West Coast EMT Block 3

A 40-year-old patient without a history of seizures experiences a generalized (tonic-clonic) seizure. The LEAST likely cause of this seizure is:

a epilepsy

b a brain tumor

c intracraniular bleeding

a

A patient who is experiencing aphasia is:

a right hemisphere stroke

b unable to produce or understand speech.

c usually concoius with slurred speach

b

A patient who is possibly experiencing a stroke is NOT eligible for thrombolytic (fibrinolytic) therapy if he or she:

a has bleeding within the brain.

b GSC score of less than 8

c has had a prior heart attack

a

A patient with an altered mental status

a typically alert but unaware of the proceeding events

b usually able to be aroused by painful stimuli

c not thinking clearly or is incapable of being aroused

c

Components of the Cincinnati Prehospital Stroke Scale include:

a air dift, memmory, facial droop

b facial droop, speech, and pupil size

c arm drift, speech, and facial droop.

c

Febrile seizures:Choose one answer.

A. are also referred to as petit mal seizures.

B. often result in permanent brain damage.

C. occur when a child's fever progressively rises.

D. are usually benign but should be evaluated.

d

Individuals with chronic alcoholism are predisposed to intracranial bleeding and hypoglycemia secondary to abnormalities in the:Select one:

a. brain.

b. kidneys.

c. pancreas.

d. liver.

d

muscle control and body coordination are controlled by the

a cerebellum

b cerebrum

c brain stem

a

Status epilepticus is characterized by:Choose one answer.

A. prolonged seizures without a return of consciousness.

B. an absence seizure that is not preceded by an aura.

C. profound tachycardia and total muscle flaccidity.

D. generalized seizures that last less than 5 minutes.

a

The most basic functions of the body, such as breathing, blood pressure, and swallowing, are controlled by the:Choose one answer.'

A. cerebellum.

B. brain stem.

C. cerebral cortex.

D. cerebrum.

b

the MOST significant risk factor for a hemorrhagic stroke is:Select one:

A. severe stress.

B. heavy exertion.

C. hypertension.

D. diabetes mellitus.

c

The spinal cord exits the cranium through the:

A. foramen magnum.

B. vertebral foramen.

C. foramen lamina.

D. cauda equina.

a

When assessing arm drift of a patient with a suspected stroke, you should:Choose one answer.

A. observe for approximately 5 minutes.

B. ask the patient to hold his or her arms up with the palms down.

C. expect to see one arm slowly drift down to the patient's side.

D. ask the patient to close his or her eyes during the assessment

d

When caring for a patient with documented hypoglycemia, you should be MOST alert for:Choose one answer.

A. an acute stroke.

B. respiratory distress.

C. a seizure.

D. a febrile convulsion.

c

Which of the following clinical signs is MOST suggestive of a ruptured aneurysm?

a confusion weakeness

b sudden severe headache

c bloody nasal discharge

b

Which of the following conditions would MOST likely affect the entire brain?Select one:

a. Respiratory failure or cardiopulmonary arrest

b. Reduced blood supply to the left hemisphere

c. Ruptured cerebral artery in the occipital lobe

d. Blocked cerebral artery in the frontal lobe

a

Which of the following findings should concern the EMT the MOST when assessing a patient who complains of a headache?

a history of miagrines

b neck pain or stiffness

c sinus congestion

b

Which of the following MOST accurately describes the cause of an ischemic stroke?

A. Acute atherosclerotic disease

B. Blockage of a cerebral artery

C. Narrowing of a carotid artery

D. Rupture of a cerebral artery

b

a technique used to gain insight into a patient's thinking, which involves repeating in question form what the patine that said, is called:

a reflective listening

b active listening

c intuitive listening

a

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

A) intense stress

B) schizophrenia

C) Alzheimer's disease

D) mind-altering substance use

c

immediately after physically restraining a violent patient, the EMT should:

a inform medical control

b reassess patients breathing and air way

c advise patient as to why restraints were used

b

organic brain syndrome is defined as:

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

b a change in behavior secondary to chemical imbalance

c a disorder that cannot be traced

a

post-traumatic stress disorder can happen after:

a alcohol abuse

b exposure to or injury from a traumatic occurrence

c extended periods of hypothermia

b

Signs of excited delirium include:

A. diaphoresis, tachycardia, and hallucinations.

B. pallor, hypotension, and constricted pupils.

C. subdued behavior, crying, and suicidal thoughts.

D. slurred speech, bradycardia, and a high fever.

a

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

A. a sudden, violent outburst of an otherwise mentally stable person toward a family member.

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

C. a situation in which a patient demonstrates bizarre behavior and becomes a risk to other people.

D. a period of severe depression that lasts longer than 2 weeks and cannot be controlled with medications.

b

Which of the following conditions or situations would MOST likely make excited delirium worse?

a Alcohol withdrawal

b elevated blood glucose

a

Which of the following is an example of a functional behavioral disorder?

a drug addiction

b alztimer disease

c Schizophrenia

c

A productive cough, fever, and chills in an 80-year-old patient with a compromised immune system should make you MOST suspicious for:

a pneumonia

b heart failure

c bronchiosis

a

An abdominal aortic aneurysm

A. causes dull pain that often radiates to the shoulders

B. can sometimes be palpated as a mass in the groin area

C. is usually not repairable, even if discovered early

D. is often the result of hypertension and atherosclerosis

d

Common causes of depression in the elderly include all of the following, EXCEPT:

A. prescription medication use

B. alcohol abuse and dependence

C. chronic medical conditions

D. an acute onset of dementia

d

Fractures of the pelvis in older patients often occur as the result of a combination of

:A) osteoporosis and low-energy trauma.

B) increased bone density and car crashes.

C) arthritic joints and high-energy trauma

.D) acetabular separation and severe falls.

a

Patients who have experienced even minor-appearing head injuries should be suspected of having a brain injury, especially if they:

A) have minor abrasions to the head area

.B) are taking blood-thinning medications.

C) do not have deformities to the skull.

D) have a history of Alzheimer's disease.

b

Poor maintenance of home, poor personal care, and dietary neglect are all possible indicators of _________ elder abuse:

A. financial

B. physical

C. emotional

D. psychological

b

The EMT should suspect left-sided heart failure in the geriatric patient who presents with:

A) fever and a cough that produces green sputum.

B) tachypnea and paroxysmal nocturnal dyspnea.

C) jugular venous distention and peripheral edema.

D) swelling of the lower extremities and weakness.

b

The use of multiple prescription drugs by a single patient, causing the potential for negative effects such as overdosing or drug interaction, is called:

a polypharmacy

b drug dependency

a

A surgical procedure that creates an opening between the intestine and the surface of the body that allows for elimination of waste products is called a(n):

a urostomies

b stoma

c colostomy

c

A tube from the brain to the abdomen that drains excessive cerebrospinal fluid is called a:Select one:

A. G-tube.

B. CS tube.

C. shunt.

D. cerebral bypass.

c

Autism is defined as a:

A. psychiatric condition related to an imbalance of serotonin in the brain.

B. mental disability caused by insufficient cognitive development of the brain.

C. congenital condition caused by factors such as malnutrition or birth complications.

D. pervasive developmental disorder characterized by impairment of social interaction.

d

If suctioning of the tracheostomy tube is necessary, the EMT should:

a attempt to use the patient's suction device first because it is probably already sized correctly.

b instill 20ml of saline to the tracheostomy tube

c attach a bag valve mask to the tracheostomy tube

a

Spina bifida is defined as:

a remove fluid from abdomen

b. a birth defect caused by incomplete closure of the spinal column.

b

The purpose of a ventricular peritoneum shunt is to:

A. divert excess cerebrospinal fluid to the ventricles of the brain.

B. prevent excess cerebrospinal fluid from accumulating in the brain.

C. remove fluid from the abdomen of patients with right-sided heart failure.

D. monitor pressure within the skull in patients with a head injury.

b

Under what circumstances is a left ventricular assist device used?

