Medical Flashcards
(403 cards)
1
Q
In contrast to the assessment of a trauma patient, assessment of a medical patient:
A
is focused on the nature of illness, the patient’s chief complaint, and his or her symptoms.
2
Q
Which of the following conditions is NOT categorized as a psychiatric condition?
A
Substance abuse
3
Q
The greatest danger in displaying a personal bias or “labeling” a patient who frequently calls EMS is:
A
overlooking a potentially serious medical condition.
4
Q
An index of suspicion is MOST accurately defined as:
A
your awareness and concern for potentially serious underlying and unseen injuries or illness.
5
Q
You and your EMT partner arrive at the residence of a 50-year-old man who complains of weakness. Your primary assessment reveals that he is critically ill and will require aggressive treatment. The closest hospital is 25 miles away. You should:
A
manage all threats to airway, breathing, and circulation and consider requesting an ALS unit.
6
Q
When forming your general impression of a patient with a medical complaint, it is important to remember that:
A
the conditions of many medical patients may not appear serious at first.
7
Q
Upon initial contact with a patient who appears to be unconscious, you should:
A
attempt to elicit a verbal response by talking to the patient.
8
Q
Your primary assessment 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:
A
administer oxygen with the appropriate device.
9
Q
In addition to looking for severe bleeding, assessment of circulation in the conscious patient should involve:
A
checking the radial pulse and noting the color, temperature, and condition of the skin.
10
Q
When assessing a patient with a medical complaint, which of the following would MOST likely reveal the cause of the problem?
A
Medical history
11
Q
Which of the following will MOST reliably allow you to determine the nature of a patient’s illness?
A
Asking questions related to the chief complaint
12
Q
A 58-year-old man complains of chest discomfort and nausea. He is conscious and alert; his blood pressure is 140/90 mm Hg, his pulse is 104 beats/min, and his respirations are 16 breaths/min. Your partner has applied supplemental oxygen. Prior to assisting the patient with one of his prescribed nitroglycerin tablets, you ask him if he takes medication to treat erectile dysfunction (ED), and he tells you that he does. You should:
A
ask him what he takes, how much, and when he last took it.
13
Q
When caring for a patient who takes numerous medications, it is best to:
A
take all of the patient’s medications with you to the hospital and document them on your patient care report.
14
Q
The secondary assessment of a medical patient:
A
is not practical if the patient is critically ill or your transport time is short.
15
Q
You have just completed your primary assessment of a 48-year-old man with crushing chest pain and difficulty breathing. The patient has been given 324 mg of aspirin and is receiving supplemental oxygen. As you begin your secondary assessment, you note that his mental status has deteriorated and he is now bradycardic. You should:
A
prepare the patient for immediate transport
16
Q
When performing a secondary assessment on a conscious patient with nontraumatic abdominal pain and stable vital signs, you should:
A
focus on his or her chief complaint.
17
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.
A
neurologic
18
Q
Which of the following assessment findings is MOST indicative of a cardiovascular problem?
A
Jugular venous distention
19
Q
Assessment of a patient’s blood pressure with an automatic BP cuff reveals that it is 204/120 mm Hg. The patient is conscious and alert and denies any symptoms. The EMT should:
A
obtain a manual blood pressure.
20
Q
A sign of respiratory distress seen in the neck is:
A
accessory muscle use.
21
Q
Reassessment of a patient with a medical complaint should begin by:
A
repeating the primary assessment.
22
Q
The primary prehospital treatment for most medical emergencies:
A
addresses the patient’s symptoms more than the actual disease process.
23
Q
Which of the following medications would the EMT be LEAST likely to administer to a patient with a medical complaint?
A
Ibuprofen
24
Q
When caring for a patient with an altered mental status and signs of circulatory compromise, you should:
A
limit your time at the scene to 10 minutes or less, if possible.
25
The determination of whether a medical patient is a high-priority or low-priority transport is typically made:
after the primary assessment has been completed.
26
In which of the following situations would it be MOST appropriate to utilize an air medical transportation service?
61-year-old man with signs and symptoms of a stroke and your ground transport time is 50 minutes
27
Which of the following conditions often requires transport to a hospital with specialized capabilities that may not be available at the closest hospital?
Stroke and heart attack
28
After sizing up the scene of a patient with a possible infectious disease, your next priority should be to:
take standard precautions.
29
Typical chief complaints in patients with an infectious disease include:
fever, rash, nausea, and difficulty breathing.
30
In addition to obtaining a SAMPLE history and asking questions related to the chief complaint, what else should you specifically inquire about when assessing a patient with a potentially infectious disease?
Recent travel
31
An infectious disease is MOST accurately defined as:
a medical condition caused by the growth and spread of small, harmful organisms within the body.
32
Which of the following statements regarding the human immunodeficiency virus (HIV) is correct?
Correct!
The risk of HIV infection is greatest when deposited on a mucous membrane or directly into the bloodstream.
33
Which of the following patients is at greatest risk for complications caused by the influenza virus?
68-year-old woman with type 2 diabetes
34
Early signs and symptoms of viral hepatitis include all of the following, EXCEPT:
jaundice and abdominal pain.
35
Which of the following statements regarding hepatitis A is correct?
Hepatitis A can only be transmitted by a patient who has an acute infection.
36
Hepatitis B is more virulent than hepatitis C, which means that it:
has a greater ability to produce disease.
37
A patient who presents with a headache, fever, confusion, and red blotches on his or her skin should be suspected of having:
meningitis
38
Patients with tuberculosis pose the greatest risk for transmitting the disease when they:
cough
39
In contrast to viral hepatitis, toxin-induced hepatitis:
is not a communicable disease.
40
Ten days after treating a 34-year-old patient with tuberculosis, you are given a tuberculin skin test, which yields a positive result. This MOST likely indicates that:
you were exposed to another infected person prior to treating the 34-year-old patient.
41
Which of the following statements regarding methicillin-resistant Staphylococcus aureus (MRSA) is correct?
MRSA is a bacterium that causes infections and is resistant to most antibiotics.
42
Factors that increase the risk for developing methicillin-resistant Staphylococcus aureus (MRSA) include:
prolonged hospitalization, especially in an intensive care unit.
43
Your patient's symptoms include high fever, cough, vomiting, bloody diarrhea, and shortness of breath. Which of the following should you suspect?
MERS-CoV
44
Three months after returning home from West Africa, a 50-year-old man begins experiencing a fever, cough, and muscle aches. The EMT should suspect:
influenza
45
Which of the following questions would be the MOST pertinent to ask a patient who recently returned from Europe and is now ill?
Is anyone else in your travel party sick?
46
The BEST way to prevent infection from whooping cough is to:
get vaccinated against diphtheria, tetanus, and pertussis.
47
The three major parts of the brain are the:
cerebrum, cerebellum, and brain stem.
48
The most basic functions of the body, such as breathing, blood pressure, and swallowing, are controlled by the:
Brain stem
49
Muscle control and body coordination are controlled by the:
cerebellum
50
The left cerebral hemisphere controls:
the right side of the body.
51
The frontal lobe of the brain controls:
emotion
52
The spinal cord exits the cranium through the:
foramen magnum.
53
Which of the following conditions would MOST likely affect the entire brain?
Respiratory failure or cardiopulmonary arrest
54
Interruption of cerebral blood flow may result from all of the following, EXCEPT:
cerebral vasodilation.
55
Which of the following MOST accurately describes the cause of an ischemic stroke?
