Random Flashcards
- Use of an automated transport ventilator is NOT appropriate for patients who are: A) in cardiac arrest. B) apneic with a pulse. C) chemically paralyzed. D) breathing spontaneously.
Ans: D Page: 885 Type: General Knowledge
- Common clinical findings in patients with obstructive lung disease include all of the following, EXCEPT: A) a decreased expiratory phase. B) pursed-lip breathing. C) abdominal muscle use. D) chronic air trapping in the lungs.
Ans: A Page: 888 Type: General Knowledge
- Decerebrate posturing: A) is characterized by abnormal flexion of the arms and extension of the lower extremities. B) is considered less severe than decorticate posturing, because it indicates that the brainstem is intact. C) is an early clinical finding, because it occurs with minimal increases in intracranial pressure. D) is a more severe finding than decorticate posturing, as it indicates damage in or near the brainstem.
Ans: D Page: 1050 Type: General Knowledge
- 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%.
Ans: A Page: 875 Type: General Knowledge
- An elderly man who is a resident of a skilled nursing facility is found unresponsive by a staff nurse. When you and your partner arrive, you assess the patient and note that his respirations are slow and shallow; his heart rate is slow, weak, and irregular; and his skin is cool and clammy. You should: A) obtain a 12-lead ECG tracing and assess his pupils. B) assist his ventilations and assess his oxygen saturation. C) assess his blood glucose level and give high-flow oxygen. D) apply oxygen via nonrebreathing mask and apply the ECG.
Ans: B Page: 1044-1045 Type: Critical Thinking
- A red, tender lump in the eyelid or at the lid margin is called a: A) rust ring. B) hyphema. C) chalazion. D) hordeolum.
Ans: D Page: 1098-1099 Type: General Knowledge
- Which of the following statements regarding epiglottitis is correct? A) Unlike croup, epiglottitis most commonly occurs in the middle of the night, when the outside temperature is cool. B) Epiglottitis has become relatively rare in children due to vaccinations against the Haemophilus influenzae type b bacterium. C) Most cases of epiglottitis are progressive in their onset and result in severe swelling of the larynx, trachea, and bronchi. D) Characteristic signs of epiglottitis include a low-grade fever, a seal-like barking cough, and varying degrees of respiratory distress.
Ans: B Page: 887 Type: General Knowledge
- Paradoxical respiratory movement is characterized by: A) the epigastrium and thorax moving in opposite directions. B) bulging of the intercostal muscles during deep inhalation. C) pulling upward of the suprasternal notch during inhalation. D) a marked decrease in movement in one of the hemithoraces.
Ans: A Page: 865 Type: General Knowledge
- When auscultating the lungs of a patient with early pulmonary edema, you will MOST likely hear: A) inspiratory rhonchi to the bilateral apices of the lungs. B) crackles in the bases of the lungs at the end of inspiration. C) faint rhonchi to all lung fields on inspiration and expiration. D) coarse crackles to the bases of the lungs during inspiration.
Ans: B Page: 895 Type: General Knowledge
- A man who was using an arc welder without eye protection presents with bilateral eye pain and diminished vision. He is conscious and alert, has a patent airway, and has stable vital signs. Treatment should include: A) covering his eyes with sterile, moist dressings; applying cool compresses lightly over his eyes; and placing him in a supine position. B) immediately irrigating his eyes with sterile saline or water; covering both eyes with dry, sterile dressings; and allowing him to sit up. C) placing him in a lateral recumbent position, keeping his eyelids closed with tape, and applying chemical warm compresses to his eyes. D) mixing baking powder with sterile water or saline and irrigating his eyes to prevent further damage caused by the ultraviolet light.
Ans: A Page: 1094-1095 Type: Critical Thinking
- When a patient with Parkinson disease is asked to turn, he or she takes small steps until the turn is complete. This is called: A) ataxia. B) decussation. C) dystonia. D) bradykinesia.
Ans: D Page: 1075 Type: General Knowledge
- Cataracts are caused by clouding of the: A) iris. B) cornea. C) retina. D) sclera.