A. To permanently replace the function of one or both of the ventricles

B. To ensure that the ventricles contract at an adequate and consistent rate

C. To reduce ventricular pumping force in patients with aortic aneurysms

D. As a bridge to heart transplantation while a donor heart is being located

d

Vagal nerve stimulators may be an alternative treatment to medication for patients with:

a chronic seizure disorders.

b chronic muscle pain

a

When enlisting the help of an interpreter who signs, it is important for you to ask the interpreter to:

A) report exactly what the patient signs and not to add any commentary.

B) voice what he or she is signing while communicating with the patient.

C) document the answers to the questions that the patient has responded to.

D) avoid any kind of lip movement while he or she is signing with the patient.

a

Which of the following statements regarding gastrostomy (gastric) tubes is correct?

a gastro tubes are place directly in the small intestine

b are used for patients who cannot digest food

c Patients with a gastrostomy tube may still be at risk for aspiration.

c

A 60-year-old female presents with a tearing sensation in her lower back. Her skin is sweaty and she is tachycardic. The EMT should suspect:Select one:

A. aortic aneurysm.

B. strangulated hernia.

C. kidney stones.

D. acute pancreatitis.

a

A strangulated hernia is one that:Select one:

A. loses its blood supply due to compression by local tissues.

B. spontaneously reduces without any surgical intervention.

C. can be pushed back into the body cavity to which it belongs.

D. is reducible if surgical intervention occurs within 2 hours.

a

Chronic renal failure is a condition that:Select one:

A. can be reversed with prompt treatment.

B. is often caused by hypertension or diabetes.

C. causes dehydration from excessive urination.

D. occurs from conditions such as dehydration.

b

Erosion of the protective layer of the stomach or duodenum secondary to overactivity of digestive juices results in:

a appendicitis

b cholecystitis

c ulcer

c

Esophageal varices MOST commonly occur in patients who:

a consume alot of alchohol

b diabetes

c weak immune systems

a

Pain that may be perceived at a distant point on the surface of the body, such as the back or shoulder, is called:Select one:

A. radiating pain.

B. visceral pain.

C. referred pain.

D. remote pain.

c

Pain that radiates to the right lower quadrant from the umbilical area, nausea and vomiting, and lack of appetite are MOST indicative of:

A. pancreatitis.

B. appendicitis.

C. cholecystitis.

D. gastroenteritis.

b

The kidneys help to regulate blood pressure by:

A. retaining key electrolytes, such as potassium.

B. eliminating toxic waste products from the body.

C. removing sodium, and thus water, from the body.

D. accommodating a large amount of blood volume.

c

The parietal peritoneum lines the:

a lungs and chest cavity

b retroperitoneal space

c walls of the abdominal cavity

c

The principal symptom in both infectious and noninfectious gastroenteritis is:

a diarrhea

b vommiting

c dysuria

a

Which of the following conditions is more common in women than in men?

A. cystitis.

B. hepatitis.

C. pancreatitis.

D. cholecystitis

a

Which of the following is characteristic of peptic ulcer disease (PUD)?

A. the passage of bright red blood in the stool or coughing up blood

B. symptom relief after taking nonsteroidal anti-inflammatory drugs

C. sharp pain that is typically located in both lower abdominal quadrants

D. burning or pain in the stomach that subsides immediately after eating

d

Which of the following organs assists in the filtration of blood, serves as a blood reservoir, and produces antibodies?

A. liver

B. kidney

C. spleen

D. pancreas

c

Which of the following organs lies in the retroperitoneal space?

A. liver

B. spleen

C. pancreas

D. gallbladder

c

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

A. liver

B. stomach

C. appendix

D. gallbladder

a

Your patient's past medical history includes hypertension, congestive heart failure, diabetes, and seizures. Today, he presents with signs of acute renal failure. Which of his medical problems MOST likely caused this?

