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Paramedic > Final Exam 2350 > Flashcards

Final Exam 2350 Flashcards

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1
Q

Your patient is a 19-year-old female who is exhibiting generalized seizure activity. Her roommate states that she had a seizure that lasted about 3 minutes, remained unresponsive, and started having another seizure about 5 minutes after the first. The patient has peripheral cyanosis and copius oral secretions. Which of the following is of HIGHEST priority for this patient?

A. Suctioning the airway, applying 15 liters per minute of oxygen by nonrebreathing mask

B. Starting an IV and administering 5mg of diazepam

C. Starting an IV, administering succinylcholine , and intubation

D. Suctioning the airway, assisting ventilations with a bag-valve-mask device.

A

D.

Suctioning the airway, assisting ventilations with a bag-valve-mask device.

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2
Q

All of the following may cause a transient ischemic attack EXCEPT:

A. cerebrovascular spasm

B. a small embolus

C. hypotension

D. intracranial hemorrhage

A

D.

intracranial hemorrhage

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3
Q

An ECG monitor is useful for:

A. evaluation the effectiveness of cardiac contractions

B. evaluating the heart’s electrical conduction system for abnormalities

C. determining stroke volume

D. determining cardiac output

A

B.

evaluating the heart’s electrical conduction system for abnormalities

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4
Q

Your patient is experiencing substernal chest pain radiating to his jaw and left shoulder, rated an 8 on a scale of 1-10, He describes an acute onset of pain that started while he was mowing his lawn and that is unrelieved with rest. Which of the following would be LEAST likely to be present?

A. Anxiety

B. Bradycardia

C. Increased pain with palpation

D. Denial

A

C.

Increased pain with palpation

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5
Q

An increase in afterload results in a(n) _______ workload of the heart, especially in the ________ ventricle.

A. increased, left

B. decreased, right

C. decreased, left

D. increased, right

A

A.

increased, left

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6
Q

Late signs of cardiogenic shock include all of the following EXCEPT:

A. Anxiety

B. cardiac arrest

C. bradycardia and hypotension

D. loss of consciousness

A

A.

Anxiety

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7
Q

The amount of resistance that must be overcome by the left ventricle during systole is called ________.

A. Stroke volume

B. Preload

C. Cardiac output

D. Afterload

A

D.

Afterload

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8
Q

A 67-year-old male is unconscious, sitting in a chair, and has agonal respirations. His wife states that he was up all night with difficulty breathing and chest discomfort but would not go to the hospital. Physical examination reveals pink, frothy sputum in the airway; cold, diaphoretic skin; and rales audible without a stethoscope. HR=108, BP=74/P, RR=4, SaO2=82%. The monitor shows sinus tachycardia. Which of the following is the highest priority when treating this patient?

A. Nitroglycerin

B. Dopamine

C. Furosemide

D. Intubation

A

D.

Intubation

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9
Q

Diffusion is defined as:

A. circulation of blood through the pulmonary capillaries

B. movement of air from the outside environment into the lungs

C. active transport of molecules across a membrane from an area of greater concentration to an area of lower concentration

D. movement of molecules across a membrane from an area of greater concentration to an area of lower concentration

A

D.

movement of molecules across a membrane from an area of greater concentration to an area of lower concentration

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10
Q

A common site of arteriovenous malformation and aneurysm in the brain is the:

A. reticular activating system

B. Circle of Willis

C. Corpus callosum

D. limbic system

A

B.

Circle of Willis

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11
Q

Which of the following be suspected as a potential cause of syncope?

A. Cardiac dysrhythmia

B. Vagal stimulation

C. Hypovolemia

D. all of the above

A

D.

all of the above

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12
Q

The functional unit of the respiratory tree is the:

A. alveolus

B. pharynx

C. bronchiole

D. lamina propria

A

A.

alveolus

`

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13
Q

The mechanical process by which air is moved into and out of the lungs is called:

A. respiration

B. ventilation

C. perfusion

D. diffusion

A

B.

ventilation

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14
Q

An increase hydrogen ion concentration in the cerebrospinal fluid result in a(n) ________ respiratory rate.

