Exam 7- Ch. 20-24

Question 1

A 28-year-old female patient is found to be responsive to verbal stimuli only. Her roommate states that she was recently diagnosed with type 1 diabetes and has had difficulty controlling her blood sugar level. She further tells you that the patient has been urinating excessively and has progressively worsened over the last 24 to 36 hours. On the basis of this patients clinical presentation, you should suspect that she:

A. is significantly hyperglycemic.
B. has a urinary tract infection.
C. has overdosed on her insulin.
D. has a low BG level.

Answer 1

A. is significantly hyperglycemic.

Question 2

A 31-year-old male with a history of diabetes had a seizure that stopped prior to EMS arrival. He is unresponsive and has rapid shallow breathing. His pulse is rapid weak, and his skin is cyanotic. The EMT should:

A. administer oxygen by nasal cannula and assess his BG level.
B. place a thin layer of oral glucose between his cheek and gums.
C. position the PT on his side and give oxygen via nonrebreathing mask.
D. assist the PTs ventilations with a bag-valve mask.

Answer 2

D. assist the PTs ventilations with a bag-valve mask.

Question 3

You respond to a residence for a PT 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:

A. contact medical control for instructions.
B. calm him down so you can assess him.
C. be assertive and talk the PT down.
D. retreat at once and call law enforcement.

Answer 3

D. retreat at once and call law enforcement.

Question 4

A 19-year-old male complains of “not feeling right” His insulin and syringe are on a nearby table. The PT says he thinks he took his insulin and cannot remember whether he ate. He is also unable to tell you the time or what day it is. The glucometer reads “error” after several attempts to assess his BG level. You should:

A. transport only with close, continuous monitoring en route.
B. contact medical control and administer oral glucose.
C. request a paramedic ambulance to administer IV glucose.
D. assist him with his insulin injection and reassess him.

Answer 4

B. contact medical control and administer oral glucose.

Question 5

A 42-year-old male is found unresponsive on his couch by a neighbor. During your assessment, you find no signs of trauma, and the patients BG level is 75 mg/dL. His BP is 168/98 mm Hg, his HR is 45 beats/min and bounding, and his respirations are 8 breaths/min and irregular. The patient is wearing a medical alert bracelet that states he has hemophilia. You should:

A. administer high-flow oxygen, perform a detailed secondary assessment at the scene, and transport promptly.
B. suspect that he has intracranial bleeding, assist his ventilations, and transport rapidly to an appropriate hospital.
C. administer oxygen via a NRBM, apply oral glucose in between his cheek and gum, and transport.
D. suspect that he has internal bleeding and is in shock, administer high-flow oxygen, and transport at once.

Answer 5

B. suspect that he has intracranial bleeding, assist his ventilations, and transport rapidly to an appropriate hospital.

Question 6

A 75-year-old male with type 1 diabetes presents with chest pain and a general feeling of weakness. He tells you that he took his insulin today and ate a regular meal approximately 2 hours ago. You should treat this PT as though he is experiencing:

A. an acute stroke.
B. hypoglycemia.
C. hyperglycemia.
D. a heart attack.

Answer 6

D. a heart attack.

Question 7

A 50-year-old male with diabetes has an altered mental status and is unable to tell you when he last ate or took his insulin. Your glucometer keeps malfunctioning and you are unable to determine his BG level. Which of the following clinical signs would MOST likely lead you to the correct diagnosis?

A. Restlessness and irritability.
B. Hypotension and tachycardia.
C. Rapid and weak pulse.
D. Deep and rapid breathing.

Answer 7

D. Deep and rapid breathing.

Question 8

A 29-year-old female presents with confusion and disorientation. Her respirations are rapid and shallow, and her pulse is 120 beats/min and thready. She is markedly diaphoretic and has an oxygen saturation of 89%. You should:

A. transport immediately.
B. provide ventilatory support.
C. administer oral glucose.
D. treat her for hyperglycemia.

Answer 8

B. provide ventilatory support.

Question 9

Classic signs and symptoms of hypoglycemia include:

A. cold, clammy skin; bradycardia; hunger; and deep, rapid respirations.
B. warm, dry skin; irritability; bradycardia; and rapid respirations.
C. warm, dry skin; hunger; abdominal pain; and deep, slow respirations.
D. cool, clammy skin; weakness; tachycardia; and rapid respirations.

Answer 9

D. cool, clammy skin; weakness; tachycardia; and rapid respirations.

Question 10

Diabetes is MOST accurately defined as a(n):

A. disorder of glucose metabolism.
B. abnormally high blood glucose level.
C. mass excretion of glucose by the kidneys.
D. lack of insulin production in the pancreas.

Answer 10

A. disorder of glucose metabolism.

Question 11

Diabetic ketoacidosis occurs when:

A. insulin is not available in the body.
B. the cells rapidly metabolize glucose.
C. the pancreas produces excess insulin.
D. blood glucose levels rapidly fall.

Answer 11

A. insulin is not available in the body.

Question 12

What is excessive eating caused by cellular “hunger” called?

Answer 12

polyphagia

Question 13

Hemoglobin is:

A. a key component of the blood and is produced in response to an infection.
B. found within the red blood cells and is responsible for carrying oxygen.
C. essential for the formation of clots, such as when vessel damage occurs.
D. the fluid portion of the blood that transport cells throughout the body.

Answer 13

B. found within the red blood cells and is responsible for carrying oxygen.

Question 14

Patients with thrombophilia are at an increased risk for:

A. hemorrhagic stroke
B. various cancers
C. acute arterial rupture
D. pulmonary embolism

Answer 14

D. pulmonary embolism

Question 15

Patients with type 2 diabetes usually control their disease with all of the following, EXCEPT:

A. tolbutamide (Orinase)
B. diet and exercise
C. glyburide (Micronase)
D. supplemental insulin

Answer 15

D. supplemental insulin

Question 16

Patients with uncontrolled diabetes experience polyuria because:

A. low BG levels result in cellular dehydration.
B. excess glucose in the blood is excreted by the kidneys.
C. they drink excess amounts of water due to dehydration.
D. high blood sugar levels cause permanent kidney damage.

Answer 16

B. excess glucose in the blood is excreted by the kidneys.

Question 17

Proper procedure for administering oral glucose to a patient includes all of the following, EXCEPT:

A. checking the medications expiration date
B. requesting permission from medical control
C. ensuring the absence of a gag reflex
D. assessing the patients mental status

Answer 17

C. ensuring the absence of a gag reflex

Question 18

Symptomatic hypoglycemia will MOST likely develop if a patient:

A. eats a regular meal followed by mild exertion
B. takes too much of his or her prescribed insulin
C. markedly overeats and misses an insulin dose
D. misses one or two prescribed insulin injections

Answer 18

B. takes too much of his or her prescribed insulin

Question 19

What is the text book normal blood glucose level?

Answer 19

Between 80 and 120 mg/dL

Question 20

To which of the following diabetic patients should you administer oral glucose?

A. a semiconscious 40-year-old female without a gag reflex
B. a confused 55-year-old male with tachycardia and pallor
C. a conscious 37-year-old female with nausea and vomiting
D. An unconscious 33-year-old male with cool, clammy skin

Answer 20

B. a confused 55-year-old male with tachycardia and pallor

Question 21

Type 1 diabetes:

A. typically occurs in PTs between 50 nd 70 years of age
B. is defined as a BG level that is less than 120 mg/dL
C. is a condition in which no insulin is produced by the body
D. is typically treated with medications such as metformin

Answer 21

C. is a condition in which no insulin is produced by the body

Question 22

When assessing an unresponsive diabetic patient, the primary visible difference between hyperglycemia and hypoglycemia is the:

A. rate of the patients pulse.
B. presence of a medical identification tag.
C. rate and depth of breathing.
D. patients mental status

Answer 22

C. rate and depth of breathing.

Question 23

Which of the following conditions is the diabetic PT at an increased risk of developing?

