Exam 2 - Section 2 & 3 Flashcards
1
Q
A 29-year-old male with a head injury opens his eyes when you speak to him, is confused as to the time and date, and is able to move all of his extremities on command. His Glasgow Coma Scale (GCS) score is: Select one: A. 10. B. 13. C. 14. D. 12.
A
B. 13.
2
Q
A 40-year-old male presents with pain to the right upper quadrant of his abdomen. He is conscious and alert with stable vital signs. During your assessment, you note that his skin and sclera are jaundiced. You should suspect: Select one: A. liver dysfunction. B. gallbladder disease. C. renal insufficiency. D. acute pancreatitis.
A
A. liver dysfunction.
3
Q
A 71-year-old female slipped on a rug and fell. She is conscious and alert and complains of severe pelvic pain. Her respirations are 22 breaths/min with adequate depth and her heart rate is 120 beats/min. Which of the following is NOT indicated for this patient? Select one: A. Rapid head-to-toe exam B. Gentle palpation of the pelvis C. Treating her for possible shock D. Application of a cervical collar
A
B. Gentle palpation of the pelvis
4
Q
A crackling sound produced by air bubbles under the skin is called: Select one: A. rhonchi. B. Korotkoff sounds. C. crepitus D. subcutaneous emphysema.
A
D. subcutaneous emphysema.
5
Q
A patient is sitting in a chair, leaning forward on his outstretched arms. His head and chin are thrust forward. This position indicates that he:
Select one:
A. has a decreased level of consciousness.
B. is experiencing difficulty breathing.
C. is experiencing severe back pain.
D. has abdominal muscle spasms.
A
B. is experiencing difficulty breathing.
6
Q
A patient with high blood pressure would be expected to have skin that is: Select one: A. cyanotic and dry. B. mottled and cool. C. pale and moist. D. flushed and red.
A
D. flushed and red.
7
Q
A patient with spontaneous respirations is breathing: Select one: A. with shallow depth. B. without difficulty. C. without assistance. D. at a normal rate.
A
C. without assistance.
8
Q
A properly sized blood pressure cuff should cover:
Select one:
A. two thirds the length from the armpit to the crease at the elbow.
B. the entire upper arm between the armpit and the crease at the elbow.
C. one half the length between the armpit and the crease at the elbow.
D. one third the length from the armpit to the crease at the elbow.
A
A. two thirds the length from the armpit to the crease at the elbow.
9
Q
After performing a head tilt–chin lift maneuver to open the airway of an unresponsive patient who has a pulse, you should:
Select one:
A. suction as needed and insert an airway adjunct.
B. place him or her in the recovery position.
C. provide positive-pressure ventilatory assistance.
D. assess respiratory rate, depth, and regularity.
A
A. suction as needed and insert an airway adjunct.
10
Q
An adult patient who is NOT experiencing difficulty breathing will:
Select one:
A. be able to speak in complete sentences without unusual pauses.
B. have a respiratory rate that is between 20 and 24 breaths/min.
C. exhibit an indentation above the clavicles and in between the ribs.
D. assume a position that will facilitate effective and easy breathing.
A
A. be able to speak in complete sentences without unusual pauses.
11
Q
As you assess the head of a patient with a suspected spinal injury, your partner should:
Select one:
A. look in the ears for gross bleeding.
B. prepare the immobilization equipment.
C. assess the rest of the body for bleeding.
D. maintain stabilization of the head.
A
D. maintain stabilization of the head.
12
Q
Clinical signs of labored breathing include all of the following, EXCEPT: Select one: A. gasping attempts to breathe. B. use of accessory muscles. C. shallow chest movement. D. supraclavicular retractions.
A
C. shallow chest movement.
13
Q
During a 30-minute transport of a stable patient, you should reassess him or her at least \_\_\_\_\_\_\_\_ times. Select one: A. 4 B. 2 C. 3 D. 6
A
B. 2
14
Q
If a patient develops difficulty breathing after your primary assessment, you should immediately:
Select one:
A. determine his or her respiratory rate.
B. reevaluate his or her airway status.
C. begin assisting his or her breathing.
D. auscultate his or her breath sounds.
A
B. reevaluate his or her airway status.
15
Q
In responsive patients who are older than 1 year of age, you should palpate the pulse at the \_\_\_\_\_\_\_\_ artery. Select one: A. brachial B. femoral C. carotid D. radial
A
D. radial
16
Q
A 37-year-old male is found unresponsive in his car. His airway is patent and his respirations are rapid and labored. As you and your partner are assessing and treating the patient, a police officer hands you a medication named Alupent, which he found in the backseat of the patient's car. This medication suggests that the patient has a history of: Select one: A. allergic reactions. B. asthma. C. heart disease. D. hypertension.
A
B. asthma.
17
Q
A mucosal atomizer device (MAD) is used to deliver certain medications via the: Select one: A. sublingual route. B. transdermal route. C. inhalation route. D. intranasal route.
A
D. intranasal route.
18
Q
Aspirin is beneficial to patients suspected of having a heart attack because it:
Select one:
A. prevents the aggregation of platelets.
B. dissolves the coronary artery clot.
C. reduces the associated chest pain.
D. causes direct coronary vasodilation.
A
A. prevents the aggregation of platelets.
19
Q
How is nitroglycerin usually given by the EMT? Select one: A. Injected B. Orally C. Sublingually D. Inhaled
A
C. Sublingually
20
Q
Shortly after assisting a 65-year-old female with her prescribed nitroglycerin, she begins complaining of dizziness and experiences a drop of 30 mm Hg in her systolic blood pressure. The patient remains conscious and her breathing is adequate. You should:
Select one:
A. wait 5 minutes and reassess her blood pressure.
B. transport her in a sitting position.
C. assist ventilations with a bag-valve mask.
D. place her in a supine position.
A
D. place her in a supine position.
21
Q
What medication form does oral glucose come in? Select one: A. Liquid B. Fine powder C. Gel D. Suspension
A
C. Gel
22
Q
Which of the following is NOT a characteristic of epinephrine?
Select one:
A. Dilates passages in the lungs
B. Secreted naturally by the adrenal glands
C. Constricts the blood vessels
D. Decreases heart rate and blood pressure
A
D. Decreases heart rate and blood pressure
23
Q
Which of the following medication routes would be the MOST appropriate to use in an unresponsive patient when intravenous access cannot be obtained? Select one: A. Intramuscular B. Intraosseous C. Transcutaneous D. Subcutaneous
A
B. Intraosseous
24
Q
Which of the following statements regarding the epinephrine auto-injector is correct?
Select one:
A. The epinephrine auto-injector delivers a preset amount of the drug.
B. The adult auto-injector delivers 0.5 to 1 mg of epinephrine.
C. The auto-injector delivers epinephrine via the subcutaneous route.
D. EMTs do not need physician authorization to use the auto-injector.
A
A. The epinephrine auto-injector delivers a preset amount of the drug.
25
You are treating a 45-year-old woman who was stung by a hornet and has a rash. She tells you that she is allergic to hornets and has her own epinephrine auto-injector. She also tells you that she takes medication for hypertension. Her breath sounds do not reveal any wheezing, her breathing is unlabored, and her blood pressure is 154/94 mm Hg. What should you do if you are not able to make contact with medical control?
