Special Populations Ch 24/25/35/36/37/38 Flashcards
1
Q
When caring for a patient with a behavioral crisis, you should ensure your own safety, and then:
Select one:
a. frisk the patient for dangerous weapons.
b. identify any life-threatening conditions.
c. determine if the patient is seeing a psychiatrist.
d. apply oxygen with a nonrebreathing mask.
A
b. identify any life-threatening conditions.
2
Q
While assessing a 32-year-old male with an acute behavioral crisis, he asks to go to into the kitchen to get something to eat. You should:
Select one:
a. tell him that he will get something to eat at the hospital.
b. leave the scene immediately and notify law enforcement.
c. not allow him to leave the area without a police escort.
d. ask him if he will allow you to accompany him.
A
c. not allow him to leave the area without a police escort.
3
Q
You are dispatched to an apartment complex for a young male experiencing an “emotional problem.” Law enforcement is at the scene when you arrive. You should:
Select one:
a. enter the scene and ask a police officer about the nature of the problem.
b. request a paramedic unit to chemically sedate the patient.
c. confer with a police officer before making patient contact.
d. have the police restrain the patient before you assess him.
A
c. confer with a police officer before making patient contact.
4
Q
Common physical signs and symptoms of agitated delirium include:
Select one:
a. constricted pupils, drowsiness, and cool skin.
b. confusion, hypotension, and pallor.
c. hypertension, tachycardia, and diaphoresis.
d. chest pain, shortness of breath, and bradycardia.
A
c. hypertension, tachycardia, and diaphoresis.
5
Q
While assessing a patient with an apparent behavioral crisis, he tells you that he sees a pink elephant in the corner of the room. This is an example of a: Select one: a. visual hallucination. b. visual delusion. c. auditory hallucination. d. auditory delusion.
A
a. visual hallucination.
6
Q
As an AEMT, you may legally restrain a patient if he or she:
Select one:
a. presents harm to you, your partner, or bystanders.
b. is under the influence of a CNS-depressant drug.
c. refuses to allow you to begin treatment or transport.
d. is acutely intoxicated and verbally abusive to you.
A
a. presents harm to you, your partner, or bystanders.
7
Q
A 31-year-old man has signs and symptoms of excited delirium. When assessing his orientation, memory, and ability to concentrate, you should:
Select one:
a. ask him if he knows the date and time and when he last visited his physician.
b. inquire about his medical history, including any medications that he is taking.
c. allow him up to 30 seconds to answer a question before asking another one.
d. ask him simple questions, such as “When did you first notice these feelings?”
A
d. ask him simple questions, such as “When did you first notice these feelings?”
8
Q
A minimum of \_\_\_\_\_ personnel should be used to restrain a 17-year-old, 120-pound, violent patient. Select one: a. 4 b. 1 c. 2 d. 3
A
a. 4
9
Q
“Normal” behavior is basically classified as what: Select one: a. is agreed upon by psychiatrists. b. is acceptable by society. c. the patient perceives. d. your protocols dictate.
A
b. is acceptable by society.
10
Q
An individual who poses a threat to the safety of his or her family, friends, or the AEMT is experiencing aNo: Select one: a. emotional crisis. b. behavioral emergency. c. psychiatric emergency. d. psychological crisis.
A
c. psychiatric emergency.
11
Q
To minimize the risk of legal implications when managing an emotionally disturbed patient, you should:
Select one:
a. gain his confidence so that he consents to care.
b. restrain him to prevent him from injuring himself.
c. transport him to a specialized psychiatric facility.
d. allow him to refuse transport if he appears alert.
A
a. gain his confidence so that he consents to care.
12
Q
Which of the following conditions would be least likely to cause an alteration in behavior? Select one: a. Hypertension b. Hypoglycemia c. Hypoxemia d. Brain injury
A
a. Hypertension
13
Q
Which of the following conditions would be the least likely cause of mental incapacitation? Select one: a. CNS-depressant drugs b. Chronic hyperthyroidism c. Hypoxia and hypercarbia d. Acute hypoglycemia
A
b. Chronic hyperthyroidism
14
Q
During your assessment of a 43-year-old male with suicidal thoughts, he becomes agitated and appears uncomfortable. You should:
Select one:
a. immediately restrain him to prevent him from injuring himself.
b. immediately assess his blood glucose level to rule out hypoglycemia.
c. continue talking to him while your partner requests police backup.
d. call for a paramedic unit so they can administer a sedative to him.
A
c. continue talking to him while your partner requests police backup.
15
Q
When performing your assessment of a 40-year-old male who is agitated and displaying bizarre behavior, you should:
Select one:
a. limit the number of personnel around the patient.
b. have at least four personnel around the patient.
c. put your hand on the patient’s arm or shoulder.
d. ask a police officer to assess the patient first.
A
a. limit the number of personnel around the patient.
16
Q
A behavioral crisis occurs when:
Select one:
a. a person experiences stress without other people’s knowledge.
b. an individual suppresses feelings of anger, guilt, or depression.
c. an individual reacts violently when faced with danger.
d. a reaction to an event interferes with daily living activities.
A
d. a reaction to an event interferes with daily living activities.
17
Q
Violent or dangerous individuals who do not require medical care should be: Select one: a. transported for psychiatric care. b. taken into police custody. c. subdued with soft restraints. d. given a sedative medication.
A
b. taken into police custody.
18
Q
You arrive at the residence of a young female who is experiencing an apparent psychotic episode. Law enforcement is on scene and has ensured that it is safe. You find the patient sitting in a chair, rocking back and forth. You should:
Select one:
a. clearly identify yourself and your partner and tell her you are there to help.
b. reassure her that everything will be okay and ask her if she can walk.
c. remain calm as you gently place your hand on her shoulder.
d. kneel down in front of the patient and ask her what is troubling her.
A
a. clearly identify yourself and your partner and tell her you are there to help.
19
Q
Which of the following situations is not an example of a patient with a mental illness?
