Midterm #2

Question 1

Atelectasis occurs when:

A) the alveoli are overinflated and rupture.
B) a deficiency of surfactant causes alveolar collapse.
C) deoxygenated blood diffuses across the alveoli.
D) surface tension on the alveolar walls is decreased

Answer 1

B) a deficiency of surfactant causes alveolar collapse.

Question 2

The self-splinting effect observed in patients with chest wall trauma:

A) allows the body to compensate for the injury.
B) may cause atelectasis, hypoxemia, or pneumonia.
C) is often accompanied by subcutaneous emphysema.
D) is characterized by a markedly increased tidal volume.

Answer 2

B) may cause atelectasis, hypoxemia, or pneumonia.

Question 3

In contrast to negative-pressure ventilation, positive-pressure ventilation occurs when:

A) the diaphragm contracts.
B) air is drawn into the lungs.
C) intrathoracic pressure falls.
D) air is forced into the lungs.

Answer 3

D) air is forced into the lungs.

Question 4

In contrast to negative-pressure ventilation, positive-pressure ventilation:

A) may impair blood return to the heart.
B) moves air into the esophagus and trachea.
C) causes decreased intrathoracic pressure.
D) is the act of normal, unassisted breathing.

Answer 4

A) may impair blood return to the heart.

Question 5

After opening an unresponsive patient’s airway, you determine that his respirations are rapid, irregular, and shallow. You should:

A) intubate him at once.
B) apply a nonrebreathing mask.
C) suction his mouth for 15 seconds.
D) begin positive-pressure ventilations.

Answer 5

D) begin positive-pressure ventilations.

Question 6

Patients with decompensated asthma or COPD who require positive-pressure
ventilation:

A) should be ventilated routinely at a rate that is slightly faster than the rate for a patient without an underlying pulmonary disease.
B) may develop a pneumothorax or experience a decrease in venous return to the heart if they are ventilated too rapidly.
C) should be intubated promptly and ventilated at a rate of 20 to 24 breaths/min to eliminate excess carbon dioxide.
D) should be given forceful positive-pressure breaths because their primary problem is difficulty with inhalation.

Answer 6

B) may develop a pneumothorax or experience a decrease in venous return to the heart if they are ventilated too rapidly.

Question 7

Which of the following patients is LEAST likely in need of positive-pressure ventilation?

A) Confused 46-year-old woman with labored respirations, adventitious breath sounds, and pallor
B) Conscious 41-year-old woman with two-word dyspnea, perioral cyanosis, and tachycardia
C) Semiconscious 39-year-old man with shallow chest wall movement, cyanosis, and bradypnea
D) Conscious 36-year-old man with difficulty breathing, symmetrical chest rise and fall, and flushed skin

Answer 7

D) Conscious 36-year-old man with difficulty breathing, symmetrical chest rise and fall, and flushed skin

Question 8

An open pneumothorax causes ventilatory inadequacy when:

A) positive pressure created by expiration forces air into the pleural space.
B) the heart stops perfusing the lung on the side of the open chest injury.
C) negative pressure created by inspiration draws air into the pleural space.
D) the glottic opening is much larger than the open wound on the chest wall.

Answer 8

C) negative pressure created by inspiration draws air into the pleural space.

Question 9

Negative-pressure ventilation occurs when:

A) the diaphragm ascends and the intercostal muscles retract.
B) air is drawn into the lungs when intrathoracic pressure decreases.
C) pressure within the chest decreases and air is forced from the lungs.
D) the phrenic nerves stop sending messages to the diaphragm

Answer 9

B) air is drawn into the lungs when intrathoracic pressure decreases.

Question 10

When ventilating a patient with a bag-mask device, you note increased compliance. This means that:

A) you are meeting resistance when ventilating.
B) air can be forced into the lungs with relative ease.
C) a lower airway obstruction should be suspected.
D) the patient likely has an upper airway obstruction.

Answer 10

B) air can be forced into the lungs with relative ease.

Question 11

A patent airway:

A) is evidenced by visible chest rise.
B) should be prophylactically suctioned.
C) does not equate to adequate ventilation.
D) is characterized by adequate tidal volume

Answer 11

C) does not equate to adequate ventilation.