Blockage of a cerebral artery
56
You are assessing a 49-year-old man who, according to his wife, experienced a sudden, severe headache and then passed out. He is unresponsive and has slow, irregular breathing. His blood pressure is 190/94 mm Hg, and his pulse rate is 50 beats/min. His wife tells you that he has hypertension and diabetes. He has MOST likely experienced:
a ruptured cerebral artery.
57
The MOST significant risk factor for a hemorrhagic stroke is:
hypertension.
58
An area of swelling or enlargement in a weakened arterial wall is called:
an aneurysm
59
Which of the following clinical signs is MOST suggestive of a ruptured aneurysm?
Sudden, severe headache
60
A transient ischemic attack (TIA) occurs when:
a small clot in a cerebral artery causes temporary symptoms.
61
A patient who is experiencing aphasia is:
unable to produce or understand speech.
62
A patient whose speech is slurred and difficult to understand is experiencing:
dysarthria
63
Which of the following conditions would be the LEAST likely to mimic the signs and symptoms of a stroke?
Hypovolemia
64
Which of the following findings should concern the EMT the MOST when assessing a patient who complains of a headache?
Neck stiffness or pain
65
Which of the following symptoms would lead the EMT to believe that a patient's headache is caused by sinus congestion?
The pain is worse when bending over.
66
A generalized (tonic-clonic) seizure is characterized by:
severe twitching of all the body's muscles.
67
Which of the following is characteristic of a focal-onset aware seizure?
Normal level of consciousness
68
Which of the following MOST accurately describes a focal-onset aware seizure?
A seizure that begins in one extremity
69
The mental status of a patient who has experienced a generalized seizure:
Correct!
is likely to improve over a period of 5 to 30 minutes.
70
Which of the following MOST accurately describes what the patient will experience during the postictal state that follows a seizure?
Confusion and fatigue
71
Status epilepticus is characterized by:
prolonged seizures without a return of consciousness.
72
Which of the following conditions is NOT a common cause of seizures?
Hypotension
73
Which of the following is a metabolic cause of a seizure?
Poisoning
74
Which of the following medications would indicate that a patient has a history of seizures?
Levetiracetam (Keppra)
75
Febrile seizures:
are usually benign but should be evaluated.
76
You respond to a residence for a child who is having a seizure. Upon arrival at the scene, you enter the residence and find the mother holding her child, a 2-year-old male. The child is conscious and crying. According to the mother, the child had been running a high fever and then experienced a seizure that lasted approximately 3 minutes. You should:
transport the child to the hospital and reassure the mother en route.
77
You arrive at a grocery store shortly after a 35-year-old male stopped seizing. Your assessment reveals that he is confused and incontinent of urine. The patient's girlfriend tells you that he has a history of seizures and takes topiramate (Topamax). When obtaining further medical history from the girlfriend, it is MOST important to:
obtain a description of how the seizure developed.
78
A patient with an altered mental status is:
not thinking clearly or is incapable of being aroused.
79
The principal clinical difference between a stroke and hypoglycemia is that patients with hypoglycemia:
usually have an altered mental status or decreased level of consciousness.
80
When caring for a patient with documented hypoglycemia, you should be MOST alert for:
a seizure
81
You arrive at a local grocery store approximately 5 minutes after a 21-year-old female stopped seizing. She is confused and disoriented; she keeps asking you what happened and tells you that she is thirsty. Her brother, who witnessed the seizure, tells you that she takes valproate (Depakote) for her seizures, but has not taken it in a few days. He also tells you that she has diabetes. In addition to administering oxygen, you should:
monitor her airway and breathing status and assess her blood glucose level.
82
Individuals with chronic alcoholism are predisposed to intracranial bleeding and hypoglycemia secondary to abnormalities in the:
liver
83
Which of the following patients would MOST likely demonstrate typical signs of infection, such as a fever?
A 17-year-old male with anxiety
84
During the primary assessment of a semiconscious 70-year-old female, you should:
ensure a patent airway and support ventilation as needed.
85
You are dispatched to a residence for a 66-year-old male who, according to family members, has suffered a massive stroke. Your primary assessment reveals that the patient is unresponsive, apneic, and pulseless. You should:
initiate CPR and attach an AED as soon as possible.
86
You are caring for a 68-year-old man with sudden onset of left-sided paralysis and slurred speech. His airway is patent, his respirations are 14 breaths/min with adequate depth, and his oxygen saturation is 98%. Treatment for this patient should include:
recovery position and transport.
87
Law enforcement has summoned you to a nightclub, where a 22-year-old female was found unconscious in an adjacent alley. Your primary assessment reveals that her respirations are rapid and shallow and her pulse is rapid and weak. She is wearing a medical alert bracelet that identifies her as an epileptic. There is an empty bottle of vodka next to the patient. You should:
assist ventilations, perform a rapid exam, and prepare for immediate transport.
88
You are caring for a 70-year-old female with signs and symptoms of an acute stroke. She is conscious, has secretions in her mouth, is breathing at a normal rate with adequate depth, and has an oxygen saturation of 96%. You should:
suction her oropharynx and transport immediately.
89
You arrive at the residence of a 33-year-old woman who is experiencing a generalized (tonic-clonic) seizure. She has a small amount of vomitus draining from the side of her mouth. After protecting her from further injury, you should:
maintain her airway with manual head positioning, suction her airway to remove the vomitus, insert a nasopharyngeal airway, and administer high-flow oxygen.
90
When you are obtaining medical history from the family of a suspected stroke patient, it is MOST important to determine:
when the patient last appeared normal.
91
A 58-year-old male presents with confusion, right-sided weakness, and slurred speech. His airway is patent, and his breathing is adequate. His wife is present and is very upset. Which of the following has the MOST immediately priority?
Asking his wife when she noticed the symptoms
92
A 40-year-old patient without a history of seizures experiences a generalized (tonic-clonic) seizure. The LEAST likely cause of this seizure is:
epilepsy
93
Components of the Cincinnati Prehospital Stroke Scale include:
arm drift, speech, and facial droop.
94
When assessing for arm drift of a patient with a suspected stroke, you should:
ask the patient to close his or her eyes during the assessment.
95
You are assessing the arm drift component of the Cincinnati Prehospital Stroke Scale on a 60-year-old woman. When she holds both of her arms out in front of her and closes her eyes, both of her arms immediately fall to her sides. You should:
repeat the arm drift test, but move the patient's arms into position yourself.
96
Your patient opens his eyes, moans, and pulls away from you when you pinch his trapezius muscle. You should assign a Glasgow Coma Scale (GCS) score of:
8
97
Your patient answers your questions appropriately, although her eyes remain closed the entire time. She moves each extremity on command, although her left side is weaker than the right. You should assign a Glasgow Coma Scale (GCS) score of:
12
98
A 29-year-old male complains of a severe headache and nausea that has gradually worsened over the past 12 hours. He is conscious, alert, and oriented and tells you that his physician diagnosed him with migraine headaches. He further tells you that he has taken numerous different medications, but none of them seems to help. His blood pressure is 132/74 mm Hg, his pulse is 110 beats/min and strong, and his respirations are 20 breaths/min. Treatment should include:
dimming the lights in the back of the ambulance and transporting without lights and siren.
99
When transporting a stable stroke patient with a paralyzed extremity, place the patient in a:
recumbent position with the paralyzed side down.
100
A patient who is possibly experiencing a stroke is NOT eligible for thrombolytic (fibrinolytic) therapy if he or she:
has bleeding within the brain.
101
Successful treatment of a stroke depends on whether:
thrombolytic therapy is given within 3 hours of symptoms beginning.
102
A 30-year-old male experienced a generalized (tonic-clonic) seizure, which stopped before you arrived at the scene. The patient is conscious, is answering your questions appropriately, and refuses EMS transport. Which of the following would be the MOST compelling reason to disagree with his refusal of transport?