A. Blindness
B. Alcoholism
C. Hepatitis B
D. Depression

Answer 23

A. Blindness

Question 24

Which of the following signs or symptoms would the EMT MOST likely encounter in a PT with new-onset type 1 diabetes?

A. total lack of appetite
B. low BG level
C. weight gain and edema
D. weight loss and polyuria

Answer 24

D. weight loss and polyuria

Question 25

Which of the following statements regarding sickle cell disease is correct?

A. because of their abnormal shape, red blood cells in PTs with sickle cell disease are less apt to lodge in a blood vessel.
B. In sickle cell disease, the red blood cells are abnormally shaped and less able to carry oxygen.
C. The red blood cells of PTs with sickle cell disease are round and contain hemoglobin.
D. Sickle cell disease is an inherited blood disorder that causes the blood to clot too quickly.

Answer 25

B. In sickle cell disease, the red blood cells are abnormally shaped and less able to carry oxygen.

Question 26

You have assisted an adult patient with his epinephrine auto-injector. When giving a report to the emergency department nurse, you should inform her that which dose of epinephrine was administered?

A) 0.25 mcg
B) 0.3 mcg
C) 0.3 mg
D) 0.1 mg

Answer 26

C) 0.3 mg

Question 27

For the EMT to achieve the best results when assisting a patient with epinephrine treatment, the medication should be properly injected into:

A) An artery
B) The skin
C) A muscle
D) A vein

Answer 27

C) A muscle

Question 28

When reassessing a patient whom you are treating for an anaphylactic reaction, which of these findings would be of the greatest concern?

A) Red, warm, and dry skin, with the patient becoming increasingly agitated
B) Respiratory rate change from 28 to 10 breaths/min with increasing patient lethargy
C) New hives appearing on the chest that were not there upon your arrival
D) Pulse oximetry reading of 95% via high-concentration oxygen

Answer 28

B) Respiratory rate change from 28 to 10 breaths/min with increasing patient lethargy

Question 29

After assisting a patient with the use of an epinephrine auto-injector, you note that the patient’s blood pressure has improved. As a knowledgeable EMT, you realize that this effect occurred due to epinephrine’s ability to:

A) Relax the smooth muscle of the blood vessels
B) Increase the oxygen-carrying capacity of the red blood cells
C) Constrict blood vessels
D) Increase the number of circulating red blood cells

Answer 29

C) Constrict blood vessels

Question 30

You are called to an outpatient surgery center for a patient who developed an allergic reaction while receiving an intravenous (IV) antibiotic. How would you document the route of exposure?

A) Ingestion
B) Contact
C) Injection
D) Topical

Answer 30

C) Injection

Question 31

On scene, you assisted a patient with his epinephrine auto-injector after he was stung multiple times by bees. You are now transporting the patient to the hospital. As you reassess the patient, which of these findings would best indicate that the epinephrine is benefiting the patient?

A) Increasing heart rate
B) Decreasing wheezing
C) Decreasing blood pressure
D) Complaint of fatigue

Answer 31

B) Decreasing wheezing

Question 32

Why would the patient experiencing an allergic reaction tell you that it is easier to breathe following administration of epinephrine?

A) Decreased blood pressure
B) Drying of mucus in the airways
C) Dilation of the bronchioles
D) Increased blood flow to the lungs

Answer 32

C) Dilation of the bronchioles

Question 33

Five minutes after assisting a patient with his epinephrine auto-injector, you determine that the patient is getting progressively worse. The patient has a second auto-injector available. What is the priority action the EMT should take at this time?

A) Continue to monitor the patient
B) Administer the second dose of epinephrine
C) Contact medical direction for further orders
D) Request advanced life support (ALS) assistance

Answer 33

C) Contact medical direction for further orders

Question 34

You have been called to a residence for a female patient who awoke with swollen lips and a rash to her arms and abdomen. In addition, she exhibits a mild expiratory wheeze in all lung fields.
She called her doctor, who advised her to take some Benadryl and call 911 for emergency care.
How will the Benadryl, acting as an antihistamine, benefit this patient?

A) It dilates the patient’s blood vessels and delivers more blood to the brain
B) It inhibits the constriction of the patient’s small airways by blocking histamine
C) It helps the patient’s immune system to deactivate the allergen
D) It acts as an allergen to stop the allergic reaction through histamine stimulation

Answer 34

B) It inhibits the constriction of the patient’s small airways

Question 35

While you are caring for a patient who wrecked his​ car, he starts to complain of a rash and itching of his skin. He then tells you that he is allergic to​ latex, and you are wearing a pair of latex exam gloves. What is the entry mechanism of this antigen to the​ patient’s body?

A. Injection
B. Ingestion
C. Inhalation
D. Absorption

Answer 35

D. Absorption

Question 36

Allergic reactions are important for EMS to identify and respond to as rapidly as possible for what​ reason?

A. The blood pressure drops within the first 10 to 15 minutes of the reaction.
B. Skin hives and redness are very disturbing to the patient.
C. If the EMT cannot get to the patient soon​ enough, the patient could drive himself to the hospital.
D. Airway closure can occur rapidly and can be fatal.

Answer 36

D. Airway closure can occur rapidly and can be fatal.

Question 37

Hives​ are:

A. always accompanied by severe itching.
B. red, itchy flat blotches on the skin.
C. caused by a lack of histamine.
D. raised red blotches over the skin.

Answer 37

D. raised red blotches over the skin.

Question 38

The​ body’s defense mechanism that is responsible for fighting off invasion by a foreign substance is a part of​ the:

A. respiratory system.
B. immune system.
C. anaphylactoid reaction.
D. endocrine system.

Answer 38

B. immune system.

Question 39

Which substances create allergic reactions in certain​ individuals?

A. Allergens
B. Antibodies
C. Immunoglobulins
D. Histamines

Answer 39

A. Allergens

Question 40

You arrive on scene to back up another EMT unit for a patient with an allergic reaction. As you approach the​ scene, you see one EMT preparing to administer the​ patient’s auto-injector. Which clinical finding would support the use of the​ EpiPen?

A. Tachycardia
B. Low pulse oximeter reading
C. Tachypnea
D. Hypoperfusion

Answer 40

D. Hypoperfusion

Question 41

During an acute allergic​ reaction, what causes the blood pressure to​ decrease?

A. Development of skin hives
B. Vasodilation and fluid shifting
C. Fluid shifting out of the gastrointestinal system and into the interstitial spaces
D. Profound vasoconstriction from the chemical mediators that are released

Answer 41

B. Vasodilation and fluid shifting

Question 42

You are on a call for a patient who dispatch reported was having an acute allergic reaction. Which of the following findings would you NOT expect to see upon​ arrival?

A. Blisters and jaundice
B. Hives and swelling
C. Sweating and pallor
D. Rash and redness

Answer 42

A. Blisters and jaundice

Question 43

A substance is introduced directly into the body by which​ method?

A. Injection
B. Ingestion
C. Absorption
D. Inhalation

Answer 43

A. Injection

Question 44

A generalized feeling of weakness or​ discomfort, commonly encountered during an anaphylactic​ reaction, is​ called:

A. urticaria.
B. edema.
C. malaise.
D. pruritus.

Answer 44

C. malaise.

Question 45

You arrive on scene for a patient in respiratory distress. When you approach the​ patient, you find him lying supine in the​ yard, unresponsive, and covered with​ hives, and you note a​ high-pitched inspiratory shrill sound with every inhalation. One of your immediate field impressions should​ be:

A. hypoglycemic episode.
B. acute stroke.
C. anaphylactic reaction.
D. seizure activity.

Answer 45

C. anaphylactic reaction.

Question 46

You have just assisted a patient with his epinephrine​ auto-injector. The patient states that he has never taken epinephrine before. What would be the appropriate EMT response about how the drug may make him​ feel?

