medical exam 1 Flashcards
Epinephrine acts as a specific antidote to:
A) adrenaline
B) histamine
C) asthma
D) bronchitis
B) histamine
Which of these medications is included in the EMT scope of practice?
A) Pepcid
B) Oxygen
C) 50% dextrose (D50)
D) Benadryl
B) Oxygen
After you assist a patient with use of her EpiPen, she tells you that it is much easier for her to breathe. However, her heart rate has increased from 92 to 118 beats/min. Regarding the epinephrine, the EMT recognizes the increased heart rate as a(n):
A) Therapeutic effect
B) Side effect
C) Contraindication
D) Allergy
B) Side effect
A patient with difficulty breathing has a metered-dose inhaler (MDI). Which of these would be a likely type of medication contained in the MDI?
A) Albuterol
B) Steroids
C) Oxygen
D) Epinephrine
A) Albuterol
You are by the side of an alert and oriented 56-year-old male patient who complains of generalized weakness and a pounding headache. His pulse is 104, respirations are 18 breaths/min, and blood pressure is 218/110 mmHg. He has a history of high blood pressure, for which he takes lisinopril. He states that he has not taken the Lisinopril for 2 weeks and hands you a container with the medication inside. You would:
A) Assist the patient in taking the lisinopril
B) Ensure that it is the patient’s medication and then administer it
C) Contact medical direction to request an order for lisinopril administration by you
D) Continue treatment and transport the patient to the hospital
D) Continue treatment and transport the patient to the hospital
As an EMT, you may assist patients in taking which kind of prescribed medication?
A) Inhalers used for difficulty breathing
B) Medications for high blood pressure
C) Drugs for heart-rhythm disorders
D) Seizure-control medications
A) Inhalers used for difficulty breathing
A patient with a history of diabetes is confused and irritable. According to family members, he accidentally took too much insulin this morning and did not eat breakfast. Since he is conscious with an intact gag reflex, medical direction orders you to administer oral glucose. Which component of this situation best represents the indication for the medication?
A) Medical command authorization
B) Confusion and irritability
C) History of diabetes
D) High blood sugar
B) Confusion and irritability
A patient with chest pain tells you that he feels the same now as when he had a heart attack 2 years ago. He is diaphoretic, nauseated, and vomiting; he has a pulse of 84, respirations of 16 breaths/min, and a blood pressure of 78/50 mmHg. The patient is allergic to aspirin. He asks you to assist him in taking one of his nitroglycerin pills because his arthritis makes it too hard for him to open the medication bottle. Which of the assessment findings represents a contraindication to the nitroglycerin?
A) Blood pressure of 78/50 mmHg
B) Heart rate less than 100
C) Nausea and vomiting
D) Allergy to aspirin
A) Blood pressure of 78/50 mmHg
A 59-year-old male patient has summoned EMS for crushing chest pain. He states that he needs his nitroglycerin, but it is in his car in a nearby parking lot. A friend of the patient explains that he also takes nitroglycerin and hands you his bottle of nitroglycerin. The patient appears very ill, and he says that this chest pain is the worst he’s ever experienced. Given the patient’s condition, your best action would be to:
A) Administer the friend’s nitroglycerin
B) Have the patient retrieve his nitroglycerin from the car
C) Ask the friend to get the patient’s nitroglycerin from his car quickly
D) Administer his friend’s nitroglycerin now, but retrieve patient’s nitroglycerin bottle from his car so you have proof and verification that this medication was appropriate to administer
C) Ask the friend to get the patient’s nitroglycerin from his car quickly
After administering oral glucose to a patient with altered mental status, which of these findings best indicates a positive therapeutic effect or response to the medication?
A) Blood pressure decrease from 156/90 to 120/80 mmHg
B) No signs or symptoms of an allergic reaction
C) Pulse oximeter reading of 99% without supplemental oxygen
D) Mental status that is now alert and oriented
D) Mental status that is now alert and oriented
The EMT should consider aspirin for a patient with:
A) Chest discomfort
B) Headache
C) Shortness of breath
D) Fever
A) Chest discomfort
Medical direction has ordered you to administer 162 mg of aspirin to a patient with chest pain. Your best response to this order would be:
A) “Confirmed. I will recontact you with any changes in the patient’s condition.”
B) “Copy. I will administer the medication as per your instruction.”
C) “Received. I will administer 162 mg of aspirin orally.”
D) “Affirmative. The patient has no allergies so I will administer the aspirin orally.”
C) “Received. I will administer 162 mg of aspirin orally.”
The label on a patient’s prescribed metered-dose inhaler reads as follows: “Administer three puffs as needed for shortness of breath.” Your protocols state that you can assist with only two puffs without medical direction consultation. The patient is extremely short of breath. What should you do?
