EMT Chapter 26 Test

Your patient was diagnosed with cholecystitis​ (gallbladder inflammation) three days ago. The patient now presents with​ nausea, vomiting, and pain in the right shoulder. The pain in the shoulder can be classified​ as:

A. visceral pain.

B. pancreatic pain.

C. referred pain.

D. somatic pain.

referred pain.

Pain that the patient feels in a body part or area of the body that has nothing to do with a diseased organ is​ termed:

A. referred pain.

B. epigastric pain.

C. retroperitoneal pain.

D. abdominal pain.

referred pain.

You are called to a nursing home for an​ 85-year-old patient complaining of abdominal pain. The patient has a history of dementia and cannot describe the pain to you. The nurse states the patient has been vomiting for about an​ hour, and the vomit looks like dark coffee grounds. His blood pressure is​ 90/40, pulse​ 100, and respiratory rate of 24. In what position should you transport the​ patient?

A. Left lateral recumbent

B. Supine

C. Trendelenburg

D. Supine with knees bent

Left lateral recumbent

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:

A. ​mid-cycle pain.

B. myocardial infarction.

C. cholecystitis.

D. renal colic.

renal colic.

You are called to a residential neighborhood at​ 12:30 A.M. Your patient has just finished eating a​ super-sized meal of deep fried fish. He is now complaining of a​ "crampy" pain in the right upper quadrant and has had two episodes of nausea and vomiting with green vomit. What condition do you suspect that your patient is​ experiencing?

A. Appendicitis

B. Intestinal obstruction

C. Peptic ulcer

D. Cholecystitis

Cholecystitis

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 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:

A. cancel the ALS​ unit: this is just gallstones and BLS can transport.

B. transport the patient in the supine position for shock.

C. apply the AED and prepare for imminent cardiac arrest from a myocardial infarction.

D. contact medical control regarding the administration of the​ patient's nitroglycerin

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

Which of the following is a characteristic of referred​ pain?

A. It is usually described as​ "crampy" or​ "colicky."

B. It is caused by psychological stress.

C. It is only felt in hollow organs.

D. It is felt in a location other than the organ causing it.

It is felt in a location other than the organ causing it.

Which of the following organs is located in the retroperitoneal​ space?

A. Uterus

B. Kidneys

C. Liver

D. Stomach

Kidneys

Which of the following is not a cause of abdominal​ pain?

A. Food poisoning

B. Diabetes

C. Stroke

D. Heart attack

Stroke

Which abdominal quadrant contains the​ appendix?

A. Right lower

B. Left upper

C. Right upper

D. Left lower

Right lower

You are responding to a​ 52-year-old male patient complaining of heartburn with epigastric pain. The​ patient's vital signs are stable and he does not have any pain upon palpation. He has a history of reflux disease and is on several medications for heartburn and acid reflux. What is your greatest concern with this​ patient?

A. His appendix will rupture.

B. He will develop peritonitis.

C. He is suffering from a myocardial infarction.

D. He will aspirate on vomit.

He is suffering from a myocardial infarction.

Most organs of the abdomen are enclosed within​ the:

A. retroperitoneal space.

B. peritoneum.

C. midline.

D. extraperitoneal space.

peritoneum.

Your patient is a​ 17-year-old with a history of asthma. She is complaining of pain in her lower abdomen. Assessment reveals that her breath sounds are clear and​ equal, she has a respiratory rate of 28 breaths per​ minute, a heart rate of 96 beats per​ minute, and a blood pressure of​ 112/74 mmHg. Which of the following is the most appropriate next​ step?

A. Assist the patient in the administration of her​ metered-dose inhaler.

B. Provide​ high-concentration oxygen.

C. Have the patient breathe into a paper bag to rebreathe some of her carbon dioxide.

D. Insert a nasopharyngeal airway in the​ patient's nose.

Provide​ high-concentration oxygen.

You are called to a nursing home for an​ 85-year-old patient complaining of abdominal pain. The patient has a history of dementia and cannot describe the pain to you. The nurse states the patient has been vomiting for about an​ hour, and the vomit looks like dark coffee grounds. His blood pressure is​ 90/40, pulse​ 100, and respiratory rate of 24. Why should the EMT use an oxygen mask with​ caution?

A. The oxygen will cause the patient to start vomiting again.

B. The patient may hyperventilate.

C. The patient cannot clear any additional vomit.

D. The patient may become unresponsive.

The patient cannot clear any additional vomit.

You are treating a​ 38-year-old female patient with abdominal distress. The​ patient's vital signs are stable and you are getting ready to transport. What is the best position to transport the​ patient?

A. Position of comfort

B. Semi-Fowler's

C. Supine

D. Right lateral

Position of comfort

You are called to a nursing home for an​ 85-year-old patient complaining of abdominal pain. The patient has a history of dementia and cannot describe the pain to you. The nurse states the patient has been vomiting for about an​ hour, and the vomit looks like dark coffee grounds. His blood pressure is​ 90/40, pulse​ 100, and respiratory rate of 24. Aside from the​ airway, what is your greatest​ concern?

