d. There are more impacts in a rollover.
You are on the scene of a 16-year-old patient in respiratory distress. The patient has a history of asthma. After placing the patient on oxygen and performing the primary and secondary assessments, you are confident that the patient is indeed having an asthma attack. How can you be sure your field diagnosis is accurate?
Think of all possible causes of respiratory distress and rule them in or out as potential diagnoses based on your clinical findings.
Once you have reached a possible diagnosis for a patient, you should:
continue to look for data that will help rule in or rule out other conditions.
”If it looks like a duck and quacks like a duck, it must be a
duck–except when itisn’t” is a way to summarize which of thefollowing?
Representativeness
When using the memory aid SAMPLE, which of the following would you do to determine L?
Ask, “When was the last time you had anything to eat or drink?”
Mrs. Butler is a 66-year-old woman who is complaining of chest pain. Which of the following questions would be best in helping you determine if the pain is radiating?
Are you having pain anywhere beside your chest?
You have responded for a patient with shortness of breath. He reports that his breathing problems began this morning and have gotten worse over the last few hours. You ask if he has taken anything to help his symptoms and he tells you that he has used his inhaler several times in the last hour. The information you have just gathered can be classified as:
the history of present illness.
Which of the following methods should be used to have a patient rate the amount of pain he is having?
Have the patient rate the pain on a scale of 0 (no pain) to 10 (worst pain)
A description of a patient’s condition that assists a clinician in further evaluation and treatment is known as which of the following?
Diagnosis
You and another EMT are discussing a call he previously ran. The EMT said the patient had classic chest pain symptoms and he treated it as a possible heart attack, but he later found out the patient just had indigestion and was discharged 2 hours later. The EMT was concerned that his patient assessment skills were not as good as they should be, and that the ED physician will no longer trust his judgment. How should you respond to his concerns?
Tell him that his misdiagnosis is a result of limited information
Expert clinicians may use different approaches of thinking through problems, but which of the following will they have in common?
Strong foundation of knowledge
Your patient is a 16-year-old female who is reporting abdominal pain and nausea. She says it came on when she woke up this morning. Her mother says that her daughter has been tired and cranky lately and has not been eating well for a couple of weeks. In fact, every time you ask a question, the patient’s mother answers. What should you do next?
Have your partner interview the mother in the next room.
Your elderly patient reports having stomach cramps for several hours. He denies any trauma and he hasn’t eaten for several hours. Which of the following is most important to your assessment of this patient?
asking if he has been having regular bowel movements
Mr. Green is complaining of severe difficulty breathing after being stung by a bee. His wife states he has had reactions to bee stings before, but not quite this severe. Which medications should you specifically ask him about?
Epinephrine
You are on the scene in the bad part of town for an unresponsive 18-year-old type 1 diabetic patient. His mother states that he is very noncompliant with his diabetes management and often goes unresponsive due to low blood sugar. After performing the primary assessment, you believe that this is the most likely cause of his unresponsiveness. However, after taking a capillary glucose reading you are surprised to see that the patient’s sugar level is normal. How will you now determine the field diagnosis?
Continue patient care by getting a complete SAMPLE history and perform a complete secondary assessment.
Your patient is a 15-year-old female complaining of shortness of breath. Which of the following is not appropriate during the focused exam?
Checking her pupils for reactivity to light
When assessing a patient’s pertinent past history, you should ask which of the following questions?
Have you been having any medical problems?
A list of potential diagnoses compiled early in the patient’s assessment is known as which of the following?
Differential diagnosis
Of the following, which would most likely give the best information regarding your patient’s mental status?
Patient’s ability to know person, place, time, and purpose
________ are signs or symptoms that suggest the possibility of a particular problem that is very serious.
red flags
While an EMT forms a field diagnosis on the scene of an emergency, how do the steps differ from the traditional approach to diagnosis?
The EMT must rule in or out the most serious conditions associated with the patient’s presentation.
Which of the following describes skepticism about one thing causing another?
Illusory correlation
The process by which an EMT forms a field diagnosis is known as:
critical thinking.
An EMT’s assessment differs from an assessment made in the emergency department in which way?
The EMT is working with limited resources.
When you begin interviewing your patient, he tells you that he has not felt well for several months, ever since he had his gallbladder removed. He goes on to tell you that he cannot get his wife to schedule a doctor’s appointment for him and when she remembers to call, the office is always closed. Which of the following is the best way to proceed?
Ask him why he decided to call 911 today.
When using the memory aid OPQRST, which of the following questions would help you find out about P?
Does anything make the pain better or worse?
Which of the following is one advantage of using heuristics?
It speeds up the process of diagnosis.
What is the feeling of bone ends rubbing together called?
Crepitation
While assessing the past medical history of a 68-year-old male patient involved in a fall from a 4-foot stepladder, you use the acronym SAMPLE. What does the A refer to?
Allergies
Your patient is a 22-year-old college student complaining of abdominal pain. She is alert and oriented, although somewhat uncomfortable. Which of the following should be your first action?
Ask the patient to describe the pain and find out if she has other complaints.
Which of the following techniques of physical examination must an EMT master?
