You are dispatched to an apartment complex where a 21-year-old female has apparently overdosed on several narcotic medications. She is semiconscious and has slow, shallow respirations. You should:
insert an oropharyngeal airway and perform oral suctioning
apply oxygen via a nonrebreathing mask and transport at once
insert a nasopharyngeal airway and begin assisted ventilation
place her in the recovery position and monitor for vomiting
Ischemic heart disease is MOST accurately defined as:
absent myocardial blood flow due to a blocked coronary artery
decreased blood flow to one or more portions of the myocardium
death of a portion of the heart muscle due to a decrease in oxygen
decreased blood flow to the heart muscle due to coronary dilation
An acute myocardial infarction (AMI) occurs when:
myocardial tissue dies secondary to an absence of oxygen
the heart muscle progressively weakens and dysfunctions
coronary artery dilation decreases blood flow to the heart
the entire left ventricle is damaged and cannot pump blood
Major risk factors for AMI include all of the following, EXCEPT:
hypoglycemia
hypertension
diabetes mellitus
elevated cholesterol
Angina pectoris occurs when:
a coronary artery is totally occluded by plaque
myocardial oxygen demand exceeds the supply
one or more coronary arteries suddenly spasm
myocardial oxygen supply exceeds the demand
Which of the following is a major difference between angina pectoris and AMI?
AMI is caused by myocardial ischemia
anginal pain typically subsides with rest
nitroglycerin has no effect on angina pectoris
pain from an AMI subsides within 30 minutes
When treating a patient with chest pain, you should assume that he or she is having an AMI because:
angina usually occurs after an AMI
most patients with chest pain are experiencing an AMI
the cause of the pain cannot be diagnosed in the field
angina and AMI present identically
A 67-year-old female with severe chest pain becomes unresponsive, pulseless, and apneic during transport. You should:
defibrillate with the AED while continuing transport to the hospital
stop the ambulance, begin CPR, and attach the AED as soon as possible
perform CPR for 1 to 2 minutes and then analyze her rhythm with an AED
alert the receiving hospital and perform CPR for the duration of the transport
You and your partner arrive at the scene of a middle-aged man who collapsed about 5 minutes ago. He is unresponsive, apneic, and pulseless. Bystanders are present, but have not provided any care. You should:
begin high-quality CPR and apply the AED without delay
perform five cycles of high-quality CPR and then apply the AED
perform two-rescuer CPR for 5 minutes and request ALS backup
immediately apply the AED pads and analyze his cardiac rhythm
When would it be MOST appropriate for a patient to take his or her prescribed nitroglycerin?
sharp pain that last longer than 10 to 15 minutes
an acute onset of dizziness during a period of exertion
chest pain that does not immediately subside with rest
difficulty breathing that awakens the patient from sleep
Common signs and symptoms of a hypertensive emergency include:
pallor, cool skin, and a temporary loss of hearing
syncope, a weak pulse, and bleeding from the ears
tachycardia, pain behind the eyes, and weakness
a bounding pulse, a severe headache, and dizziness
Which of the following signs is commonly observed in patients with right-sided heart failure?
labored breathing
dependent edema
pulmonary edema
flat jugular veins
A 67-year-old female presents with difficultly breathing and chest discomfort that awakened her from her sleep. She states that she has congestive heart failure, has had two previous heart attacks, and has prescribed nitroglycerin. She is conscious and alert with adequate breathing. Her blood pressure is 94/64 mm Hg and her heart rate is 120 beats/min. Treatment for this patient includes:
nitroglycerin for her chest pain
ventilations with a bag-mask device
oxygen at 4 L/min via nasal cannula
placing her in an upright position
Cardiogenic shock following AMI is caused by:
decreased pumping force of the heart muscle
a profound increase in the patient's heart rate
hypovolemia secondary to severe vomiting
widespread dilation of the systemic vasculature
Which of the following cardiac arrhythmias has the greatest chance of deteriorating into a pulseless rhythm?