Select one:
a. A 41-year-old male with sadness and despair with no appreciable underlying cause
b. A 38-year-old female with depression and anxiety for at least one month’s duration
c. A 55-year-old male who experiences a panic attack after being diagnosed with cancer
d. A 29-year-old female whose violent actions are no longer tolerated by society
A
c. A 55-year-old male who experiences a panic attack after being diagnosed with cancer
20
Q
General safety guidelines to follow when caring for a patient with a behavioral emergency include all of the following, except:
Select one:
a. having a predefined definitive plan of action.
b. being honest and reassuring, and avoiding judging.
c. maintaining a safe distance from the patient.
d. spending as little time as possible at the scene.
A
d. spending as little time as possible at the scene.
21
Q
Prehospital documentation of a sexual assault case should:
Select one:
a. be turned over to law enforcement.
b. be objective, factual, and detailed.
c. include your opinion of the situation.
d. remain on file for at least 6 months.
A
b. be objective, factual, and detailed.
22
Q
Pregnancy hormones cause the \_\_\_\_\_\_\_ of the uterus to thicken in preparation for implantation of a fertilized egg. Select one: a. endometrium b. myometrium c. cervical os d. perimetrium
A
a. endometrium
23
Q
Approximately 1 week following her menstrual period, a 33-year-old female complains of bilateral lower abdominal quadrant pain, vaginal discharge, and fever. This clinical presentation is most consistent with: Select one: a. an ectopic pregnancy. b. a spontaneous abortion. c. an ovarian cyst. d. pelvic inflammatory disease.
A
d. pelvic inflammatory disease.
24
Q
A 28 year old 32 week gestation patient complains of severe hand pain and deformity after slamming it in a car door. Vital signs are BP 110/70, P 80, R 14. In what position should you transport her? Select one: a. Supine b. Left lateral c. Prone d. Sim's position
A
b. Left lateral
25
```
The myometrium is the:
Select one:
a. neck of the uterus.
b. inner layer of the uterus.
c. uppermost part of the uterus.
d. muscular wall of the uterus.
```
d. muscular wall of the uterus.
26
```
Common signs and symptoms associated with menstruation include all of the following, except:
Select one:
a. breast tenderness.
b. abdominal cramping or bloating.
c. 60 mL to 100 mL of blood loss.
d. mood or behavioral changes.
```
c. 60 mL to 100 mL of blood loss.
27
```
Acute abdominal pain in a female of childbearing age should be assumed to be:
Select one:
a. an ovarian cyst.
b. a sexually transmitted disease.
c. pelvic inflammatory disease.
d. a ruptured ectopic pregnancy.
```
d. a ruptured ectopic pregnancy.
28
When palpating the abdomen of a female in pain, you should:
Select one:
a. examine the area farthest away from the pain first.
b. auscultate bowel sounds for at least 3 to 5 minutes.
c. palpate vigorously to determine the problem organ.
d. locate the area of pain and palpate that area first.
a. examine the area farthest away from the pain first.
29
```
A 45 year old female has been sexually assaulted with a blunt object. She complains of diffuse abdominal pain, and her vital signs are BP 100/60, P 120, R 26. What should you suspect?
Select one:
a. Prolapsed uterus
b. Internal hemorrhage
c. Ectopic pregnancy
d. Uterine cramping
```
b. Internal hemorrhage
30
```
A 26-year-old female, who is at the end of her first trimester of pregnancy, complains of vaginal bleeding. She denies abdominal pain, and states that her last menstrual cycle was approximately 2 months ago. She is conscious and alert, and her vital signs are stable. You should be most suspicious for:
Select one:
a. placenta previa.
b. uterine rupture.
c. premature labor.
d. spontaneous abortion.
```
d. spontaneous abortion.
31
A 38 year female is in labor in her car. This is her fourth child, contractions last 30 seconds and occur every 1-2 minutes. What should you do?
Select one:
a. Move her to the ambulance and prepare for delivery.
b. Call for air medical transport.
c. Tell her to bear down hard and to push.
d. Transport the patient to the hospital for treatment.
a. Move her to the ambulance and prepare for delivery.
32
```
The _______ is the outermost cavity of a woman's reproductive system and forms the lower portion of the birth canal.
Select one:
a. cervix
b. fundus
c. uterus
d. vagina
```
d. vagina
33
You are dispatched to a residence for a young female who was sexually assaulted. She is conscious and alert and has multiple abrasions and bruises to her face and arms. As you begin to assess her, she tells you that she does not want to go to the hospital. You should:
Select one:
a. explain the seriousness of the situation but allow her to refuse if she wishes.
b. tell her that she can take a shower if she will allow you to transport her.
c. advise her that since she was the victim of a crime she must be transported.
d. transport her because the assault has interfered with her ability to think clearly.
a. explain the seriousness of the situation but allow her to refuse if she wishes.
34
```
Estrogen and progesterone are secreted by the:
Select one:
a. mammary glands.
b. corpus luteum.
c. ovarian follicle.
d. corpus callosum.
```
b. corpus luteum.
35
```
Acute abdominal pain and vaginal bleeding during the 23rd week of pregnancy could be caused by any of the following, except:
Select one:
a. spontaneous abortion.
b. ectopic pregnancy.
c. placenta previa.
d. abruptio placenta.
```
b. ectopic pregnancy.
36
```
An ectopic pregnancy occurs when an ovum develops:
Select one:
a. within the abdominal cavity.
b. outside of the uterus.
c. inside of one of the ovaries.
d. late in the woman’s cycle.
```
b. outside of the uterus.
37
```
The uppermost portion of the uterus is called the:
Select one:
a. os.
b. cervix.
c. fundus.
d. neck.
```
c. fundus.
38
In most cases, care for a patient who presents with a complaint that is related to a sexually transmitted disease (STD) involves:
Select one:
a. a detailed examination of the genitalia and control of vaginal bleeding.
b. placing the patient in a position of comfort and providing supportive care.
c. elevating the patient's lower extremities and administering high-flow oxygen.
d. crystalloid fluid boluses because many STDs cause severe hypovolemia.
b. placing the patient in a position of comfort and providing supportive care.
