Test 6 Flashcards
1
Q
nfants have lower oxygen reserves and an increased risk of hypoxia than children and adults, so you cannot exceed more than ___ seconds at a time when suctioning.
A
5 seconds
2
Q
The maximum suction time for children is ___ seconds
A
10 seconds
3
Q
At a cardiac arrest you identify the AICD under the patient’s left clavicle. Where do you place the defib pads?
A
1” below ACID
4
Q
To keep from injuring your back when reaching for a patient, you should not extend your arms further than what distance?
A
15-20 inches
5
Q
six rights of medication administration, which are
A
- Right patient
- Right medication
- Right dose
- Right time
- Right route
- Right documentation
6
Q
Some cardiac patients with lethal dysrhythmias are often given an AICD to control their dysrhythmias. What does AICD stand for?
A
Automated Implantable Cardioverter Defibrillator
7
Q
What type of drug is procainamide?
A
antidysrhythmic
8
Q
What formula is used to calculate what size pediatric uncuffed endotracheal tube (ETT) you need for children over one year old?
A
ETT size (mm) = age (years)/4 + 4
9
Q
You assess a patient with difficulty breathing who has a history of COPD and is breathing through pursed lips. What is the patient trying to do while breathing through pursed lips?
A
Providing oxygen into the lungs and moving carbon dioxide out of the lungs
10
Q
Valium acts as a CNS depressant, and what other two things
A
anti-convulsant, and a sedative.
11
Q
The two contraindications to administering Valium are
A
known allergy and angle closure glaucoma.
12
Q
What is a metabolic causes of seizures.
A
Drug OD
13
Q
Structural causes include benign or cancerous tumors, brain abscess from an infection, scar tissue from an injury, and what other two things
A
head trauma, and stroke
14
Q
To measure an oropharyngeal airway, you should measure from the corner of the patient’s mouth to which part of their body?
A
Angle of Jaw
15
Q
What does the “S” represent in the LEMONS mnemonic for assessing intubation difficulties?
A
saturations/situations
16
Q
What does LEMONS mean for intubation?
A
Look, Evaluate, Mallampatti, Obstruction, Neck, saturations/situations
17
Q
Metabolic causes of seizures are caused by various amino acid disorders and disorders of energy metabolism, including hypoglycemia, hypoxia, poisoning, drug overdose, and sudden withdrawal from alcohol or drugs and two more
A
drug overdose and sudden withdrawal from alcohol or drugs.
18
Q
What type of trauma produces a depressed skull fracture?
A
high-energy direct trauma with a blunt object, Depressed skull fractures result from high-energy trauma directly to the head with a blunt object, such as a baseball bat. The frontal and parietal bones are the most susceptible to this type of injury as these bones are relatively thin.
19
Q
You are ordered to administer a maintenance infusion of lidocaine during your 45-minute transport. Following advanced cardiac life support (ACLS) guidelines, what is the dose for a lidocaine infusion?
A
mix 2gm/500 mL D5W (4 mg/mL)—infuse at 1-4 mg/min (15-60 mL/hr)
20
Q
What do the advanced cardiac life support (ACLS) guidelines consider hypothermia? Mild/moderate? As well as severe
A
core body temperature less than 94° F. Mild to moderate hypothermia is a core temperature greater than 86° F, while severe hypothermia is a core temperature less than 86° F.
21
Q
Knowing that your patient has good cardiac output is important. How would you calculate cardiac output?
A
Heart rate x stroke volume= cardiac output
22
Q
Which of the following is a predisposed factor for hypothermia?
A
Alcohol use, diabetes, hypoglycemia
23
Q
In children younger than 10 years of age, what is the narrowest part of their airway?
A
the cricoid ring
24
Q
What is a late sign of respiratory failure in a pediatric patient?
A
cyanosis in mucous membranes and nail beds
25
After intubating a pediatric patient, what is used to confirm and monitor endotracheal tube placement?
Waveform Capnography
26
Stroke volume is the amount of blood moved in one beat of the heart from which atrium or ventricle?
L ventricle (in one heartbeat)
27
You are treating a patient in ventricular fibrillation and are preparing to administer lidocaine IV push. The patient weighs approximately 90 kg.