Ans: B Page: 1091 Type: General Knowledge
- Which of the following statements regarding anatomic dead space is correct? A) Anatomic dead space is about 1 mL per pound of body weight. B) Air in the dead space participates in pulmonary gas exchange. C) The amount of dead space increases as tidal volume increases. D) If tidal volume is 500 mL, 200 mL remains in the dead space.
Ans: A Page: 860 Type: General Knowledge
- For any patient with an increase in intracranial pressure, the paramedic must: A) avoid administering IV fluid boluses. B) give glucose to prevent hypoglycemia. C) maintain an adequate blood pressure. D) take measures to lower blood pressure.
Ans: C Page: 1061 Type: General Knowledge
- Intrapulmonary shunting occurs when: A) nonfunctional alveoli inhibit pulmonary gas exchange. B) the volume of anatomic dead space suddenly increases. C) hyperinflated alveoli retain high levels of carbon dioxide. D) resistance to airflow increases due to bronchoconstriction.
Ans: A Page: 859 Type: General Knowledge
- Causes of rhinitis may include all of the following, EXCEPT: A) chemical irritants. B) high humidity. C) antihypertensives. D) cold temperature.
Ans: B Page: 1107 Type: General Knowledge
- A sudden increase in end-tidal CO2 may be the earliest indicator of: A) ineffective chest compressions. B) inadvertent ET tube dislodgment. C) return of spontaneous circulation. D) developing respiratory alkalosis.
Ans: C Page: 877 Type: General Knowledge
- You respond to the residence of a known heroin abuser. The patient, a 30-year-old man, is unconscious and unresponsive. He is hypoventilating, bradycardic, and hypotensive. Administration of 10 mg of naloxone has had no effect, and your transport time to the hospital is approximately 30 minutes. You should: A) check his blood glucose level as your partner prepares to intubate. B) transport at once and administer additional naloxone while en route. C) administer 25 g of 50% dextrose and reassess his level of consciousness. D) hyperventilate him with high-flow oxygen to minimize tissue hypoxia.
Ans: A Page: 1056-1057 Type: Critical Thinking
- A morbidly obese man called 9-1-1 because of difficulty breathing. When you arrive, you find the 39-year-old patient lying supine in his bed. He is in marked respiratory distress and is only able to speak in two-word sentences. He has a history of hypertension, but denies any respiratory conditions. What should you do FIRST? A) Begin assisting his ventilations. B) Assess his oxygen saturation level. C) Administer a beta-2 agonist drug. D) Sit him up or place him on his side.
Ans: D Page: 853, 880-881 Type: Critical Thinking
- A patient who is coughing up purulent sputum is MOST likely experiencing: A) emphysema. B) dehydration. C) an infection. D) pulmonary edema.
Ans: C Page: 868 Type: General Knowledge
- Use of a spacer device in conjunction with a metered-dose inhaler: A) is only indicated in children under 6 years of age, who are generally not able to use the inhaler effectively. B) may be required when assisting a patient who is breathing inadequately, but generally results in less medication delivery to the lungs. C) collects medication as it is released from the canister, allowing more to be delivered to the lungs and less to be lost to the environment. D) requires the patient to time his or her inhalation to coincide with the discharge of the metered-dose inhaler.
Ans: C Page: 879 Type: General Knowledge
- Common signs and symptoms of a cerebral abscess include: A) hemiplegia, low-grade fever, hyperactivity, and a diffuse stabbing headache. B) paralysis below the waist, high fever, a diffuse headache, and slurred speech. C) high-grade fever, persistent localized headache, confusion, and focal impairment. D) an absence of fever, severe localized headache, and vomiting without nausea.
Ans: C Page: 1079 Type: General Knowledge
- What is the pathophysiology of Meniere disease? A) Irritation and swelling in the inner ear affect the nerves of the inner ear and produce dizziness, loss of balance, and tinnitus. B) Dysfunction of the eustachian tube leads to increased pressure within the middle ear, which causes damage to the malleus, incus, and stapes. C) The angle of the eustachian tube does not allow for proper drainage, which allows infective material to collect in the middle ear and cause infection. D) Endolymphatic rupture creates increased pressure in the cochlear duct, which then leads to damage to the organ of Corti and the semicircular canals.
