Unit 18.26.32 Flashcards
1
Q
1) Pain that originates in an organ, such as the intestines, is called ________ pain.
A) visceral B) referred C) acute D) parietal
A
A) visceral
2
Q
2) The patient complaining of parietal abdominal pain who would concern you the most is the one who:
A) walks out to the ambulance informing you he has the worst “belly ache.”
B) is sitting upright in a chair, moaning in pain, and drinking antacid.
C) is rolling about on the floor complaining of pain.
D) is lying on the floor very still and quiet with his knees drawn up to his chest.
A
D) is lying on the floor very still and quiet with his knees drawn up to his chest.
3
Q
3) Your patient was diagnosed with cholecystitis (gallbladder inflammation) three days ago. The patient now presents with nausea, vomiting, and pain in the right shoulder. The pain in the shoulder can be classified as:
A) referred pain. B) visceral pain. C) pancreatic pain. D) somatic pain.
A
A) referred pain
4
Q
4) Pain that the patient feels in a body part or area of the body that has nothing to do with a diseased organ is termed:
A) epigastric pain. B) abdominal pain. C) retroperitoneal pain. D) referred pain.
A
D) referred pain.
5
Q
5) Which of the following organs is located in the retroperitoneal space?
A) Liver B) Stomach C) Kidneys D) Uterus
A
C) Kidneys
6
Q
6) Which of the following structures is (are) not located in the abdominal cavity?
A) Kidneys B) Liver C) Spleen D) Stomach
A
A) Kidneys
7
Q
7) Which abdominal quadrant contains the appendix?
A) Left lower B) Right upper C) Right lower D) Left upper
A
C) Right lower
8
Q
8) Most organs of the abdomen are enclosed within the:
A) extraperitoneal space. B) peritoneum. C) retroperitoneal space. D) midline.
A
B) peritoneum
9
Q
9) Organs of the right upper quadrant include:
A) pancreas, spleen, and part of the liver. B) most of the liver, gallbladder, and part of the large intestine.
C) small intestine, stomach, and spleen. D) most of the liver, spleen, and gallbladder.
A
B) most of the liver, gallbladder, and part of the large intestine.
10
Q
10) Which of the following is true concerning parietal pain?
A) It is often described as “crampy” or “colicky.” B) It arises from solid organs.
C) It is usually intermittent in nature. D) It is generally localized to a particular area.
A
D) It is generally localized to a particular area.
11
Q
11) Which of the following is not a cause of parietal pain?
A) Muscle spasm B) Bleeding into the abdominal cavity C) Inflammation D) Infection
A
A) Muscle spasm
12
Q
12) With the exception of the ________, most abdominal organs are not able to sense tearing sensations.
A) aorta B) ovaries C) liver D) colon
A
A) aorta
13
Q
13) Your patient is a 35-year-old female with abdominal pain. Which of the following findings cannot be attributed to the patient experiencing pain?
A) Increased respiratory rate B) Shallow respirations
C) Increased heart rate D) Decreased level of consciousness
A
D) Decreased level of consciousness
14
Q
14) Which patient is experiencing visceral pain?
A) 24-year-old male complaining of severe left flank pain
B) 19-year-old female complaining of severe cramps in the lower abdominal quadrants
C) 45-year-old female complaining of abdominal pain “all over”
D) 28-year-old male with sharp pain in the right lower quadrant
A
C) 45-year-old female complaining of abdominal pain “all over”
15
Q
15) Which of the following is a characteristic of referred pain?
A) It is only felt in hollow organs. B) It is felt in a location other than the organ causing it.
C) It is caused by psychological stress. D) It is usually described as “crampy” or “colicky.”
A
B) It is felt in a location other than the organ causing it.
16
Q
16) When the gallbladder is diseased, the pain is not only felt in the right upper quadrant (RUQ) but also in the right shoulder. This is known as:
A) parietal pain. B) visceral pain. C) referred pain. D) tearing pain.
A
C) referred pain
17
Q
17) You respond to an abdominal pain call. Your partner suspects that the patient is having an abdominal aortic aneurysm (AAA). What type of pain is the patient most likely experiencing?
A) Parietal B) Visceral C) Referred D) Tearing
A
D) Tearing
18
Q
18) You are called to a residential neighborhood at 12:30 A.M. Your patient has just finished eating a super-sized meal of deep fried fish. He is now complaining of a “crampy” pain in the right upper quadrant and has had two episodes of nausea and vomiting with green vomit. What condition do you suspect that your patient is experiencing?
A) Peptic ulcer B) Intestinal obstruction C) Cholecystitis D) Appendicitis
A
C) Cholecystitis
19
Q
19) You are called to a 25-year-old male complaining of right lower quadrant (RLQ) pain. His other symptoms are nausea and vomiting, fever, and decreasing pain in the umbilicus area. As an EMT, you feel this patient might have:
A) appendicitis. B) pancreatitis. C) cholecystitis. D) peritonitis.
A
A) appendicitis
20
Q
20) You respond to the scene of a 50-year-old male complaining of severe abdominal pain. He has a history of alcohol and drug abuse. His vital signs are stable and he presents with epigastric pain that radiates to the back. He has guarding and point tenderness in the upper quadrants. You suspect:
A) cholecystitis. B) myocardial infarction.
C) gastroesophageal reflux disease (GERD). D) pancreatitis.
A
D) pancreatitis.
21
Q
21) You are called to a residence for a 48-year-old male patient. He is lying in bed, groaning in pain and curled into a fetal position. His blood pressure is 88/50, pulse 136, and respiratory rate of 32. His wife states that he complained of lower right abdominal pain for several days that got progressively worse, until about an hour ago when it became suddenly unbearable. The wife states the husband had been refusing to see a doctor, but she finally called 911. You suspect appendicitis and are concerned about the subsequent onset of:
A) pancreatitis. B) splenic rupture. C) renal colic. D) peritonitis.
A
D) peritonitis.
22
Q
22) You arrive on the scene to find an approximately 60-year-old male patient writhing on the floor. He is complaining of a tearing pain radiating to his lower back. He has absent femoral pulses and has a pulsatile mass just superior to his umbilicus. You suspect which of the following conditions?
A) Myocardial infarction B) Abdominal aortic aneurysm C) Acute pancreatitis D) Ruptured appendix
A
B) Abdominal aortic aneurysm
23
Q
23) The detection of a bulging mass through the belly button that is not pulsating should make the EMT suspicious that the patient may be suffering from which of the following?
