CH 28 Hematologic and Renal Emergencies

Question 1

H-1) ​Dead, diseased, or injured white blood cells are removed from the body via​ the:
A. bone marrow.
B. spleen and the liver.
C. gastrointestinal system.
D. pulmonary system.

Answer 1

B. spleen and the liver

Red blood​ cells, white blood​ cells, and platelets survive in the circulation for only a finite period of time and are then removed from the circulation by means of the filtration by the spleen or liver.

Question 2

H-2) Specialized molecules called hemoglobin bind to oxygen and deliver it to the body cells​ via:
A. plasma.
B. white blood cells.
C. red blood cells.
D. platelets.

Answer 2

C. red blood cells.

Red blood cells contain specialized molecules called hemoglobin that bind to oxygen and are responsible for oxygen delivery to the cells.

Question 3

H-3) Which of the following statements about patients with chronic anemia is​ true?
A. Patients with chronic anemia experience rapid onset of​ symptoms, usually due to trauma.
B. Patients with chronic anemia appear paler than​ normal, and are easily fatigued with exertion.
C. Patients with chronic anemia rapidly exhibit signs and symptoms of shock.
D. Patients with chronic anemia have a rapid pulse​ rate; cool, clammy​ skin; and hypotension.

Answer 3

B. Patients with chronic anemia appear paler than​ normal, and are easily fatigued with exertion.

Chronic anemia occurs over​ time, and can be caused by conditions such as recurrent heavy menstrual​ periods, slow GI blood​ loss, or diseases of the bone marrow or structure of the hemoglobin molecule. Patients with chronic anemia often appear more pale than normal and often complain of fatigue and shortness of breath with exertion. Only after a prolonged period of time will patients with chronic anemia exhibit signs and symptoms of shock.

Question 4

H-4) Examining the color of the conjunctiva of a​ patient's lower eyelid is an appropriate assessment for which of the following​ conditions?
A. Acute anemia
B. Chronic anemia
C. Sickle cell anemia
D. Atrial fibrillation

Answer 4

B. Chronic anemia
(Page 768)
One of the best ways to assess for chronic anemia is to examine the color of the​ patient’s conjunctiva on the lower eyelid. Anemic patients will have very pale​ conjunctiva, as opposed to the​ red/pink color seen in normal patients.

Question 5

H-5) You arrive at the home of a​ 47-year-old female who reportedly lost her balance on her front​ porch, fell​ backward, and struck her head. She is awake and alert but complains of a headache. The only medications that she takes are Plavix and aspirin. What concerns should you have for this​ patient?
A. The medications that she is taking will mask the pain that she could be having from her head injury.
B. These​ drugs, by preventing platelet​ aggregation, could cause a serious bleed in her head.
C. The combination of these two medications may cause seizures that may have led to her fall in the first place.
D. The combination of these two medications is probably why she lost her balance in the first place.

Answer 5

B. These​ drugs, by preventing platelet​ aggregation, could cause a serious bleed in her head.

These​ drugs, by preventing platelet​ aggregation, could cause a serious bleed in her​ head, which could be​ life-threatening.

Question 6

H-6) You arrive on scene to a​ 54-year-old male with chest pain and shortness of breath. Based on his signs and symptoms as well as his​ history, you suspect​ he's having a myocardial infarction. What medication can you administer to inhibit the aggregation of platelets at the site of coronary​ occlusion?
A. Oxygen
B. Nitroglycerin
C. Morphine
D. Aspirin

Answer 6

D. Aspirin

Aspirin is used to inhibit platelet aggregation in suspected MI patients.

Question 7

H-7) You arrive on scene where an elderly patient has suffered a​ ground-level fall. He has a large hematoma on his forehead. After you perform your primary​ assessment, his wife tells you that he just had surgery and now takes Lovenox injections. What concerns do you have about this​ finding?
A. On the basis of your​ assessment, there is no cause for immediate concern.
B. Lovenox may cause kidney failure.
C. Lovenox could cause the​ patient’s blood pressure to rise to dangerous levels.
D. Lovenox is a blood thinner that could exacerbate hemorrhage.

Answer 7

D. Lovenox is a blood thinner that could exacerbate hemorrhage.

Lovenox is a prescribed blood thinner that could cause massive hemorrhage in seemingly benign situations. In this​ scenario, the patient should be evaluated and transported because of the possibility of increased internal bleeding.

Question 8

H-8) Why do patients with sickle cell disease sometimes develop​ jaundice?
A. Most patients with sickle cell disease also have hepatitis because of repeated blood transfusions.
B. The sickled red blood cells tend to leak the hemoglobin into the blood plasma.
C. The jaundice is a product of the powerful medications that are necessary to treat sickle cell disease.
D. The liver becomes overwhelmed by the breakdown in red blood cells.