39
A 21-year-old female was sexually assaulted with a glass bottle. Your assessment reveals that she is semiconscious with shallow breathing. The bottle is still inside her vagina. You should:
Select one:
a. assist ventilations, perform a head-to-toe assessment, and stabilize the bottle in place.
b. intubate the patient, perform a detailed physical exam, and stabilize the bottle in place.
c. assist ventilations, obtain baseline vital signs, and carefully remove the impaled bottle.
d. apply oxygen via nonrebreathing mask, remove the object, and place it in a plastic bag.
a. assist ventilations, perform a head-to-toe assessment, and stabilize the bottle in place.
40
When collecting potential evidence at the scene of a sexual assault, you should place any items in paper bags, because:
Select one:
a. paper bags are easier to seal and mark for later evaluation by the police.
b. plastic bags would reveal the potential evidence to curious onlookers.
c. plastic bags may develop condensation and could destroy the evidence.
d. the condensation developed in the paper bag will preserve the evidence.
c. plastic bags may develop condensation and could destroy the evidence.
41
Postpartum eclampsia is characterized by:
Select one:
a. hypertension that develops immediately before delivery.
b. a sudden drop in blood pressure following delivery.
c. seizures within 24 hours following delivery of a baby.
d. a history of seizures before pregnancy occurred.
c. seizures within 24 hours following delivery of a baby.
42
```
A 19 year old female gives birth to a baby boy. You note blue extremities and a pink trunk. His pulse is 108 and he cries weakly. He grimaces when you suction him, but other movement is limited. What is his APGAR score?
Select one:
a. 2
b. 6
c. 4
d. 8
```
b. 6
43
```
A 32 year old pregnant female complains of profuse vaginal bleeding. She denies any abdominal pain or discomfort. What should you suspect?
Select one:
a. Placenta previa
b. Abruptio placenta
c. Uterine rupture
d. Ruptured ovarian cyst
```
a. Placenta previa
44
```
When treating a woman with vaginal bleeding and signs of shock, you must:
Select one:
a. observe standard precautions.
b. perform a comprehensive assessment.
c. assist her ventilations.
d. establish two large-bore IV lines.
```
a. observe standard precautions.
45
A 28 year old female is 30 weeks pregnant with twins. Her water has broken and she feels like she has to move her bowels. The nearest hospital is 40 miles away. A medical helicopter is responding but is 45 minutes from your location. What should you do?
Select one:
a. Call for an additional ambulance
b. Administer brethine and wait for the helicopter
c. Load and go and deliver the babies en route
d. Prepare for imminent delivery
d. Prepare for imminent delivery
46
```
During your assessment of a 30-year-old pregnant patient, you determine that she has given birth to two children and has had one miscarriage. You should document her obstetric history as:
Select one:
a. G3, P2, A1.
b. G2, P2, A1.
c. G3, P1, A0.
d. G2, P2, A0.
```
a. G3, P2, A1.
47
```
A baby is born at 34 weeks' gestation. Its body is cyanotic and it has weak muscle tone. Further assessment reveals that the infant has a weak cry, a heart rate of approximately 90 beats/min, and irregular respirations of approximately 12 breaths/min. What is this infant's Apgar score?
Select one:
a. 4
b. 5
c. 7
d. 6
```
a. 4
48
```
When assessing the 1-minute Apgar score, you note that the newborn's hands and feet are cyanotic; she has weak muscle tone, a strong cry, a heart rate of approximately 120 beats/min, and irregular respirations of approximately 40 breaths/min. What is this infant's Apgar score?
Select one:
a. 8
b. 9
c. 7
d. 6
```
a. 8
49
```
A baby is born at 34 weeks' gestation. Its body is cyanotic and it has weak muscle tone. Further assessment reveals that the infant has a weak cry, a heart rate of approximately 90 beats/min, and irregular respirations of approximately 12 breaths/min. What is this infant's Apgar score?
Select one:
a. 4
b. 5
c. 7
d. 6
```
a. 4
50
```
How would you classify a woman who has been pregnant twice, had a miscarriage with her first pregnancy, and is now in active labor?
Select one:
a. Gravida 0, para 2
b. Gravida 2, para 1
c. Gravida 1, para 2
d. Gravida 2, para 0
```
d. Gravida 2, para 0
51
In utero, the ductus arteriosus functions:
Select one:
a. as a temporary opening between the right and left atria through which maternal oxygenated blood passes.
b. by connecting the pulmonary veins directly to the vena cava so that deoxygenated blood can be removed by the mother.
c. within the fetal pulmonary circulation as a large vascular network that receives oxygenated blood from the mother.
d. by connecting the left pulmonary artery and the aorta and diverting oxygenated blood away from the lungs.
d. by connecting the left pulmonary artery and the aorta and diverting oxygenated blood away from the lungs.
52
```
During pregnancy, the mother may experience a relative respiratory alkalosis when her:
Select one:
a. tidal volume increases.
b. minute volume decreases.
c. respiratory rate decreases.
d. respiratory rate increases.
```
d. respiratory rate increases.
53
Which of the following statements regarding peripheral cyanosis is correct?
Select one:
a. It reflects true hypoxia and should be treated aggressively.
b. It is limited to the hands and feet and is a common finding.
c. In most cases, it spontaneously resolves within 1 to 2 weeks.
d. It is highly suggestive of congenital peripheral vascular disease.
b. It is limited to the hands and feet and is a common finding.
54
```
When assessing a 30-year-old female in her second trimester of pregnancy, the most important clinical sign of preeclampsia for the AEMT to recognize is:
Select one:
a. vaginal bleeding.
b. peripheral edema.
c. proteinuria.
d. hypertension.
```
d. hypertension.
55
When determining whether or not prehospital delivery of an infant will occur, you should time the patient's contractions from the:
Select one:
a. start of one contraction until the start of the next.
b. start of one contraction until the end of the next.
c. end of one contraction until the start of the next.
d. end of one contraction until the end of the next.
a. start of one contraction until the start of the next
56
```
When assessing the 1-minute Apgar score, you note that the newborn's hands and feet are cyanotic; she has weak muscle tone, a strong cry, a heart rate of approximately 120 beats/min, and irregular respirations of approximately 40 breaths/min. What is this infant's Apgar score?
