Medical

Question 1

In contrast to the assessment of a trauma patient, assessment of a medical patient:

Answer 1

is focused on the nature of illness, the patient’s chief complaint, and his or her symptoms.

Question 2

Which of the following conditions is NOT categorized as a psychiatric condition?

Answer 2

Substance abuse

Question 3

The greatest danger in displaying a personal bias or “labeling” a patient who frequently calls EMS is:

Answer 3

overlooking a potentially serious medical condition.

Question 4

An index of suspicion is MOST accurately defined as:

Answer 4

your awareness and concern for potentially serious underlying and unseen injuries or illness.

Question 5

You and your EMT partner arrive at the residence of a 50-year-old man who complains of weakness. Your primary assessment reveals that he is critically ill and will require aggressive treatment. The closest hospital is 25 miles away. You should:

Answer 5

manage all threats to airway, breathing, and circulation and consider requesting an ALS unit.

Question 6

When forming your general impression of a patient with a medical complaint, it is important to remember that:

Answer 6

the conditions of many medical patients may not appear serious at first.

Question 7

Upon initial contact with a patient who appears to be unconscious, you should:

Answer 7

attempt to elicit a verbal response by talking to the patient.

Question 8

Your primary assessment of an elderly woman reveals that she is conscious and alert, but is experiencing difficulty breathing. She has a history of emphysema, hypertension, and congestive heart failure. As you assess the patient’s circulatory status, you should direct your partner to:

Answer 8

administer oxygen with the appropriate device.

Question 9

In addition to looking for severe bleeding, assessment of circulation in the conscious patient should involve:

Answer 9

checking the radial pulse and noting the color, temperature, and condition of the skin.

Question 10

When assessing a patient with a medical complaint, which of the following would MOST likely reveal the cause of the problem?

Answer 10

Medical history

Question 11

Which of the following will MOST reliably allow you to determine the nature of a patient’s illness?

Answer 11

Asking questions related to the chief complaint

Question 12

A 58-year-old man complains of chest discomfort and nausea. He is conscious and alert; his blood pressure is 140/90 mm Hg, his pulse is 104 beats/min, and his respirations are 16 breaths/min. Your partner has applied supplemental oxygen. Prior to assisting the patient with one of his prescribed nitroglycerin tablets, you ask him if he takes medication to treat erectile dysfunction (ED), and he tells you that he does. You should:

Answer 12

ask him what he takes, how much, and when he last took it.

Question 13

When caring for a patient who takes numerous medications, it is best to:

Answer 13

take all of the patient’s medications with you to the hospital and document them on your patient care report.

Question 14

The secondary assessment of a medical patient:

Answer 14

is not practical if the patient is critically ill or your transport time is short.

Question 15

You have just completed your primary assessment of a 48-year-old man with crushing chest pain and difficulty breathing. The patient has been given 324 mg of aspirin and is receiving supplemental oxygen. As you begin your secondary assessment, you note that his mental status has deteriorated and he is now bradycardic. You should:

Answer 15

prepare the patient for immediate transport

Question 16

When performing a secondary assessment on a conscious patient with nontraumatic abdominal pain and stable vital signs, you should:

Answer 16

focus on his or her chief complaint.

Question 17

It is especially important to assess pulse, sensation, and movement in all extremities as well as pupillary reactions in patients with a suspected ___________ problem.

Answer 17

neurologic

Question 18

Which of the following assessment findings is MOST indicative of a cardiovascular problem?

Answer 18

Jugular venous distention

Question 19

Assessment of a patient’s blood pressure with an automatic BP cuff reveals that it is 204/120 mm Hg. The patient is conscious and alert and denies any symptoms. The EMT should:

Answer 19

obtain a manual blood pressure.

Question 20

A sign of respiratory distress seen in the neck is:

Answer 20

accessory muscle use.

Question 21

Reassessment of a patient with a medical complaint should begin by:

Answer 21

repeating the primary assessment.

Question 22

The primary prehospital treatment for most medical emergencies:

Answer 22

addresses the patient’s symptoms more than the actual disease process.

Question 23

Which of the following medications would the EMT be LEAST likely to administer to a patient with a medical complaint?

Answer 23

Ibuprofen

Question 24

When caring for a patient with an altered mental status and signs of circulatory compromise, you should:

Answer 24

limit your time at the scene to 10 minutes or less, if possible.

Question 25

The determination of whether a medical patient is a high-priority or low-priority transport is typically made:

Answer 25

after the primary assessment has been completed.

Question 26

In which of the following situations would it be MOST appropriate to utilize an air medical transportation service?

Answer 26

61-year-old man with signs and symptoms of a stroke and your ground transport time is 50 minutes

Question 27

Which of the following conditions often requires transport to a hospital with specialized capabilities that may not be available at the closest hospital?

Answer 27

Stroke and heart attack

Question 28

After sizing up the scene of a patient with a possible infectious disease, your next priority should be to:

Answer 28

take standard precautions.

Question 29

Typical chief complaints in patients with an infectious disease include:

Answer 29

fever, rash, nausea, and difficulty breathing.

Question 30

In addition to obtaining a SAMPLE history and asking questions related to the chief complaint, what else should you specifically inquire about when assessing a patient with a potentially infectious disease?

Answer 30

Recent travel

Question 31

An infectious disease is MOST accurately defined as:

Answer 31

a medical condition caused by the growth and spread of small, harmful organisms within the body.

Question 32

Which of the following statements regarding the human immunodeficiency virus (HIV) is correct?
Correct!

Answer 32

The risk of HIV infection is greatest when deposited on a mucous membrane or directly into the bloodstream.

Question 33

Which of the following patients is at greatest risk for complications caused by the influenza virus?

Answer 33

68-year-old woman with type 2 diabetes

Question 34

Early signs and symptoms of viral hepatitis include all of the following, EXCEPT:

Answer 34

jaundice and abdominal pain.

Question 35

Which of the following statements regarding hepatitis A is correct?

Answer 35

Hepatitis A can only be transmitted by a patient who has an acute infection.

Question 36

Hepatitis B is more virulent than hepatitis C, which means that it:

Answer 36

has a greater ability to produce disease.

Question 37

A patient who presents with a headache, fever, confusion, and red blotches on his or her skin should be suspected of having:

Answer 37

meningitis

Question 38

Patients with tuberculosis pose the greatest risk for transmitting the disease when they:

Answer 38

cough

Question 39

In contrast to viral hepatitis, toxin-induced hepatitis:

Answer 39

is not a communicable disease.

Question 40

Ten days after treating a 34-year-old patient with tuberculosis, you are given a tuberculin skin test, which yields a positive result. This MOST likely indicates that:

Answer 40

you were exposed to another infected person prior to treating the 34-year-old patient.

Question 41

Which of the following statements regarding methicillin-resistant Staphylococcus aureus (MRSA) is correct?

Answer 41

MRSA is a bacterium that causes infections and is resistant to most antibiotics.

Question 42

Factors that increase the risk for developing methicillin-resistant Staphylococcus aureus (MRSA) include:

Answer 42

prolonged hospitalization, especially in an intensive care unit.

Question 43

Your patient’s symptoms include high fever, cough, vomiting, bloody diarrhea, and shortness of breath. Which of the following should you suspect?

Answer 43

MERS-CoV

Question 44

Three months after returning home from West Africa, a 50-year-old man begins experiencing a fever, cough, and muscle aches. The EMT should suspect:

Answer 44

influenza

Question 45

Which of the following questions would be the MOST pertinent to ask a patient who recently returned from Europe and is now ill?

Answer 45

Is anyone else in your travel party sick?