A. Increased

B. Unchanged

C. Erratic

D. Decreased

A

A.

Increased

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15
Q

Your patient is a 30-year-old male who is alert and oriented. He does not appear to be in respiratory distress, but after lifting a heavy box he complains of acute onset of shortness of breath associated with sharp, right-sided chest pain. HR=100, BP=122/76, RR=16, SaO2=94%. Physical examination reveals cool, slightly pale, and diaphoretic skin, Which of the following is the MOST likely finding upon auscultation of the lungs?

A. Wheezing to all fields bilaterally

B. Rales in the bases bilaterally

C. Decreased lung sounds at the apex on the right side

D. Rhonchi and wheezing in the upper right lobe

A

C.

Decreased lung sounds at the apex on the right side

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16
Q

The most common cause of dementia in the elderly is:

A. Parkinson’s disease

B. Alzheimer’s disease

C. Multi-infarct dementia

D. Cerebrovascular disease

A

B.

Alzheimer’s disease

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17
Q

Increased _______ does NOT occur due to increased venus return to the heart.

A. afterload

B. myocardial stretch

C. stroke volume

D. myocardial contraction

A

A.

afterload

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18
Q

A junctional escape beat occurs when:

A. There is a conduction block between the SA node and AV node

B. There is an accessory pathway that causes re-entry of the impulse at the AV node

C. The rate of the SA node is slower than that of the AV node

D. The AV junction becomes irritable and temporarily overrides the SA node

A

C.

The rate of the SA node is slower than that of the AV node

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19
Q

To which of the following medications does the late phase of an asthma attack BEST respond?

A. Corticosteroids

B. Ipratporium

C. Albuterol

D. Epinephrine 1:1000

A

A.

Corticosteroids

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20
Q

At standard speed, a 1 mm box on ECG paper represents ______ seconds.

A. 0.04

B. 0.12

C. 0.08

D. 0.1

A

A.

0.04

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21
Q

There are three large boxes between R waves on an ECG tracing. What is the heart rate?

A. 100

B. 150

C. 75

D. 50

A

A.

100

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22
Q

The amount of air moved in and out of the lungs during a normal, quiet respiration is called:

A. dead space volume

B. inspiratory capacity

C. functional reserve capacity

D. tidal volume

A

D.

tidal volume

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23
Q

The total duration of ventricular depolarization is represented by the _____ interval.

A. PR

B. R to R

C. QT

D. QRS

A

C.

QT

24
Q

Stroke volume x heart rate x peripheral vascular resistance =

A. ejection fraction

B. end-diastolic pressure

c. cardiac output

D. blood pressure

A

D.

blood pressure

25
Q

All of the following are assessment finds consistent with angina EXCEPT:

A. Chest pain

b. Chest pain relieved with nitroglycerin S

C. ST segment elevation

D. Chest pain relieved with rest

A

C.

ST segment elevation

26
Q

The relative refractory period of the myocardium is represented by the ______________ .

A. Beginning of the QRS complex to the apex of the T wave

B. ST segment

C. isoelectric line

D. down slope of the T wave

A

D

down slope of the T wave

27
Q

A patient tells you that she experienced an episode of involuntary “shaking” in her arm. She describes a 1- to 2-minute-long episode of muscular jerking and contracting of her entire left arm. She retained consciousness, lacked an aura, and had no pain associated with the episode. This most indicates a(n) _________ seizure.

A. psychosomatic

B. simple partial

C. petit mal

D. absence

A

B.

simple partial

28
Q

The predominant effect of a drug with primarily alpha properties would result in which of the following?

A. Increased heart rate

B. Vasoconstriction

C. Decreased heart rate

D. Vasodilation

A

B.

