EMT Chapter 28 Chapter Test

The correct terminology used for patients whose kidneys are damaged to the point where they require dialysis to survive​ is:

​end-stage renal disease.

A patient with a medical history of sickle cell anemia is complaining of chest pain and shortness of breath. The patient is breathing 26 times per minute in​ short, shallow respirations.​ However, the​ patient's oxygen saturation via pulse oximetry is​ 100% on room air. The best approach regarding supplemental oxygen is​ to:

place the patient on a nonrebreather mask.

Peritoneal dialysis allows patients to dialyze at home​ through:

the abdomen.

You are dispatched to a private residence for a sick person. When you​ arrive, you are told by the patient that due to the snow storm yesterday he missed his scheduled appointment at the dialysis center and is not feeling well. Your assessment does not reveal anything remarkable outside of the fact that he has missed his dialysis. Which of the steps below would not be part of your​ care?

A.

Assess the ABCs.

B.

Place the patient in a supine position.

C.

When you obtain vital​ signs, obtain a blood pressure on an arm that does not have a fistula.

D.

Administer oxygen at 15 lpm by nonrebreather mask.

B.

Place the patient in a supine position.

The​ kidney's major​ function(s) include(s):

A.

maintaining blood volume.

B.

balancing electrolytes.

C.

excreting urea.

D.

All of the above

D.

All of the above

Patients who dialyze at home are at high risk for what type of​ infection?

A.

Cellulitis

B.

Fistula infection

C.

Peritonitis

D.

Decubitus ulcers

C.

Peritonitis

Once you encounter uncontrolled bleeding from an AV​ fistula, which of the following methods would you consider using to control bleeding in addition to direct pressure and​ elevation?

A.

Tourniquet

B.

Internal wound management

C.

Hemostatic dressings

D.

Pressure points

C.

Hemostatic dressings

You encounter a patient who has been having diffuse abdominal pain for one week. The patient has a pulse rate of​ 86, a blood pressure of​ 140/90, and a respiratory rate of 20.​ However, the patient appears pale and complains of generalized weakness and shortness of breath during everyday activities. You suspect the patient is​ experiencing:

A.

sickle cell anemia.

B.

chronic anemia.

C.

anxiety disorder.

D.

acute anemia.

B.

chronic anemia.

Because of abnormally shaped​ hemoglobin, sickle cell anemia​ (SCA) patients may occasionally experience​ ________, causing a blockage of small blood vessels.

A.

clumping

B.

clotting

C.

sludging

D.

aggregation

C.

sludging

The most frequently transplanted organ is​ the:

A.

kidney.

B.

liver.

C.

pancreas.

D.

heart.

A.

kidney.

Approximately what percentage of United States dialysis patients treat themselves at​ home?

A.

8 percent

B.

16 percent

C.

50 percent

D.

25 percent

A.

8 percent

You are dispatched to a sick call. The patient was just extricated from a bathtub where he was trapped under the shower door for 2 days. The​ 72-year-old male had limited access to water from the bathtub faucet. The patient is complaining of​ disorientation, nausea, and vomiting. What do you think is the underlying cause for the​ illness?

A.

Gastrointestinal infection

B.

​End-stage renal disease

C.

Chronic renal failure

D.

Acute renal failure

D.

Acute renal failure

You suspect a patient who has been having a difficult time controlling the bleeding following a small laceration to the foot may have a history​ of:

A.

high blood pressure.

B.

sickle cell anemia.

C.

poorly controlled diabetes.

D.

taking blood thinners.

D.

taking blood thinners.

You are dispatched to a private residence for a​ 52-year-old African American male sitting in his living room complaining of chest pain. During your​ assessment, he discloses that he has the sickle cell trait. Because of this you​ should:

A.

treat the patient as any other​ 52-year-old with chest pain.

B.

administer​ high-concentration oxygen.

C.

be prepared to treat for shock if he also has a high fever.

D.

monitor for signs of inadequate respiration.

A.

treat the patient as any other​ 52-year-old with chest pain.

Patients with a history of chronic sickle cell anemia​ (SCA) may present with which of the following signs and​ symptoms?

A.

Yellowing of the skin and dyspnea on exertion

B.

Pale appearance and dyspnea on exertion

C.

Bluish discoloration of the skin and shortness of breath

D.

Flushed appearance and shortness of breath

A.

Yellowing of the skin and dyspnea on exertion

Platelets are actually fragments of larger cells that are crucial to the formation of clots. Clumping​ (called aggregation) of platelets is the​ body's most rapid response to stop bleeding from an injured site.​ However, in some situations the clumping of platelets is not​ desirable, such as when a plaque in a coronary artery ruptures. In this​ situation, the rapid clumping of platelets can cause a clot that then completely blocks the coronary artery and results in a heart attack​ (myocardial infarction). One of the most effective and widely available drugs to prevent the aggregation of platelets​ is:

A.

hemoglobin.