Ans: D Page: 1105 Type: General Knowledge
- What type of medication dries secretions in the airway and prevents the cilia from removing them effectively? A) Diuretic B) Antibiotic C) Antipyretic D) Antihistamine
Ans: D Page: 857 Type: General Knowledge
- Tremors that increase as the patient’s hand gets closer to an object that he or she is trying to grab are called _________ tremors and are MOST common in patients with _________. A) rest, Parkinson disease B) postural, Alzheimer disease C) clonic, cerebral palsy D) intention, multiple sclerosis
Ans: D Page: 1055, 1073 Type: General Knowledge
- Which of the following medications is a parasympathetic bronchodilator? A) Alupent B) Albuterol C) Bronkosol D) Ipratropium
Ans: D Page: 878 Type: General Knowledge
- A pulse oximetry reading would be LEAST accurate in a patient: A) with chronic hypoxia. B) whose extremities are cool. C) with persistent tachycardia. D) with poor peripheral perfusion.
Ans: D Page: 875 Type: General Knowledge
- A 56-year-old diabetic woman presents with numbness and tingling to both of her hands that have gradually intensified over the past few weeks. Your assessment reveals stable vital signs, adequate breathing, and a blood glucose level of 190 mg/dL. The cardiac monitor reveals a normal sinus rhythm. The patient tells you that she has eaten but has not taken her insulin yet. You should: A) provide supportive care and safely transport her to the hospital. B) assist her with her prescribed insulin to lower her blood glucose. C) advise her to take ibuprofen and to follow up with her physician. D) conclude that she has peripheral neuropathy and give her fentanyl.
Ans: A Page: 1079 Type: Critical Thinking
- A woman brings her 18-year-old son to your EMS station. The patient is actively seizing and, according to the mother, has been seizing for the past 10 minutes. She states that her son has a history of seizures and takes Depakote. The patient is cyanotic, is breathing erratically, and has generalized muscle twitching to all extremities. You should: A) place a bite block between his molars to prevent oral trauma, administer high-flow oxygen, and give lorazepam IM. B) protect him from further injury by restraining him, attempt orotracheal intubation, establish an IV, and give Valium. C) hyperventilate him with a bag-mask to eliminate excess carbon dioxide, establish vascular access, and give lorazepam. D) open his airway and begin assisting his ventilations, establish an IV or IO line, and administer 5 to 10 mg of diazepam.
Ans: D Page: 1069 Type: Critical Thinking
- During a generalized tonic/clonic seizure, the patient is rigid and his back is arched. This represents the _________ phase of the seizure. A) tonic B) clonic C) hypertonic D) postictal
Ans: C Page: 1067 Type: General Knowledge
- Which of the following conditions is a neural tube defect in which part of the nervous system remains outside the body? A) Multiple sclerosis B) Spina bifida C) Poliomyelitis D) Cerebral palsy
Ans: B Page: 1080-1081 Type: General Knowledge
- Which of the following statements regarding conjunctivitis is correct? A) Allergic conjunctivitis is extremely contagious. B) Conjunctivitis usually spreads to the opposite eye. C) Viral and bacterial conjunctivitis are not contagious. D) Lower respiratory infections often cause conjunctivitis.
Ans: B Page: 1097-1098 Type: General Knowledge
- In contrast to a benign neoplasm, a malignant neoplasm: A) is relatively easy to remove surgically. B) can metastasize to other parts of the body. C) results in death in the vast majority of cases. D) remains within a capsule and grows minimally.
Ans: B Page: 1071-1072 Type: General Knowledge
- You are dispatched to a residence for a young woman with difficulty breathing. When you arrive, you find the patient sitting in a tripod position, noticeably dyspneic and tachypneic. She tells you that she experienced a sudden sharp pain to the left side of her chest and then started having trouble breathing. She denies any past medical history and states that she only takes birth control pills. Based on this patient’s clinical presentation, you should be MOST suspicious for: A) a pleural effusion. B) spontaneous pneumothorax. C) acute pulmonary embolism D) hyperventilation syndrome.