A) Hernia B) Ulcer C) Gastroenteritis D) Abdominal aortic aneurysm
A
A) Hernia
24
Q
24) You respond, along with fire department Emergency Medical Responders, to a 48-year-old female having a syncope episode in the bathroom. You find the patient sitting on the commode vomiting into the trash can. The vomitus appears to look like coffee grounds and has a foul smell. The patient is pale and has been weak for the past few days. She has:
A) peritonitis. B) abdominal aortic aneurysm. C) hernia. D) GI bleeding.
A
D) GI bleeding.
25
25) You are called to the scene of a patient with abdominal pain. Upon arrival, you find a 38-year-old Asian man on the floor next to his desk writhing in pain. He is complaining of severe right-sided flank pain. His blood pressure is 140/90, pulse 100, and his skin is ashen and diaphoretic. You suspect:
A) cholecystitis. B) mid-cycle pain. C) renal colic. D) myocardial infarction.
C) renal colic
26
26) You respond to a 65-year-old patient complaining of abdominal pain. Your physical exam reveals a nonpulsating mass in the lower left quadrant. You suspect:
A) aortic abdominal aneurysm. B) appendicitis. C) splenic rupture. D) hernia.
D) hernia.
27
27) You respond to a 75-year-old female who is complaining of epigastric pain that feels like heartburn. The pain radiates to the right shoulder. Her vital signs are stable and she has a previous history of a myocardial infarction. She has prescription nitroglycerin tablets. She is most likely suffering from:
A) cholecystitis. B) abdominal aortic aneurysm. C) ectopic pregnancy. D) renal colic.
A) cholecystitis
28
28) Which of the following is not a cause of abdominal pain?
A) Stroke B) Food poisoning C) Heart attack D) Diabetes
A) Stroke
29
29) Pain felt in the epigastric region of the abdomen is of concern because of the possibility of which of the following? A) Influenza B) Extreme diarrhea with dehydration C) Myocardial infarction D) Kidney stones
C) Myocardial infarction
30
30) You are responding to a 52-year-old male patient complaining of heartburn with epigastric pain. The patient's vital signs are stable and he does not have any pain upon palpation. He has a history of reflux disease and is on several medications for heartburn and acid reflux. What is your greatest concern with this patient?
A) He will aspirate on vomit. B) He will develop peritonitis.
C) His appendix will rupture. D) He is suffering from a myocardial infarction.
D) He is suffering from a myocardial infarction.
31
31) Your patient is a 60-year-old male who is complaining of severe epigastric abdominal pain and difficulty breathing. He is pale, sweaty, and pleads with you, "Don't let me die, I think I'm going to die." Which of the following measures is not part of your initial treatment of this patient?
A) Giving 15 lpm of oxygen by nonrebreather mask B) Applying the defibrillator pads to his chest
C) Determining whether you should assist the patient in taking nitroglycerin
D) Placing the patient in a position of comfort
B) Applying the defibrillator pads to his chest
32
32) You are called to a nursing home for an 85-year-old patient complaining of abdominal pain. The patient has a history of dementia and cannot describe the pain to you. The nurse states the patient has been vomiting for about an hour, and the vomit looks like dark coffee grounds. His blood pressure is 90/40, pulse 100, and respiratory rate of 24. Aside from the airway, what is your greatest concern?
A) The patient will go into shock. B) The patient will have a myocardial infarction.
C) The patient will have a stroke. D) The patient will become dehydrated.
A) The patient will go into shock.
33
33) Which of the following is the main focus of the EMT's assessment and history taking of the patient with abdominal pain?
A) Determining the possible need for immediate surgery
B) Determining if the patient meets criteria to refuse treatment and transport
C) Determining the cause of the pain D) Determining the presence of shock
D) Determining the presence of shock
34
34) Which of the following is a concern when caring for the patient with abdominal pain?
A) Shock B) Patient comfort C) Airway management D) All of the above
D) All of the above
35
35) Your patient is a 40-year-old female who has been experiencing abdominal pain and vomiting for 2 days. She is now responsive to verbal stimulus; has cool, dry skin; a heart rate of 116; respirations of 24; and a blood pressure of 100/70. Which of the following is the best position for transporting this patient?
A) Supine with the knees bent B) Left lateral recumbent with the legs bent
C) Sitting up at a 90-degree angle D) Sitting up at a 45-degree angle
B) Left lateral recumbent with the legs bent
36
36) Your patient is a 34-year-old male complaining of pain "in his right side." He is pale and diaphoretic with a heart rate of 90 beats per minute, a respiratory rate of 28 breaths per minute, and a blood pressure of 132/80 mmHg. The patient is very agitated and anxious. Which approach is most appropriate?
A) Try to determine the cause of his pain.
B) Tell the patient that you cannot transport him unless he calms down and lies still.
C) Insert an oropharyngeal airway.
D) Reassure him that you will make him as comfortable as possible and get him to the hospital for additional care.
D) Reassure him that you will make him as comfortable as possible and get him to the hospital for additional care.
37
37) Your patient is a 17-year-old with a history of asthma. She is complaining of pain in her lower abdomen. Assessment reveals that her breath sounds are clear and equal, she has a respiratory rate of 28 breaths per minute, a heart rate of 96 beats per minute, and a blood pressure of 112/74 mmHg. Which of the following is the most appropriate next step?
A) Provide high-concentration oxygen.
B) Assist the patient in the administration of her metered-dose inhaler.
C) Have the patient breathe into a paper bag to rebreathe some of her carbon dioxide.
D) Insert a nasopharyngeal airway in the patient's nose.
A) Provide high-concentration oxygen.
38
38) You respond to a 75-year-old female who is complaining of epigastric pain that feels like heartburn and radiates to the right shoulder. Her vital signs are stable and she has a previous history of myocardial infarction. She has prescription nitroglycerine tablets. An ALS unit is en route. After performing a physical examination and applying oxygen by nasal cannula, you should:
A) transport the patient in the supine position for shock.
B) apply the AED and prepare for imminent cardiac arrest from a myocardial infarction.
C) contact medical control regarding the administration of the patient's nitroglycerin.
D) cancel the ALS unit: this is just gallstones and BLS can transport.
