EMT FISDAP READINESS EXAM 4 Questions and Answers (2022/2023) (Verified Answers)

In contrast to the assessment of a trauma patient, assessment of a medical patient:

almost exclusively focuses on physical signs that indicate the patient is experiencing a problem.

is focused on the nature of illness, the patient's chief complaint, and his or her symptoms.

requires a thorough head-to-toe exam that involves a detailed assessment of all body systems.

is not as complex for the EMT because most patients typically present with classic symptoms.

b

Which of the following statements regarding medical emergencies is correct?

Medical emergencies always take priority over traumatic injuries.

Medical emergencies can appear to be trauma in nature.

Medical emergencies and traumatic injuries always have distinctive presentations.

Medical emergencies rarely precipitate traumatic injuries.

b

You and your EMT partner arrive at the residence of a 50-year-old man who complains of weakness. Your primary assessment reveals that he is critically ill and will require aggressive treatment. The closest hospital is 25 miles away. You should:

perform a detailed secondary assessment, assess his vital signs, and then transport rapidly.

manage all threats to airway, breathing, and circulation and consider requesting an ALS unit.

administer oxygen via nonrebreathing mask and obtain as much of his medical history as possible.

load him into the ambulance, begin transport, and perform all treatment en route to the hospital.

b

ou have just completed your primary assessment of a 48-year-old man with crushing chest pain. The patient has been given 324 mg of aspirin and is receiving high-flow oxygen via nonrebreathing mask. As you begin your secondary assessment, you note that his mental status has deteriorated and he is now bradycardic. You should:

continue with your secondary assessment.

prepare the patient for immediate transport.

insert a nasal airway and assist his breathing.

request an ALS unit to respond to the scene.

b

A 33-year-old female presents with lower abdominal quadrant pain. She is conscious and alert, but in moderate pain. While your partner is asking her questions about her medical history, you take her vital signs. When you assess her radial pulse, you are unable to locate it. You should:

assess the rate, regularity, and quality of her carotid pulse.

advise your partner that the patient's blood pressure is low.

immediately take her blood pressure to see if she is hypotensive.

conclude that she is perfusing adequately since she is conscious.

a

Ten days after treating a 34-year-old patient with tuberculosis, you are given a tuberculin skin test, which yields a positive result. This MOST likely indicates that:

you are actively infected with tuberculosis and should be treated immediately.

the disease is dormant in your body, but will probably never cause symptoms.

you contracted the disease by casual contact instead of exposure to secretions.

you were exposed to another infected person prior to treating the 34-year-old patient.

d

Which of the following statements regarding the human immunodeficiency virus (HIV) is correct?

HIV is far more contagious than hepatitis B and is easily transmitted in the health care setting.

The risk of HIV infection is high, even if an infected person's blood comes in contact with your intact skin.

The risk of HIV infection is greatest when deposited on a mucous membrane or directly into the bloodstream.

Most patients who are infected with HIV experience chronic symptoms that vary in duration and severity.

c

A 58-year-old man complains of chest discomfort and nausea. He is conscious and alert. His blood pressure is 140/90 mm Hg, his pulse is 104 beats/min, and his respirations are 16 breaths/min. Your partner has applied supplemental oxygen. Prior to assisting the patient with one of his prescribed nitroglycerin tablets, you ask him if he takes medication to treat erectile dysfunction and he tells you that he does. You should:

avoid giving him nitroglycerin and transport him at once.

ask him what he takes, how much, and when he last took it.

recall that medications for erectile dysfunction can cause hypertension if given with nitroglycerin.

administer his nitroglycerin and then reassess his blood pressure.

b

Your primary assessment of an elderly woman reveals that she is conscious and alert, but she is experiencing difficulty breathing. She has a history of emphysema, hypertension, and congestive heart failure. As you assess the patient's circulatory status, you should direct your partner to:

perform a head-to-toe secondary assessment.

assess her oxygen saturation and blood pressure.

retrieve the stretcher and prepare for transport.

administer oxygen with the appropriate device.

d

Which of the following is MOST characteristic of adequate breathing?

22 breaths/min with an irregular pattern of breathing and cyanosis

20 breaths/min with shallow movement of the chest wall and pallor

24 breaths/min with bilaterally equal breath sounds and pink skin

30 breaths/min with supraclavicular retractions and clammy skin

c

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.

c

Which of the following statements regarding anaphylaxis is correct?

Patients with asthma are at lower risk of developing anaphylaxis.

Anaphylaxis is characterized by airway swelling and hypotension.

Most anaphylactic reactions occur within 60 minutes after exposure.