Question 12

A “runaway” pacemaker is characterized by:

A) an absence of pacemaker spikes.
B) profound slowing of the heart rate.
C) a tachycardic pacemaker rhythm.
D) a narrowing of the QRS complexes.

Answer 12

C) a tachycardic pacemaker rhythm.

Question 13

A delta wave is identified on a cardiac rhythm strip as a(n):

A) apparent P wave that occurs at the end of the QRS complex.
B) acute widening of the QRS complex immediately after the R wave.
C) rapid upslope to the R wave immediately after the end of the P wave.
D) delay between the end of the P wave and the beginning of the R wave.

Answer 13

C) rapid upslope to the R wave immediately after the end of the P wave.

Question 14

Hematochezia:

A) indicates digested blood from the upper gastrointestinal tract.
B) is the passage of stools that contain bright red blood.
C) suggests kidney injury and is characterized by bloody urine.
D) is the passage of dark stools and indicates lower gastrointestinal bleeding.

Answer 14

B) is the passage of stools that contain bright red blood.

Question 15

Hemoglobin functions by:

A) dissolving in blood plasma to create the partial pressure of carbon dioxide.
B) binding to oxygen that is absorbed in the lungs and transporting it to the tissues.
C) absorbing hydrogen ions in the blood in order to maintain acid-base balance.
D) transporting red blood cells throughout the body to ensure adequate oxygenation.

Answer 15

B) binding to oxygen that is absorbed in the lungs and transporting it to the tissues.

Question 16

Flash burns:

A) are usually relatively minor compared with the potential for trauma from whatever caused the flash.
B) are caused by prolonged exposure to intense heat, usually resulting in burns that extend deep into the dermis.
C) are a common source of burn injury and are most often the result of hot liquids, such as radiator fluid.
D) are generally confined to a very small area of the body, but cause extensive damage to the dermis.

Answer 16

A) are usually relatively minor compared with the potential for trauma from whatever caused the flash.

Question 17

Hyphema is defined as:

A) severe ecchymosis to the orbital region.
B) blood in the anterior chamber of the eye.
C) marked swelling of the globe of the eye.
D) double vision following blunt eye trauma.

Answer 17

B) blood in the anterior chamber of the eye.

Question 18

Common clinical findings associated with a traumatic asphyxia include all of the following, EXCEPT:

A) hyphema.
B) exopthalmos.
C) facial cyanosis.
D) tongue swelling.

Answer 18

A) hyphema.

Question 19

Because the high-pressure ventilator used with needle cricothyrotomy would cause an increase in intrathoracic pressure, ___________ and ___________ may result.

A) hypercarbia, hypoxia
B) barotrauma, pneumothorax
C) hypoventilation, hypocarbia
D) esophageal rupture, hemorrhage

Answer 19

B) barotrauma, pneumothorax

Question 20

A wandering atrial pacemaker:

A) has consistent P-wave shapes.
B) is generally faster than 100 beats/min.
C) may have variable PR intervals.
D) is generally treated with atropine.

Answer 20

C) may have variable PR intervals.

Question 21

The basal metabolic rate is MOST accurately defined as:

A) the expenditure of heat energy during strenuous exertion or exercise.
B) the heat energy produced at rest from normal body metabolic reactions.
C) the balance between heat production and heat elimination from the body.
D) a constant fluctuation in core body temperature to maintain homeostasis.

Answer 21

B) the heat energy produced at rest from normal body metabolic reactions.

Question 22

Which of the following statements regarding shivering is correct?

A) Shivering is the body’s mechanism for retaining heat.
B) Only patients with severe hypothermia present with shivering.
C) Shivering increases the basal metabolic rate by up to five times.
D) The body initially responds to cold with involuntary shivering.

Answer 22

C) Shivering increases the basal metabolic rate by up to five times.

Question 23

When administering oxygen via a nonrebreathing mask, you must ensure that the:

A) reservoir is half-filled first.
B) one-way valves are disabled.
C) patient has adequate tidal volume.
D) flow rate is set to at least 6 L/min.