Ans: C Page: 896-897 Type: Critical Thinking
- One of the hallmarks of a pulmonary embolism is: A) the disappearance of radial pulses during inhalation. B) pleuritic chest pain that occurs after a strong cough. C) cyanosis that does not resolve with oxygen therapy. D) jugular venous distention while in a supine position.
Ans: C Page: 896-897 Type: General Knowledge
- Which of the following would MOST likely cause a sustained increase in intracranial pressure? A) Bearing down B) Frequent coughing C) Projectile vomiting D) Intracranial tumor
Ans: D Page: 1060 Type: General Knowledge
- Movement of both of the eyes in unison is called: A) dysconjugate gaze. B) sympathetic eye movement. C) extraocular movement. D) physiologic anisocoria.
Ans: B Page: 1098, 1120 Type: General Knowledge
- Hepatojugular reflux occurs when: A) left-sided heart failure causes blood to accumulate in the patient’s liver. B) the jugular veins collapse in response to palpation of the right upper quadrant. C) mild pressure placed on the patient’s liver further engorges the jugular veins. D) a patient’s jugular veins are markedly engorged when lying in a supine position.
Ans: C Page: 873 Type: General Knowledge
- Which of the following is NOT an inner ear structure? A) Cochlea B) Oval window C) Eustachian tube D) Semicircular canal
Ans: C Page: 1102-1103 Type: General Knowledge
- Which of the following is a complication associated with dysfunction of cranial nerves VI, VII, IX, and XII? A) Hearing impairment B) Acute ischemic stroke C) Aspiration pneumonia D) Upper airway obstruction
Ans: C Page: 1108 Type: General Knowledge
- Which of the following statements regarding vitreous humor is correct? A) Vitreous humor is a jelly-like substance that is replenished if lost. B) Vitreous humor fills the posterior chamber and maintains the shape of the globe. C) Vitreous humor is a clear watery fluid that fills the anterior chamber. D) The most significant risk caused by a loss of vitreous humor is infection
Ans: B Page: 1092 Type: General Knowledge
- Which of the following statements regarding vitreous humor is correct? A) Vitreous humor can be replenished, but it takes many years. B) Vitreous humor is contained within the posterior chamber of the eye. C) Vitreous humor is a jelly-like substance that maintains the shape of the globe. D) Vitreous humor is a clear fluid that is responsible for tear production.
Ans: C Page: 1092 Type: General Knowledge
- Patients with pneumonia often experience a coughing fit when they roll from one side to the other because: A) movement loosens pulmonary secretions and stimulates coughing. B) most cases of pneumonia occur in conjunction with bronchospasm. C) the secretions in their lungs suddenly disperse and impair breathing. D) pneumonia often occurs in the lung bases, typically on only one side.
Ans: D Page: 893 Type: General Knowledge
- Vertigo or loss of balance following an ear infection or upper respiratory infection is MOST consistent with: A) labyrinthitis. B) Meniere disease. C) otitis externa. D) impacted cerumen.
Ans: A Page: 1104 Type: General Knowledge
- You are dispatched to a residence for a 59-year-old man with difficulty breathing. The patient, who has a history of COPD, is conscious and alert. During your assessment, he tells you that he developed chills, fever, and a productive cough 2 days ago. Auscultation of his lungs reveals rhonchi to the left lower lobe. This patient is MOST likely experiencing: A) bronchitis. B) pneumonia. C) end-stage COPD. D) COPD exacerbation.
Ans: B Page: 891 Type: Critical Thinking
- What type of tremor occurs when a body part is placed in a particular position and required to maintain that position for a long period of time? A) Rest B) Postural C) Intention D) Jacksonian
Ans: B Page: 1055 Type: General Knowledge
- Bedridden patients with excessive pulmonary secretions are MOST prone to developing: A) pneumonia. B) bronchospasm. C) a pneumothorax. D) a pulmonary embolism.
Ans: A Page: 893 Type: General Knowledge
- A chemistry student accidentally splashed a strong acid chemical into his eyes. He wears rigid gas-permeable contact lenses and is experiencing intense pain. You should: A) leave his contact lenses in place and irrigate his eyes throughout transport. B) carefully remove his contact lenses and cover both eyes with dry dressings. C) carefully remove his contact lenses and flush his eyes for at least 20 minutes. D) leave his contact lenses in place and neutralize the acid with a strong alkali.