Select one:
a. 6
b. 8
c. 7
d. 9
```
b. 8
57
When assessing a woman in labor, the AEMT's only sources of information regarding the stage of labor that she is in are:
Select one:
a. assessing for meconium and palpating the abdominal wall.
b. questioning the patient and visually inspecting for crowning.
c. the degree of cervical dilation and the presence of bleeding.
d. palpating the uterine fundus and questioning the patient.
b. questioning the patient and visually inspecting for crowning.
58
An infant born with a nuchal cord has:
Select one:
a. a kink or a knot in the umbilical cord.
b. the umbilical cord wrapped around its neck.
c. damage to the umbilical vasculature.
d. three arteries in the umbilical cord, but no vein.
b. the umbilical cord wrapped around its neck.
59
The quickest and most effective way to prevent newborn hypothermia in the prehospital setting is to:
Select one:
a. preheat the back of the ambulance and quickly dry the newborn after birth.
b. apply warmed oxygen to the newborn and wrap it with layered blankets.
c. apply chemical heat packs to the newborn and infuse warmed IV fluids.
d. leave the newborn's head exposed so that it can rapidly absorb heat.
a. preheat the back of the ambulance and quickly dry the newborn after birth.
60
As soon as the entire infant is born, you should:
Select one:
a. keep the infant below the level of the mother's vagina.
b. dry the infant off and re-suction the nose and mouth.
c. clamp and cut the umbilical cord and re-suction the nose.
d. provide warmth, maintain a patent airway, and re-suction.
d. provide warmth, maintain a patent airway, and re-suction.
61
In which of the following situations would a baby most likely be born with respiratory depression and require aggressive resuscitation?
Select one:
a. The mother occasionally drank red wine.
b. The baby's gestational age is 37 weeks.
c. The mother recently ingested narcotics.
d. The mother had no routine prenatal care.
c. The mother recently ingested narcotics.
62
Delivery of an infant at the scene should occur in all of the following situations, except when:
Select one:
a. the amniotic sac ruptured within the last 60 minutes.
b. the infant's head is visible at the vaginal opening.
c. there is a delay in transport due to inclement weather.
d. the contractions are regular and in 2-minute intervals.
a. the amniotic sac ruptured within the last 60 minutes.
63
Major events that typically occur during the first trimester of pregnancy include all of the following, except:
Select one:
a. audible fetal heart tones with a Doppler.
b. development of the major fetal organ systems.
c. notable movement of the fetus by the mother.
d. palpable uterine fundus at the pubic symphysis.
c. notable movement of the fetus by the mother.
64
```
A baby is born at 34 weeks' gestation. Its body is cyanotic and it has weak muscle tone. Further assessment reveals that the infant has a weak cry, a heart rate of approximately 90 beats/min, and irregular respirations of approximately 12 breaths/min. What is this infant's Apgar score?
Select one:
a. 5
b. 6
c. 4
d. 7
```
c. 4
65
After stopping the ambulance en route to the hospital to assist your partner with the delivery of an infant, you should resume transport after delivery has occurred and:
Select one:
a. you have established a large-bore IV in the mother.
b. the umbilical cord has been clamped and cut.
c. any needed newborn resuscitation has occurred.
d. postpartum vaginal bleeding has been controlled.
c. any needed newborn resuscitation has occurred.
66
A 34-year-old female in her second trimester of pregnancy presents with a generalized motor seizure. Her husband tells you that her obstetrician recently diagnosed her with preeclampsia. You should:
Select one:
a. protect her from injury, maintain her airway and administer oxygen, and be prepared to suction her mouth.
b. insert a multilumen airway device, protect her from injury, and contact medical control for further guidance.
c. gently restrain her extremities, assist her ventilations, start an IV, and give a 20-mL/kg fluid bolus.
d. hyperventilate her with a bag-mask device, protect her from injury, and carefully restrain her extremities.
a. protect her from injury, maintain her airway and administer oxygen, and be prepared to suction her mouth.
67
```
In full-term or preterm newborns, hypoglycemia is defined as a blood glucose level of less than ____ mg/dL.
Select one:
a. 55
b. 60
c. 70
d. 45
```
d. 45
68
You have delivered a full-term baby at the residence of a 30-year-old female. During your assessment of the infant, you note that it is pulseless and apneic, has a foul odor, and has skin blisters. This situation is most appropriately managed by:
Select one:
a. performing the initial steps of resuscitation only for the sake of the mother.
b. contacting medical control and requesting permission to attempt resuscitation.
c. initiating full resuscitative efforts and notifying the hospital of the situation.
d. not attempting resuscitation and providing emotional support to the mother.
d. not attempting resuscitation and providing emotional support to the mother.
69
It is most important for your partner to remain at the mother's head during delivery because:
Select one:
a. emotional support will likely be needed.
b. she must be observed for signs of shock.
c. most mothers need coached breathing.
d. she may become nauseated and vomit.
d. she may become nauseated and vomit.
70
At approximately 6:20 a.m., you receive a call to a residence for an “unconscious baby that is not breathing.” When you arrive at the scene, you find the mother holding her baby, a 4-month-old male, in her arms. She tells you that she found her son face down in his crib. Your assessment reveals that the infant is pulseless and apneic and has cool, pale skin. How should you manage this situation?
Select one:
a. Begin full resuscitative efforts and transport.
b. Assess the scene for evidence of foul play.
c. Tell the mother that her son is dead.
d. Initiate CPR and contact medical control.
d. Initiate CPR and contact medical control.
71
```
You receive a call to a residence for a “sick child.” Upon arrival, the mother states that her child, a 3-year-old male, has been experiencing vomiting and diarrhea for the past 24 hours. Your assessment reveals that the child is conscious, but has a decreased level of activity. His pulse rate is 150 beats/min, capillary refill time is less than 2 seconds, and his mucous membranes are dry. This clinical presentation is most consistent with:
Select one:
a. moderate dehydration.
b. mild dehydration.
c. hypovolemic shock.
d. severe dehydration.