The signs of anaphylaxis are caused by widespread vasoconstriction.

b

A 59-year-old male with a history of emphysema complains of an acute worsening of his dyspnea and pleuritic chest pain following a forceful cough. Your assessment reveals that he has a barrel-shaped chest, unilaterally diminished breath sounds, and tachycardia. What is the MOST likely cause of this patient's condition?

rupture of the diaphragm

exacerbation of his COPD

acute pulmonary embolism

spontaneous pneumothorax

d

You receive a call for a 70-year-old female with respiratory distress. Her husband tells you that she has congestive heart failure; however, he does not think that she has been taking her medications as prescribed. The patient is laboring to breathe, appears tired, and has cyanosis around her lips. You should:

assist her ventilations with a bag-mask device.

apply a pulse oximeter and obtain vital signs.

administer oxygen via a nonrebreathing mask.

obtain a complete list of all of her medications.

a

22-year-old female patient is complaining of dyspnea and numbness and tingling in her hands and feet after an argument with her fiancé. Her respirations are 40 breaths/min. You should:

have her breathe into a paper or plastic bag.

provide reassurance and give oxygen as needed.

request a paramedic to give her a sedative drug.

position her on her left side and transport at once.

b

A 62-year-old man with a history of congestive heart failure presents with severe respiratory distress and an oxygen saturation of 82%. When you auscultate his lungs, you hear widespread rales. He is conscious and alert, is able to follow simple commands, and can only speak in two- to three-word sentences at a time. You should:

place him in a position of comfort, deliver oxygen via nasal cannula, and closely monitor his breathing.

apply a continuous positive airway pressure (CPAP) device, monitor his blood pressure, and observe him for signs of improvement or deterioration.

force fluid from his alveoli by hyperventilating him with a bag-mask device at a rate of at least 20 breaths/min.

place him in a supine position and assist his ventilations with a bag-mask device and high-flow oxygen.

b

A conscious and alert 29-year-old woman with a history of asthma complains of difficulty breathing that began after her morning jog. The temperature outside is 40°F (5°C). On examination, you hear bilateral expiratory wheezing. After providing 100% oxygen, you should:

place her in a recumbent position to facilitate breathing.

contact medical control and administer an antihistamine.

call medical control and ask how to proceed with treatment.

determine if she has been prescribed a beta-agonist inhaler.

d

While auscultating an elderly woman's breath sounds, you hear low-pitched "rattling" sounds at the bases of both of her lungs. This finding is MOST consistent with which of the following conditions?

acute asthma attack

widespread atelectasis

aspiration pneumonia

early pulmonary edema

c

When auscultating the lungs of a patient with respiratory distress, you hear adventitious sounds. This means that the patient has:

normal breath sounds.

abnormal breath sounds.

diminished breath sounds.

an absence of breath sounds.

b

A 60-year-old man presents with acute respiratory distress. He is conscious and alert, has pink, 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 ventilation 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

b

A 30-year-old man presents with acute shortness of breath, widespread hives, and facial swelling. He denies any past medical history and takes no medications. During your assessment, you hear wheezing over all lung fields. His blood pressure is 90/50 mm Hg and his heart rate is 110 beats/min. In addition to giving him 100% oxygen, the MOST important treatment for this patient is:

albuterol.

epinephrine.

an antihistamine.

a beta-antagonist.

b

An alert patient presents with a regular pattern of inhalation and exhalation and breath sounds that are clear and equal on both sides of the chest. These findings are consistent with:

an obstructed airway.

adequate air exchange.

respiratory difficulty.

respiratory insufficiency.

b

At 0500 hours, you respond to the home of a 76-year-old man complaining of chest pain. Upon arrival, the patient states that he had been sleeping in the recliner all night due to indigestion, when the pain woke him up. He also tells you he has taken two nitroglycerin tablets. His vital signs are as follows: respirations, 16 breaths/min; pulse, 98 beats/min; blood pressure, 92/76 mm Hg. He is still complaining of chest pain. What actions should you take to intervene?

Provide high-flow oxygen.

Administer a third nitroglycerin tablet.

Apply an AED.