A) Administer three puffs
B) Do not administer the medication
C) Contact medical direction for orders to administer three puffs
D) Administer two puffs
C) Contact medical direction for orders to administer three puffs
Medical direction has ordered you to assist a patient in taking his metered-dose inhaler (MDI). After placing the patient’s lips on the mouthpiece, which instruction would be most appropriate?
A) “Please hold your breath and I will administer the medication.”
B) “Please inhale, then hold your breath, and I will give you the medication.”
C) “Please inhale slowly and I will administer the medication, then hold your breath.”
D) “Please exhale, hold your breath, and I will administer the medication.”
C) “Please inhale slowly and I will administer the medication, then hold your breath.”
A beta-2 medication benefits a patient by:
A) Diminishing the need for oxygen
B) Slowing the respiratory and heart rate
C) Eliminating chest pain
D) Dilating the small airways
D) Dilating the small airways
A confused, lethargic, and nonverbal 50-year-old female patient has altered mental status. You are told she has a history of chronic obstructive pulmonary disease (COPD). The primary assessment reveals a respiration rate of 6 breaths/min and cool, clammy skin with cyanosis around the lips. What should be your priority management?
A) Administer oxygen by nasal cannula at 15 lpm
B) Assist respirations with positive pressure ventilation
C) Administer oxygen by nonrebreather mask at 15 lpm
D) Sit the patient up, assess lung sounds, and obtain a blood pressure
B) Assist respirations with positive pressure ventilation
When arrive on scene, a family member directs you to a bedroom where a 62-year-old male patient is in respiratory distress. During the scene size-up, which finding would most strongly suggest that the patient suffers from a chronic respiratory disease?
A) Furnace turned on high with the humidifier running
B) Bottles of aspirin and nitroglycerin on the nightstand
C) Patient in a chair in tripod position and has a barrel-shaped chest
D) Smell of cigarettes in house and the patient is obese
C) Patient in a chair in tripod position and has a barrel-shaped chest
An alert and oriented 45-year-old female patient complains of shortness of breath. Although her respiratory volume and rate are satisfactory, you note cyanosis in her fingertips and you cannot get the pulse oximeter to show a reading. What should be your next action?
A) Administer supplemental oxygen
B) Assist respirations with the bag-valve mask
C) Place a nasopharyngeal airway and assist respirations
D) Move the patient to the stretcher for immediate and rapid transport
A) Administer supplemental oxygen
On scene, you suspect that a young female patient is suffering from hyperventilation syndrome. Which additional finding would best assist you in confirming this suspicion?
A) Heart rate of 64 beats/min
B) Urinary incontinence
C) Breathing through the mouth
D) Spasm of the hands
D) Spasm of the hands
You have been called to a residence for a patient with altered mental status and shortness of breath. On scene, an Emergency Medical Responder meets you and states that he believes the patient had a stroke and is unresponsive. As you enter the room, you see the patient lying in bed with snoring respirations. Oxygen at 15 liters per minute has been applied. Your immediate action when you reach the patient’s side would be to:
A) Place a nasal airway and suction
B) Start positive pressure ventilation
C) Perform the head-tilt, chin-lift maneuver
D) Determine whether the patient has a pulse
C) Perform the head-tilt, chin-lift maneuver
You have been called to an industrial warehouse for a young adult male patient who was exposed to an unknown chemical gas. The patient was immediately removed from the environment and presents to you with a patent airway, burning to the throat with inspiration, and complaint of shortness of breath. His vital signs are pulse, 120; respirations, 28 breaths/min; blood pressure, 164/60 mmHg; and SpO2, 90%. In addition, you note bilateral wheezing to the lungs. What should be your first action in caring for this patient?
A) Initiate manual spinal motion restriction
B) Administer supplemental oxygen
C) Identify the chemical to which the patient was exposed
D) Administer a saline mist through a small-volume nebulizer
B) Administer supplemental oxygen
If a clot occludes the blood flow through the coronary artery, what will be the detrimental effect?
A) The flow of oxygen-rich blood through the peripheral arteries will cease
B) Blood will not be able to flow between the left atrium and the left ventricle
C) The flow of oxygen-rich blood to the muscle of the ventricle will be decreased
D) Blood and fluid will back up into the lung tissue, causing pulmonary edema
C) The flow of oxygen-rich blood to the muscle of the ventricle will be decreased
A patient has pulmonary hypertension, which has increased the resistance in the pulmonary blood vessels. In response, what will most likely occur over a long period of time?