C) contact medical control regarding the administration of the patient's nitroglycerin.
39
39) You are treating a 38-year-old female patient with abdominal distress. The patient's vital signs are stable and you are getting ready to transport. What is the best position to transport the patient?
A) Right lateral B) Position of comfort C) Supine D) Semi-Fowler's
B) Position of comfort
40
40) In what position should the patient complaining of severe abdominal pain be placed if there are no signs or symptoms of shock?
A) Supine with feet elevated B) One of comfort
C) Left lateral recumbent D) Semi-Fowler with knees bent
B) One of comfort
41
41) You are called to a nursing home for an 85-year-old patient complaining of abdominal pain. The patient has a history of dementia and cannot describe the pain to you. The nurse states the patient has been vomiting for about an hour, and the vomit looks like dark coffee grounds. His blood pressure is 90/40, pulse 100, and respiratory rate of 24. In what position should you transport the patient?
A) Trendelenburg B) Supine C) Left lateral recumbent D) Supine with knees bent
C) Left lateral recumbent
42
42) You are called to a nursing home for an 85-year-old patient complaining of abdominal pain. The patient has a history of dementia and cannot describe the pain to you. The nurse states the patient has been vomiting for about an hour, and the vomit looks like dark coffee grounds. His blood pressure is 90/40, pulse 100, and respiratory rate of 24. Why should the EMT use an oxygen mask with caution?
A) The oxygen will cause the patient to start vomiting again. B) The patient may hyperventilate.
C) The patient may become unresponsive. D) The patient cannot clear any additional vomit.
D) The patient cannot clear any additional vomit.
43
43) When treating a patient with acute abdominal pain, you should do which of the following?
A) Have him take antacids in an attempt to decrease the pain.
B) Administer sips of water if patient complains of thirst.
C) Have him drink milk to coat the stomach and reduce the pain.
D) Have the patient lie still and assume a position of comfort.
D) Have the patient lie still and assume a position of comfort.
44
44) You are examining a 24-year-old female patient with lower quadrant abdominal pain. What is the most lethal possibility?
A) Pelvic inflammatory disease B) Ectopic pregnancy C) Cholecystitis D) Menstrual irregularity
B) Ectopic pregnancy
45
45) Which of the following questions may help the EMT assess a patient with abdominal pain?
A) Do you have any allergies to foods or medicines?
B) Do you have any medical problems, such as diabetes or heart problems?
C) What medications are you taking? D) All of the above
D) All of the above
46
46) Which of the following questions is inappropriate when taking the history of a female patient with abdominal pain?
A) Are you having vaginal bleeding or discharge now?
B) What is your sexual orientation?
C) Have you had sexual intercourse since your last menstrual period?
D) If you are menstruating, is the flow normal?
B) What is your sexual orientation?
47
47) Which of the following is not true concerning abdominal pain in geriatric patients?
A) The older person may not be able to give a specific description of the pain.
B) Older adults have a decreased ability to perceive pain.
C) Medications may mask signs of shock associated with an abdominal complaint.
D) The causes of abdominal pain in geriatric patients are rarely serious.
D) The causes of abdominal pain in geriatric patients are rarely serious.
48
1) Which of the following structures connect bone ends and allow for a stable range of motion?
A) Ligaments B) Cartilage C) Tendons D) Periosteum
A) Ligaments
49
2) Which of the following allows for smooth movement of bone surfaces against one another at joints?
A) Smooth muscle B) Ligaments C) Tendons D) Cartilage
D) Cartilage
50
3) The sound or feeling of the ends of broken bones rubbing together is called:
A) crepitus. B) deformity. C) angulation. D) paresthesia.
A) crepitus
51
4) Which one of the following definitions is not true?
A) A sprain is the stretching and tearing of ligaments. B) Tendons connect muscles to ligaments.
C) Another name for manual traction is tension. D) Joints are places where bones articulate.
B) Tendons connect muscles to ligaments.
52
5) The part of the skeleton that includes the skull and spinal column is called the:
A) appendicular skeleton. B) boney skeleton. C) axial skeleton. D) torso.
C) axial skeleton.
53
6) Where could you find the phalange bones? A) Arms B) Legs C) Skull and neck D) Hands and feet
D) Hands and feet
54
7) Which of the following bones is found in the chest?
A) Tarsals B) Ilium C) Sternum D) Metacarpals
C) Sternum
55
8) The strong white fibrous material called the periosteum:
A) covers the bones. B) protects the perineum.
C) surrounds the heart. D) surrounds the abdominal cavity.
A) covers the bones
56
9) Which one of the following statements is not true?
A) Cartilage is connective tissue that covers the outside of the bone end and acts as a surface for articulation.
B) Tendons are bands of connective tissue that bind the ligaments to muscles.
C) Ligaments are connective tissues that connect bone to bone.
D) Muscles are the tissues or fibers that cause movement of body parts or organs.
B) Tendons are bands of connective tissue that bind the ligaments to muscles.
57
10) Your patient is a 12-year-old female who fell onto her outstretched hands while rollerblading. She has a deformity of her forearm, about 2 inches proximal to her wrist. This injury is a result of which of the following mechanisms? A) Direct force B) Indirect force C) Sudden acceleration D) Twisting motion
B) Indirect force
58
11) Your patient is a 70-year-old male whose tractor rolled over onto him. Your assessment makes you suspicious that the patient has a fractured pelvis. Which of the following signs and symptoms should you anticipate?
A) Patient demonstrates signs of shock. B) Patient cannot lift legs when lying supine.
C) Patient feels the need to empty his bladder. D) All of the above.
D) All of the above.
59
12) Which of the following is not a mechanism of musculoskeletal injury?
A) Direct force B) Indirect force C) Twisting or rotational forces D) Extensive force
D) Extensive force
60
13) Which of the following statements is not true?
A) A fracture is any break in a bone.
B) A comminuted break is when a bone is broken in only one place.
C) A greenstick break is an incomplete break in a bone.
D) An angulated break is when the broken bone segments are at an angle to one another.
B) A comminuted break is when a bone is broken in only one place.
61
14) Which one of the following statements is not true concerning a knee injury?
A) Fractures can occur to the proximal femur. B) Fractures can occur to the proximal tibia and fibula.
C) Fractures can occur to the patella. D) There could be pain and tenderness.
A) Fractures can occur to the proximal femur
62
15) Which of the following is a muscle injury caused by overstretching or overexertion of the muscle?