A. “If you pass​ out, that is normal. I will just give you some oxygen if that​ happens.”
B. “Be prepared to feel dizzy and nauseated. These effects are common when taking​ epinephrine.”
C. “The epinephrine may make you​ drowsy, so just close your​ eyes.”
D. “You may feel a little​ shaky, but that is normal and will​ pass.”

Answer 46

D. “You may feel a little​ shaky, but that is normal and will​ pass.”

Question 47

A patient is covered with hives. He is responsive to painful stimuli but has labored respirations with an inspiratory stridor​ sound, bilateral​ wheezing, and a weak and rapid pulse. His vital signs are​ pulse, 128;​ respirations, 24​ breaths/min; and blood​ pressure, 80/50 mmHg. Given this​ presentation, the EMT should suspect that the patient​ has:

A. Sensitization
B. Anaphylaxis
C. Hypersensitivity
D. Localized allergic reaction

Answer 47

B. Anaphylaxis

Question 48

A patient who is severely short of breath and covered with hives states that she is allergic to crab. Despite her​ allergy, she tried some crab dip 10 minutes​ ago, since it had been​ “years and​ years” since she had her last allergic reaction. Which question should the EMT ask​ first?

A.​ “Do you have an epinephrine​ auto-injector?”
B. “Which medications are you currently​ taking?”
C.​ “How many allergic reactions have you​ had?”
D. “Why did you eat the dip if you are allergic to​ crab?”

Answer 48

A.​ “Do you have an epinephrine​ auto-injector?”

Question 49

When assessing a patient with a suspected anaphylactic​ reaction, which of these findings would you​ expect?

A. Weak, rapid radial pulse
B. Slow and bounding radial pulse
C. Normal to slightly increased blood pressure
D. Rapid and strong carotid pulse

Answer 49

A. Weak, rapid radial pulse

Question 50

For the EMT to achieve the best results when assisting a patient with epinephrine​ treatment, the medication should be properly injected​ into:

A. An artery
B. The skin
C. A muscle
D. A vein

Answer 50

C. A muscle

Question 51

When administering epinephrine to an infant or​ child, the EMT would place the injector at which​ site?

A. Hip muscle
B. Outer buttock
C. Upper arm
D. Lateral thigh

Answer 51

D. Lateral thigh

Question 52

A panicked and anxious patient tells you that he is allergic to peanuts and thinks he may have accidentally eaten some. He states that the last time he ate peanuts he almost died and needed to have a​ “tube put in his​ throat.” When assessing this​ patient, which of these signs or symptoms would provide the best evidence that the patient is having an​ allergic, and possibly an early​ anaphylactic, reaction?

A. Cool and dry skin
B. Elevated blood pressure
C. Panic and anxiety
D. Hives on his chest

Answer 52

D. Hives on his chest

Question 53

What is the best explanation of why patients experiencing an anaphylactic reaction have difficulty​ breathing?

A. Histamine constricts the bronchioles
B. Antibodies depress the​ brain’s respiratory center
C. Antigens increase the​ body’s need for oxygen
D. Allergens use the available oxygen molecules

Answer 53

A. Histamine constricts the bronchioles

Question 54

Regarding the pathophysiology underlying​ anaphylaxis, which of these statements is​ true?

A. Smooth muscle dilation in the lungs impairs the exchange of oxygen
B. Histamine causes the capillaries to become leaky and bronchioles to constrict
C. High blood pressure forces blood from the blood​ vessels, resulting in airway edema
D. Immunoglobulin E molecules make antibodies that cause bronchoconstriction and vasodilation

Answer 54

B. Histamine causes the capillaries to become leaky and bronchioles to constrict

Question 55

How should an EMT assist a patient in taking his epinephrine​ auto-injector?
A. Place the injector against the deltoid muscle in the​ arm, and push the plunger to slowly inject the medication
B. Pinch the skin on the lateral​ thigh, press the injector against the​ skin, and rapidly push the plunger to inject the medication
C. Press the injector onto the lateral​ thigh, and wait for it to automatically inject
D. Pinch the skin on the anterior​ thigh, press the injector against the​ skin, and wait until it activates

Answer 55

C. Press the injector onto the lateral​ thigh, and wait for it to automatically inject

Question 56

After assisting a patient with the use of an epinephrine​ auto-injector, you note that the​ patient’s blood pressure has improved. As a knowledgeable​ EMT, you realize that this effect occurred due to​ epinephrine’s ability​ to:

A. Increase the​ oxygen-carrying capacity of the red blood cells
B. Constrict blood vessels
C. Increase the number of circulating red blood cells
D. Relax the smooth muscle of the blood vessels

Answer 56

B. Constrict blood vessels

Question 57

You are responding to a call for an allergic reaction. Your partner is a new EMT and this is his first call. When prepping him on how the scene and the patient may​ present, which instruction regarding the assessment and treatment of an allergic reaction​ and/or anaphylaxis would be​ correct?

A.​ “Our first priority will not be to determine what caused the allergic​ reaction, but to treat the patient according to his or her​ symptoms.”
B. “If the allergic reaction was caused by exposure to chocolate or​ eggs, we will not be able to administer​ epinephrine.”
C. “If the allergic reaction was caused by​ food, we will need to administer activated​ charcoal.”
D. “Epinephrine really should be given to any patient experiencing even a mild allergic reaction to prevent​ anaphylaxis.”

Answer 57

A.​ “Our first priority will not be to determine what caused the allergic​ reaction, but to treat the patient according to his or her​ symptoms.”

Question 58

Five minutes after you assist a patient with her epinephrine​ auto-injector, the patient states that she feels much better and would like to refuse additional care and transport to the hospital. Which of these statements by the EMT would be most appropriate given this​ situation?

A. “Epinephrine can make you very sleepy. You can refuse to be​ transported, but just make sure that someone is here to keep an eye on​ you.”
B. “The epinephrine will start to wear off in 10 or so minutes.​ Let’s see how you are doing then before thinking about refusing​ transport.”
C. “Once we help you take your​ epinephrine, the law requires that you be transported to a hospital for additional​ care.”
D. “If you feel better​ now, there is probably no need to go to the hospital. I will get the refusal form for you to​ sign.”

Answer 58

B. “The epinephrine will start to wear off in 10 or so minutes.​ Let’s see how you are doing then before thinking about refusing​ transport.”

Question 59

Which of these assessment findings would indicate that the patient is experiencing an anaphylactic reaction after a bee sting and requires immediate​ intervention?
A. Hives to the arm that was stung and a heart rate of 96​ beats/min
B. Edema to the​ feet, with an SpO2 of​ 93% on room air and mild dyspnea
C. Swollen lips and oral​ mucosa, with a blood pressure of​ 84/50 mmHg
D. Localized swelling around the site of the bee sting

Answer 59

C. Swollen lips and oral​ mucosa, with a blood pressure of​ 84/50 mmHg

Question 60

A patient has been stung by a bee. Which of these findings would be present in​ anaphylaxis, but not in a local allergic​ reaction?

A. Hypotension
B. Swelling at the site of the sting
C. Hives
D. Anxiousness

Answer 60

A. Hypotension

Question 61

You have assisted an adult patient with his epinephrine​ auto-injector. When giving a report to the emergency department​ nurse, you should inform her that which dose of epinephrine was​ administered?

A. 0.1 mg
B. 0.3 mcg
C. 0.3 mg
D. 0.25 mcg

Answer 61

C. 0.3 mg

Question 62

What is the most severe form of an allergic reaction​ called?
A. Anaphylaxis
B. Hypersensitivity
C. Antigen response
D. Rhinorrhea

Answer 62

D. Rhinorrhea

Question 63

A football player in full uniform has been stung by a bee. Your assessment reveals him to be confused with stridorous respirations and weak radial pulses. His skin is warm and flushed and covered with hives. Vital signs are​ pulse, 164;​ respirations, 28​ breaths/min; blood​ pressure, 74/58​ mmHg; and​ SpO2, 87%. The coach notifies you that the patient is allergic to bees and hands you the​ patient’s epinephrine pen. Your next action would be​ to:
A. Lift the shirt over the​ patient’s abdomen and administer the epinephrine into his abdomen below the umbilicus
B. Completely expose the patient and administer the epinephrine into his anterior thigh
C. Administer the epinephrine through a​ pad-less area of the​ patient’s pants over the side of his thigh
D. Lift the​ patient’s shoulder pads and shirt and administer the epinephrine into his upper arm muscle

Answer 63

C. Administer the epinephrine through a​ pad-less area of the​ patient’s pants over the side of his thigh

Question 64

What is the most common trigger of anaphylaxis?