Begin chest compressions.

a

Your EMS team is performing CPR on a 60-year-old male in cardiac arrest. You connect the AED, push the analyze button, and receive a "no shock advised" message. You should:

reanalyze the patient's cardiac rhythm.

perform CPR for 2 minutes and reassess.

determine if a palpable pulse is present.

immediately assess the patient's airway.

b

You are dispatched to a convenience store for a patient who passed out. Upon arriving at the scene, you find two bystanders performing CPR on the patient, a 58-year-old male. Your initial action should be to:

assess the effectiveness of the bystanders' CPR.

quickly attach the AED and push the analyze button.

have the bystanders stop CPR and assess the patient.

request a paramedic unit and quickly attach the AED.

c

A 66-year-old female with a history of hypertension and diabetes presents with substernal chest pressure of 2 hours' duration. Her blood pressure is 140/90 mm Hg, her pulse is 100 beats/min and irregular, and her respirations are 22 breaths/min with adequate depth. The patient does not have prescribed nitroglycerin, but her husband does. You should:

administer oxygen, give her 324 mg aspirin, and assess her further.

obtain a SAMPLE history and contact medical control for advice.

give her 100% oxygen, attach the AED, and transport immediately.

give her one nitroglycerin and reassess her systolic blood pressure.

a

You are dispatched to a residence for a 56-year-old male with an altered mental status. Upon arrival at the scene, the patient's wife tells you that he complained of chest pain the day before, but would not allow her to call EMS. The patient is semiconscious; has rapid, shallow respirations; and has a thready pulse. You should:

obtain baseline vital signs.

begin ventilatory assistance.

attach the automated external defibrillator (AED) immediately.

apply a nonrebreathing mask.

b

You are assessing a 49-year-old man who complains of chest pressure that began the night before. He is conscious, but anxious, and tells you he has a history of angina and hypertension. After applying high-flow oxygen, you expose his chest to auscultate his lungs and note that he has a nitroglycerin patch on his right upper chest. His skin is cool and pale, his blood pressure is 78/50 mm Hg, and his pulse is 110 beats/min and irregular. You should:

remove the nitroglycerin patch, place him in a supine position and elevate his lower extremities, and prepare for immediate transport.

immediately remove the nitroglycerin patch, apply the AED in case he develops cardiac arrest, and transport to the closest hospital.

move the nitroglycerin patch to the other side of his chest in case you need to apply the AED, keep him warm, and transport without delay.

ask him if the nitroglycerin patch he is wearing has improved hi

a

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 CPR and apply the AED without delay.

have your partner perform CPR while you question bystanders.

perform two-rescuer CPR for 5 minutes and request ALS backup.

immediately apply the AED pads and analyze the cardiac rhythm.

a

A 40-year-old man is in cardiac arrest. Your partner is performing CPR. You are attaching the AED when the patient's wife tells you that he has an automatic implantable cardiac defibrillator (AICD). The AED advises that a shock is indicated. What should you do?

Avoid defibrillation as this will damage the patient's AICD.

Contact medical control and request permission to defibrillate.

Deliver the shock followed by immediate resumption of CPR.

Continue CPR and transport the patient to the closest appropriate hospital.

c

A 66-year-old woman presents with a stabbing pain in the middle of her chest that radiates to her back. She tells you that the pain suddenly began about 30 minutes ago and has been severe since the onset. She has a history of hypertension, but admits to not being compliant with her regimen of antihypertensive medications. During the primary assessment, you find that her blood pressure is significantly higher in her left arm than it is in her right arm. What do these signs and symptoms MOST likely indicate?

unstable angina

dissecting aortic aneurysm

AMI

hypertensive emergency

b

A 67-year-old woman 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:

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.

d

You are called to a home and find a 56-year-old woman supine in her bed. She appears alert, but has slurred speech. Her family tells you she has a history of TIAs and hypertension. You ask the patient, "What day is it today?" Her reply is "butterfly." Which area of the brain is likely affected?

Occipital lobe

Left hemisphere

Cerebellum

Right hemisphere

b

You arrive at a local grocery store approximately 5 minutes after a 21-year-old female stopped seizing. She is confused and disoriented; she keeps asking you what happened and tells you that she is thirsty. Her brother, who witnessed the seizure, tells you that she takes phenytoin (Dilantin) for her seizures, but has not taken it in a few days. He also tells you that she has diabetes. In addition to applying high-flow oxygen, you should:

administer one tube of oral glucose and prepare for immediate transport.

place her in the recovery position and transport her with lights and siren.

monitor her airway and breathing status and assess her blood glucose level.

give her small cups of water to drink and observe for further seizure activity.

c

You arrive at a grocery store shortly after a 35-year-old male stopped seizing. Your assessment reveals that he is confused and incontinent of urine. The patient's girlfriend tells you that he has a history of seizures and takes carbamazepine (Tegretol). When obtaining further medical history from the girlfriend, it is MOST important to:

determine if the patient is a known alcohol abuser.

obtain a description of how the seizure developed.

determine when he was last seen by his physician.

ask her how long the patient has been taking his medication.

b

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 mouth 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.

