Exam 3 - Section 4 Flashcards
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. repeat the epinephrine injection after consulting with medical control.
B. transport him immediately and provide supportive care while en route.
C. consider that he may actually be experiencing an acute asthma attack.
D. request a paramedic unit that is stationed approximately 15 miles away.
A. repeat the epinephrine injection after consulting with medical control.
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. cardiogenic hypoperfusion. B. acute myocardial infarction. C. a ruptured aortic aneurysm. D. severe septic hypoperfusion.
A. cardiogenic hypoperfusion.
Clinical signs of compensated shock include all of the following, EXCEPT: Select one: A. cool and clammy skin. B. restlessness or anxiety. C. absent peripheral pulses. D. rapid, shallow breathing.
C. absent peripheral pulses.
Neurogenic shock occurs when:
Select one:
A. failure of the nervous system causes widespread vasodilation.
B. massive vasoconstriction occurs distal to a spinal cord injury.
C. there is too much blood to fill a smaller vascular container.
D. the spinal cord is severed and causes massive hemorrhaging.
A. failure of the nervous system causes widespread vasodilation.
Which of the following MOST accurately describes septic shock?
Select one:
A. Bacterial infection of the nervous system with widespread vasodilation
B. Viral infection of the blood vessels, vascular damage, and vasoconstriction
C. Bacterial damage to the vessel wall, leaking blood vessels, and vasodilation
D. Widespread vasoconstriction and plasma loss due to a severe viral infection
C. Bacterial damage to the vessel wall, leaking blood vessels, and vasodilation
Which of the following statements regarding anaphylactic shock is correct?
Select one:
A. Anaphylactic shock occurs immediately after a person is sensitized to an allergen.
B. Anaphylactic shock is caused by immune system failure due to a toxic exposure.
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.
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. provide emotional support regarding her sister.
B. advise her that she needs to go to the hospital.
C. determine if she was injured when she fainted.
D. obtain baseline vital signs and a medical history.
C. determine if she was injured when she fainted.
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. take his vital signs in 15 minutes. B. reassess his condition in 5 minutes. C. arrange for an ALS rendezvous. D. repeat your secondary assessment.
B. reassess his condition in 5 minutes.
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. immediately evaluate his airway.
B. assess the rate and quality of his pulse.
C. administer 100% supplemental oxygen.
D. apply direct pressure to the wound.
D. apply direct pressure to the wound.
Your assessment of an unresponsive patient reveals that her breathing is inadequate. Your MOST immediate action should be to: Select one: A. move her to the ambulance stretcher. B. check her airway for obstructions. C. administer high-flow oxygen. D. ventilate her with a bag-valve mask.
B. check her airway for obstructions.
A 39-year-old male sustained a large laceration to his leg during an accident with a chainsaw and is experiencing signs and symptoms of shock. You should first:
Select one:
A. place the patient on high-flow oxygen.
B. perform a rapid head-to-toe assessment.
C. apply direct pressure to the wound.
D. follow appropriate standard precautions.
D. follow appropriate standard precautions.
A 70-year-old man presents with a severe nosebleed. His medical history includes COPD, depression, and a hemorrhagic stroke 3 years ago. His BP is 190/110 mm Hg, his pulse is 100 beats/min, and his respirations are 24 breaths/min. His medications include albuterol, sertraline (Zoloft), and multivitamins. Which of the following is MOST likely causing his nosebleed today? Select one: A. Diabetic complications B. High blood pressure C. His prescribed albuterol D. Hemorrhagic stroke
B. High blood pressure
A patient is bleeding severely from a severed femoral artery high in the groin region. Which of the following would MOST likely control the bleeding?
Select one:
A. Apply a pelvic binder device to stabilize the pelvis
B. Apply a topical hemostatic agent with direct pressure
C. Apply chemical ice packs to the wound and transport
D. Position the patient with his injured side down
B. Apply a topical hemostatic agent with direct pressure
An infant with a total blood volume of 800 mL would start showing signs of shock when as little as \_\_\_\_\_\_ of blood is lost. Select one: A. 100 mL B. 50 mL C. 150 mL D. 200 mL
A. 100 mL
An organ or tissue may be better able to resist damage from hypoperfusion if the:
Select one:
A. systolic arterial blood pressure is at least 60 mm Hg.
B. body’s demand for oxygen is markedly increased.
C. body’s temperature is considerably less than 98.6°F (37.0°C).
D. heart rate is maintained at more than 100 beats/min.
C. body’s temperature is considerably less than 98.6°F (37.0°C).
Blood stasis, changes in the vessel wall, and certain medications affect the:
Select one:
A. systolic blood pressure exclusively.
B. ability of the blood to effectively clot.
C. ability of red blood cells to carry oxygen.
D. white blood cells’ ability to fight infection.
B. ability of the blood to effectively clot.
Early signs and symptoms of intra-abdominal bleeding include: Select one: A. bruising only. B. widespread ecchymosis. C. significant hypotension. D. pain and distention.