What is the maximum dose you can give this patient following advanced cardiac life support (ACLS) guidelines?
270 mg. The drug dosage for lidocaine IV push is 1.0 – 1.5 mg/kg. You can repeat at half dose if necessary, with a maximum dose of 3 mg/kg
28
What type of patients do you expect to see hypoxic drive present?
COPD
29
How many phases are there of an ambulance call?
9
30
What heart rate is associated with SVT in children?
Greater than 180 Beats
SVT in infants would have a heart rate greater than 220 beats per minute, according to pediatric advanced life support (PALS).
31
Wheezing is described as a ___
high-pitched whistling sound that is most prominent on expiration.
32
Wheezing is the sound air makes when flowing through narrowed or obstructed bronchioles in the ____ airways
Lower
33
When estimating the surface area that has been burned on a patient, there is a technique called the rule of palm. Using this method, what percentage is the patient’s palm?
1%
34
Staff members at what agency developed the START triage method?
START triage is one of the easiest methods of triage. START stands for Simple Triage And Rapid Treatment. The staff members at Hoag Memorial Hospital, Newport Beach, CA, developed this triage method.
35
Morphine is a potent narcotic analgesic that reduces anxiety and promotes venous pooling, causing a___in preload.
decrease
36
Cardiac medications are ____ subcutaneous (SQ or Sub-Q).
not given
37
Tidal volume is the amount of air that moves in or out of the lungs with each respiratory cycle. The average adult male has a tidal volume of how many ml?
500
38
Following the pediatric advanced life support (PALS) guidelines, what is the dopamine dosage for pediatric patients in shock with normal blood pressure but poor perfusion?
2-20mcg /kg/mn
39
There is a scoring system to assess stroke patients called the 3-Item Stroke Severity Scale or LAG scale. What three items does the LAG scale assess?
level of consciousness, arm drift, and gaze
40
When a patient has diverticulitis, where is their abdominal pain typically felt?
LLQ
41
What in the brainstem detects an increased level of CO2 and rapidly triggers an increased respiratory rate?
Chemoreceptors
42
____ are information messengers that send and receive signals from the brain
Neurons
43
______are the tiny air sacs in the lungs where the gas exchange between oxygen and carbon dioxide takes place.
Alveoli
44
How does ventilation differ from oxygenation?
ventilation is the physical process of moving air into and out of the lungs while oxygenation loads oxygen onto the hemoglobin in the bloodstream
45
When using the Cincinnati Prehospital Stroke Scale to assess a patient suspected of having a stroke, what phrase is asked for the patient to repeat to assess their speech?
the sky is blue in Cincinnati
46
You are dispatched to a private residence for a 29-year-old pregnant female whose water broke. What is the purpose of the amniotic fluid once the amniotic sac ruptures?
to lubricate the birth canal and remove bacteria
47
You are assessing a 4-year-old female whose mother states was recently diagnosed with pertussis. What is another name for this infectious disease?
Whooping cough
48
What initial dose of adenosine would you administer to a pediatric patient in supraventricular tachycardia (SVT)?
The initial dose of adenosine for SVT in the pediatric patient is .01 mg/kg IVP or IO rapid bolus. Subsequent doses are administered at 0.2 mg/kg IVP or IO rapid bolus
49
How often do patients need a tetanus booster to be current?
10 years
50
How many factors are needed for a paramedic to be found guilty of negligence?
4
51
Meningitis can occur in children and adults, but some pediatric patients are at greater risk than others. Which of the following is not at a greater risk of contracting meningitis?
females
52
When giving an adult patient atropine for symptomatic bradycardia, what is the maximum total dose that can be administered by IV?
When giving an adult patient atropine for symptomatic bradycardia, you will administer an initial bolus of 1 mg IV. You can repeat at 3-5 minute intervals, not to exceed approximately 3 mg per ACLS guidelines.
53
You are assessing an 82-year-old female with stroke-like symptoms. When asking the patient questions, she has difficulty understanding what you are saying.
What is this called?
receptive aphasia
54
What is Inadequate cellular oxygenation.
hypoxia
55
What should you assume when you hear wheezing during respiration?
