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629 Cards in this Set
- Front
- Back
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The patient with metabolic acidosis and adequate spontaneous ventilations will typically have:
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decreased pH and increased PCO2.
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A patient with cancer of the bone might be prone to:
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hypercalcemia
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Sodium is represented by the symbol:
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Na+.
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Angiotensin II is a:
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strong vasoconstrictor.
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A patient who has suffered salt water drowning might be expected to exhibit which of the following conditions?
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pulmonary edema.
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Which of the following signs/symptoms would fit the patient with fluid overload?
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increased body weight
headache edema |
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Your patient is a 34 year old man in a coma from an overdose of Percodan. He is breathing at 4 times per minute, shallowly. His PCO2 is 82, and his PO2 is 36. The blood pH is 7.15, and HCO3- is 22. The patients presentation and results are consistent with:
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respiratory acidosis
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All of the following can cause an acidotic condition
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diabetic ketoacidosis.
cardiac arrest. narcotic overdose. |
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Magnesium is represented by the symbol:
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Mg++.
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A patient with a serious imbalance of potassium is at risk for:
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cardiac arrest
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Which of the following is/are true about ADH? Choose all that apply.
A. an increase in ADH secretion causes increased concentration of the urine B. increased secretion can occur as a result of fear, pain, traum, or administration of morphine or meperidine (Demerol) C. it is stored in the posterior pituitary gland D. increased secretion of ADH produces urine flow |
an increase in ADH secretion causes increased concentration of the urine
increased secretion can occur as a result of fear, pain, traum, or administration of morphine or meperidine (Demerol) it is stored in the posterior pituitary gland |
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The major effect of acidosis on the central nervous system is:
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depression.
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A tingling sensation in the fingers and toes is a sign of:
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respiratory alkalosis.
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Normal pH in the human body should be
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7.35 - 7.45.
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An increase in pH to 7.8 would indicate:
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alkalosis.
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Normal balance of H2CO3 to HCO3- is:
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1 to 20
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When we speak of the "third space", we mean the:
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interstitial space.
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The major effect of alkalosis on the central nervous system is:
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stimulation
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Which of the following patients is NOT at a greater risk for fluid overload?
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patient with untreated diabetes
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The amount of venous return available to the ventricle is known as
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preload
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In Addison's disease, there is a deficiency of:
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glucocorticoid production.
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Which of the following is/are true concerning sodium?
A. an a deficiency results in alkalosis. B. an excess is called hypernatremia and may result in edema C. all of these are true D. it is the most prevalent of the intracellular cations |
B
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The process by which fluid flows across a selectively permeable membrane from a solution of lower concentration to a solution of higher concentration until the solute concentration on both sides of the membrane is equalized is:
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osmosis
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Calcium is represented by the symbol:
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Ca++
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_____________________ are substances whose molecules dissociate into charged components when placed in water.
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electrolytes
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In Cushing's syndrome, the adrenal glands are overactive resulting in:
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increased production of ACTH and glucocorticoids.
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Pulmonary edema and congestive heart failure are likely to be accompanied by which of the following?
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shortness of breath.
increased respiratory rate. coughing. cyanosis. |
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The patient with diabetic ketoacidosis would probably have a pH which is:
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low
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The blood osmotic pressure is ________________ than the interstitial fluid osmotic pressure.
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greater than
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Your patient is a 42 year old female who has a history of peptic ulcer disease. She seems nervous and complains of muscle twitching. Her husband tells you that she had consumed several rolls of antacid tablets and most of a box of baking soda with water. Her PCO2 and PO2 are within normal limits. Her bicarbonate is 32, and her pH is 7.7. These readings and patient presentation are consistent with:
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metabolic alkalosis.
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Psychologically induced rapid, deep breathing would cause:
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elevated pH.
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Your 54 year old diabetic male is stuporous. His wife says he has not taken his insulin in several days. His skin is flushed; his breathing is deep and rapid with a fruity odor. His appears dehydrated. PCO2 and PO2 are within normal limits, but his pH is 7.1. These readings and patient presentation are consistent with:
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metabolic acidosis.
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Milliequivalents (mEq) are the measure of what?
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electrolytes
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In respiratory alkalosis, the pH will be ______________________.
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higher than normal
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Which are true about metabolic acidosis?
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may be present in patients with diabetes
may result in Kussmaul's respirations causes the consumption of bicarbonate may have pH of less than 7.35 |
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Phosphate is represented by the symbol:
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PO4-.
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The usual stimulus to the production of ADH is an increase in the osmotic pressure of the _________________________ fluid.
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extracellular
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Patients who take large amounts of sodium bicarbonate for indigestion would most likely suffer from:
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metabolic alkalosis.
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Which of the following is/are true respiratory acidosis? Choose all that apply.
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the kidneys compensate by retaining bicarbonate and excreting H+
H2CO3 is increased the patient should be ventilated |
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Which of the following is an isotonic fluid?
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Lactated Ringers
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Cardiac output is figured by multiplying:
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stroke volume times heart rate.
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An increase in aldosterone production causes a ____________________ of potassium.
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loss
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What body systems participate in acid-base regulation?
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renal, buffer, and respiratory
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Fluid overload may result in:
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dyspnea.
increased respiratory rate. pulmonary edema. |
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The normal hematocrit should be:
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40 - 45% of blood volume.
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Which of the following is/are colloids? Choose all that apply.
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albumin
plasma |
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Oliguria is a sign of:
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tissue dehydration.
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Normal PaCO2 is:
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35-45 torr.
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Which of the following is CORRECT regarding the Fick Principle?
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hemoglobin levels must be adequate
there must be adequate cardiac function an adequate amount of oxygen must be available to red blood cells red blood cells must be circulated to the tissue cells |
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From the choices below, select the anion.
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bicarbonate
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The universal recipient blood type is:
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ab
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Release of ADH causes:
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an decrease in the amount of urine produced by making distal and collecting tubules more permeable to water.
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The amount of venous return available to the ventricle just prior to systole is called:
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preload
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In infants, signs of dehydration might include:
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depressed fontanels.
rapid pulse and respirations. soft, sunken eyeballs. |
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Which is the fastest acting system for acid-base compensation?
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buffer
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In respiratory acidosis, the pH will be:
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lower than normal.
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Which of the following is/are crystalloids? Choose all that apply.
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D5W
lactated ringers |
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The compensatory mechanisms in shock serve what function(s)?
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to conserve oxygen.
to perfuse the vital organs. to reduce the vascular space. to reduce blood loss. |
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If extracellular fluid has 142 mEq of cation, how much anion must it have?
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142 mEq
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The major postiively charged ion in the intracellular fluid is:
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k+
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The average daily fluid intake and output for a young adult at rest would most likely be:
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2400 mL
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Which of the following statements about aldosterone is/are correct
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important in regulating sodium balance in the body.
a hormone which results in resorption of sodium, chloride and water by the kidneys. secreted when there is reduced blood volume and reduced cardiac output. |
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Cells placed in a hypotonic solution will
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swell
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Which of the following must be present in adequate supply to ensure normal cardiac function?
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calcium
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The largest amount of body fluid is in which compartment?
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intracellular
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In respiratory acidosis, the EMT's actions to relieve the condition would be to do what to the patiient?
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hyperventilation
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The osmotic pressure in the venous capillary is due to:
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globulins and albumins in the intravascular fluid.
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what are the factors that contributes to water loss?
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central diabetes insipidus
alcohol ingestion water privation due to injury impaired thirst |
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Chloride is represented by the symbol:
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Cl-
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The movement of molecules or ions from an area of higher concentration to an area of lower concentration is:
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diffusion
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An electrically charged atom with a positive charge is called a/an:
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cation
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Your patient is a 16 year old cheerleader who has become overly excited at a football game. She complains of dizziness, tightness in her chest, and "pins and needles" in her arms and legs. Her breathing is rapid and deep. At the hospital, you learn that her PCO2 is 24, and her PO2 is 100. Her pH is 7.6, and bicarbonate is 26. The readings and presentation are consistent with:
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respiratory alkalosis
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The blood hydrostatic pressure is ________________ than the interstitial fluid hydrostatic pressure.
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greater than
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Wrinkled skin in the elderly ____________ always a sign of dehydration.
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is not
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Which of the following is most likely to occur in a patient taking a diuretic?
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hypokalemia
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Hematocrit is the:
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percentage of erythrocytes in plasma.
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You find a 10 year old boy in a coma from a heroin overdose. He is breathing shallowly at 6 times per minute. You can assume that his CO2 is _____________ than normal.
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higher
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Body fluids are contained within compartments called:
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intracellular and extracellular.
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The respiratory system contributes to acid-base balance by regulating the retention and stimulation of:
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carbon dioxide
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In respiratory alkalosis, the CO2 levels in the body decrease. This in turn causes the H+ concentration to:
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decrease
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The treatment of choice for the patient in severe anaphylactic shock is:
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epinephrine
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Of total body water, what precent is in the intracellular space?
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40
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The walls of the arterioles contain:
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smooth muscle
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If NO ADH is secreted, the volume of urine production:
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becomes several times normal.
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Signs of severe water deficit include all of the following EXCEPT:
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decreased heart rate.
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Depression of the fontanel in an infant indicates:
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hypovolemia
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Addison's disease occurs when there is ____________________ activity in the adrenal cortex.
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not enough
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Cells placed in a hypertonic solution will:
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crenate
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A process that can move an ion against its concentration gradient from areas of lower concentration to areas of higher concentration is:
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active transport
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An important anion that is frequently associated with Na+ in the body and plays a role in fluid balance and renal function is:
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Cl-
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Normal PaO2 is:
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80-100 torr
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The most abundant cation in the body is:
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calcium
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The release of aldosterone causes:
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the kidneys to retain sodium and excrete potassium.
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Which of the following is NOT a function of body fluids?
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production of hormones
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H2CO3 is a _________________ acid.
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weak
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The total resistance against which blood must be pumped is:
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afterload
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An electrically charged atom with a negative charge is called a/an:
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anion
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A patient in acidosis would most likely die from:
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coma
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When the solution on both sides of a selectively permeable membrane are alike in concentration, they are:
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isotonic
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For what condition would you give sodium bicarbonate?
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metabolic acidosis
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Administration of potassium by IV drip could lead to:
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hyperkalemia
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Antibodies to the Rh antigen occur normally in the body.
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true
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Administration of furosemide (Lasix) would most likely cause:
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hypokalemia
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Hydrostatic pressure at the venous end of the capillary is __________________ at the arterial end.
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less than
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A 77 year old male is lying supine in a bed in a cheap rooming house. There is a strong smell of urine in the room. The patient is unresponsive. Respirations are deep and rapid, and his breath is sweet smelling. Pulse is weak, rapid and irregular. His skin is warm and dry. BP is 80/40. This patient is most probably suffering from:
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diabetic ketoacidosis.
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The total body water constitutes _____ percentage of body weight in the adult male.
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60
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Supply the missing compound: H20 + ______________=H2C03.
