Unit 4 Medical Part 1 Quizzes-Ch 16-19 Flashcards
1
Q
When performing a secondary assessment on a responsive patient with nontraumatic abdominal pain and stable vital signs, you should:
Select one:
a. only palpate tender areas of the abdomen.
b. prepare the patient for transport first.
c. focus on his or her chief complaint.
d. examine him or her from head to toe.
A
c. focus on his or her chief complaint.
2
Q
When forming your general impression of a patient with a medical complaint, it is important to remember that:
Select one:
a. most serious medical conditions do not present with obvious symptoms.
b. the conditions of many medical patients may not appear serious at first.
c. the majority of medical patients you encounter are also injured.
d. it is during the general impression that assessment of the ABCs occurs.
A
b. the conditions of many medical patients may not appear serious at first.
3
Q
In which of the following situations would it be most appropriate to utilize an air medical transportation service?
Select one:
a. 50-year-old conscious woman with severe nausea and vomiting, fever, and chills of 3 days’ duration
b. 29-year-old woman who is 18 weeks pregnant, has light vaginal bleeding, and stable vital signs
c. 61-year-old man with signs and symptoms of a stroke and your ground-transport time is 50 minutes
d. 43-year-old man experiencing a heart attack, and the closest appropriate hospital is 15 minutes awa
A
c. 61-year-old man with signs and symptoms of a stroke and your ground-transport time is 50 minutes
4
Q
You and your partner arrive at the residence of a 50-year-old man who complains of weakness. Your primary survey reveals that he is critically ill and will require aggressive treatment. The closest hospital is 25 miles away. You should:
Select one:
a. manage all threats to airway, breathing, and circulation, and consider requesting a paramedic unit.
b. load him into the ambulance, begin transport, and perform all treatment en route to the hospital.
c. perform a detailed secondary assessment, assess his vital signs, and then transport rapidly.
d. administer oxygen via a nonrebreathing mask, and obtain as much of his medical history as possible.
A
a. manage all threats to airway, breathing, and circulation, and consider requesting a paramedic unit.
5
Q
Hepatitis B is more virulent than hepatitis C, which means that it:
Select one:
a. is a more contagious type of disease.
b. is less resistant to treatment.
c. leads to chronic infection after exposure.
d. has a greater ability to produce disease.
A
d. has a greater ability to produce disease.
6
Q
Patients with tuberculosis pose the greatest risk for transmitting the disease when they: Select one: a. have a fever. b. cough. c. are bleeding. d. vomit.
A
b. cough.
7
Q
Which of the following statements regarding the human immunodeficiency virus (HIV) is correct?
Select one:
a. HIV is far more contagious than hepatitis B and is easily transmitted in the health care setting.
b. Most patients who are infected with HIV experience chronic symptoms that vary in duration and severity.
c. The risk of HIV infection is greatest when deposited on a mucous membrane or directly into the bloodstream.
d. The risk of HIV infection is high, even if an infected person’s blood comes in contact with your intact skin.
A
c. The risk of HIV infection is greatest when deposited on a mucous membrane or directly into the bloodstream.
8
Q
In addition to obtaining a SAMPLE history and asking questions related to the chief complaint, what else should you inquire about when assessing a patient with a potentially infectious disease? Select one: a. Recent travel b. Drug allergies c. HIV status d. Sexual practices
A
a. Recent travel
9
Q
Upon encountering an ill patient with a recent travel history, you should: Select one: a. contact medical control. b. place a mask on the patient. c. transport immediately. d. don two pairs of gloves.
A
b. place a mask on the patient.
10
Q
End-tidal carbon dioxide (ETCO2) monitoring is clearly indicated for patients who present with: Select one: a. abdominal pain. b. high blood pressure. c. a headache. d. respiratory distress
A
d. respiratory distress
11
Q
Factors that increase the risk for developing MRSA include:
Select one:
a. a history of a respiratory illness within the past 6 to 8 weeks.
b. prior exposure to Mycobacterium tuberculosis.
c. prolonged hospitalization, especially in an intensive care unit.
d. failure to be vaccinated against any strain of hepatitis.
A
c. prolonged hospitalization, especially in an intensive care unit.
12
Q
Index of suspicion is most accurately defined as:
Select one:
a. your prediction of the type of illness a patient has based on how the call is dispatched.
b. ruling out specific medical conditions based on the absence of certain signs and symptoms.
c. determining the underlying cause of a patient’s medical condition based on signs and symptoms.
d. your awareness and concern for potentially serious underlying and unseen injuries or illness.
