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141 Cards in this Set

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Which of the following ECG abnormalities is associated with hypothermia?
A: Osborn wave

B: Flat T waves


C: Peaked T waves


D: Sine wave

A: Osborn wave
Prehospital treatment for a patient with a blood glucose reading of 400 mg/dL and polyuria includes:
A: 40 mg of furosemide via the intravenous route.

B: 10 units of insulin via the subcutaneous route.


C: fluid rehydration with an isotonic crystalloid.


D: 25 g of 50% dextrose via the intravenous route.

C: fluid rehydration with an isotonic crystalloid.

In addition to CPR, treatment for a patient in cardiac arrest with a core body temperature of 90°F includes:

A:avoiding the use of antidysrhythmics such as amiodarone


B:limiting defibrillation to one attempt only if V-Fib is present


C:spacing epinephrine doses at longer than standard intervals.


D:mild hyperventilation to facilitate the production of heat.

C: spacing epinephrine doses at longer than standard intervals.

Which of the following can MOST easily be assessed without talking to a patient who is experiencing a behavioral crisis?
A: Memory

B: Thought


C: Orientation


D: Affect

D: Affect
Which of the following medications is classified as a tricyclic antidepressant?
A: Buspirone hydrochloride

B: Midazolam hydrochloride


C: Fluoxetine hydrochloride


D: Nortriptyline hydrochloride

D: Nortriptyline hydrochloride
You are called to a local park where a 30-year-old man has collapsed. When you arrive, you find that the patient is disoriented. His skin is hot and moist and his respirations are rapid and shallow. You should suspect:
A: heat prostration.

B: heatstroke.


C: heat exhaustion.


D: heat cramps.

B: heatstroke.
You are dispatched to a residence for a 65-year-old female whose husband reports a change in her behavior over the past several days. He states that initially she seemed forgetful, but today she is confused. Your assessment reveals an obese patient who has slow respirations; cold, dry skin; a heart rate of 50 beats/min; and a blood pressure of 90/50 mm Hg. The patient's husband tells you that his wife does not have any medical problems that he is aware of, but remarks about her weight gain over the past few months. This patient's history and clinical presentation are MOST likely the result of:
A: decreased thyroid hormone production.

B: excess adrenal gland production of cortisol.


C: exacerbation of undiagnosed hyperthyroidism.


D: acute dementia with hypothermia.

A: decreased thyroid hormone production.
You are called to the residence of an elderly man whose daughter states that he is not acting right. The patient becomes combative when you attempt to assess him. He refuses supplemental oxygen and states that you are not taking him anywhere. What is the MOST appropriate course of action?
A: Calmly talk to him and try to obtain a glucose reading.

B: Gently restrain him and transport him to the hospital.


C: Administer 5 mg diazepam IM to calm and sedate him.


D: Start an IV line and administer 25 gm of 50% dextrose.

A: Calmly talk to him and try to obtain a glucose reading.
Which of the following findings is the MOST clinically significant when assessing a patient with a severe headache?
A: An unsteady gait

B: BP of 140/88 mm Hg


C: Retroorbital pressure


D: Nausea or vomiting

A: An unsteady gait
Law enforcement calls you to a nearby alley, where they found an unresponsive young female. One of the officers states that the patient is a known drug abuser. The patient has slow, shallow breathing; a slow, weak pulse; and bilaterally constricted pupils. As your partner begins assisting her ventilations, you apply the cardiac monitor, which reveals sinus bradycardia. After establishing vascular access, you should:
A: begin cardiac pacing at once.

B: give 0.5 mg of atropine.


C: give 0.4 to 2 mg of naloxone.


D: give a 500-mL fluid bolus.

C: give 0.4 to 2 mg of naloxone.
You receive a call for a 55-year-old female who is ill. The patient's husband tells you that she is an alcoholic, and has been "on the wagon" for about a week. The patient is conscious, but confused and restless. Her skin is hot to the touch, she is profusely diaphoretic, and her hands are shaking. Her blood pressure is 180/90 mm Hg, pulse is 120 beats/min, respirations are 24 breaths/min, and oxygen saturation is 98% on room air. You should:
A: establish vascular access, administer 100 mg of thiamine and 25 g of 50% dextrose IV push, apply oxygen via nasal cannula, orient her and provide reassurance, and transport.

B: provide reassurance, establish vascular access and give a saline bolus, give oxygen via nonrebreathing mask, administer 5 mg of diazepam to prevent seizures, and transport.


C: administer high-flow oxygen via nonrebreathing mask, establish vascular access, give 2 to 5 mg of midazolam for sedation, monitor her cardiac rhythm, and transport.


D: provide emotional support, administer oxygen via nasal cannula, establish vascular access, monitor her cardiac rhythm, assess her blood glucose level, and transport.

D: provide emotional support, administer oxygen via nasal cannula, establish vascular access, monitor her cardiac rhythm, assess her blood glucose level, and transport.
Shorly after his dialysis treatment, a 66-year-old man presents with confusion, a headache, and nausea. You should suspect:
A: interstitial nephritis.

B: disequilibrium syndrome.


C: severe hyperkalemia.


D: acute air embolism.

B: disequilibrium syndrome.
You enter an elderly man's residence and find him sitting on the couch with his eyes closed. His respirations appear to be deep and rapid. You should:
A: manually open his airway.

B: check for a carotid pulse.


C: assess his mental status.


D: quickly move him to the floor.

C: assess his mental status.
Obsessive-compulsive disorder falls under which of the following categories?
A: Posttraumatic stress disorder

B: Generalized anxiety disorder


C: Organic brain syndrome


D: Schizophrenia

B: Generalized anxiety disorder
At 2:30 AM, you respond to a crowded homeless shelter for a 52-year-old male who is sick. The patient complains of intense itching to his hands and axillae. Assessment of these areas reveals the presence of a rash. The patient denies any medical problems, but states that he was stung by a hornet two days ago. Which of the following should you suspect?
A: Allergic reaction

B: Herpes simplex


C: Lice


D: Scabies

D: Scabies
A 64-year-old man presents with an acute onset of left-sided weakness, right-sided facial droop, and slurred speech. He is conscious, but confused. You should be MOST suspicious for:
A: left-sided ischemic stroke.

B: left-sided hemorrhagic stroke.


C: right-sided hemorrhagic stroke.


D: right-sided ischemic stroke.

D: right-sided ischemic stroke.
You are assessing a patient who presents with a melena and abdominal pain. Which of the following medical history findings is the MOST clinically significant?
A: Hypertension

B: Type II diabetes mellitus


C: Hashimoto disease


D: von Willebrand disease

D: von Willebrand disease
Prehospital treatment for a patient in ventricular fibrillation who has a core body temperature of less than 86°F (30°C) includes:
A: limiting defibrillation to one attempt only.

B: administering lidocaine instead of amiodarone.


C: doubling the dose of all medications.


D: hyperventilation with warm humidified oxygen.

A: limiting defibrillation to one attempt only
Disequilibrium syndrome, a condition associated with dialysis, manifests with signs and symptoms of:
A: increased intracranial pressure.

B: high serum potassium levels.


C: severe hypokalemia.


D: excessive catecholamine release.