sinus tachycardia
sinus bradycardia
extra ventricular beats
ventricular tachycardia
Ventricular tachycardia causes hypotension because:
the volume of blood returning to the atria increases
the right ventricle does not adequately pump blood
blood backs up into the lungs and causes congestion
the left ventricle does not adequately fill with blood
Sudden death following AMI is MOST often caused by:
cardiogenic shock
severe bradycardia
ventricular fibrillation
congestive heart failure
Rapid, labored breathing in a patient with signs and symptoms of AMI should make you suspicious for:
a cardiac arrhythmia
significant hypotension
right ventricular failure
Which of the following statements regarding the pain associated with AMI is correct?
it is often described by the patient as a sharp feeling
it often fluctuates in intensity when the patient breathes
nitroglycerin usually resolves the pain within 30 minutes
it can occur during exertion or when the patient is at rest
Common signs and symptoms of AMI include all of the following, EXCEPT:
irregular heartbeat
sudden unexplained sweating
shortness of breath or dyspnea
pain exacerbated by breathing
Acute coronary syndrome (ACS) is a term used to describe:
the warning signs that occur shortly before a heart attack
a group of symptoms that are caused by myocardial ischemia
a severe decrease in perfusion caused by changes in heart rate
the exact moment that a coronary artery is completely occluded
Which of the following statements regarding nitroglycerin is correct?
the potency of nitroglycerin is increased when exposed to light
a maximum of five nitroglycerin doses should be given to a patient
nitroglycerin should be administered between the cheek and gum
nitroglycerin usually relieves anginal chest pain within 5 minutes
A 60-year-old male presents with acute respiratory distress. He is conscious and alert, has pink and dry skin, and has respirations of 24 breaths/min with adequate depth. Which of the following treatment modalities is MOST appropriate for this patient?
assisted ventilations with a bag-mask device and a head-to-toe exam
oxygen via nonrebreathing mask and a focused secondary assessment
positive-pressure ventilations and immediate transport to the closest hospital
oxygen via a nasal cannula, vital signs, and prompt transport to the hospital
The MOST significant risk factor for a hemorrhagic stroke is:
severe stress
heavy exertion
Febrile seizures:
often results in permanent brain damage
are also referred to as petit mal seizures
are usually benign but should be evaluated
occur when a child's fever progressively rises
You respond to a residence for a child who is having a seizure. Upon arrival at the scene, you enter the residence and find the mother holding her child, a 2-year-old male. The child is conscious and crying. According to the mother, the child had been running a high fever and then experienced a seizure that lasted approximately 3 minutes. You should:
cover the child with wet towels and give oxygen via nasal cannula
transport the child to the hospital and reassure the mother en route
advise the mother to take her child to the doctor the following day
call medical control and request permission to give the child aspirin
Which of the following patients would MOST likely demonstrate typical signs of infection, such as a fever?
a 3-month-old female who was born prematurely
a 17-year-old male with depression and anxiety
a 35-year-old female in the later stages of AIDS
an 88-year-old male with chronic renal problems
You are caring for a semiconscious man with left-sided paralysis. His airway is patent and his respirations are 14 breaths/min with adequate tidal volume. Treatment for this patient should include:
oxygen via a nonrebreathing mask, left lateral recumbent position, and transport
assisted ventilation with a bag-mask device, right lateral recumbent position, and transport
an oral airway, assisted ventilation with a bag-mask device, Fowler's position, and transport
oxygen via a nonrebreathing mask, supine position with legs elevated 6" to 12", and transport
Law enforcement has summoned you to a nightclub, where a 22-year-old female was found unconscious in an adjacent alley. Your primary assessment reveals that her respirations are rapid and shallow and her pulse is rapid and weak. She is wearing a medical alert bracelet that identifies her as an epileptic. There is an empty bottle of vodka next to the patient. You should:
place a bite block in her month in case she has a seizure and transport at once
apply oxygen via a nonrebreathing mask, place her on her left side, and transport
assist ventilations, perform a rapid exam, and prepare for immediate transport
apply oxygen via nonrebreathing mask and transport her for a blood-alcohol test
What Glasgow Coma Scale (GCS) score would you assign to a patient who response to painful stimuli, uses inappropriate words, and maintains his or her arms in a flexed position?
