EMT Section 6

In which of the following situations would it be MOST appropriate to utilize an air medical transportation service?

61-year-old man with signs and symptoms of a stroke and your ground transport time is 50 minutes

An infectious disease is MOST accurately defined as:

a medical condition caused by the growth and spread of small harmful organisms within the body

Typical chief complaints in patients with an infectious disease include:

fever, rash, nausea, and difficulty breathing

Upon initial contact with a patient who appears to be unconscious, you should:

attempt to elicit a verbal response by talking to the patient

Hepatitis B is more virulent than hepatitis C, which means that it:

has a greater ability to produce disease

Alkalosis is a condition that occurs when:

blood acidity is reduced by excessive breathing

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

aspiration pneumonia

A pleural effusion is MOST accurately defined as:

fluid accumulation outside the lung

Dyspnea is MOST accurately defined as:

shortness of breath or difficulty breathing

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?

spontaneous pneumothorax

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:

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

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

abnormal breath sounds

Albuterol is a generic name for:

Proventil

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?

oxygen via nonrebreathing mask and a focused secondary assessment

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 embolism

When the level of arterial carbon dioxide rises above normal:

respirations increase in rate and depth

Weakening of the airway in patients with chronic bronchitis is the result of:

destruction of protective mechanisms that remove foreign particles

Which of the following statements regarding severe acute respiratory syndrome (SARS) is correct?

SARS is a viral infection that often begins with flulike symptoms

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 a nasopharyngeal airway and begin assisted ventilation

Common signs and symptoms of acute hyperventilation syndrome include:

tachypnea and tingling in the extremities

In contrast to the sympathetic nervous system, the parasympathetic nervous system

slows the heart and respiratory rates

Which of the following medications is commonly given to patients with chest pain to prevent blood clots from forming or getting bigger?

aspirin

Prior to defibrillating a patient with an AED, it is MOST important that you:

ensure that no one is touching patient

You are treating a patient with signs and symptoms of a myocardial infarction (MI). What is the most important drug you should administer?

Oxygen

You are on the scene of a 64-year-old male with substernal chest pain. His vital signs are blood pressure 90/70, pulse 80, respiratory rate 20, and oxygen saturation 95 percent on room air. He has a history of angina pectoris and high cholesterol. The patient is not allergic to any medications. What medications should you administer?

Oxygen and aspirin

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 being noncompliant with her antihypertensive medications. When you assess her, you find that her blood pressure is significantly higher in her left arm than it is in her right arm. What are her signs and symptoms MOST indicative of?

dissecting aortic aneurysm

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:

perform CPR for 2 minutes and reassess

When after load increases:

it becomes harder for the ventricle to push blood through the blood vessels

You are on the scene of a 68-year-old male patient complaining of severe chest pain for the last 20 minutes. He has a previous history of myocardial infarction and states it feels "just like the last time." You have applied oxygen and assisted him in administering aspirin and nitroglycerin with no reduction in the chest pain. Your nearest facility is 5 minutes away, a Level III Trauma Center is 10 minutes away, and a hospital with cardiac catheterization capabilities is 20 minutes away. The patient is requesting to be transported to his cardiologist's hospital, which is 30 minutes away. Which hospital is the best hospital?

The nearest hospital with cardiac catheterization

You are treating a male patient with chest pain caused by the complete occlusion of one of the coronary arteries. What would you most likely expect with this patient?

His pain will not be alleviated with any of the above medications

Sudden death following AMI is MOST often caused by:

ventricular fibrillation

Nitroglycerin relieves cardiac-related chest pain by:

dilating the coronary arteries and improving cardiac blood flow

Which of the following represents the MOST appropriate method of assisting a patient with his or her prescribed nitroglycerin tablet or spray?

Administer the medication sublingually and allow it to dissolve or absorb

You suspect that your patient is suffering from angina pectoris. What signs or symptoms would you expect to see with this condition?

