Unit 4 Medical Part 2 Chapter 20-23

Question 1

The primary role of the large intestine is to:

Select one:

a. receive bile and begin the digestion process.
b. complete the reabsorption of water.
c. receive digestive enzymes from the pancreas.
d. break down food so it can be digested.

Answer 1

b. complete the reabsorption of water.

Question 2

Your general impression of a 50-year-old man with acute abdominal pain reveals that he is confused and has pale, diaphoretic skin. After correcting any problems with airway, breathing, and circulation, your main focus should be on:

Select one:

a. performing a secondary assessment.
b. assessing his vital signs.
c. administering IV fluid boluses.
d. prompt transport to the hospital.

Answer 2

d. prompt transport to the hospital.

Question 3

A young female complains of acute pain located in the left lower quadrant of her abdomen. When palpating her abdomen for tenderness, and rigidity, you should first palpate the:

Select one:

a. left lower quadrant.
b. left upper quadrant.
c. right upper quadrant.
d. right lower quadrant.

Answer 3

d. right lower quadrant.

Question 4

Pain to palpation of the costovertebral angle is most suggestive of:

Select one:

a. cholecystitis.
b. diverticulitis.
c. pyelonephritis.
d. pancreatitis.

Answer 4

c. pyelonephritis.

Question 5

Which of the following illnesses or conditions would most likely predispose a patient to chronic renal disease?

Select one:

a. Pericarditis
b. Staph infection
c. Kidney stones
d. Strep throat

Answer 5

d. Strep throat

Question 6

The liver secretes ________, which is an enzyme that the body uses to:

Select one:

a. hydrochloric acid, break down foods.
b. bile, dissolve fats into solution.
c. chyme, remove waste products.
d. glucagon, convert glycogen to glucose.

Answer 6

b. bile, dissolve fats into solution.

Question 7

Disease or inflammation of organs that lie behind or beneath the abdominal cavity can cause signs of peritonitis because:

Select one:

a. the parietal peritoneum is richly supplied with very sensitive nerves.
b. the visceral peritoneum is highly vascular and prone to hemorrhage.
c. the organs become significantly enlarged due to the disease process.
d. large volumes of fluid accumulate in the retroperitoneal space.

Answer 7

a. the parietal peritoneum is richly supplied with very sensitive nerves.

Question 8

The ________ is a solid organ.

Select one:

a. urinary bladder
b. stomach
c. gallbladder
d. ovary

Answer 8

d. ovary

Question 9

During your assessment of a 39-year-old female with acute abdominal pain, you note the presence of diffuse pain while palpating her abdomen. With this information, you:

Select one:

a. can conclude that the upper abdominal organs are inflamed.
b. may be able to localize the problem organ or area causing her pain.
c. cannot identify the underlying organ that is causing the pain.
d. should suspect that she has blood in the retroperitoneal space.

Answer 9

c. cannot identify the underlying organ that is causing the pain.

Question 10

A 33-year-old female complains of acute intense pain in both lower abdominal quadrants. She is conscious and alert, tachycardic, and has a fever of 102.5°F. You should suspect:

Select one:

a. pelvic inflammatory disease.
b. acute bacterial cystitis.
c. a ruptured ectopic pregnancy.
d. a bacterial urinary tract infection.

Answer 10

a. pelvic inflammatory disease.

Question 11

Peritonitis typically causes ileus, which is the result of:

Select one:

a. a necrotic loop of the large intestine.
b. absent peristalsis in the intestine.
c. an obstruction of the large bowel.
d. a laceration to the small intestine

Answer 11

b. absent peristalsis in the intestine.

Question 12

A 67-year-old male complains of a burning sensation in his abdomen and hematemesis. During your assessment, you note pain to palpation of his left upper quadrant; his vital signs are suggestive of shock. Which of the following conditions should you suspect?