A
d. your awareness and concern for potentially serious underlying and unseen injuries or illness.
13
Q
Which of the following statements regarding methicillin-resistant Staphylococcus aureus (MRSA) is correct?
Select one:
a. The communicable period for MRSA is 10 days to 2 weeks after being infected.
b. Most cases of MRSA transmission occur following an accidental needlestick.
c. MRSA is a bacterium that causes infections and is resistant to most antibiotics.
d. Studies have shown that less than 1% of health care providers are MRSA carriers.
A
c. MRSA is a bacterium that causes infections and is resistant to most antibiotics.
14
Q
Reassessment of a patient with a medical complaint should begin by:
Select one:
a. reassessing the nature of the illness.
b. taking another set of vital signs.
c. reviewing all treatment performed.
d. repeating the primary survey.
A
d. repeating the primary survey.
15
Q
It is especially important to assess pulse, sensation, and movement in all extremities as well as pupillary reactions in patients with a suspected \_\_\_\_\_\_\_\_\_\_\_ problem. Select one: a. neurologic b. endocrine c. cardiac d. respiratory
A
a. neurologic
16
Q
Your primary survey of an elderly woman reveals that she is conscious and alert but is experiencing difficulty breathing. She has a history of emphysema, hypertension, and congestive heart failure. As you assess the patient’s circulatory status, you should direct your partner to:
Select one:
a. retrieve the stretcher and prepare for transport.
b. administer oxygen with the appropriate device.
c. assess her oxygen saturation and blood pressure.
d. perform a head-to-toe secondary assessment.
A
b. administer oxygen with the appropriate device.
17
Q
The determination of whether a medical patient is a high-priority or low-priority transport is typically made:
Select one:
a. once the patient’s baseline vital signs are known.
b. as soon as the patient voices his or her chief complaint.
c. after the primary assessment has been completed.
d. upon completion of a detailed secondary assessment.
A
c. after the primary assessment has been completed.
18
Q
After sizing up the scene of a patient with a possible infectious disease, your next priority should be to: Select one: a. take standard precautions. b. quickly access the patient. c. notify law enforcement. d. contact medical control.
A
a. take standard precautions.
19
Q
In contrast to the assessment of a trauma patient, assessment of a medical patient:
Select one:
a. is not as complex for the AEMT, because most patients typically present with classic symptoms.
b. requires a thorough head-to-toe exam that involves a detailed assessment of all body systems.
c. is focused on the nature of illness, the patient’s chief complaint, and the patient’s symptoms.
d. almost exclusively focuses on physical signs that indicate the patient is experiencing a problem.
A
c. is focused on the nature of illness, the patient’s chief complaint, and the patient’s symptoms.
20
Q
In contrast to an epidemic, a pandemic:
Select one:
a. is a disease for which a vaccine is readily available.
b. is usually confined to a specific geographic location.
c. is a disease outbreak that occurs on a global scale.
d. occurs in more of the population than was expected.
A
c. is a disease outbreak that occurs on a global scale.
21
Q
A 70-year-old male presents with an acute onset of difficulty breathing that woke him from his sleep. He has a history of hypertension, atrial fibrillation, and several heart attacks. During your assessment, you note dried blood around his mouth. The patient tells you that he cannot lie down because he will “smother.” What additional assessment findings will you most likely discover? Select one: a. Slow respiratory rate b. Fever and chills c. Diffuse wheezing d. Pulmonary rales
A
d. Pulmonary rales
22
Q
- A 61-year-old female called EMS after suddenly being awakened in the middle of the night with a feeling that she was “smothering.” You arrive to find the patient, very apprehensive and restless, sitting on the living room couch in obvious respiratory distress. Her BP is 160/90 mm Hg, pulse is 110 beats/min and irregular, and respirations are 24 breaths/min and labored. Auscultation of her lungs reveals diffuse rhonchi in all fields. Treatment for this patient should include:
Select one:
a. oxygen at 4 to 6 L/min via nasal cannula and up to three nebulizer treatments.
b. oropharyngeal suctioning and assisted ventilation with a bag-mask device.
c. an IV line with a 250-mL normal saline bolus and oxygen via a nonrebreathing mask.
d. continuous positive airway pressure and an IV line set to keep the vein open.
A
d. continuous positive airway pressure and an IV line set to keep the vein open.
