EMT CH.13-19 HW QUESTIONS (MOD3)

A patient has a low platelet count. Based on this​ finding, which complication is the patient most at risk​ for?

Bleeding

Sympathetic nervous system stimulation will cause the heart​ to:

Increase the heart rate

The tricuspid valve prevents blood​ from:

Flowing from the right ventricle into the right atrium

Chronic and untreated hypertension will affect which part of the heart first.

Left ventricle

Regarding women and cardiac​ compromise, with which of these statements would you​ agree?

​"The death rate for women suffering a heart attack is higher than that for​ men."

Which of these statements made by the patient should cause the EMT to suspect an abdominal aortic​ aneurysm?

​"I have belly pain that I also feel in my​ back."

Which of these statements regarding contraction of the heart is​ true?

Both atria contract together just before both ventricles contract together.

The EMT shows she is correctly administering aspirin to a patient with chest pain when she​ provides:

325 mg of baby aspirin and instructs the patient to chew it

The pathophysiology of heart failure that causes the common signs and symptoms of cardiogenic shock​ is:

Inadequate ejection of blood from the left ventricle

A patient who is chronically hypoxic because of anemia most likely has a problem with which component of the cardiovascular system

Red blood cells

After being dispatched for a male patient experiencing an​ "unknown cardiac​ event," you arrive to find the confused​ 67-year-old man sitting upright at his kitchen table in severe respiratory distress. You also note remarkable swelling to his lower legs and feet. He has an open​ airway, but cannot speak more than two to three words without attempting to breathe. His breathing is extremely​ labored, with inspiratory crackles heard upon auscultation. His skin is​ cool, diaphoretic, and dusky in color. A family member at the scene reports a history of​ hypertension, congestive heart​ failure, and​ angina, for which the patient takes nitroglycerin. The baseline vital signs are acceptable and the​ room-air pulse oximeter reading is​ 82%. What is your immediate action in caring for this​ patient?

administer high-flow supplemental oxygen and prepare to apply Continuous Positive Airway Pressure (CPAP) to address his severe hypoxia and acute pulmonary edema

For a patient with a history of an unstable abdominal aortic​ aneurysm, the EMT should recognize and prepare​ for:

Massive internal bleeding

Which portion of the​ heart, when weakened by a heart​ attack, is responsible for causing fluid to back up into the​ alveoli?

Left ventricle

If a clot occludes the blood flow through the coronary​ artery, what will be the detrimental​ effect?

The flow of​ oxygen-rich blood to the muscle of the ventricle will be decreased.

An alert and oriented patient presents with shortness of​ breath, crackles in both​ lungs, jugular venous​ distention, and edema to the feet and ankles. Her pulse is​ 132, respirations 26​ breaths/min, blood pressure​ 160/86 mmHg, and SpO2 at​ 88%. Based on these​ findings, the EMT should​ suspect

Congestive heart failure

You are approached by an Emergency Medical Responder who informs you that last​ week, he was on a call in which a patient with chest pain and a known history of coronary artery disease was not given oxygen by the Emergency Medical Technicians. You would​ reply:

"It has been shown that oxygen given to a patient with an acceptable pulse oximetry reading can be​ harmful."

Which of these identifies the major elements of the pathway that blood takes through the heart in the correct​ sequence?

Vena​ cava, right​ ventricle, pulmonary​ artery, left​ ventricle, and aorta

Which action is it essential that the EMT take prior to assisting the patient in taking his nitroglycerin​ tablet?

Evaluate the​ patient's systolic blood pressure and heart rate

A patient has been diagnosed with high blood pressure. A medication that can effectively serve to lower this​ patient's blood pressure is one​ that:

Dilates the arteries

When administering aspirin to a patient with chest discomfort that is suggestive of a heart​ attack, the EMT recognizes that this medication will benefit the patient​ by:

Decreasing the ability of the platelets in the blood to form clots

An obstruction of the pulmonary artery will​ cause:

Backup of blood in the right side of the heart

In the​ blood, which component is largely responsible for the formation of blood​ clots?

Platelets

You suspect that a patient with a history of chronic obstructive pulmonary disease is has right ventricular failure. In your​ assessment, which finding would reinforce this​ suspicion?

Edema to the feet

A patient with chest pain and shortness of breath informs you that the last time he had a heart​ attack, he went into heart failure. When performing your secondary​ assessment, which sign or symptom is most indicative that the patient is in heart failure​ again?