Answer 8

D. The liver becomes overwhelmed by the breakdown in red blood cells

The liver becomes overwhelmed by the breakdown in red blood cells. The red blood cells that are sickled do not survive​ long, and tend to accumulate in the​ liver, awaiting destruction. This accumulation overwhelms the liver​ function, and bilirubin accumulates in the​ blood, resulting in yellowish pigmentation of body tissues.

Question 9

H-9) Which of the following is the best explanation for the increased risk of stroke in sickle cell anemia​ patients?
A. Sludging red blood cells block the capillaries that supply the brain.
B. The sickled cells do not carry​ oxygen; therefore, some brain tissue will become ischemic.
C. The sickled cells are irregular in​ shape, and will likely damage the vascular walls.
D. Sickle cell anemia tends to develop mostly in elderly individuals.

Answer 9

A. Sludging red blood cells block the capillaries that supply the brain.

Question 10

H-10) Monitor a patient with a history of sickle cell anemia for signs of hypoperfusion​ if:
A. the patient has hypertension.
B. the patient has a high fever.
C. the patient shows a temporary increase in pulse oximetry readings.
D. the patient has inadequate respirations.

Answer 10

B. the patient has a high fever

Monitor patients with high fever for signs of​ hypo-perfusion, and treat for shock as necessary.

Question 11

H-11) Patients with acute chest syndrome commonly​ have:
A. priapism.
B. inadequate respirations.
C. jaundice.
D. strokes.

Answer 11

B. inadequate respirations.

Monitor patients with acute chest syndrome for signs of inadequate​ respiration, and provide​ bag-valve-mask ventilation as necessary.

Question 12

H-12) When an individual becomes​ dehydrated, how do the kidneys compensate for this​ state?
A. Only one kidney will continue​ filtration, whereas the other goes dormant.
B. The kidneys help the body retain needed fluid.
C. The kidneys temporarily shut down to prevent additional fluid loss.
D. The kidneys reduce the amount of blood that is initially filtered.

Answer 12

B. The kidneys help the body retain needed fluid.
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In addition to filtering​ blood, the kidneys can adjust the concentration of urine by adding water to or taking away water from urine. In patients who are​ dehydrated, this helps the body retain needed fluid.

Question 13

H-13) Which of the following functions do the kidneys normally​ perform?
A. Fluid regulation by removal of excess fluid
B. Production of hormones such as adrenaline
C. Filtration of the blood for removal of excess red blood cells
D. Maintaining a balance of the thermoregulatory hormones

Answer 13

A. Fluid regulation by removal of excess fluid
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Removal of excess fluid is a key function of the kidneys.

Question 14

H-14) Patients who suffer acute renal​ failure:
A. are unlikely to develop chronic renal failure.
B. may recover normal kidney function if the cause is rapidly discovered and treated.
C. likely have an inherited disease such as polycystic kidney disease.
D. never recover normal kidney function.

Answer 14

B. may recover normal kidney function if the cause is rapidly discovered and treated.

Some patients who experience acute renal failure can recover normal kidney function if the underlying cause of the insult to the kidneys is rapidly identified and corrected.

Question 15

H-15) For a patient with acute renal failure from severe​ dehydration, what would need to occur for recovery of normal renal​ function?
A. Hemodialysis
B. Aggressive treatment with intravenous fluids
C. Coagulopathy
D. Peritoneal dialysis

Answer 15

B. Aggressive treatment with intravenous fluids

Some patients who experience acute renal failure can recover normal kidney function if the underlying cause of the insult to the kidneys is rapidly identified and corrected. An example of this would be severe dehydration in a patient trapped in a building collapse for several​ days; with aggressive treatment with intravenous​ fluids, the patient can recover normal renal function over time.

Question 16

H-16) What is one​ short-term complication resulting from ingestion of toxic​ substances?
A. Peritoneal dialysis
B. ​Long-term hemodialysis
C. ​End-stage renal failure
D. Acute renal failure

Answer 16

D. Acute renal failure
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Patients with acute intoxication from toxic substances suffer from acute renal​ failure, and may have their renal function​ restored, if properly managed.

Question 17

H-17) ​Hemodialysis:
A. is typically performed at home.
B. involves two large catheters.
C. uses gravity to perform dialysis.
D. is the least common form of dialysis.

Answer 17

B. involves two large catheters
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In​ hemodialysis, a patient is connected to a dialysis machine by two large catheters. The machine filters the blood pumped through the catheters.

Question 18

H-18) Which of the following is true of​ hemodialysis?
A. Most patients receive hemodialysis at home.
B. Hemodialysis is temporary for most patients.
C. There are few complications from hemodialysis.
D. It is the most common type of renal dialysis in the United States.