A. Seizures

B. Diabetes

C. Hypertension

D. Heart failure

d

A 38-year-old woman was bitten by fire ants while at the park. Your primary assessment reveals that she is semiconscious: has labored breathing, and has a rapid thready pulse. She has a red rash on her entire body, and her face is swollen. You should

a place supine

b assist her ventilations with 100% oxygen.

c locate bitten area

b

Chemicals that are responsible for the signs and symptoms of an allergic reaction to a bee sting include

a histamines and leukotrienes.

b histamines and epinephrine

c adrenline and leukortines

a

Common signs and symptoms of an allergic reaction include all the following except

a abdominal cramps

b flushing red skin

c dry cough

d drying of the eyes.

d

The effects of epinephrine are typically observed within _________ following administration.

a 1 hour

b 30 minutes

c 1 minute

c

Two of the most common symptoms of anaphylaxis are

a urticaria and angioedema

b stridor and tachydria

c hypertension and swollen hands

a

Which of the following most accurately defines an allergic reaction

a destruciton of the immune system in respons to substance

b direct negative effect on the body

c an exaggerated immune system response to any substance

c

Which of the following sounds indicates swelling of the upper airway

a wheezing

b stridor

c rales

b

when auscultating breath sounds of a patient who was stung multiple times by a yellow jacket, you hear bilateral wheezing over all lung fields. This indicates

a narrowing of the bronchioles in the lungs

b rapid swelling of upper airways

c enlargment of bronchioles

a

A 28-year-old female patient 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 has progressively worsened over the last 24 to 36 hours. On the basis of this patient's clinical presentation, you should suspect that she:

a significantly hyperglycemic

b hypoglycemic

c UTI

a

Classic signs and symptoms of hypoglycemia include:

A. cold, clammy skin; bradycardia; hunger; and deep, rapid respirations.

B. warm, dry skin; hunger; abdominal pain; and deep, slow respirations.

C. cool, clammy skin; weakness; tachycardia; and rapid respirations.

D. warm, dry skin; irritability; bradycardia; and rapid respirations.

c

Diabetes is MOST accurately defined as a/an:

A. abnormally high blood glucose level

B. disorder of carbohydrates metabolism

C. lack of insulin production in the pancreas

D. mass excretion of glucose by the kidneys

b

Diabetic ketoacidosis occurs when:

A. insulin is not available in the body

B. the cells rapidly metabolize glucose

C. blood glucose levels rapidly fall

D. the pancreas produces excess insulin

a

Excessive eating caused by cellular "hunger" is called:

A. dyspepsia.

B. polydipsia.

C. polyphagia.

D. dysphasia.

c

Hemoglobin is:

A. the fluid portion of the blood that transports cells throughout the body

.B. essential for the formation of clots, such as when vessel damage occurs.

C. found within the red blood cells and is responsible for carrying oxygen.

D. a key component of the blood and is produced in response to an infection.

c

Patients with thrombophilia are at an increased risk for

:A. various cancers.

B. hemorrhagic stroke

.C. acute arterial rupture

.D. pulmonary embolism.

d

Patients with type 2 diabetes usually control their disease with all of the following, EXCEPT:

A. diet and exercise.

B. tolbutamide (Orinase).

C. glyburide (Micronase).

D. supplemental insulin.

d

Patients with uncontrolled diabetes experience polyuria because:

A. they drink excess amounts of water due to dehydration.

B. excess glucose in the blood is excreted by the kidneys.

C. low blood glucose levels result in cellular dehydration.

D. high blood sugar levels cause permanent kidney damage.

b

Symptomatic hypoglycemia will MOST likely develop if a patient:

A. takes too much of his or her prescribed insulin

.B. eats a regular meal followed by mild exertion.

C. markedly overeats and misses an insulin dose.

D. misses one or two prescribed insulin injections

a

To which of the following diabetic patients should you administer oral glucose?

A. A conscious 37-year-old female with nausea and vomiting

B. A semiconscious 40-year-old female without a gag reflex

C. An unconscious 33-year-old male with cool, clammy skin

D. A confused 55-year-old male with tachycardia and pallor

d

When assessing an unresponsive diabetic patient, the primary visible difference between hyperglycemia and hypoglycemia is the:

A. rate and depth of breathing.

B. rate of the patient's pulse.

C. patient's mental status.

D. presence of a medical identification tag.

a

Which of the following statements regarding sickle cell disease is correct?