Select one:

a. Viral gastroenteritis
b. Acute cholecystitis
c. Chronic hepatitis
d. Bleeding peptic ulcer

Answer 12

d. Bleeding peptic ulcer

Question 13

You are treating a 50-year-old female with severe abdominal pain. She is conscious but restless, and is begging you for pain medication. Her blood pressure is 136/88 mm Hg, pulse is 120 beats/min and strong, and respirations are 24 breaths/min with adequate tidal volume. You should:

Select one:

a. give her small sips of water, but only if she is not nauseated.
b. request a paramedic to administer analgesia to the patient.
c. start a large-bore IV and set it at a keep the vein open rate.
d. administer 20 mL/kg fluid boluses through two large-bore IVs.

Answer 13

c. start a large-bore IV and set it at a keep the vein open rate.

Question 14

Appropriate management for a conscious adult patient with acute abdominal pain, a BP of 80/50 mm Hg, and a pulse rate of 120 beats/min includes:

Select one:

a. fluids by mouth if the patient is not nauseated.
b. elevating the lower extremities 12 to 15 inches.
c. IV fluid boluses as needed to maintain perfusion.
d. increasing the blood pressure to 120 mm Hg.

Answer 14

c. IV fluid boluses as needed to maintain perfusion.

Question 15

During your assessment of an elderly woman, you note a shunt on her left forearm. This indicates that she:

Select one:

a. has had numerous IVs in her forearm.
b. receives hemodialysis treatments.
c. receives chemotherapy for cancer.
d. has had peritoneal dialysis in the past.

Answer 15

b. receives hemodialysis treatments.

Question 16

Shortly following a meal, a 49-year-old female complains of acute pain to the right upper quadrant of her abdomen with referred pain to her right shoulder. This is most suggestive of acute:

Select one:

a. pancreatitis.
b. appendicitis.
c. pyelonephritis.
d. cholecystitis.

Answer 16

d. cholecystitis.

Question 17

A 27-year-old male complains of an acute onset of abdominal pain. He is found curled in a fetal position with his right knee drawn up into his abdomen. This position is most commonly seen in patients with acute:

Select one:

a. pancreatitis.
b. cholecystitis.
c. appendicitis.
d. gastroenteritis.

Answer 17

c. appendicitis.

Question 18

Which of the following pain patterns is most consistent with kidney stones?

Select one:

a. Retropubic pain without radiation
b. Flank pain that radiates to the groin
c. Localized costovertebral angle tenderness
d. Flank pain with referred pain to the shoulders

Answer 18

b. Flank pain that radiates to the groin

Question 19

Which of the following causes of an acute abdomen would be least likely to present with fever?

Select one:

a. Appendicitis prior to rupture and abscess formation
b. Acute pancreatitis secondary to an infectious process
c. Inflammation of the small pockets in the large intestine
d. Acute cholecystitis caused by the presence of gallstones

Answer 19

a. Appendicitis prior to rupture and abscess formation

Question 20

A 38-year-old male with an inguinal hernia complains of increased pain and nausea. He tells you that he has been able to reduce the hernia himself in the past, but it will not reduce today. This patient is at greatest risk for:

Select one:

a. diaphragmatic rupture.
b. decreased peristalsis.
c. strangulation of the bowel.
d. intra-abdominal bleeding.

Answer 20

c. strangulation of the bowel.

Question 21

The first stage of disseminated intravascular coagulation (DIC) is marked by:

Select one:

a. reduced platelet production.
b. increased platelet production.
c. uncontrolled hemorrhage.
d. increased platelet aggregation.

Answer 21

d. increased platelet aggregation.

Question 22

Excessive eating caused by cellular “hunger” is called:

Select one:

a. polyphagia.
b. polydipsia.
c. dyspepsia.
d. dysphasia.

Answer 22

a. polyphagia.

Question 23

Glucagon will not be effective if:

Select one:

a. blood glucose levels are less than 40 mg/dL.
b. glycogen stores in the liver are depleted.
c. it is given in conjunction with 50% dextrose.
d. the patient weighs less than 20 kg.

Answer 23

b. glycogen stores in the liver are depleted.

Question 24

In which of the following situations would a transfusion reaction most likely occur?