23
Q
Which of the following is generally not indicated when treating a patient with a tension pneumothorax? Select one: a. Paramedic support b. Ventilatory assistance c. Intravenous therapy d. Medication therapy
A
d. Medication therapy
24
Q
You are treating a 2-year-old boy who is experiencing respiratory distress. During your assessment, you note that the child has mild inspiratory stridor, a barking cough, and a low-grade fever. The child is otherwise conscious, is acting appropriate for his age, and has strong radial pulses. Treatment should include: Select one: a. humidified oxygen. b. an IV fluid bolus. c. assisted ventilation. d. a beta antagonist.
A
a. humidified oxygen.
25
When assessing a patient using a pulse oximeter, it is important to remember that:
Select one:
a. the pulse oximeter provides an accurate reading of the patient's PaO2.
b. abnormally bound hemoglobin may produce inaccurate readings.
c. pulse oximetry will determine whether or not to administer oxygen.
d. an oxygen saturation of greater than 90% rules out hypoxemia.
b. abnormally bound hemoglobin may produce inaccurate readings.
26
```
Approximately 2 weeks following a total hip replacement, a 70-year-old female complains of a sudden onset of dyspnea and pleuritic chest pain. Your assessment reveals perioral cyanosis, blood-tinged sputum, and wheezing to the base of her right lung. As your partner applies high-flow oxygen, the patient states that she has a history of hypertension. You should be most suspicious of:
Select one:
a. an acute asthma attack.
b. acute left heart failure.
c. a pulmonary embolism.
d. a simple pneumothorax.
```
c. a pulmonary embolism
27
```
Definitive treatment to reduce acute respiratory distress in a patient with a pleural effusion involves:
Select one:
a. antibiotic therapy.
b. a fluid thoracentesis.
c. endotracheal intubation.
d. needle decompression.
```
b. a fluid thoracentesis.
28
The movement and utilization of oxygen in the body is dependent on all of the following, except:
Select one:
a. adequate number of functional erythrocytes.
b. effective alveolar-capillary osmosis.
c. efficient off-loading of oxygen in the tissues.
d. adequate concentration of inspired oxygen.
b. effective alveolar-capillary osmosis
29
```
The most significant risk associated with ventilating a patient too rapidly is:
Select one:
a. inadvertent respiratory alkalosis.
b. barotrauma and a pneumothorax.
c. gastric distention and regurgitation.
d. excess carbon dioxide elimination.
```
c. gastric distention and regurgitation.
30
You are dispatched to the home of a 64-year-old male patient with lung cancer. The patient complains of acute dyspnea; however, as long as he is sitting upright, his breathing is easier. He denies fever, and his breath sounds are decreased over the base of the left lung. What is the most likely cause of this patient's symptoms?
Select one:
a. Consolidation of fluid within the lung
b. Localized bronchospasm in the lungs
c. Collection of fluid outside of the lung
d. Air in the pleural space with lung collapse
c. Collection of fluid outside of the lung
31
A 30-year-old male presents with respiratory distress that began within minutes of being exposed to an unknown chemical at an industrial site. When caring for this patient, it is most important to remember that:
Select one:
a. he will likely require frequent suctioning.
b. inhalation injuries can cause aspiration pneumonia.
c. aggressive airway management may be needed.
d. he must be properly decontaminated first.
d. he must be properly decontaminated first.
32
Cheyne-Stokes respirations are characterized by:
Select one:
a. impaired respirations with sustained inspiratory effort.
b. rapid and slow breathing with alternating apneic periods.
c. irregular tachypnea with occasional periods of apnea.
d. rapid and deep breathing with an acetone breath odor.
b. rapid and slow breathing with alternating apneic periods.
33
Chronic carbon dioxide retention, as seen in patients with certain lung diseases, may cause the patient to:
Select one:
a. develop extended periods of hypocarbia.
b. develop tachypnea if given 100% oxygen.
c. experience acute tidal volume increases.
d. breathe on the basis of decreased oxygen.
d. breathe on the basis of decreased oxygen.
34
```
You are treating a 2-year-old boy who is experiencing respiratory distress. During your assessment, you note that the child has mild inspiratory stridor, a barking cough, and a low-grade fever. The child is otherwise conscious, is acting appropriate for his age, and has strong radial pulses. Treatment should include:
Select one:
a. an IV fluid bolus.
b. humidified oxygen.
c. assisted ventilation.
d. a beta antagonist.
```
b. humidified oxygen.
35
When treating a patient who complains of dyspnea, it is important for the AEMT to:
Select one:
a. be prepared to treat the patient's anxiety as well.
b. routinely request that a paramedic unit respond to the scene.
c. closely monitor the patient's cardiac rhythm.
d. give oxygen via nasal cannula to minimize anxiety.
a. be prepared to treat the patient's anxiety as well.