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CO2
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The difference between systolic and diastolic pressures is the:
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pulse pressure
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Of total body water, what percent is in the interstitial fluid?
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15
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If a solute concentation is greater at one point that at another point in the solvent, a _________________________ exists.
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concentration gradient
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The kidneys role in diabetic ketoacidosis would be to:
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excrete hydrogen ions.
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Of total body water, what precent is in the intravascular space?
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5.0
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Which of the following patients might have respiratory acidosis?
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narcotic drug overdose
cardiac arrest obstructed airway |
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Substances that dissociate into electrically charged atoms are called:
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electrolytes
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Bicarbonate is represented by the symbol:
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HCO3-
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Hyperkalemia may be caused by:
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acute or chronic renal failure.
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Any acidosis that is caused by a clinical situation that interferes with pulmonary gas exchange and causes retention of carbon dioxide is:
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respiratory
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You are working as an ER technician. You are caring for a 66 year old (fully conscious) female complaining of severe SOB. Her room air SaO2 is 86%, so you have placed her on oxygen by NRB at 12 lpm. The ER doctor wants ABG results before deciding whether or not to intubate the patient. The results are: pH 7.30, PaCO2 52, HCO3- 29, PaO2 98. The acid-base condition is:
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respiratory acidosis, partially compensated.
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Water normally leaves the body by
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respirations.
sweating. urine. feces. |
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Increasing the pH value from 7.4 to 7.6 represents an increase in:
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alkalinity.
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The loss of water (without accompanying loss of solute) from the extracellular compartment results in:
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increased sodium concentration, decreased volume of extracellular fluid.
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Standard bicarbonate content is:
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22 - 26mEq/L.
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Low pH indicates:
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high H+ concentration.
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When glucose is broken down for energy, it is first broken down into pyruvic acid molecules. If oxygen is not readily available, these will then be broken down further to:
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lactic acid.
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When a cell is placed in a solution in which the solute concentration and water concentration is the same as the solution inside the cells, the solution is said to be:
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isotonic
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Excess fluid in the interstitial spaces is called:
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edema
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You are responding to a call involving a possible diabetic emergency. You have transported your patient, providing all appropriate treatment, to the emergency room. You stick around to see her ABG results. Her gases are: pH 7.25, PaCO2 38, HCO3- 18, PaO2 92.
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metabolic acidosis, uncompensated
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Which of the following is/are true concerning potassium?
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it plays a role in mediating electric impulses in nerves and muscles
sodium takes its place when it moves into the extracellular fluid high potassium levels in the body can cause cardiac dysrhythmias patients taking diuretics may develop a deficiency in potassium |
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You answer a call where a man is a victim of a near-drowning and is sitting up, breathing rapidly and coughing up a large amount of bright red-tinged sputum. The water the victim was pulled from was most likely?
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salt water
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The gluid compartments are separated by what kind of membrane?
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selectively permeable membrane.
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Ascites is:
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a collection of fluid in the peritoneal cavity.
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When hydrogen ion concentration decreases, the respiratory system becomes _______________ active.
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less
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Capillary walls differ in permeability to:
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solutes
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Magnesium excess occurs primarily in patients with:
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chronic renal insufficiency.
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When an atom carries an electrical charge because it has either gained or lost electrons, it is called a/an:
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ions
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Metabolic alkalosis would most likely be caused by all of the following EXCEPT:
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diabetes
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Which of the following is NOT a typical question to answer when evaluating and interpreting research?
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Will the research study be published in a notable journal?
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Cells that produce interferon and interleukin to regulate immune reactions are:
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Td cells
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Your 20 year old male patient is suffering from dyspnea, hives, and itching. This is referred to as:
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a hypersensitivity reaction
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The adrenergic receptor responsible for peripheral vasoconstriction is:
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alpha 1
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A disorder that demyelenates nerve fibers causing nerve transmissions to affected fibers to cease is:
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multiple sclerosis.
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The adrenergic receptor responsible for increased rate, force, and automaticity in the cardiac muscle is:
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beta 1
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Simple healing of a wound without production of pus or granulation is called:
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primary intention.
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A 50 year old female suffers from a hereditary condition in which her body absorbs and stores to much iron. This condition is:
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hemochromatosis
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Markers on cells that allow the body to determine "self" are:
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HLA antigens.
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Small proteins that are secreted by virus infected cells are:
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interferons
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Type II reactions are:
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cytotoxic reactions.
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functions of inflammation:
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to destroy microbes and prevent their spread.
to activate and attract immune components. to repair tissue damage. |
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The process of collecting, analyzing, and reporting data on the rates of occurrence, mortality, morbidity, and transmission of infections is called:
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surveillance
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Serum sickness is an example of a Type ____ reaction.
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III
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benefits of edema:
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dilutes toxic substances.
traps microbes to prevent spreading. |
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A pyrogen that is given off by macrophages and is also active in destroying some cancer cells is:
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Tumor Necrosis Factor (TNF)
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Smoking has been shown to have a direct "cause-effect" relationship to lung cancer. This is known as:
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causal risk factor.
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You contracted chicken pox when you were four years old. You had a "good" case, and you never suffered from chicken pox again even though you were exposed numerous times. This is known as:
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natural active immunity.
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Your partner and you were exposed to Hepatitis C during the course of your job duties. Your department safety officer recommends that you both receive gamma globulin injections. This is known as:
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active immunization.
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Rheumatoid arthritis is thought to be a Type ____ reaction.
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III
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The most important factor in the development of IDDM is:
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HLA cell types.
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A genetically inherited condition that causes respiratory distress usually in response to an allergen is:
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asthma
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A cytokine that is produced by mast cells and basophils that increases vascular permeability and increases mucous production:
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histamine
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When autoantibodies attach to follicle cells that secrete thyroxin, they can cause overproduction of thyroxin and symptoms of hyperthyroidism. This condition is known as:
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graves disease
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When macrophages are unable to destroy the foreign invaders, a ________________ will form to wall off the infection from the rest of the body.
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granuloma
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The cell-mediated arm of immunity consists of:
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T lymphocytes.
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Tissues that are filled with capillaries that grow inward from healthy tissues surrounding a wound are called:
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granulation tissues.
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An autoimmune disease that generally afflicts women of childbearing years which is associated with a rash and then development of antibodies against various organs and tissues is:
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systemic lupus erythematosus.
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Which of the following is NOT a part of the body's line of defense against disease?
Choose one answer. a. infectious barriers b. immune response c. anatomic barriers d. inflammatory response |
a
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The building blocks for all blood cells are:
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stem cells
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The primary chemical neurotransmitter for response to stress by the sympathetic nervous system is:
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norepinephrine
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Which of the following factors can contribute to disease?
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microorganisms and immunologic exposures
psychosocial environment personal habits and lifestyles |
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Some drugs depress blood cell formation in the bone marrow. This is known as iatrogenic deficiency.
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true
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A systemic, life-threatening reaction that can cause airway obstruction and circulatory system collapse falls in the Type ____ category.
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I
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The biggest immunoglobulin player in a Type I reaction is:
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IgE
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A delayed hypersensitivity reaction is a Type ____ reaction.
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IV
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A 28 year old suffers from a chronic inflammatory disease of the intestines that is thought to be a genetically inherited immune response to bowel contents. This patient most likely suffers from:
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Crohn's disease.
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The adrenergic receptor responsible for bronchodilation during a stress response is:
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beta 2
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In Duchenne's muscular dystrophy:
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the female carries and transmits the abnormal gene.
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The primary response:
|
is a response that increased the titer to that antigen.
|
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A cell surface marker that is used to identify a cell as "self" or non-self" is:
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an antigen
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Cells that regulate antibody production and provide a control on the immune response to keep it from becoming too destructive are:
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Ts cells
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The first immunoglobulin to be released during a primary response is:
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IgM
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Markers on the immunoglobulin molecule that distinguish between the classes of antibodies in a given species are:
|
isotypes
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Which of the following is NOT considered to be a possible effect of stress?
a. schizophrenia or other psychiatric disorders b. shrinking or atrophy of the thymus gland and other structures of the lymphatic system c. enlargement of the outer portion of the adrenal gland (the cortex) d. development of bleeding ulcers in the stomach and in the duodenum |
a
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In the stress response, __________________________ stimulates gluconeogenesis.
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cortisol
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Blood transfusions and tissue implantation reactions are the most common forms of Type ____ reactions.
|
II
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An autoimmune disease that is progressive and debilitating, destroying joints and collagen, is:
|
rheumatoid arthritis.
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Heat or warmth caused by increased blood flow at the site is called:
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calor
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When antibodies bind to acetylcholine receptors, it causes a major muscle weakness disorder called:
|
myasthenia gravis.
|
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Dr. Seyle wrote that there are 3 stages in the general adaptation syndrome response to stress. Which of the following is NOT one of those stages?
Choose one answer. a. alarm. b. resistance. c. exhaustion. d. denial. |
denial
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The judicial branch at the state level is responsible for:
|
resolving disputes based on interpretation of law.
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Which of the following is addressed in the Emergency Medical Treatment and Active Labor Act (EMTALA)?
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Preventing medical facilities from denying medical screening and stabilization
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When determining whether or not a paramedic's actions were consistent with the standard of care, the court would be LEAST likely to:
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talk to patients to whom the paramedic has provided care in the past.
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Transporting a competent adult patient without his or her consent might result in allegations of all EXCEPT:
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false imprisonment
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When an ambulance collides with a citizen's vehicle at an intersection:
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the driver of the ambulance may be charged criminally.
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Informed consent involves:
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ensuring that a patient understands the potential risks involved in performing a particular procedure.
