Exam 2 - Section 2 & 3 Flashcards
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.
B. 13.
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. liver dysfunction.
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
B. Gentle palpation of the pelvis
A crackling sound produced by air bubbles under the skin is called: Select one: A. rhonchi. B. Korotkoff sounds. C. crepitus D. subcutaneous emphysema.
D. subcutaneous emphysema.
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.
B. is experiencing difficulty breathing.
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.
D. flushed and red.
A patient with spontaneous respirations is breathing: Select one: A. with shallow depth. B. without difficulty. C. without assistance. D. at a normal rate.
C. without assistance.
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. two thirds the length from the armpit to the crease at the elbow.
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. suction as needed and insert an airway adjunct.
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. be able to speak in complete sentences without unusual pauses.
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.
D. maintain stabilization of the head.
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.
C. shallow chest movement.
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
B. 2
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.
B. reevaluate his or her airway status.
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
D. radial
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.
B. asthma.
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.
D. intranasal route.
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. prevents the aggregation of platelets.
How is nitroglycerin usually given by the EMT? Select one: A. Injected B. Orally C. Sublingually D. Inhaled
C. Sublingually
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.
D. place her in a supine position.
What medication form does oral glucose come in? Select one: A. Liquid B. Fine powder C. Gel D. Suspension
C. Gel
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
D. Decreases heart rate and blood pressure
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
B. Intraosseous
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. The epinephrine auto-injector delivers a preset amount of the drug.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
Common side effects of nitroglycerin include all of the following, EXCEPT: Select one: A. bradycardia. B. hypertension. C. hypotension. D. severe headache.
B. hypertension.
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.
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.
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.
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
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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
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.
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.
Which of the following veins is located inferior to the trunk? Select one: A. Axillary B. Cephalic C. Saphenous D. Subclavian
C. Saphenous
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.
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.
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.
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.
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.
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.
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.