Vasoconstriction

29
Q

A positive dromotropic agent will:

A. decrease the force of myocardial contractions

B. decrease the speed of impulse conduction through the myocardium

C. increase the force of myocardial contractions

D. increase the speed of impulse conduction through the myocardium

A

D.

increase the speed of impulse conduction through the myocardium

30
Q

Your patient is a 55-year-old male who is in moderate distress and complaining of chest pain. He states that he experienced an acute onset of left-sided crushing chest pain while playing basketball with his grandson. He complains of weakness and near-syncope with exertion. His skin is pale, cool, and diaphoretic. HR=40, BP=72/40, RR=20, SaO2=95%. The monitor shows a third-degree AV block. Which of the following is most appropriate?

A. Aspirin, nitroglycerin, and morphine

B. Sedation and transcutaneous pacing

C. Dopamine at 5 mcg/kg/min

D. Atropine, 0.5 mg, up to 2.0 mg

A

B.

Sedation and transcutaneous pacing

31
Q

Which of the following would result in an increased respiratory rate?

A. A decrease of cerebrospinal fluid PO2

B. An increase of cerebrospinal fluid pH

C. Stimulation of chemoreceptors by an increase of PCO2

D. Stimulation of baroreceptors by an increase of PCO2

A

C.

Stimulation of chemoreceptors by an increase of PCO2

32
Q

Which of the following is the most important determinant of ventilator rate?

A. Venous PO2

B. Venous PCO2

C. Arterial PO2

D. Arterial PCO2

A

D.

Arterial PCO2

33
Q

Which three cranial nerves are involved in the cardinal positions of gaze?

A. I, III, and VI

B. I, III, and IV

C. VI, VII, and X

D. III, IV, and VI

A

D.

III, IV, and VI

34
Q

The structure that occludes the trachea to prevent aspiration during swallowing is the:

A. carina

B. vallecula

C. uvula

D. epiglottis

A

D.

epiglottis

35
Q

Your patient is a 72-year-old male with a history of coronary artery disease and atrial fibrillation. He complains of a sudden onset of blindness in his right eye. He is noncompliant with both his digitalis and Coumadin. He is alert and oriented. HR=112, irregular; BP=154/94; RR=16. Which of the following is LEAST likely?

A. Embolic stroke

B. Hemorrhagic stroke

C. Retinal artery occlusion

D. Thrombotic stroke

A

B.

Hemorrhagic stroke

36
Q

A 72-year-old female has a 1-week history of 101-degree-fahrenheit fever, chills, and dark brown sputum production. She also has rhonchi and rales throughout her right lung. If this condition is left untreated, it could result in:

A. septic shock

B. pneumonia

C. chronic bronchitis

D. cardiogenic shock

A

A.

septic shock

37
Q

Parasympathetic innervation of the heart occurs via the ______.

A. cardioacclerator nerves

B. phrenic nerve

C. spinal accessory nerve

D. vagus nerve

A

D.

vagus nerve

38
Q

Which of the following is NOT a role of the upper respiratory system?

A. Humidify inspired air

B. Filter inspired air

C. Warm inspired air

D. Carry out gas exchange with inspired air

A

D.

Carry out gas exchange with inspired air

39
Q

Your patient is a 32-year-old female who is alert but in significant distress, complaining of a migraine. She has a history of migraines, describes a gradual onset of headache this morning, and is now experiencing nausea and intense throbbing pain behind her temples. She is lying on a couch in a dim room and keeps her eyes closed while talking to you in a low voice. HR=100, BP=148/100, RR=12, SaO2=99%. Which of the following is MOST appropriate in the prehospital management of this patient?

A. Lorazepam, 2mg

B. NTG SL to treat her hypertension

C. Morphine sulfate, IV in 2 mg increments, up to 10 mg

D. Provide a calm, quiet environment and transport

A

D.

Provide a calm, quiet environment and transport

40
Q

Which of the following describes the ability of a cardiac cell to propagate the electrical impulse to another cell?

A. contractility

B. Automaticity

C. Excitability

D. Conductivity

A

D.

Conductivity

41
Q

Which of the following is the most likely result of increased pulmonary artery pressure?