Answer 18

D. It is the most common type of renal dialysis in the United States.

The majority of​ end-stage renal disease patients in the United States receive hemodialysis at outpatient centers. Hemodialysis presents with many​ complications, and is often a​ long-term management procedure for patients with ESRD.

Question 19

H-19) Dialysis is the process by which toxins and excess fluid are removed from the body by a medical system independent of​ the:
A. spleen.
B. liver.
C. kidneys.
D. heart.

Answer 19

C. kidneys.

Dialysis is the process by which toxins and excess fluid are removed from the body by a medical system independent of the kidneys.

Question 20

H-20) You are caring for a hemodialysis patient when you sense an odd vibration in the​ patient's lower arm. This condition is​ termed:
A. a thrill.
B. an oscillation.
C. a crepitus.
D. an excitement.

Answer 20

A. a thrill.
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A vibration felt on gentle​ palpation, such as the palpable sensation of blood flowing through an arteriovenous​ fistula, is known as a thrill.

Question 21

H-21) Patients receiving peritoneal dialysis who experience abdominal​ pain, fever, and cloudy dialysis fluid are possibly suffering​ from:
A. peritonitis.
B. completion of dialysis treatment.
C. AV fistula malfunction.
D. electrolyte imbalance.

Answer 21

A. peritonitis
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Abdominal​ pain, fever, and cloudy dialysis fluid are all signs and symptoms associated with peritonitis.

Question 22

H-22) You are seeing a​ 49-year-old hemodialysis patient for complaints of headache and arm pain. You examine her arm and find an AV fistula that is hard to the​ touch, not​ vibrating, and warm. What is the most likely​ explanation?
A. The lack of vibration suggests that the AV fistula is occluded by a clot.
B. The firmness from palpation and absence of a vibration are​ normal; being warm to touch suggests an infection.
C. Vibration is not a condition to be expected in an AV​ fistula, and the​ hard, warm condition is a result of repeated use for hemodialysis.
D. These conditions clearly indicate that electrolytes are beginning to accumulate.

Answer 22

A. The lack of vibration suggests that the AV fistula is occluded by a clot.
(Page 777 - Complications of Dialysis - Bullet 2)

The most likely explanation is an occluded fistula.​ Normally, you should feel a thrill while lightly palpating the fistula.

Question 23

H-23) After you assess the ABCs of an ESRD patient with complications of​ dialysis, you should​ immediately:
A. control any serious bleeding from the site of the AV fistula.
B. treat for shock.
C. transport the patient.
D. administer supplemental oxygen.

Answer 23

A. control any serious bleeding from the site of the AV fistula.

Question 24

H-24) For an ESRD patient who has missed dialysis and become unresponsive and​ pulseless, you​ should:
A. place the patient in a position of comfort.
B. be prepared to attach and use the AED.
C. monitor vital signs.
D. administer supplemental oxygen.

Answer 24

B. be prepared to attach and use the AED.

For an ESRD patient who has missed dialysis and become unresponsive and​ pulseless, you should be prepared to attach and use the AED. Be aware that ESRD patients who suffer cardiac arrest may not respond to defibrillation. Paramedics carry certain drugs that can be administered in the field to help stabilize​ ESRD-induced dysrhythmias. Consider ALS​ backup, but do not delay transport to the hospital.

Question 25

H-25) Recipients of kidney transplants are much more prone​ to:
A. abnormal weight loss.
B. infections.
C. heart failure.
D. high blood pressure.

Answer 25

B. infections.

Infections are a significant risk for kidney transplant​ recipients, particularly because their immune systems are​ suppressed, to avoid rejection of the transplant.

Question 26

H-26) A patient with a kidney​ transplant:
A. must take drugs to prevent organ rejection.
B. needs sustained oxygen therapy.
C. needs constant dialysis.
D. cannot resist infection.

Answer 26

A. must take drugs to prevent organ rejection

Patients with kidney transplants spend the rest of their lives on a special class of drugs that prevent organ rejection by suppressing the​ body’s immune system.

Question 27

PT-1) Why do some patients prefer peritoneal dialysis​ (PD) over hemodialysis​ (HD)?
A. Peritoneal dialysis allows patients to be treated at home.
B. Peritoneal dialysis requires fewer treatments per day than hemodialysis.
C. Peritoneal dialysis is quicker than hemodialysis.
D. Peritoneal dialysis enables full freedom of movement during treatments.

Answer 27

A. Peritoneal dialysis allows patients to be treated at home.
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Question 28

PT-2) Sickled red blood cells are believed to block blood that is trying to exit the corpus​ spongiosum, which for men​ causes:
A. strokes.
B. ​vaso-occlusive crises.
C. joint pain.
D. priapism.