A: increased intracranial pressure.
After being stung by a hornet, a 34-year-old man is unresponsive, has stridorous respirations, a generalized rash, and swelling to the face and neck. His BP is 70/44 mm Hg, his pulse is 140 beats/min and thready, and his respirations are 36 breaths/min and labored. Which of the following represents the MOST appropriate treatment for him?
A: Needle cricothyrotomy and 0.3 to 0.5 mg of epinephrine 1:1,000 SC

B: Orotracheal intubation and 0.1 mg of epinephrine 1:10,000 IV or IO


C: Blind nasal intubation and 3 to 5 mg of epinephrine 1:10,000 IV or IO


D: Bag-mask ventilation and 0.3 to 0.5 mg of epinephrine 1:1,000 SC

B: Orotracheal intubation and 0.1 mg of epinephrine 1:10,000 IV or IO
Following ingestion of a toxic dose of acetaminophen, right upper quadrant abdominal pain typically begins within:
A: 4 to 14 days

B: 24 to 72 hours


C: 72 to 96 hours


D: 12 to 24 hours

B: 24 to 72 hours
After performing your primary assessment and initial treatment of an unresponsive patient who has not been injured, you should:
A: obtain vital signs.

B: perform a detailed head-to-toe exam.


C: obtain a SAMPLE history.


D: perform a rapid assessment.

D: perform a rapid assessment.
You arrive at a local community center where a 30-year-old man has been having a seizure for the past 20 minutes. After properly managing his airway and establishing vascular access, you should give:
A: 0.4 to 2 mg of naloxone.

B: 5 to 10 mg of diazepam.


C: 25 g of glucose.


D: 100 mg of thiamine.

B: 5 to 10 mg of diazepam.
A 27-year-old female overdosed on an unknown type of drug. Her skin is hot and flushed, her breathing is rapid and deep, and she has an acetone odor on her breath. Her BP is 98/64 mm Hg and her heart rate is 120 beats/min. Which of the following drugs would MOST likely explain her clinical presentation?
A: Alcohol

B: Cocaine


C: Aspirin


D: Heroin

C: Aspirin
A 34-year-old woman overdosed on amitriptyline. She is unresponsive and has slow, shallow breathing. Her BP is 70/40 mm Hg and her heart rate is 140 beats/min. The cardiac monitor reveals sinus tachycardia. Initial treatment for her should include:
A: assisted ventilation with a bag-mask device and 0.2 mg of flumazenil IV push.

B: high-flow oxygen via nonrebreathing mask and 0.4 to 2 mg of naloxone IV push.


C: endotracheal intubation and 1 to 2 mEq/kg of sodium bicarbonate IV push.


D: assisted ventilation with a bag-mask device and 20 mL/kg normal saline boluses.

D: assisted ventilation with a bag-mask device and 20 mL/kg normal saline boluses.
A 43-year-old woman was stung by a scorpion. Within 5 minutes, she developed swelling to her face and diffuse urticaria. She is confused and has a BP of 80/60 mm Hg. After administering supplemental oxygen, you should give:
A: 125 mg of methylprednisolone IV.

B: 0.1 mg of epinephrine 1:10,000 IV.


C: a rapid 500 mL normal saline bolus.


D: 25 to 50 mg of diphenhydramine IM.

B: 0.1 mg of epinephrine 1:10,000 IV.
Which of the following is a defining factor in the transition from human immunodeficiency virus (HIV) infection to acquired immunodeficiency syndrome (AIDS)?
A: Transient increase in the T-cell count

B: Fever that lasts greater than 7 days


C: Antibodies are detected in the blood


D: Development of opportunistic infections

D: Development of opportunistic infections
A 23-year-old man was working near a wood pile when he experienced a sudden, sharp pain in his leg. Your assessment reveals that his level of consciousness is decreased and he is experiencing intense abdominal spasms. This clinical presentation is MOST consistent with the bite of a:
A: brown recluse spider.

B: black widow spider.


C: coral snake.


D: rattlesnake or other pit viper.

B: black widow spider.
Which of the following is MOST indicative of an infectious or communicable disease?
A: Sore throat and nasal discharge

B: Severe headache and photophobia


C: Persistent fever and night sweats


D: Vomiting and diarrhea for 3 days

C: Persistent fever and night sweats
Diarrhea, marked bradycardia, miosis, and hypersalivation are MOST consistent with a/an _____________ toxidrome.
A: opiate

B: sympatholytic


C: cholinergic


D: amphetamine

C: cholinergic
A young male intentionally ingested unknown quantities of ibuprofen, aspirin, Lortab, and Anafranil. He is unresponsive, and is hypoventilating, bradycardic, and hypotensive. Which of these drugs is the MOST likely cause of his clinical presentation?
A: Aspirin

B: Lortab


C: Ibuprofen


D: Anafranil

B: Lortab
Your assessment of a patient reveals a diffuse petechial rash. Which of the following hematologic disorders does this indicate?
A: Leukopenia

B: Polycythemia vera


C: Hemolytic anemia


D: Thrombocytopenia

D: Thrombocytopenia
A 33-year-old female was stung by a scorpion 45 minutes ago. She is conscious and alert, and presents with diffuse urticaria and intense itching. She denies chest tightness or difficulty breathing. Her breath sounds are clear and equal bilaterally. Her BP is 134/82 mm Hg, pulse is 104 beats/min and strong, respirations are 16 breaths/min and unlabored, and her SpO2 is 95% on room air. The MOST appropriate treatment for this patient includes:
A: assisted ventilation, IV of normal saline, 3 to 5 mL of epinephrine 1:10,000 IV.

B: supplemental oxygen, IV of an isotonic crystalloid, 25 mg diphenhydramine IV.


C: oxygen at 2 L/min via nasal cannula, 0.3 mg epinephrine 1:1,000 SQ, IV of normal saline.D: an IV of an isotonic crystalloid, 0.1 mg epinephrine 1:10,000 IV, 25 mg diphenhydramine IV.

B: supplemental oxygen, IV of an isotonic crystalloid, 25 mg diphenhydramine IV.
You are assessing a young female and are trying to determine if she experienced a seizure or a syncopal episode. Which of the following findings is MOST consistent with a seizure?
A: A bottle of lorazepam is found in her purse.

B: Her heart rate is 120 beats/min.


C: The episode occurred while she was standing.


D: The cardiac monitor displays sinus bradycardia.

B: Her heart rate is 120 beats/min.
Which of the following is MOST indicative of hyperglycemic ketoacidosis?
A: Bradypnea

B: Acute onset


C: Hyperpnea


D: Diaphoresis

C: Hyperpnea
A 39-year-old man reports nausea, lack of coordination, and frequently recurring headaches that have been getting progressively worse over the past 2 months. He denies any past medical history or head injury. On the basis of this presentation, which of the following should you suspect?
A: Chronic epidural hematoma

B: Ruptured cerebral arterial aneurysm


C: Acute subarachnoid hemorrhage


D: Space-occupying intracranial lesion

D: Space-occupying intracranial lesion
You are called to a residence for a woman who swallowed an unknown quantity of pills. Which of the following should you inquire about FIRST?
A: A history of psychiatric care

B: When the pills were taken


C: The patient’s weight in kilograms


D: What kind of pills were taken

D: What kind of pills were taken
Angioedema in a patient with a severe allergic reaction poses an immediate threat to life secondary to:
A: airway compromise.

B: intracranial pressure.


C: congestive heart failure.


D: compartment syndrome.

A: airway compromise.
Which of the following statements regarding lightning injuries is correct?
A: Lightning is alternating current that causes severe damage to the nerves and microvasculature.B: Asystole following a lightning strike is generally intractable and responds poorly to CPR.