c

A 29-year-old man is experiencing a severe headache and nausea that has gradually worsened over the past 12 hours. He is conscious, alert, and oriented and tells you that his physician gave him a diagnosis of migraine headaches. He further tells you that he has taken numerous different medications, but none of them seem to help. His blood pressure is 132/74 mm Hg, his pulse is 110 beats/min and strong, and his respirations are 20 breaths/min and adequate. In addition to high-flow oxygen, further treatment should include:

assisting him with his migraine medication and transporting without lights and siren.

placing him in a supine position and transporting with lights and siren to a stroke center.

applying warm compresses to the back of his neck and transporting with lights and siren.

dimming the lights in the back of the ambulance and transporting without lights and siren.

d

What Glasgow Coma Scale (GCS) score would you assign to a patient who responds to painful stimuli, uses inappropriate words, and maintains his or her arms in a flexed position?

6

8

9

10

b

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 inches, and transport.

a

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 boy. 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.

b

ou are assessing a 49-year-old man who, according to his wife, experienced a sudden, severe headache and then passed out. He is unresponsive and has slow, irregular breathing. His blood pressure is 190/94 mm Hg and his pulse rate is 50 beats/min. His wife tells you that he has hypertension and diabetes. He has MOST likely experienced:

acute hypoglycemia.

a ruptured cerebral artery.

a complex partial seizure.

an occluded cerebral artery.

b

You have been dispatched to the home of a 52-year-old woman with severe flank pain. Which of the following would be an appropriate question to ask regarding the pain?

Have you experienced any belching?

Do you feel nauseous?

Is the pain constant or intermittent?

Have you been urinating more or less?

c

A 59-year-old male presents with a sudden onset of severe lower back pain. He is conscious and alert, but very restless and diaphoretic. Your assessment reveals a pulsating mass to the left of his umbilicus. You should:

vigorously palpate the abdomen to establish pain severity.

administer oxygen and prepare for immediate transport.

place the patient in a sitting position and transport at once.

request a paramedic unit to give the patient pain medication.

b

Which of the following is part of the male anatomy only?

Urethra

Ureter

Prostate

Bladder

c

You are transporting a 49-year-old man with "tearing" abdominal pain. You are approximately 30 miles away from the closest hospital. During your reassessment, you determine that the patient's condition has deteriorated significantly. You should:

assist his ventilations with a bag-mask device.

immediately perform a rapid physical examination.

continue transporting and alert the receiving hospital.

consider requesting a rendezvous with an ALS unit.

d

A 30-year-old woman with a history of alcoholism presents with severe upper abdominal pain and is vomiting large amounts of bright red blood. Her skin is cool, pale, and clammy; her heart rate is 120 beats/min and weak; and her blood pressure is 70/50 mm Hg. Your MOST immediate action should be to:

protect her airway from aspiration.

keep her supine and elevate her legs.

rapidly transport her to the hospital.

give her high-flow supplemental oxygen.

a

You are dispatched to an apartment complex for a young man with abdominal pain. Your priority upon arriving at the scene should be to:

quickly gain access to the patient.

notify the dispatcher of your arrival.

assess the scene for potential hazards.

place a paramedic ambulance on standby.

c

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 rate is 120 beats/min and irregular, and his respirations are 24 breaths/min and labored. You should:

leave him in a sitting position, keep him warm, and prepare for immediate transport.

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.

a

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.

b

Which of the following organs would MOST likely bleed profusely if injured?

liver

stomach

appendix

gallbladder

a

A 54-year-old golfer collapsed on the 17th green at the golf course. His friend said he wasn't feeling well after the eighth hole, but insisted on walking and finishing out the game. His skin is pale, cool, and diaphoretic, and he provides incoherent answers to your questions. An initial blood glucose measurement indicates 65 mg/dL. The patient loses consciousness and a second blood glucose level reads 48 mg/dL. You should:

call for, or rendezvous with, an ALS unit.

ensure a patent airway.

provide high-flow oxygen.