A) Luxation B) Strain C) Fracture D) Sprain
B) Strain
63
16) Which of the following describes an open extremity injury?
A) A gunshot wound has penetrated the skin and then fractured the bone.
B) Bone ends have lacerated the soft tissues and skin from the inside.
C) The joint capsule has been torn open during a dislocation. D) Both A and B
D) Both A and B
64
17) Although it can be difficult to definitively determine hip dislocation in the field, certain signs and symptoms are usually there. Which of the following statements is false?
A) An anterior hip dislocation would probably present with the entire lower limb rotated inward.
B) A posterior hip dislocation presents with a bent knee and the foot may hang loose.
C) The posterior hip dislocation is the most common. D) Often there is lack of sensation in the limb.
A) An anterior hip dislocation would probably present with the entire lower limb rotated inward.
65
18) Distinguishing between a knee dislocation and a patella dislocation can sometimes be difficult. Which of the following statements is not true?
A) In a patellar dislocation, the knee will be stuck in flexion but the knee cap will not be displaced.
B) In a knee dislocation, the tibia is forced anteriorly or posteriorly in relation to the distal femur.
C) You should always check for a distal pulse.
D) The lack of a distal pulse could be a signal of a real emergency.
A) In a patellar dislocation, the knee will be stuck in flexion but the knee cap will not be displaced.
66
19) Which of the following is a complication of bone fractures?
A) Nerve damage B) Swelling C) Hemorrhage D) All of the above
D) All of the above
67
20) A traction splint may be used on which of the following musculoskeletal injuries?
A) Possible fracture of the cervical spine B) Possible fracture of the femur
C) Suspected multiple fractures of the femur, tibia, and fibula D) Possible fracture of the humerus
B) Possible fracture of the femur
68
21) Which of the following best describes the compartment syndrome?
A) A serious condition caused by the amount of equipment that must be carried in the ambulance compartments
B) A life-threatening condition caused by trapping the blood flow by a fracture when the bone ends cut the blood vessels
C) A serious condition caused by the bleeding and swelling from a fracture or crush injury that becomes so strong that the body can no longer perfuse the tissues against that pressure
D) A non-life-threatening condition caused by orthopedic injuries in which blood flow is stopped when the bone ends compress the blood vessels
C) A serious condition caused by the bleeding and swelling from a fracture or crush injury that becomes so strong that the body can no longer perfuse the tissues against that pressure
69
22) Which of the following is appropriate in the examination of a painful, swollen extremity of a conscious patient?
A) Gently attempting to flex the mid-portion of the bone to check for angulation
B) Asking the patient to see if he can bear weight on the extremity
C) Comparing the injured side to the uninjured side D) Seeing if you can elicit crepitus on palpation
C) Comparing the injured side to the uninjured side
70
23) When the EMT is assessing compromise to an extremity, perhaps due to an orthopedic injury, the EMT should initially check what "six Ps"?
A) Pain, pallor, position, pulses, placement, and pressure
B) Pain, pallor, paresthesia, pulses, placement, and pressure
C) Pain, pallor, position, pulses, placement, and pad
D) Pain, pallor, paresthesia, pulses, paralysis, and pressure
D) Pain, pallor, paresthesia, pulses, paralysis, and pressure
71
24) One of the more serious conditions that EMTs are confronted with would occur as follows: A fracture or crush injury causes bleeding and swelling within the extremity. Pressure and swelling caused by the bleeding within the muscle compartment become so great that the body can no longer perfuse the tissues against the pressure. Cellular damage occurs and causes additional swelling. Blood flow to the area is lost. The limb itself may be lost if the pressure is not relieved. What is this condition called?
A) Compartment syndrome B) Crushing syndrome C) Perfusing syndrome D) Fracture syndrome
A) Compartment syndrome
72
25) A method of assessing compromise to an extremity when a musculoskeletal injury is suspected is to learn and follow the six Ps. Which of the items below is not one of the six Ps?
A) Pain B) Pallor C) Paresthesia D) Parenthesis
D) Parenthesis
73
26) What is a primary problem when treating musculoskeletal injuries?
A) Many musculoskeletal injuries have a grotesque appearance, and the EMT cannot be distracted from life-threatening conditions by a deformed limb.
B) All musculoskeletal injuries are life threatening due to the bone bleeding leading to hypoperfusion.
C) Splints do not adequately fit the patient's extremities and must be modified with padding to ensure immobilization.
D) Most musculoskeletal injuries are simply splinted and not a life threat to the patient.
A) Many musculoskeletal injuries have a grotesque appearance, and the EMT cannot be distracted from life-threatening conditions by a deformed limb.
74
27) Your patient is a 60-year-old woman who stepped off a curb and injured her ankle. Your exam shows that her left ankle is swollen and painful. Which of the following should you do?
A) Explain to the patient that her ankle is fractured, and you must splint her ankle to prevent further injury and reduce pain.
B) Explain to the patient that you cannot tell if her ankle is sprained or fractured until she is X-rayed at the emergency department, then splint the ankle.
C) Transport the patient immediately to a trauma center, applying high-concentration oxygen en route.
D) Explain to the patient that her ankle is sprained and transport her with her ankle elevated on a pillow and a cold pack applied to the injury.
B) Explain to the patient that you cannot tell if her ankle is sprained or fractured until she is X-rayed at the emergency department, then splint the ankle.
75
28) Your patient is a 28-year-old male who was ejected from his motorcycle after striking a parked vehicle. He has multiple deformities to his upper and lower extremities on both sides. Which of the following would be the best way to immobilize this patient's extremities prior to transport?
A) Use traction splints for the lower extremities and allow the upper extremities to be immobilized by the long backboard.
B) Use padded board splints for the upper extremities and a PASG for the lower extremities.
C) Use moldable splints for the upper and lower extremities, padding any voids to fully stabilize the fractures.
D) Immobilize the patient to a long backboard without splinting the extremities individually.
D) Immobilize the patient to a long backboard without splinting the extremities individually.
76
29) Which of the following is not a contraindication for the use of a traction splint?
A) Pelvis, hip, or knee injury
B) Avulsion or partial amputation where traction could separate the extremity
C) Injury to the lower third of the leg that would interfere with the ankle hitch
D) Severe swelling and redness at a midshaft femur
D) Severe swelling and redness at a midshaft femur
77
30) A painter falls from his ladder and tells you he has dislocated his shoulder again. When you attempt to splint the shoulder, it "pops back into place." What should your next step be?