C: Muscle that is injured by lightning produces methemoglobin, which can damage the kidneys.D: Lightning injuries tend to resemble blast injuries more than they do high-voltage injuries.

D: Lightning injuries tend to resemble blast injuries more than they do high-voltage injuries.
You would expect to encounter trismus in a patient with:
A: rabies.

B: tetanus.


C: mumps.


D: meningitis.

B: tetanus.
When released into the bloodstream, glucagon:
A: stimulates the liver to convert glycogen to glucose.

B: stimulates the liver to take in glucose and store it as glycogen.C: directly increases circulating blood glucose levels.


D: facilitates the cellular uptake of glucose for energy production.

A: stimulates the liver to convert glycogen to glucose.
You respond to a lake at a state park where bystanders pulled a 44-year-old male from the water and are performing CPR on him. According to a park ranger, the water temperature of the lake is 85°F. No one witnessed the patient's submersion; however, one of his friends tells you that he is a diabetic and had been drinking beer all day. The cardiac monitor reveals a wide-complex bradycardic rhythm. In addition to CPR, further treatment should include:
A: cardiac pacing, intubation, gastric tube insertion, vascular access, 40 units of vasopressin, thermal management, and 25 g of 50% dextrose.B: spinal precautions, intubation, gastric tube insertion, vascular access, 1 mg of epinephrine, blood glucose assessment, and thermal management.

C: manual gastric decompression, insertion of an advanced airway device, vascular access, 1 mg of epinephrine, and 25 g of 50% dextrose.


D: spinal precautions, insertion of an advanced airway device, hyperventilation, vascular access, 1 mg of epinephrine, and 50 mEq of sodium bicarbonate.

B: spinal precautions, intubation, gastric tube insertion, vascular access, 1 mg of epinephrine, blood glucose assessment, and thermal management.
Which of the following is the BEST way to minimize the hypoxia that occurs in an apneic patient following submersion in water?
A: Frequent oropharyngeal suctioning

B: Prophylactic abdominal thrusts


C: Rescue breathing while in the water


D: Immediate tracheal intubation

C: Rescue breathing while in the water
Which of the following drug overdoses could be reversed with the administration of naloxone?
A: Phenobarbital

B: Midazolam


C: Meperidine


D: Adderall

C: Meperidine
Law enforcement requests your assistance at a convenience store for a combative patient. You arrive at the scene and find the patient, a 49-year-old male, sitting in the back of the police car; his hands are cuffed behind him. One of the police officers tells you that the clerk of the store called 9-1-1 because the patient was acting strange. The patient is conscious and has a patent airway; however, he is agitated, has disorganized speech, and is tachypneic. Further assessment reveals that he is diaphoretic and tachycardic. You should:
A: sit him forward and perform a finger stick to assess his blood glucose level.

B: have his handcuffs removed and immediately move him to the ambulance.


C: administer 5 mg of haloperidol intramuscularly to reduce his agitation.


D: apply the cardiac monitor and assess for the presence of cardiac dysrhythmias.

A: sit him forward and perform a finger stick to assess his blood glucose level.
Functions of the hypothalamus include:
A: controlling level of awareness.

B: influencing breathing.


C: maintaining equilibrium and balance.


D: regulating appetite.

D: regulating appetite.
A 60-year-old male with chronic alcoholism presents with an acute onset of hematemesis. His blood pressure is 80/40 mm Hg, pulse is 130 beats/min and weak, and respirations are 28 breaths/min and shallow. What pathophysiologic process is MOST likely responsible for his condition?
A: Severe bleeding from gastric ulcers that formed due to the excessive intake of alcohol

B: Abnormally enlarged esophageal veins secondary to impaired blood flow to the liver


C: Acute rupture of an esophageal artery secondary to repeated episodes of vomiting


D: Erosion of the large esophageal blood vessels caused by the toxic effects of alcohol

B: Abnormally enlarged esophageal veins secondary to impaired blood flow to the liver
Which of the following statements regarding sickle cell disease is correct?
A: The red blood cells in sickle cell disease have a rounded appearance, rather than the normal oblong appearance.

B: Despite their altered shape, the red blood cells of a person with sickle cell disease are effective carriers of oxygen.


C: In sickle cell disease, misshapen red blood cells can lodge in the spleen, causing it to swell and rupture.


D: When the sickle cell gene is inherited from both parents, the patient will probably not develop the disease.

C: In sickle cell disease, misshapen red blood cells can lodge in the spleen, causing it to swell and rupture
You are called to a residence for a 39-year-old woman, who, according to her husband, is "not acting right." She is confused, is experiencing hallucinations, and is repetitively smacking her lips. Which of the following should you suspect?
A: Simple partial seizure

B: Focal motor seizure


C: Generalized seizure


D: Complex partial seizure

D: Complex partial seizure
A 52-year-old man has a headache and visual disturbances that have progressively worsened over the past 3 months. These symptoms are MOST consistent with:
A: a subdural bleed.

B: an epidural hematoma.


C: a cerebral neoplasm.


D: bacterial meningitis.

C: a cerebral neoplasm.
Your assessment of a patient reveals a diffuse petechial rash. Which of the following hematologic disorders does this indicate?
A: Thrombocytopenia

B: Polycythemia vera


C: Leukopenia


D: Hemolytic anemia

A: Thrombocytopenia
A man was trapped in his burning house for approximately 20 minutes before being rescued by firefighters. Assuming that he was exposed to carbon monoxide (CO), cyanide, or both, it is important for the paramedic to remember that:
A: cyanide is typically found in higher amounts during structural fires than carbon monoxide.

B: unless the patient was unconscious while he was trapped, significant CO or cyanide toxicity is unlikely.


C: carbon monoxide and cyanide are chemical asphyxiants that displace oxygen and impair tissue oxygenation.


D: based on the length of exposure, the patient’s carboxyhemoglobin level is at least 40% to 50%.

C: carbon monoxide and cyanide are chemical asphyxiants that displace oxygen and impair tissue oxygenation.
After performing your primary assessment and initial treatment of an unresponsive patient who has not been injured, you should:
A: obtain a SAMPLE history.

B: perform a detailed head-to-toe exam.


C: obtain vital signs.


D: perform a rapid assessment.

D: perform a rapid assessment.
What is the pathophysiologic difference between cyanide and carbon monoxide?
A: Cyanide destroys the cells of the immune system.

B: Cyanide attaches to the hemoglobin molecule.


C: Carbon monoxide destroys the red blood cells.


D: Carbon monoxide binds with the hemoglobin molecule.

D: Carbon monoxide binds with the hemoglobin molecule.
A 29-year-old male ingested a bottle of extra strength acetaminophen. He presents with malaise and palpable tenderness to the right upper quadrant of his abdomen. He is conscious and alert, his BP is 136/66 mm Hg, his pulse is 100 beats/min and regular, his respirations are 16 breaths/min, and his oxygen saturation is 98%. The MOST appropriate treatment for this patient includes
A: oxygen via nasal cannula at 2 to 3 L/min, an IV of normal saline set to keep the vein open, cardiac monitoring, and transport.

B: oxygen via nasal cannula at 4 to 6 L/min, 1 to 2 g/kg of activated charcoal, IV fluid boluses, cardiac monitoring, and transport.


C: assisted ventilation, IV access, a 500 mL normal saline bolus, 1 mEq/kg of sodium bicarbonate, cardiac monitoring, and transport.


D: oxygen via nonrebreathing mask, 30 mL of ipecac, an IV of normal saline set to keep the vein open, cardiac monitoring, and transport.