A. Medications
B. Food
C. Insect stings
D. Plants

Answer 64

B. Food

Question 65

You have arrived by the side of a lethargic patient who is allergic to latex and was exposed to it when she spilled a​ latex-containing powder on her right hand. She is able to speak only a few words with each​ breath, and a quick glance at the pulse oximeter reveals the saturation is in the​ 80-90% range.​ Additionally, the​ patient’s tongue is swollen and her respirations are​ rapid, labored, and noisy. Which action is your immediate​ priority?

A. Wash the latex powder from the​ patient’s hand
B. Insert an oropharyngeal airway
C. Start positive pressure ventilation
D. Obtain a heart rate and blood pressure

Answer 65

C. Start positive pressure ventilation

Question 66

When reassessing a patient whom you are treating for an anaphylactic​ reaction, which of these findings would be of the greatest​ concern?

A. New hives appearing on the chest that were not there upon your arrival
B. Pulse oximetry reading of​ 95% via​ high-concentration oxygen
C. Respiratory rate change from 28 to 10​ breaths/min with increasing patient lethargy
D. Red, warm, and dry​ skin, with the patient becoming increasingly agitated

Answer 66

C. Respiratory rate change from 28 to 10​ breaths/min with increasing patient lethargy

Question 67

A​ 39-year-old female​ patient, who is allergic to​ shellfish, thinks that she may have accidentally ingested some that was mixed into her food at a restaurant. When assessing​ her, which of these statements made by the patient would be suggestive that she is in the early stages of an anaphylactic​ reaction?

A. “I feel dizzy and​ weak.”
B. “I suddenly feel like a have a lump in my​ throat.”
C. “I feel as though I am getting a​ fever.”
D. “My heart suddenly feels as though it is skipping some​ beats.”

Answer 67

B. “I suddenly feel like a have a lump in my​ throat.”

Question 68

An awake but confused patient experiencing an allergic reaction begins to exhibit stridorous respirations. The EMT knows that the underlying condition responsible for this presentation​ is:

A. Loss of the gag reflex
B. Constriction of the small airways
C. Spasm of the lower airway
D. Swelling to the upper airway

Answer 68

D. Swelling to the upper airway

Question 69

During the primary​ assessment, which of these findings would most lead the EMT to suspect an allergic​ reaction?

A. Blood pressure of​ 100/60 mmHg
B. Complaint of dizziness
C. Hives to the face and neck
D. Heart rate of 112​ beats/min

Answer 69

C. Hives to the face and neck

Question 70

A young female​ patient, who is allergic to​ peanuts, was just exposed to peanut butter in a sandwich at a church picnic. Assessment reveals her to be alert and​ oriented, with swollen lips and hives on her face. She is breathing adequately at a rate of 18​ breaths/min and has a heart rate of 82​ beats/min. Your partner advises you that her blood pressure is​ 118/72 mmHg and​ room-air SpO2 is​ 92%. The patient states that she also has​ asthma, for which she uses an inhaler. What should you do​ first?

A. Provide supplemental oxygen
B. Determine the amount of peanut butter consumed
C. Start positive pressure ventilation
D. Assist the patient with her inhaler

Answer 70

A. Provide supplemental oxygen

Question 71

A patient develops an allergic reaction after taking penicillin. In this​ case, the penicillin would be recognized by the body​ as:

A. A form of immunoglobulin E
B. An antibody
C. A mast cell
D. An antigen

Answer 71

D. An antigen

Question 72

After you assist a patient with his epinephrine​ auto-injector, which of these statements made by the patient best indicates that the epinephrine is working and the patient is​ improving?

A. “My heart feels as though it is​ racing.”
B. “I am more relaxed and getting​ sleepy.”
C.​ “I am getting a little bit of a​ headache.”
D. ​”My breathing feels a lot​ easier.”

Answer 72

D. ​”My breathing feels a lot​ easier.”

Question 73

You have been called to a residence for a female patient who awoke with swollen lips and a rash to her arms and abdomen. In​ addition, she exhibits a mild expiratory wheeze in all lung fields. She called her​ doctor, who advised her to take some Benadryl and call 911 for emergency care. How will the​ Benadryl, acting as an​ antihistamine, benefit this​ patient?

A. It inhibits the constriction of the​ patient’s small airways by blocking histamine
B. It helps the​ patient’s immune system to deactivate the allergen
C. It dilates the​ patient’s blood vessels and delivers more blood to the brain
D. It acts as an allergen to stop the allergic reaction through histamine stimulation

Answer 73

A. It inhibits the constriction of the​ patient’s small airways by blocking histamine

Question 74

Prior to assisting a patient with his epinephrine​ auto-injector, the EMT must ensure​ that:

A. The patient is improving
B. The medication is yellow in color
C. On-line or​ off-line medical direction for epinephrine administration exists
D. The​ patient’s heart rate and blood pressure are stable

Answer 74

C. On-line or​ off-line medical direction for epinephrine administration exists

Question 75

Why would the patient experiencing an allergic reaction tell you that it is easier to breathe following administration of​ epinephrine?

A. Decreased blood pressure
B. Increased blood flow to the lungs
C. Drying of mucus in the airways
D. Dilation of the bronchioles

Answer 75

D. Dilation of the bronchioles

Question 76

Within the​ body, the release of histamine causes dilation of​ the:

A. Salivary glands
B. Blood vessels
C. Upper airway
D. Small airways

Answer 76

B. Blood vessels

Question 77

A​ 23-year-old male patient has called EMS for swollen lips and hives. Upon entering the​ scene, which of these observations would make the EMT suspicious that the patient is having an allergic​ reaction?

A. A bottle of expired nitroglycerin on the kitchen counter
B. Other family members complaining of similar symptoms
C. A glucometer on a table in the living room
D. A new container of penicillin on a table with two pills missing

Answer 77

D. A new container of penicillin on a table with two pills missing

Question 78

Substance abuse is MOST accurately defined as:

A. knowingly selling illicit drugs in order to buy more drugs.
B. willfully using a therapeutic drug to treat a medical illness.
C. unwillingly and unknowingly consuming drugs or alcohol.
D. knowingly misusing a substance to produce a desired effect.

Answer 78

D. knowingly misusing a substance to produce a desired effect.

Question 79

The EMT’s primary responsibility to the patient who has been poisoned is to:

A. administer the appropriate antidote.
B. recognize that a poisoning occurred.
C. administer 25 g of activated charcoal.
D. contact poison control immediately.

Answer 79

B. recognize that a poisoning occurred.

Question 80

Heroin is an example of a(n):

A. opioid.
B. hypnotic.
C. benzodiazepines
D. sympathomimetic.

Answer 80

A. opioid.

Question 81

Hypotension, hypoventilation, and pinpoint pupils would be expected following an overdose of:

A. ecstasy.
B. oxycodone (Percocet).
C. amphetamine sulfate (Benzedrine).
D. crack cocaine.

Answer 81

B. oxycodone (Percocet).

Question 82

Signs and symptoms of a sympathomimetic drug overdose include:

A. sedation.
B. tachycardia.
C. hypotension.
D. slurred speech.

Answer 82

B. tachycardia.

Question 83

Which of the following drugs is NOT a sedative-hypnotic?

A. secobarbital (Seconal)
B. diazepam (Valium)
C. cocaine
D. flunitrazepam (Rohypnol)

Answer 83

C. cocaine

Question 84

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?