B.

aspirin.

C.

plasma.

D.

acetaminophen.

B.

aspirin

Dialysis patients who have missed an appointment may present with signs of​ ________, which is a similar presentation to​ ________.

A.

chest​ pain; acute myocardial infarction

B.

fluid​ accumulation; congestive heart failure

C.

neurological​ disturbances; stroke

D.

shortness of​ breath; pneumonia

B.

fluid​ accumulation; congestive heart failure

Which of the following abbreviations is not​ correct?

A.

WBC for white blood cells

B.

SCA for sickle cell anemia

C.

CAPD for continuous acute peripheral disease

D.

RBC for red blood cells

C.

CAPD for continuous acute peripheral disease

You are dispatched to a private residence for a sick person. You arrive and find a​ 47-year-old male patient who recently completed his peritoneal dialysis and complains of severe abdominal pain that is worsened by movement. One of the more serious complications of this type of dialysis is a bacterial infection within the peritoneal cavity. What would be the​ tell-tale sign that this is what is happening in this​ case?

A.

The​ patient's dialysis fluid appears cloudy when it is drained from the peritoneal cavity rather than having its normal clear appearance.

B.

The patient has swollen ankles.

C.

The patient has trouble urinating.

D.

The​ patient's dialysis fluid appears clear when it is drained from the peritoneal cavity rather than having its normal cloudy appearance.

A.

The​ patient's dialysis fluid appears cloudy when it is drained from the peritoneal cavity rather than having its normal clear appearance.

You are attending to an​ end-stage renal disease​ (ESRD) patient who has missed dialysis. Which of the following statements is most​ accurate?

A.

Patients who have missed dialysis and who become unresponsive and pulseless do not respond very well to the use of an AED.

B.

Calling for ALS would not be very helpful because they cannot really do anything that an EMT cannot do in these situations.

C.

Patients who have missed dialysis and who become unresponsive and pulseless respond very well to the use of an AED.

D.

You should delay transport if necessary to wait for ALS.

A.

Patients who have missed dialysis and who become unresponsive and pulseless do not respond very well to the use of an AED.

Certain drugs are commonly referred as​ "blood thinners" or drugs that inhibit clotting. Which of the following would not be considered such a​ drug?

A.

Prilosec

B.

Aspirin

C.

Coumadin​ (warfarin)

D.

Lovenox​ (enoxaparin)

A.

Prilosec

Which of the following organs may be seriously damaged in sickle cell​ anemia, subsequently leading to severe​ infections?

A.

Spleen

B.

Lungs

C.

Kidneys

D.

Liver

A.

Spleen

Which of the following pathologies put patients at high risk for acute renal​ failure?

A.

Shock

B.

Polycystic kidney disease

C.

Hypertension

D.

Uncontrolled diabetes

A.

Shock

Two chronic medical conditions that dialysis patients frequently have in addition to kidney failure are​ ________ and​ ________.

A.

heart​ failure; stroke

B.

​hypertension; diabetes

C.

high​ cholesterol; cerebral aneurysms

D.

blood​ clots; COPD

B.

​hypertension; diabetes

The sensation felt when palpating an​ arterial-venous fistula or shunt is known as​ a:

A.

bruit.

B.

thrill.

C.

fluttering.

D.

frill.

B.

thrill.

​________ patients are at high risk for acquiring the inherited disorder called sickle cell anemia.

A.

Native American

B.

Eastern European

C.

Hispanic

D.

African American

D.

African American

Which of the following is the most accurate definition of​ anemia?

A.

The loss of the​ kidneys' ability to filter the blood and remove toxins and excess fluid from the body

B.

An inherited disease in which a genetic defect in the hemoglobin results in abnormal structure of the red blood cells

C.

A lack of a normal number of red blood cells in the circulation

D.

The process by which toxins and excess fluid are removed from the body by a medical system independent of the kidneys

C.

A lack of a normal number of red blood cells in the circulation

You are dispatched to an unconscious hemodialysis patient. On arrival to the dialysis​ clinic, the patient is​ unresponsive, apneic, and pulseless. You secure the​ ABCs, begin​ ventilation, and initiate chest compressions.​ However, the​ patient's cardiac arrest rhythm is continuously unresponsive to defibrillations with your AED. The best approach is​ to:

A.

call online medical control to terminate the code. The probability of survival is too low to continue resuscitation efforts.

B.

begin transporting and contact an ALS intercept. The​ patient's dysrhythmia may be related to kidney failure.

C.

run a​ "no-electricity" code in which compressions and ventilation are continued. No additional defibrillations are necessary.