Select one:
A. Administer her epinephrine, reassess her condition, and transport her promptly.
B. Begin immediate transport and request an intercept with a paramedic ambulance.
C. Give her half the dose of her epinephrine in case her allergic reaction is delayed.
D. Begin transport to the hospital and closely monitor her condition while en route.
D. Begin transport to the hospital and closely monitor her condition while en route.
26
A 22-year-old female patient is complaining of dyspnea and numbness and tingling in her hands and feet after an argument with her fiancé. Her respirations are 40 breaths/min. You should:
Select one:
A. provide reassurance and give oxygen as needed.
B. request a paramedic to give her a sedative.
C. have her breathe into a paper or plastic bag.
D. position her on her left side and transport at once.
A. provide reassurance and give oxygen as needed.
27
A 62-year-old man with a history of congestive heart failure presents with severe respiratory distress and with an oxygen saturation of 82%. When you auscultate his lungs, you hear widespread rales. He is conscious and alert, is able to follow simple commands, and can only speak in two- to three-word sentences at a time. You should:
Select one:
A. place him in a position of comfort, deliver oxygen via nasal cannula, and closely monitor his breathing.
B. force fluid from his alveoli by hyperventilating him with a bag-valve mask at a rate of at least 20 breaths/min.
C. apply a CPAP device, monitor his blood pressure, and observe him for signs of improvement or deterioration.
D. place him in a supine position and assist his ventilations with a bag-valve mask and high-flow oxygen.
C. apply a CPAP device, monitor his blood pressure, and observe him for signs of improvement or deterioration.
28
```
Acute pulmonary edema would MOST likely develop as the result of:
Select one:
A. toxic chemical inhalation.
B. an upper airway infection.
C. right-sided heart failure.
D. severe hyperventilation.
```
A. toxic chemical inhalation.
29
Alkalosis is a condition that occurs when:
Select one:
A. blood acidity is reduced by excessive breathing.
B. the level of carbon dioxide in the blood increases.
C. slow, shallow breathing eliminates too much carbon dioxide.
D. dangerous acids accumulate in the bloodstream.
A. blood acidity is reduced by excessive breathing.
30
```
An alert patient presents with a regular pattern of inhalation and exhalation and breath sounds that are clear and equal on both sides of the chest. These findings are consistent with:
Select one:
A. respiratory insufficiency.
B. adequate air exchange.
C. an obstructed airway.
D. respiratory difficulty.
```
B. adequate air exchange.
31
Common signs and symptoms of acute hyperventilation syndrome include:
Select one:
A. altered mental status and bradycardia.
B. anxiety, dizziness, and severe bradypnea.
C. unilateral paralysis and slurred speech.
D. tachypnea and tingling in the extremities.
D. tachypnea and tingling in the extremities.
32
Dyspnea is MOST accurately defined as:
Select one:
A. a marked increase in the exhalation phase.
B. shortness of breath or difficulty breathing.
C. a complete cessation of respiratory effort.
D. labored breathing with reduced tidal volume.
B. shortness of breath or difficulty breathing.
33
```
Hyperventilation could be associated with all of the following, EXCEPT:
Select one:
A. high blood glucose levels.
B. an overdose of aspirin.
C. a narcotic overdose.
D. a respiratory infection.
```
C. a narcotic overdose.
34
When administering supplemental oxygen to a hypoxemic patient with a chronic lung disease, you should:
Select one:
A. begin with a low oxygen flow rate, even if the patient is unresponsive, because high-flow oxygen may depress his or her breathing.
B. avoid positive-pressure ventilation because the majority of patients with chronic lung disease are at increased risk for lung trauma.
C. recall that most patients with chronic lung diseases are stimulated to breathe by increased carbon dioxide levels.
D. adjust the flow rate accordingly until you see symptom improvement, but be prepared to assist his or her ventilations.
D. adjust the flow rate accordingly until you see symptom improvement, but be prepared to assist his or her ventilations.
35
When the level of arterial carbon dioxide rises above normal:
Select one:
A. the brain stem inhibits respirations.
B. respirations increase in rate and depth.
C. exhalation lasts longer than inhalation.
D. respirations decrease in rate and depth.
B. respirations increase in rate and depth.
36
Which of the following statements regarding anaphylaxis is correct?
Select one:
A. Patients with asthma are at lower risk of developing anaphylaxis.
B. The signs of anaphylaxis are caused by widespread vasoconstriction.
C. Anaphylaxis is characterized by airway swelling and hypotension.
D. Most anaphylactic reactions occur within 60 minutes of exposure.
C. Anaphylaxis is characterized by airway swelling and hypotension.
37
Which of the following statements regarding the hypoxic drive is correct?
Select one:
A. The hypoxic drive serves as the primary stimulus for breathing in healthy individuals.
B. The hypoxic drive stimulates a person to breathe on the basis of low oxygen levels.
C. Chronic carbon dioxide elimination often results in activation of the hypoxic drive.
D. 100% supplemental oxygen will always cause apnea in patients with a hypoxic drive.
B. The hypoxic drive stimulates a person to breathe on the basis of low oxygen levels.
38
You are dispatched to an apartment complex where a 21-year-old female has apparently overdosed on several narcotic medications. She is semiconscious and has slow, shallow respirations. You should:
Select one:
A. insert an oropharyngeal airway and perform oral suctioning.
B. apply oxygen via a nonrebreathing mask and transport at once.
C. place her in the recovery position and monitor for vomiting.
D. insert a nasopharyngeal airway and begin assisted ventilation.
A. insert an oropharyngeal airway and perform oral suctioning.
39
A 40-year-old man is in cardiac arrest. Your partner is performing CPR. You are attaching the AED when the patient's wife tells you that he has an automatic implanted cardiac defibrillator (AICD). The AED advises that a shock is indicated. What should you do?
Select one:
A. Contact medical control and request permission to defibrillate.
B. Continue CPR and transport the patient to the closest appropriate hospital.
C. Avoid defibrillation as this will damage the patient's AICD.
D. Deliver the shock followed by immediate resumption of CPR.
D. Deliver the shock followed by immediate resumption of CPR.
40
A percutaneous transluminal coronary angioplasty (PTCA) restores blood flow to the ischemic myocardium by:
Select one:
A. bypassing the coronary artery with a vessel from the chest or leg.
B. dilating the affected coronary artery with a small inflatable balloon.
C. placing a stent inside the coronary artery to keep it from narrowing.
D. scraping fatty deposits off of the lumen of the coronary artery.
B. dilating the affected coronary artery with a small inflatable balloon.
41
After assisting your patient with prescribed nitroglycerin, you should:
Select one:
A. place the patient in a recumbent position in case of fainting.
B. perform a secondary assessment before administering further doses.
C. reassess his or her blood pressure within 5 minutes to detect hypotension.
D. avoid further dosing if the patient complains of a severe headache.
C. reassess his or her blood pressure within 5 minutes to detect hypotension.
42
Cardiac output may decrease if the heart beats too rapidly because:
Select one:
A. as the heart rate increases, more blood is pumped from the ventricles than the atria.
B. a rapid heartbeat causes a decrease in the strength of cardiac contractions.
C. there is not enough time in between contractions for the heart to refill completely.
D. the volume of blood that returns to the heart is not sufficient with fast heart rates.
C. there is not enough time in between contractions for the heart to refill completely.
43
```
Common side effects of nitroglycerin include all of the following, EXCEPT:
Select one:
A. bradycardia.
B. hypertension.
C. hypotension.
D. severe headache.
```
B. hypertension.
44
During your treatment of a woman in cardiac arrest, you apply the AED, analyze her cardiac rhythm, and receive a “no shock advised” message. This indicates that:
Select one:
A. she is not in ventricular fibrillation.
B. the AED detected patient motion.
C. she has a pulse and does not need CPR.
D. the AED has detected asystole.
A. she is not in ventricular fibrillation.
45
In contrast to the sympathetic nervous system, the parasympathetic nervous system:
Select one:
A. causes an increase in the heart rate.
B. slows the heart and respiratory rates.
C. dilates the blood vessels in the muscles.
D. prepares the body to handle stress.
B. slows the heart and respiratory rates.
46
It would be MOST appropriate for a patient to take his or her prescribed nitroglycerin when experiencing:
Select one:
A. sharp chest pain that lasts longer than 10 to 15 minutes.
B. difficulty breathing that awakens the patient from sleep.
C. an acute onset of dizziness during a period of exertion.
D. chest pain that does not immediately subside with rest.
D. chest pain that does not immediately subside with rest.
47
```
Most patients are instructed by their physician to take up to _______ doses of nitroglycerin before calling EMS.
Select one:
A. five
B. two
C. three
D. four
```
C. three
48
Prior to assisting a patient with his or her prescribed nitroglycerin, the EMT must:
Select one:
A. wait at least 5 minutes after assessing the blood pressure.
B. obtain authorization from medical control.
C. determine who prescribed the nitroglycerin.
D. ensure the medication is in tablet form.
B. obtain authorization from medical control.
49
```
Sudden death following AMI is MOST often caused by:
Select one:
A. ventricular fibrillation.
B. cardiogenic shock.
C. severe bradycardia.
D. congestive heart failure.
```
A. ventricular fibrillation.
50
```
The descending aorta divides into the two iliac arteries at the level of the:
Select one:
A. nipple line.
B. umbilicus.
C. iliac crest.
D. pubic symphysis.
```
B. umbilicus.
51
```
The head and brain receive their supply of oxygenated blood from the:
Select one:
A. carotid arteries.
B. iliac arteries.
C. brachial arteries.
D. subclavian arteries.
```
A. carotid arteries.
52
```
The inferior vena cava returns deoxygenated blood to the right side of the heart from all of the following areas, EXCEPT the:
Select one:
A. kidneys.
B. brain.
C. abdomen.
D. legs.
```
B. brain.
53
```
The MOST common reason that many people experiencing AMI do not seek immediate medical attention is because they:
Select one:
A. do not trust EMTs.
B. cannot afford it.
C. are in denial.
D. are elderly.
```
C. are in denial.
54
The posterior tibial pulse can be palpated:
Select one:
A. between the trachea and the neck muscle.
B. on the dorsum of the foot.
C. behind the medial malleolus, on the inside of the ankle.
D. in the fossa behind the knee.
C. behind the medial malleolus, on the inside of the ankle.
55
The right coronary artery supplies blood to the:
Select one:
A. left ventricle and posterior wall of the right ventricle.
B. left ventricle and inferior wall of the right atrium.
C. right atrium and posterior wall of the right ventricle.
D. right ventricle and inferior wall of the left ventricle.
D. right ventricle and inferior wall of the left ventricle.
56
Ventricular tachycardia causes hypotension because:
Select one:
A. the left ventricle does not adequately fill with blood.
B. the volume of blood returning to the atria increases.
C. the right ventricle does not adequately pump blood.
D. blood backs up into the lungs and causes congestion.
A. the left ventricle does not adequately fill with blood.
57
When an electrical impulse reaches the AV node, it is slowed for a brief period of time so that:
Select one:
A. the SA node can reset and generate another impulse.
B. the impulse can spread through the Purkinje fibers.
C. blood can pass from the atria to the ventricles.
D. blood returning from the body can fill the atria.
C. blood can pass from the atria to the ventricles.
58
```
When preparing to obtain a 12-lead ECG, the V1 and V2 electrodes should be placed:
Select one:
A. on the left and right arms.
B. in the midclavicular line.
C. on either side of the sternum.
D. in the midaxillary line.
```
C. on either side of the sternum.
59
When treating a patient with chest pain, you should assume that he or she is having an AMI because:
Select one:
A. the cause of the pain cannot be diagnosed in the field.
B. angina and AMI present identically.
C. angina usually occurs after an AMI.
D. most patients with chest pain are experiencing an AMI.
A. the cause of the pain cannot be diagnosed in the field.
60
```
Which of the following is LEAST important when obtaining a medical history from a patient complaining of chest discomfort?
Select one:
A. History of cigarette smoking
B. History of previous heart attack
C. Family history of hypertension
D. Presence of personal risk factors
```
C. Family history of hypertension
61
Which of the following is the MOST reliable method of estimating a patient's cardiac output?
Select one:
A. Listen to heart sounds with a stethoscope.
B. Determine the average diastolic blood pressure.
C. Assess the heart rate and strength of the pulse.
D. Connect the patient to an electrocardiogram.
C. Assess the heart rate and strength of the pulse.
62
Which of the following statements regarding the AED and defibrillation is correct?
Select one:
A. The AED will not analyze the rhythm of a moving patient.
B. Defibrillation is the first link in the AHA chain of survival.
C. The AED will shock any rhythm not accompanied by a pulse.
D. CPR should be performed for 5 minutes before using the AED.
A. The AED will not analyze the rhythm of a moving patient.
63
```
Which of the following veins is located inferior to the trunk?
Select one:
A. Axillary
B. Cephalic
C. Saphenous
D. Subclavian
```
C. Saphenous
64
You and your EMT partner are the first to arrive at the scene of an unresponsive 70-year-old man. Your assessment reveals that he is apneic and pulseless. A paramedic unit is en route to the scene and will arrive in approximately 5 minutes. You should:
Select one:
A. apply the AED while your partner provides rescue breathing.
B. perform CPR only and wait for the manual defibrillator to arrive.
C. begin CPR, apply the AED, and deliver a shock if it is indicated.
D. begin CPR and have your partner update the responding paramedics.
C. begin CPR, apply the AED, and deliver a shock if it is indicated.
65
You are dispatched to a convenience store for a patient who passed out. Upon arriving at the scene, you find two off-duty EMTs performing CPR on the patient, a 58-year-old male. Your initial action should be to:
Select one:
A. request a paramedic unit and quickly attach the AED.
B. quickly attach the AED and push the analyze button.
C. have the EMTs stop CPR and assess for a pulse.
D. feel for a pulse while compressions are ongoing.
D. feel for a pulse while compressions are ongoing.
66
A transient ischemic attack (TIA) occurs when:
Select one:
A. signs and symptoms resolve spontaneously within 48 hours.
B. medications are given to dissolve a cerebral blood clot.
C. a small cerebral artery ruptures and causes minimal damage.
D. a small clot in a cerebral artery causes temporary symptoms.
D. a small clot in a cerebral artery causes temporary symptoms.
67
Febrile seizures:
Select one:
A. are also referred to as absence seizures.
B. often result in permanent brain damage.
C. occur when a child's fever rises slowly.
D. are usually benign but should be evaluated.
D. are usually benign but should be evaluated.
68
```
Individuals with chronic alcoholism are predisposed to intracranial bleeding and hypoglycemia secondary to abnormalities in the:
Select one:
