AMLS Pretest

Question 1

A 28 year old female is being evaluated for an acute onset of an alteration in mentation. She complained of a stiff neck and persistent headache. Vital signs are P112, R22 and regular, BP 144/88, SpO2 95% and T 102.3F (39C). The healthcare provider should observe for which complication?

• sepsis
• seizure
• cardiac arrest
• internal bleeding

Answer 1

Seizure
-Chapter 2

Question 2

A 45 year old patient is found supine on the floor of the Triage area. Healthcare providers note pinpoint pupils, shallow respirations and vomitus in and around the mouth. What course of action should be implemented next?

• initiate an IV and administer naloxone
• supplemental oxygen and suction
• obtain a blood glucose level
• begin bag - mask ventilation

Answer 2

Supplemental oxygen and suction
-Chapter 2

Question 3

Patients with a history of chronic bronchitis that present with shortness of breath are likely to have which condition?

• pulmonary embolism
• angina pectoris
• angioedema
• hypertensive crisis

Answer 3

Pulmonary embolism
-Chapter 3

Question 4

Acute Respiratory Distress Syndrome (ARDS) is characterized by what pathological change?

• excessive muscular production
• inflammation of the visceral pleura
• breakdown of fluid alveolar- capillary membrane
• accumulation of cloud between the pleural layers

Answer 4

Breakdown of fluid between the alveolar-capillary membrane
-Chapter 3

Question 5

An anxious male complains of a sore throat, fever, chills, dental pain and dyspnea. the patient has a firm, red pronounced swelling in the sublingual anterior throat area and tongue. What diagnosis is most likely?

• croup
• tonsillitis
• angioedema
• Ludwig’s angina

Answer 5

Ludwig’s angina
-Chapter 3

Question 6

Patients on mechanical ventilation may have hypoxemia due to alveolar collapse from mucous plugging. The best treatment for this is:

• increase oxygen concentration to 100%
• increase total volume
• increase respiratory rate
• administer PEEP

Answer 6

Administer PEEP
-Chapter 3

Question 7

Anaphylaxis is most associated with which physiological event?

• hemorrhage
• vasodilation
• bradycardia
• hypertension

Answer 7

Vasodilation
-Chapter 4

Question 8

An elderly patient in an assisted living facility presents with a diminished level of consciousness and elevated white blood count. Assessment reveals pale, clammy skin and a urinary catherter with dark colored urine. Vital signs are P132, R 38 and shallow, BP 78/46, SpO2 91% and T 100.8°F (32.8°C). What classification of shock is the patient most likely experiencing?

• hypovolemic
• cardiogenic
• distributive
• obstructive

Answer 8

Distributive
-Chapter 4

Question 9

Healthcare providers are assessing a patient with pronounced jugular vein distention and muffled heart tones. Vitals are P 128, R 26, BP 74/52. What classification of shock should be suspected?

• hypovolemic
• cardiogenic
• distributive
• obstructive

Answer 9

Obstructive
- Chapter 5

Question 10

During compensatory shock, the renin-angiotensin-aldosterone system is activated to cause a/an:

• increase in preload, afterload and re-absorption of sodium
• decrease in preload, afterload and re-absorption of sodium
• increase in myocardial contractility
• vasodilation and sodium retention

Answer 10

Increase in preload, afterload and re-absorption of sodium
-Chapter 4

Question 11

A 42 year old patient with a history of rheumatoid arthritis is taking glucocorticoids. Over the past two weeks, she complains of chronic fatigue, weakness, and loss of appetite with weight loss. Lab results indicate hyponatremia and hyperkalemia. What underlying diagnosis is suspected?

• adrenal insufficiency
• diabetic ketoacidosis
• hypothyroidism
• rhabdomyolysis

Answer 11

Adrenal insufficiency
-Chapter 6

Question 12

Which condition should the healthcare provider consider to usually be a non-emergent, non-life threatening illness?

• acute coronary syndrome
• thoracic outlet syndrome
• esophageal tear
• aortic dissection

Answer 12

Thoracic outlet syndrome
-Chapter 5

Question 13

Healthcare providers should use extreme caution with nitroglycerin when ST elevation is present in which ECG leads?

• V1, V2
• V3, V4
• l, aVL
• ll, lll, aVF

Answer 13

II, III, aVF
-Chapter 5

Question 14

Which is a high-risk factor for intracerebral hemorrhage?

• marijuana
• coronary artery spasm
• bradycardia
• cocaine drug abuse

Answer 14

Cocaine drug abuse
-Chapter 2

Question 15

What is the initial treatment for a patient experiencing Hyperosmolar Hyperglycemic Nonketotic Syndrome (HHNS)?

• crystalloid IV fluid resuscitation
• administration of dextrose
• administration of insulin
• fluid bolus of 5% dextrose in water (D5W)

Answer 15

Crystalloid IV fluid resuscitation
-Chapter 6

Question 16

What condition is most likely to cause respiratory acidosis?

• anxiety/panic attack
• narcotic overdose
• methanol ingestion
• diabetic ketoacidosis

Answer 16

Narcotic overdose
-Chapter 6

Question 17

What is the most effective treatment for an unconscious patient in respiratory acidosis?