Select one:

a. Patient with type A– blood receives type A+ blood
b. Patient with type A blood receives type B blood
c. Patient with type AB blood receives type O blood
d. Patient with type B– blood receives type B– blood

Answer 24

b. Patient with type A blood receives type B blood

Question 25

You are dispatched to a residence for a 60-year-old diabetic male who is unresponsive. As you are assessing the patient, your partner attempts to obtain a blood glucose reading; however, the glucometer reads “error” after two attempts. You should:

Select one:

a. start an IV and administer 50 mL of 50% dextrose.
b. treat him for hyperglycemia with severe ketoacidosis.
c. administer oral glucose in between his cheek and gum.
d. transport rapidly to the closest appropriate facility.

Answer 25

a. start an IV and administer 50 mL of 50% dextrose.

Question 26

A 29-year-old male with a history of type 1 diabetes presents with excessive urination and marked thirst. These signs indicate that the:

Select one:

a. cells of the body are producing fructose.
b. blood glucose has exceeded 120 mg/dL.
c. renal system is excreting excess glucose.
d. kidneys are excreting excess insulin.

Answer 26

c. renal system is excreting excess glucose.

Question 27

A young male with sickle cell disease presents with chest pain, fever, and a cough. His vital signs are stable, although he is experiencing mild respiratory distress. You should suspect:

Select one:

a. a pneumothorax.
b. acute aspiration.
c. an aplastic crisis.
d. pneumonia.

Answer 27

d. pneumonia.

Question 28

When managing a semiconscious patient with adequate breathing, you should administer oxygen and:

Select one:

a. position the patient in a full Fowler position to prevent aspiration.
b. position the patient on his or her side and have suction ready.
c. give D50 if the blood glucose reading is less than 90 mg/dL.
d. insert an oropharyngeal airway, and assist ventilations as needed

Answer 28

b. position the patient on his or her side and have suction ready.

Question 29

In which of the following situations would a diabetic patient most likely develop hypoglycemic crisis (insulin shock)?

Select one:

a. A large meal following a normal insulin dose
b. An inadvertent underdose of insulin
c. Nausea after taking a regular insulin dose
d. Heavy exertion following a small meal

Answer 29

d. Heavy exertion following a small meal

Question 30

When a healthy person’s blood glucose level drops, such as what occurs in between meals:

Select one:

a. the islets of Langerhans secrete more insulin.
b. the body begins producing less glycogen.
c. glucagon is secreted into the bloodstream.
d. the cells begin to metabolize fats and proteins.

Answer 30

c. glucagon is secreted into the bloodstream.

Question 31

You respond to a movie theater for a 70-year-old male who is confused. His wife tells you he has type 2 diabetes but refuses to take his pills. Your assessment reveals that he is diaphoretic, tachycardic, and tachypneic. Initial treatment for this patient should include:

Select one:

a. performing a rapid exam and obtaining vital signs.
b. applying a nonrebreathing mask at 15 L/min.
c. assisting the patient with his diabetic medication.
d. administering one to two tubes of oral glucose.

Answer 31

b. applying a nonrebreathing mask at 15 L/min.

Question 32

Signs and symptoms of hyperthyroidism include:

Select one:

a. tachycardia, weight loss, and hyperactive reflexes.
b. bradycardia, weight loss, and muscle weakness.
c. an irregular pulse, weight gain, and flushed skin.
d. tachycardia, cool skin, and sluggish reflexes.

Answer 32

a. tachycardia, weight loss, and hyperactive reflexes.

Question 33

You are treating a 40-year-old male with a documented blood sugar reading of 300 mg/dL. The patient is semiconscious and breathing shallowly and is receiving assisted ventilation from your partner. You should recognize that definitive treatment for this patient includes:

Select one:

a. insulin.
b. oxygen.
c. glucagon.
d. dextrose.

Answer 33

a. insulin.