A. liver.
B. kidneys.
C. pancreas.
D. brain.
```
A. liver.
69
The mental status of a patient who has experienced a generalized seizure:
Select one:
A. progressively worsens over a period of a few hours.
B. typically does not improve, even after several minutes.
C. is likely to improve over a period of 5 to 30 minutes.
D. is easily differentiated from that of acute hypoglycemia.
C. is likely to improve over a period of 5 to 30 minutes.
70
```
The most basic functions of the body, such as breathing, blood pressure, and swallowing, are controlled by the:
Select one:
A. cerebellum.
B. cerebral cortex.
C. brain stem.
D. cerebrum.
```
C. brain stem.
71
```
The spinal cord exits the cranium through the:
Select one:
A. cauda equina.
B. vertebral foramen.
C. foramen lamina.
D. foramen magnum.
```
D. foramen magnum.
72
When transporting a stable stroke patient with a paralyzed extremity, place the patient in a:
Select one:
A. sitting position with the head at a 45° to 90° angle.
B. supine position with the legs elevated 6 feet to 12 feet.
C. recumbent position with the paralyzed side down.
D. recumbent position with the paralyzed side up.
C. recumbent position with the paralyzed side down.
73
```
Which of the following is a metabolic cause of a seizure?
Select one:
A. Brain tumor
B. Poisoning
C. Head trauma
D. Massive stroke
```
B. Poisoning
74
You are assessing the arm drift component of the Cincinnati Prehospital Stroke Scale on a 60-year-old woman. When she holds both of her arms out in front of her and closes her eyes, both of her arms immediately fall to her sides. You should:
Select one:
A. instruct the patient to keep her eyes open and then repeat the arm drift test.
B. defer this part of the test and assess her for facial droop and slurred speech.
C. repeat the arm drift test, but move the patient's arms into position yourself.
D. repeat the arm drift test and ensure that her palms are facing downward.
C. repeat the arm drift test, but move the patient's arms into position yourself.
75
You are caring for a 70-year-old female with signs and symptoms of an acute stroke. She is conscious, has secretions in her mouth, is breathing at a normal rate with adequate depth, and has an oxygen saturation of 96%. You should:
Select one:
A. administer one tube of oral glucose and transport.
B. assist her ventilations with a bag-valve mask.
C. insert an oral airway, apply oxygen, and transport.
D. suction her oropharynx and transport immediately.
D. suction her oropharynx and transport immediately.
76
You are dispatched to a residence for a 66-year-old male who, according to family members, has suffered a massive stroke. Your primary assessment reveals that the patient is unresponsive, apneic, and pulseless. You should:
Select one:
A. initiate CPR and attach an AED as soon as possible.
B. perform CPR for 5 minutes before applying the AED.
C. assess the patient for a facial droop and hemiparesis.
D. obtain a blood glucose sample to rule out hypoglycemia.
A. initiate CPR and attach an AED as soon as possible.
77
You arrive at a local grocery store approximately 5 minutes after a 21-year-old female stopped seizing. She is confused and disoriented; she keeps asking you what happened and tells you that she is thirsty. Her brother, who witnessed the seizure, tells you that she takes valproate (Depakote) for her seizures, but has not taken it in a few days. He also tells you that she has diabetes. In addition to administering oxygen, you should:
Select one:
A. place her in the recovery position and transport her with lights and siren.
B. administer one tube of oral glucose and prepare for immediate transport.
C. monitor her airway and breathing status and assess her blood glucose level.
D. give her small cups of water to drink and observe for further seizure activity.
C. monitor her airway and breathing status and assess her blood glucose level.
78
You arrive at the residence of a 33-year-old woman who is experiencing a generalized (tonic-clonic) seizure. She has a small amount of vomitus draining from the side of her mouth. After protecting her from further injury, you should:
Select one:
A. place a bite block in between her teeth, apply high-flow oxygen via a nonrebreathing mask, and consider inserting a nasopharyngeal airway.
B. maintain her airway with manual head positioning, suction her airway to remove the vomitus, insert a nasopharyngeal airway, and administer high-flow oxygen.
C. restrain her extremities to prevent her from injuring herself, suction her airway to remove the vomitus, and assist her ventilations with a bag-mask device.
D. wait for the seizure to stop, manually open her airway, insert an oropharyngeal airway, and assess her oxygen saturation with the pulse oximeter.
B. maintain her airway with manual head positioning, suction her airway to remove the vomitus, insert a nasopharyngeal airway, and administer high-flow oxygen.
79
```
Common signs and symptoms of severe hyperglycemia include all of the following, EXCEPT:
Select one:
A. cool, clammy skin.
B. rapid, thready pulse.
C. acetone breath odor.
D. warm, dry skin.
```
A. cool, clammy skin.
80
Ketone production is the result of:
Select one:
A. acidosis when blood glucose levels are low.
B. fat metabolization when glucose is unavailable.
C. blood glucose levels higher than 120 mg/dL.
D. rapid entry of glucose across the cell membrane.
B. fat metabolization when glucose is unavailable.
81
Kussmaul respirations are an indication that the body is:
Select one:
A. compensating for decreased blood glucose levels.
B. attempting to eliminate acids from the blood.
C. trying to generate energy by breathing deeply.
D. severely hypoxic and is eliminating excess CO2.
B. attempting to eliminate acids from the blood.
82
To which of the following diabetic patients should you administer oral glucose?
Select one:
A. An unconscious 33-year-old male with cool, clammy skin
B. A semiconscious 40-year-old female without a gag reflex
C. A confused 55-year-old male with tachycardia and pallor
D. A conscious 37-year-old female with nausea and vomiting
C. A confused 55-year-old male with tachycardia and pallor
83
When assessing an unresponsive diabetic patient, the primary visible difference between hyperglycemia and hypoglycemia is the:
Select one:
A. presence of a medical identification tag.
B. patient's mental status.
C. rate of the patient's pulse.
D. rate and depth of breathing.
D. rate and depth of breathing.
84
When obtaining a SAMPLE history from a patient with diabetes, it would be MOST important to determine:
Select one:
A. if he or she has had any recent illnesses or excessive stress.
B. if there is a family history of diabetes or related conditions.
C. the name of the physician who prescribed his or her insulin.
D. approximately how much water the patient drank that day.
A. if he or she has had any recent illnesses or excessive stress.
85
```
Which of the following signs or symptoms would the EMT MOST likely encounter in a patient with new-onset type 1 diabetes?