• assisted bag-mask ventilation
• sodium bicarbonate
• supportive care
• IV fluid bolus

Answer 17

Assisted bag-mask ventilation
-Chapter 6

Question 18

An autoimmune disease which produces antibodies that mimic the role of TSH and cause an increase in thyroid hormones is:

-Addisons disease
- myzedema coma
- graves disease
- diabetic ketoacidosis

Answer 18

Grave’s disease

Question 19

Glucagon may not be effective treatment for a patient with hypoglycemia if they also have which underlying illness?

• alcoholism
• cholesystitis
• pancreatitis
• hypothyroidism

Answer 19

Alcoholism
-Chapter 6

Question 20

A 24 year old has completed a triathlon on a hot, humid day. The athlete complains of a severe headache, muscle cramps and abdominal pain. As the patient history is obtained, the athlete becomes lethargic. What underlying electrolyte disturbance should the healthcare provider most likely suspect?

• magnesemia
• hyponatremia
• hypocalcemia
• hypokalemia

Answer 20

Hyponatremia
-Chapter 6

Question 21

What is the sign on the ECG that will indicate a patient is experiencing hyperkalemia?
- flattened t waves
- peaked t waves
- hypocalcemia
- hypokalemia

Answer 21

Peaked T waves
-Chapter 6

Question 22

An 82 year old alcoholic complains of nausea, non-bloody vomiting and severe epigastric and right upper quadrant pain that radiates to the back. Palpation reveals epigastric tenderness without peritoneal signs. What working diagnosis should be considered most likely?

• acute pancreatitis
• intestinal obstruction
• peptic ulcer
• Mallory-Weiss syndrome

Answer 22

Acute pancreatitis
-Chapter 7

Question 23

A 23 year old male complains of a productive cough, fever, chills and pleuritic chest pain that has worsened over 3 days. A physical exam reveals unilateral wheezing with shallow respirations. Vitals are P 128, R 26, BP 144/88, SpO2 90%, and T 102°F (38.8°C). What treatment should be performed?

-12 lead
- beta blockers
- initiate STEMI protocols
- supplemental oxygen and immediate transport

Answer 23

Supplemental Oxygen and immediate transport
-Chapter 3

Question 24

A patient with suspected gallbladder disease is asked to take a deep breath while the provider presses upward into the upper right quadrant. If the patient ceases inspiration due to increase pain while being examined, this is known as:

• Cullen’s sign
• rovsing’s sign
• Murphy’ sign
• kehr’s sign

Answer 24

Murphy’s Sign
-Chapter 7

Question 25

The patient is alert and oriented presenting with hypotension, bradycardia, normal capillary refill and warm, dry skin. These are cardinal signs of which type of distributive shock? - anaphylactic - neurogenic - septic - toxic shock syndrome

Answer 25

Neurogenic -Chapter 4

Question 26

During what period of the communicable disease process will antibodies begin to reach detectable levels and the infected blood will test positive for exposure to a pathogen? - communiciability - incubation - disease - latent

Answer 26

Incubation -Chapter 8

Question 27

The patient presents with a history of headache, weight loss, chest discomfort, night sweats and a persistent cough for several weeks. Which infectious disease is most likely occurring? - novel H1N1 influenza - meningococcal meningitis - tuberculosis - malaria

Answer 27

Tuberculosis -Chapter 8

Question 28

A lethargic patient presents with dilated pupils and vital signs of P 122, R 26 and BP 130/80. He admits to excessive ingestion of diphenhydramine. What response is the cause for the presenting signs and symptoms? - sympathomimetic - anticholinergic - cholinergic - opioid

Answer 28

Anticholinergic -Chapter 9

Question 29

Organophosphate poisoning will present with which signs and symptoms? - dry mucous membranes and shock - altered mental status and flushed skin - euphoria and tachycardia - salivation and incontinence of urine and liquid stool

Answer 29

Salivation and incontinence of urine and liquid stool -Chapter 9 U

Question 30

What medication classification should be administered to an uncooperative, agitated patient? - opioid - nitrate - benzodiazepine - sympathomimetic

Answer 30

Benzodiazepine -Chapter 9

Question 31

A patient presents with mildly decreased mental status, slow respirations, bradycardia, hypotension, has a blood sugar of 42mg/dl (2.3 mmolL). This is most likely caused from excessive ingestion of: - calcium channel blockers - tricyclic antidepressants - beta blockers - salicylates

Answer 31

Beta blockers -Chapter 9

Question 32

The patient complains of a deep burning discomfort diffusely throughout the epigastrium. This is an example of which type of pain? - somatic - visceral - referred - radiating

Answer 32

Visceral -Chapter7

Question 33

A 24 year old female presents with lower right quadrant abdominal pain. Her skin is hot to the touch and she exhibits a Psoa Sign. She complains of nausea and vomiting for 2 days. What diagnosis is suspected? - pancreatitis - appendicitis - gastroenteritis - ectopic pregnancy