Observation, palpation, and auscultation
The patient was a driver in a lateral impact motor vehicle collision. During the assessment of his chest, the EMT notes a segment of the chest wall moving in the opposite direction from the rest of the chest. Which of the following best describes this finding?
Paradoxical motion
Your patient is a 45-year-old female who complains of “twisting her ankle” when she slipped on a patch of ice. Which of the following is not appropriate?
Detailed physical exam
Mr. Hughes is a 49-year-old man complaining of chest pain. To find out about the quality of his chest pain, which of the following questions is most appropriate?
Can you describe how the pain in your chest feels?
The term priapism means ________ and may be found in injuries of the ________.
You respond to a motor vehicle collision and find a patient with an altered mental status and angulated left femur; the other driver is deceased. Your closest trauma center is 45 minutes away. Which of the following would you do next?
Request ALS personnel.
When assessing a patient who has been stabbed, which of the following information should the EMT gain first?
You are assessing a 76-year-old male patient who has been involved in a fall from a standing position. You have completed the scene size-up and primary assessment. What should you do next?
Secondary assessment
Immediately following a rapid physical exam on an unresponsive medical patient, which of the following should you do next?
Obtain baseline vital signs.
You are called for a patient who was discovered unconscious in his bed this morning. You immediately complete a primary assessment and determine that he is breathing and has a good pulse. What should you do next?
Complete a rapid physical exam.
You respond to the scene of a motor vehicle crash to find a middle-aged man on a long spine board being cared for by first responding firefighters. He appears to be bleeding from his head and he is unconscious. You should check the car for
a bent steering wheel or starred windshield.
What does distention refer to when describing your patient’s abdomen?
Larger than normal
An unconscious trauma patient should always be assumed to have which of the following types of injury?
spine
Your patient is the 18-year-old male driver of a vehicle that struck a tree. He is conscious and complaining of neck pain. The passenger is obviously dead. You have performed your primary assessment. Which of the following is the next step?
Perform a rapid trauma assessment.
What is a surgical opening in the wall of the abdomen with a plastic bag in place to collect digestive waste?
Colostomy
For which of the following patients is a focused physical examination appropriate?
A 25-year-old female with a history of asthma and who is complaining of difficulty breathing
You are called for a patient who is complaining of being weak and dizzy. He reports that he does not have enough money to pay for his medications so he has not gotten them refilled. Your service has an automatic blood pressure machine and you use it to measure the patient’s blood pressure while you count his respirations. The blood pressure machine reports a blood pressure of 280/140. What should you do next?
Take a manual blood pressure.
In which of the following patients should you check for the possibility of spinal injury?
An unresponsive diabetic who appears to have fallen down
What term describes a permanent surgical opening in the neck through which a patient breathes?
Stoma
When assessing a 14-year-old male patient that has been involved in a bicycle accident, you notice that he has a small amount of blood coming from his left forearm. This observation is known as which of the following?
sign
Your patient is a 24-year-old female who swallowed a handful of pills of unknown type. Although she was initially alert and oriented with no complaints, you note that she is now beginning to slur her words and is becoming progressively lethargic. What is the highest priority in dealing with this patient?
Maintaining an open airway
Your patient is a 14-year-old male who was run over by a tractor and is now unresponsive. During the rapid assessment, you should look for clear drainage coming from the patient’s ________ indicating a serious injury.
ears
If a patient complains of abdominal pain localized to a specific area of the abdomen, which of the following techniques should be used to assess the abdomen?
Palpate the painful area last.
Which of the following situations is most likely to result in hidden or unsuspected injury?
Seat belt use by the vehicle occupants
In the assessment of a responsive medical patient, which of the following will provide you with the most important information?
patient medical history
You have performed a rapid trauma assessment on a patient with multiple long-bone injuries. Your next assessment step should be which of the following?
Obtain baseline vital signs and past medical history.
Your patient is an unresponsive 40-year-old woman. Which of the following should you do first?
Perform a rapid physical exam.
You are assessing a 21-year-old female who was assaulted by an unknown person. She is complaining of abdominal pain. As you perform a rapid assessment of her abdomen, you should check for all of the following except:
bowel sounds.
The ambulance is called for an assaulted patient. While transporting the patient to the hospital, the EMT notes the patient’s jugular veins are flat (nondistended). Which of these is most likely the cause of this finding?
Blood loss
You are assessing a patient who has been involved in a motor vehicle crash. Which of the following questions would be the most important to ask him?
How fast was the vehicle going?
In medical terms, bruises are known as which of the following?
contusion
You are performing a rapid trauma assessment on an unresponsive 30-year-old male. As you evaluate his head, which of the following should you check for?
Crepitation
When checking breath sounds in a trauma patient, what should the EMT assess for first?
Presence and equality
What term describes a surgical incision in the neck that is held open by a metal or plastic tube through which a patient can breathe or be placed on a ventilator?
Tracheostomy
Your patient was struck in the chest with a baseball bat during a bar fight. A crackling or crunching sensation that is felt when air escapes from its normal passageways and is trapped under the skin is called:
subcutaneous emphysema.