Answer 28

D. priapism.

Question 29

PT-3) In a patient who has recently undergone peritoneal dialysis​ (PD), which of the following findings is the most suggestive of​ peritonitis?
A. The patient is sitting upright with some breathing difficulty.
B. The patient has back pain and is pacing about.
C. The patient reports a gradual onset of bloody stools for more than 5 days.
D. The patient develops abdominal pain and fever.

Answer 29

D. The patient develops abdominal pain and fever.

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Question 30

PT-4) Patients who have had a successful kidney​ transplant:
A. will be on medicines to suppress immune function.
B. will still need dialysis.
C. will be on medications to stimulate the immune system.
D. will have two kidneys from different donors.

Answer 30

A. will be on medicines to suppress immune function.

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Question 31

PT-5) You arrive at the home of a​ 65-year-old male patient with chest pain. His wife gives you a list of medications that he is taking because of previous heart attacks. One of the daily medications is aspirin. Why does the patient take daily doses of​ aspirin?
A. Aspirin helps to inhibit clot formation by inhibiting platelet aggregation.
B. Aspirin counteracts the side effects of​ nitroglycerin, which include headache.
C. He is probably taking aspirin for his arthritis.
D. Aspirin helps to reduce the pain of angina or heart attacks.

Answer 31

A. Aspirin helps to inhibit clot formation by inhibiting platelet aggregation.

Question 32

PT-6) Which of the following statements about administering oxygen to patients with sickle cell anemia​ (SCA) is​ true?
A. Only give supplemental oxygen to patients with SCA if you have been instructed to do so by medical direction.
B. Patients with SCA experiencing high fever and hypoperfusion should receive supplemental oxygen.
C. All patients with SCA should always be given supplemental oxygen.
D. Patients with SCA experiencing shortness of​ breath, chest​ pain, or oxygen saturation below​ 95% should receive supplemental oxygen.

Answer 32

D. Patients with SCA experiencing shortness of​ breath, chest​ pain, or oxygen saturation below​ 95% should receive supplemental oxygen.

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Question 33

PT-7) You are on scene with a​ 64-year-old female who appears to have a dialysis shunt on her arm. Based on this​ finding, you know that the patient​ has:
A. acute renal insufficiency.
B. polycystic kidney disease.
C. ​end-stage renal disease.
D. diabetes.

Answer 33

C. ​end-stage renal disease

Question 34

PT-8) A drainage tube placed into the urinary system to allow the flow of urine out of the body is​ a:
A. dialyzer.
B. peritoneal catheter
C. urinary catheter.
D. surgically created fistula.

Answer 34

C. urinary catheter

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Question 35

PT-9) Sickle cell anemia differs physically from general anemia in what​ way?
A. In sickle cell​ anemia, the cells lack a normal​ structure, and tend to be easily compressible.
B. In sickle cell​ anemia, the red blood cells lack a nucleus.
C. In sickle cell​ anemia, the red blood cells have a sickle shape.
D. In sickle cell​ anemia, the white blood cells have a sickle shape.

Answer 35

C. In sickle cell​ anemia, the red blood cells have a sickle shape.

Question 36

PT-10) You are gathering a medical history on a​ 74-year-old female with chest pain. She states she has a history of atrial fibrillation and is on a​ "blood thinner." Based on this​ information, which medication would you expect her to be​ on?
A. Lisinopril
B. Lebatolol
C. Nexium
D. Lovenox

Answer 36

D. Lovenox

Question 37

PT-11) If an inadequate level of oxygen is being delivered to the tissues of the​ patient’s body, which of the following is a possible​ explanation?
A. The platelets are failing to aggregate as needed.
B. There is an inadequate number of red blood cells.
C. The number of white blood cells is too high.
D. There are too few nutrients and proteins dissolved in the plasma.

Answer 37

B. There is an inadequate number of red blood cells.

Question 38

PT-12) Kidneys​ remove:
A. healthy cells.
B. blood.
C. oxygen.
D. excessive salts.

Answer 38

D. excessive salts.

Question 39

PT-13) The renal system is made up​ of:
A. two​ kidneys, two​ ureters, and two urethra.
B. two​ kidneys, two​ ureters, and one urethra.
C. two kidneys and two ureters in males and two urethra in females.
D. two​ kidneys, two​ urethra, and one ureter.

Answer 39

B. two​ kidneys, two​ ureters, and one urethra.

Question 40

PT-14) In the United​ States, sickle cell anemia primarily​ affects:
A. African Americans.
B. ​middle-aged women.
C. children.
D. people of Mediterranean descent.