A) Contact medical control for input into the best treatment for this patient.
B) Check distal CSM, apply a sling and swathe, and transport the patient.
C) Check distal CSM, apply a traction splint, and transport the patient.
D) Report the popping sound to the receiving physician when you arrive at the hospital.
B) Check distal CSM, apply a sling and swathe, and transport the patient.
78
31) Which of the following is not a principle of splinting that must be considered by the EMT?
A) Immobilize the site of an extremity injury from the joint above it to the joint below it.
B) Splint an isolated extremity injury before moving the patient to the stretcher.
C) Check the distal neurovascular function before and after splinting.
D) Gently replace protruding bone ends back beneath the skin to prevent further contamination.
D) Gently replace protruding bone ends back beneath the skin to prevent further contamination.
79
32) There are general rules that apply to all types of splinting. Which of the following is not a general rule of splinting?
A) In order to avoid loss of use of a limb, it is important to splint before moving, even if the patient is unstable.
B) Expose the injury. C) Assess distal CSM. D) Align long-bone injuries to anatomical position.
A) In order to avoid loss of use of a limb, it is important to splint before moving, even if the patient is unstable.
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33) Which of the following is not a benefit of splinting an injury to bones and connective tissues?
A) It prevents neurological damage due to movement of bone ends or fragments.
B) It may prevent a closed injury from becoming an open injury.
C) It restricts blood flow to the site of the injury to prevent swelling. D) It reduces pain.
C) It restricts blood flow to the site of the injury to prevent swelling.
81
34) Your patient is a 20-year-old college student who has fallen from a third-level balcony onto a wooden deck below. The patient responds to verbal stimuli, is pale in color with moist skin, and has a very obvious deformity with protruding bone ends of his right forearm. Which of the following is the best sequence of intervention for this patient?
A) Provide manual in-line stabilization of the cervical spine along with assessment of breathing, pulse, and the presence of significant hemorrhage; apply high-concentration oxygen; perform a rapid trauma exam; immobilize to a long backboard; transport; and splint the extremity en route if time and resources allow.
B) Open the airway; assess breathing; check the carotid pulse; splint the forearm injury; immobilize the patient to a long backboard; apply high-concentration oxygen; and transport.
C) Provide immediate manual in-line stabilization of the cervical spine; apply high-concentration oxygen by nonrebreather mask; perform a focused history and assessment; apply the cervical collar; apply a padded board splint, sling, and swathe to the forearm injury; and transport.
D) Provide manual in-line stabilization of the cervical spine along with assessment of breathing, pulse, and the presence of significant hemorrhage; apply high-concentration oxygen; perform a rapid trauma exam; immobilize to a long backboard; and check with medical control about the need to splint the forearm injury prior to transport.
A) Provide manual in-line stabilization of the cervical spine along with assessment of breathing, pulse, and the presence of significant hemorrhage; apply high-concentration oxygen; perform a rapid trauma exam; immobilize to a long backboard; transport; and splint the extremity en route if time and resources allow.
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35) Your patient is an 11-year-old male who has a swollen, painful, and angulated right lower arm after falling from his bicycle onto his hands. Which of the following should be considered in the immobilization of his injured extremity?
A) Check pulse, movement, and sensation distal to the injury before and after splinting.
B) Immobilize from the shoulder to the wrist.
C) Use an upper extremity traction splint.
D) Do not attempt to realign the extremity before splinting.
A) Check pulse, movement, and sensation distal to the injury before and after splinting.
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36) A new EMT who is treating a suspected femur injury asks his partner, "How much traction should I pull?" The partner's best reply is which of the following?
A) No traction splint applied in the field pulls true traction; they must pull 20 pounds of countertraction.
B) Pull enough traction to give the patient some relief from the pain.
C) The amount of traction applied should be roughly 10% of the patient's body weight and not exceed 15 pounds.
D) The amount of traction applied should be 15 pounds.
C) The amount of traction applied should be roughly 10% of the patient's body weight and not exceed 15 pounds.
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37) You are treating a 16-year-old skateboarder who has fallen at the skate park. She has an angulated left forearm that she has in a guarded position. When do you splint this injury?
A) En route to the hospital B) Immediately C) During the primary exam D) During the secondary exam
D) During the secondary exam
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38) Which of the following hazards may arise from properly splinting an injured extremity?
A) Converting a closed fracture to an open one B) Compromising circulation to the extremity
C) Ignoring life-threatening problems while focusing on an extremity injury D) All of the above
C) Ignoring life-threatening problems while focusing on an extremity injury
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39) Your patient is a 3-year-old girl who is unable to move her elbow after her mother picked her up by the forearm. Proper splinting of this injury would be to immobilize from the ________ to the ________.
A) wrist; elbow B) wrist; shoulder C) forearm; humerus D) fingertips; shoulder
C) forearm; humerus
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40) A suspected musculoskeletal injury of the shoulder is best managed by which of the following techniques?
A) Placing the arm in a sling and using a triangular bandage to secure it to the body
B) Using an upper extremity traction splint
C) Placing two long padded board splints on either side of the extremity, extending from the shoulder to the wrist
D) Using a long-arm air splint
A) Placing the arm in a sling and using a triangular bandage to secure it to the body
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41) The PASG may be used as a splinting device for patients with which of the following suspected injuries?
A) Hip dislocation B) Compression fracture of the lumbar or sacral spine
C) Fractured pelvis D) None of the above
C) Fractured pelvis
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42) Blood at the meatus of the penis (opening of the urethra) is a sign of:
A) spinal fracture or injury. B) pelvic trauma/fracture. C) pelvic dislocation syndrome. D) priapism.
B) pelvic trauma/fracture.
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43) Which of the following statements is not true concerning a pelvic wrap?
A) It can be used if the pelvis shows deformity. B) It can be used if the pelvis shows instability.
C) It should not be used unless the patient shows signs of shock.
D) You can consider its use based on mechanism of injury (MOI).
C) It should not be used unless the patient shows signs of shock.
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44) Your patient is a 37-year-old man who tripped while walking down a hill and now has a painful, deformed right leg. Your assessment reveals that the foot is cold and mottled in appearance. You cannot detect a pulse in the foot or ankle. Which of the following is the best course of action?