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In the eyes of the court, a sloppy, incomplete patient care report suggests that:
|
patient care may have been sloppy and incomplete
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Which of the following general statements regarding violent patients is MOST correct?
a. Benzodiazepines are acceptable to use as a means of chemical restraint. b. Most patients become violent because of a severe psychiatric condition. c. You must rule out hypoglycemia before restraining a violent patient. d. Ideally, violent patients should be restrained in a face down position. |
A
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A patient would MOST likely file a lawsuit against you if he or she perceives your medical care as:
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incompetent
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At common law, an assault on a patient occurs when the EMS provider:
|
instills the fear of immediate bodily harm in a patient
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When a person experiences an injury and seeks redress for that injury:
|
the judicial process must determine who is responsible
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If you must deviate from your protocols because of unusual circumstances, you should FIRST:
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notify medical control
|
|
|
While caring for an 80-year-old man with a possible fractured arm, you discover other injury patterns that are suggestive of abuse. The patient is conscious and alert. You should:
|
splint the patient's arm, transport him to the hospital, and report your suspicions to the emergency department physician
|
|
|
If a conscious patient with decision-making capacity refuses care for a potentially life-threatening condition:
|
he or she cannot be treated without a court order.
|
|
|
When functioning at a crime scene, it is MOST important for the paramedic to:
|
use caution and not disturb the scene unnecessarily
|
|
|
Which aspect of the Health Insurance Portability and Accountability Act (HIPAA) is MOST pertinent to the paramedic?
|
Ensuring that the patient's privacy is protected
|
|
|
If an off-duty paramedic comes upon the scene of a motor vehicle crash in another jurisdiction, the paramedic:
|
does not have a legal duty to stop and provide care.
|
|
|
Scope of practice is defined as:
|
care that a paramedic is permitted to perform under the certifying state's laws.
|
|
|
A paramedic who was trained and certified to perform a surgical cricothyrotomy successfully performs the procedure on a patient in the field. However, because the EMS system's medical director does not permit paramedics to perform a needle cricothyrotomy, the paramedic:
|
performed outside his or her scope of practice.
|
|
|
If your EMS system receives a subpoena for a patient's protected health information (PHI), it would be MOST appropriate to:
|
notify legal counsel before releasing any information.
|
|
|
Most EMTALA violations occur when:
|
the patient does not have medical insurance.
|
|
|
You arrive at the scene of a shooting. The patient, a 19-year-old man, has a gunshot wound to the side of his head with a large amount of exposed brain mater. Further assessment reveals that the patient is apneic and pulseless. Law enforcement personnel advise you that the person who shot the patient is in their custody. You should:
|
avoid unnecessary contact with the patient and document the findings of your visual assessment of the patient and scene
|
|
|
Which of the following statements regarding certification is MOST correct?
Choose one answer. a. Certification is evidence that an individual has a certain level of credentials based on hours of training and examination. b. Unlike a licensed health care provider, a certified health care provider is not required to obtain continuing education hours. c. Certification is a process in which a certifying entity attests to the fact that the health care provider has mastered a certain skill set. d. A certified health care provider has been granted the authority and privilege to practice medicine in a certain municipality. |
A
|
|
|
Implied consent is based on the premise that a patient:
|
would consent to care because of the seriousness of his or her injury
|
|
|
Which of the following situations is an example of an act of commission?
|
A paramedic sutures a patient's lacerated arm
|
|
|
Which of the following statements regarding a psychiatric patient who is refusing transport is MOST correct?
Choose one answer. a. Family members can authorize involuntary commitment, including forcibly transporting the patient against his or her will. b. If the patient's life is not in danger, only a police officer can authorize paramedics to restrain and transport the patient. c. Medical control has the authority to order paramedics to forcibly restrain and transport any psychiatric patient. d. It is generally agreed that any psychiatric patient should be transported against his or her will for evaluation by a psychiatrist. |
b. If the patient's life is not in danger, only a police officer can authorize paramedics to restrain and transport the patient.
|
|
|
If a conflict arises between a paramedic and a physician bystander in the field, the paramedic should:
|
contact medical control to seek resolution
|
|
|
While caring for a conscious and alert 49-year-old man with a suspected myocardial infarction, you start an IV prior to obtaining the patient's consent. This action constitutes:
|
battery
|
|
|
A 40-year-old man presents with bizarre behavior. His speech is slurred and he is very belligerent. His blood glucose level is 35 mg/dL. The patient tells you to get out of his house. You should:
|
remain professional and advise the patient that he is not legally capable of refusing EMS treatment
|
|
|
While caring for a critically injured patient at the scene of a motor vehicle crash, an emergency physician bystander stops at the scene to assist. Which of the following procedures performed by the physician would require the physician to accompany the patient to the hospital in the ambulance?
|
A pericardiocentesis
|
|
|
A patient's wife called 9-1-1 because the patient was complaining of a severe headache and nausea. The patient is conscious and alert, but obviously upset that his wife called 9-1-1 without consulting with him first. As you pull out the BP cuff, the patient folds his arms and turns away from you. From this patient's actions, you should conclude that:
|
you do not have consent to treat him
|
|
|
The BEST legal protection for the paramedic is to:
|
provided a detailed patient assessment and appropriate medical care, followed by complete and accurate documentation.
|
|
|
Which of the following is an example of slander?
|
Telling the receiving facility that a patient is drunk
|
|
|
You are called to a community center for a 40-year-old woman who is “acting strange.” Upon your arrival, you assess the patient and determine that she is conscious, alert, and oriented to person, place, time, and event. She does not appear to be mentally impaired. Her oxygen saturation is 99% on room air and her blood glucose level is 112 mg/dL. The patient's husband tells you that his wife has bipolar disorder and takes medication for it. The patient tells you that she is fine and does not want to go to the hospital. You should:
|
recognize that this patient has decision-making capacity at the present time and that you cannot force her to go to the hospital.
|
|
|
When an administrative agency proposes a licensing action in a state that licenses paramedics, the agency must notify the paramedic of the actions that allegedly constituted the infraction. This is a part of:
|
due process.
|
|
|
You deliver a 61-year-old man with abdominal pain to a busy emergency department. A staff nurse instructs you to take the patient to the triage area where he will be tended to later. She further tells you that after you leave a copy of your patient care report with the clerk, you are free to leave. You should:
|
advise the nurse that you will remain with the patient until the nurse has taken your verbal report and properly assumed care of the patient.
|
|
|
Which of the following patients is NOT an emancipated minor?
a. 17-year-old woman who goes to college and lives with her parents b. 17-year-old man who is a member of the U.S. armed forces c. 16-year-old woman who is pregnant and lives with her boyfriend d. 18-year-old woman who is pregnant and lives with her grandmother |
A
|
|
|
Which of the following scenarios is considered by most states to be a medical examiner case?
|
Any violent or unexpected death
|
|
|
It is MOST important to leave a copy of the patient care report at the emergency department because:
|
this will help ensure continuity of the patient's care.
|
|
|
While off duty and outside of your jurisdiction, you encounter a motor vehicle accident. You can see one patient lying motionless on the ground near her overturned vehicle. As an off-duty paramedic, you:
|
may feel an ethical obligation to stop and assist.
|
|
|
Which of the following is an example of a protocol?
|
A written plan for patient care
|
|
|
A hospital that is in violation of EMTALA:
|
could forfeit all of its Medicare funding.
|
|
|
If a mentally competent adult refuses emergency medical treatment, your FIRST action should be to:
|
try to determine why he or she is refusing treatment.
|
|
|
A patient who rolls up his or her sleeve so that you can take his or her blood pressure has given you __________ consent.
|
expressed
|
|
|
A patient who has respiratory acidosis is most likely to be:
|
disoriented
|
|
|
A bystander physician who assists at the scene of an accident is not required to accompany the patient in the ambulance unless the physician:
|
has assumed full responsibility for the patient's care and has deviated from protocols.
|
|
|
The most common cause of airway obstruction in the unconscious patient is:
|
the tongue
|
|
|
The point at which the trachea bifurcates is known as the:
|
carina
|
|
|
Which of the following oxygen delivery devices provides the highest concentration of oxygen to a spontaneously breathing patient?
|
non-rebreather mask
|
|
|
Hypercarbia is a term to describe"
|
high carbon dioxide levels in the blood.
|
|
|
You are transporting your 70 year old CHF patient from the back of the ambulance to ICU, which is located on the 3rd floor of the hospital. You have the patient on a NRB mask at 10 lpm, and your D cylinder contains 500 PSI. How many minutes do you have to safely locate your patient's destination?
|
5 mins
|
|
|
The hollow pockets along the lateral borders of the larynx is/are the:
|
pyriform fossae.
|
|
|
To select the proper endotracheal tube size for an infant, you should look at:
|
the patient's nares or his little finger.
|
|
|
Whenever a Combitube is removed, you should prepare to immediately:
|
suction the patient
|
|
|
The most common and most easily prevented side effect of tracheal suctioning is:
|
hypoxia
|
|
|
You have identified a patient in cardiac arrest as having a complete laryngectomy. Which is the correct course of action in airway management?
|
Intubate the stoma and ventilate the patient with a BVM.
|
|
|
When performing endotracheal intubation in the trauma patient, you must:
|
place the head in a sniffing position to facilitate intubation.
|
|
|
Your 20 year old female trauma patient is unresponsive. You have opted to intubate her. As you begin inserting the blade into her mouth, you note that her O2 sat immediately begins to drop and her pulse rate rapidly decreases into bradycardia. You should:
|
stop the intubation process and ventilate the patient.
|
|
|
The correct size ETT for the newborn is:
|
3.0 mm
|
|
|
Your 35 year old female is suffering from a complete airway obstruction with food. Your attempts at relieving the obstruction with the Heimlich maneuver are unsuccessful. The most definitive method of removing foreign objects and the one that should be used now is:
|
direct laryngoscopy with Magill forceps
|
|
|
All of the following are disadvantages of the standard adult size Combitube (SA) EXCEPT:
a. it can be inserted without direct vocal cord visualization. b. it should not be used by untrained or inexperienced personnel. c. it cannot be used in patients over 7 feet tall. d. use in a patient with esophageal varices could cause bleeding. |
A
|
|
|
An average setting of no greater than ____ is appropriate for PEEP when using a transport ventilator.
|
15
|
|
|
The substance which decreases surface tension of the alveoli is:
|
surfactant.
|
|
|
The amount of gas that can be expired after a passive (relaxed) expiration is:
|
expiratory reserve volume.
|
|
|
Which of the following patients is most likely to have a decreased minute volume?
a. 20 year old with a head injury and shallow, slow respirations b. 30 year old in early shock with an increased respiratory rate c. 17 year old with deep respirations and signs of hyperventilation d. 45 year old with a possible MI and respirations at 16/min and of normal depth |
20 year old with a head injury and shallow, slow respirations
|
|
|
The Magill forceps are used most often in conjunction with direct laryngoscopy to:
|
remove foreign bodies of the upper airway.
|
|
|
A common complication of endotracheal intubation is aspiration of chipped tooth fragments. This can be prevented largely by:
|
keeping the laryngoscope off of the teeth.
|
|
|
You are delivering 15 lpm with a non-rebreathing mask. The percentage of oxygen delivered is approximately:
|
90%
|
|
|
Your 10 year old acute asthmatic is suffering from an acute attack. He is sitting in a tripod position and using accessory muscles to breathe. When taking his radial pulse, you notice that it seems to get significantly weaker during the end of inspiration. This patient is probably exhibiting signs of:
|
pulsus paradoxus
|
|
|
Suctioning through the ET tube is:
|
a sterile procedure
|
|
|
Proper placement of the endotracheal tube should take no longer than:
|
30 seconds
|
|
|
The Sellick's Maneuver is no longer an accepted practice in EMS when intubating your patient. As of AHA 2010, it's been determined to not be effective. With that being said, the accepted practice you may want to employ to bring vocal cords that are otherwise invisible into the full view is:
|
BURP
|
|
|
A tracheostomy tube has a standard ____ mm adaptor which will fit most any BVM.
|
15
|
|
|
You are ventilating your 20 year old patient with a BVM (with reservoir) and O2 at 15 lpm. At approximately what percentage are you delivering oxygen?