Answer 40

A. African Americans.

Question 41

PT-15) Which of the following statements about sickle cell anemia is​ false?
A. The abnormally shaped red blood cells cause sludging within the​ body’s smaller blood vessels.
B. Patients with sickle cell anemia live as long as anyone else.
C. The sickled red blood cells cannot survive as long as normal red blood cells.
D. During a sickle cell​ crisis, patients will often complain of severe joint pain and difficulty in breathing.

Answer 41

B. Patients with sickle cell anemia live as long as anyone else.

Page 769

“Despite advances in modern medical care, patients with SCA still have an abnormally short life span.”

Question 42

PT-16) In addition to the delivery of oxygen to the tissues of the​ body, what role does the blood play in tissue​ regulation?
A. The conversion of carbon dioxide into glucose and oxygen molecules
B. The conservation of body heat through blood vessel dilation
C. The removal of carbon dioxide and other waste products from the tissue
D. The creation of certain hormones for body regulation

Answer 42

C. The removal of carbon dioxide and other waste products from the tissue

Question 43

PT-17) You are assessing a patient who has abdominal pain. During your​ history, you have determined that the patient receives dialysis three times a​ week, and you note a dialysis fistula in his left arm. How would this knowledge change your assessment of vitals on the​ patient?
A. You would not evaluate the skin condition on the left arm.
B. You would not assess any of the vitals in the arm with the dialysis fistula.
C. You would not listen to breath sounds on the left side of the body.
D. You would not use the arm with the dialysis fistula to obtain a blood pressure.

Answer 43

D. You would not use the arm with the dialysis fistula to obtain a blood pressure.

Question 44

PT-18) Recipients of kidney transplants​ have:
A. a restoration of normal kidney function within 12 years.
B. two kidneys from different donors.
C. their donor kidney in their lower abdomen instead of the retroperitoneal space.
D. the need to replace their donated kidney in about 20 years.

Answer 44

C. their donor kidney in their lower abdomen instead of the retroperitoneal space.

Question 45

PT-19) Which of the following patients is most likely in acute renal​ failure?
A. ​52-year-old male who ingested a toxic dose of aspirin
B. ​70-year-old male with multiple medical problems coupled with years of renal insufficiency
C. ​57-year-old female with high blood pressure and poorly controlled diabetes
D. ​32-year-old female with polycystic kidney disease

Answer 45

A. ​52-year-old male who ingested a toxic dose of aspirin

Question 46

PT-20) A surgically created fistula in one of the extremities of a patient undergoing hemodialysis​ connects:
A. the kidneys with the liver.
B. the ureters with the urethra.
C. the trachea and the aorta.
D. arterial and venous blood flow.

Answer 46

D. arterial and venous blood flow.

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Question 47

CT-1) The​ kidney's major​ function(s) include(s):
A. balancing electrolytes.
B. maintaining blood volume.
C. excreting urea.
D. All of the above

Answer 47

D. All of the above

Question 48

CT-2) You are dispatched to a private residence for a sick person. When you​ arrive, you are told by the patient that due to the snow storm yesterday he missed his scheduled appointment at the dialysis center and is not feeling well. Your assessment does not reveal anything remarkable outside of the fact that he has missed his dialysis. Which of the steps below would not be part of your​ care?
A. When you obtain vital​ signs, obtain a blood pressure on an arm that does not have a fistula.
B. Administer oxygen at 15 lpm by nonrebreather mask.
C. Place the patient in a supine position.
D. Assess the ABCs.

Answer 48

C. Place the patient in a supine position

Question 49

CT-3) What is the purpose of the red blood​ cells?
A. They are responsible for the removal of oxygen from the cells.
B. They are crucial in the formation of clots.
C. They are responsible for the delivery of oxygen to the cells.
D. They are critical in response to infection and are mediators of the​ body’s immune response.

Answer 49

C. They are responsible for the delivery of oxygen to the cells.

Question 50

CT-4) Which of the following is the most accurate definition of​ anemia?
A. An inherited disease in which a genetic defect in the hemoglobin results in abnormal structure of the red blood cells
B. The loss of the​ kidneys’ ability to filter the blood and remove toxins and excess fluid from the body
C. A lack of a normal number of red blood cells in the circulation
D. The process by which toxins and excess fluid are removed from the body by a medical system independent of the kidneys

Answer 50

C. A lack of a normal number of red blood cells in the circulation

Question 51

CT-5) Dialysis patients who have missed an appointment may present with signs of​ ________, which is a similar presentation to​ ________.
A. neurological​ disturbances; stroke
B. fluid​ accumulation; congestive heart failure
C. shortness of​ breath; pneumonia
D. chest​ pain; acute myocardial infarction

Answer 51

B. fluid​ accumulation; congestive heart failure

Question 52

CT-6) Which of the following organs may be seriously damaged in sickle cell​ anemia, subsequently leading to severe​ infections?
A. Liver
B. Lungs
C. Spleen
D. Kidneys