A) Explain to the patient that, because you cannot detect circulation in his foot, his leg will most likely have to be amputated above the site of the injury.
B) Gently attempt to straighten the leg to regain a pulse before splinting.
C) Splint the leg in the position in which it was found and transport without delay.
D) Transport rapidly to the nearest trauma center.
B) Gently attempt to straighten the leg to regain a pulse before splinting.
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45) A pillow is frequently used to splint an ankle or foot injury. It is effective, rapid, and can be used for most patients. Its main weakness is:
A) it requires three people to apply. B) you might not have a pillow on your ambulance.
C) you are not immobilizing the knee and the joint adjacent to the ankle.
D) it is hard to access distal pulses after application.
C) you are not immobilizing the knee and the joint adjacent to the ankle.
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1) The symptoms or circumstances for which a medication is given are called:
A) contraindications. B) indications. C) side effects. D) untoward effects.
B) indications.
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2) When you give patients nitroglycerin, they sometimes develop a headache. This would be called a(n):
A) side effect. B) contraindication. C) untoward effect. D) indication.
A) side effect.
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3) Which of the following best describes a contraindication to a medication?
A) An unintended action of the drug
B) The way in which a drug causes its effects
C) A reason why you should not give a medication to a patient
D) A reason why you should give a medication to a patient
C) A reason why you should not give a medication to a patient
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4) What condition must be present before you give oral glucose?
A) The patient must not have a history of diabetes.
B) The patient, if conscious, must be able to swallow; if unconscious, you can apply the gel to a tongue depressor and place it between the cheek and gum or under the tongue.
C) The patient must be conscious and able to swallow with an altered mental status and history of diabetes.
D) The patient must be unconscious and have a history of diabetes.
C) The patient must be conscious and able to swallow with an altered mental status and history of diabetes.
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5) Why should EMTs study pharmacology?
A) As an EMT, you will be trusted to administer medications in emergency situations; many of these may be lifesaving, but there is potential to do harm.
B) An EMT must know the manufacturer, sources, characteristics, and effects of every medication that the patient may use.
C) As an EMT, you will be trusted to administer medications in emergency situations, although many of these may do nothing but give the patient false hope.
D) An EMT must know the sources, characteristics, and effects of each medication that the physician may prescribe.
A) As an EMT, you will be trusted to administer medications in emergency situations; many of these may be lifesaving, but there is potential to do harm.
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6) What medication is given when a patient suffers from a medical or traumatic condition called hypoxia?
A) Oxygen B) Oral glucose C) Epinephrine D) Aspirin
A) Oxygen
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7) Which of the following is the commonly accepted list of medications an EMT can assist the patient in taking or administer under the direction of the Medical Director?
A) Prescribed bronchodilator inhalers, prescribed nitroglycerin, and prescribed epinephrine auto-injectors
B) Any over-the-counter medication, oral glucose, and oxygen
C) Aspirin, acetaminophen, oral glucose, insulin, prescribed bronchodilator inhalers, nitroglycerin, and epinephrine auto-injectors
D) Aspirin, oral glucose, oxygen, prescribed bronchodilator inhalers, nitroglycerin, epinephrine auto-injectors, and naloxone
D) Aspirin, oral glucose, oxygen, prescribed bronchodilator inhalers, nitroglycerin, epinephrine auto-injectors, and naloxone
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8) Why would an EMT give aspirin to a patient?
A) Aspirin reduces the heart's ability to beat fast and works to prevent a rapid heart rate.
B) Aspirin reduces the pain level in patients who are in pain.
C) Aspirin reduces the blood's ability to clot and works to prevent further clot formation in patients suffering chest pain.
D) It is given to calm the patient by reducing the pain because stress is the real killer.
C) Aspirin reduces the blood's ability to clot and works to prevent further clot formation in patients suffering chest pain.
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9) Which of the following statements concerning oxygen is true?
A) Never give oxygen to a patient with chronic obstructive pulmonary disease (COPD).
B) Always document the need for oxygen by pulse oximetry before giving it to the patient.
C) Only withhold oxygen from anyone who is allergic to it.
D) Never withhold oxygen from any patient who needs it.
D) Never withhold oxygen from any patient who needs it.
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10) Nitroglycerin is indicated for which of the following chief complaints?
A) Decreased level of consciousness B) Chest pain C) Headache D) Difficulty breathing
B) Chest pain
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11) What is the reason for giving an epinephrine auto-injector in a life-threatening allergic reaction?
A) It will help raise the patient's blood pressure and slow the heart rate.
B) It will constrict the patient's airway passages and blood vessels.
C) It will help constrict the patient's blood vessels and relax the airway passages.
D) It will help dilate the patient's blood vessels and relax the airway passages.
C) It will help constrict the patient's blood vessels and relax the airway passages.
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12) Which of the following is often prescribed for a patient with a heart condition?
A) Ventolin B) Nitroglycerin
C) Epinephrine auto-injector D) Non-aspirin pain relievers such as Tylenol
B) Nitroglycerin
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13) Epinephrine delivered by auto-injector may be indicated for patients with which of the following conditions?
A) Drug overdose B) Severe allergies to peanut butter, shellfish, penicillin, or bee stings
C) Chest pain D) Chronic obstructive pulmonary disease
B) Severe allergies to peanut butter, shellfish, penicillin, or bee stings
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14) Which of the following is a desired action of epinephrine delivered by auto-injector?
A) Constriction of blood vessels B) Decreased perfusion of tissues
C) Dilation of coronary arteries D) Decrease in blood pressure
A) Constriction of blood vessels
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15) Which of the following is an example of a medication's trade name?
A) Epinephrine B) Nitrostat C) 4 dihydroxyphenyl acetate D) Oxygen
B) Nitrostat
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16) You respond to a medical call for a 59-year-old female complaining of tightness in her chest. You place her on a high concentration of oxygen and prepare for a short 5-minute transport to the hospital. The patient tells you she is on nitroglycerin, which she has not taken. Your partner tells you that you can give aspirin per protocol. Should you delay the patient transport to give the medication, and why?
A) No, any delay will cause the patient more heart damage; each delay weakens the myocardium.
B) Yes, the nitroglycerin will cause the blood vessels to dilate and restore some blood flow, and the aspirin will slow the clotting process.