All of these answers are correct

d

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

d

30-year-old female presents with severe acute pain to the left upper quadrant of her abdomen. During your assessment, she tells you that she has sickle cell disease. You should suspect that:

her spleen is enlarged because of red blood cell engorgement.

the pain in her abdomen is referred pain from an enlarged liver.

she has gastrointestinal bleeding due to large blood vessel rupture.

she is experiencing an aplastic crisis and needs a blood transfusion

a

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.

c

A man finds his 59-year-old wife unconscious on the couch. He states that she takes medications for type 2 diabetes. He further tells you that his wife has been ill recently and has not eaten for the past 24 hours. Your assessment reveals that the patient is unresponsive. You should:

quickly assess for the presence of a medical identification tag.

administer 100% oxygen via a nonrebreathing mask.

open and maintain her airway and assess breathing.

administer oral glucose between her cheek and gum.

c

You respond to a residence for a patient who is "not acting right." As you approach the door, the patient, a 35-year-old male, begins shouting profanities at you and your partner while holding a baseball bat. The man is confused and diaphoretic, and is wearing a medical identification bracelet. You should:

calm him down so you can assess him.

be assertive and talk the patient down.

contact medical control for instructions.

retreat at once and call law enforcement.

d

19-year-old man has a chief complaint of "not feeling right." His insulin and a syringe are on a nearby table. The patient says he thinks he took his insulin and cannot remember whether he ate. He is also unable to tell you the time or what day it is. The glucometer reads "error" after several attempts to assess his blood glucose level. In addition to administering oxygen, you should:

contact medical control and administer oral glucose.

assist him with his insulin injection and reassess him.

request a paramedic ambulance to administer IV glucose.

transport only with close, continuous monitoring en route.

a

A 29-year-old woman presents with confusion and disorientation. Her respirations are rapid and shallow and her pulse is 120 beats/min and thready. She is markedly diaphoretic and has an oxygen saturation of 89%. You should:

transport immediately.

administer oral glucose.

provide ventilatory support.

treat for hyperglycemia.

c

You respond to a movie theater for a 70-year-old man who is confused. His wife tells you he has type 2 diabetes but refuses to take his pills. Your assessment reveals that the patient is diaphoretic, tachycardic, and tachypneic. Initial management for this patient should include:

administering one to two tubes of oral glucose.

applying a nonrebreathing mask at 15 L/min.

assisting the patient with his diabetic medication.

performing a rapid exam and obtaining vital signs.

b

A 75-year-old man 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:

hypoglycemia.

an acute stroke.

hyperglycemia.

a heart attack.

d

A 28-year-old woman is found to be responsive to verbal stimuli only. Her roommate states that she was recently diagnosed with type 1 diabetes and has had difficulty controlling her blood sugar level. She further tells you that the patient has been urinating excessively and her condition has progressively worsened over the last 24 to 36 hours. On the basis of this patient's clinical presentation, you should suspect that she:

is significantly hyperglycemic.

has a low blood glucose level.

has a urinary tract infection.

has overdosed on her insulin.

a

A 37-year-old woman with a history of diabetes presents with excessive urination and weakness of 2 days' duration. You apply 100% oxygen and assess her blood glucose level, which is 320 mg/dL. If this patient's condition is not promptly treated, she will MOST likely develop:

severe insulin shock.

acidosis and dehydration.

complete renal failure.

hypoxia and overhydration.

b

You have been called to a park where a local church is holding a potluck dinner. As you exit your ambulance, a woman approaches you holding her 7-year-old son who is wheezing and having difficulty breathing. She informs you that he inadvertently ate a brownie with nuts, and he is allergic to nuts. The child's mother has an EpiPen that contains the appropriate dose of epinephrine for a child. What dose would that be?

0.8 mg

0.5 mg

0.4 mg

0.15 mg

d

A 37-year-old male is having a severe allergic reaction to penicillin. He does not have an epinephrine auto-injector and your protocols do not allow you to carry epinephrine on the ambulance. How should you proceed with the treatment of this patient?

Ask the patient if he has any diphenhydramine (Benadryl) tablets that you can administer.

Administer oxygen, transport at once, and request a paramedic intercept.

Remain at the scene with the patient and request a paramedic ambulance.

Quickly determine if there are any bystanders who may carry epinephrine.

b

Assessment of his leg reveals a wheal surrounded by an area of redness. He states that he had a "bad reaction" the last time he was stung by a scorpion, and carries his own epinephrine auto-injector. You should:

apply high-flow oxygen, apply a chemical cold pack directly to the injection site, and transport at once.

apply high-flow oxygen, obtain approval from medical control to assist him with his epinephrine, and transport.

assess his ABCs and vital signs in 15 minutes and allow him to drive himself to the hospital if he remains stable.

apply oxygen as needed, clean the area with soap and water or a mild antiseptic, and transport him to the hospital.

d

A 48-year-old male is found unconscious in the garden by his wife. When you arrive at the scene and assess the man, you find that he is unresponsive, has severely labored breathing, and has hives over his entire trunk. You should:

perform a detailed secondary assessment.

maintain his airway and assist his ventilations.

ask his wife if he has any known allergies.

apply the automated external defibrillator (AED) in the event that cardiac arrest occurs.