Answer 52

C. Spleen

Question 53

CT-7) Because of abnormally shaped​ hemoglobin, sickle cell anemia​ (SCA) patients may occasionally experience​ \_\_\_\_\_\_\_\_, causing a blockage of small blood vessels.
A. clumping
B. sludging
C. clotting
D. aggregation

Answer 53

B. sludging

Question 54

CT-8) What is one of the most common diseases to affect the renal and urinary​ system?
A. Urinary tract infections
B. Acute renal failure
C. ​End-stage renal disease
D. Kidney stones

Answer 54

A. Urinary tract infections

Question 55

CT-9) What is a cycle of filling and draining of the abdominal cavity during peritoneal dialysis​ called?
A. Set
B. Trade
C. Rotation
D. Exchange

Answer 55

D. Exchange

Question 56

CT-10) The sensation felt when palpating an​ arterial-venous fistula or shunt is known as​ a:
A. thrill.
B. fluttering.
C. frill.
D. bruit.

Answer 56

A. thrill

Question 57

CT-11) The blood has many functions critical to a​ patient’s health. Which of the following is not a function of the​ blood?
A. Delivery of oxygen to the cells
B. Removal of carbon monoxide from the cells
C. Control of bleeding by clotting
D. Removal and delivery of waste products to organs that provide filtration and​ removal, such as the kidneys and liver

Answer 57

B. Removal of carbon monoxide from the cells

Carbon Monoxide is a by product of combustion
Carbon DIOXIDE is what blood removes from the cells

Question 58

CT-12) You suspect a patient who has been having a difficult time controlling the bleeding following a small laceration to the foot may have a history​ of:
A. high blood pressure.
B. taking blood thinners.
C. sickle cell anemia.
D. poorly controlled diabetes.

Answer 58

B. taking blood thinners

Question 59

CT-13) Approximately how many Americans are currently on some type of​ dialysis?
A. ​450,000
B. ​900,000
C. ​100,000
D. ​200,000

Answer 59

A. ​450,000

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Question 60

CT-14) Which of the following abbreviations is not​ correct?
A. CAPD for continuous acute peripheral disease
B. WBC for white blood cells
C. SCA for sickle cell anemia
D. RBC for red blood cells

Answer 60

A. CAPD for continuous acute peripheral disease

Question 61

CT-15) What is continuous ambulatory peritoneal​ dialysis?
A. A mechanical process for peritoneal dialysis in which a machine fills and empties the abdominal cavity of dialysis solution
B. A gravity exchange process for peritoneal dialysis in which a bag of dialysis fluid is lowered below the level of an abdominal catheter to fill the abdominal cavity and raised above the level of the abdominal catheter to drain the fluid out
C. A gravity exchange process for peritoneal dialysis in which a bag of dialysis fluid is raised above the level of an abdominal catheter to fill the abdominal cavity and lowered below the level of the abdominal catheter to drain the fluid out
D. A type of dialysis that is performed while walking

Answer 61

C. A gravity exchange process for peritoneal dialysis in which a bag of dialysis fluid is raised above the level of an abdominal catheter to fill the abdominal cavity and lowered below the level of the abdominal catheter to drain the fluid out

Question 62

CT-16) Which of the following medications does not interfere with the​ blood-clotting process?
A. Aspirin
B. Clopidogrel
C. Warfarin
D. Acetaminophen

Answer 62

D. Acetaminophen

Question 63

CT-17) Peritoneal dialysis allows patients to dialyze at home​ through:
A. the abdomen.
B. the urethra.
C. a dialysis machine.
D. an AV fistula.

Answer 63

A. the abdomen

Question 64

CT-18) ​\_\_\_\_\_\_\_\_ patients are at high risk for acquiring the inherited disorder called sickle cell anemia.
A. Native American
B. Eastern European
C. Hispanic
D. African American

Answer 64

D. African American

Question 65

CT-19) A patient with renal disease who is currently on dialysis and missed an appointment may present with dangerously high levels of the​ electrolyte:
A. potassium.
B. sodium.
C. phosphorous.
D. calcium.

Answer 65

A. potassium

Question 66

CT-20) You are attending to an​ end-stage renal disease​ (ESRD) patient who has missed dialysis. Which of the following statements is most​ accurate?
A. Patients who have missed dialysis and who become unresponsive and pulseless respond very well to the use of an AED.
B. Patients who have missed dialysis and who become unresponsive and pulseless do not respond very well to the use of an AED.
C. You should delay transport if necessary to wait for ALS.
D. Calling for ALS would not be very helpful because they cannot really do anything that an EMT cannot do in these situations.