D. pain and distention.
Gastrointestinal bleeding should be suspected if a patient presents with: Select one: A. hematemesis. B. dyspnea. C. hematuria. D. hemoptysis.
A. hematemesis.
In nontrauma patients, an early indicator of internal bleeding is: Select one: A. a decreasing blood pressure. B. dizziness upon standing. C. rapid, shallow breathing. D. a rapid, thready pulse.
B. dizziness upon standing.
Most cases of external bleeding from an extremity can be controlled by: Select one: A. elevating the injured extremity. B. compressing a pressure point. C. packing the wound with gauze. D. applying local direct pressure.
D. applying local direct pressure.
The ability of a person's cardiovascular system to compensate for blood loss is MOST related to: Select one: A. the part of the body injured. B. how fast his or her heart beats. C. his or her baseline blood pressure. D. how rapidly he or she bleeds.
D. how rapidly he or she bleeds.
The smaller vessels that carry blood away from the heart and connect the arteries to the capillaries are called the: Select one: A. venules. B. arterioles. C. vena cavae. D. capillary arteries.
B. arterioles.
The systemic veins function by:
Select one:
A. returning deoxygenated blood back to the heart.
B. delivering oxygen-poor blood to the capillaries.
C. returning oxygen-rich blood back to the left atrium.
D. delivering deoxygenated blood to the capillaries.
A. returning deoxygenated blood back to the heart.
Which of the following body systems or components is the LEAST critical for supplying and maintaining adequate blood flow to the body?
Select one:
A. An effectively pumping heart
B. The filtering of blood cells in the spleen
C. Adequate blood in the vasculature
D. An intact system of blood vessels
B. The filtering of blood cells in the spleen
Which of the following occurs after tissues are injured? Select one: A. Local blood vessels begin to dilate B. Red blood cells separate from plasma C. Red blood cells become less sticky D. Platelets collect at the injury site
D. Platelets collect at the injury site
Which of the following organs can tolerate inadequate perfusion for 2 to 3 hours? Select one: A. Brain B. Heart C. Skeletal muscle D. Kidneys
C. Skeletal muscle
A 17-year-old male was shot in the right anterior chest during an altercation. As your partner is applying oxygen, you perform a rapid assessment and find an open chest wound with a small amount of blood bubbling from it. You should:
Select one:
A. apply an occlusive dressing to the wound and continue your assessment.
B. place a sterile dressing over the wound and apply direct pressure.
C. direct your partner to assist the patient’s ventilations with a BVM.
D. control the bleeding from the wound and prepare to transport at once.
A. apply an occlusive dressing to the wound and continue your assessment.
A 38-year-old male was electrocuted while attempting to wire a house. Your assessment reveals that he is unresponsive, pulseless, and apneic. A coworker has shut off the power to the house. You should: Select one: A. begin CPR and apply the AED. B. begin CPR and transport at once. C. assess for entry and exit wounds. D. fully immobilize his spinal column.
A. begin CPR and apply the AED.
A laceration:
Select one:
A. rarely penetrates through the subcutaneous tissue to the muscle.
B. is a jagged cut caused by a sharp object or blunt force trauma.
C. is an injury that separates various layers of soft tissue.
D. is a sharp, smooth cut that is made by a surgical scalpel.
B. is a jagged cut caused by a sharp object or blunt force trauma.
A partial-thickness burn involves the outer layer of skin and a portion of the: Select one: A. muscle fascia. B. fatty layer. C. epidermis. D. dermal layer.
D. dermal layer.
A utility worker was trimming branches and was electrocuted when he accidentally cut a high-power line. He fell approximately 20 feet and is lying unresponsive on the ground; the power line is lying across his chest. You should:
Select one:
A. rapidly assess the patient after ensuring that the power line is not live.
B. apply insulated gloves and assume manual control of his c-spine.
C. quickly but carefully move the patient away from the power line.
D. manually stabilize his head as your partner assesses for breathing.
A. rapidly assess the patient after ensuring that the power line is not live.
All of the following body structures are lined with mucous membranes, EXCEPT for the: Select one: A. mouth. B. nose. C. anus. D. lips.