He is currently not prescribed any medications.
103
Solid abdominal organs include the:
spleen, kidneys, and pancreas.
104
Which of the following organs would MOST likely bleed profusely if injured?
Liver
105
Which of the following organs lies in the retroperitoneal space?
Pancreas
106
Injury to a hollow abdominal organ would MOST likely result in:
leakage of contents into the abdominal cavity.
107
Functions of the liver include:
secretion of bile and filtration of toxic substances.
108
Which of the following organs assists in the filtration of blood, serves as a blood reservoir, and produces antibodies?
Spleen
109
The kidneys help to regulate blood pressure by:
removing sodium and water from the body.
110
The parietal peritoneum lines the:
walls of the abdominal cavity.
111
The MOST common and significant complication associated with an acute abdomen is:
peritonitis
112
In the presence of ileus, the only way the stomach can empty itself is by:
vomiting
113
Peritonitis may result in shock because:
fluid shifts from the bloodstream into body tissues.
114
In contrast to the parietal peritoneum, the visceral peritoneum:
is supplied by nerves of the autonomic nervous system, which are less able to localize pain or sensation.
115
Pain that may be perceived at a distant point on the surface of the body, such as the back or shoulder, is called:
referred pain.
116
A 35-year-old obese woman is complaining of localized pain in the right upper quadrant with referred pain to the right shoulder. The MOST likely cause of her pain is:
acute cholecystitis.
117
A young female presents with costovertebral angle tenderness. She is conscious and alert with stable vital signs. Which of the following organs is MOST likely causing her pain?
Kidney
118
Pain that is localized to the lower back and/or lower abdominal quadrants is MOST suggestive of:
an aortic aneurysm.
119
Which of the following statements regarding the acute abdomen is correct?
The initial pain associated with an acute abdomen tends to be vague and poorly localized.
120
Erosion of the protective layer of the stomach or duodenum secondary to overactivity of digestive juices results in:
an ulcer
121
Which of the following is characteristic of peptic ulcer disease (PUD)?
Burning or gnawing stomach pain that subsides immediately after eating
122
Pain that radiates to the right lower quadrant from the umbilical area, nausea and vomiting, and lack of appetite are MOST indicative of:
appendicitis
123
Which of the following statements regarding gastrointestinal bleeding is correct?
Bleeding within the gastrointestinal tract is a symptom of another disease, not a disease itself.
124
Esophageal varices MOST commonly occur in patients who:
consume a lot of alcohol.
125
A 29-year-old pregnant woman has had severe vomiting for the last 2 days. Today, she is vomiting large amounts of blood. Her skin is cool and pale, and she is tachycardic. The EMT should suspect:
Mallory-Weiss tear.
126
The principal symptom in both infectious and noninfectious gastroenteritis is:
diarrhea.
127
Which of the following conditions is more common in women than in men?
Cystitis
128
Chronic renal failure is a condition that:
is often caused by hypertension or diabetes.
129
Your patient's past medical history includes hypertension, congestive heart failure, diabetes, and seizures. Today, he presents with signs of acute renal failure. Which of his medical problems MOST likely caused this?
Heart failure
130
A strangulated hernia is one that:
loses its blood supply due to compression by local tissues.
131
You are dispatched to an apartment complex for a young male with abdominal pain. Your priority upon arriving at the scene should be to:
assess the scene for potential hazards.
132
Most patients with abdominal pain prefer to:
lie on their side with their knees drawn into the abdomen.
133
A 60-year-old female presents with a tearing sensation in her lower back. Her skin is sweaty, and she is tachycardic. The EMT should suspect:
aortic aneurysm.
134
A 30-year-old woman with a history of alcoholism presents with severe upper abdominal pain and is vomiting large amounts of bright red blood. Her skin is cool, pale, and clammy; her heart rate is 120 beats/min and weak; and her blood pressure is 70/50 mm Hg. Your MOST immediate action should be to:
protect her airway from aspiration.
135
Patients with acute abdominal pain should not be given anything to eat or drink because:
substances in the stomach increase the risk of aspiration.
136
When assessing a patient with abdominal pain, you should:
palpate the abdomen in a clockwise direction, beginning with the quadrant after the one the patient indicates is painful.
137
Older patients with abdominal problems may not exhibit the same pain response as younger patients because of:
age-related deterioration of their sensory systems.
138
An important aspect in the treatment of a patient with severe abdominal pain is to:
provide emotional support en route to the hospital.
139
A 47-year-old male presents with severe abdominal pain of 3 hours' duration. His abdomen is distended and guarded. Your MOST important consideration for this patient should be to:
be alert for signs and symptoms of shock.
140
The MOST important treatment for a patient with severe abdominal pain and signs of shock is:
transporting the patient without delay.
141
A 59-year-old male presents with sudden-onset severe lower back pain. He is conscious and alert, but very restless and diaphoretic. Your assessment reveals a pulsating mass to the left of his umbilicus. You should:
administer oxygen and prepare for immediate transport.
142
You are transporting a 49-year-old male with "tearing" abdominal pain. You are approximately 30 miles away from the closest hospital. During your reassessment, you determine that the patient's condition has deteriorated significantly. You should:
consider requesting a rendezvous with an ALS unit.
143
Which of the following statements regarding dialysis is correct?
Patients who miss a dialysis treatment often present with weakness.
144
You respond to the residence of a 70-year-old male who complains of weakness and severe shortness of breath. His wife tells you that he is a dialysis patient, but has missed his last two treatments. After applying oxygen, you auscultate his lungs and hear diffuse rhonchi. The patient is conscious, but appears confused. His blood pressure is 98/54 mm Hg, his pulse rate is 120 beats/min and irregular, and his respirations are 24 breaths/min and labored. You should:
leave him in a sitting position, keep him warm, and prepare for immediate transport.
145
A dysbarism injury refers to the signs and symptoms related to changes in:
barometric pressure.
146
When a warm hand is immersed in water that is 70°F (21°C), heat is transferred from the hand to the water through a process called:
conduction
147
The transfer of heat to circulating air, such as when cool air moves across the body's surface, is called:
convection.
148
The body's natural cooling mechanism, in which sweat is converted to a gas, is called:
evaporation
149
Heat loss from the body through respiration occurs when:
warm air is exhaled into the atmosphere.
150
Shivering is a mechanism in which the body generates heat by:
increasing the metabolic rate
151
Covering a patient's _________ will significantly minimize radiation heat loss.
head
152
Hypothermia occurs when the core body temperature falls below:
95°F (35°C).
153
The body's natural protective mechanisms against heat loss are:
constriction of blood vessels in the skin and shivering
154
Compared to adults, infants and children are at higher risk for hypothermia for all of the following reasons, except:
a relatively small surface area.
155
Which of the following conditions would be the least likely to increase a person's risk of hypothermia?
Hyperglycemia
156
To assess a patient's general body temperature, pull back on your glove and place the back of your hand on his or her skin at the:
abdomen
157
To obtain the most accurate reading of a patient's core body temperature, you should place a special hypothermia thermomet
into the patient's rectum.
158
A patient with a core body temperature of 95°F (35°C) will most likely experience:
rapid breathing.
159
Which of the following would be the least likely to occur in a patient with a core body temperature of between 89°F (32°C) and 92°F (33°C)?
Muscle activity increases
160
A person's ability to shiver is lost when his or her body temperature falls below:
90°F (32°C).
161
All of the following terms refer to a body part that is cold but not frozen, except:
frostbite
162
Patients with generalized hypothermia are at an increased risk of a local cold injury because:
Correct!
blood is shunted away from the extremities to the body's core.