36
When assessing the severity of nocturnal dyspnea in a patient with a chronic respiratory disease, you should determine:
Select one:
a. if he or she uses a beta2 agonist at least twice per day.
b. how many pillows he or she sleeps with at night.
c. how far he or she can walk before dyspnea occurs.
d. if he or she sleeps on the stomach or back.
b. how many pillows he or she sleeps with at night.
37
```
You are treating a 2-year-old boy who is experiencing respiratory distress. During your assessment, you note that the child has mild inspiratory stridor, a barking cough, and a low-grade fever. The child is otherwise conscious, is acting appropriate for his age, and has strong radial pulses. Treatment should include:
Select one:
a. assisted ventilation.
b. humidified oxygen.
c. an IV fluid bolus.
d. a beta antagonist.
```
b. humidified oxygen.
38
```
In contrast to bronchitis, pneumonia typically presents with:
Select one:
a. varying levels of hypoxia.
b. fluid in the lungs.
c. fever and chills.
d. a productive cough.
```
c. fever and chills.
39
Chronic carbon dioxide retention, as seen in patients with certain lung diseases, may cause the patient to:
Select one:
a. develop extended periods of hypocarbia.
b. breathe on the basis of decreased oxygen.
c. experience acute tidal volume increases.
d. develop tachypnea if given 100% oxygen.
b. breathe on the basis of decreased oxygen.
40
Cystic fibrosis is a genetic disorder that results in:
Select one:
a. spontaneous collapsing of one or both lungs.
b. profound dehydration and a fever greater than 102°F.
c. excess sodium loss and thick pulmonary secretions.
d. acute pulmonary edema and diffuse bronchospasm.
c. excess sodium loss and thick pulmonary secretions.
41
```
The most significant risk associated with ventilating a patient too rapidly is:
Select one:
a. barotrauma and a pneumothorax.
b. inadvertent respiratory alkalosis.
c. gastric distention and regurgitation.
d. excess carbon dioxide elimination.
```
c. gastric distention and regurgitation.
42
```
Approximately 2 weeks following a total hip replacement, a 70-year-old female complains of a sudden onset of dyspnea and pleuritic chest pain. Your assessment reveals perioral cyanosis, blood-tinged sputum, and wheezing to the base of her right lung. As your partner applies high-flow oxygen, the patient states that she has a history of hypertension. You should be most suspicious of:
Select one:
a. a simple pneumothorax.
b. a pulmonary embolism.
c. acute left heart failure.
d. an acute asthma attack.
```
b. a pulmonary embolism.
43
```
The respiratory syncytial virus (RSV) is a common cause of:
Select one:
a. asthma and chronic bronchitis.
b. MRSA and whooping cough.
c. bronchiolitis and pneumonia.
d. pertussis and the flu.
```
c. bronchiolitis and pneumonia.
44
Which of the following statements most accurately describes asthma?
Select one:
a. Irreversible airway disease that results in increased alveolar surface tension
b. Reversible obstruction caused by bronchospasm, mucus production, and edema
c. Acute, irreversible airway obstruction that presents with inspiratory wheezing
d. Chronic respiratory disease caused by long-term exposure to toxic substances
b. Reversible obstruction caused by bronchospasm, mucus production, and edema
45
When treating a 56-year-old female with chest pain, you have placed on her oxygen, established IV access, and administered two doses of sublingual nitroglycerin. However, the patient's pain has not improved. You reassess her blood pressure and note that it is 106/66 mm Hg. You should:
Select one:
a. administer one more dose of nitroglycerin.
b. give a 500-mL saline bolus to raise her BP.
c. request permission to give her morphine.
d. transport at once and closely monitor her.
a. administer one more dose of nitroglycerin.
46
Which of the following cardiac rhythms or conditions requires defibrillation?
Select one:
a. Pulseless electrical activity
b. Any tachycardic rhythm with a weak pulse
c. Asystole
d. Ventricular tachycardia without a pulse
d. Ventricular tachycardia without a pulse
47
Percutaneous coronary intervention (PCI) is a procedure in which:
Select one:
a. the affected coronary artery is bypassed by way of a graft.
b. medications are given in order to increase cardiac contractility.
c. the coronary thrombus is destroyed with a fibrinolytic agent.
d. the coronary artery is mechanically cleared via angioplasty.
d. the coronary artery is mechanically cleared via angioplasty.
48
What are the physiologic effects of nitroglycerin when given to a patient with suspected cardiac-related chest pain?