D.

continue defibrillating as the monitor recommends. The myocardium becomes increasingly responsive to successive defibrillations.

B.

begin transporting and contact an ALS intercept. The​ patient's dysrhythmia may be related to kidney failure.

What is one of the most common diseases to affect the renal and urinary​ system?

A.

Kidney stones

B.

Acute renal failure

C.

​End-stage renal disease

D.

Urinary tract infections

D.

Urinary tract infections

The medications that transplant patients need to take for the rest of their lives to prevent organ rejection also often lead to high susceptibility​ of:

A.

congestive heart failure.

B.

ulcers.

C.

infection.

D.

renal failure.

C.

infection.

Approximately how many Americans are currently on some type of​ dialysis?

A.

​450,000

B.

​200,000

C.

​100,000

D.

​900,000

A.

​450,000

How frequently is peritoneal dialysis treatment​ required?

A.

Once a day

B.

Three to five times per week

C.

Multiple treatments per day

D.

Once a week

C.

Multiple treatments per day

Hemodialysis is used to help the kidneys filter​ ________ and remove excess​ ________.

A.

​urine; poisons

B.

​electrolytes; hormones

C.

​blood; cholesterol

D.

​toxins; fluids

D.

​toxins; fluids

A patient with renal disease who is currently on dialysis and missed an appointment may present with dangerously high levels of the​ electrolyte:

A.

sodium.

B.

phosphorous.

C.

potassium.

D.

calcium.

C.

potassium.

What is continuous ambulatory peritoneal​ dialysis?

A.

A gravity exchange process for peritoneal dialysis in which a bag of dialysis fluid is raised above the level of an abdominal catheter to fill the abdominal cavity and lowered below the level of the abdominal catheter to drain the fluid out

B.

A mechanical process for peritoneal dialysis in which a machine fills and empties the abdominal cavity of dialysis solution

C.

A type of dialysis that is performed while walking

D.

A gravity exchange process for peritoneal dialysis in which a bag of dialysis fluid is lowered below the level of an abdominal catheter to fill the abdominal cavity and raised above the level of the abdominal catheter to drain the fluid out

A.

A gravity exchange process for peritoneal dialysis in which a bag of dialysis fluid is raised above the level of an abdominal catheter to fill the abdominal cavity and lowered below the level of the abdominal catheter to drain the fluid out

Which of the following medications does not interfere with the​ blood-clotting process?

A.

Acetaminophen

B.

Warfarin

C.

Clopidogrel

D.

Aspirin

A.

Acetaminophen

There are two main types of​ dialysis, hemodialysis and peritoneal dialysis. The main difference between them​ is:

A.

hemodialysis is usually done at home and peritoneal dialysis is usually done at a special facility.

B.

hemodialysis is usually done at a special facility and peritoneal dialysis is usually done at home.

C.

hemodialysis filters the blood and peritoneal dialysis filters the urine.

D.

hemodialysis filters the urine and peritoneal dialysis filters the blood.

B.

hemodialysis is usually done at a special facility and peritoneal dialysis is usually done at home.

How long does a typical hemodialysis treatment​ last?

A.

10 to 12 hours

B.

1 to 2 hours

C.

3 to 4 hours

D.

7 to 8 hours

C.

3 to 4 hours

What is the purpose of the red blood​ cells?

A.

They are responsible for the removal of oxygen from the cells.

B.

They are critical in response to infection and are mediators of the​ body's immune response.

C.

They are responsible for the delivery of oxygen to the cells.

D.

They are crucial in the formation of clots.

C.

They are responsible for the delivery of oxygen to the cells

The blood has many functions critical to a​ patient's health. Which of the following is not a function of the​ blood?

A.

Delivery of oxygen to the cells

B.

Control of bleeding by clotting

C.

Removal of carbon monoxide from the cells

D.

Removal and delivery of waste products to organs that provide filtration and​ removal, such as the kidneys and liver

C.

Removal of carbon monoxide from the cells

What is a cycle of filling and draining of the abdominal cavity during peritoneal dialysis​ called?

A.

Set

B.

Rotation

C.

Exchange

D.

Trade

C.

Exchange

One of the more serious diseases of the body is renal failure. Renal failure occurs when​ the:

A.

liver fails to function properly.

B.

kidneys fail to function as required.

C.

pancreas stops working.

D.

adrenal glands stop working.

B.

kidneys fail to function as required

Under which of the following circumstances do the kidneys help the body retain​ fluid?

A.

Urinary tract infection

B.

Kidney stones

C.

Electrolyte imbalance

D.

Dehydration

D.

Dehydration

How many times per week do the majority of American hemodialysis patients receive​ treatment?

A.

Seven

B.

Five

C.

One

D.

Three

D.

Three