163
A frostbitten foot can be identified by the presence of:
mottling and blisters
164
A 30-year-old male was rescued after being lost in the woods for approximately 18 hours. The outside temperature is 30°F (-1°C). He is immediately placed in the warmed ambulance, where you perform a primary assessment. He is unresponsive, pale, and apneic. You should:
assess for a carotid pulse for up to 60 seconds.
165
Hypothermia can worsen internal bleeding secondary to:
blood-clotting abnormalities.
166
Rough handling of a hypothermic patient with a pulse might cause:
ventricular fibrillation.
167
Your assessment of a 23-year-old female reveals a core body temperature of 93.4°F (34°C). She is conscious, answers your questions appropriately, is shivering, and complains of nausea. Her skin is cold and pale, her muscles appear rigid, and her respirations are rapid. You should:
place heat packs to her groin, axillae, and behind her neck; cover her with warm blankets; and avoid rough handling.
168
You are transporting a 28-year-old man with a frostbitten foot. The patient's vital signs are stable, and he denies any other injuries or symptoms. The weather is treacherous, and your transport time to the hospital is approximately 45 minutes. During transport, you should:
protect the affected part from further injury
169
The two most efficient ways for the body to eliminate excess heat are:
sweating and vasodilation.
170
Which of the following most accurately describes hyperthermia?
The body is exposed to more heat than it can lose
171
High air temperature reduces the body's ability to lose heat by:
radiation
172
Geriatric patients, newborns, and infants are especially prone to hyperthermia because they:
exhibit poor thermoregulation
173
When the body loses sweat, it also loses:
electrolytes.
174
For sweating to be an effective cooling mechanism
it must evaporate from the body.
175
High humidity reduces the body's ability to lose heat through:
evaporation
176
Common signs and symptoms of heat exhaustion include all of the following, except:
hot, dry skin.
177
Heatstroke occurs when:
'the body's heat-eliminating mechanisms are overwhelmed
178
Signs of late heatstroke include:
a weak, rapid pulse.
179
Which of the following medications increases a person's risk of a heat-related emergency?
Diuretics
180
You receive a call to a residence for a sick patient. Upon your arrival, you find the patient, a 53-year-old diabetic male, lying down on his front porch. His wife tells you that he was mowing the lawn in the heat for the past three hours. The patient is confused and has hot, moist skin. His pulse is weak and thready, and his blood pressure is 90/50 mm Hg. You should:
load him into the ambulance and begin rapid cooling interventions.
181
You are dispatched to a local high school track and field event for a 16-year-old male who fainted. The outside temperature is approximately 95°F (35°C) with high humidity. Upon your arrival, the patient is conscious, alert, and complains of nausea and a headache. His skin is cool, clammy, and pale. You should:
move him into the cooled ambulance.
182
You are assessing a man with suspected hypothermia. The patient is conscious, alert, and actively shivering. His respiratory rate is increased, but his breathing is unlabored, and the pulse oximeter reads 72%. The pulse oximetry reading is most likely
secondary to decreased perfusion in the extremities
183
Drowning is most accurately defined as:
death from suffocation after submersion in water.
184
Which of the following statements regarding drowning is correct?
Patients with a submersion injury might deteriorate rapidly because of pulmonary injury and cerebral hypoxia.
185
A 20-year-old male was pulled from cold water by his friends. The length of his submersion is not known and was not witnessed. You perform a primary assessment and determine that the patient is apneic and has a slow, weak pulse. You should:
. provide rescue breathing, remove his wet clothing, immobilize his entire spine, keep him warm, and transport carefully.
186
The EMT must assume that any unwitnessed water-related incident is accompanied by:
possible spinal injury.
187
You and your partner are standing by at a large social event at a river resort when a frantic woman tells you that she found a young male floating face-down in the water. Nobody claims to have witnessed the event. After you and your partner enter the water and reach the patient, you should:
move him as a unit to a supine position
188
The diving reflex might allow a person to survive extended periods of submersion in cold water secondary to:
bradycardia and a slowing of the metabolic rate.
189
The diving reflex might allow a person to survive extended periods of submersion in cold water secondary to:
bradycardia and a slowing of the metabolic rate
190
Most of the serious injuries associated with scuba diving are caused by:
too rapid of an ascent.
191
An air embolism associated with diving occurs when:
the diver holds his or her breath during a rapid ascent.
192
Signs and symptoms of an air embolism include all of the following, except:
pale skin.
193
The most prominent symptom of decompression sickness is:
abdominal or joint pain.
194
You respond to a local lake where a diver complains of difficulty breathing that occurred immediately after rapidly ascending from a depth of approximately 30 feet. On assessment, you note that he has cyanosis around his lips and pink froth coming from his nose and mouth. You should:
suction his mouth and nose, apply high-flow oxygen, monitor the patient's breath sounds for a pneumothorax, and contact medical control regarding transport to a recompression facility.
195
Breath-holding syncope is caused by a decreased stimulus to breathe and occurs when
a swimmer hyperventilates prior to entering the water.
196
Burns associated with lightning strikes are typically:
superficial
197
Which of the following statements regarding lightning strikes is correct?
Lightning strikes might cause cardiac dysrhythmias that spontaneously resolve.
198
You and your partner respond to a park where several people were reportedly struck by lightning. When you arrive, you find three patients. The first patient is lying supine on the ground; he is unresponsive and does not appear to be breathing. The second patient is ambulatory, appears confused, and is holding his arm against his chest. The third patient is sitting on the ground holding the sides of his head. After calling for backup, you should:
assess the unresponsive patient's pulse, begin CPR starting with chest compressions if he is pulseless, and attach the automated external defibrillator as soon as possible.
199
The venom of a black widow spider is toxic to the:
nervous system.
200
In contrast to the brown recluse spider, the black widow spider:
is large and has a red-orange hourglass mark on its abdomen.
201
The venom of a brown recluse spider is cytotoxic, meaning that it:
causes severe local tissue damage.
202
You are assessing a 33-year-old male who complains of severe abdominal pain, weakness, and nausea. He tells you that he was gathering wood to build a fire when he felt a sudden, sharp pain on the back of his hand. Your assessment reveals that the patient's abdomen is rigid and painful to palpation. You should suspect:
a black widow spider bite.
203
All of the following snakes are pit vipers, except for the:
coral snake.
204
Which of the following is an early sign of pit viper envenomation?
Local swelling and ecchymosis
205
A 31-year-old male was bitten on the leg by an unidentified snake. The patient is conscious and alert and in no apparent distress. Your assessment of his leg reveals two small puncture marks with minimal pain and swelling. In addition to administering oxygen and providing reassurance, further care for this patient should include:
supine positioning, splinting the leg, and transporting.
206
You are dispatched to a residence for a young female who is sick. The patient complains of a rash to her lower extremities and truncal area. Your assessment reveals a small, painful blister on her inner thigh. As your partner is taking the patient's vital signs, she states that she and her family returned from a camping trip two days ago. On the basis of this patient's presentation, you should suspect:
Lyme disease.
207
After being stung on the leg by a jellyfish, a man complains of severe pain to his leg, dizziness, and difficulty breathing. He has a red rash covering his trunk, and his blood pressure is 90/50 mm Hg. The EMT should:
administer oxygen and epinephrine and prepare for rapid transport.
208
In contrast to Lyme disease, Rocky Mountain spotted fever:
can cause paralysis and cardiorespiratory collapse.
209
Substance abuse is most accurately defined as:
misusing a substance to produce a desired effect.