A) The right side of the heart will weaken
B) The heart muscle will become stronger
C) The left side of the heart will weaken and fail
D) The aorta will weaken and potentially rupture
A) The right side of the heart will weaken
A patient with a history of COPD is breathing 32 times a minute. Her vital signs are pulse, 140; blood pressure, 168/102 mmHg; and SpO2, 98% on room air. You would classify this patient’s condition as:
A) Apnea
B) Dyspnea
C) Bradypnea
D) Hypoxia
B) Dyspnea
You are caring for an alert and oriented patient with chest pain. Emergency First Responders have initiated supplemental oxygen, and your EMT partner assisted in the administration of aspirin and two nitroglycerin tablets. Currently, the patient’s vital signs are pulse, 76; respirations, 16 breaths/min; blood pressure, 110/56 mmHg; and SpO2, 95%. When transporting this patient on the stretcher, which position is best?
A) Semi-Fowler’s position
B) Supine with head elevated
C) Lateral recumbent
D) Position of comfort
D) Position of comfort
Prior to administering nitroglycerin to a patient with chest pain, the EMT must ensure that:
A) The nitroglycerin is prescribed for the patient
B) The patient rates his chest pain as 10 out of 10
C) The patient’s systolic blood pressure is greater than 110 mmHg
D) The patient is standing in an upright position
A) The nitroglycerin is prescribed for the patient
Immediately after assisting a patient with diabetes to take her nitroglycerin, she states that she feels weak, dizzy, and nauseated. What should the EMT do next?
A) Position her in an upright position
B) Inform her that this feeling is normal
C) Check her blood glucose level
D) Check her blood pressure
D) Check her blood pressure
You are assessing a patient in heart failure. Which sign or symptom seemingly indicates that the left ventricle is the cause of the heart failure?
A) Crackles in the bases of both lungs
B) SpO2of 95% with no supplemental oxygen
C) Difficulty breathing when in an upright position
D) Heart rate of 62 beats/min
A) Crackles in the bases of both lungs
When administering aspirin to a patient with chest discomfort that is suggestive of a heart attack, the EMT recognizes that this medication will benefit the patient by:
A) Breaking up the blood clot that is occluding the coronary artery
B) Treating the headache that may occur when nitroglycerin is administered
C) Decreasing the ability of the platelets in the blood to form clots
D) Decreasing the chest pain caused by the possible heart attack
C) Decreasing the ability of the platelets in the blood to form clots
You suspect that a patient with a history of chronic obstructive pulmonary disease (COPD) is has right ventricular failure. In your assessment, which finding would reinforce this suspicion?
A) Elevated blood pressure
B) Edema to the feet
C) Crackles in both lungs
D) Bounding radial pulse
B) Edema to the feet
After blood enters the right ventricle, it next moves into the:
A) Left ventricle
B) Pulmonary artery
C) Left atrium
D) Aorta
B) Pulmonary artery
Which of these statements made by the patient should cause the EMT to suspect an abdominal aortic aneurysm?
A) “I have belly pain that I also feel in my back.”
B) “My heart is beating so hard, you can feel it on my chest.”
C) “The pain is sharp and spreads to both arms.”
D) “I seem to be vomiting up some blood.”
A) “I have belly pain that I also feel in my back.”
Which of these therapies is the best option for definitively treating a known myocardial infarction (AMI)?
A) Oxygen
B) Fibrinolytics
C) Oxygen, aspirin, and nitroglycerin
D) Angioplasty
D) Angioplasty
Which of these patients is most likely to suffer a silent MI?
A) A 55-year-old female with diabetes
B) A 72-year-old male with a syncopal episode
C) A 60-year-old female with colon cancer
D) A 48-year-old male with undiagnosed hypertension
A) A 55-year-old female with diabetes
Resuscitation, when started during which phase of cardiac arrest, provides the patient with the best chance of survival?
A) Circulatory
B) Metabolic
C) Electrical
D) Bradycardic
C) Electrical
The AED should never be applied to a patient who is not in cardiac arrest because some patients in:
A) Ventricular tachycardia may still have a pulse
B) Ventricular fibrillation may still be conscious and alert
C) Ventricular fibrillation may still have a pulse
D) Asystole may still have a pulse
A) Ventricular tachycardia may still have a pulse
Which link of the American Heart Association’s Chain of Survival must occur first, if a patient is to survive cardiac arrest?
A) Early CPR
B) Early defibrillation
C) Early activation
D) Early advanced life support
C) Early activation
A 47-year-old patient has been in cardiac arrest for 6 minutes. While you set up the AED, you would direct your partner to:
A) Perform CPR at a ratio of 30 ventilations to 2 compressions
B) Assist you in making sure that the AED is ready for application
C) Perform a primary and secondary assessment
D) Perform CPR until the AED is ready
D) Perform CPR until the AED is ready
A patient goes into cardiac arrest at 11:40 a.m. Which of these treatments gives the patient the best chance for recovery?
A) CPR at 11:42 m. and advanced cardiac drugs at 11:48 a.m.
B) Defibrillation at 11:46 m., followed by ALS (ACLS) at 11:51 a.m.