Answer 66

B. Patients who have missed dialysis and who become unresponsive and pulseless do not respond very well to the use of an AED.

Question 67

CT-21) You are dispatched to a private residence for a​ 52-year-old African American male sitting in his living room complaining of chest pain. During your​ assessment, he discloses that he has the sickle cell trait. Because of this you​ should:
A. administer​ high-concentration oxygen.
B. monitor for signs of inadequate respiration.
C. treat the patient as any other​ 52-year-old with chest pain.
D. be prepared to treat for shock if he also has a high fever.

Answer 67

C. treat the patient as any other​ 52-year-old with chest pain.

Question 68

CT-22) Platelets are actually fragments of larger cells that are crucial to the formation of clots. Clumping​ (called aggregation) of platelets is the​ body's most rapid response to stop bleeding from an injured site.​ However, in some situations the clumping of platelets is not​ desirable, such as when a plaque in a coronary artery ruptures. In this​ situation, the rapid clumping of platelets can cause a clot that then completely blocks the coronary artery and results in a heart attack​ (myocardial infarction). One of the most effective and widely available drugs to prevent the aggregation of platelets​ is:
A. acetaminophen.
B. plasma.
C. hemoglobin.
D. aspirin.

Answer 68

D. aspirin.

Question 69

CT-23) The medications that transplant patients need to take for the rest of their lives to prevent organ rejection also often lead to high susceptibility​ of:
A. congestive heart failure.
B. infection.
C. ulcers.
D. renal failure.

Answer 69

B. infection

This is due to the fact that the medications counteract the immune system so that it does not attack the new organ which it perceives as “foreign.”

Question 70

CT-24) Certain drugs are commonly referred as​ "blood thinners" or drugs that inhibit clotting. Which of the following would not be considered such a​ drug?
A. Aspirin
B. Lovenox​ (enoxaparin)
C. Prilosec
D. Coumadin​ (warfarin)

Answer 70

C. Prilosec

This is for acid reflux

Question 71

CT-25) How frequently is peritoneal dialysis treatment​ required?
A. Three to five times per week
B. Multiple treatments per day
C. Once a week
D. Once a day

Answer 71

B. Multiple treatments per day

Question 72

CT-26) Under which of the following circumstances do the kidneys help the body retain​ fluid?
A. Kidney stones
B. Electrolyte imbalance
C. Urinary tract infection
D. Dehydration

Answer 72

D. Dehydration

Question 73

CT-27) The most frequently transplanted organ is​ the:
A. liver.
B. kidney.
C. heart.
D. pancreas.

Answer 73

B. kidney

Question 74

CT-28) Hemodialysis is used to help the kidneys filter​ \_\_\_\_\_\_\_\_ and remove excess​ \_\_\_\_\_\_\_\_.
A. ​toxins; fluids
B. ​blood; cholesterol
C. ​urine; poisons
D. ​electrolytes; hormones

Answer 74

A. ​toxins; fluids

Question 75

CT-29) You encounter a patient who has been having diffuse abdominal pain for one week. The patient has a pulse rate of​ 86, a blood pressure of​ 140/90, and a respiratory rate of 20.​ However, the patient appears pale and complains of generalized weakness and shortness of breath during everyday activities. You suspect the patient is​ experiencing:
A. acute anemia.
B. chronic anemia.
C. sickle cell anemia.
D. anxiety disorder.

Answer 75

B. chronic anemia

Question 76

CT-30) You are dispatched to a sick call. The patient was just extricated from a bathtub where he was trapped under the shower door for 2 days. The​ 72-year-old male had limited access to water from the bathtub faucet. The patient is complaining of​ disorientation, nausea, and vomiting. What do you think is the underlying cause for the​ illness?
A. Gastrointestinal infection
B. Chronic renal failure
C. ​End-stage renal disease
D. Acute renal failure

Answer 76

D. Acute renal failure

Question 77

CT-31) A patient with a medical history of sickle cell anemia is complaining of chest pain and shortness of breath. The patient is breathing 26 times per minute in​ short, shallow respirations.​ However, the​ patient’s oxygen saturation via pulse oximetry is​ 100% on room air. The best approach regarding supplemental oxygen is​ to:
A. place the patient on a nasal cannula.
B. place the patient on a nonrebreather mask.
C. place the patient on a simple face mask.
D. do​ nothing; no supplemental oxygen is necessary.

Answer 77

B. place the patient on a nonrebreather mask.

Question 78

CT-32) You are dispatched to a private residence for a sick person. You arrive and find a​ 47-year-old male patient who recently completed his peritoneal dialysis and complains of severe abdominal pain that is worsened by movement. One of the more serious complications of this type of dialysis is a bacterial infection within the peritoneal cavity. What would be the​ tell-tale sign that this is what is happening in this​ case?
A. The​ patient’s dialysis fluid appears clear when it is drained from the peritoneal cavity rather than having its normal cloudy appearance.
B. The patient has swollen ankles.
C. The​ patient’s dialysis fluid appears cloudy when it is drained from the peritoneal cavity rather than having its normal clear appearance.
D. The patient has trouble urinating.