Select one:
a. Vascular smooth muscle contraction and increased venous return
b. Vascular smooth muscle relaxation and coronary artery dilation
c. Coronary artery dilation and increased systemic vascular resistance
d. Decreased venous pooling of blood and coronary vasoconstriction
b. Vascular smooth muscle relaxation and coronary artery dilation
49
You respond to call at a residence for a “man down.” Your primary survey reveals that the patient is unresponsive, pulseless, and apneic. His wife tells you that he has recently had the flu, and that he collapsed about 10 minutes ago. You should:
Select one:
a. begin CPR, insert a King airway, and request a paramedic unit.
b. begin CPR and apply the AED as soon as it is available.
c. begin CPR, start an IV, and give a 20-mL/kg fluid bolus.
d. elevate the patient's legs, begin CPR, and attach an AED.
b. begin CPR and apply the AED as soon as it is available.
50
An acute myocardial infarction is more apt to occur in the left ventricle because:
Select one:
a. it is a fairly small chamber that is quickly depleted of oxygenated blood.
b. it is large and thick and demands more oxygen than the right ventricle.
c. its inherently low oxygen demand predisposes it to injury or infarct.
d. its coronary arteries are more susceptible to atherosclerotic disease.
b. it is large and thick and demands more oxygen than the right ventricle.
51
While treating a patient who is in cardiogenic shock, your paramedic partner makes the comment that the patient needs an inotropic medication. You should recall that this type of medication is intended to:
Select one:
a. increase the patient's heart rate.
b. affect electrical conduction through the heart.
c. constrict the blood vessels.
d. affect the strength of cardiac contraction.
d. affect the strength of cardiac contraction.
52
```
The middle, muscular layer of the heart is called the:
Select one:
a. epicardium.
b. pericardium.
c. endocardium.
d. myocardium.
```
d. myocardium.
53
Stimulation of the sympathetic nervous system results in:
Select one:
a. vasodilation and a mild heart-rate decrease.
b. vasoconstriction and decreased heart rate.
c. increased blood pressure and heart rate.
d. decreased blood pressure and heart rate.
c. increased blood pressure and heart rate.
54
Which of the following cardiac dysrhythmias requires immediate defibrillation?
Select one:
a. Sinus tachycardia with a low BP
b. Perfusing ventricular tachycardia
c. Nonperfusing ventricular fibrillation
d. Sinus bradycardia without a pulse
c. Nonperfusing ventricular fibrillation
55
A 60-year-old female is in possible cardiogenic shock. She is semiconscious with shallow respirations, an irregular pulse, and hypotension. Appropriate treatment for this patient should include:
Select one:
a. continuous positive airway pressure, a 500-mL saline bolus, thermal management, and transport.
b. insertion of a supraglottic airway device, mild hyperventilation, a saline lock, and prompt transport.
c. high-flow oxygen via nonrebreathing mask, a saline lock, thermal management, and transport.
d. assisted ventilation with a bag-mask device, thermal management, 250-mL fluid boluses, and transport.
d. assisted ventilation with a bag-mask device, thermal management, 250-mL fluid boluses, and transport.
56
Unstable angina pectoris is characterized by:
Select one:
a. chest pain or pressure that occurs during periods of strenuous activity and promptly subsides with rest.
b. chest pain or pressure that lasts longer than 15 minutes and is associated with myocardial necrosis.
c. chest pain or discomfort that may not be relieved by rest or nitroglycerin, and that occurs without a fixed frequency.
d. a fixed frequency of chest pain or pressure that is often relieved by rest and several doses of nitroglycerin.
c. chest pain or discomfort that may not be relieved by rest or nitroglycerin, and that occurs without a fixed frequency.
57
```
In addition to oxygen, which of the following medications would the AEMT be the most likely to administer to a patient who is experiencing acute chest pain, pressure, or discomfort?
Select one:
a. Aspirin and nitroglycerin
b. Nitroglycerin and morphine
c. Morphine and aspirin
d. Aspirin only
```
a. Aspirin and nitroglycerin
58
When applying the AED pads to a patient with a surgically implanted pacemaker, you should:
Select one:
a. apply both pads on the posterior aspect of the chest.
b. apply the pads at least 1 inch away from the pacemaker.
c. apply the pad directly over the implanted pacemaker.
d. avoid applying the AED and perform CPR only.
b. apply the pads at least 1 inch away from the pacemaker.
59
When treating a patient with a blood pressure of 80/40 mm Hg due to “pump failure,” you should:
Select one:
a. place the patient in a supine position with his or her legs elevated.
b. assist the patient with his or her prescribed nitroglycerin.
c. apply a nonrebreathing mask if the patient is breathing shallowly.
d. give 250-mL fluid boluses as needed to improve perfusion.
d. give 250-mL fluid boluses as needed to improve perfusion.