A. pupillary constriction
B. excessive lacrimation
C. a fall in blood pressure
D. dry mucous membranes

Answer 84

D. dry mucous membranes

Question 85

Which of the following questions would be of LEAST pertinence during the initial questioning of a patient
who ingested a substance?

A. How much of the substance was taken?
B. How long ago was it taken?
C. What type of substance was taken?
D. Why was the substance ingested?

Answer 85

D. Why was the substance ingested?

Question 86

A poison that enters the body by __________ is the MOST difficult to treat.

A. injection
B. ingestion
C. inhalation
D. absorption

Answer 86

A. injection

Question 87

The poison control center will be able to provide you with the most information regarding the appropriate
treatment for a patient with a drug overdose if the center:
A. knows the location of the closest hospital.
B. is aware of the patient’s age and gender.
C. is aware of the substance that is involved.
D. knows why the patient overdosed on the drug

Answer 87

C. is aware of the substance that is involved.

Question 88

Which of the following statements regarding inhaled poisons is correct?

A. Lung damage may progress after the patient is removed from the environment.
B. Carbon monoxide is very irritating to the upper airway and may cause swelling.
C. Burns around the eyes are the most common indication of an inhalation poisoning.
D. Chlorine is a colorless and odorless gas that causes hypoxia and pulmonary edema.

Answer 88

A. Lung damage may progress after the patient is removed from the environment.

Question 89

Your priority in caring for a patient with a surface contact poisoning is to:

A. move the patient to a safe area.
B. avoid contaminating yourself.
C. decontaminate the patient’s skin.
D. obtain and maintain a patent airway.

Answer 89

B. avoid contaminating yourself.

Question 90

Phosphorus or elemental sodium should be brushed off of the skin instead of irrigated with water because:

A. water makes these chemicals impossible to remove.
B. severe swelling will occur when mixed with water.
C. this will eliminate the chances of you being exposed.
D. these chemicals may ignite upon contact with water.

Answer 90

D. these chemicals may ignite upon contact with water.

Question 91

Most poisonings occur via the __________ route.

A. ingestion
B. injection
C. inhalation
D. absorption

Answer 91

A. ingestion

Question 92

About __% of poisonings are by mouth.

A. 60
B. 70
C. 80
D. 90

Answer 92

C. 80

Question 93

Activated charcoal is given to patients who have ingested certain substances because it:

A. induces vomiting and empties the stomach.
B. binds to the substance and prevents absorption.
C. decreases absorption of poisons into the lungs.
D. is a direct antidote for many toxic substances.

Answer 93

B. binds to the substance and prevents absorption.

Question 94

In general, injected poisons are impossible to dilute or remove because they:
A. are usually absorbed quickly into the body.
B. are usually fatal within 30 minutes of exposure.
C. absorb slowly into the body, despite their potency.
D. react with the blood, which increases their toxicity.

Answer 94

A. are usually absorbed quickly into the body.

Question 95

As you enter the residence of a patient who has possibly overdosed, you should:

A. be alert for personal hazards.
B. look for drug paraphernalia.
C. observe the scene for drug bottles.
D. quickly gain access to the patient.

Answer 95

A. be alert for personal hazards.

Question 96

Your unit is dispatched to the county jail for an intoxicated inmate. Upon arrival, you find the patient, a 33-
year-old male, lying supine in a jail cell. He is responsive to painful stimuli only and has slow, shallow
respirations. You should be MOST concerned that this patient:

A. might become violent.
B. may vomit and aspirate.
C. may experience a seizure.
D. is severely hypoglycemic.

Answer 96

B. may vomit and aspirate.

Question 97

ou receive a call to a residence where a man found his wife unconscious on the couch. The patient is
unresponsive, her respiratory rate is 8 breaths/min, her breathing is shallow, her heart rate is 40 beats/min,
and her pulse is weak. The husband hands you an empty bottle of hydrocodone (Vicodin), which was
refilled the day before. You should:

A. initiate ventilatory assistance.
B. contact the poison control center.
C. perform a rapid head-to-toe exam.
D. apply oxygen via a nonrebreathing mask.

Answer 97

A. initiate ventilatory assistance.

Question 98

It is MOST important to determine a patient’s weight when asking questions pertaining to a toxic ingestion
because:

A. additional help may be needed at the scene to lift the patient.
B. this will allow you to predict if the exposure is lethal.
C. this will determine whether or not to give syrup of ipecac.
D. activated charcoal is given based on a patient’s weight.

Answer 98

D. activated charcoal is given based on a patient’s weight.

Question 99

Airborne substances are diluted with:

A. oxygen.
B. syrup of ipecac.
C. activated charcoal.
D. an alkaline antidote.

Answer 99

A. oxygen.

Question 100

Activated charcoal administration is contraindicated in patients who have ingested:

A. ibuprofen.
B. acetaminophen (Tylenol).
C. acids or alkalis.
D. steroid drugs.

Answer 100

C. acids or alkalis.

Question 101

Common names for activated charcoal include all of the following, EXCEPT:

A. Fructose.
B. Actidose.
C. LiquiChar.
D. InstaChar.

Answer 101

A. Fructose.

Question 102

The major side effect associated with ingestion of activated charcoal is:

A. headache.
B. black stools.
C. abdominal pain.
D. ringing in the ears.

Answer 102

B. black stools.

Question 103

After administering activated charcoal to a patient, it is MOST important to:

A. call medical control.
B. be alert for vomiting.
C. reassess the patient’s blood pressure.
D. document the intervention.

Answer 103

B. be alert for vomiting.

Question 104

A person who routinely misuses a substance and requires increasing amounts to achieve the same effect is
experiencing a(n):

A. addiction.
B. dependence.
C. withdrawal.
D. tolerance.

Answer 104

D. tolerance.

Question 105

The MOST commonly abused drug in the United States is:

A. cocaine.
B. alcohol.
C. codeine.
D. marijuana.

Answer 105

B. alcohol.

Question 106

A hypnotic drug is one that:

A. induces sleep.
B. prevents amnesia.
C. increases the pulse.
D. increases the senses.

Answer 106

A. induces sleep.

Question 107

DTs is a syndrome associated with withdrawal from:

A. cocaine.
B. opioids.
C. alcohol.
D. sedatives.

Answer 107

C. alcohol.

Question 108

A 49-year-old male presents with confusion, sweating, and visual hallucinations. The patient’s wife tells
you that he is a heavy drinker and she thinks he had a seizure shortly before your arrival. This patient is
MOST likely experiencing:

A. acute hypovolemia.
B. alcohol intoxication.
C. acute schizophrenia.
D. DTs.

Answer 108

D. DTs.

Question 109

During your assessment of a 50-year-old male who was found unconscious in an alley, you note that he has
slow, shallow respirations; significant bradycardia; facial cyanosis; and pinpoint pupils. As your partner
begins assisting the patient’s ventilations, he directs your attention to the patient’s arms, which have
multiple needle tracks on them. This patient’s clinical presentation is MOST consistent with:

A. a heroin overdose.
B. alcohol intoxication.
C. a closed head injury.
D. an overdose of diazepam (Valium).

Answer 109

A. a heroin overdose.

Question 110

You and your paramedic partner are caring for a patient who ingested codeine, acetaminophen (Tylenol),
and propoxyphene (Darvon). The patient is unresponsive, his breathing is slow and shallow, and his pulse is
slow and weak. Treatment for this patient will include:

A. assisted ventilation, naloxone (Narcan), and rapid transport.
B. oxygen via a nonrebreathing mask and rapid transport.
C. assisted ventilation, flumazenil (Romazicon), and rapid transport.
D. oxygen via a nasal cannula, atropine, and rapid transport.