b

A 50-year-old male was stung by a honeybee approximately 15 minutes ago. He presents with respiratory distress, facial swelling, and hypotension. After placing him on oxygen and administering his epinephrine via auto-injector, you note that his breathing has improved. Additionally, his facial swelling is resolving and his blood pressure is stable. Your next action should be to:

reassess his breathing and blood pressure in 15 minutes.

visualize his airway to assess for oropharyngeal swelling.

notify medical control of the patient's response to your treatment.

record the time and dose of the injection, and transport promptly.

d

A 19-year-old female was stung multiple times on the legs by fire ants. She states that she is allergic to fire ants, but does not carry her own epinephrine. The patient is conscious and alert and complains of pain to the area of the bites. Her blood pressure is 122/70 mm Hg, her pulse is 100 beats/min and strong, and her respirations are 18 breaths/min and unlabored. You should:

position her legs well above the level of her heart.

administer oxygen and transport her to the hospital.

request a paramedic unit to administer epinephrine.

advise her to see her physician as soon as possible.

b

ou have administered one dose of epinephrine to a 40-year-old woman to treat an allergic reaction that she experienced after being stung by a scorpion. Your reassessment reveals that she is still having difficulty breathing, has a decreasing mental status, and has a blood pressure of 80/50 mm Hg. You should:

monitor her en route to the hospital and call medical control if she worsens.

crush up an antihistamine tablet and place it in between her cheek and gum.

request permission from medical control to give another dose of epinephrine.

administer a nebulized bronchodilator to improve the status of her breathing.

c

You respond to the residence of a 55-year-old woman with a possible allergic reaction to peanuts that she ate approximately 30 minutes ago. The patient is conscious and alert, but has diffuse urticaria and the feeling that she has a lump in her throat. As your partner applies oxygen to the patient, you should:

ask her if she has prescribed epinephrine.

obtain a complete set of baseline vital signs.

ascertain if she has a family history of allergies.

ask her when her last allergic reaction occurred.

a

A 38-year-old woman was bitten by fire ants while at the park with her children. 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 inches.

b

At the site of the injury, signs and symptoms of an animal or insect bite or sting may include pain, localized heat, and a wheal, which appears as __________.

an uncomfortable depression in the skin

a series of small, raised pustules

a raised, well-defined area of the skin

a large area of red, blotchy skin

d

A 73-year-old man presents with a generalized rash, which he thinks may have been caused by an antibiotic that he recently began taking. He has a history of coronary artery disease, hypertension, and emphysema. He is conscious and alert, his blood pressure is 144/94 mm Hg, and his pulse is 64 beats/min and regular. You auscultate his breath sounds and hear scattered wheezing, although he is not experiencing respiratory distress. In addition to administering oxygen, you should:

contact medical control if needed, transport the patient, and monitor him for signs of deterioration.

ask him if he has epinephrine and request approval from medical control to administer it to the patient.

avoid the use of epinephrine because of his cardiac history, even if his symptoms become severe.

begin transport and request to administer epinephrine if his systolic blood pressure falls below 110 mm Hg.

a

You have responded to the home of a 26-year-old woman who has reportedly taken a large number of pills in an attempt to commit suicide. As you enter the living room, you see her sleeping in her chair, with several empty alcohol containers. She is breathing heavily. You are able to arouse her consciousness for a short period of time. Which course of action takes priority?

Administer syrup of ipecac.

Cover her with a blanket to maintain body temperature.

Have her take activated charcoal while she is conscious.

Ask her why she attempted suicide.

c

Your unit is dispatched to the county jail for an intoxicated inmate. Upon arrival, you find the patient, a 33-year-old male, lying supine in a jail cell. He is responsive to painful stimuli only and has slow, shallow respirations. You should be MOST concerned that this patient:

might become violent.

may vomit and aspirate.

may experience a seizure.

is severely hypoglycemic.

b

A 49-year-old male presents with confusion, sweating, and visual hallucinations. The patient's wife tells you that he is a heavy drinker and she thinks he had a seizure shortly before your arrival. This patient is MOST likely experiencing:

acute hypovolemia.

alcohol intoxication.

acute schizophrenia.