60
You are assessing a 62-year-old female who has an automatic implantable cardiac defibrillator (AICD). As you are applying oxygen to her, she becomes unconscious, pulseless, and apneic. You should:
Select one:
a. allow the AICD to defibrillate her and start CPR.
b. begin CPR and apply the AED as soon as possible.
c. begin CPR and insert a multilumen airway device.
d. deactivate the AICD with a magnet and begin CPR.
b. begin CPR and apply the AED as soon as possible.
61
Which of the following most accurately describes the correct sequence of events after attaching an AED to a patient in cardiac arrest and pushing the analyze button?
Select one:
a. “No shock advised” message, stand clear, reanalyze, “no shock advised” message, perform CPR for 2 minutes
b. “Shock advised” message, stand clear, defibrillate, immediately resume CPR, reanalyze after 2 minutes
c. “No shock advised” message, check pulse for up to 10 seconds, resume CPR, reanalyze after 2 minutes
d. “Shock advised” message, stand clear, defibrillate, perform CPR for 1 minute, stand clear, reanalyze, defibrillate if needed
b. “Shock advised” message, stand clear, defibrillate, immediately resume CPR, reanalyze after 2 minutes
62
When assessing a middle-aged male patient with chest pain, you note a large vertical scar in the center of his chest. This indicates that he has most likely had:
Select one:
a. a surgically implanted cardiac pacemaker.
b. coronary artery stent placement.
c. a percutaneous coronary angioplasty.
d. a coronary artery bypass graft.
d. a coronary artery bypass graft.
63
Which of the following cardiac rhythms or conditions requires defibrillation?
Select one:
a. Asystole
b. Any tachycardic rhythm with a weak pulse
c. Ventricular tachycardia without a pulse
d. Pulseless electrical activity
c. Ventricular tachycardia without a pulse
64
Ventricular tachycardia often causes hypotension because:
Select one:
a. blood from the atria fills the ventricles too quickly due to the rapid heart rate.
b. afterload increases, which causes the ventricles to work against higher pressure.
c. tachycardia causes widespread vasodilation, which lowers the blood pressure.
d. there is not enough time between beats for the left ventricle to fill with blood.
d. there is not enough time between beats for the left ventricle to fill with blood.
65
```
Shortly following acute myocardial infarction, a 55-year-old man collapses and is in cardiac arrest. Which of the following dysrhythmias is he most likely experiencing?
Select one:
a. Ventricular tachycardia
b. Asystole
c. Ventricular fibrillation
d. Bradycardia
```
c. Ventricular fibrillation
66
According to the Starling law of the heart:
Select one:
a. damage to the right ventricle causes blood to back up in the systemic circulation.
b. decreased venous return reduces the amount of blood delivered to the lungs.
c. the cardiac muscle can generate its own electrical impulses without outside influence.
d. increased venous return stretches the ventricles, resulting in increased contractility.
d. increased venous return stretches the ventricles, resulting in increased contractility.
67
```
Which of the following is not a component of the cardiac electrical conduction system?
Select one:
a. Sinoatrial node
b. Interatrial septum
c. Purkinje fibers
d. Atrioventricular node
```
b. Interatrial septum
68
```
The middle, muscular layer of the heart is called the:
Select one:
a. myocardium.
b. pericardium.
c. endocardium.
d. epicardium.
```
a. myocardium.
69
If a patient has a ventricular assist device (VAD) that provides continuous blood flow:
Select one:
a. strong central pulses will be easily palpable.
b. he or she will not have any palpable pulses.
c. it is not possible for the ventricles to fibrillate.
d. the VAD is supporting the right ventricle.
b. he or she will not have any palpable pulses.
70
Which of the following cardiac rhythms or conditions requires defibrillation?
Select one:
a. Pulseless electrical activity
b. Asystole
c. Any tachycardic rhythm with a weak pulse
d. Ventricular tachycardia without a pulse
d. Ventricular tachycardia without a pulse
71
When the parasympathetic nervous system is stimulated, it:
Select one:
a. increases the heart rate by increasing SA node discharge.
b. slows the heart rate by decreasing SA node discharge.
c. produces epinephrine and increases cardiac contractility.
d. enhances conduction through the atrioventricular node.
b. slows the heart rate by decreasing SA node discharge.