Crackles in the lungs

A TV reporter has been assigned to your ambulance for a​ ride-along. He is doing a segment on the local EMS system for EMS Week. In your down​ time, the reporter tells you that his wife was diagnosed with atherosclerosis. He is unsure what this condition is and asks you to explain it to him. Your response would​ be:

​"The coronary arteries become damaged and narrowed by fat​ deposits."

Which of these statements regarding acute coronary syndrome should the EMT recognize as​ true?

Cardiac compromise should be suspected for any patient with chest discomfort

The primary pacemaker site of the heart is​ the:

Sinoatrial node

You are caring for a​ 69-year-old male patient who is short of breath and in acute congestive heart failure. He is​ alert, anxious, and​ panicked, with an open airway and rapid shallow respirations. His heart rate is​ tachycardic, and his skin is cool and​ diaphoretic, with cyanosis noted to the lips and fingers. There are crackles noted in both​ lungs, as well as pedal edema in both feet. The patient denies chest pain or​ discomfort, but is having a difficult time speaking due to the shortness of breath. When caring for this​ patient, you​ should:

Apply continuous positive airway pressure

After blood enters the right​ ventricle, it next moves into​ the:

Pulmonary artery

A patient is very dizzy and has an altered mental status. Vital signs are​ pulse, 84;​ respirations, 16​ breaths/min; blood​ pressure, 74/32​ mmHg; and

SpO2​, 93%. Medical direction has ordered the paramedic to start an IV infusion of a medication that causes blood vessel constriction. You would recognize that the medication is benefiting the patient when you​ observe:

The blood pressure increase to​ 110/64 mmHg

Family directs you to a bedroom where a 62-year-old male is in respiratory distress. During the scene size-up, which of the following most strongly suggests that the patient suffers from a chronic respiratory disease?

Patient in chair in tripod position

The mother of a 5-year-old female states that her daughter has been "sick" with a sore throat and fever for several days. The mother became concerned tonight and called 911 because the child was "making funny noises" and could not breathe. Your assessment reveals a lethargic, well-developed child sitting upright and with high-pitched tracheal noises when she breathes. Of the following, what is the priority action?

Administering supplemental oxygen

How many breaths per minute is normal for a child who is breathing adequately?

15 to 30

How many breaths per minute is normal for an infant?

20-40

Which one of the following is considered an early sign of inadequate breathing in children?

Nasal flaring

The medication contained within a metered-dose inhaler is in what form?

Aerosolized

You are assisting a patient in taking her metered-dose inhaler for the first time. Which one of the following statements about the side effects of the medication would be most appropriate?

"You may feel anxious and your heart rate may increase."

Your medical director's written protocol instructs you to obtain on-line medical direction prior to assisting a patient with a metered-dose inhaler (MDI). Given this protocol, you must contact:

an emergency physician prior to assisting with the MDI.

You have been called for a patient who is complaining of shortness of breath. On scene you find the 41-year-old woman sitting upright in bed with nasal flaring and wheezing. A metered-dose inhaler (MDI) is lying on the nightstand next to her. To assist her with the MDI, which of the following criteria must be met?

The MDI must be prescribed for the patient.

You are called to a motor vehicle collision. A 26-year-old female states that she was unrestrained and struck the steering column with her chest after the car she was driving struck another from behind. She is somewhat confused, and complaining of chest pain and difficult and painful breathing when she inhales. Her airway is patent and her breathing is adequate. Assessment of the radial pulse reveals it to be rapid and very irregular and weak. She has cyanosis in her nose and finger tips. Her breath sounds are clear and equal and skin moist and pale. She informs you that she suffers from asthma and has a metered-dose inhaler (MDI). What is your best action in treating this patient?

Apply supplemental oxygen.

A 4-year-old female is having great difficulty breathing. She is responsive to verbal stimuli and has an open airway. Her respiratory rate is 40 breaths per minute, and she has an SpO 2 reading of 88% while receiving high-concentration oxygen through a pediatric nonrebreather mask. Her pulse is rapid, and her skin cool to the touch. As a knowledgeable EMT, you would recognize what condition?

Respiratory failure

You have been dispatched for a young child with difficulty breathing. As you enter the apartment, which one of the following scene clues would best indicate that the patient is experiencing a problem in her upper airway?