A. Increased left ventricular workloads and cor pulmonale

B. Increased left ventricular workloads and congestive heart failure

C. Increased right ventricular workloads and cor pulmonale

D. Decreased right atrial workload and right ventricular hypertrophy

A

C.

Increased right ventricular workloads and cor pulmonale

42
Q

Your patient is a 68-year-old male complaining of difficulty breathing for 2 days. He is sitting up, conscious, alert, and oriented and appears to be in mild respiratory distress. Physical examination reveals cool, dry, pink skin; he is thin with well-defined accessory muscles, and you note diffuse wheezing to all lung fields. HR=102, BP=136/96, RR=20, SaO2=92%. The patient gives a 20-pack-a-year history of smoking. Based on these clinical exam findings, which of the following is most likely?

A. Congestive heart failure

B. Chronic bronchitis

C. Emphysema

D. Asthma

A

C.

Emphysema

43
Q

You have intubated a 66-year-old female who was experiencing an acute exacerbation of her emphysema. What special consideration does this patient, with her specific pathology, require?

A. She requires frequent, deep suctioning

B. She requires hyperventilation to blow off excess CO2

C. Oxygen flow should be limited to 4 lpm because of the hypoxic drive common in COPD patients.

D. While ventilating, you must allow for a prolonged expiratory phase.

A

D.

While ventilating, you must allow for a prolonged expiratory phase.

44
Q

You are transporting a male patient to the hospital for an evaluation after a possible seizure when you notice the patient’s loss of consciousness. His muscles start to contract so that he is arching his back. This best describes the ______ phase of a generalized seizure.

A. tonic

B. postictal

C. clonic

D. hypertonic

A

D.

hypertonic

45
Q

All of the following are methods for clearing an obstructed airway EXCEPT:

A. jaw thrust

B. head-tilt, chin-lift

C. oropharyngeal airway

D. abdominal thrust

A

C.

oropharyngeal airway

46
Q

A hyperresponsive airway is likely to be in all of the following conditions EXCEPT:

A. Asthma

B. emphysema

C. adult respiratory distress syndrome

D. pulmonary embolism

A

D.

pulmonary embolism

47
Q

Your patient is a 55-year-old male cab driver who was found unresponsive in the driver’s seat of his vehicle, which has been parked in front of a hotel for about 45 minutes. The patient is unresponsive to painful stimulus; has snoring respirations at 12 per minute; is cool, pale and diaphoretic; and has a heart rate of 58 and a blood pressure of 170/104. Which of the following does NOT help when determining the underlying cause of the patient’s condition?

A. Blood glucose level determination

B. Pulse Oximetry

C. Scene survey

D. Checking the pupils

A

B.

Pulse Oximetry

48
Q

Your patient is a 16-year-old male who attempted suicide. He is unconscious and apneic, lying supine on a garage floor. The family states they found the patient unconscious in the front seat of a car that was running in an enclosed garage. HR=70, BP=100/60, RR=0. In addition to an IV of normal saline, which of the following is the most appropriate?

A. Remove the patient from the garage, initiate BVM ventilations with 100% oxygen, intubate, and transport to nearest facility

B. Remove the patient from the garage, intubate, and transport to the nearest hospital.

C. Remove the patient form the garage, initiate BVM ventilations with 100% oxygen, intubate, and transport to a hospital with a hyperbaric chamber.

D. Intubate, remove the patient from the garage, and transport to a hospital with a hyperbaric chamber.

A

C.

Remove the patient form the garage, initiate BVM
ventilations with 100% oxygen, intubate, and transport to a hospital with a hyperbaric chamber.

49
Q

Based on the following clinical information, which of the following patients is MOST likely experiencing a myocardial infarction?

A. A 19-year-old female presents complaining of shortness of breath and left-sided chest pain. She describes acute onset while at rest, pain described as sharp and nonradiating. Social history includes smoking; meds include PCP’s

B. A 42-year-old male presents with a 2-month history of a burning sensation extending from his epigastric region to his throat. He typically experiences the pain after eating. His skin is warm and dry.