6
8
9
10
You are assessing the arm drift component of the Cincinnati Prehospital Stroke Scale on a 60-year-old woman. When she holds both of her arms out in front of her and closes her eyes, both of her arms immediately fall to her sides. You should:
repeat the arm drift test and ensure that her palms are facing downwards
repeat the arm drift test, but move the patient's arms into position yourself
instruct the patient to keep her eyes open and then repeat the arm drift test
defer this part of the test and assess her for facial droop and slurred speech
When assessing arm movement of a patient with a suspected stroke, you should:
observe for approximately 5 minutes
expect to see one arm slowly drift down to the patient's side
ask the patient to close his or her eyes during the assessment
ask the patient to hold his or her arms up with the palms down
Functions of the liver include:
storage of bile, which is produced in the gallbladder
production of substances necessary for blood clotting
production of hormones that regulate blood sugar levels
release of amylase, which breaks down starches into sugar
Which of the following organs assists in the filtration of blood, serves as a blood reservoir, and produces antibodies?
liver
kidney
spleen
pancreas
The kidneys help to regulate blood pressure by:
retaining key electrolytes, such as potassium
eliminating toxic waste products from the body
removing sodium, and thus water, from the body
accommodating a large amount of blood volume
A 35-year-old mildly obese woman is complaining of localized pain in the right upper quadrant with referred pain to the right shoulder. The MOST likely cause of her pain is:
acute cystitis
acute cholecystitis
appendicitis
pancreatitis
Pain that is localized to the lower back and/or lower abdominal quadrants is MOST suggestive of:
acute pancreatitis
an aortic aneurysm
a kidney infection
acute appendicitis
Which of the following statements regarding the acute abdomen is correct?
the most common cause of an acute abdomen is inflammation of the gallbladder and liver
the parietal peritoneum is typically the first abdominal layer that becomes inflamed and irritated
the initial pain associated with an acute abdomen tends to be vague and poorly localized
an acute abdomen almost always occurs as the result of blunt trauma to solid abdominal organs
Pain that radiates to the right lower quadrant from the umbilical area, nausea and vomiting, and anorexia are MOST indicative of:
cholecystitis
gastroenteritis
Esophageal varices MOST commonly occur in patients who:
drink a lot of alcohol
have severe diabetes
have a history of esophagitis
have weak immune systems
Most patients with abdominal pain prefer to:
lie on their side with their knees drawn into the abdomen
sit in a semi-Fowler position with their knees slightly bent
lie in a supine position with their knees in a flexed position
sit fully upright because it helps relax the abdomen muscles
Which of the following statements regarding dialysis is correct?
acute hypertension is a common adverse effect of dialysis
hemodialysis is effective but carries a high risk of peritonitis
patients who miss a dialysis treatment often present with weakness
the purpose of dialysis is to help the kidneys retain salt and water
You respond to the residence of a 70-year-old male who complains of weakness and severe shortness of breath. His wife tells you that he is a dialysis patient, but has missed his last two treatments. After applying high-flow oxygen, you auscultate his lungs and hear diffuse rhonchi. The patient is conscious, but appears confused. His blood pressure is 98/54 mm Hg, his pulse is 120 beats/min and irregular, and his respirations are 24 breaths/min and labored. You should:
leave him in a sitting position, keep him warm, and prepare for immediate transport
place him in a supine position, elevate his lower extremities, and transport at once
treat for shock and request a paramedic unit to respond to the scene and assist you
perform a detailed secondary assessment and then transport him to a dialysis center
Diabetes is MOST accurately defined as a(n):
disorder of carbohydrate metabolism
abnormally high blood glucose level
mass excretion of glucose by the kidneys
lack of insulin production in the pancreas
Which of the following statements regarding glucose is correct?