```
a. moderate dehydration.
72
Despite 100% oxygen and the administration of a beta-2 agonist, a conscious 9-year-old female still has diffuse expiratory wheezing and respiratory distress. Medical control or local protocol will most likely dictate the administration of:
Select one:
a. 0.01 mL/kg of epinephrine 1:10,000 IV.
b. 0.02 mg/kg of albuterol.
c. 1:1,000 epinephrine SC.
d. nebulizer treatments every 3 minutes.
c. 1:1,000 epinephrine SC.
73
```
According to the JumpSTART triage system, what should you do after delivering five rescue breaths to an unresponsive, apneic child?
Select one:
a. Reposition his airway.
b. Assign him a high priority.
c. Reassess breathing.
d. Assess for a pulse.
```
c. Reassess breathing.
74
The pediatric assessment triangle (PAT) is designed to:
Select one:
a. provide a mechanism for rapidly assessing the child from head to toe.
b. determine whether or not you need to perform a “hands-on” assessment.
c. be used in place of the initial assessment of a sick or injured child.
d. rapidly identify the general category of a child's physiologic condition.
d. rapidly identify the general category of a child's physiologic condition.
75
A 4-year-old female presents with tachypnea, intercostal retractions, and nasal flaring. Several minutes after applying 100% oxygen via pediatric nonrebreathing mask, you note that her respirations have slowed and her retractions have become less prominent. You should:
Select one:
a. apply a nasal cannula and reassess her condition.
b. protect her airway with an advanced device.
c. be prepared to perform ventilatory assistance.
d. recognize that her condition is improving.
c. be prepared to perform ventilatory assistance.
76
When assessing a child who has potentially been abused, you should:
Select one:
a. repeatedly question the child's parents.
b. look for bruises to the face or buttocks.
c. assess for yellowish bruises to the shins.
d. report the case only if abuse is confirmed.
b. look for bruises to the face or buttocks.
77
```
An 8-year-old child requires fluid resuscitation to treat severe dehydration. The child's mother is so upset that she cannot tell you how much her child weighs. On the basis of the child's age, you should administer a _____ mL bolus of an isotonic crystalloid.
Select one:
a. 400
b. 380
c. 480
d. 430
```
c. 480
78
When caring for a 4-month-old infant, it is most important to keep his or her nares clear of mucus because:
Select one:
a. thick mucus production is very common at this age.
b. nasal occlusion is the most common cause of hypoxia.
c. the nares are inherently narrow and easily obstructed.
d. infants may not have the intuition to mouth breathe.
d. infants may not have the intuition to mouth breathe.
79
Infants and small children are referred to as “belly breathers” because:
Select one:
a. gastric distention interferes with diaphragmatic movement.
b. their intercostal muscles are weak and not well developed.
c. the diaphragm is less developed than the intercostal muscles.
d. the skin covering the abdomen is thicker than the chest wall.
b. their intercostal muscles are weak and not well developed.
80
Components of the pediatric assessment triangle (PAT) include:
Select one:
a. appearance, capillary refill, and breathing effort.
b. level of consciousness, gross bleeding, and heart rate.
c. appearance, work of breathing, and skin circulation.
d. level of consciousness, breathing effort, and heart rate.
c. appearance, work of breathing, and skin circulation.
81
After you have completed the primary survey and initiated any required treatment for a 2-year-old child, you should:
Select one:
a. repeat the primary assessment and take vital signs.
b. perform a secondary assessment.
c. determine if immediate transport is needed.
d. begin rapid transport to an appropriate medical facility.
c. determine if immediate transport is needed.
82
A 6-year-old female is unconscious and in severe hypovolemic shock. Three attempts at obtaining intravenous access have been unsuccessful. You should:
Select one:
a. place an intraosseous catheter in the epiphyseal plate.
b. continue IV attempts using a larger sized catheter.
c. transport at once and continue IV attempts en route.
d. insert an intraosseous catheter in the proximal tibia.
d. insert an intraosseous catheter in the proximal tibia.
83
When dealing with a suspected case of sudden infant death syndrome (SIDS), in which the infant is obviously dead, it is important for the AEMT to:
Select one:
a. leave the family alone so they can deal with the situation.
b. thoroughly document that child abuse cannot be ruled out.
c. appreciate his or her own feelings regarding the event.
d. begin full resuscitative efforts in the infant's best interest.
c. appreciate his or her own feelings regarding the event.
84
When assessing a conscious 5-year-old male with suspected epiglottitis, you should:
Select one:
a. avoid anything that will agitate the child.
b. perform up to five abdominal thrusts.
c. give oxygen via nasal cannula at 2 L/min.
d. separate the child from his mother.
a. avoid anything that will agitate the child.
85
```
General treatment for a small child with a fever of 102.5°F and no other symptoms includes:
Select one:
a. administering oral glucose.
b. rapid cooling with cold water.
c. supportive care and transport.
d. IV crystalloid fluid boluses.
```
c. supportive care and transport.
86
A 5-year-old male presents with respiratory distress, a decreased level of consciousness, bradypnea, and poor muscle tone. When treating this child, you should:
Select one:
a. recognize that his minute volume is reduced.
b. initiate an IV and then rapidly transport him.
c. apply 100% oxygen via nonrebreathing mask.
d. conclude that his PCO2 is markedly decreased.
a. recognize that his minute volume is reduced.
87
A 6-year-old female is unconscious and in severe hypovolemic shock. Three attempts at obtaining intravenous access have been unsuccessful. You should:
Select one:
a. transport at once and continue IV attempts en route.
b. insert an intraosseous catheter in the proximal tibia.
c. continue IV attempts using a larger sized catheter.
d. place an intraosseous catheter in the epiphyseal plate.
b. insert an intraosseous catheter in the proximal tibia.