210
An EMT's primary responsibility to the patient who has been poisoned is to:
recognize that a poisoning occurred
211
Heroin is an example of a(n):
opioid
212
Hypotension, hypoventilation, and pinpoint pupils would be expected following an overdose of:
oxycodone (Percocet)
213
Signs and symptoms of a sympathomimetic drug overdose include:
tachycardia
214
Which of the following drugs is not a sedative-hypnotic?
oxycodone (Percocet)
215
Your paramedic partner administers atropine to a 49-year-old male with bradycardia. Which of the following side effects would you expect the patient to experience?
Dry mucous membranes
216
Which of the following questions would be least pertinent during the initial questioning of a patient who ingested a substance?
Why was the substance ingested?
217
If you are uncertain how to treat a patient who has been poisoned or exposed to a specific substance, you should:
try to find the container the substance was in.
218
The poison control center will provide you with the most information regarding the appropriate treatment for a patient with a drug overdose if the center:
is aware of the substance that is involved.
219
Which of the following statements regarding inhaled poisons is correct?
Lung damage might progress after the patient is removed from the environment.
220
Your priority in caring for a patient with a surface contact poisoning is to:
avoid contaminating yourself.
221
A construction worker complains of intense pain after a bag of dry powder was spilled on his arm. The EMT should:
brush the chemical from his arm and then flush the skin with water.
222
Most poisonings occur via the __________ route.
ingestion
223
Activated charcoal may be indicated for a patient who ingested:
aspirin
224
Activated charcoal is given to patients who have ingested certain substances because it:
binds to the substance and prevents absorption
225
In general, injected poisons are impossible to dilute or remove because they:
are usually absorbed quickly into the body.
226
As you enter the residence of a patient who has possibly overdosed, you should:
be alert for personal hazards.
227
Your unit is dispatched to the county jail for an intoxicated inmate. Upon arrival, you find the patient, a 33-year-old male, lying supine in a jail cell. He is responsive to painful stimuli only and has slow, shallow respirations. You should be most concerned that this patient:
might vomit and aspirate.
228
You receive a call to a residence where a man found his wife unresponsive on the couch. The patient's respiratory rate is 8 breaths/min, her breathing is shallow, her heart rate is 40 beats/min, and her pulse is weak. The husband hands you an empty bottle of hydrocodone (Vicodin), which was refilled the day before. You should:
ventilate her with a bag-mask device.
229
It is most important to determine a patient's weight when asking questions pertaining to a toxic ingestion because:
activated charcoal is given based on a patient's weight.
230
Airborne substances should be diluted with:
oxygen
231
Signs of absorbed poison exposure include all of the following, except:
severe nausea, vomiting, and diarrh
232
Common names for activated charcoal include all of the following, except:
Fructose
233
What type of poisoning will cause burns around the mouth in children?
Alkaline poison.
234
A 4-year-old, 15-kg male ingested an unknown quantity of acetaminophen (Tylenol). The child's mother states that she does not know when the ingestion occurred. The child is conscious and alert and in no apparent distress. The EMT should:
administer 15 g of activated charcoal.
235
Before giving activated charcoal, you should:
obtain approval from medical control
236
The major side effect associated with administration of activated charcoal is:
black stools.
237
After administering activated charcoal to a patient, it is most important to:
be alert for vomiting.
238
A person who routinely misuses a substance and requires increasing amounts to achieve the same effect is experiencing:
tolerance
239
A man with a prolonged history of alcohol abuse fell from a second-story balcony. His blood pressure is 80/60 mm Hg, his heart rate is 120 beats/min, and his skin is cool and pale. When caring for this patient, the EMT should recall that:
reduced blood clotting worsens internal bleeding.
240
A hypnotic drug is one that:
induces sleep.
241
When caring for a known alcoholic patient with severe trauma to the chest and abdomen, you should be concerned that:
internal bleeding might be profuse because prolonged alcohol use might impair the blood's ability to clot.
242
Delirium tremens (DTs) is a syndrome associated with withdrawal from:
alcohol
243
A 49-year-old male presents with confusion, sweating, and visual hallucinations. The patient's wife tells you that he is a heavy drinker and that he might have had a seizure shortly before your arrival. This patient is most likely experiencing:
delirium tremens.
244
During your assessment of a 50-year-old male who was found unresponsive in an alley, you note that he has slow, shallow respirations; bradycardia; facial cyanosis; and pinpoint pupils. As your partner begins assisting the patient's ventilations, he directs your attention to the patient's arms, which have multiple needle tracks on them. Which of the following would most likely explain the patient's presentation?
Heroin overdose
245
You and your paramedic partner are caring for a patient who ingested codeine, acetaminophen (Tylenol), and hydrocodone (Vicodin). The patient is unresponsive, his breathing is slow and shallow, and his pulse is slow and weak. Treatment for this patient should include:
assisted ventilation and naloxone (Narcan).
246
You respond to a local motel for a young female who was sexually assaulted. The patient is conscious but confused. She tells you that the last thing she remembers was drinking beer at a club with her friends the night before. When she awoke, she was in the bed of the motel room. You should suspect that this patient:
was given flunitrazepam (Rohypnol).
247
You respond to a college campus for a young male who is acting strangely. After law enforcement has secured the scene, you enter the patient's dorm room and find him sitting on the edge of the bed; he appears agitated. As you approach him, you note that he has dried blood around both nostrils. He is breathing adequately, his pulse is rapid and irregular, and his blood pressure is 200/110 mm Hg. Treatment for this patient includes:
attempting to calm him and giving him oxygen if tolerated.
248
In an apparent suicide attempt, a 19-year-old female ingested a full bottle of amitriptyline (Elavil). At present, she is conscious and alert and states that she swallowed the pills approximately 30 minutes earlier. Her blood pressure is 90/50 mm Hg, her pulse is 140 beats/min and irregular, and her respirations are 22 breaths/min with adequate depth. When transporting this patient, you should be most alert for:
seizures and cardiac dysrhythmias.
249
You are dispatched to a local nursery for a 39-year-old female who is sick. When you arrive, you find the patient lying on the floor. She is semiconscious, has copious amounts of saliva coming from her mouth, and is incontinent of urine. You quickly feel her pulse and note that it is very slow. Immediate management for this patient should include:
thoroughly suctioning her oropharynx.
250
Atropine sulfate and pralidoxime chloride are antidotes for:
nerve gas agents.
251
A patient who presents with rapid breathing, nausea and vomiting, ringing in the ears, and hyperthermia should be suspected of ingesting a significant quantity of:
aspirin
252
An overdose of acetaminophen, the active ingredient in Tylenol, will most likely cause:
liver damage and failure.
253
Which of the following statements regarding the Salmonella bacterium is correct?
The Salmonella bacterium itself causes food poisoning.
254
A 3-year-old female ingested several leaves from a plant in the living room. The child's mother is not sure what type of plant it is, stating that she bought it simply because it was pretty. After completing your primary assessment of the child, you should:
contact the regional poison control center.
255
A 25-year-old man overdosed on heroin and is unresponsive. His breathing is slow and shallow and he is bradycardic. He has track marks on both arms. The EMT should:
insert a nasal airway and ventilate with a bag-mask device.
256
Naloxone (Narcan) would reverse the effects of:
hydromorphone (Dilaudid).
257
EMTs are dispatched for a teenage male who is "not acting right." When they arrive, they are informed that the patient was huffing. Several cans of Freon are found near the patient. Which of the following is a unique consideration for this patient?
A sudden adrenaline release can cause a fatal dysrhythmia.
258
Which of the following sets of vital signs would the EMT most likely encounter in a patient with acute cocaine overdose?