most cells will function normally without glucose
blood glucose levels decrease in the absence of insulin
the brain requires glucose as much as it requires oxygen
the brain requires insulin to allow glucose to enter the cells
Ketone production is the result of:
acidosis when blood glucose levels are low
blood glucose levels higher than 120 mg/dL
fat metabolization when glucose is unavailable
rapid entry of glucose across the cell membrane
Kussmaul respirations are an indication that the body is:
attempting to eliminate acids from the blood
trying to generate energy by breathing deeply
severely hypoxic and is eliminating excess CO2
compensating for decreased blood glucose levels
the normal blood glucose level, as measured by a glucometer, is between:
60 and 80 mg/dL
80 and 120 mg/dL
130 and 150 mg/dL
160 and 200 mg/dL
Which of the following statements regarding diabetic coma is correct?
diabetic coma can be prevented by taking smaller insulin doses
diabetic coma typically develops over a period of hours or days
patients with low blood glucose levels are prone to diabetic coma
diabetic coma rapidly progesses aonce hyperglycemia develops
Hypoglycemic crisis tends to develop more often and more severely in children because:
they have larger glucose stores than adults do
they do not always eat correctly and on schedule
their cells do not uptake glucose as fast as adults' do
their low activity levels cause rapid glucose depletion
Assessment of a patient with hypoglycemia will MOST likely reveal:
sunken eyes
hyperactivity
warm, dry skin
combativeness
In contrast to insulin shock, diabetic coma:
is rapidly reversible if oral glucose is given
commonly results in excess water retention
can only be corrected in the hospital setting
is a rapidly developing metabolic distrubance
A 75-year-old male with type 1 diabetes presents with chest pain and a general feeling of weakness. He tells you that he took his insulin today and ate a regular meal approximately 2 hours ago. You should treat this patient as though he is experiencing:
an acute stroke
hyperglycemia
a heart attack
You are treating a 40-year-old male with a documented blood sugar reading of 300 mg/dL. The patient is semiconscious and breathing shallowly, and is receiving assisted ventilation from your partner. You should recognize that definitive treatment for this patient includes:
oxygen
glucagon
insulin
dextrose
To which of the following diabetic patients should you administer oral glucose?
an unconscious 33-year-old male with cool, clammy skin
a conscious 37-year-old female with nausea and vomiting
a semiconscious 40-year-old female without a gag reflex
a confused 55-year-old male with tachycardia and pallor
An acute accelerated drop in the hemoglobin level, which is caused by red blood cells breaking down at a faster rate than normal, occurs during a(n) hemolytic aplastic vaso-occlusive splenic sequestration( hemolytic, aplastic, vaso-occlusive, splenic sequestration ) crisis.
Your initial attempt to ventilate an unresponsive apneic 30-year-old man is met with resistance and you do not see the chest rise. Your second ventilation attempt is also unsuccessful. You should:
suction the airway
perform a blind finger sweep
perform 30 chest compressions
ventilate again with greater force
Abnormalities in metabolism are MOST likely caused by dysfunction of the:
thyroid gland
adrenal gland
parathyroid gland
The usual dose for activated charcoal is up to 25 g 5 g 10 g 12.5 g( 25 g, 5 g, 10 g, 12.5 g ) for a pediatric patient and up to 50 g 10 g 20 g 25 g( 50 g, 10 g, 20 g, 25 g ) for an adult patient.
