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nero test Flashcards

1
Q

You would NOT expect a person using methamphetamine to present with:

A

Bradypnea

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2
Q

Patient with alcoholism are prone to subdural hematomas gastrointestinal bleeding MAINLY because:

A

Their blood-clotting mechanisms are impaired.

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3
Q

The clinical presentation of a stimulant abuser includes:

A

Excitement, hypertension, tachycardia, and dilated puplis.

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4
Q

Which of the following ECG abnormalities is MOST suggestive of cocaine toxicity..

A

Prolongation of the QT interval.

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5
Q

If you are treating a patient with a suspected benzodiazepine overdose, and find that that the patient is hypotensive, bradycardia, and comatose:

A

You should consider concomitant overdose with another CNS depressant.

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6
Q

Narcan (naloxone) is a narcotic that displaces narcotic molecules from opiate receptors. Which of hte following should be anticipated when Narcan is given to a person who is physically addicted to a narcotic?

A

Extreme combativeness

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7
Q

The recommended dose and method for administering naloxone to a patient who overdosed on a narcotic and is unresponsive and hypo-ventilating is:

A

0.8 mg injected IM to improve respiratory effort/

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8
Q

Signs and symptoms of organophosphate poisoning include:

A

vomiting

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9
Q

Common signs and symptoms of a tricyclic antidepressant overdose include:

A

altered mental status and tachycardia

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10
Q

Severe salicylate toxicity produces:

A

Metabolic acidosis

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11
Q

A 29-year-old woman was found unresponsive by her husband. When you arrive at the scene and begin your assessment, you note that that patient’s reparations are slow and shallow, her pulse is slow and weak, and her pupils are markedly dilated. Your partner begins assisting the patient’s ventilations as you assess her blood pressure, which is 70/48 mm Hg. The patient’s husband hands you an empty bottle of phenobarbital, which was filled the day before, and tells that his wife takes the medication for seizures. After establishing vascular access, you should:

A

recognize the need for crystalloid fluid boluses to improve her blood pressure

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12
Q

Sammy a 2 y/o got hold of his grandmothers’ Verapamil (a calcium channel blocker). Like Cardizem (diltiazem) and Procardia (nifedipine), Verapamil at toxic levels can cause some serious dysrhythmias including:

A

Complete heart block
Sinus arrest
Bradycardia
Asystole

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13
Q

The two main classifications of seizures are:

A

Focal & Generalized

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14
Q

Which of the following pose a high risk for the occurrence of seizures?

A

Eclampsia
Drug withdrawal
Pyrexia

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15
Q

Seizures can often result from which of the following problems?

A

Hypoxia
Hypoglycemia
Metabolic imbalance
Stroke

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16
Q

You are transporting a stroke patient to the hospital. Which of the following assessment findings would be most indicative of a deteriorating state?

A

Ataxic respirations
A bradycardia
Projectile vomiting
A period of seizure activity

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17
Q

Ischemic cerebrovascular accidents include which of the following pathology:

A

Tumor
Embolism
Thrombosis

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18
Q

Which of the following statement is/are true?

A

An ischemic stroke of stroke is often occurs in the early morning
A hemorrhagic stroke may occur with a “sentinel hemorrhage” or warning leak.
A hemorrhagic stroke occurs often in an area known as the Circle of Willis

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19
Q

Signs and symptoms of a leaking or ruptured abdominal aortic aneurysm include:

A

Unexplained syncope or hypotension
Acute onset of back pain
Diaphoresis and cool skin

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20
Q

Bilious vomit can result from:

A

Cholecystitis

Acute pancreatitis

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21
Q

Which of the following statement regarding pancreatitis are true?

A

In men this disease can be associated with alcoholism and/or peptic ulcer
In women this disease is commonly associated with biliary tract disease
In many patients then first epigastric pain centered close to the umbilicus and unrelieved by vomiting

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22
Q

Acute pancreatitis may result in:

A

Pancreatic enzymes entering the vascular system and causing vasodilation
A large amount of plasma volmue being trapped in the pancreas
Pain after the ingestion of alcohol of food
Haemorrhage as necrosis develops and pancreatic tissue breaks away.

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23
Q

An abrupt increase in muscle tone of the face and torso, along with flexion of arms and extension of legs, lasting only seconds, best describes a:

A

Tonic seizure

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24
Q

Seizures or convulsions have many causes but all result from:

A

Excessive disordered discharge of neural impulses

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25
Q

Of the following, which is the most common cause of a CVA:

A

Thrombosis

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26
Q

A presentation with a dilated left pupil: left ptosis (drooping of eyelid): and inability to look up, down, or medially with her left eye may indicate a problem with:

A

left oculomotor nerve

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27
Q

Sensory phenomena or auras can be initial symptom of a seizure. The likely location of the initial cortical discharge can be deduced from these clinical features at onset. Olfactory or gustatory hallucinations often come from an area in the:

A

Temporal lobe

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28
Q

Receptive aphasia usually indicates a lesions in:

A

Wernicke’s area in the temporal lobe

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29
Q

Lasting seconds only and resulting in apnea, muscular rigidity, and incontinence best describes which phase of a grand-mal seizure?