BP, 200/100 mm Hg; pulse, 150 beats/min
259
Diabetes is MOST accurately defined as a(n):
disorder of glucose metabolism.
260
Type 1 diabetes:
is a condition in which no insulin is produced by the body.
261
Patients with type 2 diabetes usually control their disease with all of the following, EXCEPT:
supplemental insulin
262
Glipizide, a non-insulin-type medication, is another name for:
Glucotrol
263
Which of the following statements regarding glucose is correct?
The brain requires glucose as much as it requires oxygen.
264
Insulin functions in the body by:
enabling glucose to enter the cells
265
Patients with uncontrolled diabetes experience polyuria because:
excess glucose in the blood is excreted by the kidneys.
266
Excessive eating caused by cellular "hunger" is called:
polyphagia
267
Ketone production is the result of:
fat metabolization when glucose is unavailable
268
A 37-year-old female with a history of diabetes presents with excessive urination and weakness of 2 days' duration. Her blood glucose level reads 320 mg/dL. If this patient's condition is not promptly treated, she will MOST likely develop:
acidosis and dehydration
269
Kussmaul respirations are an indication that the body is:
attempting to eliminate acids from the blood.
270
The normal blood glucose level is between:
80 and 120 mg/dL.
271
Diabetic ketoacidosis occurs when:
insulin is not available in the body.
272
A 28-year-old female patient is found to be responsive to verbal stimuli only. Her roommate states that she was recently diagnosed with type 1 diabetes and has had difficulty controlling her blood sugar level. She further tells you that the patient has been urinating excessively and has progressively worsened over the last 24 to 36 hours. On the basis of this patient's clinical presentation, you should suspect that she:
is significantly hyperglycemic.
273
A 50-year-old man with diabetes has an altered mental status and is unable to tell you when he last ate or took his insulin. Your glucometer keeps malfunctioning and you are unable to determine his blood glucose level. Which of the following clinical signs would MOST likely lead you to the correct diagnosis?
Deep and rapid breathing
274
In contrast to type 1 diabetes, type 2 diabetes:
is caused by resistance to insulin at the cellular level.
275
Common signs and symptoms of severe hyperglycemia include all of the following, EXCEPT:
cool, clammy skin.
276
Which of the following signs or symptoms would the EMT MOST likely encounter in a patient with new-onset type 1 diabetes
Weight loss and polyuria
277
Symptomatic hypoglycemia will MOST likely develop if a patient:
takes too much of his or her prescribed insulin.
278
The EMT should assess for hypoglycemia in small children with a severe illness or injury because:
children cannot store excess glucose as effectively as adults.
279
Classic signs and symptoms of hypoglycemia include:
cool, clammy skin; weakness; tachycardia; and rapid respirations.
280
Assessment of a patient with hypoglycemia will MOST likely reveal:
combativeness
281
In contrast to hypoglycemia, hyperglycemia:
can only be corrected in the hospital setting.
282
A 75-year-old male with type 1 diabetes presents with chest pain and a general feeling of weakness. He tells you that he took his insulin today and ate a regular meal approximately 2 hours ago. You should treat this patient as though he is experiencing:
a heart attack.
283
You respond to a residence for a patient who is "not acting right." As you approach the door, the patient, a 35-year-old male, begins shouting profanities at you and your partner while holding a baseball bat. The man is confused and diaphoretic, and is wearing a medical identification bracelet. You should:
retreat at once and call law enforcement.
284
A 29-year-old female presents with confusion and disorientation. Her respirations are rapid and shallow, and her pulse is 120 beats/min and thready. She is markedly diaphoretic and has an oxygen saturation of 89%. You should:
provide ventilatory support.
285
A man finds his 59-year-old wife unconscious on the couch. He states that she takes medications for type 2 diabetes. He further tells you that his wife has been ill recently and has not eaten for the past 24 hours. Your assessment reveals that the patient is unresponsive. You should:
open and maintain her airway and assess breathing.
286
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 the patient is diaphoretic, tachycardic, and tachypneic. Initial management for this patient should include
applying a nonrebreathing mask at 15 L/min
287
When obtaining a SAMPLE history from a patient with diabetes who has an altered mental status, it would be MOST important to determine:
if he or she has had any recent illnesses or excessive stress.
288
When assessing an unresponsive diabetic patient, the primary visible difference between hyperglycemia and hypoglycemia is the:
rate and depth of breathing.
289
You are treating a 40-year-old male with a documented blood sugar reading of 480 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:
insulin
290
A 19-year-old male complains of "not feeling right." His insulin and a syringe are on a nearby table. The patient says he thinks he took his insulin and cannot remember whether he ate. He is also unable to tell you the time or what day it is. The glucometer reads "error" after several attempts to assess his blood glucose level. You should:
contact medical control and administer oral glucose.
291
Which of the following conditions is the diabetic patient at an increased risk of developing?
Blindness
292
In general, oral glucose should be given to any patient who:
has an altered mental status and a history of diabetes.
293
To which of the following diabetic patients should you administer oral glucose?
A confused 55-year-old male with tachycardia and pallor
294
Proper procedure for administering oral glucose to a patient includes all of the following, EXCEPT:
ensuring the absence of a gag reflex.
295
Hemoglobin is:
found within the red blood cells and is responsible for carrying oxygen.
296
Which of the following statements regarding sickle cell disease is correct?
In sickle cell disease, the red blood cells are abnormally shaped and are less able to carry oxygen.
297
A 31-year-old male with a history of diabetes had a seizure that stopped prior to EMS arrival. He is unresponsive and has rapid, shallow breathing. His pulse is rapid and weak, and his skin is cyanotic. The EMT should:
assist the patient's ventilations with a bag-valve mask.
298
A 66-year-old woman experienced a sudden onset of difficulty breathing. She has a history of type 2 diabetes and deep vein thrombosis (DVT). On the basis of her medical history, which of the following should the EMT suspect?
Pulmonary embolism
299
Patients with thrombophilia are at an increased risk for:
acute arterial rupture.
300
During your assessment of a 19-year-old male, you are told that he is being treated with factor VIII. This indicates that:
he has hemophilia A
301
A 42-year-old male is found unresponsive on his couch by a neighbor. During your assessment, you find no signs of trauma, and the patient's blood glucose level is 75 mg/dL. His blood pressure is 168/98 mm Hg, his heart rate is 45 beats/min and bounding, and his respirations are 8 breaths/min and irregular. The patient is wearing a medical alert bracelet that states he has hemophilia. You should:
suspect that he has intracranial bleeding, assist his ventilations, and transport rapidly to an appropriate hospital.
302
During your assessment of a 70-year-old woman, she tells you that she takes blood-thinning medication and has to wear compression stockings around her legs. This information should make you suspect that she has:
deep vein thrombosis
303
Which of the following MOST accurately defines an allergic reaction?
An exaggerated immune system response to any substance
304
Chemicals that are responsible for the signs and symptoms of an allergic reaction to a bee sting include:
histamines and leukotrienes.
305
Anaphylaxis is MOST accurately defined as a(n):
extreme allergic reaction that may affect multiple body systems.
306
Two of the MOST common signs of anaphylaxis are:
urticaria and angioedema
307
Urticaria is the medical term for:
hives
308
The foreign substance responsible for causing an allergic reaction is called a(n):
allergen
309
Which of the following patients would MOST likely have a delayed onset of an allergic reaction?
A 45-year-old male who ingested penicillin
310
Which of the following statements regarding fire ants is correct?
Fire ants often bite a person repeatedly.
311
A raised, swollen, well-defined area on the skin that is the result of an insect bite or sting is called:
a wheal
312
Because the stinger of a honeybee remains in the wound following a sting:
it can continue to inject venom for up to 20 minutes.