An overdose on acetaminophen, the active ingredient in Tylenol, will MOST likely cause:
liver failure
gastric ulcers
kidney failure
central nervous system (CNS) depression
A 47-year-old male presents with severe abdominal pain of 3 hours' duration. His abdomen is distended and guarded. Your MOST important consideration for this patient should be to:
transport him in a supine position
be alert for signs and symptoms of shock
assess his blood pressure to determine perfusion adequacy
determine the exact location and cause of his pain
Harsh, high-pitched inspiratory sounds are characteristic of:
rales
stridor
rhonchi
wheezing
A transient ischemic attack (TIA) occurs when:
medications are given to dissolve a cerebral blood clot
a small cerebral artery ruptures and causes minimal damage
the normal body processes destroy a clot in a cerebral artery
signs and symptoms resolve spontaneously within 48 hours
During your assessment of a 19-year-old male, you are told that he is being treated with factor VIII. This indicates that:
he has a thrombosis
he has hemophilia B
he has hemophilia A
his blood clots too quickly
You are dispatched to a residence for a 67-year-old female who was awakened by shortness of breath and sharp chest pain. Her husband tells you that she was recently discharged from the hospital after having hip surgery. Your assessment reveals dried blood around her mouth, facial cyanosis, and an oxygen saturation of 88%. This patient's presentation is MOST consistent with:
acute pulmonary edema
right-sided heart failure
acute pulmonary embolism
spontaneous pneumothorax
An increase in heart rate and contractility occurs due to stimulation of:
beta-1 receptors
beta-2 receptors
alpha-1 receptors
alpha-2 receptors
The term "behavioral crisis" is MOST accurately defined as:
a sudden, violent outburst of an otherwise mentally stable person toward a family member
any reaction that interferes with activities of daily living or is deemed unacceptable by others
a situation in which a patient demonstrates bizarre behavior and becomes a risk to other people
a period of severe depression that lasts longer than 2 weeks and cannot be controlled with medications
A technique used to gain insight into a patient's thinking, which involves repeating in question form what the patient has said, is called:
active listening
passive listening
intuitive listening
reflective listening
Paroxysmal noctural dyspnea (PND), rales, and dependent edema are clinical indicators of:
emphysema
severe pneumonia
bronchitis or asthma
Acute pulmonary edema would MOST likely develop as the result of:
severe hyperventilation
toxic chemical inhalation
an upper airway infection
Atropine sulfate and pralidoxime chloride are antidotes for:
lysergic acid diethylamide (LSD)
diphenhydramine (Benadryl)
nerve gas agents
anticholinergic drugs
In anticipation of receiving a fertilized ovum, the lining of the uterine wall:
thins and begins to separate
becomes engorged with blood
diverts blood flow to the vagina
sheds and is expelled externally
When you use the palpation method to obtain a blood pressure, the measurement you obtain is the:
pulse pressure
systolic blood pressure
diastolic blood pressure
cardiac output pressure
Common signs and symptoms of acute hyperventilation syndrome include:
altered mental status and bradycardia
unilateral paralysis and slurred speech
anxiety, dizziness, and severe bradypnea
tachypnea and tingling in the extremities
Most patients are instructed by their physician to take up to three two four five( three, two, four, five ) doses of nitroglycerin before calling EMS.
Clinical signs of compensated shock include all of the following, EXCEPT:
cool and clammy skin
absent peripheral pulses
restlessness or anxiety
rapid, shallow breathing
The air you breathe is 21% 16% 25%( 21%, 16%, 25% ) oxygen, and the sir you exhale is 16% 25% 32% 35%( 16%, 25%, 32%, 35% ) oxygen.
A blood pressure cuff that is too small for a patient's arm will give a:
falsely low systolic and diastolic reading
falsely high systolic but low diastolic reading
falsely high systolic and diastolic reading
falsely low systolic but high diastolic reading
A 42-year-old male is found unresponsive on his couch by a neighbor. During your assessment, you find no signs of trauma and the patient's blood glucose level is 75 mg/dL. His blood pressure is 168/98 mm Hg, his heart rate is 45 beats/min and bounding, and his respirations are 8 breaths/min and irregular. The patient is wearing a medical alert bracelet that states he has hemophilia. You should:
administer oxygen via a nonrebreathing mask, apply oral glucose in between his cheek and gum, and transport
suspect that he has internal bleeding and is in shock, administer high-flow oxygen, and transport at once
administer high-flow oxygen, perform a detailed secondary assessment at the scene, and transport promptly
suspect that he has intracranial bleeding, assist his ventilations, and transport rapidly to an appropriate hospital
Which of the following statements regarding pelvic inflammatory disease (PID) is correct?