Answer 78

C. The​ patient’s dialysis fluid appears cloudy when it is drained from the peritoneal cavity rather than having its normal clear appearance.

Question 79

CT-33) Two chronic medical conditions that dialysis patients frequently have in addition to kidney failure are​ \_\_\_\_\_\_\_\_ and​ \_\_\_\_\_\_\_\_.
A. high​ cholesterol; cerebral aneurysms
B. heart​ failure; stroke
C. ​hypertension; diabetes
D. blood​ clots; COPD

Answer 79

C. ​hypertension; diabetes

Question 80

CT-34) One of the more serious diseases of the body is renal failure. Renal failure occurs when​ the:
A. pancreas stops working.
B. liver fails to function properly.
C. kidneys fail to function as required.
D. adrenal glands stop working.

Answer 80

C. kidneys fail to function as required.

Question 81

CT-35) Which of the following pathologies put patients at high risk for acute renal​ failure?
A. Shock
B. Polycystic kidney disease
C. Hypertension
D. Uncontrolled diabetes

Answer 81

A. Shock

Question 82

CT-36) The correct terminology used for patients whose kidneys are damaged to the point where they require dialysis to survive​ is:
A. acute renal failure.
B. hepatic failure.
C. ​end-stage renal disease.
D. terminal kidney disease.

Answer 82

C. ​end-stage renal disease

Question 83

CT-37) Once you encounter uncontrolled bleeding from an AV​ fistula, which of the following methods would you consider using to control bleeding in addition to direct pressure and​ elevation?
A. Internal wound management
B. Hemostatic dressings
C. Tourniquet
D. Pressure points

Answer 83

B. Hemostatic dressings

Question 84

CT-38) How long does a typical hemodialysis treatment​ last?
A. 3 to 4 hours
B. 10 to 12 hours
C. 7 to 8 hours
D. 1 to 2 hours

Answer 84

A. 3 to 4 hours

Question 85

CT-39) Approximately what percentage of United States dialysis patients treat themselves at​ home?
A. 16 percent
B. 8 percent
C. 50 percent
D. 25 percent

Answer 85

B. 8 percent

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Question 86

CT-40) How many times per week do the majority of American hemodialysis patients receive​ treatment?
A. One
B. Seven
C. Five
D. Three

Answer 86

D. Three

Question 87

CT-41) Patients who dialyze at home are at high risk for what type of​ infection?
A. Fistula infection
B. Peritonitis
C. Decubitus ulcers
D. Cellulitis

Answer 87

B. Peritonitis

Question 88

CT-42) Patients with a history of chronic sickle cell anemia​ (SCA) may present with which of the following signs and​ symptoms?
A. Flushed appearance and shortness of breath
B. Yellowing of the skin and dyspnea on exertion
C. Bluish discoloration of the skin and shortness of breath
D. Pale appearance and dyspnea on exertion

Answer 88

B. Yellowing of the skin and dyspnea on exertion

Question 89

CT-43) There are two main types of​ dialysis, hemodialysis and peritoneal dialysis. The main difference between them​ is:
A. hemodialysis is usually done at home and peritoneal dialysis is usually done at a special facility.
B. hemodialysis is usually done at a special facility and peritoneal dialysis is usually done at home.
C. hemodialysis filters the blood and peritoneal dialysis filters the urine.
D. hemodialysis filters the urine and peritoneal dialysis filters the blood.

Answer 89

B. hemodialysis is usually done at a special facility and peritoneal dialysis is usually done at home.

Question 90

CT-44) You are dispatched to an unconscious hemodialysis patient. On arrival to the dialysis​ clinic, the patient is​ unresponsive, apneic, and pulseless. You secure the​ ABCs, begin​ ventilation, and initiate chest compressions.​ However, the​ patient’s cardiac arrest rhythm is continuously unresponsive to defibrillations with your AED. The best approach is​ to:
A. run a​ “no-electricity” code in which compressions and ventilation are continued. No additional defibrillations are necessary.
B. continue defibrillating as the monitor recommends. The myocardium becomes increasingly responsive to successive defibrillations.
C. begin transporting and contact an ALS intercept. The​ patient’s dysrhythmia may be related to kidney failure.
D. call online medical control to terminate the code. The probability of survival is too low to continue resuscitation efforts.

Answer 90

C. begin transporting and contact an ALS intercept. The​ patient’s dysrhythmia may be related to kidney failure.