Answer 110

A. assisted ventilation, naloxone (Narcan), and rapid transport.

Question 111

You respond to a local motel for a young female who was sexually assaulted. The patient is conscious but
confused. She tells you that the last thing she remembers was drinking beer at a club with her friends the
night before. When she awoke, she was in the bed of the motel room. You should be MOST suspicious that
this patient:

A. is a heroin abuser.
B. is acutely intoxicated.
C. was given flunitrazepam (Rohypnol).
D. is abusing marijuana.

Answer 111

C. was given flunitrazepam (Rohypnol).

Question 112

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:

A. requesting a paramedic to administer naloxone (Narcan).
B. assisting his ventilations with a bag-mask device.
C. asking law enforcement to place handcuffs on the patient.
D. attempting to calm him and giving him oxygen if tolerated.

Answer 112

D. attempting to calm him and giving him oxygen if tolerated.

Question 113

In an apparent suicide attempt, a 19-year-old female ingested a full bottle of amitriptyline (Elavil). At
present, she is conscious and alert and states that she swallowed the pills approximately 30 minutes earlier.
Her blood pressure is 90/50 mm Hg, her pulse is 140 beats/min and irregular, and her respirations are 22
breaths/min with adequate depth. When transporting this patient, you should be MOST alert for:

A. acute respiratory depression.
B. a sudden outburst of violence.
C. an increase in her blood pressure.
D. seizures and cardiac arrhythmias.

Answer 113

D. seizures and cardiac arrhythmias.

Question 114

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. Initial management for this
patient should include:

A. thoroughly suctioning her oropharynx.
B. assisted ventilation with a bag-mask device.
C. performing a rapid secondary assessment.
D. requesting a paramedic to give her atropine.

Answer 114

B. assisted ventilation with a bag-mask device.

Question 115

Atropine sulfate and pralidoxime chloride are antidotes for:

A. lysergic acid diethylamide (LSD).
B. diphenhydramine (Benadryl).
C. nerve gas agents.
D. anticholinergic drugs.

Answer 115

D. anticholinergic drugs.

Question 116

A patient who presents with rapid breathing, nausea and vomiting, ringing in the ears, and a high fever
should be suspected of ingesting a significant quantity of:

A. cocaine.
B. aspirin.
C. Tylenol.
D. ibuprofen.

Answer 116

B. aspirin.

Question 117

An overdose on acetaminophen, the active ingredient in Tylenol, will MOST likely cause:

A. liver failure.
B. gastric ulcers.
C. kidney failure.
D. central nervous system (CNS) depression.

Answer 117

A. liver failure.

Question 118

Which of the following statements regarding the Salmonella bacterium is correct?

A. Refrigeration of food will prevent salmonellosis.
B. Symptoms of salmonellosis appear within 12 hours.
C. The Salmonella bacterium produces toxins that cause food poisoning.
D. The Salmonella bacterium itself causes food poisoning.

Answer 118

D. The Salmonella bacterium itself causes food poisoning.

Question 119

_________ is what you can see of a person’s response to the environment.
A. Affect
B. Psychosis
C. Behavior
D. Neurosis

Answer 119

C. Behavior

Question 120

A psychologic disorder that impairs bodily function when the body seems to be structurally normal is called a:

A. Functional disorder
B. Seizure
C. Traumatic brain injury
D. Drug and alcohol abuse

Answer 120

A. Functional disorder

Question 121

A technique used to gain insight into a patient ‘s thinking, which involves repeating in question form what the patient has said, is called:

A. Active listening
B. Reflective listening
C. Intuitive listening
D. Passive listening

Answer 121

B. Reflective listening

Question 122

Common causes of acute psychotic behavior include all the following, EXCEPT:

A. Schizophrenia
B. Mind-altering substance use
C. Alzheimer’s disease
D. Intense stress

Answer 122

C. Alzheimer’s disease

Question 123

General guidelines for managing a patient with a behavioral emergency include:

A. Placing the patient between yourself and an exit
B. Allowing the patient to be alone if he or she wishes
C. Firmly identifying yourself as an EMS provider
D. Being prepared to spend extra time with the patient

Answer 123

D. Being prepared to spend extra time with the patient

Question 124

Immediately after physically restraining a violent patient, the EMT should:

A. Document the time the restraints were applied
B. Inform medical control of the situation
C. Reassess the patient’s airway and breathing
D. Advise the patient why restraint was needed

Answer 124

C. Reassess the patient’s airway and breathing

Question 125

In which position should you restrain a physically uncooperative patient?

A. Supine
B. With hands tied behind the back
C. With arms and legs bound together
D. Prone

Answer 125

A. Supine

Question 126

Organic brain syndrome is defined as:

A. Bizarre behavior secondary to a chemical imbalance or disturbance in the brain.
B. A disorder that cannot be traced to the abnormal structure or function of an organ.
C. A dysfunction of the brain caused by abnormal physical or psychophysical function.
D. A change in behavior or mental status secondary to decreased cerebral blood flow.

Answer 126

C. A dysfunction of the brain caused by abnormal physical or psychophysical function.

Question 127

People at risk for suicide include all of the following, EXCEPT:

A. Those of a recent diagnosis of a serious illness
B. Married males older than 30 years
C. Substance abusers
D. Children with parents addicted to alcohol

Answer 127

B. Married males older than 30 years

Question 128

Posttraumatic stress disorder can happen after:

A. Battle with depression
B. Exposure to an injury from a traumatic occurrence
C. Extended periods of hyperthermia or hypothermia
D. Alcohol withdrawal

Answer 128

B. Exposure to an injury from a traumatic occurrence

Question 129

Signs of excited delirium include:

A. Slurred speech, bradycardia, and a high fever.
B. Diaphoresis, tachycardia, and hallucinations.
C. Subdued behavior, crying, and suicidal thoughts
D. Pallor, hypotension, and constricted pupil

Answer 129

B. Diaphoresis, tachycardia, and hallucinations.

Question 130

The first step in assessing a patient with behavioral emergency is to:

A. Ensure your safety.
B. Obtain proper consent
C. Restrain the patient
D. Take vital signs

Answer 130

A. Ensure your safety.

Question 131

The single most significant factor that contributes to suicide is:

A. A chronic illness
B. Drug abuse
C. Depression
D. Advanced age

Answer 131

C. Depression

Question 132

The term “behavioral crisis” is MOST accurately defined as:

A. A medical illness with psychological symptoms that may lead to limited motor functioning
B. A situation in which a patient of any age exhibits agitated, violent, or uncooperative behavior
C. A sudden, violent outburst of an otherwise mentally stable person toward a family member
D. A period of severe depression that last longer than 2 weeks and cannot be controlled with medications

Answer 132

B. A situation in which a patient of any age exhibits agitated, violent, or uncooperative behavior

Question 133

When assessing a patient with a behavioral crisis, you should:

A. Ask the police to handcuff the patient for safety
B. Be direct and clearly state your intentions
C. Spend as little time with the patient as possible
D. Frisk the patient for the presence of weapons

Answer 133

B. Be direct and clearly state your intentions

Question 134

Which of the following conditions or situations would MOST likely make excited delirium worse?

A. Alcohol withdrawal
B. Elevated blood glucose
C. Limited physical contact
D. Dimly lit environment

Answer 134

A. Alcohol withdrawal

Question 135

Which of the following is an example of a functioning behavioral disorder?

A. Head trauma
B. Alzheimer’s disease
C. Drug addiction
D. Schizophrenia

Answer 135

D. Schizophrenia

Question 136

Which of the following statements regarding the physical examination of a patient with a behavioral problem is correct?

A. Performing a physical examination on a patient with a behavioral problem will likely cause him or her to become violent and should be avoided in the field
B. It is only appropriate to perform a physical examination on a patient with a behavioral problem if he or she is unconscious or is being physically restrained
C. The physical examination of a patient with a behavioral problem often yields crucial information and should always be performed, even if the patient is violent
D. Although the physical exam can be difficult, the patient’s emotional state may be determined by noting facial expressions, pulse rate, and respirations

Answer 136

D. Although the physical exam can be difficult, the patient’s emotional state may be determined by noting facial expressions, pulse rate, and respirations

Question 137

You may not be able to determine whether a person has a mental illness, but you can predict the person’s likelihood of becoming:

A. Diabetic
B. Psychotic
C. Suicidal
D. Violent

Answer 137

D. Violent

Question 138

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?