88
You are dispatched to a daycare center for a 4-year-old male who is unresponsive. Your primary survey reveals that the child is semiconscious, breathing rapidly, and has warm and dry skin. You administer 100% oxygen and obtain several blood glucose readings, but consistently receive an “error” message. You should:
Select one:
a. administer 1 to 2 tubes of oral glucose.
b. transport and monitor the child en route.
c. start an IV and administer 50% dextrose.
d. give 20-mL/kg saline boluses and transport.
c. start an IV and administer 50% dextrose.
89
Blood pressure is usually not assessed in children younger than 3 years of age because:
Select one:
a. their blood pressure is usually low and difficult to obtain.
b. blood pressure cuffs are not available for this age group.
c. it provides little information about the circulatory status.
d. it is very dynamic and can be assessed only by palpation.
c. it provides little information about the circulatory status.
90
A 4-year-old male is found unresponsive by his father. When you arrive at the scene, you perform a primary assessment, which reveals that the child is unresponsive and breathing shallowly. He is also tachycardic and diaphoretic. You obtain a blood glucose reading of 38 mg/dL. Treatment for this child should include:
Select one:
a. assisted ventilation and 0.5 to 1 g/kg of 50% dextrose IV.
b. oxygen via nonrebreathing mask and 1 tube of oral glucose.
c. 1 mg of glucagon via IV push, followed by a reassessment.
d. assisted ventilation and immediate transport to the hospital.
a. assisted ventilation and 0.5 to 1 g/kg of 50% dextrose IV.
91
```
You receive a call to a residence for a “sick child.” Upon arrival, the mother states that her child, a 3-year-old male, has been experiencing vomiting and diarrhea for the past 24 hours. Your assessment reveals that the child is conscious, but has a decreased level of activity. His pulse rate is 150 beats/min, capillary refill time is less than 2 seconds, and his mucous membranes are dry. This clinical presentation is most consistent with:
Select one:
a. hypovolemic shock.
b. moderate dehydration.
c. mild dehydration.
d. severe dehydration.
```
b. moderate dehydration.
92
A 4-year-old male requires peripheral venous access to treat significant dehydration. The child is conscious, crying, and is clinging to his mother. When starting the IV, you should:
Select one:
a. gently restrain the child on the stretcher.
b. insert a butterfly catheter in a scalp vein.
c. allow the child to remain with his mother.
d. avoid the veins in the back of the hand.
c. allow the child to remain with his mother.
93
```
Appropriate management for an unresponsive 6-month-old infant with a severe foreign body airway obstruction includes:
Select one:
a. subdiaphragmatic thrusts.
b. chest compressions.
c. blind finger sweeps.
d. back slaps and chest thrusts.
```
b. chest compressions.
94
```
You are assessing a 76-year-old female who complains of chest pressure and shortness of breath. During your assessment, the patient tells you that her daughter has not refilled her prescribed medications in over a week. This is an example of:
Select one:
a. psychological abuse.
b. financial abuse.
c. physical abuse.
d. benign neglect.
```
c. physical abuse.
95
```
A 71-year-old male presents with sudden diaphoresis, malaise, and near-syncope. You should be most suspicious for:
Select one:
a. myocardial infarction.
b. an acute infection.
c. severe dehydration.
d. acute ischemic stroke.
```
a. myocardial infarction.
96
A 69-year-old female presents with chest pressure and nausea. As you begin your assessment, the patient's husband hands you a valid “do not resuscitate” (DNR) document and tells you that his wife has terminal cancer. How should you manage this situation?
Select one:
a. Adhere to the DNR order and do not transport the patient to the hospital.
b. Treat the patient as though she is experiencing a myocardial infarction.
c. Administer oxygen and pain relief only during transport to the hospital.
d. Transport the patient and be prepared to defibrillate her if it is needed.
b. Treat the patient as though she is experiencing a myocardial infarction.
97
```
In the geriatric patient, a pressure ulcer can develop in as little as ____ minutes.
Select one:
a. 45
b. 10
c. 25
d. 35
```
c. 25
98
When assessing an 82-year-old female who takes multiple medications, you should:
Select one:
a. determine overall medication compliance.
b. assume that she has inadvertently overdosed.
c. ascertain the names of all of her physicians.
d. ask her if she took her medications today.
a. determine overall medication compliance.
99
```
Alzheimer disease and Parkinson disease are examples of ________ causes of an altered mental status.
Select one:
a. degenerative
b. systemic
c. congenital
d. metabolic
```
a. degenerative
100
You are assessing a 76-year-old widowed female who complains of shortness of breath and malaise. Upon advising her of the need for EMS treatment and transport, she tells you that she does not want to go to the hospital. Her refusal is most likely the result of:
Select one:
a. fear that she will be placed in a nursing home.
b. stubbornness that is typical in elderly patients.
c. an inability to pay for the hospital expenses.
d. paranoia that her home will be burglarized.
a. fear that she will be placed in a nursing home.
101
```
________ is/are the leading cause of trauma, death, and disability in older patients.
Select one:
a. Falls
b. Self-inflicted injuries
c. Motor-vehicle crashes
d. Abuse
```
a. Falls
102
Which of the following statements regarding the elderly patient's nervous system is correct?
Select one:
a. Reduction in brain size increases the risk of significant head trauma.
b. Parkinson disease affects the cells in the sensory area of the brain.
c. Alzheimer disease is the most common form of acute delirium.
d. Short-term memory impairment is not simply the result of aging.
a. Reduction in brain size increases the risk of significant head trauma.
103
You are transporting an 80-year-old male who is hearing impaired. When speaking to the patient, you should:
Select one:
a. elevate your tone of voice and talk directly into the patient's ear.
b. recall that changes in the inner ear distort low-frequency sounds.
c. visually inspect both internal ears for the presence of cerumen.
d. always attempt to position yourself on the patient's “good” side.
d. always attempt to position yourself on the patient's “good” side.
104
Which of the following is a reason why the prevalence of elder abuse is not fully known?
Select one:
a. There is no official method for reporting abuse.
b. Protective services organizations are overloaded.
c. AEMTs are not required to report suspected abuse.
d. Victims are often hesitant to report the crime.
d. Victims are often hesitant to report the crime.
105
When interviewing a 70-year-old male with a headache, you ask him when the headache began. What should you do if he does not answer your question immediately?