Ans: C Page: 1095-1097 Type: Critical Thinking
- Hypoventilating patients: A) eliminate too much carbon dioxide. B) become hypercapneic and acidotic. C) experience an increase in blood pH. D) typically do not have an open airway.
Ans: B Page: 852-853 Type: General Knowledge
- With regard to pulse oximetry, the more hypoxic a patient becomes: A) the slower his or her PaO2 will fall. B) the faster he or she will desaturate. C) the slower he or she will desaturate. D) the less reliable the pulse oximeter is.
Ans: B Page: 876 Type: General Knowledge
- In contrast to patients in shock, patients with increased intracranial pressure MOST often experience: A) systolic hypotension. B) an increased diastolic blood pressure. C) a widened pulse pressure. D) tachycardia and tachypnea.
Ans: C Page: 1045 Type: General Knowledge
- A ruptured tympanic membrane: A) commonly results in permanent hearing loss. B) is characterized by CSF leakage from the ears. C) commonly leads to an infection of the middle ear. D) is extremely painful but typically heals spontaneously
Ans: D Page: 1106 Type: General Knowledge
- Within the cochlea, at the ______________, vibration stimulates hair movements that form nerve impulses that travel to the brain via the auditory nerve. A) oval window B) cochlear duct C) semicircular canals D) organ of Corti
Ans: D Page: 1102 Type: General Knowledge
- Intubation of a patient with severe asthma: A) is clearly indicated if the patient’s condition does not resolve following field corticosteroid therapy. B) is often a last resort because asthmatics are difficult to ventilate and are prone to pneumothoraces. C) should only be performed after hyperventilating the patient with a bag-mask device for 2 to 3 minutes. D) is generally contraindicated because weaning the patient off of a ventilator can take several days.
Ans: B Page: 885 Type: General Knowledge
- A patient experiences severe, shock-like or stabbing pain to one side of the face. This is consistent with: A) an acoustic neuroma. B) hemifacial spasm. C) trigeminal neuralgia. D) glossopharyngeal neuralgia.
Ans: C Page: 1076 Type: General Knowledge
- Pickwickian syndrome is a condition in which respiratory compromise results from: A) extreme obesity. B) pulmonary edema. C) cervical spine injury. D) diaphragmatic rupture.
Ans: A Page: 853 Type: General Knowledge
- The presence of diffuse rhonchi (low-pitched crackles) in the lungs indicates: A) right-sided congestive heart failure. B) isolated consolidation of secretions. C) thick secretions in the large airways. D) air being forced through narrowed airways.
Ans: C Page: 867 Type: General Knowledge
- 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
Ans: C Page: 864 Type: General Knowledge
- 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.
Ans: B Page: 864 Type: General Knowledge
- The diaphragm of the stethoscope is designed to auscultate: A) heart tones. B) low-pitched sounds. C) bowel sounds. D) high-pitched sounds.
Ans: D Page: 874-875 Type: General Knowledge
- The cricothyroid membrane: A) is a cartilaginous structure located between the thyroid and cricoid cartilages. B) serves as the primary entry point to the airway when a patient is not breathing. C) is relatively avascular and is covered by skin and minimal subcutaneous tissue. D) is a thin membrane that can be palpated easily just above the thyroid cartilage.
Ans: C Page: 855 Type: General Knowledge
- A 76-year-old woman with emphysema presents with respiratory distress that has worsened progressively over the past 2 days. She is breathing through pursed lips and has a prolonged expiratory phase and an oxygen saturation of 76%. She is on home oxygen at 2 L/min. Your initial action should be to: A) increase her oxygen flow rate to 6 L/min. B) administer a beta-2 agonist via nebulizer. C) place her in a position that facilitates breathing. D) auscultate her lungs for adventitious breath sounds.
Ans: C Page: 880-881 Type: Critical Thinking
- Mastication is defined as: A) chewing. B) swallowing. C) digesting. D) teeth clenching.