The small airways are constricted
56
What chronic lung disease results from damage to the bronchi and alveoli during the neonatal period, often due to positive pressure ventilation and high-concentration oxygen?
bronchopulmonary dysplasia. Bronchopulmonary dysplasia (BPD) results from a newborn’s lungs not developing normally while in the womb. Emphysema and congestive heart failure are seen in adult patients, while bronchiolitis is an inflammation of the bronchioles caused by a virus
57
What does it mean when a prescription medication has a positive dromotropic effect?
it increases conduction velocity
58
Trace the electrical conduction system through the heart from the pacemaker site to the ventricles
SA node, AV node, bundle of His, Purkinje fibers, ventricles
59
What type of communication is taught in prehospital care that describes various verbal and nonverbal techniques and strategies to communicate with patients?
therapeutic communication
60
How long does a patient typically remain postictal after a seizure?
5-30min
61
Which of the following refers to “the manner in which you must act or behave”?
Standard of Care
62
When is pregnancy considered full term?
39 weeks
63
To calculate the minute volume, you would multiply the tidal volume by which of the following?
RR
64
What type of seizure activity is absent of large muscle contractions where the patient often stares off in space?
Peit Mal
65
Advanced cardiac life support (ACLS) guidelines suggest pre-charging the defibrillator how many seconds before the rhythm check and shock are due when working on a patient in cardiac arrest?
15 seconds
66
Your cardiac patient has distended jugular veins, indicating failure of which side of the heart?
The right ventricle
67
___ ____ failure is indicated by fluid backing up into the lungs, difficulty breathing, edema, and hypertension.
Left ventricular
68
Pediatric patients’ airways are different from adults in many ways. One difference is that the larynx is higher and more anterior. Where is the larynx located in pediatric patients?
C3-4
69
You are working on a mass-casualty incident using the SALT triage system. What does the SALT acronym represent?
Sort, Assess, Lifesaving interventions, Treatment/Transport
70
What factor increases carbon dioxide (CO2) levels in patients?
hypoventilation
71
Right ventricular failure is indicated by distended neck veins and what other finding?
Fluid backing up in the peripheral vascular system.
72
How much energy is given on the first shock when defibrillating a pediatric patient in cardiac arrest?
2j/kg. The energy given for the second shock is doubled at 4 J/kg. Subsequent shocks are greater than or equal to 4 J/kg, with the maximum of 10 J/kg or adult dose.
73
When a patient has a healthy pancreas, what function(s) does the pancreas have?
both exocrine and endocrine functions
74
The pediatric assessment triangle (PAT) has three components
airway and appearance, breathing (work of breathing), and circulation.
75
What should you try and avoid when inserting OPA in peds
180 degree. f you were to rotate the airway, you risk damaging the soft palate.
76
Jugular vein distention (JVD), narrowing pulse pressure, and muffled heart sounds are signs and symptoms of ____
cardiac tamponade
77
____ is generally a finding of a tension pneumothorax
Tracheal deviation
78
What are the first two arteries off the aorta called?
coronary arteries
79
What factor often causes left ventricular hypertrophy?
HTN
80
What does continual exhaled CO2 monitoring specifically evaluate?
perfusion at the alveoli level
81
a spontaneous pneumothorax, which is a ____ due to trauma or lung disease.
collapsed lung
82
Cardiogenic shock can be caused by acute myocardial infarction, cardiac tamponade, and ____
tension pneumothorax.
83
What is a Jacksonian seizure?
Partial focal seizure
84
Where does blood travel when it leaves the right ventricle of the heart?
To the pulmonary arteries, then to the lungs
85
Which heart rhythm often converts to ventricular fibrillation?
VT
86
What are the only two situations where you can insert a finger or hand into a pregnant patient’s vagina?
Breech birth or prolapsed cord
87
The ACLS guidelines have three core concepts of ACLS regarding cerebral perfusion during CPR and post-cardiac care, which are to____
restore, improve, and maintain.
88
What is the purpose of the left atrium?
Receives blood from the pulmonary veins
89
A sudden accumulation of air in the pleural space
spontaneous pneumothorax
90
What condition is characterized by a high-pitched sound resulting from obstructed air flow in the upper airway? It may be inspiratory, expiratory, or present on both inspiration and expiration.