Select one:
a. Conclude that the patient does not understand you and transport him at once.
b. Immediately repeat the question but slightly increase the volume of your voice.
c. Ask another pertinent question and requestion him later about the onset of the headache.
d. Remain patient and give him time to comprehend and answer your question.
d. Remain patient and give him time to comprehend and answer your question.
106
```
The skin of an elderly person is more susceptible to injury from even minor trauma because of a decrease in:
Select one:
a. collagen.
b. sebum.
c. synovial fluid.
d. elastin.
```
a. collagen.
107
The “G” in the GEMS diamond recognizes the patient as a geriatric patient and serves as a reminder for the AEMT to:
Select one:
a. consider that changes in mentation are a natural part of the aging process.
b. gear his or her thought process to the potential problems of an aging patient.
c. gather all pertinent information regarding the elderly patient's family history.
d. assess the environment in which the ill or injured elderly patient is found.
b. gear his or her thought process to the potential problems of an aging patient.
108
Which of the following findings would fall into the “E” category of the GEMS diamond?
Select one:
a. An elderly patient experiences a pathologic hip fracture due to osteoporosis.
b. Your patient has a history of diabetes mellitus and degenerative joint disease.
c. An elderly widowed female has no one whom she can call or with whom she can communicate.
d. You slip on a throw rug upon entering the home of an elderly patient who fell.
d. You slip on a throw rug upon entering the home of an elderly patient who fell.
109
Which of the following patients would require the most structured and comprehensive dependent living facility?
Select one:
a. A 69-year-old male with Alzheimer disease
b. A 65-year-old female with controlled diabetes
c. A 72-year-old female who is hearing impaired
d. A 76-year-old male with cardiovascular disease
a. A 69-year-old male with Alzheimer disease
110
You respond to a skilled nursing facility for an 81-year-old female with abdominal pain. As you begin your assessment, the patient tells you that she is waiting for her husband to visit her and adamantly refuses going to the hospital. She is conscious and alert to person, place, and time. You should:
Select one:
a. explain the potential complications and then obtain a signed refusal.
b. obtain a court order that allows you to transport her against her will.
c. wait for her husband to arrive and then transport her to the hospital.
d. transport her because she is clearly unable to live an independent life.
a. explain the potential complications and then obtain a signed refusal.
111
Although the alveoli become enlarged, elderly people have difficulty expelling used air from the lungs because of:
Select one:
a. sustained vasoconstriction of the alveolar-capillary vessels.
b. decreased alveolar tension secondary to increased surfactant.
c. decreased alveolar elasticity secondary to decreased surfactant.
d. frequent consolidation of infectious material in the alveoli.
c. decreased alveolar elasticity secondary to decreased surfactant.
112
```
Infection with the respiratory syncytial virus would have the greatest potential to cause death in patients who have:
Select one:
a. a pacemaker.
b. hypertension.
c. hypothyroidism.
d. cancer.
```
d. cancer.
113
```
Over the past 6 months, a woman has noticed that her 68-year-old husband has experienced difficulty concentrating and communicating his thoughts. He also tends to forget recent events. What should you suspect?
Select one:
a. Delirium
b. Parkinson disease
c. Alzheimer disease
d. Depressive disorder
```
c. Alzheimer disease
114
Syncope in an elderly person is the result of aNo:
Select one:
a. sudden but transient cardiac dysrhythmia.
b. “silent” or atypical acute myocardial infarction.
c. obstruction of a large cerebral artery.
d. temporary interruption of cerebral blood flow.
d. temporary interruption of cerebral blood flow.
115
Polypharmacy is defined as the:
Select one:
a. simultaneous use of multiple medications.
b. intentional use of five or more medications.
c. use of two drugs to treat the same condition.
d. prescription of medications by two physicians.
a. simultaneous use of multiple medications.
116
When assessing an 80-year-old male with acute shortness of breath, it is most important to remember that:
Select one:
a. gas exchange in the lungs and at the cellular level is decreased.
b. lung cancer is the most common cause of death in the elderly.
c. motor nerves have deteriorated and reaction time has decreased.
d. elderly patients experience a steady decrease in blood pressure.
a. gas exchange in the lungs and at the cellular level is decreased.
117
Which of the following statements regarding gastrostomy (gastric) tubes is correct?
Select one:
a. Gastrostomy tubes are used for patients who cannot digest food.
b. Gastrostomy tubes are placed directly into the small intestine.
c. Patients with a gastrostomy tube may still be at risk for aspiration.
d. Most gastrostomy tubes are temporary and are not sutured in place.
c. Patients with a gastrostomy tube may still be at risk for aspiration.
118
```
Approximately 50% of children born with Down syndrome have:
Select one:
a. diabetes mellitus.
b. unilateral paralysis.
c. congenital heart defects.
d. intracranial bleeding.
```
c. congenital heart defects.
119
A 13-year-old child is on a home ventilator. The parents called because the ventilator is malfunctioning and the child has increasing respiratory distress. You should:
Select one:
a. reset the ventilator by unplugging it for 30 to 60 seconds.
b. attempt to troubleshoot the ventilator problem.
c. disconnect the ventilator and use a bag-mask device.
d. place a call to the home health agency treating this patient.
c. disconnect the ventilator and use a bag-mask device.
120
When caring for a morbidly obese patient, you should:
Select one:
a. call for ALS backup because obese patients are at high risk for heart attack.
b. ask the patient if he or she knows what led to his or her obesity problem.
c. leave him or her in a supine position, because this often facilitates breathing.
d. establish his or her chief complaint and then communicate your plan to help.
d. establish his or her chief complaint and then communicate your plan to help.
121
```
A significant number of patients with cerebral palsy also have:
Select one:
a. type 2 diabetes.
b. a seizure disorder.
c. paralysis.
d. brain tumors.
```
b. a seizure disorder.
122
Spina bifida is most accurately defined as:
Select one:
a. congenital inflammation of the spinal cord, usually in the neck.
b. a birth defect caused by incomplete closure of the spinal column.
c. a birth defect in which the child is born without spinal vertebrae.
d. chronic pressure on the brain caused by excess cerebrospinal fluid.
b. a birth defect caused by incomplete closure of the spinal column.