DTs.

d (delirium tremors)

You and your paramedic partner are caring for a patient who ingested codeine, acetaminophen (Tylenol), and propoxyphene (Darvon). The patient is unresponsive, his breathing is slow and shallow, and his pulse is slow and weak. Treatment for this patient will include:

assisted ventilation, naloxone (Narcan), and rapid transport.

oxygen via a nonrebreathing mask and rapid transport.

assisted ventilation, flumazenil (Romazicon), and rapid transport.

oxygen via a nasal cannula, atropine, and rapid transport.

a

You respond to a college campus for a young male who is acting strangely. After law enforcement has secured the scene, you enter the patient's dorm room and find him sitting on the edge of the bed; he appears agitated. As you approach him, you note that he has dried blood around both nostrils. He is breathing adequately, his pulse is rapid and irregular, and his blood pressure is 200/110 mm Hg. Treatment for this patient includes:

requesting a paramedic to administer naloxone (Narcan).

assisting his ventilations with a bag-mask device.

asking law enforcement to place handcuffs on the patient.

attempting to calm him and giving him oxygen if tolerated.

d

You are dispatched to a local nursery for a 39-year-old female who is sick. When you arrive, you find the patient lying on the floor. She is semiconscious, has copious amounts of saliva coming from her mouth, and is incontinent of urine. You quickly feel her pulse and note that it is very slow. Initial management for this patient should include:

thoroughly suctioning her oropharynx.

assisted ventilation with a bag-mask device.

performing a rapid secondary assessment.

requesting a paramedic to give her atropine.

b

A 3-year-old girl ingested several leaves from a plant in the living room. The child's mother is not sure what type of plant it is, stating that she bought it simply because it was pretty. After completing your initial assessment of the child, you should:

administer 25 g of activated charcoal.

induce vomiting with syrup of ipecac.

contact the regional poison control center.

immediately transport the child to the hospital.

c

In an apparent suicide attempt, a 19-year-old woman ingested a full bottle of amitriptyline (Elavil). At present, she is conscious and alert and states that she swallowed the pills approximately 30 minutes earlier. Her blood pressure is 90/50 mm Hg, her pulse is 140 beats/min and irregular, and her respirations are 22 breaths/min with adequate depth. When transporting this patient, you should be MOST alert for:

acute respiratory depression.

a sudden outburst of violence.

an increase in her blood pressure.

seizures and cardiac arrhythmias.

d

You respond to a local motel for a young woman who was sexually assaulted. The patient is conscious but confused. She tells you that the last thing she remembers was drinking beer at a club with her friends the night before. When she awoke, she was in the bed of the motel room. You should be MOST suspicious that this patient:

is a heroin abuser.

is acutely intoxicated.

was given flunitrazepam (Rohypnol).

is abusing marijuana.

c

During your assessment of a 50-year-old man who was found unconscious in an alley, you note that he has slow, shallow respirations; significant bradycardia; facial cyanosis; and pinpoint pupils. As your partner begins assisting the patient's ventilations, he directs your attention to the patient's arms, which have multiple needle tracks on them. This patient's clinical presentation is MOST consistent with:

a heroin overdose.

alcohol intoxication.

a closed head injury.

an overdose of diazepam (Valium).

a

A 4-year-old male ingested an unknown quantity of acetaminophen (Tylenol). The child's mother states that the ingestion occurred approximately 20 minutes ago. The child is conscious and alert and in no apparent distress. After contacting medical control, you should:

induce vomiting with syrup of ipecac.

transport the child for definitive care.

administer up to 25 g of activated charcoal.

give the child cold milk to absorb the Tylenol.

c

You receive a call to a residence where a man found his wife unconscious on the couch. The patient is unresponsive, her respiratory rate is 8 breaths/min, her breathing is shallow, her heart rate is 40 beats/min, and her pulse is weak. The husband hands you an empty bottle of hydrocodone (Vicodin), which was refilled the day before. You should:

initiate ventilatory assistance.

contact the poison control center.

perform a rapid head-to-toe exam.

apply oxygen via a nonrebreathing mask.

a

Dean, a man in his 50s, is acting irrationally. His wife states that he thinks he is the dictator of a small country, and he is wearing nothing but a baseball cap and a belt with a small handgun attached to it. What is your best course of action?

Call for ALS backup.

Assess Dean from a distance.

Have his wife take the gun from him.

