Chapters 14-23: Test Question Guide

1. What are the side effects of epinephrine?

   1. Hypertension, nausea, chest pain, cardiac arrhythmia, anxiety, tremors, nervousness

2. How long can a bee stinger keep pumping venom inside you?

   1. 20 minutes

   2. Try to take out the stinger with another object

3. What are the symptoms of a heart attack?

   1. Crushing pain in the chest

   2. Weakness

   3. The pain will travel to the left side

4. What are the signs of hypoglycemia?

   1. Possibly seizures in diabetic patients

   2. Normal or shallow to rapid respirations

   3. Moist and pale skin, pale and clammy

   4. Low blood pressure

   5. Rapid, weak pulse

   6. Altered mental status, steadily deteriorating

   7. Taken insulin but not eaten

5. What are the signs of hyperglycemia?

   1. Hyperventilating, rapid, deep breathing

   2. Kussmaul respirations

   3. Dry and warm skin

   4. Normal blood pressure

   5. Rapid, weak, thready pulse

   6. A fruity odor on their breath: acetone/ketone odor

   7. Altered mental status, steadily deteriorating

   8. Eaten but not taken insulin

6. What would tell you that a patient has pulmonary edema?

   1. Cannot be supine, cannot breathe if supine

   2. Labored breathing, respiratory distress

   3. Crackles/Rhonchi

   4. History of heart failure

   5. History of high blood pressure

   6. Treat them by putting them on CPAP

7. What are normal glucose levels?

   1. 80-120

8. Steps of the primary patient assessment:

   1. General impression

   2. AVPU

   3. Chief complaint

   4. ABCs

   5. Transport decision

9. What is the dose of epinephrine for children and adults? What are the age ranges for each?

   1. Child: under 4: 0.15

   2. Adult: over 4: 0.30

10. You have put an AED on a patient. It is shocking. What should you do?

    1. Say CLEAR and administer the shock

11. You have given all the doses you can of medication, but the patient is in distress and the transport time is long. Who do you call?