A: oxygen via nasal cannula at 2 to 3 L/min, an IV of normal saline set to keep the vein open, cardiac monitoring, and transport.
Increased parasympathetic tone, bradycardia, shunting of blood to the brain, and hypotension describes:
A: Beck’s triad.

B: Cushing’s reflex.


C: Cullen’s sign.


D: the diving reflex.

D: the diving reflex.
You are assessing a 29-year-old male with an apparent emotional crisis. He is agitated and refuses to give you any information because his roommate told him not to trust anyone. His small apartment clearly indicates that he is the sole occupant. Your partner finds a prescription for Zyprexa, which is prescribed to the patient. This patient MOST likely has:
A: bipolar disorder.

B: schizophrenia.


C: obsessive-compulsive disorder.


D: trichotillomania.

B: schizophrenia.
Which of the following clinical presentations is consistent with significant insecticide exposure?
A: Excessive salivation and severe bradycardia

B: Acute urinary retention and abdominal pain


C: Extreme hyperactivity and pupillary dilation


D: A dry cough, tachycardia, and hypertension

A: Excessive salivation and severe bradycardia
A 34-year-old woman overdosed on amitriptyline. She is unresponsive and has slow, shallow breathing. Her BP is 70/40 mm Hg and her heart rate is 140 beats/min. The cardiac monitor reveals sinus tachycardia. Initial treatment for her should include:
A: endotracheal intubation and 1 to 2 mEq/kg of sodium bicarbonate IV push.

B: assisted ventilation with a bag-mask device and 0.2 mg of flumazenil IV push.


C: assisted ventilation with a bag-mask device and 20 mL/kg normal saline boluses.


D: high-flow oxygen via nonrebreathing mask and 0.4 to 2 mg of naloxone IV push.

C: assisted ventilation with a bag-mask device and 20 mL/kg normal saline boluses.
A 49-year-old female complains of severe neck pain. Her head is turned to the side and appears locked in that position. You also note that her eyes are clenched shut. She is conscious, but agitated. Her husband tells you that she started taking lithium the day before after being diagnosed with bipolar disorder. Based on this patient’s clinical presentation, which of the following medications would MOST likely be indicated?

A: Naloxone


B: Diphenhydramine


C: Calcium chloride


D: Haloperidol

B: Diphenhydramine
When the body’s blood glucose level falls, such as following strenuous exercise:
A: the pancreatic beta cells cease insulin production altogether until the blood sugar level increases.

B: the cells metabolize fat, which produces a weaker form of glucose that the body can still utilize.


C: the body’s cells release their glucose stores into the bloodstream to maintain homeostasis.


D: the pancreas secretes glucagon, which stimulates the liver to convert glycogen to glucose.

D: the pancreas secretes glucagon, which stimulates the liver to convert glycogen to glucose.
The clinical presentation of thyroid storm MOST closely resembles that of:
A: heroin overdose.

B: myxedema.


C: amphetamine use.


D: ketoacidosis.

C: amphetamine use.
You receive a call for a 55-year-old female who is ill. The patient's husband tells you that she is an alcoholic, and has been "on the wagon" for about a week. The patient is conscious, but confused and restless. Her skin is hot to the touch, she is profusely diaphoretic, and her hands are shaking. Her blood pressure is 180/90 mm Hg, pulse is 120 beats/min, respirations are 24 breaths/min, and oxygen saturation is 98% on room air. You should:
A: establish vascular access, administer 100 mg of thiamine and 25 g of 50% dextrose IV push, apply oxygen via nasal cannula, orient her and provide reassurance, and transport.

B: administer high-flow oxygen via nonrebreathing mask, establish vascular access, give 2 to 5 mg of midazolam for sedation, monitor her cardiac rhythm, and transport.


C: provide reassurance, establish vascular access and give a saline bolus, give oxygen via nonrebreathing mask, administer 5 mg of diazepam to prevent seizures, and transport.


D: provide emotional support, administer oxygen via nasal cannula, establish vascular access, monitor her cardiac rhythm, assess her blood glucose level, and transport.

D: provide emotional support, administer oxygen via nasal cannula, establish vascular access, monitor her cardiac rhythm, assess her blood glucose level, and transport.
Which of the following is MOST indicative of hyperglycemic ketoacidosis
A: Acute onset

B: Bradypnea


C: Hyperpnea


D: Diaphoresis

C: Hyperpnea
A 27-year-old female overdosed on an unknown type of drug. Her skin is hot and flushed, her breathing is rapid and deep, and she has an acetone odor on her breath. Her BP is 98/64 mm Hg and her heart rate is 120 beats/min. Which of the following drugs would MOST likely explain her clinical presentation?
A: Alcohol

B: Cocaine


C: Heroin


D: Aspirin

D: Aspirin
You are dispatched to a residence for a patient with respiratory distress. The patient, a 59-year-old female, has a tracheostomy tube in place and is ventilator dependent. She has marked respiratory distress, perioral cyanosis, and an oxygen saturation of 80%. You should:
A: disconnect her from the mechanical ventilator and provide manual positive-pressure ventilation.B: suspect tracheostomy tube dislodgement and quickly remove the tube as the patient exhales.

C: adjust the settings on the mechanical ventilator to ensure that she is receiving adequate tidal volume.


D: detach the ventilator tubing from the tracheostomy and suction the tracheostomy tube for 10 seconds.

A: disconnect her from the mechanical ventilator and provide manual positive-pressure ventilation.
A 42-year-old male presents with difficulty breathing, diffuse wheezing, urticaria, and a blood pressure of 74/44 mm Hg. His skin is cool and clammy. Given his clinical presentation, which of the following interventions would be the LEAST effective?
A: 1 to 2 L saline bolus

B: Diphenhydramine, 25 mg IV


C: Epinephrine, 2 µg/min IV


D: Epinephrine, 0.3 mg SC

D: Epinephrine, 0.3 mg SC
Which of the following describes the typical sequence of events that precedes cardiac arrest in a drowning episode?
A: Laryngospasm, hypoxia, dysrhythmias

B: Hypoxia, laryngospasm, dysrhythmias


C: Laryngospasm, dysrhythmias, hypoxia


D: Dysrhythmias, laryngospasm, hypoxia

A: Laryngospasm, hypoxia, dysrhythmias
A patient with diabetic ketoacidosis would typically present with which of the following signs and/or symptoms?
A: Hyperglycemia and oliguria

B: Hypoglycemia and dehydration


C: Hyperglycemia and dehydration


D: Hypoglycemia and polyuria

C: Hyperglycemia and dehydration
A 71-year-old female presents with an altered mental status. According to her husband, she has type II diabetes and hypertension, and was recently diagnosed with a urinary tract infection. Her medications include Glucophage, Zestril, and Bactrim. The patient is confused, and has slurred speech and poor skin turgor. Her blood pressure is 112/60 mm Hg, pulse is 120 beats/min and weak, and respirations are 30 breaths/min and shallow. Her blood glucose level reads "high," but you do not notice any unusual odors on her breath. The primary cause of this patient's problem is MOST likely:
A: severe dehydration due to an infection.

B: primary adrenal insufficiency.


C: hyperglycemic ketoacidosis.


D: hyperosmolar hyperglycemic nonketosis.

D: hyperosmolar hyperglycemic nonketosis.
You are assessing a 32-year-old female who complains of chills, muscle aches, and a headache. She tells you that she began feeling bad a few days ago, and has been taking ibuprofen for her headache. Her blood pressure is 130/72 mm Hg, pulse is 118 beats/min and strong, and respirations are 16 breaths/min and unlabored. The patient denies any significant medical problems and is conscious and alert. Further assessment of this patient will MOST likely reveal:
A: fever.