Stridorous noises with inspiration

A 36-year-old patient has overdosed on an unknown drug and is unresponsive. He is breathing shallowly at 6 times per minute. He has cyanosis around his lips and to his fingertips. His skin is cool to the touch, and his radial pulse is rapid. His breath sounds are diminished but clear. The EMT should recognize which one of the following respiratory conditions?

Hypoxia

When assessing a patient complaining of shortness of breath, which of the following actions should the EMT perform first?

Assess the adequacy of a patient's breathing.

You realize the EMT is properly ventilating an unresponsive adult male patient when he:

delivers each breath over a 1-second period.

A 71-year-old female is complaining of the sudden onset of shortness of breath and rapid breathing. She also states that she is experiencing some chest pain that seems to worsen when she takes a deep breath. The primary assessment shows her to be alert and oriented with a patent airway and rapid breathing that is adequate. Her pulse rate is 92 per minute and her blood pressure is 116/68 mmHg. When obtaining a history, which statement made by the patient should raise your suspicion that the patient may be experiencing a pulmonary embolism?

"I had foot surgery five days ago."

When auscultating breath sounds, the EMT should recognize rhonchi when he hears which of the following sounds?

Rattling-like noises that decrease when the patient coughs

You have been called for a 3-year-old male who is "not breathing right." Aside from a notable expiratory wheeze, which one of the following would be cause for most concern?

Prolonged and forced expiration

A 4-year-old female with a decreased level of consciousness is in respiratory distress. Her airway is patent and respirations are 12 per minute. Breath sounds are diminished bilaterally and there is noted accessory muscle use with inspiration and expiration. Her pulse is 84 and SpO 2 88%. Which of the following should be your immediate action?

Start positive pressure ventilation.

The EMT is correctly assessing a patient for subcutaneous emphysema when he:

palpates the anterior and posterior chest.

Which of the following statements regarding ventilation in a healthy patient is true?

Inspiration is an active process that requires energy; expiration requires little to no energy.

You are administering positive pressure ventilation to an elderly male with a history of advanced chronic obstructive pulmonary disease (COPD). Which of the following must you keep in mind as you care for this patient?

Too forceful ventilations may rupture the lung tissue and cause a pneumothorax

When auscultating the lungs of an elderly patient, you note rhonchi-like noises to the upper lobes of both lungs. As a knowledgeable EMT, you would recognize that this is caused by:

accumulation of mucus in the bronchi.

When administering albuterol to a patient with shortness of breath, the EMT realizes that the therapeutic effect of this medication is achieved by:

dilating the small airways.

As you enter a room for an unknown medical emergency, you find an unresponsive male with snoring respirations lying supine in bed. Which one of the following actions should you take immediately?

Perform a head-tilt, chin-lift maneuver.

The EMT indicates that he is properly assessing the patient's breath sounds when he gives which one of the following instructions to the patient?

"Please breathe slowly through your mouth as I listen to your lungs."

You have a patient that you suspect of being infected with pertussis (whooping cough). While performing the primary assessment, you note a deep cough with clear breath sounds. Her vital signs are: pulse 108, respirations 16, and SpO 2 at 96% on room air. Given this scenario, which one of the following would be most appropriate?

Monitor the patient and transport.

Which of the following pieces of information would heighten the EMT's suspicion that a child with a persistent cough may have pertussis (whooping cough)?

Never had childhood immunizations

You have been dispatched to a home for a 16-year-old female with shortness of breath. On scene you find the patient in bed with her mother at her side. Her mother states that her daughter has a fever with a past medical history of cystic fibrosis and would like to have her transported to the hospital for evaluation of possible pneumonia. As a knowledgeable EMT, you know that the underlying pathophysiology of cystic fibrosis is a:

condition in which excessive and thick mucus often plugs the airways.

You have been called to a residence for an 18-year-old female with shortness of breath and a history of cystic fibrosis. On scene you find the patient to be very thin and sick looking. Her airway is patent and breathing adequate, although slightly labored. Her radial pulse is strong, and she has a constant cough, which produces green- and yellow-colored mucus. Auscultation of the lungs reveals rhonchi to the upper portion of both lungs. Vital signs are pulse 108, respirations 20, blood pressure 98/56 mmHg, and SpO 2 92%. Based on these findings, appropriate care should include:

humidified oxygen via nasal cannula at 2 liters per minute.

You are transporting a 4-year-old female who you found sitting in a chair with labored respirations, inspiratory stridor, and drooling. Which one of the following signs would warrant immediate reassessment?