C) Yes, the nitroglycerin will cause the heart to beat stronger and restore some blood flow, and the aspirin will ease the pain.
D) No, any delay will cause the patient more stress; she needs to be in a definitive care facility.
B) Yes, the nitroglycerin will cause the blood vessels to dilate and restore some blood flow, and the aspirin will slow the clotting process.
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17) What is the first medication that should be administered to a patient experiencing chest pain with difficulty breathing? A) Oxygen B) Aspirin C) Nitroglycerin D) Albuterol
A) Oxygen
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18) What is the most important medication that should be administered to a patient experiencing chest pain with difficulty breathing? A) Oxygen B) Aspirin C) Nitroglycerin D) Albuterol
B) Aspirin
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19) You are on the scene of a 68-year-old patient with a history of COPD who is breathing 44 times per minute and has a diminished level of consciousness. His wife states he has an albuterol inhaler and nitroglycerin tablets for angina. What is the most important drug you can administer to the patient?
A) Oxygen by bag-valve mask B) Oxygen by nonrebreather mask C) Albuterol D) Nitroglycerin
A) Oxygen by bag-valve mask
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20) Albuterol and epinephrine both have bronchodilation properties that improve the amount of oxygen that a person can inhale and absorb. However, albuterol is administered only for asthma, whereas epinephrine is administered for both asthma and anaphylaxis. Why is epinephrine, and not Albuterol, the first choice for anaphylaxis?
A) Albuterol makes the heart rate increase too much. B) Albuterol slows down the heart rate too much.
C) Albuterol drops the blood pressure too low. D) Albuterol is not a vasoconstrictor.
D) Albuterol is not a vasoconstrictor.
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21) How does nitroglycerin decrease the level of chest pain that a patient experiences?
A) It constricts the blood vessels, forcing more blood into the heart muscle.
B) It dilates the blood vessels, allowing more blood to enter the heart muscle.
C) It constricts the blood vessels, forcing the toxic lactic acid out of the heart.
D) It dilates the blood vessels, allowing more blood flow to wash away the toxic lactic acid.
B) It dilates the blood vessels, allowing more blood to enter the heart muscle.
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22) How does aspirin actually reduce the chances that a patient suffering a heart attack will die?
A) It reduces the amount of pain in the heart. B) It prevents a deadly fever from developing.
C) It reduces the inflammation in the heart. D) It reduces the ability of the blood to form clots.
D) It reduces the ability of the blood to form clots.
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23) You are on the scene of a 44-year-old female patient who has attempted suicide by taking all 30 pills of her antidepressant medication at once. You are ordered by medical control to administer activated charcoal. How will activated charcoal reduce the effects of the medication?
A) Activated charcoal will cause the patient to vomit the medication.
B) Activated charcoal will inactivate the patient's stomach acid.
C) Activated charcoal will coat the intestines, preventing absorption.
D) Activated charcoal will bind to the medication, reducing absorption.
D) Activated charcoal will bind to the medication, reducing absorption.
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24) A contraindication for giving Nitrostat is a drug interaction with what medications?
A) Nitroglycerin, Ventolin, and epinephrine B) Sildenafil, vardenafil, and epinephrine
C) Viagra, Levitra, or medication for erectile dysfunction D) Oral glucose, activated charcoal, and aspirin
C) Viagra, Levitra, or medication for erectile dysfunction
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25) Which of the following is a potential side effect of nitroglycerin?
A) Decreased blood pressure B) Sudden increase in heart rate C) Difficulty breathing D) All of the above
A) Decreased blood pressure
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26) You have just administered nitroglycerin to a 68-year-old patient. Within a few minutes, she complains of feeling faint and lightheaded, but states that she is still having some chest pain. Which of the following would be the best sequence of actions?
A) Lower the head of the stretcher and take the patient's blood pressure.
B) Administer activated charcoal to prevent further absorption of the nitroglycerin and closely monitor the patient's blood pressure.
C) Advise the patient that this is a normal occurrence and administer a second dose of nitroglycerin.
D) Increase the amount of oxygen you are giving to the patient before administering a second dose of nitroglycerin.
A) Lower the head of the stretcher and take the patient's blood pressure.
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27) You are on the scene of a 48-year-old male patient complaining of chest pain. He has nitroglycerin prescribed and available. After performing your physical examination, you contact medical control and are ordered to assist the patient in taking his nitroglycerin. Five minutes after taking his nitroglycerin, the patient complains of being dizzy and having a headache. You lie the patient down on the stretcher and reassess his vital signs. He is now hypotensive. The patient is suffering from a(n):
A) allergic reaction to nitroglycerin. B) anaphylactic reaction to nitroglycerin.
C) untoward reaction to nitroglycerin. D) side effect of nitroglycerin.
D) side effect of nitroglycerin.
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28) Bronchodilator inhalers have several common side effects, which include:
A) decreased blood pressure and increased heart rate. B) bronchodilation and decreased heart rate.
C) vasoconstriction and increased heart rate. D) jitteriness and increased heart rate.
D) jitteriness and increased heart rate.
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29) A drug's form refers to which of the following?
A) Its physical state, such as powder, liquid, or gas
B) The mandatory paperwork that must be completed when giving any drug
C) The type of container it comes in
D) The way in which it is administered
A) Its physical state, such as powder, liquid, or gas
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30) How is activated charcoal, which is carried by some EMS systems, supplied for use in emergency situations?
A) As a powder, which is mixed with water before administration B) As a gel or paste
C) As tablets D) As a fine liquid spray for inhalation
A) As a powder, which is mixed with water before administration
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31) Nitroglycerin (Nitro) is used for patients with recurrent chest pain or a history of heart attack. Nitro is most commonly supplied in what two forms?
A) Pills and injectable B) Aerosol and spray C) Pills and spray D) Ointment and pills
C) Pills and spray
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32) Which of the following instructions should you give to a patient whom you are about to assist with administering epinephrine?
A) Insert the mouthpiece and inhale deeply as you depress the canister.
B) I am going to inject medication into your thigh.
C) Open your mouth and lift your tongue so I can spray this medication under your tongue.
D) This is not pleasant tasting, but it is important that you drink all of it.
B) I am going to inject medication into your thigh.