Stridor
91
There are several methods used to assess patients for signs of a stroke. One approach is to use the CPSS. What does this acronym represent?
Cincinnati Prehospital Stroke Scale
92
What condition is most commonly associated with H. pylori?
Peptic ulcer
93
When monitoring CO2 using continuous waveform capnography, what does a high CO2 reading represent?
Respiratory acidosis
94
When a patient has a stroke, a medication called tPA can be used to open blocked blood vessels within a specific time. What is tPA?
tissue plasminogen activator
95
Which of the following is the correct answer regarding the differences between croup and epiglottitis?
Croup produces a low-grade fever, and epiglottitis presents with a high fever
96
croup is seen primarily in ages 6 months to ____years
4
97
epiglottis is seen in children 3 year to ___
7 years
98
You are transporting a 38-week pregnant female in active labor with a prolapsed cord. What is the best way to transport this patient?
supine with the foot end of the gurney raised 6 to 12 inches higher than the head, and the hips elevated on a pillow
99
What is considered a significant fall for adult patients?
Greater than 15 ft
100
What makes up the birth canal?
Vagina and cervix
101
Where do electrical impulses originate in the heart’s conduction system?
SA node
102
Electrical pathway of heart
Electrical impulses originate in the sinoatrial (SA) node. The signal then gets sent to the atrioventricular (AV) node and into the bundle of His.
The bundle of His and the Purkinje fibers spread the impulses along the ventricles, causing them to contract.
103
What is the main difference between stable and unstable angina?
stable angina is typically upon exertion; unstable angina is at rest
104
Which chamber of the heart pumps oxygen-rich blood out to the body tissues?
left VENTRICLE
105
birth is when a baby is born too early, before ____ weeks of pregnancy have been completed.
37
106
If the patient is taking Tegretol or Persantine, what initial drug dose would you administer for a pt in SVT?
3 mg rapid IV/IO push(half the regular dose)
107
Following the pediatric advanced life support (PALS) guidelines, what is the drug dose when administering atropine to a pediatric patient in bradycardia with a pulse?
.02 mg/kg IV or IO
108
When the diaphragm relaxes, it regains its domed shape. This action causes an increase in thoracic pressure, which forces air out of the lungs. To have air forced out of the lungs, the pressure in the thorax must rise above _______________ pressure?
Atmospheric
109
At what stage does an embryo turn into a fetus
from 10 weeks until delivery
110
What are the most common injuries associated with angular motorcycle crashes?
crushing injuries to the lower extremities
111
What does the mitral valve do?
Prevents blood from back-flowing into the left atrium
112
What does continual exhaled CO2 monitoring specifically evaluate?
perfusion at the alveoli level
113
____ are rules or standards that govern professional conduct
Ethics
114
One cause of spontaneous pneumothorax is a cystic lesion on a lobe of the lung that ruptures. What is this cystic lesion called?
subpleural bleb
115
Using words to destroy someone
Slander
116
What is the most common spinal injury associated with improper lifting techniques?
Lumbar
117
partial seizures are classified as simple or___
complex
118
After delivering a baby, your 36-year-old female patient is bleeding heavily from her vagina. What amount of blood loss is considered excessive?
more than 500 mL
119
What carries deoxygenated blood from the fetus’s heart to the placenta?
the umbilical arteries
120
Where does blood travel when it leaves the right ventricle of the heart?
To the pulmonary arteries, then to the lungs
120
What causes a thermal burn?
Heat
121
As a paramedic, you release information on a patient to the newspaper. The patient felt he had been slandered. Which specific area of the law may the patient sue under?
Tort
122
All healthcare professionals are trained on HIPAA. When was HIPAA enacted?
1996
123
You are assessing a 30-year-old male with a recent history of myocarditis. What is the most common cause of myocarditis?
Viral infection
124
What treatment should be provided to a pediatric patient before using an external pacemaker to treat unstable bradycardias?
sedation
125
What does subluxation mean?
partial dislocation of joint
126
What is the recommended size of a landing zone for a helicopter?