B: wheezing.


C: petechiae.


D: hypoglycemia.

A: fever.
You are assessing a young female and are trying to determine if she experienced a seizure or a syncopal episode. Which of the following findings is MOST consistent with a seizure?
A: A bottle of lorazepam is found in her purse.

B: The cardiac monitor displays sinus bradycardia.C: The episode occurred while she was standing.D: Her heart rate is 120 beats/min.

D: Her heart rate is 120 beats/min.
Treatment for a patient with a severe migraine headache, nausea, and vomiting includes:
A: 2 mg of morphine sulfate IV.

B: heat packs to the forehead.


C: transport in a supine position.


D: 5 mg of prochlorperazine IV.

D: 5 mg of prochlorperazine IV.
Correct:18Incorrect:27A man was trapped in his burning house for approximately 15 minutes before firefighters rescued him. He reports burning in his throat and a severe headache. He has a blood pressure of 180/90 mm Hg, a pulse rate of 120 beats/min, and labored respirations of 28 breaths/min. In addition to providing supplemental oxygen, treatment should include:
A: rapid transport to a local hyperbaric facility.

B: amyl nitrite inhaled in 20-second increments.


C: a slow infusion of sodium nitroprusside.


D: IV administration of 1 mL/kg of ethyl alcohol.

B: amyl nitrite inhaled in 20-second increments.
What is a common finding in both fresh water and salt water drownings?
A: Pulmonary edema

B: Severe metabolic alkalosis


C: Inadequate oxygenation


D: Loss of surfactant

C: Inadequate oxygenation
What portion of the brain regulates a person's level of consciousness?
A: Medulla oblongata

B: Cerebrum


C: Reticular activating system


D: Cerebellum

C: Reticular activating system
A 23-year-old man was working near a wood pile when he experienced a sudden, sharp pain in his leg. Your assessment reveals that his level of consciousness is decreased and he is experiencing intense abdominal spasms. This clinical presentation is MOST consistent with the bite of a:
A: coral snake.

B: brown recluse spider.


C: rattlesnake or other pit viper. D: black widow spider.

D: black widow spider.
Which of the following patients is at greatest risk for suicide?
A: A man who owns multiple guns and knives

B: A woman whose depression acutely improves


C: A woman whose mother committed suicide


D: A man who has not slept for over 72 hours

B: A woman whose depression acutely improves
Which of the following hormones stimulates the kidneys to reabsorb sodium and excrete potassium?
A: Adrenocorticotropic hormone B: Somatostatin

C: Aldosterone


D: Antidiuretic hormone

C: Aldosterone
When assessing a patient who was stung by a bee, which of the following assessment findings is MOST indicative of anaphylactic shock?
A: Known allergy to bees

B: Diaphoretic skin


C: A fine, red rash


D: Flushing of the skin

B: Diaphoretic skin
You are dispatched to a residence for a 65-year-old female whose husband reports a change in her behavior over the past several days. He states that initially she seemed forgetful, but today she is confused. Your assessment reveals an obese patient who has slow respirations; cold, dry skin; a heart rate of 50 beats/min; and a blood pressure of 90/50 mm Hg. The patient's husband tells you that his wife does not have any medical problems that he is aware of, but remarks about her weight gain over the past few months. This patient's history and clinical presentation are MOST likely the result of:
A: exacerbation of undiagnosed hyperthyroidism. B: acute dementia with hypothermia.

C: excess adrenal gland production of cortisol.


D: decreased thyroid hormone production.

D: decreased thyroid hormone production.
Which of the following assessment findings helps distinguish envenomation due to a black widow spider bite from an acute abdominal condition?
A: Dizziness, nausea, vomiting, and diaphoresis

B: Fever, palpable abdominal tenderness, and tachycardia


C: Hematemesis, dysphagia, and significant hypotension


D: Abdominal rigidity without palpable tenderness

D: Abdominal rigidity without palpable tenderness
Easy bruising, lymph node enlargement, and splenomegaly are clinical manifestations of:
A: polycythemia.

B: lymphoma.


C: leukemia.


D: anemia.

C: leukemia.
During your assessment of a patient with a suspected neurologic disorder, you ask him to shrug his shoulders and turn his head from side to side. Which of the following cranial nerves are you assessing?
A: Trigeminal

B: Vestibulocochlear


C: Glossopharyngeal


D: Spinal accessory

D: Spinal accessory
A 60-year-old woman, who has been taking high doses of prednisone for several months to treat her rheumatoid arthritis, presents with weakness and fatigue that has progressively worsened. On appearance, her face appears swollen. You should be MOST suspicious that this patient has:
A: Adrenal insufficiency.

B: Cushing’s syndrome.


C: Addison’s disease.


D: Grave’s disease.

B: Cushing’s syndrome.
Polycythemia is a condition that results in:
A: a marked increase in the core body temperature.

B: increased oxygen-carrying capacity of the blood.


C: spontaneous bleeding due to a low platelet count.


D: lactic acidosis due to anaerobic metabolism.

B: increased oxygen-carrying capacity of the blood.
A 19-year-old female ingested an unknown quantity of Elavil and Ativan approximately 3 hours ago. She is slow to answer your questions and her speech is slurred. Her BP is 80/60 mm Hg, her pulse is 140 beats/min, and her respirations are 22 breaths/min. The ECG reveals sinus tachycardia with QRS complexes that measure 0.08 seconds. Treatment should include:
A: 1 to 2 g/kg of activated charcoal.

B: 20 mL/kg sequential IV fluid boluses.


C: 1 mEq/kg of sodium bicarbonate.


D: 0.2 to 0.3 mg of flumazenil IV push.

B: 20 mL/kg sequential IV fluid boluses.
A 39-year-old man is unresponsive, pulseless, and apneic after being lost in the woods during the middle of winter. He has a core body temperature of 85°F (29.4°C). When treating this patient, you should avoid:
A: intubation.

B: defibrillation.


C: cardiac medications.


D: passive rewarming.

C: cardiac medications.
Following prolonged dehydration, a 67-year-old man presents with hypotension, tachycardia, and oliguria. He has no past medical history. Which of the following is the MOST likely cause of his condition?
A: Prerenal acute renal failure

B: Intrarenal acute renal failure C: Postrenal acute renal failure


D: Chronic renal failure

A: Prerenal acute renal failure
Pickwickian syndrome is a condition in which:
A: voluntary muscles are poorly controlled secondary to developmental brain defects that occur in utero.

B: an autoimmune disorder causes destruction of the myelin and nerve axons within the brain and spinal cord.


C: hypoventilation secondary to morbid obesity leads to hypoxemia, hypercarbia, and polycythemia.


D: antibodies prevent acetylcholine from reaching the muscles by blocking or damaging the receptor sites.

C: hypoventilation secondary to morbid obesity leads to hypoxemia, hypercarbia, and polycythemia.
Which of the following is MOST indicative of an infectious or communicable disease?
A: Persistent fever and night sweats

B: Severe headache and photophobia


C: Sore throat and nasal discharge


D: Vomiting and diarrhea for 3 days

A: Persistent fever and night sweats
A 23-year-old male is found unresponsive. According to a friend, the patient had a headache and said that he was going to take a nap. His breathing is rapid and shallow, his pulse is rapid and weak, and he is profusely diaphoretic. Which of the following represents the MOST appropriate treatment for this patient?
A: Apply oxygen via nonrebreathing mask, start an IV line, administer 25 g of 50% dextrose, apply a cardiac monitor, and obtain vital signs.