the most severe cases of PID occur in women who are not sexually active
PID can scar the fallopian tubes, which increases the risk of an ectopic pregnancy
PID most commonly affects women who have had an ectopic pregnancy in the past
the most common presenting symptom of PID is generalized upper abdominal pain
Asthma is caused by a response of the:
immune system
endocrine system
respiratory system
cardiovascular system
A 38-year-old female was bitten by fire ants while at the park with her kids. Your primary assessment reveals that she is semiconscious, has profoundly labored breathing, and has a rapid, thready pulse. She has a red rash on her entire body and her face is very swollen. You should:
perform a rapid secondary assessment
assist her ventilations with 100% oxygen
administer 0.3 mg of epinephrine
place her supine with her legs elevated 6" to 12"
Which of the following is NOT a common sign or symptom associated with malfunction of an implanted cardiac pacemaker?
a rapid heart rate
syncope or dizziness
heart rate less than 60 beats/min
generalized weakness
The AED has delivered a shock to an elderly male in cardiac arrest. Following 2 minutes of CPR, you reanalyze the patient's cardiac rhythm and receive a "no shock advised" message. After further resuscitation, you restore a palpable carotid pulse. Your next action should be to:
obtain a blood pressure and apply the pulse oximeter
place him in the recovery position and apply oxygen
transport at once and reanalyze his rhythm en route
reassess airway and breathing and treat accordingly
The spread of HIV and hepatitis in the health care setting can usually be traced to:
careless handling of sharps
a lack of proper immunizations
excessive blood splashing or splattering
a noncompliance with standard precautions
Alkalosis is a condition that occurs when:
blood acidity is reduced by excessive breathing
dangerous acids accumulate in the bloodstream
the level of carbon dioxide in the blood increases
slow, shallow breathing eliminates too much carbon dioxide
Signs and symptoms of a hypertensive emergency would MOST likely be delayed in patients who:
have chronic hypertension
regularly take illegal drugs
have had a stroke in the past
are older than 40 years of age
When using the pulse oximeter as part of your assessment of a patient, it is important to remember that:
pulse oximetry is especially useful in patients who have cold extremities because vasoconstriction forces blood to the capillary beds
carbon monoxide has no effect on pulse oximetry readings because the pulse oximeter presumes that oxygen is saturating the hemoglobin
as long as the patient's oxygen saturation is greater than 95%, oxygen is usually not necessary, even if the patient has respiratory distress
any situation that causes vasoconstriction or loss of red blood cells, such as anemia or bleeding, may result in an inaccurate or misleading value
When the level of arterial carbon dioxide rise above normal:
the brain stem inhibits respirations
respirations increase in rate and depth
exhalation lasts longer than inhalation
respirations decrease in rate and depth
A palpable pulse is created by:
the pressure of circulating blood against the walls of the arteries
the pressure that is caused when venous blood returns to the heart
pressure waves through the arteries caused by cardiac contraction
electrical conduction in the heart producing ventricular contraction
acute prancreatitis
A 56-year-old male is found semiconscious by his wife. Your assessment reveals that his respirations are rapid and shallow, his pulse is rapid and irregular, and his blood pressure is low. The patient's wife states that he complained of left arm pain and nausea the day before, but would not allow her to call 9-1-1. The MOST likely cause of this patient's present condition is:
acute myocardial infarction
cardiogenic hypoperfusion
severe septic hypoperfusion
a ruptured aortic aneurysm
The EMT's scope of practice within his or her local response area is defined by the:
medical director
state EMS office
EMS supervisor
local health district
Breathing is often more labor intensive in older adults because the:
elasticity of the lungs decreases
surface area of the alveoli increases
overall size of the airway decreases
diaphragm and intercostal muscles enlarge
Muscle control and body coordination are controlled by the:
cerebrum
cerebellum
brain stem
cerebral cortex
A 67-year-old female presents with difficulty breathing and chest discomfort that awakened her from her sleep. She states that she has congestive heart failure, has had two previous heart attacks, and has prescribed nitroglycerin. She is conscious and alert with adequate breathing. Her blood pressure is 94/64 mm Hg and her heart rate is 120 beats/min. Treatment for this patient includes:
A pleural effusion is MOST accurately defined as:
a unilaterally collapsed lung
diffuse collapsing of the alveoli
fluid accumulation outside the lung
a bacterial infection of the lung tissue