|
90-100
|
|
|
You are evaluating a 29 year old patient who has suffered an asthma attack. You place the pulse oximeter on her finger, and it reads 93%. You are evaluating:
|
oxygen in the blood that is bound to hemoglobin.
|
|
|
To ensure adequate ventilation with a Combitube, the prehospital provider must be certain that:
|
both cuffs are properly inflated with syringes removed.
|
|
|
You are placing a nasopharyngeal airway in a somewhat conscious patient. The proper way to measure for correct size is:
|
bridge of the nose to the earlobe.
|
|
|
The volume of gas inhaled or exhaled during a single respiratory cycle is:
|
tidal volume
|
|
|
All of the following are functions of the upper airway EXCEPT:
Choose one answer. a. to filter incoming air. b. to humidify the incoming air. c. to reduce the pressure of incoming air. . d. to warm the incoming air. |
to reduce the pressure of incoming air
|
|
|
What is a complication of an oral airway?
|
It can occlude the airway if improperly sized.
|
|
|
An advantage of a nasal airway over an oral airway is:
|
it may be tolerated by a patient with a gag reflex.
|
|
|
The average adult male lung volume is:
|
6 L
|
|
|
If 30 seconds have elapsed from the last ventilation and tracheal intubation has not been accomplished, you should:
|
remove the tube, ventilate, and then try again.
|
|
|
Endotracheal intubation as part of a resuscitation sequence:
|
should not be done if it requires interruption of chest compressions for >10 seconds.
|
|
|
The primary control center for respiratory rate is located in the:
|
medulla
|
|
|
Prior to inserting a Combitube you would do all EXCEPT:
Choose one answer. a. check both cuffs for proper inflation pressures. b. insert a stylet into the blue tube. c. position the head in a neutral position. d. lubricate the distal end of the tube. |
insert a stylet into the blue tube.
|
|
|
The combined pressure of all atmospheric gases at sea level is:
|
760 torr
|
|
|
All of the following are complications of endotracheal intubation EXCEPT:
Choose one answer. a. placing the tube in the trachea without use of a stylet. b. accidental intubation of the esophagus. c. fractured teeth or dentures. d. insertion of the ET tube too far down in the trachea. |
placing the tube in the trachea without use of a stylet.
|
|
|
To ensure proper placement of an orogastric or nasogastric tube, you should:
|
auscultate over the stomach while injecting 30-50 cc of air.
|
|
|
In suctioning the nasopharynx of the adult patient:
|
preoxygenate the patient with 100% oxygen
|
|
|
Although cricoid pressure is no longer used, it is important to understand its function in early EMS. Essentially, it was once used in:
|
preventing gastric regurgitation
|
|
|
"Compliance" means:
|
the ease with which the lungs are inflated
|
|
|
One of the most important precautions to be taken while using the multi-lumen airway is:
|
auscultation for breath sounds following insertion.
|
|
|
Which of the following is TRUE regarding the use of a gas-powered positive pressure airway device?
Choose one answer. a. It should never be placed on a patient who is experiencing pulmonary edema. b. Compliance of the lungs is easily detectable. c. It can be used safely in the pediatric patient with adult settings. d. There is danger of gastric distention when it is used in a non-intubated patient. |
D
|
|
|
The large, shield-shaped cartilage in the anterior neck is the:
|
thyroid cartilage.
|
|
|
The FIRST step that you should perform after the Combitube has been placed and both cuffs inflated should be to:
|
auscultate for breath sounds.
|
|
|
Your 55 year old COPD patient has been placed on O2 via nasal cannula at 6 lpm. You are delivering approximately how much oxygen to this patient?
|
40%
|
|
|
Which of the following are contraindications to the use of a demand valve?
Choose one answer. a. patients with a lung removed. b. all of these are contraindications. c. small children. d. patient who is making no attempt to breathe. |
B
|
|
|
Anatomic dead space is generally approximately:
|
150 cc.
|
|
|
You have placed a regulator on your M cylinder on your ambulance. The purpose of this regulator is to "step down" the oxygen pressure to:
|
50psi
|
|
|
The preferred method for managing the airway of the unconscious patient is:
|
endotracheal intubation
|
|
|
The anterior portion of the roof of the mouth is called the:
|
hard palate
|
|
|
When tracheal suctioning is performd, the suction is applied:
|
intermittently while removing the catheter.
|
|
|
Which of the following should be considered when ventilating a patient with a BVM?
Choose one answer. a. change in compliance b. gastric distention c. improvement or deterioration of condition d. all of these are important |
all
|
|
|
In a healthy person, average tidal volume is:
|
5-7 cc/kg.
|
|
|
Your 4 year old patient was eating lunch and began choking on a piece of food. At first, he was moving air and coughing. Now he appears to be turning blue and is making high-pitched, squeaking noises. You should:
|
perform subdiaphragmatic abdominal thrusts
|
|
|
All of the following are potential contraindications for insertion of a standard adult size Combitube (SA) EXCEPT:
Choose one answer. a. any patient with a gag reflex. b. patients over 7 feet tall. c. patients who have ingested strong acids or base. d. patients with abdominal distention. |
D
|
|
|
You have intubated your patient with an ET tube, and you note diminished breath sounds over the left lung on auscultation. What is the probable cause?
|
The tube is too far down the right bronchus
|
|
|
All of the following can assist in opening the airway EXCEPT:
Choose one answer. a. ventilate the patient with a BVM. b. suction the mouth and hypopharynx. c. insert an oropharyngeal airway. d. extend the neck and pull the jaw forward. |
ventilate the patient with a BVM.
|
|
|
The correct head position for performing endotracheal intubation is:
|
the sniffing position
|
|
|
The depression between the epiglottis and the base of the tongue is the:
|
vallecula
|
|
|
In performing a jaw thrust maneuver:
|
displace the mandible anteriorly
|
|
|
Your 30 year old male patient was involved in an MVA and is suffering from a possible head injury. You have decided to decompress his stomach with an orogastric tube. To properly measure the tube, you should measure from the:
|
xiphoid process to the nose to the ear
|
|
|
Your patient has a Combitube in place but has regained consciousness and is fighting the airway. The BEST course of action would be to:
|
prepare to suction and remove the Combitube.
|
|
|
Nasotracheal intubation may be considered for intubating all of the following patients EXCEPT:
Choose one answer. a. a status epilepticus patient b. a CHF patient who is laboring to breathe. c. an apneic patient d. an asthma patient who is breathing. |
an apneic patient
|
|
|
Which of the following would be the BEST indicator that the Combitube is positioned in the trachea?
Choose one answer. a. breath sounds with ventilations on Port #2. b. no breath sounds with ventilations on either port. c. breath sounds with ventilations on Port #1. d. coughing, movement, bucking or straining by the patient. |
breath sounds with ventilations on Port #2.
|
|
|
Which BEST describes the technique of laryngoscopy?
|
Insert the curved blade from the right side, move the tongue to the left, and fit it into the vallecula.
|
|
|
Your 72 year old patient is unresponsive. He is breathing deeply with gasping respirations, and you note that his blood sugar is greater than 350 mg/dcL. His respirations are most likely:
|
Kussmaul's respirations.
|
|
|
Which of the following would be MOST helpful when opening an airway completely occluded by a foreign body?
|
Magill forceps and direct laryngoscopy
|
|
|
An involuntary deep breath that increases opening of the alveoli is a:
|
sigh
|
|
|
When performing tracheobronchial suctioning on your 72 year old male patient, you should apply suction for no longer than:
|
15 seconds
|
|
|
Alveolar volume in the average adult male is approximately:
|
350 cc
|
|
|
When using a stylet for intubation, the tip of the stylet:
|
shouldn't extend past Murphey's eye on the tube
|
|
|
The transfer of care to the receiving facility staff should always include:
|
giving a formal verbal briefing about the patient.
|
|
|
Marks: 1
For which of the following patients would a burette chamber IV tubing be appropriate? Choose one answer. a. a 5 year old in hypovolemic shock b. a 24 year old MVC/MVA victim c. a 24 year old in anaphylactic shock d. a 5 year old receiving IV antibiotics |
D
|
|
|
Systems that transmit and receive on the same frequency are:
|
simplex
|
|
|
Eye contact is an important part of nonverbal communication because:
|
you can hold the attention of a patient in a time of need.
|
|
|
Saying "Don't worry, everything will be alright" is an example of:
|
providing false reassurance.
|
|
|
You've arrived at ABC Plastics for an unknown medical emergency. Bystanders state that your patient may have been exposed to dihydropyrophosphate and organophosphate used in the making of plastics. What signs or symptoms would you NOT expect to encounter from such an exposure?
|
dilated pupils
|
|
|
A beta-2 specific agent will cause what physiologic response?
|
bronchodilation
|
|
|
Which of the following routes of administration is NOT parenteral?
Choose one answer. a. endotracheal (ET) b. topical (TD) c. intraosseous d. intravenous (IV) |
B
|
|
|
One way to build trust and rapport with a patient is to:
|
use a professional, but compassionate tone.
|
|
|
Should a legal case be brought against you, your best defense in court is usually:
|
a complete and thorough PCR.
|
|
|
A tear in the tracheo-bronchial tree or a pneumothorax can be characterized by _____________________ in the neck.
|
subcutaneous emphysema
|
|
|
Drugs that have accepted medical indications and a relatively low abuse potential that may nevertheless lead to limited physical or psychological dependence are classified as:
|
Schedule III.
|
|
|
When in a situation using an interpreter, it is important to:
|
ask only one question at a time.
|
|
|
Variables to consider when determining the proper method of drug storage include all of the following EXCEPT:
|
packaging.
|
|
|
You are palpating the abdomen of a 60 year old male, and you feel a structure in the right upper quadrant (RUQ). Upon percussion of the area, you hear a dull sound. The underlying structure is probably:
|
liver
|
|
|
You are examining a patient's peripheral vasculature when you note that he has no radial pulse. Your next step would be to:
|
palpate a more proximal pulse site.
|
|
|
Glucagon will affect blood glucose levels by:
|
stimulating glycogenolysis and gluconeogenesis, increasing blood glucose levels.
|
|
|
The abbreviation "Hgb" stands for:
|
hemoglobin
|
|
|
The best method for determining responsiveness to painful stimuli in an infant patient is to:
|
flick the soles of her feet.
|
|
|
Arterial occlusions, retinal hemorrhages, and cataracts can be visualized with a(n):
|
opthalmoscope
|
|
|
The standard sequence for examining the chest is:
|
inspect, palpate, percuss, auscultate.
|
|
|
"Please tell me about your abdominal pain" is an example of what type of question?
|
open ended question
|
|
|
A 48 year old female is complaining of arm pain. You initially inspect and palpate her arms and find no abnormalities. Your next step in the exam would be to:
|
evaluate range of motion
|
|
|
The S2 heart sound represents:
|
closing of the semilunar valves
|
|
|
Social distance refers to a space between people of:
|
4-12 feet
|
|
|
By placing the tip of the index finger into the depression in front of the tragus and asking the patient to open his mouth, the paramedic can evaluate the:
|
temporomandibular joint.