Ans: A Page: 1109 Type: General Knowledge
- A 39-year-old woman presents with signs and symptoms of an acute hemorrhagic stroke. She is responsive to deep painful stimuli only and has bilaterally dilated and sluggishly reactive pupils. Her respirations are slow and irregular, blood pressure is 80/50 mm Hg, and pulse is 40 and bounding. Initial treatment for this patient involves: A) positive-pressure ventilatory support. B) rapid infusion of a crystalloid solution. C) high-flow oxygen via nonrebreathing mask. D) immediate transcutaneous cardiac pacing.
Ans: A Page: 1061 Type: Critical Thinking
- The anterior chamber is the portion of the globe between the _____ and the _____, and is filled with _____ humor. A) iris, lens, vitreous B) cornea, iris, aqueous C) lens, iris, vitreous D) lens, cornea, aqueous
Ans: D Page: 1092 Type: General Knowledge
- When present at low levels, oxygen binds easily to hemoglobin molecules, resulting in: A) small changes in oxygen saturation when large changes in PaO2 occur. B) large changes in oxygen saturation when small changes in PaO2 occur. C) small changes in oxygen saturation when small changes in PaO2 occur. D) large changes in oxygen saturation when large changes in PaO2 occur.
Ans: B Page: 876 Type: General Knowledge
- You are assessing a man who was boxing with his friend. He complains of seeing flashing lights and “floaters” in his field of vision. The MOST important intervention is: A) high-flow oxygen. B) immediate transport. C) irrigation of his eyes. D) covering both of his eyes.
Ans: B Page: 1101 Type: Critical Thinking
- Signs or symptoms of otitis media include: A) hypersensitivity to sound. B) bilateral chronic tinnitus. C) bulging tympanic membrane. D) vertigo and violent vomiting.
Ans: C Page: 1105 Type: General Knowledge
- Which of the following statements regarding anisocoria is correct? A) Anisocoria is a condition in which the pupils are unequal. B) Anisocoria is a normal finding in the majority of the population. C) Physiologic anisocoria indicates significant intracranial pressure. D) Anisocoria is a condition characterized by bilateral pupillary dilation.
Ans: A Page: 1094 Type: General Knowledge
- As intracranial pressure rises: A) the heart rate acutely increases. B) the brain becomes hypocarbic. C) cerebral herniation may occur. D) mean arterial pressure decreases.
Ans: C Page: 1060 Type: General Knowledge
- A yeast infection that causes white patches in the mouth or on the tongue is called: A) thrush. B) gingivitis. C) leukoplakia. D) halitosis.
Ans: A Page: 1111 Type: General Knowledge
- Which of the following conditions would LEAST likely present with an acute onset of respiratory distress? A) Pneumonia B) Anaphylaxis C) Pneumothorax D) Pulmonary embolism
Ans: A Page: 863 Type: General Knowledge
- A 21-year-old man experienced an acute onset of pleuritic chest pain and dyspnea while playing softball. He is noticeably dyspneic, has an oxygen saturation of 93% on room air, and has diminished breath sounds to the upper right lobe. The MOST appropriate treatment for this patient involves: A) performing a needle decompression to the right side of his chest. B) assisting his ventilations in order to increase his oxygen saturation. C) administering high-flow supplemental oxygen and transporting at once. D) applying a CPAP unit and starting an IV line en route to the hospital.
Ans: C Page: 896 Type: Critical Thinking
- When a neuron generates an electrical impulse, it first sends the signal: A) along its axon to the axon terminal. B) to the cell’s nucleus via a dendrite. C) via neurotransmitters at the synapse. D) to the cell’s dendrites simultaneously.
Ans: A Page: 1042 Type: General Knowledge
- Apneustic breathing is characterized by: A) a sustained pattern of tachypnea and increased tidal volume. B) short, brisk inhalations with a long pause before exhalation. C) regular respirations with a normal rate and adequate tidal volume. D) a crescendo-decrescendo pattern of breathing with apneic periods.
Ans: B Page: 868 Type: General Knowledge
- In contrast to syncope, a seizure: A) is less commonly observed in older patients. B) can occur when the patient is in any position. C) most often occurs when the patient is standing. D) is characterized by a quick return of orientation.