Select one:
A. Weight loss and polyuria
B. Total lack of appetite
C. Low blood glucose level
D. Weight gain and edema
```
A. Weight loss and polyuria
86
You respond to a residence for a patient who is “not acting right.” As you approach the door, the patient, a 35-year-old male, begins shouting profanities at you and your partner while holding a baseball bat. The man is confused and diaphoretic, and is wearing a medical identification bracelet. You should:
Select one:
A. retreat at once and call law enforcement.
B. contact medical control for instructions.
C. calm him down so you can assess him.
D. be assertive and talk the patient down.
A. retreat at once and call law enforcement.
87
A 25-year-old man overdosed on heroin and is unresponsive. His breathing is slow and shallow and he is bradycardic. He has track marks on both arms. The EMT should:
Select one:
A. insert a nasal airway and ventilate with a BVM.
B. position the patient on his side and transport.
C. administer naloxone via the intranasal route.
D. administer naloxone via the intramuscular route.
A. insert a nasal airway and ventilate with a BVM.
88
```
Activated charcoal may be indicated for a patient who ingested:
Select one:
A. methanol.
B. aspirin.
C. ethanol.
D. iron.
```
B. aspirin.
89
```
Airborne substances should be diluted with:
Select one:
A. oxygen.
B. an alkaline antidote.
C. syrup of ipecac.
D. activated charcoal.
```
A. oxygen.
90
```
Common names for activated charcoal include all of the following, EXCEPT:
Select one:
A. Fructose.
B. LiquiChar.
C. Actidose.
D. InstaChar.
```
A. Fructose.
91
```
Signs and symptoms of a sympathomimetic drug overdose include:
Select one:
A. slurred speech.
B. hypotension.
C. tachycardia.
D. hypothermia.
```
C. tachycardia.
92
```
The major side effect associated with administration of activated charcoal is:
Select one:
A. headache.
B. black stools.
C. abdominal pain.
D. ringing in the ears.
```
B. black stools.
93
You are dispatched to a local nursery for a 39-year-old female who is sick. When you arrive, you find the patient lying on the floor. She is semiconscious, has copious amounts of saliva coming from her mouth, and is incontinent of urine. You quickly feel her pulse and note that it is very slow. Immediate management for this patient should include:
Select one:
A. assisted ventilation with a BVM.
B. thoroughly suctioning her oropharynx.
C. requesting a paramedic to give her atropine.
D. performing a rapid secondary assessment.
B. thoroughly suctioning her oropharynx.
94
You respond to a college campus for a young male who is acting strangely. After law enforcement has secured the scene, you enter the patient's dorm room and find him sitting on the edge of the bed; he appears agitated. As you approach him, you note that he has dried blood around both nostrils. He is breathing adequately, his pulse is rapid and irregular, and his blood pressure is 200/110 mm Hg. Treatment for this patient includes:
Select one:
A. asking law enforcement to place handcuffs on the patient.
B. assisting his ventilations with a bag-valve mask device.
C. attempting to calm him and giving him oxygen if tolerated.
D. requesting a paramedic to administer naloxone (Narcan).
C. attempting to calm him and giving him oxygen if tolerated.
95
```
Your paramedic partner administers atropine to a 49-year-old male with bradycardia. Which of the following side effects would you expect the patient to experience?
Select one:
A. A fall in blood pressure
B. Pupillary constriction
C. Excessive lacrimation
D. Dry mucous membranes
```
D. Dry mucous membranes
96
```
Your priority in caring for a patient with a surface contact poisoning is to:
Select one:
A. obtain and maintain a patent airway.
B. decontaminate the patient's skin.
C. move the patient to a safe area.
D. avoid contaminating yourself.
```
D. avoid contaminating yourself.
97
```
____________ is what you can see of a person's response to the environment.
Select one:
A. Behavior
B. Affect
C. Neurosis
D. Psychosis
```
A. Behavior
98
A 66-year-old male presents with bizarre behavior. His daughter states that he did not seem to recognize her and was very rude to her. The patient is conscious, and has a patent airway and adequate breathing. You should:
Select one:
A. advise the patient that his behavior is unacceptable.
B. ask the daughter how her father normally behaves.
C. carefully restrain the patient and transport at once.
D. conclude that the patient has Alzheimer disease.
B. ask the daughter how her father normally behaves.
99
A patient with a history of schizophrenia called EMS because he was experiencing abdominal pain. When law enforcement arrived, the patient became violent, necessitating the placement of handcuffs. When you assess the patient, he tells you that killing someone will make his abdominal pain go away. His vital signs are stable. How should you manage this situation?
Select one:
A. Transport the patient in a prone position on the stretcher
B. Refuse to transport the patient because of his homicidal threat
C. Request that a police officer transport him to the hospital
D. Request a police officer to accompany you in the ambulance
D. Request a police officer to accompany you in the ambulance
100
General guidelines for managing a patient with a behavioral emergency include:
Select one:
A. allowing the patient to be alone if he or she wishes.
B. firmly identifying yourself as an EMS provider.
C. placing the patient between yourself and an exit.
D. being prepared to spend extra time with the patient.
D. being prepared to spend extra time with the patient.
101
In addition to ensuring his or her own safety, the EMT's responsibility when caring for a patient with a behavioral emergency is to:
Select one:
A. determine the underlying cause of the problem and offer advice.
B. diffuse and control the situation and safely transport the patient.
C. transport the patient directly to a specialized psychiatric facility.
D. diagnose the patient's problem and provide definitive treatment.
B. diffuse and control the situation and safely transport the patient.
102
Organic brain syndrome is defined as:
Select one:
A. a dysfunction of the brain caused by abnormal physical or physiological function.
B. bizarre behavior secondary to a chemical imbalance or disturbance in the brain.
C. a change in behavior or mental status secondary to decreased cerebral blood flow.
D. a disorder that cannot be traced to the abnormal structure or function of an organ.
A. a dysfunction of the brain caused by abnormal physical or physiological function.
103
```
The first step in assessing a patient with a behavioral emergency is to:
Select one:
A. take vital signs.
B. ensure your safety.
C. obtain proper consent.
D. restrain the patient.
```
B. ensure your safety.
104
When assessing a patient with a behavioral crisis, you should:
Select one:
A. be direct and clearly state your intentions.
B. ask the police to handcuff the patient for safety.
C. frisk the patient for the presence of weapons.
D. spend as little time with the patient as possible.
A. be direct and clearly state your intentions.
105
```
Which of the following conditions or situations would MOST likely make excited delirium worse?
Select one:
A. Alcohol withdrawal
B. Dimly lit environment
C. Limited physical contact
D. Elevated blood glucose
```
A. Alcohol withdrawal
106
```
You are assessing a conscious 55-year-old male with a sudden change in behavior. Which of the following clinical findings would be MOST suggestive of dysfunction of this patient's central nervous system?
Select one:
A. An irregular pulse
B. Consistent eye contact
C. Excessive tearing or crying
D. Rapid eye movement
```
D. Rapid eye movement
107
A 19-year-old male was stung multiple times by fire ants. He is experiencing obvious signs and symptoms of anaphylactic shock. You administer high-flow oxygen and give him epinephrine via intramuscular injection. Upon reassessment, you determine that his condition has not improved. You should:
Select one:
A. consider that he may actually be experiencing an acute asthma attack.
B. transport him immediately and provide supportive care while en route.
C. repeat the epinephrine injection after consulting with medical control.
D. request a paramedic unit that is stationed approximately 15 miles away.
C. repeat the epinephrine injection after consulting with medical control.
108
```
A 56-year-old male is found semiconscious by his wife. Your assessment reveals that his respirations are rapid and shallow, his pulse is rapid and irregular, and his blood pressure is low. The patient's wife states that he complained of left arm pain and nausea the day before, but would not allow her to call 9-1-1. The MOST likely cause of this patient's present condition is:
Select one:
A. a ruptured aortic aneurysm.
B. acute myocardial infarction.
C. severe septic hypoperfusion.
D. cardiogenic hypoperfusion.
```
D. cardiogenic hypoperfusion.
109
```
Clinical signs of compensated shock include all of the following, EXCEPT:
Select one:
A. cool and clammy skin.
B. restlessness or anxiety.
C. rapid, shallow breathing.
D. absent peripheral pulses.
```
D. absent peripheral pulses.
110
Neurogenic shock occurs when:
Select one:
A. there is too much blood to fill a smaller vascular container.
B. failure of the nervous system causes widespread vasodilation.
C. the spinal cord is severed and causes massive hemorrhaging.
D. massive vasoconstriction occurs distal to a spinal cord injury.
B. failure of the nervous system causes widespread vasodilation.
111
Which of the following MOST accurately describes septic shock?