Question 34

You are caring for a 27-year-old male with suspected ketoacidosis. He is unresponsive and his blood glucose level, as measured by glucometer, reads “high.” His blood pressure is 80/50 mm Hg, pulse is 130 beats/min and weak, and respirations are 40 breaths/min and shallow. Which of the following represents the most appropriate treatment approach?

Select one:

a. Assisted ventilation, 0.5 to 1 mg of glucagon IM, 20-mL/kg crystalloid boluses to maintain perfusion, and transport
b. Oxygen via nonrebreathing mask, an IV of normal saline set to keep the vein open, 50 mL of D50, and rapid transport
c. Oxygen via nonrebreathing mask, 10-mL/kg crystalloid boluses to maintain perfusion, and prompt transport
d. Assisted ventilation, 20-mL/kg crystalloid boluses to maintain perfusion, transport, and consider an advanced airway

Answer 34

d. Assisted ventilation, 20-mL/kg crystalloid boluses to maintain perfusion, transport, and consider an advanced airway

Question 35

Which of the following would you expect to encounter in a patient with Kussmaul breathing?

Select one:

a. Low end-tidal carbon dioxide
b. High end-tidal carbon dioxide
c. pH greater than 7.45
d. Low oxygen saturation

Answer 35

a. Low end-tidal carbon dioxide

Question 36

Adrenocorticotropic hormone targets the adrenal _______ and causes it to release _______.

Select one:

a. medulla; cortisol
b. medulla; epinephrine
c. cortex; cortisol
d. cortex; epinephrine

Answer 36

c. cortex; cortisol

Question 37

When assessing a patient with von Willebrand disease, you should be especially alert for:

Select one:

a. any evidence of bleeding.
b. evidence of a pulmonary embolism.
c. signs of splenic enlargement.
d. peripheral edema.

Answer 37

a. any evidence of bleeding.

Question 38

Patients with thrombophilia are at an increased risk for:

Select one:

a. acute arterial rupture.
b. pulmonary embolism.
c. various cancers.
d. hemorrhagic stroke.

Answer 38

b. pulmonary embolism.

Question 39

Hemoglobin is:

Select one:

a. essential for the formation of clots, such as when vessel damage occurs.
b. the fluid portion of the blood that transports cells throughout the body.
c. found within the red blood cells and is responsible for carrying oxygen.
d. a key component of the blood and is produced in response to an infection.

Answer 39

c. found within the red blood cells and is responsible for carrying oxygen.

Question 40

A 22-year-old female with type 1 diabetes is unresponsive and has a blood glucose level of 29 mg/dL. She is receiving high-flow oxygen, and several attempts to establish IV access have failed. You should:

Select one:

a. begin transport and continue to attempt IV access en route.
b. administer 0.5 to 1 mg of glucagon via the intramuscular route.
c. call for a paramedic unit so they can establish intraosseous access.
d. place small amounts of oral glucose between her cheek and gum.

Answer 40

b. administer 0.5 to 1 mg of glucagon via the intramuscular route.

Question 41

The cells convert glucose into energy through the Krebs cycle and:

Select one:

a. gluconeogenesis.
b. glucogenesis.
c. glycogenolysis.
d. glycolysis.

Answer 41

d. glycolysis.

Question 42

Prehospital treatment for a patient with hyperglycemic ketoacidosis should focus on:

Select one:

a. IV fluid rehydration.
b. insulin administration.
c. glucagon administration.
d. administering sugar.

Answer 42

a. IV fluid rehydration.

Question 43

During your assessment of a 19-year-old male, you are told that he is being treated with factor VIII. This indicates that:

Select one:

a. his blood clots too quickly.
b. he has a thrombosis.
c. he has hemophilia A.
d. he has hemophilia B.

Answer 43

c. he has hemophilia A.

Question 44

Which of the following statements regarding hyperosmolar hyperglycemic syndrome (HHS) is correct?

Select one:

a. Most cases of HHS are caused by severe overhydration.
b. Pneumonia and urinary tract infections are often caused by HHS.
c. HHS most often occurs in patients with type 1 diabetes.
d. HHS is not associated with a fruity odor on the patient’s breath.