100x100
127
What is leukopenia?
a decreased level of white blood cells in the blood
128
Which is the most muscular chamber of the heart?
the left ventricle
129
Technically, the passage of the fetus and placenta before ____ weeks gestation is called abortion.
20
130
According to the National Center for Injury Prevention and control, in what age group is unintentional and traumatic injuries the leading cause of death?
44 and younger
131
When using the START triage method, how do you assess the hemodynamic status of an adult patient?
check for bilateral radial pulses
132
A fixed suctioning unit should generate how much airflow when the tubing is clamped?
40LPM
133
What does a patient’s diastolic blood pressure reading represent?
the pressure exerted against the arterial walls while the left ventricle is at rest
134
Following the advanced cardiac life support (ACLS) guidelines, how often do you deliver a breath with an advanced airway in place?
One every six seconds
135
When setting up a landing zone for a medivac, what minimum dimensions can be used?
60x60
136
How far below the armpit should you place the left AED pad to have it in the correct location?
2-3 inches below
137
The four steps of START triage are:
Assess the patient’s ability to walk.
Assess respiratory status.
Assess the patient’s radial pulses (hemodynamic status).
Assess neurologic status.
138
What is the purpose of the uterus during pregnancy?
Protects the fetus from injury
139
You and your team are starting CPR on an unresponsive male wearing an external defibrillator vest. You see blue gel underneath the patient’s defibrillation pad as you expose the patient’s chest to apply the AED pads. What does this indicate?
the device has delivered at least one shock
140
Patients with diabetes are at risk for a life-threatening illness called diabetic ketoacidosis (DKA). What is the pathophysiology behind DKA?
the body burns fat rather than glucose, and acid waste is produced
141
What part of the heart is the endocardium?
Innermost layer of the HEART
142
What is a pregnancy that has reached full term called?
Term gestation
143
When a patient has an ulcer, where do they typically have pain?
in the upper mid-abdomen or upper part of the back
144
When the mucous plug is discharged into the vagina as the cervix dilates, pink-tinged mucus will appear. What is this called?
bloody show
145
Where does rigor mortis first develop?
The face and jaw
146
crackling or bubbling sounds indicating inflammation or infection.
Crackles (rales)
147
Which lung sounds present as high-pitched, whistling sounds?
wheezes
148
Depending on the patient’s weight, a typical adult male has a total blood volume of approximately ____ pints (6 L).
10 to 12
149
The body cannot tolerate an acute blood loss of what percentage of this total blood volume?
Greater than 20%
150
Patients with kidney stones will complain of pain in the____
right or left flank
151
___ presents with left lower abdominal pain
Diverticulitis
152
What is the definition of anemic?
Too few RBC
153
What is the normal inhalation to exhalation ratio in healthy adults during normal breathing?
1:2
154
It is vital to keep the nares clear in infants under ____ months of age.
6 months
155
How much does a pregnant patient’s heart rate increase by the end of the third trimester?
Up to 20%
156
What is the recommended dose when administering activated charcoal to a 15-year-old patient?
30-100grams
157
You are ordered to pace a 6-year-old male who is unstable in bradycardia and has not responded to drug therapy. At what level would you set the pacer above the patient’s intrinsic heart rate?
10-20 beats per minute
158
Following advanced cardiac life support (ACLS) guidelines, what is the initial drug dose of dopamine for an adult patient in refractory bradycardia?
5-20 mcg/min
159
What is the pain due to when a patient is experiencing an AMI?
due to the death of the cells in the heart muscle
160
What is another name for the LAG scale?
the 3-Item Stroke Severity Scale
161
What does it mean if a hernia is incarcerated?
the hernia cannot be pushed back within the body cavity
162
What model outlines the skills EMS providers can perform?
the National EMS Scope of Practice Model
163
According to the chain of survival, rapid defibrillation should ultimately take place within how many minutes of the onset of cardiac arrest?
2 minutes
164
Which of the following is the definition of cardiac output (CO)?
the amount of blood moved throughout the vessels in one minute
165
Which of the following represents perfusion and the perfusion triangle?
the blood, blood vessels, and heart
166
When using a pulse oximeter, what does Spo2 measure?
the percentage of hemoglobin molecules bound in arterial blood
167
What is the recommended percentage of body weight recommended when applying traction?