|
|
|
You are examining a patient who has "passed out", as reported by friends. Upon reviewing medications carried by the patient, you discover he is taking Zidovudine (Retrovir). You suspect the patient has which of the following medical conditions?
|
ARC/HIV
|
|
|
The proper site for placement of an intraosseous needle for the pediatric patient is the:
|
medial aspect of the proximal tibia.
|
|
|
You and your partner are treating a 27 year old asthmatic patient outside a bar when a growing crowd becomes hostile and unruly. To protect yourself, your partner, and the patient, you should:
|
remove yourselves and the patient from the scene.
|
|
|
Skin color is best evaluated at the:
|
nailbeds and conjunctiva.
|
|
|
Seeking out and recording pertinent negatives demonstrates the:
|
thoroughness of your examination.
|
|
|
The standard charting abbreviation for Tylenol (acetaminophen) is:
|
APAP.
|
|
|
To correct an error on the PCR, the Paramedic should:
|
cross it out with a single line.
|
|
|
A sign or a symptom that causes a patient or bystander to request medical help is known as the:
|
chief complaint
|
|
|
To check anteriorly for symmetrical chest expansion, you should place your thumbs along the ___________ and ask the patient to inhale.
|
costal margins
|
|
|
Which of the following is an "official" name of this common sedative?
|
diazepam, USP
|
|
|
The S3 ventricular heart sound is characterized by the sound:
|
"lub-dub-dee."
|
|
|
Which of the following is a "generic" name?
|
meperidine hydrochloride
|
|
|
It is important to be careful what you say to a child because the child:
|
takes words very literally.
|
|
|
Using "why" questions is poor interviewing technique because it:
|
appears to place blame on the patient.
|
|
|
Arms extended, open hands, relaxed large muscles, and a nodding head all characterize a(n):
|
open stance
|
|
|
Focusing the patient on one particular factor of the interview is known as:
|
confrontation
|
|
|
A physician orders 0.9% normal saline to be administered to a patient at a rate of 125 cc/hr. The administration set that you will be using is a macrodrip set with a drip factor of 12 gtts/ml. At what rate would you run the infusion?
|
25 gtt/min
|
|
|
One of the first bits of information to be transmitted to the base physician is the:
|
unit and provider information.
|
|
|
Why do patient refusals generally warrant more thorough documentation than the typical EMS call?
|
The potential for abandonment charges is greater
|
|
|
____________________ are documents containing vital information, affixed to the patient during large-scale incidents with multiple patients.
|
Triage tags
|
|
|
At 6 months of age, a baby can:
a. play "peek-a-boo". b. begin to respond to the word "no". c. quickly shift moods from crying to laughing. d. make one-syllable sounds. |
A
|
|
|
The main duties of the dispatcher after sending the responders and providing prearrival instructions include:
|
support and coordination.
|
|
|
Blood is administered with which IV solution?
|
Normal Saline
|
|
|
A 5 year old is introduced to you as Robert Smith. The proper way for you to address him as:
|
"Hi, Robert."
|
|
|
A person who has a visual acuity test result of 20/100 can see at ____ feet what a normal person can see at ____ feet.
|
20, 100
|
|
|
A condition marked by exaggerated lumbar concavity (swayback) is called:
|
lordosis
|
|
|
Special considerations must be given to pregnant, pediatric, and geriatric patients with regard to medication administration because they:
|
present with variations in metabolic function, fluid distribution, and body composition.
|
|
|
You suspect that a patient is dehydrated. When checking for skin turgor, you should:
|
pick up a fold of skin and then release it, looking for tenting.
|
|
|
One of the main reasons you should call for additional assistance when dealing with multiple patients is that:
|
you cannot safely and effectively treat them all
|
|
|
By the age of 80, cardiac vessel elasticity has decreased by approximately:
|
50%
|
|
|
A person who electronically records patient information may be subject to _______ charges for defaming a person in writing.
|
libel
|
|
|
The patient care form is all of the following EXCEPT:
|
a public record available on request.
|
|
|
All of the following encourage patient communication EXCEPT:
|
use of sophisticated medical terminology.
|
|
|
Your patient is complaining of respiratory distress. In ruling out congestive heart failure, the absence of swollen ankles would be a(n):
|
pertinent negative.
|
|
|
You are dispatched to a residence where a three year old male presents with a fever. His parents state that he has had diarrhea and been vomiting for two days. The patient has not eaten in 24 hours. To best assess his peripheral perfusion status, you should evaluate:
|
capillary refill.
|
|
|
When dealing with a hostile patient, you should:
|
be sure to leave yourself a clear path to the nearest exit.
|
|
|
For cannulation of the external jugular vein, place the patient in the:
|
supine or Trendelenburg position.
|
|
|
Without formal transfer of care to the receiving hospital, paramedics could be charged with:
|
abandonment
|
|
|
You are completing your PCR and cannot remember the correct spelling of a medical term. You should:
|
use plain English to document instead.
|
|
|
You are examining a patient's face. Upon observing the external eyes, you notice a droop to the eyelids. This condition is known as:
|
ptosis
|
|
|
A loud, harsh sound over the trachea suggests:
|
foreign body obstruction
|
|
|
Which of the following is usually the FIRST sign of extravasation at an IV site?
Choose one answer. a. bleeding at the IV site b. edema at the IV site c. redness of the IV site d. warmth of the IV site |
B
|
|
|
In terms of written communications, a neat and complete PCR is a good indicator of:
|
professionalism
|
|
|
At which rate does breathing become ineffective for an infant?
|
60 breaths per minute
|
|
|
Serum glucose cannot readily pass through the cellular membrane without insulin first affecting the permeability of the membrane. This process of glucose's "reliance" upon insulin for access into the cell is known as:
|
facilitated transport.
|
|
|
The process in which a paramedic places a hand on a body part and then sharply taps a distal knuckle with the tip of another finger is known as:
|
percussion
|
|
|
A scalp condition marked by mild flaking of the skin is known as:
|
dandruff
|
|
|
Echoing a patient's message back to him using your own words is an example of:
|
reflection
|
|
|
A _____________ system uses a computer to route transmissions to the first available frequency.
|
trunked
|
|
|
Hypersecretion of thyroid hormone in adults may result in:
|
tachycardia
|
|
|
A 23 year old is complaining of lower abdominal and genital pain. Upon examination, you find a white, curd-like vaginal discharge with a sweet odor. This is indicative of:
|
candidiasis
|
|
|
To test the nervous system for pain sensation, you should:
|
use a sharp object and assess for sharp or dull sensation.
|
|
|
All of the following are indications for intravenous access EXCEPT:
Choose one answer. a. fluid and blood replacement. b. allergy testing. c. drug administration. d. obtaining venous blood specimens |
allergy testing.
|
|
|
A patient would be positioned in a __________ position and at a ____ degree angle to be assessed for JVD.
|
supine, 45
|
|
|
Which of the following is a complication associated with the use of infusion pumps?
|
extravasation
|
|
|
At what age does "magical thinking" begin?
|
24-36 months
|
|
|
Which best describes "magical thinking"?
|
thinking or wishing something can cause it to occur
|
|
|
Marks: 1
School-age children usually develop all of the following EXCEPT: Choose one answer. a. decision-making skills. b. an extreme sense of privacy. c. self-concept. d. self-esteem. |
B
|
|
|
While a person is thinking under pressure, hormones can diminish his or her:
|
concentration ability.
|
|
|
Palpation and inspection of the PMI (apical impulse) is best accomplished with the patient:
|
in the left lateral decubitus position
|
|
|
You are examining a patient who complains of difficulty breathing. Upon auscultation of the lung fields you notice a light, popping, nonmusical sound. This is known as:
|
crackles
|
|
|
An addition or supplement to an original report is called a(n):
|
addendum
|
|
|
Loss of teeth due to cavities or periodontal disease can lead to all of the following EXCEPT:
Choose one answer. a. increased weight gain. b. vitamin and mineral deficiencies. c. increased chance of malnutrition. d. changes in diet. |
A
|
|
|
During the late adulthood, years, there is a(n):
|
decrease in T3 production.
|
|
|
Fontanelles usually remain open until approximately:
|
18 months to 2 years of age.
|
|
|
_________________ can make changes and addition to the original PCR.
|
The original author
|
|
|
When percussing the chest, the finger should lie ______ to and _________ the ribs.
|
parallel, between
|
|
|
While evaluating neurologic status in an elderly patient, you ask him to stick out his tongue. You notice that it deviates to the right. This is probably due to a lesion to the patient's ______________ cranial nerve.
|
hypoglossal
|
|
|
Microdrip tubing delivers how many drops (gtts) per milliliter?
|
60 gtts/ml
|
|
|
At the end of systole, a paramedic can listen for the __________ heart sounds at the _______ intercostal space.
|
S2, 2nd
|
|
|
The federal agency that control and regulates nongovernmental communications is the:
|
FCC
|
|
|
Effusion is characterized by diminished or absent lung sounds in the affected area and is defined as:
|
fluid in the pleural space.
|
|
|
All of the followinng are Schedule I drugs EXCEPT:
Choose one answer. a. mescaline. b. LSD. c. opium. d. heroin. |
opium
|
|
|
The bone MOST commonly used for intraosseous access is the:
|
tibia
|
|
|
The condition of a patient's fingernails can give insight into the patient's:
|
self-care and hygiene.
|
|
|
The number of times a minute a radio wave oscillates is its:
|
frequency.
|
|
|
You are assigned to respond to a motor vehicle collision where a car has struck a telephone pole. You assess the patient and find no life-threatening problems during the primary survey (initial assessment). However, your patient cannot move any muscles below her knees. This patient probably has a spinal cord lesion at the level of:
|
L2
|
|
|
A person who shifts the focus of a conversation rather than getting into a discussion of something difficult is using:
|
avoidance language
|
|
|
You arrive on location and begin to "read the scene." You do this by:
|
observing the immediate surroundings.
|
|
|
The time from administration of a drug until it reaches minimum effective concentration is known as the:
|
onset of action.
|
|
|
Serum glucose cannot readily pass through the cellular membrane without insulin first affecting the permeability of the membrane. This process of glucose's "reliance" upon insulin for access into the cell is known as:
|
facilitated diffusion
|
|
|
The official standard for information about pharmaceuticals is the:
|
united States Pharmacopoeia (USP).
|
|
|
The active listening technique of reflection involves:
|
asking for clarification of the patient's complaint.
|
|
|
What pathology may result from a lesion to the posterior pituitary gland causing a hypersecretion of ADH?
|
hyponatremia
|
|
|
You are assessing a 34 year old female who appears to be in hypovolemic shock. You would expect her pulse to be:
|
tachycardic and weak.
|
|
|
Which of the following is NOT an advantage of a nebulizer or a metered dose inhaler?