Chest pain that is relieved with nitroglycerin

A 49-year-old male presents with an acute onset of crushing chest pain and diaphoresis. You should:

assess the adequacy of his respirations

What are the three items that make up the Cincinnati Prehospital Stroke Scale?

Ask the patient to smile, hold his arms straight out in front of him with his eyes closed, and ask him to say a sentence to see if it is clear

The medical term for fainting is:

syncope

Which of the following is a typical cause of seizures in children 6 months to 3 years of age?

Fever

Which of the following is the most critical piece of equipment to have immediately available for the seizure patient who has just stopped convulsing?

Suction

A patient who demonstrates any one of the three symptoms from the Cincinnati Prehospital Stroke Scale has a ______ percent chance of having an acute stroke

70

With advances in clot-busting (thrombolytic) drugs, the patient has a window of _______ hours to receive treatment

3

Which of the following is the most important intervention the EMT can provide to the patient having a stroke?

Avoiding delay in transporting to the hospital

You are called to the scene of a 16-year-old female patient complaining of severe lower quadrant abdominal pain. The patient states she is sexually active. Upon palpation, you observe rebound tenderness in the right lower quadrant. You suspect:

appendicitis

You respond to a 75-year-old female who is complaining of epigastric pain that feels like heartburn and radiates to the right shoulder. Her vital signs are stable and she has a previous history of an myocardial infarction. She has prescription nitroglycerine tablets. An ALS unit is en route. After performing a physical examination and applying oxygen by nasal cannula, you should:

contact medical control regarding the administration of the patient's nitroglycerin

You are called to the scene of a patient with abdominal pain. Upon arrival, you find a 38- year-old Asian man on the floor next to his desk writhing in pain. He is complaining of severe right-sided flank pain. His blood pressure is 140/90, pulse 100, and his skin is ashen and diaphoretic. You suspect:

renal colic

You respond to an abdominal pain call. Your partner suspects that the patient is having an abdominal aortic aneurysm (AAA). What type of pain is the patient most likely experiencing?

Tearing

Many diabetics today have an insulin pump. Which of the following statements about insulin pumps is not true?

They are usually worn around the ankle

The condition in which there is an insufficient amount of sugar in the blood is called:

hypoglycemia

Normal consciousness is regulated by a series of neurologic circuits in the brain that comprise the reticular activating system (RAS). The RAS has simple requirements to function properly. Which one of the items below is not one of those requirements?

Blood

If the blood sugar level is very high, which of the following may result?

Excessive urination, excessive thirst, and excessive hunger

Which of the following is an action of insulin?

It increases the movement of sugar from the bloodstream to the cell

Which of the following may result in hypoglycemia in the diabetic patient?

Vomiting after eating a meal

When someone is experiencing hypoglycemia, the body attempts to compensate by using the fight-or- flight mechanism of the autonomic nervous system. Which one of the statements below is not one of the fight-or-flight responses?

The skin is hot and dry

Most of the diabetic emergencies that you will be called to deal with will be related to hypoglycemia. However, occasionally you will experience an instance of hyperglycemia. In the list below, which item is not likely to be a sign or symptom of hyperglycemia?

A reduced rate of breathing

The most common medical emergency for the diabetic is hypoglycemia, or low blood sugar. Which one of the factors below is not a cause of hypoglycemia?

Reduces sugar intake by eating too much

During your primary assessment you find your patient has an altered mental status. This could indicate which of the following?

Failing respiratory system

Which of the following is a general term for a substance to which the body may have an anaphylactic reaction?

Allergen

What is another name for a severe allergic reaction?

Anaphylaxis

Your patient is a 2-year-old conscious male who has swallowed a small quantity of bleach. Which of the following findings should you evaluate the patient for?

Irritation in and around the mouth

Which of the following is the reason why infants rarely experience anaphylactic reactions?

Infants have not yet developed antibodies to allergens

Your patient is experiencing signs and symptoms of an allergic reaction. Which of the following is a priority in this patient's care?

Administer oxygen by nonrebreather mask

You are managing a patient who has been stung by a bee and has had an allergic reaction to bee stings in the past. The patient has some localized redness and swelling in the area of the bee sting but is not having difficulty breathing. Of the following, which would be performed first for this patient?