10%
168
What monitors the levels of oxygen, carbon dioxide, hydrogen ions, and the pH of cerebrospinal fluid?
Chemoreceptors
169
How deep do you compress an infant’s chest when performing chest compressions?
1.5 inches
170
What nerves are responsible for moving the diaphragm?
Phrenic nerve
171
What is the lung capacity of an adult male?
6,000ml
172
What is the lung capacity of an adult female?
4,000ml
173
The primary functions of insulin are to increase glucose transport into cells, increase glucose metabolism by cells, what are two more
increase liver glycogen levels, and decrease blood glucose concentration toward normal levels.
174
How is electrical energy from an AED delivered to stun the heart so it can resume normal function?
the electrical energy is delivered from one pad to the other, then returns to the first pad
175
The mnemonic DUMBELS is used to identify patients exposed and poisoned by a cholinergic agent. List the acronym
DUMBELS: Diarrhea, Urination, Miosis (constriction of the pupils) or muscle weakness, Bradycardia, bronchospasm, or bronchorrhea (discharge of mucus from the lungs), Emesis (vomiting), Lacrimation (excessive tearing), and Seizures, salivation, or sweating.
176
Which bacteria is responsible for 90% of all bacterial cases of pneumonia in adult patients?
Streptococcus pneumoniae
177
What is a Mallory-Weiss tear?
tear in the tissues of the lower esophagus causing severe bleeding and potentially death. Primary risk factors include alcoholism and eating disorders.
178
When a patient is in ventricular tachycardia, what will the QRS complex measure?
more than 0.12 seconds
179
What are some facts about breech birth
occurring in 3 to 4% of deliveries at term. Breech presentation is more frequent with multiple births and when labor occurs before 32 weeks of gestation.
180
There are two categories of traumatic injuries
Blunt and penetrating
181
What condition commonly occurs in patients with a crush injury over a prolonged period (4 hours or more)?
Compartment syndrome commonly occurs in patients with a prolonged crush injury. While it typically takes 4 to 6 hours of compression to cause compartment syndrome, the syndrome may develop after 1 hour in a severe crush situation.
182
When operating an emergency vehicle on a wet road surface, there is the possibility of hydroplaning at speeds greater than ____.
30mph
183
After injecting the EpiPen into the patient’s thigh, how long do you hold the injector in place?
10 seconds
184
Pulsus paradoxus is defined as a drop of __ mm Hg or more in the systolic blood pressure on inspiration
10. Pulsus paradoxus is sometimes seen in patients with COPD, asthma, and pericardial tamponade.
185
What two types of shock are related to pump failure?
Obstructive and cardiogenic
186
What parts of the body do not sense pain associated with a headache?
The brain and skull
187
The three most common examples of obstructive shock are
tension pneumothorax, pulmonary embolism, and cardiac tamponade
188
The chordae tendineae are thin bands of tissue attached to the valves in the heart. What is the purpose of these thin bands of tissue?
they prevent the valves from inverting
189
The 5 T’s are 1. Toxins (overdose), 2. Thrombosis (pulmonary), 3. Thrombosis (coronary), .....
4. Tamponade (cardiac), and 5. Tension pneumothorax
190
The mnemonic TICLS is used in determining if a pediatric patient is sick or not sick
Tone, Interactiveness, Consolability, Look or gaze, and Speech or cry.
191
Extrapyramidal effects refer to involuntary movements a person cannot control, most commonly seen when ___
taking antipsychotic medications.
192
What are the two most common signs of anaphylaxis?
urticaria and angioedema
193
How is tidal volume defined?
the amount of air moved into or out of the lungs in a single breath
194
Patients with emphysema often develop thin-walled cystic lesions in the lung from the destruction of the alveolar walls. What are these lesions called?
Bullae
195
A massive and centrally located pulmonary embolism can lead to which type of shock?
Obstructive
196
Stop: CPR IN FIELD
S: PT starts breathing
T:Pts care is transferred to another provider
O: out of strength or too tired to continue
P: physician advices to stop