B: Assist ventilations with a bag-mask device, assess his blood glucose level, apply the cardiac monitor, obtain vital signs, and establish vascular access.


C: Hyperventilate him with a bag-mask device, conduct an in-depth neurologic exam, obtain a 12-lead ECG, and administer 1 mg of glucagon IM. D: Preoxygenate him and prepare to intubate, start an IV line, administer 2 mg of naloxone, assess his vital signs, and apply the cardiac monitor.

B: Assist ventilations with a bag-mask device, assess his blood glucose level, apply the cardiac monitor, obtain vital signs, and establish vascular access.
You arrive at a local community center where a 30-year-old man has been having a seizure for the past 20 minutes. After properly managing his airway and establishing vascular access, you should give:
A: 5 to 10 mg of diazepam.

B: 25 g of glucose.


C: 0.4 to 2 mg of naloxone.


D: 100 mg of thiamine.

A: 5 to 10 mg of diazepam.
Law enforcement calls you to a nearby alley, where they found an unresponsive young female. One of the officers states that the patient is a known drug abuser. The patient has slow, shallow breathing; a slow, weak pulse; and bilaterally constricted pupils. As your partner begins assisting her ventilations, you apply the cardiac monitor, which reveals sinus bradycardia. After establishing vascular access, you should:
A: give 0.5 mg of atropine.

B: begin cardiac pacing at once. C: give a 500-mL fluid bolus.


D: give 0.4 to 2 mg of naloxone.

D: give 0.4 to 2 mg of naloxone.
Which of the following assessment findings is MOST indicative of peritoneal irritation?
A: Pain that increases when the patient is placed on his or her side

B: Pain that is referred to the shoulder, neck, or scapulae


C: A decrease in pain when drawing the knees into the abdomen


D: A relief of pain when the patient moves around frequently

C: A decrease in pain when drawing the knees into the abdomen
You are dispatched to a residence for a patient having a seizure. Upon arriving at the scene, you find that the patient, a 39-year-old male, is experiencing a generalized tonic-clonic seizure and is cyanotic. His wife tells you that he has been like this since she called 9-1-1. In addition to protecting the patient from injury, you should:
A: apply high-flow oxygen via nonrebreathing mask, place him on his side, and wait for the seizure to stop.

B: assist his breathing with a bag-mask device, establish vascular access, and administer 5 mg of diazepam.


C: intubate him to prevent aspiration, establish IV or IO access, and administer 0.1 mg/kg of lorazepam.


D: administer 0.5 mg/kg of diazepam rectally, cover him with a blanket, and administer high-flow oxygen.

B: assist his breathing with a bag-mask device, establish vascular access, and administer 5 mg of diazepam.
A 59-year-old male with a history of hypertension and diabetes presents with dark, tarry stools. He is confused, has a blood pressure of 84/62 mm Hg, and a pulse rate of 74 beats/min and weak. Which of the following would MOST likely explain his heart rate?
A: Inadvertent overdose of his prescribed hypoglycemic medication

B: Increased parasympathetic tone in response to hypovolemia


C: A prescribed adrenergic blocking agent to treat his hypertension


D: Insulin suppressing the patient’s sympathetic nervous system

C: A prescribed adrenergic blocking agent to treat his hypertension
A 30-year-old man complains of difficulty breathing and a fever for the past 10 days. He is emaciated, is coughing, and has purple blotches on his trunk. This patient's clinical presentation is MOST consistent with:
A: HIV/AIDS.

B: pneumonia.


C: tuberculosis.


D: hepatitis.

A: HIV/AIDS.
Which of the following findings is MOST suggestive of myxedema?
A: Hyperactivity

B: Tachycardia


C: Hypothermia


D: Weight loss

C: Hypothermia
A known heroin abuser is found unresponsive by a law enforcement officer. Your primary assessment of the patient, a 24-year-old female, reveals that she is unresponsive, is breathing at a rate of 6 breaths/min and shallow, and has a pulse rate of 40 beats/min and weak. You should:
A: intubate her trachea, start an IV line, and give her naloxone.

B: administer high-flow oxygen, start an IV, and give her atropine. C: begin immediate cardiac pacing to increase her heart rate.


D: ensure that her airway is clear and begin assisting her ventilations.

D: ensure that her airway is clear and begin assisting her ventilations.
An older woman presents with severe weakness, hypotension, lower back pain, and vomiting. Her husband tells you that she has not taken her prednisone in several days because she has not been feeling well. Which of the following should you suspect?
A: Pheochromocytoma

B: Cushing syndrome


C: Thyrotoxic crisis


D: Addisonian crisis

D: Addisonian crisis
Multiple sclerosis is a disease caused by:
A: dysfunction or damage to the portion of the brain that is responsible for the production of dopamine. B: an autoimmune disorder in which the body attacks the myelin sheath of the neurons in the brain and spinal cord. C: a genetic disorder in which defective DNA causes an error in muscle tissue, such that the malformed muscle cells rupture. D: inflammation of the trigeminal nerve that leads to deterioration of the myelin sheath and causes severe, chronic pain.
B: an autoimmune disorder in which the body attacks the myelin sheath of the neurons in the brain and spinal cord.
You are called to an assisted living facility for a sick resident. The patient, a 70-year-old woman, reports tinnitus and difficulty concentrating. The patient's neighbor, who is present at the scene, tells you that the patient has consumed five or six cups of ice over the past hour. You should suspect:
A: acute leukemia.

B: lymphoma.


C: chronic anemia.


D: polycythemia.

C: chronic anemia.
Prehospital treatment for a patient in ventricular fibrillation who has a core body temperature of less than 86°F (30°C) includes:
A: hyperventilation with warm humidified oxygen.

B: limiting defibrillation to one attempt only.


C: administering lidocaine instead of amiodarone.


D: doubling the dose of all medications.

B: limiting defibrillation to one attempt only.
Which of the following findings is the MOST clinically significant when assessing a patient with a severe headache?
A: BP of 140/88 mm Hg

B: Retroorbital pressure


C: Nausea or vomiting


D: An unsteady gait

D: An unsteady gait
A patient with a blood glucose level of 650 mg/dL would be expected to present with:
A: hypercarbia, anorexia, hyperactivity, and diaphoresis.

B: hyperpnea, dehydration, warm skin, and tachycardia.


C: tachypnea, anuria, alkalosis, and a bounding pulse.


D: hypopnea, oliguria, abdominal pain, and vomiting.

B: hyperpnea, dehydration, warm skin, and tachycardia.
When assessing a patient with a preexisting mental illness, which of the following observations would be the MOST suggestive of the potential for violence?
A: Sitting, crying, unable to recall birthday

B: Large body size, sitting, flat affect


C: Sitting, clenched fists, erratic speech


D: Standing facing you, arms crossed

C: Sitting, clenched fists, erratic speech
What is the MOST appropriate dose and route of diphenhydramine for a patient who is experiencing a severe allergic reaction?
A: 25 to 50 mg IM

B: 0.3 to 0.5 mg IM


C: 0.3 to 0.5 mg SC


D: 25 to 50 mg IV

D: 25 to 50 mg IV
Which of the following statements regarding hypoglycemia is correct?
A: The skin of a hypoglycemic patient is typically warm and dry secondary to severe dehydration. B: Most diabetic patients develop symptoms when their blood glucose level falls below 90 mg/dL.