Choose one answer. a. Implementing or discontinuing drug administration and delivery is easy. b. Supplemental oxygen administered simultaneously can assist a hypoxic patient. c. It is a less expensive method of drug delivery for an EMS system. d. Less medication is needed because it reaches its exact site of action |
It is a less expensive method of drug delivery for an EMS system.
|
|
|
The destruction of red blood cells during blood draw is known as:
|
hemolysis
|
|
|
What pathology may result from a lesion to the posterior pituitary gland causing a hypersecretion of ADH?
|
hyponatremia
|
|
|
As part of the mental status exam, assessing a patient's mood can be accomplished by:
|
observing the patient's verbal and nonverbal behavior.
|
|
|
Which of the following statements is inappropriate for a prehospital care report?
|
The patient was very drunk.
|
|
|
When using direct patient statements during documentation, you should:
|
identify the quote with quotation marks.
|
|
|
Using an otoscope placed in the ear canal, you can examine the patient for ______________ and _________________.
|
tympanic membrane rupture, color changes.
|
|
|
Administering an oral medication to a patient who cannot support his airway may result in:
|
aspiration into the lungs.
|
|
|
In order for a nebulizer to be effective, the patient must have:
|
adequate tidal volume and adequate respiratory rate.
|
|
|
Petechiae are skin lesions characterized by:
|
reddish-purple spots less than 0.5 cm in diameter.
|
|
|
By 4 to 6 months, a child should have:
|
doubled his or her birth weight.
|
|
|
One sign of gonorrhea is males is a(n):
|
profuse, yellow discharge.
|
|
|
A loud, harsh sound over the trachea suggests:
|
foreign body obstruction
|
|
|
Why should the PCR be completed immediately after the call?
|
The information is fresh in your mind.
|
|
|
Palpation and inspection of the PMI (apical impulse) can reveal certain conditions such as:
|
tension pneumothorax.
|
|
|
Moving a finger in an "H" pattern in front of your patient's eyes tests:
|
extraocular muscles.
|
|
|
You are examining a 50 year old male complaining of a fever. You inspect the tympanic membrane and note that it is a pearly, translucent grady color. You conclude that the patient has a(n):
|
normal appearing eardrum.
|
|
|
A drug mixed with a wax-like base that melts at body temperature, allowing absorption by body tissue is called a:
|
suppository.
|
|
|
Questions formed to guide the direction of a patient's answers and to maintain control of the conversation by the questioner are:
|
leading questions.
|
|
|
___________ are the sounds of turbulent blood flow around a partial obstruction in the carotid sinuses.
|
Bruits
|
|
|
A preparation in which a solid does not dissolve in a solvent is known as:
|
suspension
|
|
|
In the first few days of life, the ductus venosus constricts and the foramen ovale closes leading to:
|
an increase in systemic vascular resistance and a decrease in pulmonary vascular resistance.
|
|
|
Inspection of the maxillary sinuses is accomplished by:
|
palpating under the zygomatic arches.
|
|
|
You are called to the scene where a pedestrian has fallen on the sidewalk. When you arrive, the man is sitting up and appears alert and responsive. However, as you attempt to start your interview in your normal manner, you note that he is reluctant to speak with you. How should you proceed?
|
Try to develop rapport by reviewing the reason you were dispatched on the call.
|
|
|
Discoloration over the umbilicus, known as _____________ sign, is a(n) ________________ indicator of intra-abdominal bleeding.
|
Cullen's, late
|
|
|
A complete neurological exam includes assessment of mental status and speech, the motor and sensory systems, reflexes, and the:
|
cranial nerves.
|
|
|
Multiplex systems transmit:
|
voice and data simultaneously
|
|
|
You encounter a patient who was in a motor vehicle collision but was not discovered until three hours later. When you examine the patient, you discover bilateral discolored skin over the mastoid processes. You should suspect:
|
basilar skull fracture.
|
|
|
Which of the following statements regarding rollover motor vehicle crashes is MOST correct?
Choose one answer. a. Ejection of the patient from the vehicle increases the chance of death by 5 times. b. Unrestrained passengers are struck with each change in direction the car makes. c. Injuries to the passengers are usually not serious if seatbelts are worn properly. d. The restrained occupant's head and neck usually remain stationary during a rollover. |
B
|
|
|
Which of the following characteristics of an entry wound MOST likely indicates that the weapon was fired at close range?
Choose one answer. a. Indentation of cutaneous tissues b. Severe bleeding from the wound c. Tattoo marks from powder burns d. Abrasions around the wound |
C
|
|
|
During a lateral impact collision:
|
trauma to the upper extremities depends on the spatial orientation of the arms upon impact.
|
|
|
If a person survives the initial trauma from a shotgun wound at close range:
|
contaminants that were driven into the wound can cause a severe infection.
|
|
|
During a frontal collision, MOST pneumothoraces occur when:
|
the patient takes a deep breath just before impact and the lungs rapidly decompress at the time of impact
|
|
|
A specific attribute of a Level I trauma center is that it:
|
has 24-hour in-house coverage by general surgeons.
|
|
|
A properly worn motorcycle helmet will:
|
not protect the cervical spine
|
|
|
During an explosion, secondary blast injuries occur when:
|
the patient is struck by flying debris, such as shrapnel.
|
|
|
Sudden deceleration of a motor vehicle that is traveling at 60 mph:
|
dissipates tremendous forces and causes major injuries.
|
|
|
Which of the following mechanisms of injury poses the LEAST threat for significant injury?
Choose one answer. a. Vehicular intrusion of greater than 12 inches b. Motorcycle crash at greater than 20 mph c. Vehicle rollover with restrained passenger d. Death of an occupant in the same vehicle |
C
|
|
|
The MOST significant fall occurs from a height greater than:
Choose one answer. a. 10 feet. b. 15 feet. c. 1.5 times the patient's height. d. 2 times the patient's height. |
B
|
|
|
Which of the following is common when adults are struck by motor vehicles, but not when children are stuck?
Choose one answer. a. the patient is thrown under the vehicle and dragged b. the front of the car hits the patient's chest c. head and face strike the front bumper of the vehicle d. adults are more likely to turn away from the vehicle |
D
|
|
|
Which of the following injury mechanisms would MOST likely result in blunt trauma?
Choose one answer. a. The pressure wave caused by a blast b. Small-caliber gunshot wound c. Falling from a tree and onto a fence d. Explosion involving shards of glass |
A
|
|
|
The MOST reliable indicator that significant energy was dissipated by braking before a motor vehicle collision is:
|
the presence of tire skid marks at the scene
|
|
|
Which of the following general statements regarding trauma is MOST correct?
Choose one answer. a. The position of the patient at the time of the event is considered to be an internal factor. b. Rapidly applied amounts of energy are better tolerated than a similar amount of energy applied over a longer period. c. Bullet impact is less if the energy in the bullet is applied to a small area. d. Blunt trauma is difficult to diagnose by paramedics in the field and is often more lethal than penetrating trauma. |
D
|
|
|
The energy stored in an object, such as a bridge pillar, is called __________ energy, and the energy from motion is called __________ energy.
|
potential, kinetic
|
|
|
Children who have outgrown a car seat but are too small to be restrained by seatbelts designed for adults:
|
are at risk for hyperflexion and abdominal injuries.
|
|
|
Which of the following will be of MOST benefit in helping the paramedic predict the type of injuries that a patient experienced?
Choose one answer. a. Mechanism of injury b. Age of the patient c. Index of suspicion d. Past medical history |
A
|
|
|
A vagus nerve-mediated form of cardiogenic shock without compensatory vasoconstriction that may be seen following a blast injury would MOST likely present with:
|
bradycardia and hypotension
|
|
|
The third phase of a motor vehicle accident involves:
|
deceleration of internal organs.
|
|
|
When providing thermal management to a patient in shock, you should avoid applying heating pads to the patient because:
|
heat may cause vasodilation and further decrease blood pressure.
|
|
|
Which of the following hemodynamic parameters is generally decreased, regardless of the etiology of shock?
Choose one answer. a. Central venous pressure b. Mean arterial pressure c. Peripheral vascular resistance d. The patient's heart rate |
B
|
|
|
A weak radial pulse in a patient with shock indicates:
|
Vascular dilation and decreased blood flow
|
|
|
Perfusion is MOST accurately defined as:
|
the circulation of blood through an organ or tissue in amounts adequate to meet the body's demands.
|
|
|
The MOST reliable indicator of the extent and severity of internal bleeding in a trauma patient is the:
|
patient's signs and symptoms.
|
|
|
If a lacerated upper extremity is not fractured, you should:
|
elevate it above the level of the heart.
|
|
|
External bleeding would be the LEAST difficult to control in a patient with a large laceration to the _____________ and a BP of ______ mm Hg.
|
brachial artery, 68/46
|
|
|
During compensated shock:
|
an increase in respiratory rate and depth creates a compensatory respiratory alkalosis to offset metabolic acidosis.
|
|
|
Which of the following two factors DIRECTLY affect cardiac output?
|
Stroke volume and pulse rate
|
|
|
Failure of the body's compensatory mechanisms to preserve perfusion results in all of the following, EXCEPT:
|
an increase in preload
|
|
|
A woman finds her 50-year-old husband unresponsive on the couch. When you arrive and begin your assessment, the wife tells you that her husband experienced an episode of chest discomfort 2 days prior, but refused to seek medical attention. The patient is unconscious and unresponsive; is breathing with a marked reduction in tidal volume; and has rapid, thready radial pulses. Your partner reports that the patient's systolic BP is 70 mm Hg. The MOST appropriate treatment for this patient involves:
|
Assisting his ventilations, applying a cardiac monitor, intubating if necessary, auscultating his lungs, transporting at once, establishing vascular access en route, administering a 200-mL crystalloid bolus if his lungs are clear, and considering a dopamine infusion.
|
|
|
Which of the following statements regarding blood flow is MOST correct?
Choose one answer. a. Ejection fraction is the percentage of blood that the heart pumps per contraction. b. The amount of blood that returns to the atrium remains fixed from minute to minute. c. If more blood returns to the heart, stroke volume decreases and cardiac output falls. d. As more blood is pumped with each contraction, the ejection fraction increases. |
A
|
|
|
The cardiac cycle begins with the onset of myocardial contraction and ends:
|
with the beginning of the next contraction
|
|
|
Which of the following organs or body systems requires a constant blood supply, regardless of external factors?
|
Kidneys
|
|
|
The MOST significant factor that determines how well the body compensates for blood loss is:
|
the period of time over which the blood is lost.
|
|
|
A trauma patient with suspected internal hemorrhage and inadequate breathing requires:
|
Ventilation assistance and rapid transport
|
|
|
The term relative hypovolemia means that:
|
blood volume is inadequate relative to an enlarged vascular system
|
|
|
Which of the following clinical signs or symptoms would you NOT expect to see in a patient with significant dehydration?
|
A decreased pulse rate upon standing
|
|
|
You are administering a normal saline bolus to a patient in hypovolemic shock secondary to severe external blood loss. How much saline will remain in the patient's intravascular space after 20 minutes if you have infused a total of 500 mL?
|
200 ML
|
|
|
Which of the following components is LEAST crucial to the continuous circulation of oxygenated blood throughout the body?
|
Spleen
|
|
|
All of the following are functions of the skin, EXCEPT:
Choose one answer. a. sensing changes in the external environment. b. providing the immune response for the body. c. assisting in the regulation of body temperature. d. protecting the underlying tissue from injury. |
B
|
|
|
A laceration that lies perpendicular to the skin's tension lines:
|
often remains open, heals more slowly, and is more likely to result in abnormal scar formation
|
|
|
When applying a dressing and bandage to a scalp wound, you should:
|
carefully assess the skull for an underlying fracture
|
|
|
Elevation of a bleeding extremity:
|
helps control the bleeding when used in conjunction with direct pressure.
|
|
|
When the ambient temperature is high:
|
blood vessels in the dermis dilate, which increases blood flow to the skin and allows heat to dissipate.
|
|
|
During the secondary phase of a blast injury:
|
flying shrapnel may cause penetrating injuries
|
|
|
Which of the following statements regarding lacerations is MOST correct?
