Test 3

Question 1

A 60-year-old man complains of severe chest pressure that feels like a vise around his chest. His skin is cool and moist, and he is short of breath and very anxious. The patient tells you that he has taken three nitroglycerin tablets, but the pain has not been relieved. What do you think is wrong with him and what should you do?

Answer 1

Assume that he is having a heart attack, then help the patient take one adult aspirin (ASA) or 2-4 low-dose aspirins. Administer oxygen if it is available and arrange for prompt transportation.

Question 2

Which condition is characterized by acute spasm of the smaller air passages in the lungs?

Answer 2

Asthma (bronchospasm).

Question 3

When does a pandemic occur?

Answer 3

When an infectious disease spreads to different parts of the world at the same time.

Question 4

How is a stroke most accurately defined? (What is a stroke?)

Answer 4

Damage or death of a portion of the brain as a result of a lack of oxygen.

Question 5

Acute blockage of a coronary artery most often causes a patient to experience what?

Answer 5

Immediate severe chest pain.

Question 6

What is angina pectoris and what does it indicate/when does it occur?

Answer 6

Recurring acute chest pain or discomfort resulting from decreased blood supply to the heart muscle (myocardial ischemia). Usually due to obstruction or spasm of the coronary/heart arteries.

Question 7

What is atherosclerosis most accurately defined as?

Answer 7

Narrowing/hardening of the arteries as a result of the buildup of fatty material like cholesterol.

Question 8

A fruity odor of the breath occurs with which condition?

Answer 8

Diabetic ketoacidosis - when the body does not have enough insulin to allow blood sugar into cells for use as energy and the blood produces excess blood acids (ketones)

Question 9

You respond to the home of a known diabetic patient. The patient’s husband tells you that his wife was fine earlier in the day, but then suddenly began acting strange. He further tells you that she took her insulin but did not eat. The patient is conscious but confused. Her skin is pale, moist, and cool, and her pulse is weak and rapid. After ensuring a patent airway and adequate breathing, what should you do next?

Answer 9

Give her a tube of oral glucose if available.

Question 10

What is the most important thing to consider when assessing a patient’s mental status?

Answer 10

The patient’s initial level of consciousness and any changes that may have occurred.

Question 11

On which part of the Nervous System do Opioid drugs have a direct negative effect?

Answer 11

Central nervous system (brain & spinal cord).

Question 12

What are symptoms of exposure to an organophosphate insecticide or nerve agent?

Answer 12

Slow heart rate, salivation, and excessive tearing (MAIN ONES).

SLUDGEM symptoms:

S - salivation, sweating
L - lacrimation (excessive tearing of the eye)
U - urination
D - defecation, drooling, diarrhea
G - gastrointestinal upset and cramps
E - emesis (vomiting)
M - muscle twitching, miosis (pinpoint pupils)

Question 13

When administering Naloxone (Narcan) via the intranasal route, what should the EMR do?

Answer 13

Administer one-half dose (1 mL maximum) into each nostril.

Question 14

What are the different routes by which a poison can enter the body?

Answer 14

Ingestion (eating/drinking), inhalation, injection, or absorption.

Question 15

When administering a DuoDote nerve agent auto-injector, how should you inject the medication?

Answer 15

Into the lateral thigh of the leg and hold the injector in place for 10 seconds

Question 16

What is the most effective way to slow the spread of an injected poison throughout the body?

Answer 16

Keep the patient quiet and still

Question 17

Which route occurs when a person is stung by an insect or bitten by a snake? (e.g. ingestion, injection, absorption, etc.)

Answer 17

Injection

Question 18

Which of the following statements regarding nerve agents is correct?
a.In general, it takes a significant amount of a nerve agent to cause cardiac arrest.
b.Because of their unique chemical structure, nerve agents can only be inhaled.
c.Nerve agents are much stronger organophosphates than those found in pesticides.
d.Anthrax is a nerve agent that can cause death in very small amounts.

Answer 18

d. Anthrax is a nerve agent that can cause death in very small amounts.

Question 19

T/F: A snake’s venom is dangerous because it can affect the entire body.

Answer 19

True

Question 20

Which two environmental toxins, when mixed together, can irritate the lungs and upper respiratory tract and result in violent coughing?