C: A patient with prolonged hypoglycemia may require more than one dose of IV dextrose.


D: Hypoglycemia typically occurs within 4 to 6 hours after inadvertently taking too much insulin.

C: A patient with prolonged hypoglycemia may require more than one dose of IV dextrose.
A 26-year-old woman was bitten on the leg by a rattlesnake while hiking. She is conscious and alert, but is anxious. Her BP is 114/66 mm Hg, her heart rate is 112 beats/min, her respirations are 20 breaths/min, and her oxygen saturation is 97%. Treatment for her should include:
A: oxygen via nasal cannula, splinting the affected extremity, and an IV line of normal saline set at a keep-vein-open rate. B: oxygen via nasal cannula, elevating the extremity above the level of the heart, and 1 gm of calcium chloride IV push. C: oxygen via non-rebreathing mask, applying a chemical ice pack to the bite wound, and splinting the affected extremity. D: oxygen via non-rebreathing mask, elevating the extremity above the level of the heart, and a 20 mL/kg IV fluid bolus.
A: oxygen via nasal cannula, splinting the affected extremity, and an IV line of normal saline set at a keep-vein-open rate.
A 30-year-old female is found unresponsive by her roommate. According to the roommate, the patient, who has type I diabetes, was fine 30 minutes ago. On assessment, the patient has rapid, shallow respirations; pallor and diaphoresis; and a weak, thready pulse. Additional assessment of this patient will MOST likely reveal:
A: an acetone or fruity odor on her breath.

B: peaked T waves and wide QRS complexes.


C: marked hyperglycemia.


D: a blood glucose level less than 70 mg/dL.

D: a blood glucose level less than 70 mg/dL.
Prehospital treatment for cutaneous exposure to hydrofluoric acid includes:
A: baking powder covered with a dry, sterile dressing.

B: 20 mL of a 10% solution of calcium gluconate IV.


C: 1 to 2 g of magnesium sulfate via slow IV push. D: antacid preparations, such as Mylanta or Maalox.

D: antacid preparations, such as Mylanta or Maalox.
Which of the following is a defining factor in the transition from human immunodeficiency virus (HIV) infection to acquired immunodeficiency syndrome (AIDS)?
A: Antibodies are detected in the blood

B: Development of opportunistic infections


C: Transient increase in the T-cell count


D: Fever that lasts greater than 7 days

B: Development of opportunistic infections
A 19-year-old male experienced a syncopal episode after several hours of vigorous exercise in the heat. Upon arrival at the scene, bystanders direct you to the patient, who they moved under a tree. The patient moans in response to painful stimuli, and his skin is flushed, hot, and moist. After ensuring airway and breathing adequacy, your MOST immediate action should be to:
A: infuse 500 mL of IV fluid.

B: begin rapid cooling measures.


C: assess his blood glucose level.


D: take his temperature orally.

B: begin rapid cooling measures.
A 46-year-old woman was found unresponsive on her couch by a concerned neighbor. According to the neighbor, the patient uses heroin, but recently boasted that she has “been clean.” The patient is unresponsive; has rapid, shallow breathing; and slow, weak radial pulses. You should:
A: apply oxygen via nonrebreathing mask, apply the cardiac monitor, establish vascular access, and administer 2 mg of naloxone slow IV push. B: insert an oral airway, assist her ventilations with a bag-mask device, apply the cardiac monitor, consider transcutaneous pacing, and establish vascular access. C: secure her airway with an endotracheal tube, apply the cardiac monitor, establish vascular access, and administer 1 mg of atropine rapid IV push. D: provide some form of positive-pressure ventilation, apply the cardiac monitor, establish vascular access, and administer 25 g of 50% dextrose IV
B: insert an oral airway, assist her ventilations with a bag-mask device, apply the cardiac monitor, consider transcutaneous pacing, and establish vascular access
A person's level of consciousness is regulated by the:
A: limbic system.


B: reticular activating system.


C: medulla oblongata.


D: diencephalon.

B: reticular activating system.
Which of the following combinations of drugs are indicated for a patient with copious bronchial secretions, marked bradycardia, and profuse diaphoresis following exposure to an industrial pesticide?
A: Pralidoxime chloride and diazepam

B: Epinephrine and 2-PAM chloride


C: Atropine and pralidoxime chloride


D: Atropine and physostigmine

C: Atropine and pralidoxime chloride
You are assessing a patient who presents with a melena and abdominal pain. Which of the following medical history findings is the MOST clinically significant?
A: Hypertension

B: Type II diabetes mellitus


C: Hashimoto disease


D: von Willebrand disease

D: von Willebrand disease
Treatment for a patient who has a pulse and a documented core body temperature of 92.8°F includes:
A: passive and active external rewarming.

B: prophylactic antidysrhythmic therapy.


C: passive rewarming only.


D: 20 mL/kg boluses of warm normal saline.

A: passive and active external rewarming.
Which of the following medications is classified as a tricyclic antidepressant?
A: Fluoxetine hydrochloride

B: Nortriptyline hydrochloride


C: Midazolam hydrochloride


D: Buspirone hydrochloride

B: Nortriptyline hydrochloride
Which of the following patients is at greatest risk for hypothermia?
A: 55-year-old woman with hypothyroidism

B: 60-year-old woman with Cushing syndrome


C: 65-year-old man with coronary artery disease


D: 45-year-old man with hyperglycemia

A: 55-year-old woman with hypothyroidism
Shorly after his dialysis treatment, a 66-year-old man presents with confusion, a headache, and nausea. You should suspect:
A: severe hyperkalemia.

B: interstitial nephritis.


C: acute air embolism.


D: disequilibrium syndrome.

D: disequilibrium syndrome.
A 40-year-old female presents with diffuse abdominal cramping, nausea, vomiting, and diarrhea. She tells you that this began the day before, and is worse today. She is conscious and alert, lightheaded, and has a resting heart rate of 120 beats/min. Her temperature is 97.7°F orally, blood pressure is 110/70 mm Hg, and oxygen saturation is 95% on room air. She denies any past medical history, but states that she has been taking ibuprofen for a headache. The MOST appropriate treatment for this patient includes:
A: obtaining orthostatic vital signs, oxygen as tolerated, establishing vascular access, and setting the flow rate at 125 mL/hr. B: supplemental oxygen, an IV of normal saline set to keep the vein open, and 25 to 50 mg of diphenhydramine IV. C: oxygen as tolerated via nasal cannula, an IV of normal saline, a 500 mL fluid bolus, and 12.5 mg of promethazine IV. D: high-flow oxygen via nonrebreathing mask, an IV of normal saline, sequential 20 mL/kg fluid boluses, and 2 mg of morphine.
C: oxygen as tolerated via nasal cannula, an IV of normal saline, a 500 mL fluid bolus, and 12.5 mg of promethazine IV.
Following ingestion of a toxic dose of acetaminophen, right upper quadrant abdominal pain typically begins within:
A: 12 to 24 hours

B: 24 to 72 hours


C: 72 to 96 hours


D: 4 to 14 days

B: 24 to 72 hours
You are treating a 50-year-old male who ingested a significant amount of his prescribed propranolol. He is unresponsive, bradycardic, hypotensive, and has poor respiratory effort. In addition to assisting his ventilations, applying a cardiac monitor, and establishing vascular access, the MOST appropriate treatment for him includes:
A: calcium chloride, isoproterenol, and dopamine. B: cardiac pacing, glucagon, and a vasopressor.