A

Tonic

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30
Q

Your patient is a 24-year-old male who is alert and oriented, complainting of severe “dizziness” and an earache for two days. He stated that any movement of his head causes him to become very dizzy and nauseated. The patient’s skin warm and dry, his pupils are equal and reactive, and there is no gross neurological deficit.. HR = 82 BP = 120/82, RR = 12, SaO2 + 99%. Which of the following is most likely?

A

Labyrinthitis

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31
Q

All of the following are assessed during the Los Angles Motor Screen EXCEPT:

A

Motor strength of lower extremities.

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32
Q

Which of the following statement if false regrading hyperkalemia?

A

Kayexalate is the primary drug used to treat hyperkalemia greater than 7 mmol/L

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33
Q

Underproduction of ____ caused by decreasing functioning of the adrenal cortex called adrenal insufficiency (AI)

A

Aldosterone and cortisol

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34
Q

An ____ is a twisting of the intestine onto itself, usually resulting in strangulation

A

volvulus

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35
Q

Which of the following is an appropriate dose and route of administration of Midazolam for a 60 kg patient, according to the Medical Directive.

A

Administer Midazolam 10 mg IN

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36
Q

Benozodiazepines

A

Effect GABA receptors, thus allowing more more CL- to enter the cell and hyper polarizing it

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37
Q

You are called at 1900 to care for a 40 y/o woman who is complaining of intermitten severe RUQ abdominal pain. She is vomitting and has a low grade fever. What do you suspect.

A

Cholecystitis

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38
Q

Hemodynamic instability, hematuria, or melena can confirm hemorrhagic complications in a peptic ulcer. Although not always bleeding, a perforation usually will present with severe pain to peritoneal signs. Sudden mid-back pain from a posterior perforation of the stomach may indicate:

A

Pancreatitis

39
Q

Seizures can often result from which of the following problems?

A

hypoxia
hypoglycaemia
metabolic imbalance
stroke

40
Q

Dangerous complications of seizures include:

A

Status epilepticus brain damage

41
Q

Nuchal rigidity and photophobia are most often associated with which two neurological problems

A

Subarachnoid bleed

meningitis

42
Q

Which of the following statement is/are true?

A

An ischemic stroke type of stroke is often occurs in the early morning
A hemorrhagic stroke may occur with a “sentinel hemorrhage” or warning leak
A hemorrhagic stroke occurs often in an area known as the Circle of Willis

43
Q

While performing an abdominal assessment, you palpate deeply against the abdomen and then quickly release the pressure. As you release the pressure, you are observing for pain reported on the opposite side. When using this technique, what physical finding is documented?

A

rebound tenderness

44
Q

Which of the following is most consistent with a pathology of upper gastrointestinal bleeding?

A

dark, melanotic stool

45
Q

During an abdominal assessment, you palpate deeply into the right upper quadrant. The patient immediately responds with severe pain during the palpation. The patient actually catches her breath for a moment. This is a positive _______ sign.

A

Murphy’s

46
Q

While performing a neurologic assessment, you complete the GCS score. On examination, you note that your patient will open her eyes when you call her name; she is oriented to person, place, and time; and she obeys verbal commands. Based on these findings, what GCS score will you assign to this patient?

A

14

47
Q

The _______ is responsible for managing fluid volumes, maintaining acid-base balance, and discarding toxins. Approximately one-fourth of all cardiac output flows through it each minute.

A

kidney

48
Q

The glomerular filtration rate (GFR) is a benchmark for:

A

renal function

49
Q

All of the following are causes of upper GI bleeding EXCEPT:

A

angiodysplasia

50
Q

A root cause of esophageal varices is/are:

A

cirrhosis.

51
Q

The most common cause of lower GI bleeding is:

A

diverticulosis.

52
Q

_______ is the most common symptom associated with lower GI disorders.

A

Diarrhea

53
Q

Proton pump inhibitors are administered to control:

A

peptic ulcers

54
Q

A(n) _______ is a twisting of the intestine onto itself, usually resulting in strangulation.

A

volvulus

55
Q

Which of the following is a major factor that makes children susceptible to hypothermia?

A

the inability to shiver

56
Q

Physical assessment of a child’s cardiovascular system begins with:

A

observing the child’s general appearance and level of consciousness.

57
Q

All pediatric assessments should begin with forming a general impression using the:

A

pediatric assessment triangle.

58
Q

Because the respiratory control center in infants is immature, their respiratory pattern is often:

A

irregular

59
Q

Due to the relatively large tongue of a child in proportion to his or her mouth, successful intubation requires: proper blade size, proper positioning, and proper:

A

sweeping of the tongue.