Answer 23

C) patient has adequate tidal volume.

Question 24

A construction worker fell approximately 15 ft and landed on his head. He is semiconscious. His respiratory rate is 14 breaths/min with adequate depth. Further assessment reveals blood draining from his nose. You should:

A) administer oxygen via nonrebreathing mask and continue your assessment.
B) insert a nasopharyngeal airway and assist ventilations with a bag-mask device.
C) suction his nasopharynx for up to 30 seconds and apply oxygen via nasal cannula.
D) insert a nasopharyngeal airway and administer oxygen via nonrebreathing mask

Answer 24

A) administer oxygen via nonrebreathing mask and continue your assessment.

Question 25

A 45-year-old unrestrained man was ejected from his small truck when it struck a tree. The patient is found approximately 20 feet from the wreckage. Your primary assessment reveals that he is unresponsive and has sonorous respirations and a rapid pulse. Your initial actions should include:

A) applying a cervical collar and assisting his ventilations with a bag-mask device.
B) rolling the patient onto his side as a unit and suctioning his mouth for 15 seconds.
C) performing a tongue-jaw lift and looking in his mouth for any obvious obstructions.
D) manually stabilizing his head and opening his airway with the jaw-thrust maneuver.

Answer 25

D) manually stabilizing his head and opening his airway with the jaw-thrust maneuver.

Question 26

The fraction of inspired oxygen (FIO2) increases with:

A) increased tidal volume.
B) forceful inhalation.
C) supplemental oxygen.
D) an increase in respirations.

Answer 26

C) supplemental oxygen.

Question 27

The upper airway of an adult consists of all the structures above the:

A) carina.
B) bronchus.
C) Glottis/vocal cords
D) cricoid ring

Answer 27

C) Glottis/vocal cords

Question 28

Indications for CPAP include:

A) cardiopulmonary arrest.
B) acute pulmonary edema.
C) severe opiate toxicity.
D) acute bacterial pneumonia

Answer 28

B) acute pulmonary edema.

Question 29

A hyperventilating patient:

A) may be acidotic and is trying to decrease his or her pH level.
B) is most effectively treated by administering a sedative drug.
C) should rebreathe his or her carbon dioxide to effect resolution.
D) presents with tachypnea and marked use of accessory muscles

Answer 29

A) may be acidotic and is trying to decrease his or her pH level.

Question 30

A patient who is coughing up purulent sputum is MOST likely experiencing:

A) emphysema.
B) dehydration.
C) an infection.
D) pulmonary edema.

Answer 30

C) an infection.

Question 31

Which of the following findings is MOST clinically significant in a 30-year-old woman with difficulty breathing and a history of asthma?

A) Oral temperature of 97.9°F
B) Expiratory wheezing on exam
C) Prior ICU admission for her asthma
D) 3 mm Hg drop in systolic BP during inhalation

Answer 31

C) Prior ICU admission for her asthma

Question 32

A patient with a history of asthma is at GREATEST risk for respiratory arrest if he or she:

A) takes a bronchodilator and a corticosteroid.
B) was previously intubated for his or her condition.
C) was recently evaluated in an emergency department.
D) has used his or her inhaler twice in the previous week.

Answer 32

B) was previously intubated for his or her condition.

Question 33

A patient with quiet tachypnea is MOST likely experiencing:

A) shock.
B) asthma.
C) alkalosis.
D) airway swelling.

Answer 33

A) shock.

Question 34

A patient with respiratory distress who is willing to lie flat:

A) should be intubated at once.
B) may be acutely deteriorating.
C) has minimal fluid in the lungs.
D) likely has basilar pneumonia.

Answer 34

B) may be acutely deteriorating.

Question 35

A patient with status asthmaticus commonly presents with:

A) compensatory respiratory alkalosis and stridor.
B) accessory muscle use and inspiratory wheezing.
C) audible expiratory wheezing and severe cyanosis.
D) physical exhaustion and inaudible breath sounds.

Answer 35

D) physical exhaustion and inaudible breath sounds.