A. The patient will go into shock.

B. The patient will have a myocardial infarction.

C. The patient will have a stroke.

D. The patient will become dehydrated.

The patient will go into shock.

Which of the following questions may help the EMT assess a patient with abdominal​ pain?

A. Do you have any medical​ problems, such as diabetes or heart​ problems?

B. Do you have any allergies to foods or​ medicines?

C. What medications are you​ taking?

D. All of the above

All of the above

With the exception of the​ ________, most abdominal organs are not able to sense tearing sensations.

A. liver

B. ovaries

C. colon

D. aorta

aorta

You respond to a​ 65-year-old patient complaining of abdominal pain. Your physical exam reveals a nonpulsating mass in the lower left quadrant. You​ suspect:

A. aortic abdominal aneurysm.

B. splenic rupture.

C. hernia.

D. appendicitis.

hernia.

Which of the following is the main focus of the​ EMT's assessment and history taking of the patient with abdominal​ pain?

A. Determining if the patient meets criteria to refuse treatment and transport

B. Determining the cause of the pain

C. Determining the possible need for immediate surgery

D. Determining the presence of shock

Determining the presence of shock

When treating a patient with acute abdominal​ pain, you should do which of the​ following?

A.

Have him take antacids in an attempt to decrease the pain.

B. Administer sips of water if patient complains of thirst.

C. Have him drink milk to coat the stomach and reduce the pain.

D. Have the patient lie still and assume a position of comfort.

Have the patient lie still and assume a position of comfort.

Which of the following is true concerning parietal​ pain?

A. It is generally localized to a particular area.

B. It is often described as​ "crampy" or​ "colicky."

C. It is usually intermittent in nature.

D. It arises from solid organs.

It is generally localized to a particular area.

Which of the following structures is​ (are) not located in the abdominal​ cavity?

A. Spleen

B. Kidneys

C. Stomach

D. Liver

Kidneys

Which patient is experiencing visceral​ pain?

A. 24-year-old male complaining of severe left flank pain

B. 28-year-old male with sharp pain in the right lower quadrant

C. 45-year-old female complaining of abdominal pain​ "all over"

D. 19-year-old female complaining of severe cramps in the lower abdominal quadrants

​45-year-old female complaining of abdominal pain​ "all over"

You​ respond, along with fire department Emergency Medical​ Responders, to a​ 48-year-old female having a syncope episode in the bathroom. You find the patient sitting on the commode vomiting into the trash can. The vomitus appears to look like coffee grounds and has a foul smell. The patient is pale and has been weak for the past few days. She​ has:

A. abdominal aortic aneurysm.

B. hernia.

C. GI bleeding.

D. peritonitis

GI bleeding.

Your patient is a​ 34-year-old male complaining of pain​ "in his right​ side." He is pale and diaphoretic with a heart rate of 90 beats per​ minute, a respiratory rate of 28 breaths per​ minute, and a blood pressure of​ 132/80 mmHg. The patient is very agitated and anxious. Which approach is most​ appropriate?

A. Try to determine the cause of his pain.

B. Insert an oropharyngeal airway.

C. Reassure him that you will make him as comfortable as possible and get him to the hospital for additional care.

D. Tell the patient that you cannot transport him unless he calms down and lies still.

Reassure him that you will make him as comfortable as possible and get him to the hospital for additional care.

Your patient is a​ 40-year-old female who has been experiencing abdominal pain and vomiting for 2 days. She is now responsive to verbal​ stimulus; has​ cool, dry​ skin; a heart rate of​ 116; respirations of​ 24; and a blood pressure of​ 100/70. Which of the following is the best position for transporting this​ patient?

A. Supine with the knees bent

B. Sitting up at a​ 90-degree angle

C. Left lateral recumbent with the legs bent

D. Sitting up at a​ 45-degree angle

Left lateral recumbent with the legs bent

Which of the following is not true concerning abdominal pain in geriatric​ patients?

A. The causes of abdominal pain in geriatric patients are rarely serious.

B. Older adults have a decreased ability to perceive pain.

C. The older person may not be able to give a specific description of the pain.

D. Medications may mask signs of shock associated with an abdominal complaint.

The causes of abdominal pain in geriatric patients are rarely serious.

You respond to the scene of a​ 50-year-old male complaining of severe abdominal pain. He has a history of alcohol and drug abuse. His vital signs are stable and he presents with epigastric pain that radiates to the back. He has guarding and point tenderness in the upper quadrants. You​ suspect:

A. pancreatitis.

B. gastroesophageal reflux disease​ (GERD).

C. myocardial infarction.

D. cholecystitis.

pancreatitis.

You are called to a​ 25-year-old male complaining of right lower quadrant​ (RLQ) pain. His other symptoms are nausea and​ vomiting, fever, and decreasing pain in the umbilicus area. As an​ EMT, you feel this patient might​ have:

A. appendicitis.

B. cholecystitis.

C. peritonitis.

D. pancreatitis.

appendicitis.