Question 46

The BEST way to prevent infection from whooping cough is to:

Answer 46

get vaccinated against diphtheria, tetanus, and pertussis.

Question 47

The three major parts of the brain are the:

Answer 47

cerebrum, cerebellum, and brain stem.

Question 48

The most basic functions of the body, such as breathing, blood pressure, and swallowing, are controlled by the:

Answer 48

Brain stem

Question 49

Muscle control and body coordination are controlled by the:

Answer 49

cerebellum

Question 50

The left cerebral hemisphere controls:

Answer 50

the right side of the body.

Question 51

The frontal lobe of the brain controls:

Answer 51

emotion

Question 52

The spinal cord exits the cranium through the:

Answer 52

foramen magnum.

Question 53

Which of the following conditions would MOST likely affect the entire brain?

Answer 53

Respiratory failure or cardiopulmonary arrest

Question 54

Interruption of cerebral blood flow may result from all of the following, EXCEPT:

Answer 54

cerebral vasodilation.

Question 55

Which of the following MOST accurately describes the cause of an ischemic stroke?

Answer 55

Blockage of a cerebral artery

Question 56

You are assessing a 49-year-old man who, according to his wife, experienced a sudden, severe headache and then passed out. He is unresponsive and has slow, irregular breathing. His blood pressure is 190/94 mm Hg, and his pulse rate is 50 beats/min. His wife tells you that he has hypertension and diabetes. He has MOST likely experienced:

Answer 56

a ruptured cerebral artery.

Question 57

The MOST significant risk factor for a hemorrhagic stroke is:

Answer 57

hypertension.

Question 58

An area of swelling or enlargement in a weakened arterial wall is called:

Answer 58

an aneurysm

Question 59

Which of the following clinical signs is MOST suggestive of a ruptured aneurysm?

Answer 59

Sudden, severe headache

Question 60

A transient ischemic attack (TIA) occurs when:

Answer 60

a small clot in a cerebral artery causes temporary symptoms.

Question 61

A patient who is experiencing aphasia is:

Answer 61

unable to produce or understand speech.

Question 62

A patient whose speech is slurred and difficult to understand is experiencing:

Answer 62

dysarthria

Question 63

Which of the following conditions would be the LEAST likely to mimic the signs and symptoms of a stroke?

Answer 63

Hypovolemia

Question 64

Which of the following findings should concern the EMT the MOST when assessing a patient who complains of a headache?

Answer 64

Neck stiffness or pain

Question 65

Which of the following symptoms would lead the EMT to believe that a patient’s headache is caused by sinus congestion?

Answer 65

The pain is worse when bending over.

Question 66

A generalized (tonic-clonic) seizure is characterized by:

Answer 66

severe twitching of all the body’s muscles.

Question 67

Which of the following is characteristic of a focal-onset aware seizure?

Answer 67

Normal level of consciousness

Question 68

Which of the following MOST accurately describes a focal-onset aware seizure?

Answer 68

A seizure that begins in one extremity

Question 69

The mental status of a patient who has experienced a generalized seizure:

Answer 69

Correct!
is likely to improve over a period of 5 to 30 minutes.

Question 70

Which of the following MOST accurately describes what the patient will experience during the postictal state that follows a seizure?

Answer 70

Confusion and fatigue

Question 71

Status epilepticus is characterized by:

Answer 71

prolonged seizures without a return of consciousness.

Question 72

Which of the following conditions is NOT a common cause of seizures?

Answer 72

Hypotension

Question 73

Which of the following is a metabolic cause of a seizure?

Answer 73

Poisoning

Question 74

Which of the following medications would indicate that a patient has a history of seizures?

Answer 74

Levetiracetam (Keppra)

Question 75

Febrile seizures:

Answer 75

are usually benign but should be evaluated.

Question 76

You respond to a residence for a child who is having a seizure. Upon arrival at the scene, you enter the residence and find the mother holding her child, a 2-year-old male. The child is conscious and crying. According to the mother, the child had been running a high fever and then experienced a seizure that lasted approximately 3 minutes. You should:

Answer 76

transport the child to the hospital and reassure the mother en route.

Question 77

You arrive at a grocery store shortly after a 35-year-old male stopped seizing. Your assessment reveals that he is confused and incontinent of urine. The patient’s girlfriend tells you that he has a history of seizures and takes topiramate (Topamax). When obtaining further medical history from the girlfriend, it is MOST important to:

Answer 77

obtain a description of how the seizure developed.

Question 78

A patient with an altered mental status is:

Answer 78

not thinking clearly or is incapable of being aroused.

Question 79

The principal clinical difference between a stroke and hypoglycemia is that patients with hypoglycemia:

Answer 79

usually have an altered mental status or decreased level of consciousness.

Question 80

When caring for a patient with documented hypoglycemia, you should be MOST alert for:

Answer 80

a seizure

Question 81

You arrive at a local grocery store approximately 5 minutes after a 21-year-old female stopped seizing. She is confused and disoriented; she keeps asking you what happened and tells you that she is thirsty. Her brother, who witnessed the seizure, tells you that she takes valproate (Depakote) for her seizures, but has not taken it in a few days. He also tells you that she has diabetes. In addition to administering oxygen, you should:

Answer 81

monitor her airway and breathing status and assess her blood glucose level.

Question 82

Individuals with chronic alcoholism are predisposed to intracranial bleeding and hypoglycemia secondary to abnormalities in the:

Answer 82

liver

Question 83

Which of the following patients would MOST likely demonstrate typical signs of infection, such as a fever?

Answer 83

A 17-year-old male with anxiety

Question 84

During the primary assessment of a semiconscious 70-year-old female, you should:

Answer 84

ensure a patent airway and support ventilation as needed.

Question 85

You are dispatched to a residence for a 66-year-old male who, according to family members, has suffered a massive stroke. Your primary assessment reveals that the patient is unresponsive, apneic, and pulseless. You should:

Answer 85

initiate CPR and attach an AED as soon as possible.

Question 86

You are caring for a 68-year-old man with sudden onset of left-sided paralysis and slurred speech. His airway is patent, his respirations are 14 breaths/min with adequate depth, and his oxygen saturation is 98%. Treatment for this patient should include:

Answer 86

recovery position and transport.

Question 87

Law enforcement has summoned you to a nightclub, where a 22-year-old female was found unconscious in an adjacent alley. Your primary assessment reveals that her respirations are rapid and shallow and her pulse is rapid and weak. She is wearing a medical alert bracelet that identifies her as an epileptic. There is an empty bottle of vodka next to the patient. You should:

Answer 87

assist ventilations, perform a rapid exam, and prepare for immediate transport.

Question 88

You are caring for a 70-year-old female with signs and symptoms of an acute stroke. She is conscious, has secretions in her mouth, is breathing at a normal rate with adequate depth, and has an oxygen saturation of 96%. You should:

Answer 88

suction her oropharynx and transport immediately.

Question 89

You arrive at the residence of a 33-year-old woman who is experiencing a generalized (tonic-clonic) seizure. She has a small amount of vomitus draining from the side of her mouth. After protecting her from further injury, you should:

Answer 89

maintain her airway with manual head positioning, suction her airway to remove the vomitus, insert a nasopharyngeal airway, and administer high-flow oxygen.

Question 90

When you are obtaining medical history from the family of a suspected stroke patient, it is MOST important to determine:

Answer 90

when the patient last appeared normal.

Question 91

A 58-year-old male presents with confusion, right-sided weakness, and slurred speech. His airway is patent, and his breathing is adequate. His wife is present and is very upset. Which of the following has the MOST immediately priority?