Question 36

A pulse oximetry reading would be least accurate in a patient:

A) with chronic hypoxia
B) with poor peripheral perfusion
C) whose extremities are cool
D) with persistent tachycardia

Answer 36

B) with poor peripheral perfusion

Question 37

Abnormal breath sounds associated with pneumonia and congestive heart failure are most often heard in the:

A) right middle lobe
B) midaxillary line
C) apices of the lungs
D) bases of the lungs

Answer 37

D) bases of the lungs

Question 38

Patients with COPD typically experience an acute exacerbation of their condition because of:

A) a secondary condition such as congestive heart failure or a pneumothorax.
B) progressively worsening pneumonia that results in a diminished cough reflex.
C) chronic noncompliance with their prescribed medications and home oxygen.
D) environmental changes such as weather or the inhalation of trigger substances.

Answer 38

D) environmental changes such as weather or the inhalation of trigger substances.

Question 39

If a patient’s hemoglobin level is 8 g/dL due to hemorrhage and all of the hemoglobin molecules are attached to oxygen, the patient’s oxygen saturation would MOST likely read:

A) above 95%.
B) between 90% and 95%
C) between 85% and 90%.
D) significantly lower than 85%.

Answer 39

A) above 95%.

Question 40

Bedridden patients with excessive pulmonary secretions are MOST prone to developing:

A) pneumonia.
B) bronchospasm.
C) a pneumothorax.
D) a pulmonary embolism.

Answer 40

A) pneumonia.

Question 41

COPD is characterized by:

A) narrowing of the smaller airways that is often reversible with prompt treatment.
B) changes in pulmonary structure and function that are progressive and irreversible.
C) small airway spasms during the inhalation phase, resulting in progressive hypoxia.
D) widespread alveolar collapse due to increased pressure during the exhalation phase.

Answer 41

B) changes in pulmonary structure and function that are progressive and irreversible

Question 42

A “run” of ventricular tachycardia occurs if at least ____ PVCs occur in a row.
A) two
B) three
C) four
D) five

Answer 42

B) three

Question 43

A 33-year-old male presents with chest pain that is alleviated when he sits forward. the 12-lead ECG shows ST elevation of 2 to 3 mm in multiple noncontiguous leads. What should you suspect?

A) Unstable angina
B) Pericarditis
C) Acute myocardial infarction
D) Aortic aneurysm

Answer 43

B) Pericarditis

Question 44

A 60-year-old man with crushing chest pain has 3mm of ST elevation in leads V1 through V4. What should you suspect?

A) Left anterior descending artery occlusion
B) Right ventricular infarction
C) Left circumflex occlusion
D) Right coronary artery occlusion

Answer 44

A) Left anterior descending artery occlusion

Question 45

A 60-year-old woman presents with fever, chills, and shortness of breath. She has a history of mitral valve prolapse. Assessment reveals flat, painless red lesions on the palms of the hands. What should you suspect?

A) Myocarditis
B) Pericarditis
C) Endocarditis
D) Cardiac tamponade

Answer 45

C) Endocarditis

Question 46

A 70-year-old presents with pain in his legs while walking. Within a few minutes of sitting down, however, his symptoms resolve. What should you suspect?

A) Abdominal aortic aneurysm
B) Deep vein thrombosis
C) Right ventricular failure
D) Peripheral arterial disease

Answer 46

D) Peripheral arterial disease

Question 47

A concordant precordial pattern exists when all the QRS complexes:

A) are less than 120 milliseconds
B) are greater than 120 milliseconds
C) In V1 through V6 end with an R wave
D) are upright in leads V1 though V6

Answer 47

D) are upright in leads V1 though V6

Question 48

A decreased cardiac output secondary to a heart rate greater than 150 beats/min is caused by:

A) myocardial stretching due to increased preload.
B) decreases in stroke volume and ventricular filling.
C) increased automaticity of the cardiac pacemaker.
D) ectopic pacemaker sites in the atria or ventricles.

Answer 48

B) decreases in stroke volume and ventricular filling.