C. A 68-year-old female with cool, pale, diaphoretic skin complains of substernal chest pressure radiating across her chest. She also complains of nausea, dizziC. Remove the patient form the garage, initiate BVM ventilations with 100% oxygen, intubate, and transport to a hospital with a hyperbaric chamber.
ness, and weakness.

D. A 24-year-old male with warm, diaphoretic skin complains of an acute onset of sharp, left-sided chest pain while playing soccer. He states that the pain is worse with deep inspiration.

A

C.

Remove the patient form the garage, initiate BVM
ventilations with 100% oxygen, intubate, and transport to a hospital with a hyperbaric chamber.

50
Q

All of the following ions play important roles in normal cardiac function EXCEPT:

A. CI-

B. K+

C. H+

D. Ca++

A

C.

H+

51
Q

Your patient is a 24-year-old female with a history of asthma, She is in severe respiratory distress. She states that she started having difficulty breathing 6 hours ago that initially responded to her albuterol and Atrovent metered dose inhalers (MDI). However, her breathing has worsened over the past 4 hours and is not responsive to her MDIs. she can speak in 4- to 5- word sentences. Her skin is pale and diaphoretic, and she is using accessory muscles, has expiatory wheezing in all lung fields, and diminished air movement in the bases. HR=142, BP=132/78, RR=30, SaO2=88%. In addition to 100% oxygen and an IV of normal saline, which of the following is the best course of prehospital treatment?

A. Endotracheal intubation, albuterol and ipratropium via nebulizer

B. Albuterol and ipratropium via nebulizer

C. Albuterol via nebulizer, IV corticosteroids

D. Albuterol and ipratropium via nebulizer, IV corticosteroids

A

D.

Albuterol and ipratropium via nebulizer, IV corticosteroids

52
Q

A patient’s ECG shows a rhythm at a rate of 40, regular RR intervals, a varying PR interval, and a QRS of 0.28 seconds. This best fits the criteria for:

A. second-degree type II AV block

B. third-degree AV block

C. sinus bradycardia with PVCs

D. first-degree AV block

A

B.

third-degree AV block

53
Q

Your patient is a 54-year-old male who is unresponsive and cyanotic and has agonal respirations. A “quick look” shows ventricular tachycardia. Which of the following is most important when determining the immediate treatment of this patient?

A. Whether he has an implanted cardioverter-defibrillator

B. How long he has been “down”

C. Whether he is allergic to Lidocaine

D. Whether he has a pulse

A

D.

Whether he has a pulse

54
Q

During a domestic disturbance, your patient experienced a sudden onset of violent, bizarre movements of the extremities followed by unresponsiveness to verbal stimuli. On your arrival, the bizarre movements begin again but stop suddenly when you firmly say, “Stop!” This most indicates _____ seizure.

A. absence

B. simple partial

C. complex partial

D. pseudo

A

D.

pseudo

55
Q

Your patient is a 62-year-old female who is alert and oriented, sitting at her kitchen table. Her husband describes an episode of slurred speech and facial drooping that lasted about 10 minutes and resolved just before your arrival. Physical examination is unremarkable. she has no significant medical history and takes no medications. HR=78, BP=134/78, RR=12, SaO2=99%. Which of the following is most likely?

A. Absence seizure

B. Meniere’s disease

C. Transient ischemic attack

D. Stroke

A

C.

Transient ischemic attac

56
Q

A patient’s ECG shows a rhythm at a rate of 42, regular RR intervals, a PR interval of 0.16 seconds, a QRS of 0.12 seconds. This best fits the criteria for:

A. sinus bradycardia

B. atrial flutter

C. sinus dysrhythmia

D. atrial fibrillation

A

A.

sinus bradycardia

57
Q

A patient’s ECG shows a rhythm at a rate of 64, regular RR intervals, a PR interval of 0.24 seconds, and a QRS of 0.12 seconds. This best fits the criteria for:

A. third-degree AV block

B. second-degree type I AV block

C. second-degree type II AV block

D. first-degree AV block

A

D.

first-degree AV block

Paramedic (19 decks)

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