A. Refuse to transport the patient because of his homicidal threat
B. Request a police officer to accompany you in the ambulance
C. Transport the patient in a prone position on the stretcher
D. Request that the police officer transport him to the hospital

Answer 138

B. Request a police officer to accompany you in the ambulance

Question 139

A 78-year-old female present with an acute change in behavior. The patient’s son tells you that his mother has type 2 diabetes and was diagnosed with Alzheimer’s disease 6 months ago. The patient speech is slurred, and she is not alert to her surroundings. You should?

A. Conclude that the patient’s blood sugar is high
B. Allow the patient to refuse transport is she wishes
C. Inquire about the possibility of head trauma
D. Transport the patient to a psychiatric facility

Answer 139

C. Inquire about the possibility of head trauma

Question 140

You are assessing a 45-year-old female who is severely depressed. She states that it seems that her entire world is crashing down around her. She further states that she has had frequent thoughts of suicide but is not sure if she can actually go through with it. How do you manage this situation?

A. Encourage the patient to remain quiet during transport
B. Leave the scene and have the neighbor check in on her
C. Have law enforcement place her into protective care
D. Ask the patient if she has developed a suicidal plan

Answer 140

D. Ask the patient if she has developed a suicidal plan

Question 141

A 22-year-old male with a history of clinical depression called 9-1-1 and stated that he attempted to kill himself. Your unit and law enforcement officers show up on scene simultaneously. You find the patient lying supine on the living room floor. He is unresponsive and cyanotic. An empty bottle of hydromorphone (Dilaudid) is found on an adjacent table. You should:

A. Ask the patient to handcuff the patient for safety purposes
B. Wait for the police to examine him before providing care
C. Open the patient’s airway and assess his respirations
D. Provide care after determining what Dilaudid is used for

Answer 141

C. Open the patient’s airway and assess his respirations

Question 142

Law enforcement personnel request your assistance for a 30-year-old man who was pulled over for erratic driving. The patient became acutely violent while he was being questioned, which required one of the officers to subdue him with a taser. When you arrive and assess the patient, you find that he is very agitated and is experiencing apparent hallucinations. His skin is flushed and diaphoretic. You should:

A. Quickly rule out any life-threatening conditions and then perform a detailed secondary assessment as he is being restrained.
B. Suspect that he is acutely hypoglycemic, considering giving him one tube of oral glucose, and transport with lights and sirens.
C. Limit physical contact with the patient as much as possible and avoid interrupting him if he is attempting to communicate with you.
D. Recognize that he is experiencing a complex psychiatric crisis, quickly load him into the ambulance, and transport without delay

Answer 142

C. Limit physical contact with the patient as much as possible and avoid interrupting him if he is attempting to communicate with you.

Question 143

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:

A. Carefully restrain the patient and transport at once.
B. Ask the daughter how her father normally behaves.
C. Advise the patient that his behavior is unacceptable.
D. Conclude that the patient has Alzheimer’s disease.

Answer 143

B. Ask the daughter how her father normally behaves.

Question 144

Which of the following would best define a behavioral emergency?

A. A patient that cannot be woken up
B. A patient that is having difficulty speaking
C. A patient unable to walk as he normally would
D. A patient exhibiting harmful behavior

Answer 144

D. A patient exhibiting harmful behavior

Question 145

A 50-year-old male has had an acute onset of altered mental status and erratic behavior. You find him with a stumbling gate and slurred speech. The patient’s wife states the patient has not been abusing alcohol and has had no recent injuries. The patient’s only past medical history is diabetes. You should first:

A. restrain this patient for safety.
B. initiate transport.
C. test this patient’s blood glucose.
D. complete a detailed physical examination.

Answer 145

C. test this patient’s blood glucose.

Question 146

A 19-year-old female is completely emotionally distressed after being involved in a relatively minor car crash. You find her sobbing and lashing out violently when spoken to. You note her face is flushed and her behavior displays agitation. You should:

A. tell the patient everything will be fine.
B. assert control by using a loud authoritarian voice.
C. be honest with your emotions and demonstrate that you are getting frustrated.
D. quietly let the patient know that you are listening to what she is saying.

Answer 146

D. quietly let the patient know that you are listening to what she is saying.

Question 147

A 49-year-old female is suffering with an acute onset of hallucinations and has begun interacting with her caregivers violently. Your assessment reveals no physical illnesses or injuries, and the patient’s only medical history is schizophrenia. Which of the following would best describe her current condition?

A. Acute psychosis
B. Acute stress reaction
C. An organic behavioral change
D. A catatonic state

Answer 147

A. Acute psychosis

Question 148

A 35-year-old male has been found shouting and pacing back and forth on his front porch. Neighbors called EMS after he broke a window. They state that the patient is normally a nice person and that this behavior is extremely unusual. You should:

A. engage him with a calm voice and assure him you are listening.
B. aggressively restrain the patient to prevent him from injuring himself.
C. stage outside his line of sight and await law enforcement assistance.
D. approach him professionally and provide a structured authoritarian response.

Answer 148

C. stage outside his line of sight and await law enforcement assistance.

Question 149

A 17-year-old female is experiencing delusions, and her parents are concerned she may want to harm herself. Upon approaching her, you note she is visibly upset and scared. You should:

A. not identify yourself as an EMT.
B. not make eye contact with her.
C. tell her how sorry you feel for her.
D. use positive body language as you draw near.

Answer 149

D. use positive body language as you draw near.

Question 150

A 17-year-old male has experienced an acute psychosis at school. Bystanders note that over about 15 minutes the patient began acting very strangely and started lashing out violently at other students. When staff members approach him, he reacts by punching and kicking. Law enforcement is present, but thus far no one has been able to get close enough to actually assess the patient. You should:

A. approach him with a calm and quiet voice.
B. use an open body position to attempt to calm him.
C. move into his personal space to show him your concern.
D. use law enforcement to restrain this patient.

Answer 150

D. use law enforcement to restrain this patient.

Question 151

What is part of a suicide​ plan?
A. Talking about not being able to go on
B. Giving away personal possessions
C. Saying that a current problem seems insurmountable
D. Expressing feelings of depression

Answer 151

B. Giving away personal possessions

Question 152

Which of the following techniques in caring for a patient with a stress reaction is LEAST helpful in managing the​ situation?
A. Displaying a​ genuine, empathetic approach to the​ patient’s concerns
B. Moving through your assessment quickly to ease the​ patient’s tension
C. Gaining the​ patient’s full attention by speaking to him or her in a calm voice
D. Having the patient take​ deep, slow breaths to help induce calm

Answer 152

B. Moving through your assessment quickly to ease the​ patient’s tension

Question 153

Most states have a provision in law that will allow a patient to be transported against his will if he is
A. obviously in need of care.
B. belligerent.
C. uncooperative.
D. a danger to himself or others.

Answer 153

D. a danger to himself or others.

Question 154

You have been called to the local jail for a patient who has made several superficial lacerations on the wrists. The patient has been disarmed but is still threatening to commit suicide. What should you​ do?
A. Make the lacerations on the​ patient’s wrists your primary concern.
B. Tell the patient that you are not trained in suicide counseling.
C. Try to convince the patient that suicide is not the answer.
D. Avoid visual or verbal contact with the patient.

Answer 154

A. Make the lacerations on the​ patient’s wrists your primary concern.

Question 155

Which of the following medical conditions is MOST likely to present as a psychiatric or emotional​ disorder?
A. Gastroenteritis
B. Stroke
C. Emphysema
D. Heart attack

Answer 155

B. Stroke

Question 156

You are at the home of a​ middle-aged male patient who is exhibiting unusual behavior and acting erratically. You and your partner are standing in the doorway of the​ patient’s bedroom while you talk with him. Which of the following observations is MOST likely to suggest imminent aggression from the​ patient?
A. The patient is sitting on the​ bed, holding his head in his hands while​ weeping, and he asks for help.
B. The patient is sitting on the​ bed, hands clenched into​ fists, and he is looking down toward the floor.
C. The patient makes eye contact with you when you speak to him.
D. The patient smiles at you and answers your questions.