Question 49

The most significant fall occurs from a height greater than:

A) 4 times the patient’s height
B) 5 feet
C) 1.5 times the patient’s height
D) 15 feet

Answer 49

D) 15 feet

Question 50

The peak magnitude of the pressure wave experienced by a person:

A) lessens as a person is farther away from the center of the explosion
B) causes secondary and tertiary injuries as a result of the explosion
C) will cause less severe trauma if the person is standing beside a solid object
D) causes more severe trauma if the person is in an open area during the explosion

Answer 50

A) lessens as a person is farther away from the center of the explosion

Question 51

A fall in blood pressure and the resultant changes in plasma osmolality cause the release of:

A) T3 and T4 from the thyroid gland
B) Aldosterone and antidiuretic hormone
C) glycogen and luteinizing hormone
D)acetylcholine and angiotensin I

Answer 51

B) Aldosterone and antidiuretic hormone

Question 52

How can you tell if bleeding from the ears and nose contains cerebrospinal fluid?

A) CSF is a bright yellow color
B) CSF has a dark brow color
C) CSF has a high glucose content
D) CSF clots within 10 seconds

Answer 52

C) CSF has a high glucose content

Question 53

Applying direct pressure to a bleeding would stops the flow of blood because:

A) direct pressure facilitates vasoconstriction
B) pressure shunts blood away from the injury
C) it allows platelets to seal the vascular walls
D) pressure stimulates the release of fibrin

Answer 53

C) it allows platelets to seal the vascular walls

Question 54

Systemic signs of infection secondary to a soft tissue injury include:

A) pus drainage
B) lymphangitis
C) fever and chills
D) erythema

Answer 54

C) fever and chills

Question 55

When applying a dressing and bandage to a scalp wound, you should:

A) remove any foreign particles from the wound first
B) apply a cervical collar in case the c-spine is injured
C) carefully assess the skull for an underlying fracture
D) always use a loose dressing to soak up the blood

Answer 55

C) carefully assess the skull for an underlying fracture

Question 56

A 24-year-old woman was struck by lightning. Bystanders moved the patient to an area of safety by did not provide any other care before your arrival. Your primary assessment reveals that the patient is pulseless and apneic. You begin CPR and apply the cardiac monitor, which reveals asystole. After requesting a backup paramedic until, the most appropriate treatment for this patient involves:

A) performing adequate BLS, following standard ACLS protocol, and considering terminating your efforts if asystole persists after 10 minutes

B) continuing CPR, providing full spinal precautions, intubating her trachea, and ventilating her at a rate of 20 to 24 breaths per minute

C) continuing CPR, protecting her spine while ventilating, reassessing her cardiac rhythm after 2 minutes of CPR, and defibrillating if necessary.

D) instructing your partner to resume one-rescuer CPR, establishing an IV of normal saline, and reassessing her cardiac rhythm in 5 minutes.

Answer 56

C) continuing CPR, protecting her spine while ventilating, reassessing her cardiac rhythm after 2 minutes of CPR, and defibrillating if necessary.

Question 57

Full-thickness circumferential burns to the chest:

A) require the paramedic to incise the burn to decompress it.
B) may cause significant restriction of respiratory excursion.
C) are generally not significant unless the skin is unyielding.
D) necessitate immediate intubation and ventilatory support.

Answer 57

B) may cause significant restriction of respiratory excursion.

Question 58

A patient with a dysconjugate gaze following an ocular injury:

A) should have ice applied to the eyes to prevent blindness
B) has discoordination between the movements of both eyes
C) most likely has a concomitant basilar skill fracture
D) should be treated by irrigating both eyes for 20 minutes

Answer 58

B) has discoordination between the movements of both eyes

Question 59

Bradycardia that occurs shortly after you have dressed and bandaged an open neck wound is MOST likely the result of:

A) decreased vagal tone secondary to direct injury to the vagus nerve.
B) decreased venous return from the brain and an increase in intracranial pressure.
C) an acute pulmonary embolism due to the entrainment of air into one of the jugular veins.
D) parasympathetic nervous system stimulation due to excessive pressure on the carotid artery.

Answer 59

D) parasympathetic nervous system stimulation due to excessive pressure on the carotid artery.