313
The stinger from a honeybee should be:
scraped away from the skin.
314
Most patients who die of anaphylaxis do so within the first ____ minutes following exposure
30
315
You are assessing a young male who was stung on the leg by a scorpion. He is conscious and alert, his breathing is regular and unlabored, and his blood pressure is 122/64 mm Hg. Assessment of his leg reveals a wheal surrounded by an area of redness. He states that he had a "bad reaction" the last time he was stung by a scorpion, and carries his own epinephrine auto-injector. You should
apply oxygen as needed, clean the area with soap and water or a mild antiseptic, and transport him to the hospital.
316
Which of the following would MOST likely provide clues regarding the source of a patient's allergic reaction?
The environment in which the patient is found
317
A 73-year-old man presents with a generalized rash, which he thinks may have been caused by an antibiotic that he recently began taking. He has a history of coronary artery disease, hypertension, and emphysema. He is conscious and alert, his blood pressure is 144/94 mm Hg, and his pulse is 64 beats/min and regular. You auscultate his breath sounds and hear scattered wheezing, although he is not experiencing respiratory distress. You should:
administer oxygen if needed, transport the patient, and monitor him for signs of deterioration.
318
A 37-year-old male is having a severe allergic reaction to penicillin. He does not have an epinephrine auto-injector, and your protocols do not allow you to carry epinephrine on the ambulance. How should you proceed with the treatment of this patient?
Administer oxygen, transport at once, and request a paramedic intercept.
319
Which of the following negative effects of anaphylaxis will be the MOST rapidly fatal if not treated immediately?
Upper airway swelling
320
A 38-year-old woman was bitten by fire ants while at the park. Your primary assessment reveals that she is semiconscious; has labored breathing; and has a rapid, thready pulse. She has a red rash on her entire body, and her face is swollen. You should:
assist her ventilations with 100% oxygen.
321
A 48-year-old male is found unconscious in the garden by his wife. When you arrive at the scene and assess the man, you find that he is unresponsive, has labored breathing, and has hives over his entire trunk. You should:
maintain his airway and assist his ventilations.
322
You respond to the residence of a 55-year-old woman with a possible allergic reaction to peanuts that she ate approximately 30 minutes ago. The patient is conscious and alert, but has diffuse urticaria and the feeling that she has a lump in her throat. As your partner applies oxygen to the patient, you should:
ask her if she has prescribed epinephrine.
323
Which of the following medications blocks the release of histamines?
Diphenhydramine (Benadryl)
324
Common signs and symptoms of an allergic reaction include all of the following, EXCEPT:
drying of the eyes
325
Which of the following sounds indicates swelling of the upper airway?
Stridor
326
While auscultating breath sounds of a patient who was stung multiple times by a yellow jacket, you hear bilateral wheezing over all lung fields. This indicates:
narrowing of the bronchioles in the lungs.
327
Which of the following physiologic actions does epinephrine produce when given for an allergic reaction?
Vasoconstriction and bronchodilation
328
Epinephrine is indicated for patients with an allergic reaction when:
wheezing and hypotension are present.
329
The adult epinephrine auto-injector delivers ______ mg of epinephrine, and the infant-child auto-injector delivers ______ mg.
0.3; 0.15
330
When an auto-injector is used to give epinephrine, the primary injection site is the:
lateral portion of the thigh.
331
When administering epinephrine via auto-injector, you should hold the injector in place for:
3 seconds
332
Immediately after giving an epinephrine injection, you should:
properly dispose of the syringe.
333
A 50-year-old male was stung by a honeybee approximately 15 minutes ago. He presents with respiratory distress, facial swelling, and hypotension. After placing him on oxygen and administering his epinephrine via auto-injector, you note that his breathing has improved. Additionally, his facial swelling is resolving and his blood pressure is stable. Your next action should be to:
record the time and dose of the injection and transport promptly.
334
You have administered one dose of epinephrine to a 40-year-old female to treat an allergic reaction that she developed after being stung by a scorpion. Your reassessment reveals that she is still having difficulty breathing, has a decreasing mental status, and has a blood pressure of 80/50 mm Hg. You should:
request permission from medical control to give another dose of epinephrine.
335
The effects of epinephrine are typically observed within _________ following administration.
1 minute
336
Common side effects of epinephrine include all of the following, EXCEPT:
drowsiness
337
A 19-year-old female was stung multiple times on the legs by fire ants. She states that she is allergic to fire ants, but does not carry her own epinephrine. The patient is conscious and alert and complains of pain to the area of the bites. Her blood pressure is 122/70 mm Hg, her pulse is 100 beats/min and strong, and her respirations are 18 breaths/min and unlabored. You should:
administer oxygen and transport her to the hospital.
338
After administering 0.3 mg of epinephrine via auto-injector to a 22-year-old female with an allergic reaction, you note improvement in her breathing and resolution of her hives. However, she is still anxious and tachycardic. You should
monitor her closely but recall that anxiety and tachycardia are side effects of epinephrine.
339
Which of the following statements regarding epinephrine administration via the intramuscular (IM) route is correct?
The 1:1000 concentration should be used.
340
____________ is what you can see of a person's response to the environment.
Behavior
341
The term "behavioral crisis" is MOST accurately defined as:
a situation in which a patient of any age exhibits agitated, violent, or uncooperative behavior.
342
You may not be able to determine whether a person has a mental illness, but you can predict the person's likelihood of becoming:
violent
343
In contrast to a behavioral crisis, a behavioral health emergency occurs when a person:
becomes agitated or violent and is a threat to him- or herself or others.
344
When assessing a patient who is displaying bizarre behavior, the EMT should:
consider that an acute medical illness may be causing the patient's behavior.
345
Organic brain syndrome is defined as:
a dysfunction of the brain caused by abnormal physical or physiological function.
346
A 78-year-old female presents with an acute change in her behavior. The patient's son tells you that his mother has type 2 diabetes and was diagnosed with Alzheimer's disease 6 months ago. The patient's speech is slurred and she is not alert to her surroundings. You should:
inquire about the possibility of head trauma.
347
A physiologic disorder that impairs bodily function when the body seems to be structurally normal is called a:
functional disorder
348
Which of the following is an example of a functional behavioral disorder?
Schizophrenia
349
The first step in assessing a patient with a behavioral emergency is to:
ensure your safety.
350
You respond to a call for an unknown emergency. When you arrive at the scene, the patient's husband meets you at the door and states that his wife has been depressed and has locked herself in an upstairs bedroom. He further tells you that he keeps his handgun in the bedroom. You should:
remain in a safe place and request law enforcement.
351
General guidelines for managing a patient with a behavioral emergency include:
being prepared to spend extra time with the patient.
352
A 40-year-old male intentionally cut his wrist out of anger after losing his job. Law enforcement has secured the scene prior to your arrival. As you enter the residence and visualize the patient, you can see that he has a towel around his wrist and a moderate amount of blood has soaked through it. You should:
calmly identify yourself to the patient
353
When assessing a patient with a behavioral crisis, you should:
be direct and clearly state your intentions.
354
A 22-year-old male with a history of clinical depression called 9-1-1 and stated that he has attempted to kill himself. Your unit and law enforcement officers arrive at the scene simultaneously. You find the patient lying supine on the living room floor. He is unresponsive and cyanotic. An empty bottle of hydromorphone (Dilaudid) is found on an adjacent table. You should:
open the patient's airway and assess his respirations
355
A 66-year-old male presents with bizarre behavior. His daughter states that he did not seem to recognize her and was very rude to her. The patient is conscious, and has a patent airway and adequate breathing. You should:
ask the daughter how her father normally behaves
356
A technique used to gain insight into a patient's thinking, which involves repeating in question form what the patient has said, is called:
reflective listening
357
Which of the following statements regarding the physical examination of a patient with a behavioral problem is correct?