60
Q

Upper airway obstruction may be recognized by signs of nasal flaring, stridor, increased respiratory effort, and:

A

a prolonged inspiratory phase.

61
Q

Which of the following statements about croup (laryngotracheobronchitis) is TRUE?

A

It is commonly associated with a low-grade fever.

62
Q

An increase in _______ is the chief compensatory mechanism in children to increase end-organ perfusion and to maintain blood pressure.

A

heart rate

63
Q

In young children, the narrowest part of the trachea is the:

A

cricoid ring

64
Q

Which of the following factors contribute to an infant’s increased risk of hypoglycemia?

A

an increased metabolic rate, fewer glycogen stores, and an immature liver

65
Q

Hypothermia in the newborn/neonate is associated with:

A

hypoxia.

66
Q

During uterine life, which of the following statements is MOST accurate regarding fetal circulation?

A

Blood returns from the lungs into the left atrium

67
Q

In a potential neonatal resuscitation situation, the initial evaluation begins with the evaluation of:

A

breathing, color, and pulse rate

68
Q

Which of the following clearly indicates the need for positive-pressure ventilation (PPV)?

A

a pulse rate of 64 beats/min and marked respiratory distress

69
Q

Immediately after delivery, stimulation, and suctioning, there are still absent respirations in the newborn. As you prepare to begin bag-valve-mask (BVM) ventilations, you know that:

A

due to the risks of oxygen toxicity in the newborn, the current recommended practice is to perform PPV with room air only.

70
Q

Which of the following is an indication for endotracheal intubation in the neonate?

A

Meconium staining is present and there is marked respiratory distress

71
Q

Which of the following is a complication of endotracheal intubation in the neonate?

A

All of the above.

72
Q

When considering interventions during neonatal resuscitation, which of the following is TRUE?

A

Medications are rarely needed because infants can be resuscitated with effective ventilatory support.

73
Q

Due to their immature immune systems, neonates are at especially high risk for pneumonia. Which of the following symptoms are most likely associated with a pneumonia presentation?

A

increased work of breathing, hypothermia, and a respiration rate of 64 breaths/min

74
Q

Which of the following are common pathologic causes for tachycardia?

A

tissue hypoxia and hypovolemia

75
Q

Which of the following statements is TRUE regarding intussusception?

A

Bloody or currant jelly stool is typical.

76
Q

Which of the following is a cause or risk factor for birth injuries to the neonate?

A

breech presentation

77
Q

What is the rule of ET tube depth in the neonate?

A

6 + weight in kg

78
Q

If an emergent needle decompression for a possible tension pneumothorax is indicated, what area most closely approximates the second intercostal space?

A

just above the nipple

79
Q

Persistent pulmonary hypertension (PPHN) is:

A

persistence of elevated pressures in pulmonary vasculature after birth.

80
Q

What are some possible causes of apnea at birth?

A

pneumonia, congenital heart disease, and hypoglycemia

81
Q

Which of the following is an appropriate heart rate for a healthy neonate?

A

154

82
Q

During a neonatal resuscitation, BVM ventilations have been ongoing for 10 minutes. Which of the following should be considered?

A

gastric decompression with an orogastric tube

83
Q

When performing a circulation assessment for the neonate, which of the following is/are assessed?

A

renal output

84
Q

Neonates are particularly more susceptible to:

A

group B Streptococcus.

85
Q

Priority care for an unresponsive patient who has overdosed on phenobarbital includes:

A

securing the airway and preventing aspiration.

86
Q

A 45-year-old man is found unresponsive in an alley. During your assessment, you note that he is tachycardic and breathing rapidly. He has an obvious odor of alcohol on his breath. Your MOST immediate concern should be to:

A

take actions to prevent aspiration

87
Q

Treatment for cyanide poisoning may include all of the following EXCEPT:

A

calcium gluconate.

88
Q

The hyperpnea and tachypnea associated with methyl alcohol intoxication is secondary to:

A

metabolic acidosis.

89
Q

You are transporting a young female who intentionally ingested a large quantity of her prescribed Pamelor. She is conscious, but drowsy, and complains of a dry mouth and blurred vision. The cardiac monitor reveals sinus tachycardia at 120 beats/min. You are administering high-flow oxygen and have established a patent IV line. With regard to her electrocardiogram rhythm, you should be especially alert for:

A

QRS widening.

90
Q

Which of the following cardiac medications has a small therapeutic window and the GREATEST propensity to reach toxic levels?

A

Digoxin

91
Q

Any sympathomimetic drug will cause:

A

tachycardia

92
Q

When caring for an unresponsive patient with a toxicologic emergency, you should:

A

protect the airway, perform a rapid assessment, obtain vital signs, try to gather a medical history from the family, and transport promptly.

93
Q

Which of the following is caused by unilateral paralysis of cranial nerve VII?

A

Bell’s palsy

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