The stridor disappears

You have been called to an industrial warehouse for a young adult male who was exposed to an unknown chemical gas. The patient was immediately removed from the environment and presents to you with a patent airway, burning to the throat with inspiration, and complaint of shortness of breath. His vital signs are: pulse 120, respirations 28, blood pressure 164/60, and SpO 2 of 90%. In addition, you note bilateral wheezing to the lungs. What should be your first action in caring for this patient?

Administer high-concentration oxygen

Which of the following respiratory sounds would make you suspicious of an upper airway problem?

Stridor

A patient, with a history of COPD, is breathing 32 times a minute. Her vital signs are: pulse 140, blood pressure 168/102, and SpO 2 98% on room air. You would classify this as:

dyspnea

The best way to gauge the effectiveness of oxygen therapy would be to monitor the:

pulse oximetry

A patient in respiratory distress is exhibiting pursed lip breathing. You realize that he is doing this to

keep the small airways open.

An alert and distressed 72-year-old male with a history of congestive heart failure is in severe respiratory distress, breathing 28 to 32 times a minute. His airway is patent, respirations labored, and skin diaphoretic with a weak and rapid radial pulse. Vital signs are: pulse 136, respirations 28, blood pressure 202/110 mmHg, and SpO 2 83%. Cyanosis is evident in the fingertips. The best treatment of his breathing would be:

CPAP

A patient with an unknown medical problem is responsive to painful stimuli and breathing poorly at a rate of 8 per minute. The airway is patent and skin warm and moist. His radial pulse is strong and irregular. Breath sounds are clear. Vital signs are pulse 84, blood pressure 256/120, and SpO 2 81%. Your best treatment of the patient's breathing would be:

positive pressure ventilation.

A 4-year-old boy in respiratory distress is sitting upright in bed and drooling. His mother states that he has been complaining of a sore throat throughout the day and tonight became severely short of breath and started drooling. He is alert with adequate breathing. His skin is hot to the touch. Vital signs are pulse 132, respirations 28, and SpO 2 90% on room air. Which one of the following is your first action in caring for this child?

Apply supplemental oxygen.

You have been called to a residence for a patient with altered mental status and shortness of breath. On scene an Emergency Medical Responder meets you and states that he believes the patient had a stroke and is unresponsive. As you enter the room, you see the patient lying in bed with snoring respirations. Oxygen at 15 liters per minute has been applied. Your immediate action when you reach the patient's side would be to:

perform the head-tilt, chin-lift.

You suspect that a patient involved in a motor vehicle collision is in shock. What sign or symptom of shock would you expect to see last?

Decreased blood pressure

The AED has just been applied to a female cardiac arrest patient. After analyzing the heart rhythm, it provides a "No Shock Advised" message. The EMT should immediately:

resume cardiopulmonary resuscitation.

A patient with a severe gastrointestinal bleed is in shock. Which of the following would best correct the patient's underlying problem?

Blood replacement

You have been called to transport a patient in septic shock from the emergency department of a local hospital to the critical care unit of another. Two nurses will be accompanying you. As a knowledgeable EMT, you recognize that this state of shock has been caused by:

infection

A patient has been involved in a very serious motor vehicle collision and is in shock. Assessment findings indicate that he sustained blunt trauma to the abdominal and pelvic areas. What type of shock is the patient most likely suffering?

Hypovolemic

You are instructing a first-aid class at a local chemical plant. The course includes instruction regarding an AED that is to be placed in the plant. What point would you emphasize about the most common cause of AED failure?

"The batteries must be checked regularly."

You have been called to a public pool for an unresponsive patient. On arrival you find lifeguards performing CPR with a pocket mask and oxygen on a 67-year-old male. They report that the patient was in the water and was seen clutching his chest seconds before going unresponsive. He was immediately pulled from the water and CPR was initiated. They estimate that CPR has been performed for 5 minutes. Assessment shows the man to be unresponsive, apneic, and pulseless. Which one of the following is your first response?

"Let's take a towel and dry off his chest."

You have applied the AED's electrodes to an obese male patient in cardiac arrest. When you press the analyze button, the AED gives you a "check electrode" message. In looking at the patient, which one of the following would most likely be responsible for this message?