Ans: B Page: 1069-1070 Type: General Knowledge
- Which of the following cranial nerves are assessed when you ask a patient to follow your finger as you move it in an “H” shape? A) Trochlear, oculomotor, abducens B) Facial, accessory, glossopharyngeal C) Accessory, olfactory, hypoglossal D) Optic, trigeminal, glossopharyngeal
Ans: A Page: 1054 Type: General Knowledge
- A 51-year-old man complains of chronic headaches that have worsened progressively over the past 3 months. Today, he called 9-1-1 because his headache is severe and he is nauseated. His vital signs are stable and he is breathing adequately. The patient denies any medical problems and states that he has been taking acetaminophen for the headaches. You should be MOST suspicious for: A) acute sinusitis. B) an intracranial neoplasm. C) acute hemorrhagic stroke. D) a ruptured cerebral artery.
Ans: B Page: 1071-1072 Type: Critical Thinking
- A neoplasm is MOST accurately defined as a: A) normal cell. B) new growth. C) damaged cell. D) cancerous tumor.
Ans: B Page: 1071 Type: General Knowledge
- A patient with a unilateral eyelid droop when smiling: A) has a condition called miosis. B) may be experiencing Bell palsy. C) likely has an intracerebral hemorrhage. D) is experiencing transient cerebral ischemia.
Ans: B Page: 1048 Type: General Knowledge
- The barrel-chest appearance classically seen in emphysemic patients is secondary to: A) widespread atelectasis. B) chest wall hypertrophy. C) air trapping in the lungs. D) carbon dioxide retention.
Ans: C Page: 863 Type: General Knowledge
- Digital clubbing is MOST indicative of: A) acute hypoxemia. B) chronic hypoxia. C) right heart failure. D) peripheral vascular disease.
Ans: B Page: 874 Type: General Knowledge
- The middle ear consists of the: A) cochlea and semicircular canals. B) organ of Corti and the external auditory canal. C) inner portion of the tympanic membrane and the ossicles. D) pinna and the exterior portion of the tympanic membrane.
Ans: C Page: 1102 Type: General Knowledge
- The _________ cartilage forms a complete ring and maintains the trachea in an open position. A) cricoid B) thyroid C) arytenoid D) laryngeal
Ans: A Page: 855 Type: General Knowledge
- Which of the following has the greatest potential for causing an airway problem? A) Oral candidiasis B) Leukoplakia C) Ludwig angina D) A dental abscess
Ans: C Page: 1113 Type: General Knowledge
- A patient with a Glasgow Coma Scale score of 8 or less: A) may require definitive airway control. B) has moderate neurologic dysfunction. C) is often able to localize his or her pain. D) is likely experiencing brain herniation.
Ans: A Page: 1051 Type: General Knowledge
- Inspiratory and expiratory__________ sounds are both loud, but the inspiratory sounds are shorter than the expiratory sounds. A) tracheal B) bronchial C) vesicular D) bronchovesicular
Ans: B Page: 866 Type: General Knowledge
- You are transporting a middle-aged man on a CPAP unit for severe pulmonary edema. An IV line of normal saline is in place. Prior to applying the CPAP device, the patient was tachypneic and had an oxygen saturation of 90%. When you reassess him, you note that his respirations have increased and his oxygen saturation has dropped to 84%. You should: A) continue the CPAP treatment and administer a diuretic to remove fluids from his lungs quickly. B) remove the CPAP unit, assist his ventilations with a bag-mask device, and prepare to intubate him. C) suspect that he has developed a pneumothorax and prepare to perform a needle chest decompression. D) decrease the amount of positive-end expiratory pressure that you are delivering and reassess.
Ans: B Page: 884 Type: Critical Thinking
- A 4-year-old child presents with a deep “croup-like” cough, difficulty breathing, and a high fever. You should suspect: A) epiglottitis. B) pharyngitis. C) laryngitis. D) tracheitis.
Ans: D Page: 1113 Type: Critical Thinking
- The most obvious external landmark of the larynx is the:
A) cricoid cartilage.
B) hyoid bone.
C) arytenoid cartilage.
D) thyroid cartilage.