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33) An EMT is on the scene of a 48-year-old male patient complaining of chest pain. He has nitroglycerin prescribed and available. After performing the primary and secondary assessments, the EMT contacts medical control and is ordered to assist the patient in taking his nitroglycerin. Carefully, the EMT performs the "five rights" and checks the expiration before administering the medication. The patient states the medicine is not helping his pain. The patient also states he does not have a headache. Reassessment of the patient's vital signs shows no change in blood pressure. The EMT suspects the nitro is not working because the:
A) medication is expired. B) medication is not nitroglycerin.
C) EMT only gave one tablet instead of two. D) medication was somehow rendered inert
D) medication was somehow rendered inert
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34) What is the first step in administering a prescribed aerosol medication?
A) Check to make sure the medication is correct.
B) Determine that the inhaler actually belongs to the patient.
C) Make sure the patient is suffering from asthma, emphysema, or bronchitis.
D) Determine that the dose is correct.
B) Determine that the inhaler actually belongs to the patient.
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35) Which of the following best describes the five rights?
A) In date, right medication, right order, right dose, right time
B) Right patient, right medication, in date, right dose, right route
C) Right decision, right medication, right order, right dose, right place
D) Right patient, right medication, right time, right dose, right route
D) Right patient, right medication, right time, right dose, right route
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36) You are called to an elementary school for an 8-year-old female patient who is experiencing respiratory distress. The school nurse states the patient has an epinephrine auto-injector for a possible anaphylactic reaction to bee stings. The patient also has an albuterol inhaler for exercise-induced asthma. The patient is breathing 30 times a minute, is in the tripod position, and is speaking in two- to three-word sentences. The nurse states the patient was playing basketball in the gym when she started having difficulty breathing. The patient has wheezing in all lung fields. An ALS unit is en route but it is 10 minutes away. You are 20 minutes away from the nearest hospital. After placing the patient on oxygen, your next intervention should be to:
A) contact medical control and request to assist the patient with her epinephrine.
B) provide supportive care until the ALS unit arrives.
C) cancel the ALS unit and call medical control to assist with the albuterol administration while en route to the hospital.
D) contact medical control and request to assist the patient with her albuterol.
D) contact medical control and request to assist the patient with her albuterol.
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37) You are called to assist a 25-year-old female patient who is in profound respiratory distress. The patient has a history of asthma and a severe allergy to peanuts. She has a prescribed albuterol inhaler and an epinephrine auto-injector. The patient states she was working in her garden when she accidentally stirred up a hornets' nest and was stung multiple times. The patient has wheezing in all fields, and is breathing at 28 times per minute. She states that she triggered her asthma by running across the yard to the safety of her home. As you apply oxygen, you notice that she is now speaking in two- to three-word sentences, her skin has splotches, and her tongue and neck appear to be swelling. Your next action is to call medical control and then do what?
A) Request to assist the patient with her albuterol inhaler for her asthma.
B) Request to assist the patient with her epinephrine pen for anaphylaxis.
C) Request to assist the patient with her albuterol for anaphylaxis.
D) Do not request to give epinephrine. It was prescribed for a peanut reaction, not for hornet stings.
B) Request to assist the patient with her epinephrine pen for anaphylaxis.
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38) You are on the scene at a fancy hotel room for a 60-year-old male patient who calls 911 at 10 p.m. for chest pains. He states he was about to go to bed when he suddenly had chest pain that would not go away. He rates his pain as a 7 out of 10 and is diaphoretic. His vital signs are stable, and he takes medications for hypertension, high cholesterol, and erectile dysfunction. The patient is allergic to morphine. After placing the patient on oxygen, you contact medical control and request:
A) to administer aspirin to the patient. B) to administer nitroglycerin to the patient.
C) to administer both aspirin and nitroglycerin to the patient. D) no orders.
A) to administer aspirin to the patient
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39) Name the type of medical direction consisting of standing orders and protocols.
A) Off-line B) Verbal C) On-line D) Written
A) Off-line
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40) The epinephrine auto-injector is given via the ________ route.
A) oral B) enteral C) digestive D) parenteral
D) parenteral
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41) Which of the following describes the sublingual route of medication administration?
A) The medication is injected under the skin.
B) The medication is breathed into the lungs, such as from an inhaler.
C) The medication is placed under the tongue.
D) The medication is swallowed whole, not chewed.
C) The medication is placed under the tongue.
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42) Nitroglycerin is given via the ________ route.
A) parenteral B) oral C) sublingual D) enteral
C) sublingual
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43) The study of the effects of medications on the body in relation to patient-specific factors such as age and weight is called:
A) pharmacology. B) pharmacodynamics.
C) measurement and documentation. D) reassessment.
B) pharmacodynamics.
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44) The EMT, after administering any medication, must do which of the following?
A) Reconsider the five rights, reassess the patient, and contact medical control.
B) Reassess the patient, document the medication, and report to the receiving facility.
C) Wait 5 minutes, repeat the medication if needed, and reassess the patient's vitals.
D) Document the route, dose, and time; reassess the patient; and re-administer the medication.
B) Reassess the patient, document the medication, and report to the receiving facility.
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45) Your patient is a 59-year-old woman with a history of emphysema. Per protocol, you have assisted the patient in using her medication inhaler. Which of the following must be documented?
A) Chemical name of the medication B) Expiration date of the medication
C) Patient's response to the medication D) All of the above
C) Patient's response to the medication
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46) What are the names given to each medication listed in the U.S. Pharmacopoeia?
A) Official, chemical, and generic B) Manufacturer, general, and governmental
C) Trade, chemical, and generic D) Trade, brand, and generic
C) Trade, chemical, and generic
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47) Choose the correct completion to this statement regarding intravenous (IV) administration: This route is used to administer medication into the body directly or through the bloodstream and is:
A) beyond the scope of the EMT level.
B) typically only performed in the prehospital environment.
C) used in advanced life support only when the patient is intubated.
D) given in the field only with respect to blood transfusions.
A) beyond the scope of the EMT level.
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48) When is a heparin or saline lock used in IV administration?
A) When fluid is likely to be administered B) When medication or IV access might be needed later on
C) When IV administration will not involve a vein D) When a traditional IV bag is used
B) When medication or IV access might be needed later on
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49) If an EMT is enlisted to help set up the IV administration set, the first step is to:
A) select the proper administration set. B) connect the extension set to the administration set.
C) take out and inspect the fluid bag. D) make sure the flow regulator is closed.
C) take out and inspect the fluid bag.