72
Shortly after administering a second nitroglycerin dose to a 44-year-old male with chest pain, he becomes lightheaded. You take his blood pressure, and it reads 80/50 mm Hg. You have already established IV access and are administering oxygen. You should:
Select one:
a. give him a 500-mL normal saline bolus.
b. cover him with a blanket to keep him warm.
c. contact medical control for further guidance.
d. place him supine and reassess his BP.
d. place him supine and reassess his BP.
73
```
What is the approximate cardiac output of a person with a heart rate of 70 beats/min and a stroke volume of 75 mL?
Select one:
a. 6 L/min
b. 5 L/min
c. 7 L/min
d. 4 L/min
```
b. 5 L/min
74
After applying the AED to your cardiac arrest patient, you receive a “shock advised” message. You should:
Select one:
a. perform CPR for 2 minutes and then reanalyze.
b. resume CPR as the defibrillator is charging.
c. check to ensure the pads are correctly placed.
d. reanalyze again before you deliver the shock.
b. resume CPR as the defibrillator is charging.
75
A 70-year-old male presents with acute aphasia, unilateral weakness, and confusion. You should:
Select one:
a. use the Cincinnati Stroke Scale to rule out a stroke.
b. assess his blood glucose level to rule out hypoglycemia.
c. apply an AED in case the patient develops cardiac arrest.
d. start an IV line with a hypertonic crystalloid solution.
b. assess his blood glucose level to rule out hypoglycemia.
76
```
Patients with a hemorrhagic stroke typically experience a rapidly declining level of consciousness because of:
Select one:
a. blood in the subarachnoid space.
b. global anoxia of the cerebrum.
c. increasing intracranial pressure.
d. pressure on the brain stem.
```
c. increasing intracranial pressure.
77
A patient experiencing status epilepticus:
Select one:
a. has a return of consciousness in between seizures.
b. is having a prolonged generalized motor seizure.
c. commonly has a therapeutic anticonvulsant level.
d. typically maintains bowel and bladder continence.
b. is having a prolonged generalized motor seizure.
78
Treatment for a conscious and alert patient who is experiencing a migraine headache includes:
Select one:
a. placing a cold washcloth on the patient's forehead and transporting with lights but no siren.
b. a 250-mL normal saline bolus and transporting to the closest appropriate medical facility.
c. applying a chemical heat pack to the back of the neck and transporting without lights and siren.
d. dimming the lights in the back of the ambulance and transporting without lights and siren.
d. dimming the lights in the back of the ambulance and transporting without lights and siren.
79
You are dispatched to an assisted-living center for a 67-year-old male with “mental status changes.” You arrive at the scene and begin to assess the patient. He is responsive to painful stimuli only, has rapid and shallow breathing, and a slow radial pulse. You should:
Select one:
a. begin assisting the patient's ventilations.
b. apply a nonrebreathing mask set at 15 L/min.
c. assess his blood glucose level and start an IV.
d. start an IV and administer a fluid bolus.
a. begin assisting the patient's ventilations.
80
To minimize the amount of brain-cell damage that occurs following an ischemic stroke, fibrinolytic therapy must be administered within:
Select one:
a. 3 hours after the onset of symptoms.
b. 2 hours after assessing the patient.
c. 2 hours after arriving at the hospital.
d. 3 hours after the call is received.
a. 3 hours after the onset of symptoms.
81
```
An ischemic stroke is most often the result of a:
Select one:
a. sudden cerebral vasospasm.
b. blocked cerebral artery.
c. intracerebral hemorrhage.
d. cerebral embolism.
```
b. blocked cerebral artery.
82
```
Past brain trauma is an example of a _______ cause of a seizure.
Select one:
a. idiopathic
b. structural
c. epileptic
d. metabolic
```
b. structural
83
```
Your 23-year-old female patient complains of pain to the superior portion of her face. She tells you that the pain has persisted for the past few days and gets worse when she bends down to pick something up. This is most consistent with a:
Select one:
a. tension headache.
b. cluster headache.
c. sinus headache.
d. migraine headache.
```
c. sinus headache.
84
```
Which of the following conditions would most likely mimic the signs and symptoms of an acute ischemic stroke?
Select one:
a. Ruptured cerebral aneurysm
b. Hyperglycemic ketoacidosis
c. Severe intracranial pressure
d. Low blood glucose level
```
d. Low blood glucose level
85
The clonic phase of a generalized motor seizure is characterized by:
Select one:
a. muscle contraction and relaxation occurring in rapid succession.
b. continuous and unremitting total body muscular contractions.
c. paralysis of the intercostal muscles and the diaphragm.
d. total body muscle flaccidity immediately following the seizure.
a. muscle contraction and relaxation occurring in rapid succession.