Answer 44

d. HHS is not associated with a fruity odor on the patient’s breath.

Question 45

An acute accelerated drop in the hemoglobin level, which is caused by red blood cells breaking down at a faster rate than normal, occurs during a _______ crisis.

Select one:

a. vasoocclusive
b. hemolytic
c. aplastic
d. splenic sequestration

Answer 45

b. hemolytic

Question 46

The chemical mediators that cause an allergic reaction are released by:

Select one:

a. basophils and mast cells.
b. macrophages and eosinophils.
c. histamines and leukotrienes.
d. lymphocytes and neutrophils.

Answer 46

a. basophils and mast cells.

Question 47

In contrast to anaphylaxis, an anaphylactoid reaction:

Select one:

a. typically does not present with respiratory symptoms.
b. can occur without previous exposure to the offending agent.
c. is classified as a response mediated by IgE antibodies.
d. is typically not life-threatening and does not require epinephrine.

Answer 47

b. can occur without previous exposure to the offending agent.

Question 48

A biphasic response to an antigen occurs when:

Select one:

a. an acute response is followed later by a delayed response.
b. the acute response is sustained despite appropriate care.
c. there is no acute response but a delayed response hours later.
d. the acute response is rapidly corrected by the immune system.

Answer 48

a. an acute response is followed later by a delayed response.

Question 49

A 50-year-old male was stung two times by a yellow jacket. He has a history of coronary artery disease and thinks that he is allergic to yellow jackets. Your assessment reveals a fine rash to his trunk and arms. His breath sounds are clear and equal bilaterally, his vital signs are stable, and he denies shortness of breath. Treatment for this patient should include all of the following, except:

Select one:

a. an IV line set to keep the vein open.
b. oxygen therapy as needed.
c. psychological support.
d. epinephrine via auto-injector.

Answer 49

d. epinephrine via auto-injector.

Question 50

A 30-year-old man presents with widespread urticaria after being bitten numerous times by fire ants. He is conscious and alert and denies respiratory distress. Further assessment reveals that his breath sounds are clear and equal bilaterally. He tells you that his wife has a prescribed epinephrine auto-injector because she is allergic to hornets. However, he does not have a prescribed auto-injector of his own. You should:

Select one:

a. refer him to his primary care physician for epinephrine.
b. administer oxygen as needed and transport promptly.
c. assist him in self-administering his wife’s epinephrine.
d. request a paramedic unit to administer epinephrine.

Answer 50

b. administer oxygen as needed and transport promptly.

Question 51

. A 29-year-old male experienced multiple fire-ant bites to his lower extremities. He is conscious and alert, and denies respiratory distress. His skin is warm, dry, and without urticaria and his breath sounds are clear and equal bilaterally. Appropriate management for this patient includes:

Select one:

a. administering prophylactic epinephrine in a dose of 0.3 to 0.5 mg IM.
b. assisting the patient with an epinephrine auto-injector if he has one.
c. administering 100% oxygen via nonrebreathing mask and starting an IV.
d. applying ice to the bites and observing for signs of an allergic reaction.

Answer 51

d. applying ice to the bites and observing for signs of an allergic reaction.

Question 52

Epinephrine is a critical treatment for patients with severe allergic reactions (anaphylaxis) because it:

Select one:

a. markedly increases the patient’s heart rate and improves perfusion to the brain, kidneys, and myocardium.
b. works rapidly to raise the BP by constricting the vasculature and improves ventilation by dilating the bronchioles.
c. directly blocks the endogenous chemicals that are responsible for the negative effects of the allergic reaction.
d. does not increase myocardial oxygen demand and consumption as if it were given to patients with other conditions.

Answer 52

b. works rapidly to raise the BP by constricting the vasculature and improves ventilation by dilating the bronchioles.

Question 53

You should attempt to remove an imbedded stinger from a patient who was stung by a bee because:

Select one:

a. it can inject venom for up to 20 minutes after the initial sting.
b. the toxicity of the venom increases when it enters the bloodstream.
c. desensitization to the venom will occur following prolonged exposure.
d. it is likely to cause severe local swelling and intense pain.