Question 60

If a patient is unable to follow your finger above the midline following blunt trauma to the face, you should be most suspicious for a(n):

A) basilar skull fracture
B) nasal bone fracture
C) Le Fort II fracture
D) orbital skull fracture

Answer 60

D) orbital skull fracture

Question 61

When assessing a patient with maxillofacial trauma, it is most important to:

A) have the patient open their mouth and assess for dental malocclusion
B) gently palpate the maxilla, mandible, and zygoma to elicit crepitus
C) protect the cervical spine and monitor the patient’s neurologic status
D) apply a cervical collar and determine if the patient has visual disturbances

Answer 61

C) protect the cervical spine and monitor the patient’s neurologic status

Question 62

A 39-year-old man crashed his vehicle into a wooded area and was not found for approximately 8 hours. When you arrive at the scene and assess him, you note that he is conscious but anxious. He is unable to feel or move below his mid-thoracic area and complains of a severe headache. His blood pressure is 210/130 mm Hg, heart rate is 44 beats/min, and respirations are 22 breaths/min. This patient’s clinical presentation is MOST consistent with:

A) neurogenic shock.
B) intracranial pressure.
C) autonomic dysreflexia.
D) symptomatic bradycardia.

Answer 62

C) autonomic dysreflexia.

Question 63

A blood pressure of 110/68 Hg in the presence of clinical signs of a tension pneumothorax:

A) indicates that prehospital needle decompression likely will not be required
B) should be treated with crystalloid fluid boluses to prevent hypotension
C) suggests adequate cardiac compensation for the diminished venous return
D) is likely the result of systemic vasodilation in an attempt to reduce preload

Answer 63

C) suggests adequate cardiac compensation for the diminished venous return

Question 64

A pulmonary contusion following blunt chest trauma results in:

A) blood leakage from injured lung tissue into the pleural space.
B) decreased pulmonary shunting with rupture of the alveolar sacs.
C) alveolar and capillary damage with intraparenchymal lung hemorrhage.
D) pulmonary vasodilation as the body attempts to shunt blood to the injury.

Answer 64

C) alveolar and capillary damage with intraparenchymal lung hemorrhage.

Question 65

As air accumulates in the pleural space, the first thing to occur is:

A) jugular venous distension
B) decreased pulmonary function
C) marked decrease in venous return
D) compression of the great vessels

Answer 65

B) decreased pulmonary function

Question 66

Dysrhythmias following a myocardial contusion are usually secondary to:

A) excess tachycardia that accompanies the injury.
B) damage to myocardial tissue at the cellular level.
C) aneurysm formation caused by vascular damage.
D) direct damage to the vasculature of the epicardium.

Answer 66

B) damage to myocardial tissue at the cellular level.

Question 67

When assessing a patient with abdominal trauma for distention, you must recall that:

A) a distended abdomen is one of the earliest clinical findings in patients with abdominal trauma.
B) abdominal distention is usually caused by muscle tensing rather than intraabdominal bleeding.
C) a significant amount of blood volume in the abdominal cavity is required to produce distention.
D) because distention is a late sign of intraabdominal bleeding, it should not be assessed for in the field.

Answer 67

C) a significant amount of blood volume in the abdominal cavity is required to produce distention.

Question 68

Which of the following is NOT a function of the pancreas?

A) Enzyme secretion
B) Secretion of insulin
C) Glucagon secretion
D) Reservoir for bile

Answer 68

B) Secretion of insulin

Question 69

A dislocation is considered an urgent injury because of its potential to cause:

A) significant internal bleeding
B) severe hemodynamic instability
C) proximal sensory and motor loss
D) neurovascular compromise

Answer 69

D) neurovascular compromise

Question 70

Correctly splinting an injured extremity:

A) typically provides complete pain relief without the need to administer narcotic analgesia.
B) effectively reduces swelling and inflammation by shunting blood away from the injured area.
C) eliminates the need to elevate the extremity because immobilization causes blood stasis.
D) helps to control internal bleeding by allowing clots to form where vessels are damaged.

Answer 70

D) helps to control internal bleeding by allowing clots to form where vessels are damaged.