Answer 91

Asking his wife when she noticed the symptoms

Question 92

A 40-year-old patient without a history of seizures experiences a generalized (tonic-clonic) seizure. The LEAST likely cause of this seizure is:

Answer 92

epilepsy

Question 93

Components of the Cincinnati Prehospital Stroke Scale include:

Answer 93

arm drift, speech, and facial droop.

Question 94

When assessing for arm drift of a patient with a suspected stroke, you should:

Answer 94

ask the patient to close his or her eyes during the assessment.

Question 95

You are assessing the arm drift component of the Cincinnati Prehospital Stroke Scale on a 60-year-old woman. When she holds both of her arms out in front of her and closes her eyes, both of her arms immediately fall to her sides. You should:

Answer 95

repeat the arm drift test, but move the patient’s arms into position yourself.

Question 96

Your patient opens his eyes, moans, and pulls away from you when you pinch his trapezius muscle. You should assign a Glasgow Coma Scale (GCS) score of:

Answer 96

8

Question 97

Your patient answers your questions appropriately, although her eyes remain closed the entire time. She moves each extremity on command, although her left side is weaker than the right. You should assign a Glasgow Coma Scale (GCS) score of:

Answer 97

12

Question 98

A 29-year-old male complains of a severe headache and nausea that has gradually worsened over the past 12 hours. He is conscious, alert, and oriented and tells you that his physician diagnosed him with migraine headaches. He further tells you that he has taken numerous different medications, but none of them seems to help. His blood pressure is 132/74 mm Hg, his pulse is 110 beats/min and strong, and his respirations are 20 breaths/min. Treatment should include:

Answer 98

dimming the lights in the back of the ambulance and transporting without lights and siren.

Question 99

When transporting a stable stroke patient with a paralyzed extremity, place the patient in a:

Answer 99

recumbent position with the paralyzed side down.

Question 100

A patient who is possibly experiencing a stroke is NOT eligible for thrombolytic (fibrinolytic) therapy if he or she:

Answer 100

has bleeding within the brain.

Question 101

Successful treatment of a stroke depends on whether:

Answer 101

thrombolytic therapy is given within 3 hours of symptoms beginning.

Question 102

A 30-year-old male experienced a generalized (tonic-clonic) seizure, which stopped before you arrived at the scene. The patient is conscious, is answering your questions appropriately, and refuses EMS transport. Which of the following would be the MOST compelling reason to disagree with his refusal of transport?

Answer 102

He is currently not prescribed any medications.

Question 103

Solid abdominal organs include the:

Answer 103

spleen, kidneys, and pancreas.

Question 104

Which of the following organs would MOST likely bleed profusely if injured?

Answer 104

Liver

Question 105

Which of the following organs lies in the retroperitoneal space?

Answer 105

Pancreas

Question 106

Injury to a hollow abdominal organ would MOST likely result in:

Answer 106

leakage of contents into the abdominal cavity.

Question 107

Functions of the liver include:

Answer 107

secretion of bile and filtration of toxic substances.

Question 108

Which of the following organs assists in the filtration of blood, serves as a blood reservoir, and produces antibodies?

Answer 108

Spleen

Question 109

The kidneys help to regulate blood pressure by:

Answer 109

removing sodium and water from the body.

Question 110

The parietal peritoneum lines the:

Answer 110

walls of the abdominal cavity.

Question 111

The MOST common and significant complication associated with an acute abdomen is:

Answer 111

peritonitis

Question 112

In the presence of ileus, the only way the stomach can empty itself is by:

Answer 112

vomiting

Question 113

Peritonitis may result in shock because:

Answer 113

fluid shifts from the bloodstream into body tissues.

Question 114

In contrast to the parietal peritoneum, the visceral peritoneum:

Answer 114

is supplied by nerves of the autonomic nervous system, which are less able to localize pain or sensation.

Question 115

Pain that may be perceived at a distant point on the surface of the body, such as the back or shoulder, is called:

Answer 115

referred pain.

Question 116

A 35-year-old obese woman is complaining of localized pain in the right upper quadrant with referred pain to the right shoulder. The MOST likely cause of her pain is:

Answer 116

acute cholecystitis.

Question 117

A young female presents with costovertebral angle tenderness. She is conscious and alert with stable vital signs. Which of the following organs is MOST likely causing her pain?

Answer 117

Kidney

Question 118

Pain that is localized to the lower back and/or lower abdominal quadrants is MOST suggestive of:

Answer 118

an aortic aneurysm.

Question 119

Which of the following statements regarding the acute abdomen is correct?

Answer 119

The initial pain associated with an acute abdomen tends to be vague and poorly localized.

Question 120

Erosion of the protective layer of the stomach or duodenum secondary to overactivity of digestive juices results in:

Answer 120

an ulcer

Question 121

Which of the following is characteristic of peptic ulcer disease (PUD)?

Answer 121

Burning or gnawing stomach pain that subsides immediately after eating

Question 122

Pain that radiates to the right lower quadrant from the umbilical area, nausea and vomiting, and lack of appetite are MOST indicative of:

Answer 122

appendicitis

Question 123

Which of the following statements regarding gastrointestinal bleeding is correct?

Answer 123

Bleeding within the gastrointestinal tract is a symptom of another disease, not a disease itself.

Question 124

Esophageal varices MOST commonly occur in patients who:

Answer 124

consume a lot of alcohol.

Question 125

A 29-year-old pregnant woman has had severe vomiting for the last 2 days. Today, she is vomiting large amounts of blood. Her skin is cool and pale, and she is tachycardic. The EMT should suspect:

Answer 125

Mallory-Weiss tear.

Question 126

The principal symptom in both infectious and noninfectious gastroenteritis is:

Answer 126

diarrhea.

Question 127

Which of the following conditions is more common in women than in men?

Answer 127

Cystitis

Question 128

Chronic renal failure is a condition that:

Answer 128

is often caused by hypertension or diabetes.

Question 129

Your patient’s past medical history includes hypertension, congestive heart failure, diabetes, and seizures. Today, he presents with signs of acute renal failure. Which of his medical problems MOST likely caused this?

Answer 129

Heart failure

Question 130

A strangulated hernia is one that:

Answer 130

loses its blood supply due to compression by local tissues.

Question 131

You are dispatched to an apartment complex for a young male with abdominal pain. Your priority upon arriving at the scene should be to:

Answer 131

assess the scene for potential hazards.

Question 132

Most patients with abdominal pain prefer to:

Answer 132

lie on their side with their knees drawn into the abdomen.

Question 133

A 60-year-old female presents with a tearing sensation in her lower back. Her skin is sweaty, and she is tachycardic. The EMT should suspect:

Answer 133

aortic aneurysm.

Question 134

A 30-year-old woman with a history of alcoholism presents with severe upper abdominal pain and is vomiting large amounts of bright red blood. Her skin is cool, pale, and clammy; her heart rate is 120 beats/min and weak; and her blood pressure is 70/50 mm Hg. Your MOST immediate action should be to:

Answer 134

protect her airway from aspiration.

Question 135

Patients with acute abdominal pain should not be given anything to eat or drink because:

Answer 135

substances in the stomach increase the risk of aspiration.

Question 136

When assessing a patient with abdominal pain, you should:

Answer 136

palpate the abdomen in a clockwise direction, beginning with the quadrant after the one the patient indicates is painful.

Question 137

Older patients with abdominal problems may not exhibit the same pain response as younger patients because of:

Answer 137

age-related deterioration of their sensory systems.

Question 138

An important aspect in the treatment of a patient with severe abdominal pain is to:

Answer 138

provide emotional support en route to the hospital.

Question 139

A 47-year-old male presents with severe abdominal pain of 3 hours’ duration. His abdomen is distended and guarded. Your MOST important consideration for this patient should be to:

Answer 139

be alert for signs and symptoms of shock.