Answer 53

a. it can inject venom for up to 20 minutes after the initial sting.

Question 54

Which of the following is an example of acquired immunity?

Select one:

a. Sensitized to a specific antigen
b. Desensitized following a bite or sting
c. Desensitized with a vaccination
d. Born with specific antigens

Answer 54

c. Desensitized with a vaccination

Question 55

The dose of epinephrine, via auto-injector, for patients who weigh more than 33 pounds is:

Select one:

a. 1.5 mg.
b. 0.15 mg.
c. 3 mg.
d. 0.3 mg.

Answer 55

d. 0.3 mg.

Question 56

A 46-year-old female presents with respiratory difficulty, facial swelling, and widespread hives after she was stung by an unknown type of insect. Her blood pressure is 88/58 mm Hg; auscultation of her lungs reveals diffuse expiratory wheezing. The patient has a prescribed EpiPen, but has not used it. After administering 100% oxygen, you should:

Select one:

a. administer a nebulized beta2 agonist to relieve the bronchospasm.
b. administer 0.3 to 0.5 mL of epinephrine 1:1,000 subcutaneously.
c. start an IV and administer a 20 mL/kg saline bolus to raise her BP.
d. assist the patient with her EpiPen in accordance with your protocols.

Answer 56

d. assist the patient with her EpiPen in accordance with your protocols.

Question 57

Unlike the honeybee, wasps and hornets:

Select one:

a. have weaker venom, which is less likely to cause anaphylactic shock.
b. can sting multiple times, because their stinger is not left imbedded in the skin.
c. have a barbed stinger, which will remain imbedded in the skin.
d. are typically easier to identify as the species that caused an allergic reaction.

Answer 57

b. can sting multiple times, because their stinger is not left imbedded in the skin.

Question 58

Shortly after administering epinephrine to a 49-year-old male with anaphylactic shock, he becomes unconscious. Your assessment reveals that he is pulseless and apneic. You should:

Select one:

a. insert a supraglottic airway device.
b. begin CPR and apply the AED.
c. request a paramedic crew to assist.
d. begin CPR and start an IV line.

Answer 58

b. begin CPR and apply the AED.

Question 59

An allergic reaction is most accurately defined as aNo:

Select one:

a. exaggerated response of the body’s immune system to a foreign stimulus.
b. direct negative effect on the human body as the result of a foreign toxin.
c. abnormal sensitivity of the body to a foreign toxin or substance.
d. autoimmune response of the body to an internal or external stimulus.

Answer 59

a. exaggerated response of the body’s immune system to a foreign stimulus.

Question 60

A foreign substance that stimulates the body’s immune response is called aNo:

Select one:

a. antigen.
b. antibody.
c. histamine.
d. leukotriene.

Answer 60

a. antigen.

Question 61

Which of the following scenarios is an example of an intentional poisoning?

Select one:

a. A 4-year-old male gets into the medicine cabinet and swallows approximately 10 sleeping pills.
b. A 40-year-old male is exposed to organophosphates after failing to wear the appropriate protective gear.
c. A 24-year-old female sprays mace into the eyes of a perpetrator during a burglary attempt.
d. A 68-year-old female inadvertently takes too much of her high blood pressure medication.

Answer 61

c. A 24-year-old female sprays mace into the eyes of a perpetrator during a burglary attempt.

Question 62

If you suspect that your patient has ingested a poisonous substance, you should:

Select one:

a. call poison control for specific treatment guidelines.
b. initiate emergency care and notify medical control.
c. administer activated charcoal as soon as possible.
d. transport the patient to the closest medical facility.

Answer 62

b. initiate emergency care and notify medical control.

Question 63

When responding to the scene of a patient who has possibly overdosed on a drug, your primary responsibility is to:

Select one:

a. notify law enforcement.
b. rapidly assess the patient.
c. ensure that you are safe.
d. identify the drug involved.