Question 71

A motorcycle rider struck a parked car and was catapulted over the handlebars of his bike. Your assessment reveals that he is tachypneic, diaphoretic, and tachycardic. There is no gross external bleeding present. What is the MOST likely cause of this patient’s clinical presentation?

A) Closed head injury
B) Bilateral femur fractures
C) Proximal upper extremity fractures
D) Sympathetic nervous system failure

Answer 71

B) Bilateral femur fractures

Question 72

In a closed femur fracture, blood loss may exceed _______ before enough pressure develops to tamponade the bleeding.

A) 250 mL
B) 500 mL
C) 750 mL
D) 1,000 mL

Answer 72

D) 1,000 mL

Question 73

The risk of a pulmonary embolism following musculoskeletal trauma is HIGHEST in patients with:

A) upper extremity fractures that result in lengthy hospital admissions.
B) pelvic and lower extremity injuries that lead to prolonged immobilization.
C) numerous rib fractures who are taking anticoagulant medications.
D) any proximal long bone fracture that occurred greater than 72 hours prior to medical intervention.

Answer 73

B) pelvic and lower extremity injuries that lead to prolonged immobilization.

Question 74

A 56-year-old diabetic woman presents with a painful, reddened area on her left forearm, which she first noticed a few days ago. Closer examination reveals a blister in the center of the affected area. The patient denies being bitten or stung by anything and states that the only thing she has been doing is storing boxes in the attic. You should be MOST suspicious that this patient has a(n):

A) poorly healed diabetic ulcer.
B) local reaction to an ant bite.
C) infection caused by a tick.
D) brown recluse spider bite.

Answer 74

D) brown recluse spider bite.

Question 75

A flail chest is characterized by:

A) a free-floating segment of fractured ribs.
B) bulging of fractured ribs during inspiration.
C) excessive negative intrathoracic pressure.
D) drawing in of fractured ribs during expiration.

Answer 75

A) a free-floating segment of fractured ribs.

Question 76

Biot respirations are characterized by:

A) slow, shallow irregular respirations or occasional gasping breaths.
B) an irregular pattern of breathing with intermittent periods of apnea.
C) deep, gasping respirations that are often rapid but may be slow.
D) increased respirations followed by apneic periods.

Answer 76

B) an irregular pattern of breathing with intermittent periods of apnea.

Question 77

CPAP is NOT appropriate for patients with:

A) acute or chronic bronchospasm.
B) slow, shallow respiratory effort.
C) an oxygen saturation less than 90%.
D) evidence of congestive heart failure.

Answer 77

B) slow, shallow respiratory effort.

Question 78

A wide QRS complex that is preceded by a normal P wave indicates:

A) that the rhythm is ventricular in origin.
B) rapid conduction through the ventricles.
C) a delay in conduction at the AV junction.
D) an abnormality in ventricular conduction.

Answer 78

D) an abnormality in ventricular conduction.

Question 79

Atrial fibrillation can be interpreted by noting:

A) PR intervals that vary from complex to complex.
B) an irregularly irregular rhythm and absent P waves.
C) a regularly irregular rhythm with abnormal P waves.
D) the presence of wide QRS complexes and a rapid rate.

Answer 79

B) an irregularly irregular rhythm and absent P waves.

Question 80

The MOST likely cause of heat syncope is:

A) paroxysmal tachycardia.
B) vasodilation and dehydration.
C) underlying cardiovascular disease.
D) profound peripheral vasoconstriction.

Answer 80

B) vasodilation and dehydration.

Question 81

What do the spleen and liver have in common?

A) They are both highly vascular and bleed profusely when injured.
B) The liver and spleen are well protected by the abdominal muscles.
C) They are less likely to be crushed by blunt trauma than other organs.
D) The liver and spleen are the only solid organs in the abdominal cavity.

Answer 81

A) They are both highly vascular and bleed profusely when injured.

Question 82

Common clinical findings associated with a traumatic asphyxia include all of the following, EXCEPT:

A) hyphema.
B) exopthalmos.
C) facial cyanosis.
D) tongue swelling.

Answer 82

A) hyphema.