Question 140

The MOST important treatment for a patient with severe abdominal pain and signs of shock is:

Answer 140

transporting the patient without delay.

Question 141

A 59-year-old male presents with sudden-onset severe lower back pain. He is conscious and alert, but very restless and diaphoretic. Your assessment reveals a pulsating mass to the left of his umbilicus. You should:

Answer 141

administer oxygen and prepare for immediate transport.

Question 142

You are transporting a 49-year-old male with “tearing” abdominal pain. You are approximately 30 miles away from the closest hospital. During your reassessment, you determine that the patient’s condition has deteriorated significantly. You should:

Answer 142

consider requesting a rendezvous with an ALS unit.

Question 143

Which of the following statements regarding dialysis is correct?

Answer 143

Patients who miss a dialysis treatment often present with weakness.

Question 144

You respond to the residence of a 70-year-old male who complains of weakness and severe shortness of breath. His wife tells you that he is a dialysis patient, but has missed his last two treatments. After applying oxygen, you auscultate his lungs and hear diffuse rhonchi. The patient is conscious, but appears confused. His blood pressure is 98/54 mm Hg, his pulse rate is 120 beats/min and irregular, and his respirations are 24 breaths/min and labored. You should:

Answer 144

leave him in a sitting position, keep him warm, and prepare for immediate transport.

Question 145

A dysbarism injury refers to the signs and symptoms related to changes in:

Answer 145

barometric pressure.

Question 146

When a warm hand is immersed in water that is 70°F (21°C), heat is transferred from the hand to the water through a process called:

Answer 146

conduction

Question 147

The transfer of heat to circulating air, such as when cool air moves across the body’s surface, is called:

Answer 147

convection.

Question 148

The body’s natural cooling mechanism, in which sweat is converted to a gas, is called:

Answer 148

evaporation

Question 149

Heat loss from the body through respiration occurs when:

Answer 149

warm air is exhaled into the atmosphere.

Question 150

Shivering is a mechanism in which the body generates heat by:

Answer 150

increasing the metabolic rate

Question 151

Covering a patient’s _________ will significantly minimize radiation heat loss.

Answer 151

head

Question 152

Hypothermia occurs when the core body temperature falls below:

Answer 152

95°F (35°C).

Question 153

The body’s natural protective mechanisms against heat loss are:

Answer 153

constriction of blood vessels in the skin and shivering

Question 154

Compared to adults, infants and children are at higher risk for hypothermia for all of the following reasons, except:

Answer 154

a relatively small surface area.

Question 155

Which of the following conditions would be the least likely to increase a person’s risk of hypothermia?

Answer 155

Hyperglycemia

Question 156

To assess a patient’s general body temperature, pull back on your glove and place the back of your hand on his or her skin at the:

Answer 156

abdomen

Question 157

To obtain the most accurate reading of a patient’s core body temperature, you should place a special hypothermia thermomet

Answer 157

into the patient’s rectum.

Question 158

A patient with a core body temperature of 95°F (35°C) will most likely experience:

Answer 158

rapid breathing.

Question 159

Which of the following would be the least likely to occur in a patient with a core body temperature of between 89°F (32°C) and 92°F (33°C)?

Answer 159

Muscle activity increases

Question 160

A person’s ability to shiver is lost when his or her body temperature falls below:

Answer 160

90°F (32°C).

Question 161

All of the following terms refer to a body part that is cold but not frozen, except:

Answer 161

frostbite

Question 162

Patients with generalized hypothermia are at an increased risk of a local cold injury because:

Answer 162

Correct!
blood is shunted away from the extremities to the body’s core.

Question 163

A frostbitten foot can be identified by the presence of:

Answer 163

mottling and blisters

Question 164

A 30-year-old male was rescued after being lost in the woods for approximately 18 hours. The outside temperature is 30°F (-1°C). He is immediately placed in the warmed ambulance, where you perform a primary assessment. He is unresponsive, pale, and apneic. You should:

Answer 164

assess for a carotid pulse for up to 60 seconds.

Question 165

Hypothermia can worsen internal bleeding secondary to:

Answer 165

blood-clotting abnormalities.

Question 166

Rough handling of a hypothermic patient with a pulse might cause:

Answer 166

ventricular fibrillation.

Question 167

Your assessment of a 23-year-old female reveals a core body temperature of 93.4°F (34°C). She is conscious, answers your questions appropriately, is shivering, and complains of nausea. Her skin is cold and pale, her muscles appear rigid, and her respirations are rapid. You should:

Answer 167

place heat packs to her groin, axillae, and behind her neck; cover her with warm blankets; and avoid rough handling.

Question 168

You are transporting a 28-year-old man with a frostbitten foot. The patient’s vital signs are stable, and he denies any other injuries or symptoms. The weather is treacherous, and your transport time to the hospital is approximately 45 minutes. During transport, you should:

Answer 168

protect the affected part from further injury

Question 169

The two most efficient ways for the body to eliminate excess heat are:

Answer 169

sweating and vasodilation.

Question 170

Which of the following most accurately describes hyperthermia?

Answer 170

The body is exposed to more heat than it can lose

Question 171

High air temperature reduces the body’s ability to lose heat by:

Answer 171

radiation

Question 172

Geriatric patients, newborns, and infants are especially prone to hyperthermia because they:

Answer 172

exhibit poor thermoregulation

Question 173

When the body loses sweat, it also loses:

Answer 173

electrolytes.

Question 174

For sweating to be an effective cooling mechanism

Answer 174

it must evaporate from the body.

Question 175

High humidity reduces the body’s ability to lose heat through:

Answer 175

evaporation

Question 176

Common signs and symptoms of heat exhaustion include all of the following, except:

Answer 176

hot, dry skin.

Question 177

Heatstroke occurs when:

Answer 177

‘the body’s heat-eliminating mechanisms are overwhelmed

Question 178

Signs of late heatstroke include:

Answer 178

a weak, rapid pulse.

Question 179

Which of the following medications increases a person’s risk of a heat-related emergency?

Answer 179

Diuretics

Question 180

You receive a call to a residence for a sick patient. Upon your arrival, you find the patient, a 53-year-old diabetic male, lying down on his front porch. His wife tells you that he was mowing the lawn in the heat for the past three hours. The patient is confused and has hot, moist skin. His pulse is weak and thready, and his blood pressure is 90/50 mm Hg. You should:

Answer 180

load him into the ambulance and begin rapid cooling interventions.

Question 181

You are dispatched to a local high school track and field event for a 16-year-old male who fainted. The outside temperature is approximately 95°F (35°C) with high humidity. Upon your arrival, the patient is conscious, alert, and complains of nausea and a headache. His skin is cool, clammy, and pale. You should:

Answer 181

move him into the cooled ambulance.

Question 182

You are assessing a man with suspected hypothermia. The patient is conscious, alert, and actively shivering. His respiratory rate is increased, but his breathing is unlabored, and the pulse oximeter reads 72%. The pulse oximetry reading is most likely

Answer 182

secondary to decreased perfusion in the extremities

Question 183

Drowning is most accurately defined as:

Answer 183

death from suffocation after submersion in water.

Question 184

Which of the following statements regarding drowning is correct?

Answer 184

Patients with a submersion injury might deteriorate rapidly because of pulmonary injury and cerebral hypoxia.

Question 185

A 20-year-old male was pulled from cold water by his friends. The length of his submersion is not known and was not witnessed. You perform a primary assessment and determine that the patient is apneic and has a slow, weak pulse. You should:

Answer 185

. provide rescue breathing, remove his wet clothing, immobilize his entire spine, keep him warm, and transport carefully.