Answer 63

c. ensure that you are safe.

Question 64

The presence of ________ often contributes to the signs and symptoms of acute alcohol intoxication.

Select one:

a. epidural bleeding
b. severe sepsis
c. hypoglycemia
d. ketoacidosis

Answer 64

c. hypoglycemia

Question 65

During your assessment of a 19-year-old male who has abused an unknown type of drug, you note severe deformity to his hand. The patient, who is very agitated, states that he bent his fingers back in an attempt to break them. This abnormal behavior is most consistent with the use of:

Select one:

a. LSD.
b. marijuana.
c. PCP.
d. cocaine.

Answer 65

c. PCP.

Question 66

In an attempt to kill herself, a 56-year-old female ingested a large quantity of Darvon. Your primary survey reveals that she is semiconscious; has slow, shallow respirations; and has a heart rate of 40 beats/min. Further assessment reveals that her BP is 80/50 mm Hg. Initial management for this patient includes:

Select one:

a. assisted ventilation with a bag-mask device and 100% oxygen.
b. a large-bore IV and 20 mL/kg fluid boluses to increase her BP.
c. insertion of a King airway and hyperventilation with 100% oxygen.
d. 100% oxygen via a nonrebreathing mask and suction as needed.

Answer 66

a. assisted ventilation with a bag-mask device and 100% oxygen.

Question 67

A 40-year-old female presents with confusion, slurred speech, and tachycardia. Her blood pressure is low and her pupils are dilated. Which of the following medications types would most likely explain her symptoms?

Select one:

a. Benzodiazepine
b. Tricyclic antidepressant
c. Barbiturate
d. Opiate

Answer 67

b. Tricyclic antidepressant

Question 68

Which of the following clinical signs would suggest significant exposure to an anticholinergic substance?

Select one:

a. Severe hypotension
b. Profound tachycardia
c. Excessive salivation
d. Pupillary constriction

Answer 68

b. Profound tachycardia

Question 69

Which of the following signs or symptoms would you be least likely to encounter during your assessment of a patient who has overdosed on a benzodiazepine?

Select one:

a. Slurred speech
b. Drowsiness
c. Combativeness
d. Confusion

Answer 69

c. Combativeness

Question 70

You and your partner are standing by at the scene of a structural fire when two firefighters carry a patient to you that they rescued from one of the rooms inside the house. The patient is not moving and has no obvious burns. You should:

Select one:

a. rapidly assess the patient for gross external bleeding and apply 100% oxygen.
b. insert an advanced airway device and begin positive-pressure ventilation.
c. apply 100% oxygen via a nonrebreathing mask and apply the pulse oximeter.
d. determine if the patient’s airway is patent and then assess ventilatory effort.

Answer 70

d. determine if the patient’s airway is patent and then assess ventilatory effort.

Question 71

Which of the following medications will not respond to the administration of naloxone (Narcan)?

Select one:

a. Morphine
b. Cocaine
c. Oxycodone
d. Fentanyl

Answer 71

b. Cocaine

Question 72

You respond to the residence of a 39-year-old male who, according to his wife, is not acting right. Law enforcement has secured the scene prior to your arrival. As you assess the patient, you find that he is confused, has a fever, and is agitated. The patient’s wife states that he is an alcoholic and stopped drinking 2 days ago. In addition to assessing and managing his airway, you should be most concerned with the potential for:

Select one:

a. vomiting.
b. seizures.
c. hypovolemia.
d. hyperglycemia.

Answer 72

b. seizures.

Question 73

A 3-year-old, 15-kg female swallowed an unknown quantity of gasoline. Your assessment reveals that she is conscious, crying, and alert. Her airway is patent and her breathing is adequate. You should:

Select one:

a. administer oxygen as tolerated and promptly transport her.
b. apply 100% oxygen as tolerated and request a paramedic unit.
c. induce vomiting and closely monitor the status of her airway.
d. administer 15 g of activated charcoal and have suction ready.

Answer 73

a. administer oxygen as tolerated and promptly transport her.