C: 2 to 3 liters of normal saline to increase his BP. D: atropine, calcium gluconate, and vasopressin.

B: cardiac pacing, glucagon, and a vasopressor.
A middle-aged female with a history of hypertension presents with an acute onset of tearing abdominal pain. She is conscious and alert, but restless. Her BP is 86/56 mm Hg, pulse rate is 120 beats/min, and respirations are 28 breaths/min. You should:
A: vigorously palpate her abdomen for a pulsating mass.

B: administer 5 mg of morphine to relieve her pain.


C: determine if her femoral pulses are of equal strength.


D: increase her blood pressure with IV fluid boluses.

C: determine if her femoral pulses are of equal strength.
You enter an elderly man's residence and find him sitting on the couch with his eyes closed. His respirations appear to be deep and rapid. You should:
A: quickly move him to the floor. B: check for a carotid pulse.

C: assess his mental status.


D: manually open his airway.

C: assess his mental status.
In contrast to an anaphylactic reaction, an anaphylactoid reaction:
A: is usually less severe and does not require drug therapy. B: can occur without prior exposure to an offending agent. C: is an immune response mediated by IgE antibodies. D: usually does not respond to antihistamine medications.
B: can occur without prior exposure to an offending agent.
Disequilibrium syndrome, a condition associated with dialysis, manifests with signs and symptoms of:
A: excessive catecholamine release.

B: severe hypokalemia.


C: high serum potassium levels.


D: increased intracranial pressure.

D: increased intracranial pressure.
A 16-year-old boy has a severe headache and vomiting that has progressively worsened over the past 36 hours. Which of the following questions would be MOST important to ask him?
A: Have you experienced a recent head injury?

B: Do you have any abdominal pain or diarrhea? C: Is there a history of meningitis in your family? D: Do you have a history of hypertension?

A: Have you experienced a recent head injury?
You are called to transport a patient from an urgent care clinic to the emergency department. When reviewing the lab results from the clinic, you note that the patient's thyroid-stimulating hormone (TSH) level is very high. This indicates:
A: an underactive thyroid.

B: Graves disease.


C: Cushing syndrome.


D: elevated T3/T4 levels.

A: an underactive thyroid.
A 59-year-old female complains of a headache. She is conscious and alert, has a patent airway, and is breathing adequately. You should:
A: ask her if she takes any medications.

B: inquire about a history of stroke.


C: determine when her headache began.


D: assess her pupils for equality and reactivity.

C: determine when her headache began.
A 70-year-old male presents with confusion, a blood pressure of 74/56 mm Hg, and a pulse of 80 beats/min and weak. His son tells you that he has had black tarry stools for the past 3 days, but refused to go to the hospital. He further tells you that his father has hypertension and Alzheimer's disease, and hands you a medication list that includes Toprol, Zestril, Zyprexa, and vitamins. You should be MOST concerned that this patient:
A: is hypoglycemic.

B: is hypo perfused.


C: is not tachycardia.


D: has GI bleeding.

B: is hypo perfused.
Prehospital treatment for a black widow spider bite includes:
A: 2 mg/kg of 10% calcium gluconate.

B: 2.5 to 10 mg of diazepam.


C: 10 mL of calcium chloride.


D: antivenin derived from horse serum.

B: 2.5 to 10 mg of diazepam.
A 33-year-old female was stung by a scorpion 45 minutes ago. She is conscious and alert, and presents with diffuse urticaria and intense itching. She denies chest tightness or difficulty breathing. Her breath sounds are clear and equal bilaterally. Her BP is 134/82 mm Hg, pulse is 104 beats/min and strong, respirations are 16 breaths/min and unlabored, and her SpO2 is 95% on room air. The MOST appropriate treatment for this patient includes:
A: assisted ventilation, IV of normal saline, 3 to 5 mL of epinephrine 1:10,000 IV. B: an IV of an isotonic crystalloid, 0.1 mg epinephrine 1:10,000 IV, 25 mg diphenhydramine IV. C: supplemental oxygen, IV of an isotonic crystalloid, 25 mg diphenhydramine IV. D: oxygen at 2 L/min via nasal cannula, 0.3 mg epinephrine 1:1,000 SQ, IV of normal saline.
C: supplemental oxygen, IV of an isotonic crystalloid, 25 mg diphenhydramine IV.
At 2:30 AM, you respond to a crowded homeless shelter for a 52-year-old male who is sick. The patient complains of intense itching to his hands and axillae. Assessment of these areas reveals the presence of a rash. The patient denies any medical problems, but states that he was stung by a hornet two days ago. Which of the following should you suspect?
A: Herpes simplex

B: Allergic reaction


C: Lice


D: Scabies

D: Scabies
You respond to a residence for an overdose. While en route, the dispatcher advises you that CPR is in progress. A second paramedic unit is dispatched, but their response to the scene will be delayed. When you arrive at the scene, an emergency medical responder is performing CPR on the patient, a 30-year-old male, who apparently ingested an unknown quantity of Darvon. After confirming apnea and pulselessness, you should direct resumption of CPR and then:
A: locate the medication bottle to confirm what he evidently ingested. B: establish vascular access and administer 2 mg of naloxone. C: insert an advanced airway device to ensure adequate ventilation. D: apply the ECG electrodes and assess the patient’s cardiac rhythm.
D: apply the ECG electrodes and assess the patient’s cardiac rhythm.
Which of the following conditions would produce the MOST rapid loss of consciousness?
A: Ischemic stroke

B: Ketoacidosis


C: Insulin shock


D: Hyperglycemia

C: Insulin shock
Which of the following can MOST easily be assessed without talking to a patient who is experiencing a behavioral crisis?
A: Memory

B: Orientation


C: Affect


D: Thought

C: Affect
A hiker was bitten on the leg by a rattlesnake approximately 20 minutes ago. He complains of pain to the lateral aspect of his left leg, just proximal to the ankle. Assessment of that area reveals two small puncture wounds surrounded by edema. You also note localized twitching of his calf muscles. He is conscious and alert, but anxious. His blood pressure is 112/70 mm Hg, pulse is 120 beats/min, and respirations are 24 breaths/min with adequate depth. In addition to keeping him calm, you should:
A: administer high-flow oxygen via nonrebreathing mask, apply a tight constricting band proximal to the wound, cover the wound with a sterile dressing, start an IV line and set it at a KVO rate, and transport. B: administer high-flow oxygen via nonrebreathing mask, apply a sterile dressing to the wound, immobilize his leg and keep it below the level of the heart, start an IV line and set it at a KVO rate, and transport. C: apply a chemical icepack to the wound to decrease venom absorption, immobilize his leg and keep it below the level of the heart, administer high-flow oxygen via nonrebreathing mask, and transport. D: place him in a supine position, assist his ventilations with a bag-mask device, immobilize his leg and elevate it 6” to 12”, start an IV line and give a 20 mL/kg crystalloid bolus, and transport.
B: administer high-flow oxygen via nonrebreathing mask, apply a sterile dressing to the wound, immobilize his leg and keep it below the level of the heart, start an IV line and set it at a KVO rate, and transport.
A 59-year-old woman with a history of Grave's disease presents with an altered mental status. Her skin is hot to the touch and her pulse rate is 160 beats/min. These findings are MOST consistent with:
A: Cushing syndrome.

B: myxedema.


C: addisonian crisis.


D: thyrotoxic crisis.

D: thyrotoxic crisis.