Question 186

The EMT must assume that any unwitnessed water-related incident is accompanied by:

Answer 186

possible spinal injury.

Question 187

You and your partner are standing by at a large social event at a river resort when a frantic woman tells you that she found a young male floating face-down in the water. Nobody claims to have witnessed the event. After you and your partner enter the water and reach the patient, you should:

Answer 187

move him as a unit to a supine position

Question 188

The diving reflex might allow a person to survive extended periods of submersion in cold water secondary to:

Answer 188

bradycardia and a slowing of the metabolic rate.

Question 189

The diving reflex might allow a person to survive extended periods of submersion in cold water secondary to:

Answer 189

bradycardia and a slowing of the metabolic rate

Question 190

Most of the serious injuries associated with scuba diving are caused by:

Answer 190

too rapid of an ascent.

Question 191

An air embolism associated with diving occurs when:

Answer 191

the diver holds his or her breath during a rapid ascent.

Question 192

Signs and symptoms of an air embolism include all of the following, except:

Answer 192

pale skin.

Question 193

The most prominent symptom of decompression sickness is:

Answer 193

abdominal or joint pain.

Question 194

You respond to a local lake where a diver complains of difficulty breathing that occurred immediately after rapidly ascending from a depth of approximately 30 feet. On assessment, you note that he has cyanosis around his lips and pink froth coming from his nose and mouth. You should:

Answer 194

suction his mouth and nose, apply high-flow oxygen, monitor the patient’s breath sounds for a pneumothorax, and contact medical control regarding transport to a recompression facility.

Question 195

Breath-holding syncope is caused by a decreased stimulus to breathe and occurs when

Answer 195

a swimmer hyperventilates prior to entering the water.

Question 196

Burns associated with lightning strikes are typically:

Answer 196

superficial

Question 197

Which of the following statements regarding lightning strikes is correct?

Answer 197

Lightning strikes might cause cardiac dysrhythmias that spontaneously resolve.

Question 198

You and your partner respond to a park where several people were reportedly struck by lightning. When you arrive, you find three patients. The first patient is lying supine on the ground; he is unresponsive and does not appear to be breathing. The second patient is ambulatory, appears confused, and is holding his arm against his chest. The third patient is sitting on the ground holding the sides of his head. After calling for backup, you should:

Answer 198

assess the unresponsive patient’s pulse, begin CPR starting with chest compressions if he is pulseless, and attach the automated external defibrillator as soon as possible.

Question 199

The venom of a black widow spider is toxic to the:

Answer 199

nervous system.

Question 200

In contrast to the brown recluse spider, the black widow spider:

Answer 200

is large and has a red-orange hourglass mark on its abdomen.

Question 201

The venom of a brown recluse spider is cytotoxic, meaning that it:

Answer 201

causes severe local tissue damage.

Question 202

You are assessing a 33-year-old male who complains of severe abdominal pain, weakness, and nausea. He tells you that he was gathering wood to build a fire when he felt a sudden, sharp pain on the back of his hand. Your assessment reveals that the patient’s abdomen is rigid and painful to palpation. You should suspect:

Answer 202

a black widow spider bite.

Question 203

All of the following snakes are pit vipers, except for the:

Answer 203

coral snake.

Question 204

Which of the following is an early sign of pit viper envenomation?

Answer 204

Local swelling and ecchymosis

Question 205

A 31-year-old male was bitten on the leg by an unidentified snake. The patient is conscious and alert and in no apparent distress. Your assessment of his leg reveals two small puncture marks with minimal pain and swelling. In addition to administering oxygen and providing reassurance, further care for this patient should include:

Answer 205

supine positioning, splinting the leg, and transporting.

Question 206

You are dispatched to a residence for a young female who is sick. The patient complains of a rash to her lower extremities and truncal area. Your assessment reveals a small, painful blister on her inner thigh. As your partner is taking the patient’s vital signs, she states that she and her family returned from a camping trip two days ago. On the basis of this patient’s presentation, you should suspect:

Answer 206

Lyme disease.

Question 207

After being stung on the leg by a jellyfish, a man complains of severe pain to his leg, dizziness, and difficulty breathing. He has a red rash covering his trunk, and his blood pressure is 90/50 mm Hg. The EMT should:

Answer 207

administer oxygen and epinephrine and prepare for rapid transport.

Question 208

In contrast to Lyme disease, Rocky Mountain spotted fever:

Answer 208

can cause paralysis and cardiorespiratory collapse.

Question 209

Substance abuse is most accurately defined as:

Answer 209

misusing a substance to produce a desired effect.

Question 210

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

Answer 210

recognize that a poisoning occurred

Question 211

Heroin is an example of a(n):

Answer 211

opioid

Question 212

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

Answer 212

oxycodone (Percocet)

Question 213

Signs and symptoms of a sympathomimetic drug overdose include:

Answer 213

tachycardia

Question 214

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

Answer 214

oxycodone (Percocet)

Question 215

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?

Answer 215

Dry mucous membranes

Question 216

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

Answer 216

Why was the substance ingested?

Question 217

If you are uncertain how to treat a patient who has been poisoned or exposed to a specific substance, you should:

Answer 217

try to find the container the substance was in.

Question 218

The poison control center will provide you with the most information regarding the appropriate treatment for a patient with a drug overdose if the center:

Answer 218

is aware of the substance that is involved.

Question 219

Which of the following statements regarding inhaled poisons is correct?

Answer 219

Lung damage might progress after the patient is removed from the environment.

Question 220

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

Answer 220

avoid contaminating yourself.

Question 221

A construction worker complains of intense pain after a bag of dry powder was spilled on his arm. The EMT should:

Answer 221

brush the chemical from his arm and then flush the skin with water.

Question 222

Most poisonings occur via the __________ route.

Answer 222

ingestion

Question 223

Activated charcoal may be indicated for a patient who ingested:

Answer 223

aspirin

Question 224

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

Answer 224

binds to the substance and prevents absorption

Question 225

In general, injected poisons are impossible to dilute or remove because they:

Answer 225

are usually absorbed quickly into the body.

Question 226

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

Answer 226

be alert for personal hazards.

Question 227

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:

Answer 227

might vomit and aspirate.

Question 228

You receive a call to a residence where a man found his wife unresponsive on the couch. The patient’s 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:

Answer 228

ventilate her with a bag-mask device.

Question 229

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

Answer 229

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

Question 230

Airborne substances should be diluted with:

Answer 230

oxygen

Question 231

Signs of absorbed poison exposure include all of the following, except:

Answer 231

severe nausea, vomiting, and diarrh

Question 232

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

Answer 232

Fructose

Question 233

What type of poisoning will cause burns around the mouth in children?

Answer 233

Alkaline poison.

Question 234

A 4-year-old, 15-kg male ingested an unknown quantity of acetaminophen (Tylenol). The child’s mother states that she does not know when the ingestion occurred. The child is conscious and alert and in no apparent distress. The EMT should:

Answer 234

administer 15 g of activated charcoal.

Question 235

Before giving activated charcoal, you should:

Answer 235

obtain approval from medical control

Question 236

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

Answer 236

black stools.

Question 237

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

Answer 237

be alert for vomiting.

Question 238

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

Answer 238

tolerance

Question 239

A man with a prolonged history of alcohol abuse fell from a second-story balcony. His blood pressure is 80/60 mm Hg, his heart rate is 120 beats/min, and his skin is cool and pale. When caring for this patient, the EMT should recall that:

Answer 239

reduced blood clotting worsens internal bleeding.

Question 240

A hypnotic drug is one that:

Answer 240

induces sleep.

Question 241

When caring for a known alcoholic patient with severe trauma to the chest and abdomen, you should be concerned that:

Answer 241

internal bleeding might be profuse because prolonged alcohol use might impair the blood’s ability to clot.