Question 74

Severe aspirin toxicity would most likely cause:

Select one:

a. metabolic acidosis.
b. metabolic alkalosis.
c. respiratory alkalosis.
d. respiratory acidosis.

Answer 74

a. metabolic acidosis.

Question 75

Upon entering the residence of a young female with a possible toxic exposure, you begin surveying the scene. Which of the following findings would provide you with the least amount of information regarding the type of exposure?

Select one:

a. An unpleasant odor in the residence
b. General condition of the living area
c. Needles or syringes in the residence
d. Presence of empty medication bottles

Answer 75

b. General condition of the living area

Question 76

You are assessing a patient who has self-injected an unknown substance. He is unconscious with rapid, shallow breathing and tachycardia. As you are assessing and treating this patient, it is important to note that:

Select one:

a. he has most likely injected himself with an opiate.
b. injected toxins are slowly absorbed into the body.
c. it is impossible to dilute or remove injected poisons.
d. cocaine is the single most commonly injected drug.

Answer 76

c. it is impossible to dilute or remove injected poisons.

Question 77

Approximately 12 hours after eating at a restaurant with his wife, a 49-year-old male complains of blurred vision, severe weakness, and difficulty breathing. This patient’s clinical signs are most consistent with exposure to:

Select one:

a. Salmonella
b. C botulinum
c. Toxoplasma
d. Listeria

Answer 77

b. C botulinum

Question 78

Patients with cyanide poisoning often have breath odor that resembles:

Select one:

a. camphor.
b. bitter almonds.
c. acetone.
d. wintergreen.

Answer 78

b. bitter almonds.

Question 79

General management for a patient who has overdosed on a benzodiazepine includes:

Select one:

a. inserting a supraglottic airway, deferring IV therapy, and transporting without delay.
b. inserting an oropharyngeal airway, administering oxygen, and transporting promptly.
c. administering 0.4 to 2 mg of naloxone, administering oxygen, and transporting.
d. maintaining airway patency, supporting ventilations as needed, and transporting.

Answer 79

d. maintaining airway patency, supporting ventilations as needed, and transporting.

Question 80

The self-administration of licit or illicit substances in a manner that is not consistent with approved medical or social practice is called:

Select one:

a. drug addiction.
b. substance abuse.
c. psychological dependence.
d. unintentional poisoning.

Answer 80

b. substance abuse.

Question 81

A 6-year-old, 44-lb male ingested an unknown quantity of aspirin approximately 20 minutes ago. He is conscious and alert and has stable vital signs. The appropriate dose of activated charcoal for this child is:

Select one:

a. 20 g.
b. 40 g.
c. 30 g.
d. 10 g.

Answer 81

a. 20 g.

Question 82

When assessing a patient suspected of overdosing on cocaine, you must be especially alert for:

Select one:

a. cardiac dysrhythmias.
b. respiratory depression.
c. profound hypotension.
d. significant bradycardia.

Answer 82

a. cardiac dysrhythmias.

Question 83

A 67-year-old female complains of nausea, vomiting, and abdominal pain that woke her from her sleep. As you and your partner enter her residence, you immediately note the smell of natural gas. Suspecting carbon monoxide toxicity, you quickly remove the patient from her home and place her in the ambulance. When assessing her, it is important to remember that:

Select one:

a. hyperbaric oxygen must be given within 20 minutes in order to prevent death.
b. definitive airway management is the most effective treatment for her condition.
c. breathing room air will not eliminate any carbon monoxide from the bloodstream.
d. a pulse oximetry reading that is high does not rule out significant hypoxemia.

Answer 83

d. a pulse oximetry reading that is high does not rule out significant hypoxemia.

Question 84

A 32-year-old male ingested a large quantity of an opioid. Which of the following clinical signs would you most likely encounter during your assessment?

Select one:

a. Pupillary dilation and severe hypertension
b. Hyperventilation and excessive tachycardia
c. Respiratory depression and hypotension
d. Slurred speech and combative behavior

Answer 84

c. Respiratory depression and hypotension