Choose one answer. a. Lacerations are linear cuts that tend to heal well due to their relatively even wound margins. b. The seriousness of a laceration depends on its depth and the structures that have been damaged. c. The first priority in treating a laceration is to cover it with a sterile dressing to prevent infection. d. A laceration must be sutured or otherwise closed within 8 to 10 hours following the injury. |
B
|
|
|
When a patient's leg is entrapped under a crushing object for a prolonged period of time, toxic metabolic waste products are released into the systemic circulation:
|
after the patient's leg is freed from entrapment.
|
|
|
You should splint an open soft-tissue injury to an extremity because:
|
motion of the extremity may disrupt the blood clotting process.
|
|
|
Applying direct pressure to a bleeding wound stops the flow of blood because:
|
it allows platelets to seal the vascular walls.
|
|
|
The swelling that occurs in conjunction with a contusion is caused by:
|
leakage of fluid into spaces between the cells.
|
|
|
Which of the following wounds usually requires substantial irrigation and debridement prior to closure?
|
Degloving injuries
|
|
|
The skin is also referred to as the:
|
integument.
|
|
|
Systemic signs of infection secondary to a soft-tissue injury include:
|
fever and chills.
|
|
|
After controlling the bleeding from a grossly contaminated open wound to the leg, you should next:
|
irrigate with sterile water and apply a sterile dressing.
|
|
|
_________ is a fibrous protein that gives the skin high resistance to breakage under mechanical stress.
|
Collagen
|
|
|
When caring for an amputated body part:
|
early notification of the hospital is important.
|
|
|
The skin helps regulate body temperature through:
|
the production of sweat, which is evaporated from the surface of the skin
|
|
|
During the neovascularization phase of the wound healing process:
|
new blood vessels form as the body attempts to bring oxygen and nutrients to the injured tissue
|
|
|
A crushing or tearing amputation:
|
can result in excessive blood loss due to hemorrhage if the paramedic does not intervene rapidly.
|
|
|
A partial-thickness burn is considered to be critical if it:
|
involves more than 30% of the body surface area
|
|
|
Burn shock is caused by:
|
fluid loss across damaged skin and volume shifts within the rest of the body.
|
|
|
What type of thermal burn is MOST commonly associated with inhalation injury?
|
Steam burns
|
|
|
A superficial burn is:
|
characterized by reddened skin with varying degrees of pain.
|
|
|
Which of the following chemicals corrode the skin and cause massive protein denaturing?
|
Ammonium
|
|
|
Which of the following statements regarding the rule of palm is MOST correct?
Choose one answer. a. It is most accurate when a patient has experienced burns to less than 20% of his or her total body surface area. b. The patient's palm, excluding the fingers, represents 1% of his or her total body surface area. c. The rule of palm is not an accurate estimator of total body surface area burned in pediatric patients. d. The patient's palm, including the fingers, represents 1% of his or her total body surface area. |
B
|
|
|
The LEAST significant complication associated with damage to the skin following a burn injury is:
|
decreased melanin granules.
|
|
|
The LEAST common cause of death from fires is:
|
integument burns
|
|
|
If an acutely burned patient is in shock in the prehospital setting:
|
you should look for another injury as the source of shock.
|
|
|
Most lightning-related injuries occur when the victim:
|
receives a “splash” effect after lightning strikes a nearby object
|
|
|
If intubation of a burn patient becomes necessary, you should avoid cutting the ET tube down to make it shorter because:
|
facial edema may cause tube dislodgement 2 to 3 days after the burn.
|
|
|
Chemicals such as Lewisite and phosgene oxime:
|
are vesicant agents that produce cutaneous blisters rapidly.
|
|
|
A burn patient with a history of chronic obstructive pulmonary disease:
|
may be triaged as a critically burned patient, even if the burn injury is small.
|
|
|
You are caring for a 41-year-old man who was trapped in his burning house before being rescued by fire fighters. He has full-thickness burns to his head and anterior trunk, and mixed partial- and full-thickness burns to both anterior upper extremities. What percent of his total body surface area has been burned?
|
36%
|
|
|
A person who is exposed to cement:
|
may not notice a skin burn for hours because cement penetrates through clothing and reacts with sweat.
|
|
|
A 4-year-old boy pulled a pot of boiling water off of the stove and experienced partial-thickness splash burns to his neck, anterior trunk, and both anterior arms. During your assessment, you note that the child is conscious, but is not crying. He is tachypneic and tachycardic and his skin is cool and moist. Other than the burns, there are no other gross injuries. Which of the following statements regarding this scenario is MOST correct?
|
The child may be hypoglycemic and requires assessment of his blood glucose level.
|
|
|
The progression of a chemical burn is MOSTLY dependent on:
|
the length of time the corrosive chemical remains on the skin.
|
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|
The appropriate treatment for MOST chemical burns is:
|
flushing with copious amounts of water.
|
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When assessing a burn patient, it is MOST important to:
|
be alert for occult trauma that could affect patient outcome.
|
|
|
The detailed physical exam of a severely burned patient is intended to:
|
dentify other injuries that may have a higher priority for treatment
|
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A male patient with a closed head injury opens his eyes in response to pain, makes incomprehensible sounds, and responds to pain with flexion of his arms. His Glasgow Coma Scale (GCS) score is ___, and the MOST appropriate treatment for him involves:
|
7; intubation, ventilations performed at a rate of 10 breaths/min, IV fluids as needed to maintain a systolic BP of at least 90 mm Hg, and maintaining his oxygen saturation at greater than 95%.
|
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|
Which of the following statements regarding a cerebral concussion is MOST correct?
Choose one answer. a. A cerebral concussion is a moderate focal brain injury. b. A concussion results in permanent dysfunction of the cerebral cortex. c. Concussions are usually not associated with structural brain injury. d. Prolonged loss of consciousness is common with a cerebral concussion. |
C
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Autoregulation is MOST accurately defined as:
|
an increase in mean arterial pressure to maintain cerebral blood flow.
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Paralysis of the extremities would MOST likely result from injury to the:
|
cerebral cortex.
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Blood supply to the face is provided PRIMARILY through the:
|
external carotid artery.
|
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When an unrestrained passenger's head strikes the windshield of a motor vehicle following rapid deceleration:
|
compression injuries occur to the anterior portion of the brain and stretching or tearing injuries occur to the posterior portion of the brain.
|
|
|
Signs and symptoms of retinal detachment include:
|
flashing lights, specks, or floaters in the field of vision.
|
|
|
Cerebrospinal fluid (CSF) is manufactured in the __________ of the brain and serves to _______.
|
ventricles, cushion and protect the brain
|
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What type of skull fracture is MOST common following high-energy direct trauma to a small surface area of the head with a blunt object?
|
Depressed fracture
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|
Following a traumatic brain injury, initial swelling of the brain occurs due to:
|
cerebral vasodilation
|
|
|
Which of the following bones is part of the cranial vault AND the face?
|
Ethmoid
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The middle ear consists of the:
|
inner portion of the tympanic membrane and the ossicles.
|
|
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The cerebellum is located in the ____________ part of the brain and is responsible for _______.
|
Inferoposterior, posture and equilibrium
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|
In addition to massive bleeding, injury to a carotid or vertebral artery would MOST likely cause:
|
cerebral hypoxia
|
|
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If a knife is impaled in the neck:
|
a cricothyrotomy may be required to establish a patent airway.
|
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|
Following blunt trauma to the face, a 30-year-old man presents with epistaxis, double vision, and an inability to look upward. You should be MOST suspicious of:
|
an orbital blowout fracture.
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|
The respiratory centers of the brain stem lie within the:
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pons and medulla.
|
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The crista galli:
|
is the anatomic point of attachment of the meninges.
|
|
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Hyperventilation of the brain-injured patient:
|
may be appropriate if the patient exhibits signs of herniation of the brain.
|
|
|
What portion of the eye may become icteric in patients with hepatitis?
|
Sclera
|
|
|
According to the National Spinal Cord Injury Database, MOST spinal cord injuries are caused by:
|
motor vehicle crashes.
|
|
|
The MOST effective method for decreasing morbidity and mortality associated with spinal cord injury (SCI) is:
|
public education and prevention strategies.
|
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|
In addition to the supporting muscles and ligaments found in the vertebral column, the thoracic spine is further stabilized by the:
|
rib attachments.
|
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|
When assigning a Glasgow Coma Scale (GCS) score to a patient who has limb paralysis due to a spinal cord injury, you should:
|
ask the patient to blink or move a facial muscle.
|
|
|
Displacement of bony fragments into the anterior portion of the spinal cord results in:
|
anterior cord syndrome
|
|
|
Spinal shock is a condition that:
|
is usually temporary and results from swelling of the spinal cord.
|
|
|
In which of the following situations would it be MOST appropriate to apply a vest-type extrication device to a patient who is seated in his or her crashed motor vehicle?
a. Unconscious with obvious spinal deformity b. Conscious with bilateral femur fractures c. Confused with lower back pain and tachycardia d. Conscious with neck pain and stable vital signs |
D
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|
|
The spine:
|
is the major structural component of the axial skeleton.
|
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|
A skier wiped out while skiing down a large hill. He is conscious and alert and complains of being very cold; he also complains of neck stiffness and numbness and tingling in all of his extremities. A quick assessment reveals that his airway is patent and his breathing is adequate. You should:
|
immobilize his spine and quickly move him to a warmer environment.
|
|
|
A motorcycle or football helmet should be removed if:
|
the patient is breathing shallowly and access to the airway is difficult.
|
|
|
You have intubated an unconscious, apneic patient with a suspected spinal injury. After confirming proper ET tube placement and securing the tube, you should:
|
ventilate at 10 to 12 breaths/min and monitor end-tidal CO2.
|
|
|
Which of the following statements regarding the hangman's fracture is MOST correct?