123
```
A surgical procedure that creates an opening between the intestine and the surface of the body that allows for elimination of waste products is called aNo:
Select one:
a. colostomy.
b. gastrostomy.
c. gastric stoma.
d. intestinal shunt.
```
a. colostomy.
124
When interacting with a developmentally disabled patient, the best approach is to:
Select one:
a. position yourself slightly above the patient's level to reduce his or her anxiety.
b. approach the patient as a team to reassure him or her that you are there to help.
c. speak primarily with the patient's family to establish the degree of disability.
d. ask your team members to wait until you can establish a rapport with the patient.
d. ask your team members to wait until you can establish a rapport with the patient.
125
```
A service dog is easily identified by its:
Select one:
a. size.
b. color.
c. harness.
d. breed.
```
c. harness.
126
Autism is most accurately defined as a:
Select one:
a. congenital condition caused by factors such as malnutrition or birth complications.
b. pervasive developmental disorder characterized by impairment of social interaction.
c. psychiatric condition related to an imbalance of serotonin in the brain.
d. mental disability caused by insufficient cognitive development of the brain.
b. pervasive developmental disorder characterized by impairment of social interaction.
127
```
Down syndrome is a genetic defect that occurs as the result of:
Select one:
a. an extra pair of chromosomes.
b. a triplication of chromosome 21.
c. a sperm that contains 24 chromosomes.
d. a separation of chromosome 21.
```
b. a triplication of chromosome 21.
128
```
The tip of a central venous catheter rests in the:
Select one:
a. pulmonary vein.
b. vena cava.
c. left atrium.
d. right ventricle.
```
b. vena cava.
129
Most people who are hearing impaired:
Select one:
a. have learned to read body language, such as hand gestures.
b. have conductive hearing loss due to ear wax impaction.
c. experience great difficulty hearing high-pitched sounds.
d. are able to hear if you simply raise the tone of your voice.
a. have learned to read body language, such as hand gestures.
130
Airway management can be challenging in patients with Down syndrome because their:
Select one:
a. mandible is large, which inhibits a mask-to-face seal.
b. teeth are misaligned and they have a large tongue.
c. tongue is relatively small and falls back in the throat.
d. occiput is round, which causes flexion of the neck.
b. teeth are misaligned and they have a large tongue.
131
```
Because hearing-impaired patients typically have more difficulty hearing high-frequency sounds, it is important for you to:
Select one:
a. try basic sign language first.
b. lower the pitch of your voice.
c. speak in a monotone voice.
d. increase the volume of your voice.
```
b. lower the pitch of your voice.
132
When caring for patients with cerebral palsy, it is important to remember that:
Select one:
a. most patients have the ability to walk, but have an unsteady gait.
b. their limbs are often underdeveloped and are prone to injury.
c. hearing aids are usually ineffective for patients with hearing loss.
d. they are unable to walk and are totally dependent upon you.
b. their limbs are often underdeveloped and are prone to injury.
133
The purpose of a ventricular peritoneum shunt is to:
Select one:
a. divert excess cerebrospinal fluid to the ventricles of the brain.
b. prevent excess cerebrospinal fluid from accumulating in the brain.
c. remove fluid from the abdomen of patients with right heart failure.
d. monitor pressure within the skull in patients with a head injury.
b. prevent excess cerebrospinal fluid from accumulating in the brain.
134
Under what circumstances is a left ventricular assist device used?
Select one:
a. As a bridge to heart transplantation while a donor heart is being located
b. To reduce ventricular pumping force in patients with aortic aneurysms
c. To ensure that the ventricles contract at an adequate and consistent rate
d. To permanently replace the function of one or both of the ventricles
a. As a bridge to heart transplantation while a donor heart is being located
135
```
A person is said to be obese when he or she is ________ or more over his or her ideal weight.
Select one:
a. 10%
b. 20%
c. 40%
d. 30%
```
d. 30%
136
A 70-year-old male complains of shortness of breath. During your assessment, you note that he has bilateral hearing aids. When you ask him questions related to his chief complaint, he does not answer you. You can hear a whistling sound coming from his hearing aids. You should:
Select one:
a. try repositioning the hearing aids or removing them and turning down the volume.
b. remove both of his hearing aids and use pencil and paper to communicate.
c. recognize that the batteries in his hearing aids are probably depleted.
d. remove his hearing aids, turn up the volume, and replace them in his ears.
a. try repositioning the hearing aids or removing them and turning down the volume.
137
```
For which of the following conditions would you most likely encounter a ventricular peritoneum shunt?
Select one:
a. Hydrocephalus
b. Cerebral palsy
c. Heart failure
d. Subdural hematoma
```
a. Hydrocephalus
138
Which of the following statements regarding autism is correct?
Select one:
a. Autism affects females four times more often than males.
b. Most cases of autism are diagnosed by 3 years of age.
c. Impairment of motor activity is a classic sign of autism.
d. The majority of patients with autism do not speak at all.
b. Most cases of autism are diagnosed by 3 years of age.
139
When caring for a patient who is visually impaired, it is important to:
Select one:
a. tell him or her what is happening, identify noises, and describe the situation and surroundings.
b. allow a service dog to remain with the patient at all times, even if the patient is critically ill.
c. leave items such as canes and walkers at the residence if the patient will be carried on a gurney.
d. stand to the side of the patient when speaking if his or her peripheral vision is impaired.
a. tell him or her what is happening, identify noises, and describe the situation and surroundings.
140
```
Which of the following conditions would most likely cause a patient to slur words, speak very slowly, or speak in a monotone?
Select one:
a. Parkinson disease
b. Advanced age
c. Cerebral palsy
d. Visual impairment
```
a. Parkinson disease
141
```
Common associated conditions in patients with spina bifida include all of the following, except:
Select one:
a. spastic limb movement.
b. hydrocephalus.
c. extreme latex allergy.
d. loss of bladder control.
```
a. spastic limb movement.