Question 242

Delirium tremens (DTs) is a syndrome associated with withdrawal from:

Answer 242

alcohol

Question 243

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 that he might have had a seizure shortly before your arrival. This patient is most likely experiencing:

Answer 243

delirium tremens.

Question 244

During your assessment of a 50-year-old male who was found unresponsive in an alley, you note that he has slow, shallow respirations; 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. Which of the following would most likely explain the patient’s presentation?

Answer 244

Heroin overdose

Question 245

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

Answer 245

assisted ventilation and naloxone (Narcan).

Question 246

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 suspect that this patient:

Answer 246

was given flunitrazepam (Rohypnol).

Question 247

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:

Answer 247

attempting to calm him and giving him oxygen if tolerated.

Question 248

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:

Answer 248

seizures and cardiac dysrhythmias.

Question 249

You are dispatched to a local nursery for a 39-year-old female who is sick. When you arrive, you find the patient lying on the floor. She is semiconscious, has copious amounts of saliva coming from her mouth, and is incontinent of urine. You quickly feel her pulse and note that it is very slow. Immediate management for this patient should include:

Answer 249

thoroughly suctioning her oropharynx.

Question 250

Atropine sulfate and pralidoxime chloride are antidotes for:

Answer 250

nerve gas agents.

Question 251

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

Answer 251

aspirin

Question 252

An overdose of acetaminophen, the active ingredient in Tylenol, will most likely cause:

Answer 252

liver damage and failure.

Question 253

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

Answer 253

The Salmonella bacterium itself causes food poisoning.

Question 254

A 3-year-old female ingested several leaves from a plant in the living room. The child’s mother is not sure what type of plant it is, stating that she bought it simply because it was pretty. After completing your primary assessment of the child, you should:

Answer 254

contact the regional poison control center.

Question 255

A 25-year-old man overdosed on heroin and is unresponsive. His breathing is slow and shallow and he is bradycardic. He has track marks on both arms. The EMT should:

Answer 255

insert a nasal airway and ventilate with a bag-mask device.

Question 256

Naloxone (Narcan) would reverse the effects of:

Answer 256

hydromorphone (Dilaudid).

Question 257

EMTs are dispatched for a teenage male who is “not acting right.” When they arrive, they are informed that the patient was huffing. Several cans of Freon are found near the patient. Which of the following is a unique consideration for this patient?

Answer 257

A sudden adrenaline release can cause a fatal dysrhythmia.

Question 258

Which of the following sets of vital signs would the EMT most likely encounter in a patient with acute cocaine overdose?

Answer 258

BP, 200/100 mm Hg; pulse, 150 beats/min

Question 259

Diabetes is MOST accurately defined as a(n):

Answer 259

disorder of glucose metabolism.

Question 260

Type 1 diabetes:

Answer 260

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

Question 261

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

Answer 261

supplemental insulin

Question 262

Glipizide, a non-insulin-type medication, is another name for:

Answer 262

Glucotrol

Question 263

Which of the following statements regarding glucose is correct?

Answer 263

The brain requires glucose as much as it requires oxygen.

Question 264

Insulin functions in the body by:

Answer 264

enabling glucose to enter the cells

Question 265

Patients with uncontrolled diabetes experience polyuria because:

Answer 265

excess glucose in the blood is excreted by the kidneys.

Question 266

Excessive eating caused by cellular “hunger” is called:

Answer 266

polyphagia

Question 267

Ketone production is the result of:

Answer 267

fat metabolization when glucose is unavailable

Question 268

A 37-year-old female with a history of diabetes presents with excessive urination and weakness of 2 days’ duration. Her blood glucose level reads 320 mg/dL. If this patient’s condition is not promptly treated, she will MOST likely develop:

Answer 268

acidosis and dehydration

Question 269

Kussmaul respirations are an indication that the body is:

Answer 269

attempting to eliminate acids from the blood.

Question 270

The normal blood glucose level is between:

Answer 270

80 and 120 mg/dL.

Question 271

Diabetic ketoacidosis occurs when:

Answer 271

insulin is not available in the body.

Question 272

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 patient’s clinical presentation, you should suspect that she:

Answer 272

is significantly hyperglycemic.

Question 273

A 50-year-old man 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 blood glucose level. Which of the following clinical signs would MOST likely lead you to the correct diagnosis?

Answer 273

Deep and rapid breathing

Question 274

In contrast to type 1 diabetes, type 2 diabetes:

Answer 274

is caused by resistance to insulin at the cellular level.

Question 275

Common signs and symptoms of severe hyperglycemia include all of the following, EXCEPT:

Answer 275

cool, clammy skin.

Question 276

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

Answer 276

Weight loss and polyuria

Question 277

Symptomatic hypoglycemia will MOST likely develop if a patient:

Answer 277

takes too much of his or her prescribed insulin.

Question 278

The EMT should assess for hypoglycemia in small children with a severe illness or injury because:

Answer 278

children cannot store excess glucose as effectively as adults.

Question 279

Classic signs and symptoms of hypoglycemia include:

Answer 279

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

Question 280

Assessment of a patient with hypoglycemia will MOST likely reveal:

Answer 280

combativeness

Question 281

In contrast to hypoglycemia, hyperglycemia:

Answer 281

can only be corrected in the hospital setting.

Question 282

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 patient as though he is experiencing:

Answer 282

a heart attack.

Question 283

You respond to a residence for a patient who is “not acting right.” As you approach the door, the patient, a 35-year-old male, begins shouting profanities at you and your partner while holding a baseball bat. The man is confused and diaphoretic, and is wearing a medical identification bracelet. You should:

Answer 283

retreat at once and call law enforcement.

Question 284

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:

Answer 284

provide ventilatory support.

Question 285

A man finds his 59-year-old wife unconscious on the couch. He states that she takes medications for type 2 diabetes. He further tells you that his wife has been ill recently and has not eaten for the past 24 hours. Your assessment reveals that the patient is unresponsive. You should:

Answer 285

open and maintain her airway and assess breathing.

Question 286

You respond to a movie theater for a 70-year-old male who is confused. His wife tells you he has type 2 diabetes but refuses to take his pills. Your assessment reveals that the patient is diaphoretic, tachycardic, and tachypneic. Initial management for this patient should include

Answer 286

applying a nonrebreathing mask at 15 L/min

Question 287

When obtaining a SAMPLE history from a patient with diabetes who has an altered mental status, it would be MOST important to determine:

Answer 287

if he or she has had any recent illnesses or excessive stress.

Question 288

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

Answer 288

rate and depth of breathing.

Question 289

You are treating a 40-year-old male with a documented blood sugar reading of 480 mg/dL. The patient is semiconscious and breathing shallowly, and is receiving assisted ventilation from your partner. You should recognize that definitive treatment for this patient includes:

Answer 289

insulin

Question 290

A 19-year-old male complains of “not feeling right.” His insulin and a syringe are on a nearby table. The patient 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 blood glucose level. You should:

Answer 290

contact medical control and administer oral glucose.

Question 291

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

Answer 291

Blindness

Question 292

In general, oral glucose should be given to any patient who:

Answer 292

has an altered mental status and a history of diabetes.

Question 293

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

Answer 293

A confused 55-year-old male with tachycardia and pallor

Question 294

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

Answer 294

ensuring the absence of a gag reflex.

Question 295

Hemoglobin is:

Answer 295

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

Question 296

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

Answer 296

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

Question 297

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 and weak, and his skin is cyanotic. The EMT should:

Answer 297

assist the patient’s ventilations with a bag-valve mask.