D. lips.
An injury that separates various layers of soft tissue, resulting in complete detachment or a flap of skin, is called a(n): Select one: A. amputation. B. laceration. C. avulsion. D. incision.
C. avulsion.
During an altercation in a bar, two patrons got into a fist fight. The first patient, a 44-year-old female, was struck in the mouth and refuses EMS care. The second patient, a 39-year-old female, has a small laceration to her left knuckle and also refuses EMS care. Which of the following statements regarding this scenario is correct?
Select one:
A. You should contact the police and have the patients arrested.
B. The 39-year-old female is at high risk for an infection.
C. The 44-year-old female is at high risk for an infection.
D. The patient struck in the mouth should be immobilized.
B. The 39-year-old female is at high risk for an infection.
During the normal wound-healing process, bleeding may occur from even a minor injury because:
Select one:
A. there is a substantial decrease in the number of platelets in and around the wound, which increases the risk of bleeding.
B. new capillaries that stem from intact capillaries are delicate and take time to become as stable as the preexisting capillaries.
C. bacteria and other microorganisms invade the wound site and damage the capillaries, which makes them more prone to bleeding.
D. histamines released by the immune system constrict the blood vessels, which increases the pressure within them.
B. new capillaries that stem from intact capillaries are delicate and take time to become as stable as the preexisting capillaries.
Patients with full-thickness (third-degree) burns generally do not complain of pain because:
Select one:
A. subcutaneous vessels are usually clotted.
B. the nerve endings have been destroyed.
C. blister formation protects the burn.
D. they are generally not conscious.
B. the nerve endings have been destroyed.
What layer of the skin forms a watertight, protective seal for the body? Select one: A. Muscular layer B. Epidermis C. Dermis D. Subcutaneous layer
B. Epidermis
When a person is exposed to a cold environment:
Select one:
A. the skin becomes flushed secondary to peripheral vasodilation.
B. peripheral vessels constrict and divert blood away from the skin.
C. sweat is produced and is warmed when the vessels constrict.
D. blood vessels dilate and divert blood to the core of the body.
B. peripheral vessels constrict and divert blood away from the skin.
When assessing a patient with a closed soft-tissue injury, it is MOST important to:
Select one:
A. manipulate the injury site for signs of a fracture.
B. remain alert for more severe underlying injuries.
C. assess circulation distal to the site of the injury.
D. recognize that the integrity of the skin is broken.
B. remain alert for more severe underlying injuries.
Which of the following is a severe burn in a 2-year-old child?
Select one:
A. Superficial burn that covers 25% of the BSA
B. Partial-thickness burn that covers 10% of the BSA
C. Any burn that involves the arms, legs, or posterior part of the body
D. Any full-thickness burn, regardless of its location on the body
D. Any full-thickness burn, regardless of its location on the body
Which of the following is a severe burn in a 35-year-old patient?
Select one:
A. Partial-thickness burn to 20% of the body surface area
B. Full-thickness burn to 5% of the body surface area
C. Superficial burn covering 50% of the body surface area
D. Circumferential partial-thickness burn to the chest
D. Circumferential partial-thickness burn to the chest
Which of the following is of LEAST importance when initially assessing the severity of a burn? Select one: A. Past medical history B. Known drug allergies C. Age of the patient D. Area(s) burned
B. Known drug allergies
Which of the following statements regarding electrical burns is correct?
Select one:
A. Entrance wounds are small relative to the amount of internal tissue damage.
B. The exit wound caused by electrical burns is smaller than the entrance wound.
C. Respiratory or cardiac arrest following an electrical burn is very uncommon.
D. The size of the entry and exit wounds is a reliable indicator of internal damage.
A. Entrance wounds are small relative to the amount of internal tissue damage.
Which of the following statements regarding the dermis is correct?
Select one:
A. The dermis lies above the germinal layer and provides protection.
B. The dermis contains hair follicles, sweat glands, and nerve endings.
C. The dermis produces a substance that provides color to the skin.
D. The cells of the dermis are worn away and are constantly replaced.
B. The dermis contains hair follicles, sweat glands, and nerve endings.
Which of the following statements regarding the rule of nines is correct?
Select one:
A. The posterior of a child’s leg is equal to 13.5% of the BSA.
B. The anterior arm in the adult is equal to 9% of the total BSA.
C. The anterior trunk of an adult is equal to 18% of the BSA.
D. A child’s head is equal to 14% of his or her total BSA.
C. The anterior trunk of an adult is equal to 18% of the BSA.