You respond to a​ 75-year-old female who is complaining of epigastric pain that feels like heartburn. The pain radiates to the right shoulder. Her vital signs are stable and she has a previous history of a myocardial infarction. She has prescription nitroglycerin tablets. She is most likely suffering​ from:

A. renal colic.

B. ectopic pregnancy.

C. abdominal aortic aneurysm.

D. cholecystitis.

cholecystitis.

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?

A. Tearing

B. Parietal

C. Referred

D. Visceral

Tearing

Organs of the right upper quadrant​ include:

A. most of the​ liver, spleen, and gallbladder.

B. ​pancreas, spleen, and part of the liver.

C. small​ intestine, stomach, and spleen.

D. most of the​ liver, gallbladder, and part of the large intestine.

most of the​ liver, gallbladder, and part of the large intestine.

Pain that originates in an​ organ, such as the​ intestines, is called​ ________ pain.

A. referred

B. visceral

C. parietal

D. acute

visceral

In what position should the patient complaining of severe abdominal pain be placed if there are no signs or symptoms of​ shock?

A. Supine with feet elevated

B. One of comfort

C. Semi-Fowler with knees bent

D. Left lateral recumbent

One of comfort

The detection of a bulging mass through the belly button that is not pulsating should make the EMT suspicious that the patient may be suffering from which of the​ following?

A. Ulcer

B. Abdominal aortic aneurysm

C. Gastroenteritis

D. Hernia

Hernia

The patient complaining of parietal abdominal pain who would concern you the most is the one​ who:

A. walks out to the ambulance informing you he has the worst​ "belly ache."

B. is rolling about on the floor complaining of pain.

C. is lying on the floor very still and quiet with his knees drawn up to his chest.

D. is sitting upright in a​ chair, moaning in​ pain, and drinking antacid.

is lying on the floor very still and quiet with his knees drawn up to his chest.

When the gallbladder is​ diseased, the pain is not only felt in the right upper quadrant​ (RUQ) but also in the right shoulder. This is known​ as:

A. parietal pain.

B. tearing pain.

C. referred pain.

D. visceral pain.

referred pain.

Which of the following is not a cause of parietal​ pain?

A. Inflammation

B. Bleeding into the abdominal cavity

C. Muscle spasm

D. Infection

Muscle spasm

Pain felt in the epigastric region of the abdomen is of concern because of the possibility of which of the​ following?

A. Extreme diarrhea with dehydration

B. Influenza

C. Myocardial infarction

D. Kidney stones

Myocardial infarction

You are called to a residence for a​ 48-year-old male patient. He is lying in​ bed, groaning in pain and curled into a fetal position. His blood pressure is​ 88/50, pulse​ 136, and respiratory rate of 32. His wife states that he complained of lower right abdominal pain for several days that got progressively​ worse, until about an hour ago when it became suddenly unbearable. The wife states the husband had been refusing to see a​ doctor, but she finally called 911. You suspect appendicitis and are concerned about the subsequent onset​ of:

A. renal colic.

B. pancreatitis.

C. peritonitis.

D. splenic rupture.

peritonitis.

You are examining a​ 24-year-old female patient with lower quadrant abdominal pain. What is the most lethal​ possibility?

A. Pelvic inflammatory disease

B. Ectopic pregnancy

C. Menstrual irregularity

D. Cholecystitis

Ectopic pregnancy

Your patient is a​ 35-year-old female with abdominal pain. Which of the following findings cannot be attributed to the patient experiencing​ pain?

A. Shallow respirations

B. Decreased level of consciousness

C. Increased respiratory rate

D. Increased heart rate

Decreased level of consciousness

Your patient is a​ 60-year-old male who is complaining of severe epigastric abdominal pain and difficulty breathing. He is​ pale, sweaty, and pleads with​ you, "Don't let me​ die, I think​ I'm going to​ die." Which of the following measures is not part of your initial treatment of this​ patient?

A. Applying the defibrillator pads to his chest

B. Giving 15 lpm of oxygen by nonrebreather mask

C. Placing the patient in a position of comfort

D. Determining whether you should assist the patient in taking nitroglycerin

Applying the defibrillator pads to his chest

You arrive on the scene to find an approximately​ 60-year-old male patient writhing on the floor. He is complaining of a tearing pain radiating to his lower back. He has absent femoral pulses and has a pulsatile mass just superior to his umbilicus. You suspect which of the following​ conditions?

A. Acute pancreatitis

B. Abdominal aortic aneurysm

C. Myocardial infarction

D. Ruptured appendix

Abdominal aortic aneurysm

Which of the following questions is inappropriate when taking the history of a female patient with abdominal​ pain?

A. Are you having vaginal bleeding or discharge​ now?

B. If you are​ menstruating, is the flow​ normal?

C. Have you had sexual intercourse since your last menstrual​ period?

D. What is your sexual​ orientation?

What is your sexual​ orientation?

Which of the following is a concern when caring for the patient with abdominal​ pain?

A. Airway management

B. Patient comfort

C. Shock

D. All of the above

All of the above