Answer 20

Ammonia and chlorine

Question 21

Which of the following findings is least indicative of a patient who may become violent?
a.A patient who is shouting obscenities
b.A patient with a large body size
c.A patient who has used alcohol or drugs
d.A patient who cannot sit still

Answer 21

A patient with a large body size

Question 22

Does working in large numbers increase the risk for violence in the workplace?

Answer 22

No

Question 23

What is it called when you imagine yourself in another person’s situation, sharing his or her feelings?

Answer 23

Empathy

Question 24

What should your initial action be when arriving at a scene where a patient is exhibiting abnormal behavior?

Answer 24

Conduct a scene size-up

Question 25

What should you NOT say to an emotionally disturbed patient if you are trying to reassure him or her?

Answer 25

Should not - make it clear you are in control of the situation not the patient
Should - establish eye and verbal contact and avoid arguing

Question 26

What is a situational crisis and what can cause one?

Answer 26

Caused by a sudden and disruptive event such as physical illness and death of a love one. Most situational crises are sudden and unexpected and cannot be handled by a person’s usual coping mechanism.

Question 27

Which of the following is not an appropriate response when acknowledging a patient’s or family member’s anger?
a.“What can I do to help you?”
b.“What’s the matter?”
c.“Get control of yourself?”
d.“Is there anyone I can call for you?”

Answer 27

c.“Get control of yourself?”

Question 28

Which of the following statements regarding a situational crisis is correct?
a.Situational crises are of long duration and usually can be managed by the patient’s coping mechanisms.
b.A situational crisis is typically the result of an ongoing situation, such as a loved one with a terminal disease.
c.A situational crisis always causes the patient to exhibit socially unacceptable, self-destructive, or dangerous behavior.
d.Most situational crises are sudden and unexpected and cannot be handled by a person’s usual coping mechanisms.

Answer 28

d.Most situational crises are sudden and unexpected and cannot be handled by a person’s usual coping mechanisms.

Question 29

If a patient dies and a family member becomes verbally abusive towards you, what is important to remember?

Answer 29

retreat and notify law enforcement personnel.

Question 30

You are dispatched to a residence for an injured child. Your unit and a police officer arrive at the scene at the same time. The patient, a 9-year-old boy, has a possible broken arm. The child’s father, who appears very nervous, tells you that his son wrecked his bike and that he will take his son to the hospital. Your assessment of the child reveals a deformed left arm and multiple bruises of various colors. The child is clearly frightened and looks at his father every time you ask the child a question. What should you do?

Answer 30

provide care for the child’s injury and ask the police officer to speak with the father in another room as you speak to the child.

Question 31

A 10-year-old child, who was submerged in cold water for approximately 30 minutes, is removed by rescue personnel. The child is unconscious, not breathing, and without a pulse. What should you do first?

Answer 31

remove his wet clothing and begin CPR

Question 32

T/F: A patient suffering from heat stroke may be semiconscious or unconscious.

Answer 32

True

Question 33

What are some factors that can increase a person’s susceptibility to frostbite?

Answer 33

Old age, Hunger, Exhaustion

Question 34

What are the signs and symptoms of heat exhaustion?

Answer 34

tiredness. dizziness. headache. feeling sick or being sick

Question 35

During your primary assessment of a 21-year-old man who was rescued from the water, you note that he is unresponsive, is not breathing, and has water draining from the side of his mouth. What should you do?

Answer 35

carefully turn him onto his side

Question 36

How may the mammalian diving reflex protect a person who was submerged in cold water for an extended period of time?

Answer 36

The reflex slows the heart rate and metabolic rate and decreases oxygen demand.

Question 37

Which body parts are most susceptible to frostbite?

Answer 37

hands, feet, ears, nose and lips

Question 38

What are some of the physiological effects of hypothermia?

Answer 38

Decreased body temperature, pulse, and respiration.

Question 39

While assessing a conscious and alert 28-year-old man who was exposed to the cold for a prolonged period of time, you note that he is shivering and his fingers are numb and pale. Initial care includes:
a.submerging his hands in water that is 120°F (49°C).
b.asking him to place his hands in his armpits.
c.briskly rubbing his fingers with your hands.
d.rubbing his hands with a chemical heat pack.

Answer 39

b.asking him to place his hands in his armpits.

Question 40

With frostnip, the affected part of the body first becomes:
a.swollen.
b.numb.
c.pale white.
d.painful.

Answer 40

b.numb