A. In sickle cell disease, the red blood cells are abnormally shaped and are less able to carry oxygen.

B. Because of their abnormal shape, red blood cells in patients with sickle cell disease are less apt to lodge in a blood vessel.

C. Sickle cell disease is an inherited blood disorder that causes the blood to clot too quickly.

a

A hypnotic drug is one that:

a induces sleep.

b prevents amnesia.

c increases the pulse

d.increases the sense

a

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

a cocaine.

b aspirin.

c Tylenol.

d ibuprofen.

b

Activated charcoal may be indicated for a patient who ingested:

A) iron.

B) ethanol.

C) aspirin.

D) methanol.

c

Airborne substances should be diluted with:

A) oxygen

.B) syrup of ipecac.

C) activated charcoal.

D) an alkaline antidote.

a

The EMT's primary responsibility to the patient who has been poisoned is to:

A. administer the appropriate antidote

.B. recognize that a poisoning occurred.

C. administer 25 g of activated charcoal.

D. contact poison control immediately.

b

Hypotension, hypoventilation, and pinpoint pupils would be expected following an overdose of:

A) ecstasy.

B) oxycodone (Percocet)

.C) amphetamine sulfate (Benzedrine).

D) crack cocaine.

b

Most poisonings occur via the __________ route.Select one:

A. inhalation

B. ingestion

C. absorption

D. injection

b

signs and symptoms of a sympathomimetic drug overdose include:

A) tachycardia.

B) hypothermia.

C) hypotension.

D) slurred speech.

a

The major side effect associated with administration of activated charcoal is:

A) headache.\

B) black stools.

C) abdominal pain.

D) ringing in the ears.

b

Which of the following statements regarding the Salmonella bacterium is correct?Select one:

A. The Salmonella bacterium produces toxins that cause food poisoning

.B. Symptoms of salmonellosis appear within 12 hours.

C. Refrigeration of food will prevent salmonellosis.

D. The Salmonella bacterium itself causes food poisoning.

d

As a woman approaches menopause:

a) she usually experiences abdominal cramping without vaginal bleeding.

b) her menstrual periods may become irregular and vary in severity.

c) her risk of developing PID lowers significantly.

d) she cannot become pregnant because of fluctuating hormone levels.

b

EMTs receive a call for a possible sexual assault. The patient is a young female who is conscious and alert and has no apparent injuries. She states, "I can't remember anything, but I know I was raped." The EMTs should suspect that:

A. an underlying head injury is causing her amnesia.

B. the patient knew her attacker, but is afraid to say.

C. the traumatic experience has created a mental block.

D. the patient was given a drug prior to the incident.

d

General treatment for a woman with vaginal bleeding and shock following sexual assault includes all of the following, EXCEPT:

A. refraining from placing any dressings into the vagina.

B. treating external lacerations with sterile compresses.

C. supplemental oxygen and keeping the patient supine.

D. carefully removing any foreign bodies from the vagina

d

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

A. becomes engorged with blood.

B. diverts blood flow to the vagina

.C. sheds and is expelled externally.

D. thins and begins to separate.

a

In contrast to bleeding caused by external trauma to the vagina, bleeding caused by conditions such as polyps or cancer:

\A. may be relatively painless.

B. is typically not as severe.

C. often presents with acute pain.

D. can be controlled in the field.

a

Potentially life-threatening consequences of pelvic inflammatory disease (PID) include:

A. bacterial vaginosis and chlamydia

B. ovarian abscess and ectopic pregnancy

.C. ovarian cysts and gonorrhea.

D. uterine rupture with severe bleeding.

b

When a female has reached menarche:

A. she is capable of becoming pregnant.

B. she can no longer produce an ovum

.C. menstrual periods become less frequent.

D. she usually requires hormone therapy.

a

When a woman presents with abdominal pain or other vague symptoms, the EMT is often unable to determine the nature of the problem until he or she:

A. has formed a general impression of the patient.

B. ascertains if the patient was ever pregnant.

C. has obtained a complete set of vital signs.

D. has gathered patient history information.

d