Continue the focused assessment

You have responded to a park where you find a 23-year-old female sitting on a bench near a running trail. She states that she has been running for the past 30 minutes, and all of a sudden she can't catch her breath. She states that this has never happened before and she usually runs 5 miles a day. Your assessment reveals that she is flushed, her pulse is fast and weak, her respirations are fast and she is wheezing, and she has hives on her arms and chest. She is most likely suffering from which of the following?

Anaphylaxis

Which of the following would you expect to hear when auscultating the lungs of a patient having an anaphylactic reaction?

Wheezing

Which of the following is MOST likely to be a complaint of a patient suffering from anaphylaxis?

"My throat feels like it is closing."

Which of the following is NOT a sign or symptom of an allergic reaction involving the skin?

Cyanosis

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:

assisted ventilation with a bag-mask device

When caring for a known alcoholic patient with severe trauma to the chest and abdomen, you should be concerned that:

internal bleeding may be profuse because prolonged alcohol use may impair the blood's ability to clot.

As you enter the residence of a patient who has possibly overdosed, you should:

be alert for personal hazards

It is MOST important to determine a patient's weight when asking questions pertaining to a toxic ingestion because:

activated charcoal is given based on a patient's weight

Most poisonings occur via the __________ route

ingestion

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:

DTs

After administering activated charcoal to a patient, it is MOST important to:

be alert for vomiting

A patient who presents with rapid breathing, nausea and vomiting, ringing in the ears, and a high fever should be suspected of ingesting a significant quantity of:

aspirin

Which of the following statements regarding the Salmonella bacterium is correct?

The Salmonella bacterium itself causes food poisoning

In addition to ensuring his or her own safety, the EMT's responsibility when caring for a patient with a behavioral emergency is to:

diffuse and control the situation and safely transport the patient

Your number one priority during a behavioral emergency is to:

Scene Safety

Common causes of acute psychotic behavior include all of the following, EXCEPT:

Alzheimer's disease

The term "behavioral crisis" is MOST accurately defined as:

any reaction that interferes with activities of daily living or is deemed unacceptable by others

You are assessing a conscious 55-year-old male with a sudden change in behavior. Which of the following clinical findings would be MOST suggestive of dysfunction of this patient's central nervous system?

rapid eye movement

The first step in assessing a patient with a behavioral emergency is to:

ensure your safety

Which of the following statements regarding the physical examination of a patient with a behavioral problem is correct?

A physical examination for a behavioral problem may be difficult to perform but may provide clues to the patient's state of mind and thought processes

Organic brain syndrome is MOST accurately defined as:

a dysfunction of the brain caused by abnormal physical or physiological function

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 large body

Signs of agitated delirium include:

diaphoresis, tachycardia, and hallucinations

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:

calmly identify yourself to the patient

A 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

General guidelines for managing a patient with a behavioral emergency include

being prepared to spend extra time with the patient

People at risk for suicide include all of the following, EXCEPT:

married males older than 30 years

When assessing a patient with a behavioral crisis, you should:

be direct and clearly state your intentions

Which of the following conditions or factors would be the LEAST likely to result in a change in behavior?

antihypertensive medications

The single most significant factor that contributes to suicide is:

depression

It is MOST important for the EMT to remember that suicidal patients may:

be homicidal as well

___________ is what you can see of a person's response to the environment

Behavior

From a mental health standpoint, an abnormal or disturbing pattern of behavior is a matter of concern if it lasts for at least:

1 month

PID typically does NOT affect the:

urinary bladder

In anticipation of receiving a fertilized ovum, the lining of the uterine wall:

becomes engorged with blood

Which of the following statements regarding rape is correct?

Rape is a legal diagnosis, not a medical diagnosis

It is not uncommon for young females who experience their first menstrual period to:

experience abdominal cramping, which may be misinterpreted

Each ovary produces an ovum in alternating months and releases it into the:

fallopian tube