Select one:
A. Widespread vasoconstriction and plasma loss due to a severe viral infection
B. Bacterial infection of the nervous system with widespread vasodilation
C. Bacterial damage to the vessel wall, leaking blood vessels, and vasodilation
D. Viral infection of the blood vessels, vascular damage, and vasoconstriction
C. Bacterial damage to the vessel wall, leaking blood vessels, and vasodilation
112
Which of the following statements regarding anaphylactic shock is correct?
Select one:
A. Anaphylactic shock is caused by immune system failure due to a toxic exposure.
B. Anaphylactic shock occurs immediately after a person is sensitized to an allergen.
C. Subsequent exposure after sensitization often produces a more severe reaction.
D. Sensitized people will experience less severe reactions upon subsequent exposure.
C. Subsequent exposure after sensitization often produces a more severe reaction.
113
You are dispatched to a residence for a 40-year-old female who fainted. Upon your arrival, the patient is conscious and alert, and states that she is fine. Her husband tells you that she fainted after receiving news that her sister was killed in a car crash. You offer oxygen to the patient, but she refuses to accept it. At this point, your primary concern should be to:
Select one:
A. determine if she was injured when she fainted.
B. obtain baseline vital signs and a medical history.
C. advise her that she needs to go to the hospital.
D. provide emotional support regarding her sister.
A. determine if she was injured when she fainted.
114
```
You are transporting a 33-year-old male who was involved in a major motor vehicle crash. You have addressed all immediate and potentially life-threatening conditions and have stabilized his condition with the appropriate treatment. With an estimated time of arrival at the hospital of 20 minutes, you should:
Select one:
A. reassess his condition in 5 minutes.
B. repeat your secondary assessment.
C. arrange for an ALS rendezvous.
D. take his vital signs in 15 minutes.
```
A. reassess his condition in 5 minutes.
115
You respond to a residence for a patient with a severe leg injury following an accident with a chainsaw. When you arrive, you find the patient, a 44-year-old male, lying supine in the backyard. He has a partial amputation of his right lower leg that is actively bleeding. The patient is conscious and breathing adequately; however, he is restless and his skin is diaphoretic. You should:
Select one:
A. administer 100% supplemental oxygen.
B. apply direct pressure to the wound.
C. assess the rate and quality of his pulse.
D. immediately evaluate his airway.
B. apply direct pressure to the wound.
116
```
Your assessment of an unresponsive patient reveals that her breathing is inadequate. Your MOST immediate action should be to:
Select one:
A. administer high-flow oxygen.
B. ventilate her with a bag-valve mask.
C. check her airway for obstructions.
D. move her to the ambulance stretcher.
```
C. check her airway for obstructions.
117
Bacterial vaginosis is a condition that occurs when:
Select one:
A. numerous bacteria enter the uterus through the cervix and cause severe tissue damage.
B. normal bacteria in the vagina are replaced by an overgrowth of other bacterial forms.
C. abnormal bacteria enter the vagina and cause damage without causing any symptoms.
D. harmful bacteria infect and cause damage to the uterus, cervix, and fallopian tubes.
B. normal bacteria in the vagina are replaced by an overgrowth of other bacterial forms.
118
```
Each ovary produces an ovum in alternating months and releases it into the:
Select one:
A. fallopian tube.
B. vagina.
C. uterus.
D. cervix.
```
A. fallopian tube.
119
```
If a woman with vaginal bleeding reports syncope, the EMT should assume that she:
Select one:
A. is in shock.
B. has an ectopic pregnancy.
C. has an infection.
D. is pregnant.
```
A. is in shock.
120
```
Pelvic inflammatory disease (PID) typically does NOT affect the:
Select one:
A. fallopian tubes.
B. ovaries.
C. urinary bladder.
D. uterus.
```
C. urinary bladder.
121
```
The onset of menstruation usually occurs in women who are:
Select one:
A. between 11 and 16 years of age.
B. between 8 and 10 years of age.
C. between 25 and 28 years of age.
D. between 18 and 23 years of age.
```
A. between 11 and 16 years of age.
122
When a woman presents with abdominal pain or other vague symptoms, the EMT is often unable to determine the nature of the problem until he or she:
Select one:
A. ascertains if the patient was ever pregnant.
B. has obtained a complete set of vital signs.
C. has gathered patient history information.
D. has formed a general impression of the patient.
C. has gathered patient history information.
123
When caring for a woman who is experiencing a gynecologic emergency, the EMT's main focus should be to:
Select one:
A. keep assessment and treatment to a minimum.
B. maintain her ABCs and transport without delay.
C. ask questions related to her gynecologic history.
D. determine the underlying cause of her problem.
B. maintain her ABCs and transport without delay.
124
Whenever possible, a female sexual assault victim should be:
Select one:
A. given the option of being treated by a female EMT.
B. thoroughly assessed, even if no signs of injury exist.
C. encouraged to take a shower and change her clothes.
D. asked to provide a brief description of the perpetrator.
A. given the option of being treated by a female EMT.
125
Which of the following clinical presentations is MOST consistent with pelvic inflammatory disease (PID)?
Select one:
A. Pain around the umbilicus, low-grade fever, and generalized weakness
B. Lower abdominal pain, fever, general malaise, and foul-smelling vaginal discharge
C. Upper abdominal cramping, severe headache, and heavy vaginal bleeding
D. Left lower quadrant pain, referred pain to the left shoulder, and fever
B. Lower abdominal pain, fever, general malaise, and foul-smelling vaginal discharge
126
Which of the following statements regarding gonorrhea is correct?
Select one:
A. Most men who are infected with gonorrhea do not experience symptoms.
B. Symptoms of gonorrhea usually appear within 3 months of being infected.
C. Painful urination is a common symptom of gonorrhea in both men and women.
D. Mild infections with gonorrhea cause abdominal pain, vomiting, and fever.
C. Painful urination is a common symptom of gonorrhea in both men and women.
127
Which of the following statements regarding rape is correct?
Select one:
A. Rape is a legal diagnosis, not a medical diagnosis.
B. The EMT should try to determine if rape occurred.
C. Only a licensed physician can make a diagnosis of rape.
D. Rape causes more physical harm than emotional harm.
A. Rape is a legal diagnosis, not a medical diagnosis.
128
```
Accumulation of blood in the abdominal cavity will MOST likely cause:
Select one:
A. nausea or vomiting.
B. diffuse bruising.
C. referred pain.
D. distention.
```
D. distention.
129
```
Assuming that no obvious signs of intra-abdominal injury are present, which of the following injuries would MOST likely cause an injury to the liver or spleen to be overlooked?