Question 298

A 66-year-old woman experienced a sudden onset of difficulty breathing. She has a history of type 2 diabetes and deep vein thrombosis (DVT). On the basis of her medical history, which of the following should the EMT suspect?

Answer 298

Pulmonary embolism

Question 299

Patients with thrombophilia are at an increased risk for:

Answer 299

acute arterial rupture.

Question 300

During your assessment of a 19-year-old male, you are told that he is being treated with factor VIII. This indicates that:

Answer 300

he has hemophilia A

Question 301

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 patient’s blood glucose level is 75 mg/dL. His blood pressure is 168/98 mm Hg, his heart rate 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:

Answer 301

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

Question 302

During your assessment of a 70-year-old woman, she tells you that she takes blood-thinning medication and has to wear compression stockings around her legs. This information should make you suspect that she has:

Answer 302

deep vein thrombosis

Question 303

Which of the following MOST accurately defines an allergic reaction?

Answer 303

An exaggerated immune system response to any substance

Question 304

Chemicals that are responsible for the signs and symptoms of an allergic reaction to a bee sting include:

Answer 304

histamines and leukotrienes.

Question 305

Anaphylaxis is MOST accurately defined as a(n):

Answer 305

extreme allergic reaction that may affect multiple body systems.

Question 306

Two of the MOST common signs of anaphylaxis are:

Answer 306

urticaria and angioedema

Question 307

Urticaria is the medical term for:

Answer 307

hives

Question 308

The foreign substance responsible for causing an allergic reaction is called a(n):

Answer 308

allergen

Question 309

Which of the following patients would MOST likely have a delayed onset of an allergic reaction?

Answer 309

A 45-year-old male who ingested penicillin

Question 310

Which of the following statements regarding fire ants is correct?

Answer 310

Fire ants often bite a person repeatedly.

Question 311

A raised, swollen, well-defined area on the skin that is the result of an insect bite or sting is called:

Answer 311

a wheal

Question 312

Because the stinger of a honeybee remains in the wound following a sting:

Answer 312

it can continue to inject venom for up to 20 minutes.

Question 313

The stinger from a honeybee should be:

Answer 313

scraped away from the skin.

Question 314

Most patients who die of anaphylaxis do so within the first ____ minutes following exposure

Answer 314

30

Question 315

You are assessing a young male who was stung on the leg by a scorpion. He is conscious and alert, his breathing is regular and unlabored, and his blood pressure is 122/64 mm Hg. Assessment of his leg reveals a wheal surrounded by an area of redness. He states that he had a “bad reaction” the last time he was stung by a scorpion, and carries his own epinephrine auto-injector. You should

Answer 315

apply oxygen as needed, clean the area with soap and water or a mild antiseptic, and transport him to the hospital.

Question 316

Which of the following would MOST likely provide clues regarding the source of a patient’s allergic reaction?

Answer 316

The environment in which the patient is found

Question 317

A 73-year-old man presents with a generalized rash, which he thinks may have been caused by an antibiotic that he recently began taking. He has a history of coronary artery disease, hypertension, and emphysema. He is conscious and alert, his blood pressure is 144/94 mm Hg, and his pulse is 64 beats/min and regular. You auscultate his breath sounds and hear scattered wheezing, although he is not experiencing respiratory distress. You should:

Answer 317

administer oxygen if needed, transport the patient, and monitor him for signs of deterioration.

Question 318

A 37-year-old male is having a severe allergic reaction to penicillin. He does not have an epinephrine auto-injector, and your protocols do not allow you to carry epinephrine on the ambulance. How should you proceed with the treatment of this patient?

Answer 318

Administer oxygen, transport at once, and request a paramedic intercept.

Question 319

Which of the following negative effects of anaphylaxis will be the MOST rapidly fatal if not treated immediately?

Answer 319

Upper airway swelling

Question 320

A 38-year-old woman was bitten by fire ants while at the park. Your primary assessment reveals that she is semiconscious; has labored breathing; and has a rapid, thready pulse. She has a red rash on her entire body, and her face is swollen. You should:

Answer 320

assist her ventilations with 100% oxygen.

Question 321

A 48-year-old male is found unconscious in the garden by his wife. When you arrive at the scene and assess the man, you find that he is unresponsive, has labored breathing, and has hives over his entire trunk. You should:

Answer 321

maintain his airway and assist his ventilations.

Question 322

You respond to the residence of a 55-year-old woman with a possible allergic reaction to peanuts that she ate approximately 30 minutes ago. The patient is conscious and alert, but has diffuse urticaria and the feeling that she has a lump in her throat. As your partner applies oxygen to the patient, you should:

Answer 322

ask her if she has prescribed epinephrine.

Question 323

Which of the following medications blocks the release of histamines?

Answer 323

Diphenhydramine (Benadryl)

Question 324

Common signs and symptoms of an allergic reaction include all of the following, EXCEPT:

Answer 324

drying of the eyes

Question 325

Which of the following sounds indicates swelling of the upper airway?

Answer 325

Stridor

Question 326

While auscultating breath sounds of a patient who was stung multiple times by a yellow jacket, you hear bilateral wheezing over all lung fields. This indicates:

Answer 326

narrowing of the bronchioles in the lungs.

Question 327

Which of the following physiologic actions does epinephrine produce when given for an allergic reaction?

Answer 327

Vasoconstriction and bronchodilation

Question 328

Epinephrine is indicated for patients with an allergic reaction when:

Answer 328

wheezing and hypotension are present.

Question 329

The adult epinephrine auto-injector delivers ______ mg of epinephrine, and the infant-child auto-injector delivers ______ mg.

Answer 329

0.3; 0.15

Question 330

When an auto-injector is used to give epinephrine, the primary injection site is the:

Answer 330

lateral portion of the thigh.

Question 331

When administering epinephrine via auto-injector, you should hold the injector in place for:

Answer 331

3 seconds

Question 332

Immediately after giving an epinephrine injection, you should:

Answer 332

properly dispose of the syringe.

Question 333

A 50-year-old male was stung by a honeybee approximately 15 minutes ago. He presents with respiratory distress, facial swelling, and hypotension. After placing him on oxygen and administering his epinephrine via auto-injector, you note that his breathing has improved. Additionally, his facial swelling is resolving and his blood pressure is stable. Your next action should be to:

Answer 333

record the time and dose of the injection and transport promptly.

Question 334

You have administered one dose of epinephrine to a 40-year-old female to treat an allergic reaction that she developed after being stung by a scorpion. Your reassessment reveals that she is still having difficulty breathing, has a decreasing mental status, and has a blood pressure of 80/50 mm Hg. You should:

Answer 334

request permission from medical control to give another dose of epinephrine.

Question 335

The effects of epinephrine are typically observed within _________ following administration.

Answer 335

1 minute

Question 336

Common side effects of epinephrine include all of the following, EXCEPT:

Answer 336

drowsiness

Question 337

A 19-year-old female was stung multiple times on the legs by fire ants. She states that she is allergic to fire ants, but does not carry her own epinephrine. The patient is conscious and alert and complains of pain to the area of the bites. Her blood pressure is 122/70 mm Hg, her pulse is 100 beats/min and strong, and her respirations are 18 breaths/min and unlabored. You should:

Answer 337

administer oxygen and transport her to the hospital.

Question 338

After administering 0.3 mg of epinephrine via auto-injector to a 22-year-old female with an allergic reaction, you note improvement in her breathing and resolution of her hives. However, she is still anxious and tachycardic. You should

Answer 338

monitor her closely but recall that anxiety and tachycardia are side effects of epinephrine.

Question 339

Which of the following statements regarding epinephrine administration via the intramuscular (IM) route is correct?

Answer 339

The 1:1000 concentration should be used.