86
```
You are assessing a 59-year-old male with an altered mental status. You should suspect an acute ischemic stroke versus hypoglycemia if the patient:
Select one:
a. rapidly loses consciousness.
b. is incontinent of urine and feces.
c. attempts to communicate with you.
d. has a prescription for phenobarbital.
```
c. attempts to communicate with you.
87
The hypertension that is commonly observed in patients with an intracerebral hemorrhage is usually the result of:
Select one:
a. a reflex bradycardia as the body compensates.
b. the body's attempt to shunt blood to the brain.
c. systemic vasodilation caused by autoregulation.
d. massive vasoconstriction within the cerebrum.
b. the body's attempt to shunt blood to the brain.
88
```
In most people, speech is controlled by the:
Select one:
a. frontal lobe.
b. left hemisphere.
c. occipital lobe.
d. right hemisphere.
```
b. left hemisphere.
89
You are assessing the arm drift of an elderly male with a suspected stroke and note that both of his arms drift toward the ground. You should:
Select one:
a. ensure the patient understood your instructions and repeat the test.
b. treat the patient for a hemorrhagic stroke to the right side of the brain.
c. conclude that the patient is having a left-sided ischemic stroke.
d. assess the arm drift by having the patient hold up one arm at a time.
a. ensure the patient understood your instructions and repeat the test.
90
A 57-year-old female with a history of peripheral vascular disease presents with an acute onset of confusion, aphasia, left-sided hemiparesis, and facial droop. You should suspect an:
Select one:
a. arterial hemorrhage in the left cerebral hemisphere.
b. arterial blockage in the left cerebral hemisphere.
c. arterial blockage in the right cerebral hemisphere.
d. arterial hemorrhage in the right cerebral hemisphere.
c. arterial blockage in the right cerebral hemisphere.
91
During a seizure, neurons are in a hypermetabolic state. This means that:
Select one:
a. electrical impulses travel from one neuron to another very slowly.
b. brain cell death occurs in as little as 60 seconds after a seizure begins.
c. the cells have converted to aerobic metabolism and are producing CO2.
d. they are using large amounts of glucose and producing lactic acid.
d. they are using large amounts of glucose and producing lactic acid.
92
The spinal nerves branch out from the spinal cord and:
Select one:
a. send motor responses to the brain.
b. send messages exclusively to the brain.
c. carry signals to and from the body.
d. are only capable of sensory input.
c. carry signals to and from the body.
93
A transient ischemic attack (TIA) occurs when:
Select one:
a. the body's normal processes destroy a cerebral thrombus.
b. a cerebral artery becomes partially occluded by a blood clot.
c. neurological abnormalities resolve within 36 to 48 hours.
d. hemostasis causes activation of blood-clotting mechanisms.
a. the body's normal processes destroy a cerebral thrombus.
94
When using the Cincinnati Stroke Scale to assess a 59-year-old female with a suspected stroke, you note a left-sided facial droop when you ask her to smile. You should:
Select one:
a. suspect intracerebral bleeding with mild intracranial pressure.
b. start an IV line and administer 25 g of 50% dextrose (D50).
c. determine if the patient has dysarthria or is unable to speak.
d. ask the patient to keep her eyes open as you assess arm drift.
c. determine if the patient has dysarthria or is unable to speak.
95
Which of the following scenarios is most descriptive of an absence seizure?
Select one:
a. A 6-year-old male who is conscious, but will not respond to his mother; symptoms subside spontaneously within a few minutes.
b. An 8-year-old female with a brief period of unresponsiveness and unilateral muscle twitching; she becomes agitated after the event.
c. A 4-year-old female with tonic-clonic muscle movement to her entire body; the child remains unresponsive after the event.
d. A 2-year-old male with high fever and a sudden onset of generalized muscle twitching; symptoms subside after 2 minutes.
a. A 6-year-old male who is conscious, but will not respond to his mother; symptoms subside spontaneously within a few minutes.
96
```
The largest part of the brain is the:
Select one:
a. brain stem.
b. cerebellum.
c. occiput.
d. cerebrum.
```
d. cerebrum.
97
With regard to potential treatment in the hospital, which of the following questions is most important to ask the spouse of a 66-year-old female who presents with signs and symptoms of an acute ischemic stroke?
Select one:
a. “Did your wife pass out or have a seizure?”
b. “When did you first notice the symptoms?”
c. “When was the last time that your wife ate?”
d. “Does your wife have high blood pressure?”
b. “When did you first notice the symptoms?”