Answer 156

B. The patient is sitting on the​ bed, hands clenched into​ fists, and he is looking down toward the floor.

Question 157

As a woman approaches menopause:

A. she usually experiences abdominal cramping without vaginal bleeding.
B. her menstrual periods may become irregular and vary in severity.
C. her risk of developing PID lowers significantly.
D. she cannot become pregnant because of fluctuating hormone levels.

Answer 157

B. her menstrual periods may become irregular and vary in severity.

Question 158

Each ovary produces an ovum in alternating months and releases it into the:

A. vagina.
B. cervix.
C. fallopian tube.
D. uterus.

Answer 158

C. fallopian tube.

Question 159

General treatment for a woman with vaginal bleeding and shock following sexual assault includes all of the following, EXCEPT:

A. refraining from placing any dressings into the vagina.
B. treating external lacerations with sterile compresses.
C. supplemental oxygen and keeping the patient supine.
D. carefully removing any foreign bodies from the vagina

Answer 159

D. carefully removing any foreign bodies from the vagina

Question 160

EMTs receive a call for a possible sexual assault. The patient is a young female who is conscious and alert and has no apparent injuries. She states, “I can’t remember anything, but I know I was raped.” The EMTs should suspect that:

A. an underlying head injury is causing her amnesia.
B. the patient knew her attacker, but is afraid to say.
C. the traumatic experience has created a mental block.
D. the patient was given a drug prior to the incident.

Answer 160

D. the patient was given a drug prior to the incident.

Question 161

In anticipation of receiving a fertilized ovum, the lining of the uterine wall:

A. becomes engorged with blood.
B. diverts blood flow to the vagina.
C. sheds and is expelled externally.
D. thins and begins to separate.

Answer 161

A. becomes engorged with blood.

Question 162

In contrast to bleeding caused by external trauma to the vagina, bleeding caused by conditions such as polyps or cancer:

A. may be relatively painless.
B. is typically not as severe.
C. often presents with acute pain.
D. can be controlled in the field.

Answer 162

A. may be relatively painless.

Question 163

Which of the following clinical presentations is MOST consistent with pelvic inflammatory disease (PID)?

A. Left lower quadrant pain, referred pain to the left shoulder, and fever
B. Upper abdominal cramping, severe headache, and heavy vaginal bleeding
C. Lower abdominal pain, fever, general malaise, and foul-smelling vaginal discharge
D. Pain around the umbilicus, low-grade fever, and generalized weakness

Answer 163

C. Lower abdominal pain, fever, general malaise, and foul-smelling vaginal discharge

Question 164

Which of the following statements regarding gonorrhea is correct?

A. Most men who are infected with gonorrhea do not experience symptoms.
B. Symptoms of gonorrhea usually appear within 3 months after being infected.
C. Painful urination is a common symptom of gonorrhea in men and women.
D. Mild infections with gonorrhea cause abdominal pain, vomiting, and fever.

Answer 164

C. Painful urination is a common symptom of gonorrhea in men and women.

Question 165

Law enforcement personnel request your assistance to assess a 31-year-old female who was sexually assaulted. When you arrive at the scene, you find the patient sitting on a curb outside her apartment. She is conscious, alert, and crying. When you ask her what happened, she tells you that she does not want to be treated or transported to the hospital. She further tells you that all she wants to do is clean up. You should:

A. provide emotional support and visually assess her for obvious trauma.
B. ask her if there is anyone you can contact, such as a friend or relative.
C. defer any physical assessment so that you do not destroy potential evidence.
D. advise her that she cannot clean herself up because this will destroy evidence.

Answer 165

A. provide emotional support and visually assess her for obvious trauma.

Question 166

It is common for young females who experience their first menstrual period to:

A. experience abdominal cramping, which may be misinterpreted.
B. have a false positive home pregnancy test result.
C. become so emotionally distraught that they contemplate suicide.
D. lose up to 500 mL of blood within the first 24 hours.

Answer 166

A. experience abdominal cramping, which may be misinterpreted.

Question 167

Potentially life-threatening consequences of pelvic inflammatory disease (PID) include:

A. bacterial vaginosis and chlamydia.
B. ovarian abscess and ectopic pregnancy.
C. ovarian cysts and gonorrhea.
D. uterine rupture with severe bleeding.

Answer 167

B. ovarian abscess and ectopic pregnancy.

Question 168

The onset of menstruation usually occurs in females who are:

A. between 18 and 23 years of age.
B. between 8 and 10 years of age.
C. between 25 and 28 years of age.
D. between 11 and 16 years of age.

Answer 168

D. between 11 and 16 years of age.

Question 169

When a female has reached menarche:

A. she is capable of becoming pregnant.
B. she can no longer produce an ovum.
C. menstrual periods become less frequent.
D. she usually requires hormone therapy.

Answer 169

A. she is capable of becoming pregnant.

Question 170

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. determine the underlying cause of her problem.
C. maintain her ABCs and transport without delay.
D. ask questions related to her gynecologic history.

Answer 170

C. maintain her ABCs and transport without delay.

Question 171

Which of the following conditions would MOST likely lead to pelvic inflammatory disease if left untreated?

A. Ectopic pregnancy
B. Ovarian cysts
C. Chlamydia
D. Genital herpes

Answer 171

C. Chlamydia

Question 172

Which of the following statements regarding pelvic inflammatory disease (PID) is correct?

A. The most common presenting symptom of PID is generalized upper abdominal pain.
B. PID can scar the fallopian tubes, which increases the risk of an ectopic pregnancy.
C. PID most commonly affects women who have had an ectopic pregnancy in the past.
D. The most severe cases of PID occur in women who are not sexually active.

Answer 172

B. PID can scar the fallopian tubes, which increases the risk of an ectopic pregnancy.

Question 173

Menstrual flow will typically last approximately _________.

A. 1 day
B. 3 days
C. 1 week
D. 1 month

Answer 173

C. 1 week

Question 174

If fertilization has not occurred in approximately 14 days postovulation:

A. the ovum will begin to travel to the uterus.
B. another egg will be released.
C. menstruation will begin.
D. All of these answers are correct.

Answer 174

C. menstruation will begin.

Question 175

Which of the following signs/symptoms is considered particularly significant in gynecological emergencies?

A. Syncope
B. Abdominal cramping
C. Painful urination
D. Vaginal bleeding

Answer 175

A. Syncope

Question 176

You are dispatched to a residence for a 40-year-old female who complains of lower abdominal pain, fever and chills, and a foul-smelling vaginal discharge. Which of the following additional assessment findings would increase your index of suspicion for pelvic inflammatory disease?

A. A shuffling gait when walking
B. Bright red blood in the urine
C. A history of ectopic pregnancy
D. Vaginal passage of blood clots

Answer 176

A. A shuffling gait when walking

Question 177

Which of the following drugs is commonly referred to as “roofies”?

A. Ketamine
B. GHB
C. MDMA
D. Rohypnol

Answer 177

D. Rohypnol

Question 178

Some women experience ___________ during ovulation.

A. hypotension
B. severe bleeding
C. severe abdominal pain
D. slight cramping

Answer 178

D. slight cramping

Question 179

Each ovary produces an ovum in alternating months and releases it into the:

A. fallopian tube
B. cervix
C. uterus
D. vagina

Answer 179

A. fallopian tube

Question 180

Left untreated, _____ can lead to premature birth or low birth weight in pregnant women.

A. chlamydia
B. gonorrhea
C. bacterial vaginosis
D. vaginal bleeding

Answer 180

C. bacterial vaginosis