C) CPR at 11:41 m. and defibrillation at 11:43 a.m.
D) Defibrillation at 11:44 m., followed by CPR at 11:49 a.m.
C) CPR at 11:41 m. and defibrillation at 11:43 a.m.
Which of these statements about the heart rhythm of ventricular fibrillation is true?
A) Ventricular fibrillation occurs when the heart rate is so slow and weak that a pulse cannot be felt
B) When a patient’s heart is in ventricular fibrillation, it is unable to pump blood throughout the body
C) The most effective treatment for converting ventricular fibrillation to a normal heart rhythm is CPR
D) The AED is designed to identify ventricular tachycardia and give a “no shock advised” message when it is present
B) When a patient’s heart is in ventricular fibrillation, it is unable to pump blood throughout the body
When a 52-year-old male patient collapsed on his front porch, his family dialed 911. When you arrive, the daughter informs you that the patient has been down for approximately 8 minutes. Assessment reveals him to be in cardiac arrest. What should you do immediately?
A) Contact medical direction for permission to use the AED given the down time
B) Perform five cycles of CPR at a ratio of 2 compressions to 30 ventilations
C) Withhold CPR so that the AED can be applied
D) Start CPR while the AED is applied and readied for use
D) Start CPR while the AED is applied and readied for use
You have arrived at the residence of a 66-year-old female patient who is in cardiac arrest. In the living room, you find Emergency Medical Responders performing CPR on the patient. They quickly report that they found the patient in cardiac arrest and have been doing CPR for 5 minutes. Which of these statements should you make at this time?
A) “Let’s stop CPR so I can check the airway, breathing, and circulation.”
B) “Let’s stop CPR so I can put the electrodes of the AED on her chest.”
C) “Let’s continue CPR for another 2 minutes, and then I will put the AED on.”
D) “Let’s continue CPR while I talk with the family to see if they want us to continue.”
A) “Let’s stop CPR so I can check the airway, breathing, and circulation.”
You have been called for an elderly male patient who suddenly collapsed. On scene, you find an 82-year-old man lying on the garage floor. Assessment reveals him to be unresponsive and not breathing. What should you do immediately?
A) Determine the “down time”
B) Apply the AED
C) Start cardiopulmonary resuscitation
D) Check for a carotid pulse
D) Check for a carotid pulse
Which of these unresponsive patients would the EMT recognize as in cardiac arrest?
A) A female who has an occasional gasp for a breath but no palpable carotid pulse
B) A male with a heart rate of 16 beats/min and agonal respirations
C) A female who is not breathing and has a heart rate of 24 beats/min
D) A male with an absent radial pulse but breathing 20 times per minute
A) A female who has an occasional gasp for a breath but no palpable carotid pulse
After analyzing the heart rhythm of a patient in cardiac arrest, the AED provides a “deliver shock” message. After clearing the patient, the EMT’s next step should be to:
A) Press the shock button, and then check for the return of a pulse
B) Press the shock button, and then allow the AED to analyze the heart rhythm
C) Press the shock button, and then perform CPR for 2 minutes
D) Check for a pulse, and then press the shock button if a pulse is not present
C) Press the shock button, and then perform CPR for 2 minutes
You have just applied the AED to a female patient in cardiac arrest and the machine is ready to analyze the heart rhythm. Which of these instructions is appropriate to give at this time?
A) “Stop CPR and clear the patient.”
B) “Stop chest compressions but continue ventilation.”
C) “Continue CPR until we see if a shock is advised.”
D) “Stop CPR but continue to check for a pulse.”
A) “Stop CPR and clear the patient.”
After you applied the AED to a patient in cardiac arrest, it delivered a shock. Immediately after the shock, what should you do next?
A) Check the patient for a pulse and reanalyze the rhythm if no pulse is present
B) Provide 2 minutes of CPR, and then check the patient for a pulse
C) Check the patient for a pulse and start CPR if no pulse can be located
D) Provide five cycles of single-rescuer CPR with a ratio of 15 compressions to 2 ventilations
B) Provide 2 minutes of CPR, and then check the patient for a pulse
Which of these conditions places the patient at the greatest risk for an acute neurologic deficit?
A) Acute myocardial infarction (AMI)
B) Transient ischemic attack (TIA)
C) Chronic obstructive pulmonary disease (COPD)
D) New onset of type 2 diabetes (NIDDM)
B) Transient ischemic attack (TIA)
When assessing a patient with a suspected stroke, the order of the exam would be:
A) Primary assessment, then secondary assessment including a stroke scale
B) Level of consciousness, facial droop, arm drift, airway, and then secondary assessment
C) Abnormal speech, facial droop, arm drift, primary assessment, and then secondary assessment
D) Secondary assessment, primary assessment, stroke exam, and then SAMPLE history
A) Primary assessment, then secondary assessment including a stroke scale