Select one:
A. Femur fracture
B. Lumbar spine fracture
C. Pelvic fracture
D. Shoulder fracture
```
D. Shoulder fracture
130
```
Bruising to the right upper quadrant of the abdomen following blunt trauma is MOST suggestive of injury to the:
Select one:
A. stomach.
B. liver.
C. spleen.
D. kidney.
```
B. liver.
131
```
Contraction or tensing of the abdominal muscles in an effort to ease pain is called:
Select one:
A. withdrawing.
B. flexing.
C. guarding.
D. referring.
```
C. guarding.
132
```
During your assessment of a patient who experienced blunt trauma to the abdomen, you notice bruising around the umbilicus. This is a sign of:
Select one:
A. a severe liver laceration.
B. a ruptured spleen.
C. intra-abdominal bleeding.
D. rupture of a hollow organ.
```
C. intra-abdominal bleeding.
133
```
Early bruising following abdominal trauma often manifests as:
Select one:
A. gross distention.
B. red areas of skin.
C. localized pain.
D. dark-purple marks.
```
B. red areas of skin.
134
Peritonitis usually occurs when:
Select one:
A. the vessels that supply the abdominal organs become inflamed.
B. solid abdominal organs bleed secondary to penetrating trauma.
C. hollow abdominal organs are damaged and spill their contents into the peritoneal cavity.
D. bacteria or viruses invade the walls of the gastrointestinal tract.
C. hollow abdominal organs are damaged and spill their contents into the peritoneal cavity.
135
The mesentery is:
Select one:
A. a membranous fold that attaches the intestines to the walls of the body.
B. a layer of thick skeletal muscles that protects the abdominal organs.
C. a complex network of blood vessels that supply blood to the liver.
D. the point of attachment between the small and large intestines.
A. a membranous fold that attaches the intestines to the walls of the body.
136
The presence of tachycardia following a significant abdominal injury:
Select one:
A. indicates a state of decompensated shock.
B. is always accompanied by hypotension.
C. is most commonly caused by severe pain.
D. should be assumed to be a sign of shock.
D. should be assumed to be a sign of shock.
137
When worn properly, a seatbelt should lie:
Select one:
A. across the abdominal wall at the level of the umbilicus and against the hip joints.
B. below the anterior superior iliac spines of the pelvis and against the hip joints.
C. across the abdominal wall at the level of the diaphragm and below the hip joints.
D. above the anterior posterior iliac spines of the pelvis and below the hip joints.
B. below the anterior superior iliac spines of the pelvis and against the hip joints.
138
```
A person's ability to shiver is lost when his or her body temperature falls below:
Select one:
A. 92°F (33°C).
B. 90°F (32°C).
C. 95°F (35°C).
D. 94°F (34°C).
```
B. 90°F (32°C).
139
```
Compared to adults, infants and children are at higher risk for hypothermia for all of the following reasons, EXCEPT:
Select one:
A. a decreased ability to shiver.
B. a smaller amount of body fat.
C. a smaller overall muscle mass.
D. a relatively small surface area.
```
D. a relatively small surface area.
140
Heat loss from the body through respiration occurs when:
Select one:
A. the core body temperature is greater than 98°F (37°C).
B. cool air is inhaled and displaces warm air.
C. air temperature is greater than body temperature.
D. warm air is exhaled into the atmosphere.
D. warm air is exhaled into the atmosphere.
141
```
High air temperature reduces the body's ability to lose heat by:
Select one:
A. evaporation.
B. conduction.
C. radiation.
D. convection.
```
C. radiation.
142
```
Hypothermia can worsen internal bleeding secondary to:
Select one:
A. a decreased heart rate.
B. blood-clotting abnormalities.
C. cardiac arrhythmias.
D. severe muscular rigidity.
```
B. blood-clotting abnormalities.
143
In order for sweating to be an effective cooling mechanism:
Select one:
A. it must be able to evaporate from the body.
B. several layers of clothing must be worn.
C. the body must produce at least 1 L per hour.
D. the relative humidity must be above 90%.
A. it must be able to evaporate from the body.
144
```
The body's natural protective mechanisms against heat loss are:
Select one:
A. respiration and vasoconstriction.
B. vasoconstriction and shivering.
C. vasodilation and respiration.
D. shivering and vasodilation.
```
B. vasoconstriction and shivering.
145
```
To assess a patient's general body temperature, pull back on your glove and place the back of your hand on his or her skin at the:
Select one:
A. forehead.
B. neck.
C. abdomen.
D. chest.
```
C. abdomen.
146
```
When the body loses sweat, it also loses:
Select one:
A. electrolytes.
B. erythrocytes.
C. plasma.
D. nutrients.
```
A. electrolytes.
147
```
Which of the following medications increases a person's risk of a heat-related emergency?
Select one:
A. Motrin
B. Tylenol
C. Diuretics
D. Aspirin
```
C. Diuretics
148
A 33-year-old woman who is 36 weeks pregnant is experiencing vaginal bleeding. During transport, you note that she suddenly becomes diaphoretic, tachycardic, and hypotensive. You should:
Select one:
A. carefully place sterile gauze into her vagina.
B. place her in a left lateral recumbent position.
C. position her supine and elevate her legs 12 inches.
D. ventilate her with a bag-valve mask.
B. place her in a left lateral recumbent position.
149
Abruptio placenta occurs when:
Select one:
A. the placenta prematurely separates from the uterine wall.
B. the placenta develops over and covers the cervical opening.
C. the placenta affixes itself to the outer layer of the uterus.
D. a tear in the placenta causes severe internal hemorrhage.
A. the placenta prematurely separates from the uterine wall.
150
An infant is considered to be premature if it:
Select one:
A. is born before 40 weeks' gestation or weighs less than 7 lb.
B. weighs less than 5.5 lb or is born before 37 weeks' gestation.
C. weighs less than 5 lb or is born before 36 weeks' gestation.
D. is born before 38 weeks' gestation or weighs less than 6 lb.
C. weighs less than 5 lb or is born before 36 weeks' gestation.
151
```
Fetal complications associated with drug- or alcohol-addicted mothers include all of the following, EXCEPT:
Select one:
A. low birth weight.
B. premature delivery.
C. respiratory depression.
D. profound tachycardia.
```
D. profound tachycardia.
152
Following delivery of the placenta, the mother is experiencing vaginal bleeding. After massaging the uterine fundus and allowing the mother to breastfeed, the bleeding stops. This occurred because:
Select one:
A. a portion of the placenta was retained in the uterus.
B. these actions simulate the production of oxytocin and cause uterine contraction.
C. breastfeeding causes uterine blood vessels to dilate.
D. uterine massage increases blood flow to the uterus.
B. these actions simulate the production of oxytocin and cause uterine contraction.
153
In contrast to abruptio placenta, placenta previa:
Select one:
A. may not present with heavy vaginal bleeding.
B. may present without significant abdominal pain.
C. is caused by hypertension or abdominal trauma.
D. is typically associated with severe abdominal pain.
A. may not present with heavy vaginal bleeding.
154
Placenta previa is defined as:
Select one:
A. premature placental separation from the uterine wall.
B. development of the placenta over the cervical opening.
C. abnormal development and functioning of the placenta.
D. delivery of a portion of the placenta before the baby.
B. development of the placenta over the cervical opening.
155
Spina bifida is a developmental defect in which:
Select one:
A. the spinal column is severely deformed, resulting in permanent paralysis.
B. an excessive amount of cerebrospinal fluid damages the spinal cord.
C. a portion of the spinal cord or meninges protrudes outside of the vertebrae.
D. nerve fibers that arise from the spinal cord do not function properly.
C. a portion of the spinal cord or meninges protrudes outside of the vertebrae.
156
The ONLY indications for placing your gloved fingers in the vagina during delivery are:
Select one:
A. limb presentation and severe vaginal hemorrhage.
B. breech presentation and prolapsed umbilical cord.
C. nuchal cord and presentation of an arm or leg.
D. vertex presentation and delivery of the placenta.
B. breech presentation and prolapsed umbilical cord.
157
The umbilical cord:
Select one:
A. contains two veins and one large umbilical artery.
B. separates from the placenta shortly after birth.
C. carries blood away from the baby via the artery.
D. carries oxygen to the baby via the umbilical vein.
D. carries oxygen to the baby via the umbilical vein.
158
Upon delivery of an infant's head, you note that the umbilical cord is wrapped around its neck. You should:
Select one:
A. provide free-flow oxygen to the infant and transport.
B. give high-flow oxygen to the mother and transport.
C. attempt to slip the cord gently over the infant's head.
D. immediately clamp and cut the umbilical cord.
C. attempt to slip the cord gently over the infant's head.
159
Which of the following are normal physiologic changes that occur in the mother's respiratory system during pregnancy?
Select one:
A. Decreased respiratory rate and increased minute volume
B. Increased respiratory reserve and decreased oxygen demand
C. Increased respiratory depth and decreased respiratory rate
D. Increased respiratory rate and decreased respiratory reserve
D. Increased respiratory rate and decreased respiratory reserve
160
Which of the following is NOT generally considered an obstetrical emergency?
Select one:
A. Failure of the placenta to deliver after 30 minutes
B. Return of contractions following delivery of the baby
C. Significant bleeding after delivery of the placenta
D. More than 500 mL of blood loss before placental delivery
B. Return of contractions following delivery of the baby
161
Which of the following statements regarding gestational diabetes is correct?
Select one:
A. The onset of gestational diabetes typically manifests with hypoglycemia.
B. Gestational diabetes results in permanent diabetes mellitus after delivery.
C. Diet and exercise are typically ineffective in controlling gestational diabetes.
D. In some cases, women with gestational diabetes require insulin injections.
D. In some cases, women with gestational diabetes require insulin injections.
162
Which of the following statements regarding suctioning of a newborn's mouth and oropharynx is correct?
Select one:
A. Newborns rapidly expel fluid from their lungs and do not require suctioning.
B. Suctioning is indicated prior to cutting the cord if respiratory distress is present.
C. If the head delivers facedown, the mouth and nose should be suctioned at once.
D. Suctioning should be performed on all newborns immediately following delivery.
B. Suctioning is indicated prior to cutting the cord if respiratory distress is present.
163
Which of the following statements regarding the placenta is correct?
Select one:
A. The placenta allows oxygen, carbon dioxide, and other products to transfer between the mother and fetus but does not allow blood to mix between the mother and fetus.
B. The placenta allows for the transfer of oxygen and carbon dioxide between the mother and fetus but prevents most medications from passing between the mother and fetus.
C. The placental barrier consists of two layers of cells and allows the mother's blood that contains high concentrations of oxygen to directly mix with the blood of the fetus.
D. The placenta provides oxygen and nutrients to the fetus and is expelled from the vagina about 30 minutes before the baby is born.
A. The placenta allows oxygen, carbon dioxide, and other products to transfer between the mother and fetus but does not allow blood to mix between the mother and fetus.
164
Which of the following statements regarding twins is correct?
Select one:
A. Twins are typically larger than single infants.
B. Most twins are born within 45 minutes of each other.
C. Fraternal twins have two cords coming from one placenta.
D. Identical twins are typically of different gender.
B. Most twins are born within 45 minutes of each other.
165
While examining a woman in labor, you see the umbilical cord protruding from the vagina. You should:
Select one:
A. push the infant's head away from the cord.
B. carefully push the cord back into the vagina.
C. cover the umbilical cord with a dry dressing.
D. gently pull on the cord to facilitate delivery.
A. push the infant's head away from the cord.
166
```
You have just delivered a baby boy. His body is pink, but his hands and feet are blue. His heart rate is approximately 110 beats/min and his respirations are rapid and irregular. He has a weak cry when stimulated and resists attempts to straighten his legs. His Apgar score is:
Select one:
A. 8
B. 6
C. 7
D. 9
```
A. 8
167
You have just delivered a premature baby. Your assessment reveals that he is breathing adequately; however, his heart rate is 90 beats/min. You should:
Select one:
A. assess his skin color and give free-flow oxygen as needed.
B. clamp and cut the umbilical cord and keep him warm.
C. keep him warm and ventilate with a BVM.
D. begin chest compressions and reassess in 30 seconds.
C. keep him warm and ventilate with a BVM.
168
```
A 67-year-old female presents with difficulty breathing and chest discomfort that awakened her from her sleep. She states that she has congestive heart failure, has had two previous heart attacks, and has been prescribed nitroglycerin. She is conscious and alert with adequate breathing. Her blood pressure is 94/64 mm Hg and her heart rate is 120 beats/min. Treatment for this patient includes:
Select one:
A. placing her in an upright position.
B. ventilations with a BVM.
C. nitroglycerin for her chest pain.
D. oxygen at 2 L/min via nasal cannula.
```
A. placing her in an upright position.
169
Acute coronary syndrome (ACS) is a term used to describe:
Select one:
A. a severe decrease in perfusion caused by changes in heart rate.
B. the warning signs that occur shortly before a heart attack.
C. the exact moment that a coronary artery is completely occluded.
D. a group of symptoms that are caused by myocardial ischemia.
D. a group of symptoms that are caused by myocardial ischemia.
170
```
Blood that is ejected from the right ventricle:
Select one:
A. enters the systemic circulation.
B. has a high concentration of oxygen.
C. flows into the pulmonary arteries.
D. was received directly from the aorta.
```
C. flows into the pulmonary arteries.
171
Cardiogenic shock following AMI is caused by:
Select one:
A. widespread dilation of the systemic vasculature.
B. a profound increase in the patient's heart rate.
C. decreased pumping force of the heart muscle.
D. hypovolemia secondary to severe vomiting.
C. decreased pumping force of the heart muscle.
172
```
Common signs and symptoms of AMI include all of the following, EXCEPT:
Select one:
A. shortness of breath or dyspnea.
B. irregular heartbeat.
C. sudden unexplained sweating.
D. pain exacerbated by breathing.
```
D. pain exacerbated by breathing.
173
In contrast to AMI, a dissecting aortic aneurysm:
Select one:
A. is typically preceded by other symptoms, such as nausea.
B. often presents with pain that is maximal from the onset.
C. usually presents gradually, often over a period of hours.
D. is more commonly associated with pressure in the chest.
B. often presents with pain that is maximal from the onset.
174
Ischemic heart disease is defined as:
Select one:
A. death of a portion of the heart muscle due to a decrease in oxygen.
B. absent myocardial blood flow due to a blocked coronary artery.
C. decreased blood flow to one or more portions of the myocardium.
D. decreased blood flow to the heart muscle due to coronary dilation.
C. decreased blood flow to one or more portions of the myocardium.
175
```
Major risk factors for AMI include all of the following, EXCEPT:
Select one:
A. hypertension.
B. diabetes mellitus.
C. hypoglycemia.
D. elevated cholesterol.
```
C. hypoglycemia.