Question 340

____________ is what you can see of a person’s response to the environment.

Answer 340

Behavior

Question 341

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

Answer 341

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

Question 342

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

Answer 342

violent

Question 343

In contrast to a behavioral crisis, a behavioral health emergency occurs when a person:

Answer 343

becomes agitated or violent and is a threat to him- or herself or others.

Question 344

When assessing a patient who is displaying bizarre behavior, the EMT should:

Answer 344

consider that an acute medical illness may be causing the patient’s behavior.

Question 345

Organic brain syndrome is defined as:

Answer 345

a dysfunction of the brain caused by abnormal physical or physiological function.

Question 346

A 78-year-old female presents with an acute change in her 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’s speech is slurred and she is not alert to her surroundings. You should:

Answer 346

inquire about the possibility of head trauma.

Question 347

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

Answer 347

functional disorder

Question 348

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

Answer 348

Schizophrenia

Question 349

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

Answer 349

ensure your safety.

Question 350

You respond to a call for an unknown emergency. When you arrive at the scene, the patient’s husband meets you at the door and states that his wife has been depressed and has locked herself in an upstairs bedroom. He further tells you that he keeps his handgun in the bedroom. You should:

Answer 350

remain in a safe place and request law enforcement.

Question 351

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

Answer 351

being prepared to spend extra time with the patient.

Question 352

A 40-year-old male intentionally cut his wrist out of anger after losing his job. Law enforcement has secured the scene prior to your arrival. As you enter the residence and visualize the patient, you can see that he has a towel around his wrist and a moderate amount of blood has soaked through it. You should:

Answer 352

calmly identify yourself to the patient

Question 353

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

Answer 353

be direct and clearly state your intentions.

Question 354

A 22-year-old male with a history of clinical depression called 9-1-1 and stated that he has attempted to kill himself. Your unit and law enforcement officers arrive at the 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:

Answer 354

open the patient’s airway and assess his respirations

Question 355

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:

Answer 355

ask the daughter how her father normally behaves

Question 356

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

Answer 356

reflective listening

Question 357

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

Answer 357

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

Question 358

You are assessing a conscious 55-year-old male with a sudden change in behavior. Which of the following clinical findings would be MOST suggestive of dysfunction of this patient’s central nervous system?

Answer 358

Rapid eye movement

Question 359

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?

Answer 359

Request a police officer to accompany you in the ambulance.

Question 360

After ensuring his or her own safety, the EMT’s next priority when caring for a patient with a behavioral emergency is to:

Answer 360

assess the patient’s response to his or her environment.

Question 361

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

Answer 361

Alzheimer’s disease.

Question 362

The single most significant factor that contributes to suicide is:

Answer 362

depression

Question 363

You are assessing a 45-year-old female who is severely depressed. She states that it seems as though 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 should you manage this situation?

Answer 363

Ask the patient if she has developed a suicidal plan.

Question 364

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

Answer 364

married males older than 30 years

Question 365

It is MOST important for the EMT to remember that suicidal patients may:

Answer 365

be homicidal as well.

Question 366

Signs of excited delirium include:

Answer 366

diaphoresis, tachycardia, and hallucinations

Question 367

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:

Answer 367

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

Question 368

A 38-year-old male with a history of schizophrenia is reported by neighbors to be screaming and throwing things in his house. You are familiar with the patient and have cared for him in the past for unrelated problems. Law enforcement officers escort you into the residence when you arrive. The patient tells you that he sees vampires and is attempting to ward them off by screaming and throwing things at them. He has several large lacerations to his forearms that are actively bleeding. The MOST appropriate way to manage this situation is to:

Answer 368

restrain the patient with appropriate force in order to treat his injuries.

Question 369

You receive a call for a domestic dispute. When you arrive at the scene, you find a young male standing on the front porch of his house. You notice that an adjacent window is broken. The patient has a large body, is clenching his fists, and is yelling obscenities at you. Which of the following findings is LEAST predictive of this patient’s potential for violence?

Answer 369

His large body size

Question 370

In which position should you restrain a physically uncooperative patient?

Answer 370

Supine

Question 371

When caring for a patient experiencing excited delirium, the EMT should remember that:

Answer 371

sudden death can occur if the patient’s violence is not controlled.

Question 372

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

Answer 372

reassess the patient’s airway and breathing.

Question 373

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

Answer 373

Alcohol withdrawal

Question 374

Posttraumatic stress disorder can happen after:

Answer 374

exposure to or injury from a traumatic occurrence.

Question 375

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

Answer 375

fallopian tube.

Question 376

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

Answer 376

becomes engorged with blood

Question 377

The onset of menstruation usually occurs in females who are:

Answer 377

between 11 and 16 years of age

Question 378

When a female has reached menarche:

Answer 378

she is capable of becoming pregnant.

Question 379

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

Answer 379

experience abdominal cramping, which may be misinterpreted.

Question 380

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

Answer 380

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

Question 381

Pelvic inflammatory disease (PID) typically does NOT affect the:

Answer 381

urinary bladder.

Question 382

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

Answer 382

ovarian abscess and ectopic pregnancy

Question 383

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

Answer 383

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

Question 384

As a woman approaches menopause:

Answer 384

her menstrual periods may become irregular and vary in severity.

Question 385

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

Answer 385

Chlamydia

Question 386

Bacterial vaginosis is a condition that occurs when:

Answer 386

normal bacteria in the vagina are replaced by an overgrowth of other bacterial forms.

Question 387

Which of the following statements regarding gonorrhea is correct?

Answer 387

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

Question 388

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

Answer 388

may be relatively painless.

Question 389

Whenever possible, a female sexual assault victim should be:

Answer 389

given the option of being treated by a female EMT

Question 390

When a woman presents with abdominal pain or other vague symptoms, the EMT is often unable to determine the nature of the problem until he or she:

Answer 390

has gathered patient history information.

Question 391

During your assessment of a young female with nontraumatic vaginal bleeding, you note that her level of consciousness is decreased, her respirations are rapid and shallow, her skin is cool and moist, and her pulse is rapid and weak. You should:

Answer 391

assist her ventilations with a bag-mask device.

Question 392

If a woman with vaginal bleeding reports syncope, the EMT should assume that she:

Answer 392

s in shock.

Question 393

When caring for a woman who is experiencing a gynecologic emergency, the EMT’s main focus should be to:

Answer 393

maintain her ABCs and transport without delay

Question 394

A 26-year-old female presents with heavy vaginal bleeding. She is conscious, but restless. Her blood pressure is 84/54 mm Hg, her pulse is 120 beats/min and weak, and her respirations are 22 breaths/min with adequate depth. She tells you that she inserted a tampon about 2 hours ago. You should:

Answer 394

administer high-flow oxygen, place a sterile pad over her vagina, keep her warm, elevate her lower extremities, and transport without delay.

Question 395

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

Answer 395

carefully removing any foreign bodies from the vagina.

Question 396

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?

Answer 396

A shuffling gait when walking

Question 397

Which of the following statements regarding rape is correct?

Answer 397

Rape is a legal term, not a medical diagnosis.

Question 398

When caring for a female patient who has been sexually assaulted, you should:

Answer 398

place any bloodstained clothing or other articles in separate paper bags.

Question 399

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:

Answer 399

provide emotional support and visually assess her for obvious trauma.

Question 400

The physical examination of a sexual assault victim should be:

Answer 400

limited to a brief survey for life-threatening injuries

Question 401

When documenting a call in which a female was sexually assaulted, you should:

Answer 401

keep the report concise and record only what the patient stated in her own words.

Question 402

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:

Answer 402

the patient was given a drug prior to the incident.

Question 403

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

Answer 403

Rohypnol