Hairy chest

A driver was ejected from his vehicle in a rollover-type collision. Assessment findings reveal the patient to be unresponsive with bruising to the abdominal and pelvic areas along with an open femur fracture. The patient has an open airway and is breathing 32 times per minute. His skin is cool and clammy and the radial pulses weak. Manual in-line spinal stabilization is being maintained. The EMT's next intervention would be to:

assist respirations

A patient goes into cardiac arrest at 11:40 A.M. Which of the following treatment descriptions gives the patient the best chance for recovery?

CPR at 11:41 A.M. and defibrillation at 11:43 A.M.

Your cardiac arrest patient has regained a pulse after two shocks. Which of the following actions would be appropriate?

Transporting the patient supine and secured to a back board

While cleaning a gun, a 44-year-old patient accidentally shot himself in the abdomen. On arrival, you observe the patient on the floor lying on his side with his legs drawn to his chest. Blood is evident on his shirt and pants. Which one of the following indicates the correct sequence of events when caring for this patient?

Perform the primary assessment, administer high-concentration oxygen, perform a rapid secondary assessment, transfer to the stretcher, rapid transport

You have been asked to describe the American Heart Association's Chain of Survival to a group of Emergency Medical Responder students. What description is best?

A sequence of events that, if enacted quickly, gives the best chance for surviving cardiac arrest

A 47-year-old patient has been in cardiac arrest for 6 minutes. While you set up the AED, you would direct your partner to

start cardiopulmonary resuscitation until the AED is ready.

If a cardiac arrest patient were in asystole ("flat line"), which of the following messages would the AED provide?

"No shock advised"

After two cardiac arrests, a large home improvement center has purchased a fully automated AED. You have been asked to provide education on its use. During an instructional session, a student asks you what will happen when the AED indicates that a shock is indicated. Your response should be:

"The AED will automatically shock the patient."

You have arrived at a residence where a 4-month-old baby was found in his crib in cardiac arrest. Emergency Medical Responders have been on scene for 5 minutes prior to arrival. They began CPR immediately on reaching the patient's side. You have an AED with adult pads with you, but not pediatric pads. After rechecking and confirming that the patient is in cardiac arrest, you would:

place the AED on the patient and follow all prompts.

A patient in shock with abdominal pain indicates he noticed a lot of blood in the toilet after having a bowel movement this morning. The EMT should suspect what type of shock?

Hemorrhagic hypovolemic

Which one of the following actions performed by the EMT indicates appropriate care with the AED when treating a patient in cardiac arrest?

He places, then quickly removes, a set of electrodes in an attempt to remove hair from a patient's chest.

An EMT has just received a "Shock Advised" message from the AED. Just before delivering the shock, the EMT must:

ensure that all rescuers are clear of the patient.

A 44-year-old male has been shot in the abdomen. What assessment findings would lead you to believe that the patient is in compensated shock?

Alert and anxious, pulse 96, BP 134/88 mmHg, pale and cool skin

You are transporting a patient in cardiac arrest. The AED is being used and a shock has been advised. Prior to administering the shock, what should you do?

Ensure that no rescuer is touching the stretcher

Why is defibrillation in the first few minutes of cardiac arrest so critical?

If cardiac arrest is not treated within the first few minutes, ventricular fibrillation will convert to asystole, a non-shockable heart rhythm.

Because of a shortage of paramedics at your ambulance service, it has been announced that there will be AEDs placed on every ambulance for use by EMT crews. Which of the following statements indicates an understanding of how this will affect the EMTs?

"The AED will let us know whether or not to shock the patient."

The EMT would recognize which of the following as the most probable case of cardiogenic shock?

Myocardial infarction

A 52-year-old male has collapsed on his front porch and his family dialed 911. When you arrive, the daughter informs you that the patient has been down for approximately 8 minutes. Assessment reveals him to be in cardiac arrest. Which one of the following should you do immediately?

Start CPR while the AED is readied for use

The EMT should request advanced life support (ALS) backup for a patient in cardiac arrest because:

ALS treatment decreases the possibility of the patient going back into cardiac arrest once successful defibrillation has occurred.

Which one of the following is a benefit of the automated external defibrillator?

The ease and speed by which it can be used

Your service has a new AED. During the in-service on the new device, the instructor informs you that it is a semi-automated AED and uses a biphasic wave form, as opposed to the monophasic form used by the previous AED. As a knowledgeable EMT, you should recognize that

the new AED will defibrillate with lower amounts of electrical energy.

Which one of the following links in the American Heart Association's Chain of Survival must occur first, if a patient is to survive cardiac arrest?

Early access