Although the physical exam can be difficult, the patient's emotional state may be determined by noting facial expressions, pulse rate, and respirations.
358
You are assessing a conscious 55-year-old male with a sudden change in behavior. Which of the following clinical findings would be MOST suggestive of dysfunction of this patient's central nervous system?
Rapid eye movement
359
A patient with a history of schizophrenia called EMS because he was experiencing abdominal pain. When law enforcement arrived, the patient became violent, necessitating the placement of handcuffs. When you assess the patient, he tells you that killing someone will make his abdominal pain go away. His vital signs are stable. How should you manage this situation?
Request a police officer to accompany you in the ambulance.
360
After ensuring his or her own safety, the EMT's next priority when caring for a patient with a behavioral emergency is to:
assess the patient's response to his or her environment.
361
Common causes of acute psychotic behavior include all of the following, EXCEPT:
Alzheimer's disease.
362
The single most significant factor that contributes to suicide is:
depression
363
You are assessing a 45-year-old female who is severely depressed. She states that it seems as though her entire world is crashing down around her. She further states that she has had frequent thoughts of suicide, but is not sure if she can actually go through with it. How should you manage this situation?
Ask the patient if she has developed a suicidal plan.
364
People at risk for suicide include all of the following, EXCEPT:
married males older than 30 years
365
It is MOST important for the EMT to remember that suicidal patients may:
be homicidal as well.
366
Signs of excited delirium include:
diaphoresis, tachycardia, and hallucinations
367
Law enforcement personnel request your assistance for a 30-year-old man who was pulled over for erratic driving. The patient became acutely violent while he was being questioned, which required one of the officers to subdue him with a Taser. When you arrive and assess the patient, you find that he is very agitated and is experiencing apparent hallucinations. His skin is flushed and diaphoretic. You should:
limit physical contact with the patient as much as possible and avoid interrupting him if he is attempting to communicate with you.
368
A 38-year-old male with a history of schizophrenia is reported by neighbors to be screaming and throwing things in his house. You are familiar with the patient and have cared for him in the past for unrelated problems. Law enforcement officers escort you into the residence when you arrive. The patient tells you that he sees vampires and is attempting to ward them off by screaming and throwing things at them. He has several large lacerations to his forearms that are actively bleeding. The MOST appropriate way to manage this situation is to:
restrain the patient with appropriate force in order to treat his injuries.
369
You receive a call for a domestic dispute. When you arrive at the scene, you find a young male standing on the front porch of his house. You notice that an adjacent window is broken. The patient has a large body, is clenching his fists, and is yelling obscenities at you. Which of the following findings is LEAST predictive of this patient's potential for violence?
His large body size
370
In which position should you restrain a physically uncooperative patient?
Supine
371
When caring for a patient experiencing excited delirium, the EMT should remember that:
sudden death can occur if the patient's violence is not controlled.
372
Immediately after physically restraining a violent patient, the EMT should:
reassess the patient's airway and breathing.
373
Which of the following conditions or situations would MOST likely make excited delirium worse?
Alcohol withdrawal
374
Posttraumatic stress disorder can happen after:
exposure to or injury from a traumatic occurrence.
375
Each ovary produces an ovum in alternating months and releases it into the:
fallopian tube.
376
In anticipation of receiving a fertilized ovum, the lining of the uterine wall:
becomes engorged with blood
377
The onset of menstruation usually occurs in females who are:
between 11 and 16 years of age
378
When a female has reached menarche:
she is capable of becoming pregnant.
379
It is common for young females who experience their first menstrual period to:
experience abdominal cramping, which may be misinterpreted.
380
Which of the following statements regarding pelvic inflammatory disease (PID) is correct?
PID can scar the fallopian tubes, which increases the risk of an ectopic pregnancy.
381
Pelvic inflammatory disease (PID) typically does NOT affect the:
urinary bladder.
382
Potentially life-threatening consequences of pelvic inflammatory disease (PID) include:
ovarian abscess and ectopic pregnancy
383
Which of the following clinical presentations is MOST consistent with pelvic inflammatory disease (PID)?
Lower abdominal pain, fever, general malaise, and foul-smelling vaginal discharge
384
As a woman approaches menopause:
her menstrual periods may become irregular and vary in severity.
385
Which of the following conditions would MOST likely lead to pelvic inflammatory disease if left untreated?
Chlamydia
386
Bacterial vaginosis is a condition that occurs when:
normal bacteria in the vagina are replaced by an overgrowth of other bacterial forms.
387
Which of the following statements regarding gonorrhea is correct?
Painful urination is a common symptom of gonorrhea in men and women.
388
In contrast to bleeding caused by external trauma to the vagina, bleeding caused by conditions such as polyps or cancer:
may be relatively painless.
389
Whenever possible, a female sexual assault victim should be:
given the option of being treated by a female EMT
390
When a woman presents with abdominal pain or other vague symptoms, the EMT is often unable to determine the nature of the problem until he or she:
has gathered patient history information.
391
During your assessment of a young female with nontraumatic vaginal bleeding, you note that her level of consciousness is decreased, her respirations are rapid and shallow, her skin is cool and moist, and her pulse is rapid and weak. You should:
assist her ventilations with a bag-mask device.
392
If a woman with vaginal bleeding reports syncope, the EMT should assume that she:
s in shock.
393
When caring for a woman who is experiencing a gynecologic emergency, the EMT's main focus should be to:
maintain her ABCs and transport without delay
394
A 26-year-old female presents with heavy vaginal bleeding. She is conscious, but restless. Her blood pressure is 84/54 mm Hg, her pulse is 120 beats/min and weak, and her respirations are 22 breaths/min with adequate depth. She tells you that she inserted a tampon about 2 hours ago. You should:
administer high-flow oxygen, place a sterile pad over her vagina, keep her warm, elevate her lower extremities, and transport without delay.
395
General treatment for a woman with vaginal bleeding and shock following sexual assault includes all of the following, EXCEPT:
carefully removing any foreign bodies from the vagina.
396
You are dispatched to a residence for a 40-year-old female who complains of lower abdominal pain, fever and chills, and a foul-smelling vaginal discharge. Which of the following additional assessment findings would increase your index of suspicion for pelvic inflammatory disease?
A shuffling gait when walking
397
Which of the following statements regarding rape is correct?
Rape is a legal term, not a medical diagnosis.
398
When caring for a female patient who has been sexually assaulted, you should:
place any bloodstained clothing or other articles in separate paper bags.
399
Law enforcement personnel request your assistance to assess a 31-year-old female who was sexually assaulted. When you arrive at the scene, you find the patient sitting on a curb outside her apartment. She is conscious, alert, and crying. When you ask her what happened, she tells you that she does not want to be treated or transported to the hospital. She further tells you that all she wants to do is clean up. You should:
provide emotional support and visually assess her for obvious trauma.
400
The physical examination of a sexual assault victim should be:
limited to a brief survey for life-threatening injuries
401
When documenting a call in which a female was sexually assaulted, you should:
keep the report concise and record only what the patient stated in her own words.
402
EMTs receive a call for a possible sexual assault. The patient is a young female who is conscious and alert and has no apparent injuries. She states, "I can't remember anything, but I know I was raped." The EMTs should suspect that:
the patient was given a drug prior to the incident.
403
Which of the following drugs is commonly referred to as "roofies"?
Rohypnol