Call for police backup.

d

A 38-year-old male with a history of schizophrenia is reported by neighbors to be screaming and throwing things in his house. You are familiar with the patient and have cared for him in the past for unrelated problems. Law enforcement officers escort you into the residence when you arrive. The patient tells you that he sees vampires and is attempting to ward them off by screaming and throwing things at them. He has several large lacerations to his forearms that are actively bleeding. The MOST appropriate way to manage this situation is to:

try to gain the patient's trust by telling him that you see the vampires too.

request that the police officers arrest him and take him to the hospital.

restrain the patient with appropriate force in order to treat his injuries.

approach the patient and calm him by placing your hand on his shoulder.

c

22-year-old male with a history of clinical depression called 9-1-1 and stated that he has attempted to kill himself. Your unit and law enforcement officers arrive at the scene simultaneously. You find the patient lying supine on the living room floor. He is unconscious and cyanotic. An empty bottle of hydromorphone (Dilaudid) is found on an adjacent table. You should:

open the patient's airway and assess his respirations.

ask the police to handcuff the patient for safety purposes.

provide care after determining what Dilaudid is used for.

wait for the police to examine him before providing care.

a

A 40-year-old male intentionally cut his wrist out of anger after losing his job. Law enforcement has secured the scene prior to your arrival. As you enter the residence and visualize the patient, you can see that he has a towel around his wrist and a moderate amount of blood has soaked through it. You should:

approach the patient with caution.

quickly tend to the bleeding wound.

tell the patient that you want to help.

calmly identify yourself to the patient.

d

You respond to a call for an unknown emergency. When you arrive at the scene, the patient's husband meets you at the door and states that his wife has been depressed and has locked herself in an upstairs bedroom. He further tells you that he keeps his handgun in the bedroom. You should:

ask the husband to attempt to reason with his wife.

remain in a safe place and request law enforcement.

get in your ambulance and leave the scene immediately.

go upstairs with caution and attempt to talk to the patient.

b

A 78-year-old female presents with an acute change in her behavior. The patient's son tells you that his mother has type 2 diabetes and was diagnosed with Alzheimer's disease 6 months ago. The patient's speech is slurred and she is not alert to her surroundings. You should:

transport the patient to a psychiatric facility.

inquire about the possibility of head trauma.

conclude that the patient's blood sugar is high.

allow the patient to refuse transport if she wishes.

b

Which of the following is considered an organic brain syndrome?

schizophrenia

Alzheimer disease

anxiety conditions

depression

b

You receive a call for a domestic dispute. When you arrive at the scene, you find a young male standing on the front porch of his house. You notice that an adjacent window is broken. The patient has a large body, is clenching his fists, and is yelling obscenities at you. Which of the following findings is LEAST predictive of this patient's potential for violence?

his clenched fists

the broken window

his shouting of obscenities

his large body

d

Law enforcement personnel request your assistance for a 30-year-old man who they pulled over for erratic driving. The patient became acutely violent while he was being questioned, which required one of the officers to subdue him with a Taser. When you arrive and assess the patient, you find that he is very agitated and is apparently experiencing hallucinations. His skin is flushed and diaphoretic. You should:

quickly rule out any life-threatening conditions and then perform a detailed secondary assessment as he is being restrained.

suspect that he is acutely hypoglycemic, consider giving him one tube of oral glucose, and transport with lights and siren.

limit physical contact with the patient as much as possible and avoid interrupting him if he is attempting to communicate with you.

recognize that he is experiencing a complex psychiatric crisis, quickly load him into the ambulance, and immediately transport.

c

You are assessing a 45-year-old woman who is severely depressed. She states that it seems as though her entire world is crashing down around her. She further states that she has had frequent thoughts of suicide, but is not sure if she can actually go through with it. How should you manage this situation?

Ask the patient if she has developed a plan for suicide.

Leave the scene and have a neighbor check in on her.

Have law enforcement place her in protective custody.

Encourage the patient to remain quiet during transport.

a

You are called to the scene of a possible assault. Upon arrival, you are directed by police to a dark room where you find a 22-year-old woman who says she was sexually assaulted by a coworker this afternoon. The patient tells you that she would really like to be transported to the hospital but refuses a physical examination. You should:

explain to her that she cannot be transported without a physical exam.

have the police take the patient into custody in order to legally force a physical exam.

explain to her that this is a criminal case and that she must be examined.

follow your system's refusal of treatment policy and respect the patient's wishes without judgment.

d

You are dispatched to a residence for a 40-year-old female who complains of lower abdominal pain, fever and chills, and a foul-smelling vaginal discharge. Which of the following additional assessment findings would increase your index of suspicion for PID?

a shuffling gait when walking

bright red blood in the urine

a history of ectopic pregnancy

vaginal passage of blood clots

a

The EMT should perform a "rapid scan" to determine if the patient is __________ during the __________.

stable or unstable; primary assessment

breathing or not breathing; primary assessment

complaining of vaginal bleeding; history taking

pregnant; secondary assessment

a

______________ may be a cause of vaginal bleeding in a patient who states that she is NOT pregnant.

Bacterial vaginosis

Hypotension

Ectopic pregnancy

Menopause

c

The sperm typically fertilizes the egg in the _________.

fallopian tube

vagina

uterus

ovary

a