Choose one answer. a. Hangman's fractures occur when the patient's skull rapidly accelerates. b. Severe hyperflexion of the neck commonly results in a hangman's fracture. c. It is a fracture of C2 that is secondary to significant distraction of the neck. d. Most hangman's fractures occur during a fall from greater than 10 feet. |
C
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|
The detailed exam for a trauma patient with a significant mechanism of injury and signs of a spinal cord injury:
|
should be performed en route to the hospital.
|
|
|
In which of the following situations would spinal motion restriction precautions likely NOT be necessary?
|
Syncopal episode in which the patient was already seated or supine
|
|
|
Signs of neurogenic shock include all of the following, EXCEPT:
Choose one answer. a. bradycardia. b. flushed skin. c. diaphoresis. d. hypothermia. |
C
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|
|
A compression or burst fracture of the cervical spine would MOST likely occur following:
|
a significant fall in which the patient lands head first.
|
|
|
The phrenic nerve arises from the _________ plexus and innervates the _______.
|
cervical, diaphragm
|
|
|
Hypotension that is associated with neurogenic shock is the result of:
|
Loss of alpha receptor stimulation.
|
|
|
An unconscious trauma patient whose head and neck are passively rotated to one side:
|
should be maintained in this position unless breathing is compromised.
|
|
|
Inability to feel or move below the level of the nipple line indicates injury to which spinal nerve root?
|
T4
|
|
|
A flail chest is characterized by:
|
a free-floating segment of fractured ribs.
|
|
|
The eighth, ninth, and tenth ribs are indirectly attached to the sternum by the:
|
costal cartilage.
|
|
|
Which of the following thoracic injuries generally does NOT require immediate treatment?
|
Myocardial contusion
|
|
|
Which of the following statements regarding the thorax is MOST correct?
Choose one answer. a. The dimensions of the thorax are defined inferiorly by the thoracic inlet. b. The dimensions of the thorax are defined anteriorly by the thoracic vertebrae. c. The thoracic cavity extends to the ninth or tenth rib posteriorly. d. The diaphragm inserts into the anterior thoracic cage below the fifth rib. |
D
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|
|
Following blunt trauma to the anterior chest, a 44-year-old man presents with restlessness, respiratory distress, perioral cyanosis, and tachycardia. Further assessment reveals a midline trachea, engorged jugular veins, and absent breath sounds on the right side of his chest. You should:
|
perform an immediate needle thoracentesis to the right side of the chest.
|
|
|
The anterior-most portion of the heart is the:
|
RIGHT VENTRICLE
|
|
|
Any normotensive patient with a sternal fracture should receive:
|
ECG monitoring.
|
|
|
By definition, a massive hemothorax is characterized by:
|
more than 1,500 mL of blood within the pleural space.
|
|
|
Patients suspected of having a partial tracheal tear should be managed with:
|
the least invasive airway techniques possible.
|
|
|
Most of the heart is protected:
|
anteriorly by the sternum.
|
|
|
Jugular venous distention during a tension pneumothorax:
|
is caused by blood accumulation in the vena cava.
|
|
|
You would NOT expect a patient with a flail chest to present with:
|
hyperpnea
|
|
|
The pressure within the right ventricle is:
|
one fourth of the pressure within the left ventricle.
|
|
|
You should be MOST suspicious that your patient has a pericardial tamponade if he or she presents with hypotension, jugular vein distention, and:
|
normal lung sounds.
|
|
|
The preferred site for performing a needle thoracentesis is:
|
superior to the third rib into the intercostal space at the midclavicular line.
|
|
|
The diaphragm:
|
forms a barrier between the thoracic and abdominal cavities.
|
|
|
Ribs 4 through 9 are the most commonly fractured because:
|
they are less protected by other bony and muscular structures.
|
|
|
Which of the following is NOT a mediastinal structure?
|
Lung
|
|
|
The self-splinting effect observed in patients with chest wall trauma:
|
may cause atelectasis, hypoxemia, or pneumonia.
|
|
|
Barotrauma causes a pneumothorax when:
|
pressure is applied to the chest during a period of inhalation and glottic closure.
|
|
|
A 39-year-old man sustained an abdominal evisceration after he was cut in the abdomen with a machete. The patient is semiconscious and is breathing with a marked reduction in tidal volume. You should:
|
assist ventilations with a bag-mask device; cover the exposed bowel with moist, sterile dressings and protect them from injury; transport at once; and initiate IV therapy en route.
|
|
|
At least two thirds of all abdominal injuries:
|
involve blunt trauma.
|
|
|
Which of the following assessment findings is MOST indicative of intraabdominal hemorrhage?
Choose one answer. a. Diffuse tenderness b. Signs of shock c. Palpable pain d. Nausea and vomiting |
B
|
|
|
Anatomically, the abdominal cavity extends from the:
|
diaphragm to the pelvis
|
|
|
You are dispatched to the parking lot of a shopping mall for an injured person. When approaching the scene, it is MOST important for you to:
|
Observe the scene for dangers.
|
|
|
Grey Turner's sign is defined as ecchymosis to the _________ and is indicative of:
|
flank, retroperitoneal bleeding.
|
|
|
Intraabdominal bleeding may produce few signs and symptoms of trauma because:
|
the intraabdominal cavity can accommodate large amounts of blood.
|
|
|
Fractures of the lower rib cage should make you MOST suspicious for injuries to the:
|
liver or spleen
|
|
|
When assessing a patient with abdominal trauma for distention, you must recall that:
|
a significant amount of blood volume in the abdominal cavity is required to produce distention.
|
|
|
Generalized abdominal pain following rupture of a hollow organ is MOST indicative of:
|
diffuse peritoneal contamination.
|
|
|
What do the spleen and liver have in common?
|
They are both highly vascular and bleed profusely when injured.
|
|
|
Gross hematuria and suprapubic pain following a pelvic injury is MOST indicative of injury to the:
|
BLADDER
|
|
|
Which of the following organs lies within the retroperitoneal space?
Choose one answer. a. Liver b. Ovaries c. Kidneys d. Spleen |
C
|
|
|
Injuries to the vascular structures in the intraperitoneal space:
|
are often caused by shearing forces secondary to blunt trauma.
|
|
|
A 59-year-old construction worker collapsed on the job and fell into a pile of steel rods. Your assessment reveals that he is pulseless and apneic, and has a 12-inch steel rod impaled in his epigastrium. As your partner and a first responder begin CPR, you should:
|
control any external bleeding, stabilize the rod in place with bulky dressings, apply the cardiac monitor, and start at least one large-bore IV line en route to the hospital.
|
|
|
What type of motor vehicle crash poses the LEAST threat for abdominal trauma if the patient is properly restrained?
|
Rear-end crash
|
|
|
Because of its anatomical position in the retroperitoneum, it typically takes high-energy force to damage the:
|
pancreas
|
|
|
During the third collision in a motor vehicle crash:
|
abdominal organs shear from their points of attachment.
|
|
|
EMS providers can have the MOST positive impact on mortality and morbidity from abdominal trauma by:
|
recognizing the need for rapid transport.
|
|
|
The abdomen extends superiorly to the level of the:
|
fourth intercostal space
|
|
|
A young man has an isolated injury to his left lower leg. Your assessment reveals obvious deformity and ecchymosis. Distal circulation, motor, and sensory functions are grossly intact, and the patient is hemodynamically stable. In addition to stabilizing the suspected fracture site, you should:
|
immobilize the knee and the ankle
|
|
|
The fibula
a. is not a component of the knee joint. b. is more easily fractured than the tibia. c. can be felt just beneath the skin. d. forms the distal medial malleolus. |
A
|
|
|
Swelling and inflammation associated with musculoskeletal injuries are reduced:
|
if ice packs are applied during the acute stage of the injury.
|
|
|
The likelihood of experiencing systemic complications from a musculoskeletal injury is related to all of the following factors, EXCEPT the:
Choose one answer. a. splinting method used in the field. b. degree of force that caused the injury. c. anatomic location of the injury. d. patient's overall health. |
A
|
|
|
The energy for muscular contraction is derived from the metabolism of _______ and results in the production of _______.
|
glucose, lactic acid
|
|
|
The FIRST step in splinting a musculoskeletal injury involves:
|
exposing and assessing the injury site.
|
|
|
Which of the following is the BEST example of an indirect injury?
Choose one answer. a. Shoulder dislocation secondary to falling on an outstretched hand b. Patellar fracture after the knee strikes an automobile's dashboard c. Dislocated olecranon process following direct trauma to the elbow d. Fractured ankle after stepping in a hole and twisting the lower leg |
A
|
|
|
Isolated musculoskeletal injuries:
|
often result in short- or long-term disability
|
|
|
The joints that connect the ribs to the sternum are examples of:
|
cartilaginous joints
|
|
|
After ensuring your own safety, your next priority when caring for a patient with an extremity injury is to:
|
prevent further injury
|
|
|
When a person jumps from a height and lands on his or her feet, direct trauma occurs to the:
|
calcaneus.
|
|
|
The MOST significant immediate risk associated with an open fracture is:
|
hemorrhage.
|
|
|
Which of the following musculoskeletal injuries would MOST likely occur together?
Choose one answer. a. Calcaneal and c-spine fractures b. Scaphoid and femur fractures c. Knee dislocation and tibial fracture d. Scapular and clavicular fractures |
C
|
|
|
Which of the following medical conditions would MOST likely cause changes in sensation in a patient with an extremity injury?
Choose one answer. a. Diabetes b. Renal insufficiency c. Rheumatoid arthritis d. Hypertension |
A
|
|
|
You have applied board splints to a suspected lower leg fracture in a young woman and have given her Fentanyl for pain. En route to the hospital, the patient states that the pain is excruciating. Further narcotics fail to relieve the pain. Reassessment of the injured area reveals that the overlying skin is taut and the pedal pulse is weak. You should:
|
loosen the splint, elevate the leg, apply ice, and notify the hospital.
|
|
|
A patient standing with his or her head cocked toward a knocked-down left shoulder MOST likely has a fracture of the:
|
left clavicle
|
|
|
A 45-year-old man was cutting down a large tree when it collapsed, pinning him at the thighs. The patient's wife found him approximately 4 hours after the incident. The patient is conscious and in severe pain. His BP is 128/68 mm Hg, pulse is 120 beats/min and regular, and respirations are 22 breaths/min with adequate depth. In addition to supplemental oxygen and cardiac monitoring, which of the following treatments should you provide BEFORE the tree is removed from his legs?
|
IV therapy with a crystalloid fluid bolus and albuterol via nebulizer or mucosal atomizer device
|
|
|
When assessing distal pulses in a patient with a lower extremity injury, it is MOST important to:
|
compare the strength of the pulses in both lower extremities.
|
|
|
When assessing a multi-systems trauma patient, it is MOST important to:
|
avoid being distracted by visually impressive injuries.
|
|
|
Signs of bursitis include all of the following, EXCEPT:
Choose one answer. a. swelling. b. deformity. c. erythema. d. warmth. |
B
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