Answer 33

Appendicitis -Chapter 7

Question 34

A known chronic alcoholic complains of the constant, severe mid-epigastric pain, nausea and blood-streaked emesis. The patient has a temperature of 101.9°F (38.8°C) and severe abdominal tenderness. What underlying diagnosis should be suspected? - gastritis - pancreatitis - diverticulitis - perforated gastric ulcer

Answer 34

Pancreatitis -Chapter 7

Question 35

What component of a patient's past medical history is most helpful in considering myocardial infarction as a working diagnosis? - daily intake of an aspirin - history of CHF - recent hip surgery - familial heart disease history

Answer 35

Familial heart disease history -Chapter 5

Question 36

A patient describes an "aching" sensation in his chest. It occurred suddenly while resting and radiates to the jaw. He self administered 1 nitroglycerin tablet without relief and the 12 lead reveals a normal sinus rhythm with ST elevation in leads II, III, and aVF. What working diagnosis is most likely? - anterior wall myocardial injury - inferior wall myocardial injury - costocholdritis - pericarditis

Answer 36

Inferior wall myocardial injury -Chapter

Question 37

Healthcare providers are managing a patient presenting with substernal chest discomfort. They describe the pain as "pressure-like" and it radiates to the jaw and left arm. The discomfort subsides with rest, oxygen and administration of nitroglycerin. What is the most likely working diagnosis? - pleurisy - angina pectoris - myocardial infarction - pulmonary embolism

Answer 37

Angina pectoris -Chapter 5

Question 38

Which infectious disease must have oxygen present to survive? - tuberculosis - lung abscess - botulism - tetanus

Answer 38

Tuberculosis -Chapter 8

Question 39

Which best practices help to prevent the spread of infectious disease? - alcohol based anti microbial equipment cleaning and handwashing - goggles, gown and gloves for all patient contact - facial protection and gloves for all patient contact - handwashing before and after all patient contact and standard precautions

Answer 39

Handwashing before and after all patient contact and standard precautions -Chapter 8

Question 40

Continuous positive airway pressure would be most appropriate in treating which patient? - 43 yr old with decreased LOC with respiratory difficulty - 22 yr old with severe asthma and not responding to nebulizer treatments - 38 yr old with carpal pedal spams, clear lung sounds and respirations 40 times per min - 55 yr old with JVD and BP 90/60

Answer 40

22 year old with severe asthma and not responding to nebulizer treatments -Chapter 3

Question 41

A patient has attempted suicide by ingesting ethylene glycol about 20 hours prior to arriving for treatment. Lung sounds reveal bilateral crackles and respirations of 30 with symptoms of pulmonary edema and cyanosis of the lips. The ECG reveals ventricular tachycardia. Which stage of ethylene glycol poisoning has occurred? - 1 - 2 - 3 - 4

Answer 41

2 -Chapter 9

Question 42

A patient with a history of Grave's disease presents with anxiety, profuse sweating and a palpable goiter. Vitals are P 151, R 35 and labored, BP 84/42. Which working diagnosis is most likely? - myxedema - cocaine toxicity - thyrotoxicosis - diabetes insipidus

Answer 42

Thyrotoxicosis -Chapter 6

Question 43

A patient experiences unilateral facial weakness and droop, garbled speech, altered sense of taste and no extremity weakness. The patient has a history of Lyme's disease. What condition is the patient likely experiencing? - meningitis - Bell’s palsy - ischemic stroke - hemorrhagic stroke

Answer 43

Bell's palsy -Chapter 2

Question 44

Which component of the history is most crucial when assessing a potential stroke patient? - time of onset - last oral intake - medication allergies - familial risk factors

Answer 44

Time of onset -Chapter 2

Question 45

The determination of a working diagnosis is dependent on the provider's assessment, critical thinking and ____________________ __________________________ skills. - pattern recognition - written documentation - radio communication - treatment intervention

Answer 45

Pattern recognition -Chapter 1

Question 46

When performing a patient assessment, what information provides the most essential information in determining a working diagnosis? - ordering and correctly interpreting all diagnostic information - a through head to toe examination on all patients - obtaining inforformation from bystanders - medical history

Answer 46

Medical history -Chapter 1

Question 47

Clinical reasoning requires the healthcare provider to: - adaquetly communicate to peers regarding evidence- based practice - order and interpret diagnostic testing results - adequately perform a physical assessment - process relevant information, filter out irrelevant information

Answer 47

Process relevant information, filter out irrelevant information -Chapter 1

Question 48

According to the AMLS Assessment Pathway, determining whether a patient is "Sick or Not Sick" is initially done which component of the assessment process? - detailed assessment - first impression - initial observation - ongoing management

Answer 48

First impression

Question 49

Select an example of a communication barrier that impairs an efficient and thorough assessment process. - the patient speaks clearly and is shy - the patient’s family is present in the home - you and your patient community fluently in the Spanish language - the patient’s family can’t find his hearing aid

Answer 49

The patient can't find his hearing aid -Chapter 1

Question 50

Healthcare providers are treating an unresponsive patient who overdosed on lorazepam. What intervention should be initiated? - airway support - administration of naloxone - gather a SAMPLE history - supplemental oxygen with nasal cannula

Answer 50

Airway support -Chapter