Ans: D Page: 854 Type: General Knowledge
- Why are children more prone to croup when they acquire a viral infection than adults infected with the same virus? A) Children’s immune systems are not as developed as adults’, so they are more prone to infection. B) Adults were vaccinated against the virus that causes croup, whereas most children were not. C) A child’s airway is narrower than an adult’s, and even minor swelling can result in obstruction. D) The virus that causes croup replicates far more aggressively in children than it does in adults.
Ans: C Page: 886 Type: General Knowledge
- An unresponsive patient who overdosed on a central nervous system depressant drug would be expected to have __________ respirations. A) eupneic B) hyperpneic C) bradypneic D) Kussmaul
Ans: C Page: 868-869 Type: General Knowledge
- Headaches, nausea and vomiting, narrowing vision fields, and a “graying” in the field of vision are consistent with: A) glaucoma. B) papilledema. C) corneal abrasion. D) anterior uveitis.
Ans: B Page: 1101 Type: General Knowledge
- Patients with a corneal abrasion may present with all of the following, EXCEPT: A) hyphema. B) severe pain. C) photophobia. D) excess tearing.
Ans: A Page: 1098 Type: General Knowledge
- A patient with quiet tachypnea is MOST likely experiencing: A) shock. B) asthma. C) alkalosis. D) airway swelling.
Ans: A Page: 868 Type: General Knowledge
- A 19-year-old man presents with a decreased level of consciousness. According to his girlfriend, he has no known medical problems and takes no medications. Initial treatment for this patient involves: A) administering oxygen via nonrebreathing mask. B) ensuring airway patency and adequate breathing. C) evaluating his cardiac rhythm with the ECG monitor. D) performing a rapid check of his blood glucose level.
Ans: B Page: 1065-1066 Type: Critical Thinking
- A patient with orthopnea: A) seeks a sitting position when short of breath. B) is awakened from sleep with severe dyspnea. C) prefers to lie flat in order to facilitate breathing. D) generally has a slow, shallow respiratory pattern.
Ans: A Page: 881 Type: General Knowledge
- ________ cells are found in the lining of the airways and produce a blanket of mucus that covers the entire lining of the conducting airways. A) Kupfer B) Alveolar C) Ciliary D) Goblet
Ans: D Page: 857 Type: General Knowledge
- 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.
Ans: B Page: 1100 Type: General Knowledge
- What function do the nasal turbinates serve?
A) Separating the left and right nostrils
B) Warming and humidifying inhaled air
C) Decreasing the surface area of the nasopharynx
D) Secreting mucus that traps viruses and bacteria
Ans: B Page: 854 Type: General Knowledge
- Increased intracranial pressure hydrocephalus occurs when: A) the movement of CSF in the brain exceeds the production of CSF. B) the movement of CSF decreases, but the production of CSF does not. C) CSF production increases, which causes increased pressure in the skull. D) total CSF volume decreases, which leads to excessive cerebral edema.
Ans: B Page: 1080 Type: General Knowledge
- A 29-year-old woman is experiencing a severe asthma attack. Her husband reports that she was admitted to an intensive care unit about 6 months ago, and had a breathing tube in place. Prior to your arrival, the patient took 3 puffs of her rescue inhaler without effect. She is anxious and restless, is tachypneic, and has audible wheezing. You should: A) apply a CPAP unit, transport immediately, and attempt to establish vascular access en route to the hospital. B) begin assisting her ventilations with a bag-mask device and 100% oxygen and prepare to intubate her trachea. C) start an IV of normal saline, administer methylprednisolone via IV push, and transport as soon as possible. D) attempt to slow her breathing with respiratory coaching, administer a nebulized bronchodilator, and transport.
Ans: A Page: 884, 888-889 Type: Critical Thinking
- On either side of the glottis, tissue forms a pocket called the: A) vallecula. B) piriform fossae. C) cuneiform cartilage. D) hypopharyngeal space.
Ans: B Page: 855 Type: General Knowledge
- The ONLY indication for removing contact lenses in the prehospital setting is: A) chemical eye burns. B) acute conjunctivitis. C) cardiopulmonary arrest. D) a foreign body in the eye.
Ans: A Page: 1097 Type: General Knowledge