    1. Call medical control

12. How do we position a stroke patient while transporting?

    1. On the affected side

13. What do you do if a scene is unsafe?

    1. Make it safe if you can

    2. Call for appropriate resources

14. What is the big problem with narcotics in terms of a patient taking them?

    1. The lowered respiratory rate for OPIOIDS especially

    2. Ventilate with a BVM, optimally at 100% O2 with 15 L/min

15. What are the symptoms of an overdose of benzedrine?

    1. An amphetamine, not a benzodiazepine/barbiturate

    2. A Sympathomimetic stimulant, not a Sedative-Hypnotic

       1. An agent that produces an excited state

       2. Ex: amphetamine, methamphetamine

    3. Usually taken to make the user feel good

       1. Improve task performance

       2. Suppress appetite

       3. Prevent sleepiness

    4. May produce irritability, anxiety, fear, lack of concentration, seizures

    5. Paranoia and delusions are common signs of abuse

16. What are the symptoms of an overdose of ecstasy?

    1. A Sympathomimetic stimulant, not a Sedative-Hypnotic

    2. Agitation and restlessness

    3. Panic attacks or severe anxiety

    4. Severe confusion or disorientation

    5. Hallucinations or delirium

    6. Rapid heartbeat (tachycardia) or irregular heartbeat (arrhythmia)

    7. High blood pressure

    8. Nausea and vomiting

    9. Blurred vision

    10. Fainting or loss of consciousness

    11. Hyperthermia (dangerously high body temperature)

    12. Seizures

17. What are the symptoms of an overdose of cocaine?

    1. A Sympathomimetic stimulant, not a Sedative-Hypnotic

    2. Classically inhaled into the nose and absorbed by the nasal mucosa

       1. Damaging tissue, causing nosebleeds (epistaxis), and eventually destroying the nasal septum

       2. In any form the immediate effects of a given dose, including excitement and euphoria, last an hour

    3. Intense agitation or anxiety

    4. Severe paranoia or hallucinations

    5. Aggressive or violent behavior

    6. Tremors or muscle twitches

    7. Increased heart rate and blood pressure

    8. Irregular heart rhythm

    9. Chest pain or discomfort

    10. Difficulty breathing

    11. Nausea and vomiting

    12. Seizures

    13. Stroke

    14. Coma

18. What are the symptoms of an overdose of oxycodone?

    1. CNS depressants

    2. Can cause respiratory depression

       1. Decreased volume of inspired air

       2. Decreased rate of respirations (below 10)

       3. This can lead to respiratory and cardiac arrest

    3. Produce a high/kick when administered intravenously

    4. Overdose can result in rare seizures, comatose condition

    5. Patients appear sedated or unconscious

    6. Exhibit cyanosis with pinpoint pupils (most specific sign)

19. Contraindications for administering oral glucose:

    1. The patient is unable to swallow

    2. The patient has a severely altered mental status

       1. Very confused, cannot follow commands, etc.

    3. The patient is unconscious

    4. The glucose is expired

20. How does anaphylaxis kill people?

    1. Airway swelling

    2. Respiratory distress/arrest

    3. Overdilation of blood vessels → shock

21. Symptoms of a myocardial infarction?

    1. AMI pain differs from angina pain

       1. Once dead, cells cannot be revived.

       2. “Clot-busting” (thrombolytic) drugs or angioplasty within the first few hours prevent damage.

       3. Immediate transport is essential

    2. Not always due to exertion

    3. Lasts 30 minutes to several hours

    4. Not always relieved by rest or nitroglycerin

    5. AMI and cardiac compromise physical findings

    6. Movement or palpation should not alter pain

    7. Chest discomfort: Pressure, squeezing, fullness, pain, burning, or heaviness

    8. Upper body discomfort: Neck, jaw, shoulder, arms, back

    9. Shortness of breath: Shortness of breath, feeling light-headed, or unusually tired

    10. Diaphoresis: Sweating

    11. Nausea: Feeling nauseous

    12. Peripheral cyanosis: Peripheral cyanosis, edema, pallor, diminished pulse volume, delayed rise, and delayed capillary refill

    13. Pulse and neck-vein patterns: Pulse and neck-vein patterns may reveal other associated abnormalities

    14. Cardiac bulge: Rarely, a cardiac bulge with a pace different from the pulse rhythm can be felt on precordial examination

22. How do you care for a sexual assault victim?

    1. Move them to a private area

    2. Be respectful, supportive, and a good listener

    3. Get some evidence, clothing, hair, nails, etc.

    4. Wrap evidence materials in a paper bag, plastic degrades DNA

23. What is a TIA?

    1. A transient ischemic attack

    2. Stroke symptoms that resolve within 24 hours on their own with no deficit in function

24. You are doing CPR and have the return of spontaneous circulation. What should you do?

    1. Check the pulse

    2. Check the airway

    3. Check the breathing

    4. Give ventilation if needed

    5. In the JB LEARNING world, ALWAYS VENTILATE for shallow respirations

25. How do we treat a patient with dyspnea?

    1. Oxygen and position of comfort

    2. Sitting up: Fowler’s or Semi-Fowler’s

26. AEIOU TIPS:

    1. A: Alcohol or drug abuse

    2. E: Epilepsy, electrolyte imbalances, and endocrine problems

    3. I: Insulin, inborn errors of metabolism, and overdose or oxygen

    4. O: Underdose, uremia, or overdose

    5. T: Trauma

    6. I: Infection, psychiatric, or poisoning

    7. P: Psychosis

    8. S: Stroke or subarachnoid hemorrhage (SAH)

27. What do you do for a patient with good breathing with a lot of oral secretions that they cannot clear on their own?

    1. Suction

28. What would happen if a solid organ is ruptured?

    1. Severe internal bleeding

29. What would happen if a hollow organ is ruptured?

    1. Its contents would spill out

    2. This would lead to sepsis, bacterial infection

30. What are the signs of adequate air exchange?

    1. Chest rise

    2. Skin is pink, warm, and dry

    3. LOC is alert and oriented

    4. Respirations between 12-20 for an adult, etc.

31. For a patient with a narcotic overdose, what type of airway would you use?

    1. An oral airway until gasoline/Narcan is administered

    2. Have to use an oral until Narcan is administered in two nostrils

    3. Only suction if the person has vomitus or something in the mouth

32. How does nitroglycerin work?

    1. Dilates the coronary arteries

    2. Causes blood pressure to drop

33. What are the signs and symptoms of acute hyperventilation?

    1. Breathing fast and deep

    2. Tingling and spasms in the limbs

    3. For diabetic ketoacidosis: Kussmaul respirations

    4. The patient is breathing typically for an emotional cause

34. When calling medical control, I want the correct course of treatment for a patient. They have to know:

    1. Size of the patient (weight)

    2. What they took

    3. When they took it

    4. How much they took

35. What do you have to watch for when giving activated charcoal?

    1. Vomiting

36. First two steps of assessing any patient:

    1. PPE and scene safety

37. How long should a generalized seizure last?

    1. 3-5 minutes

38. What happens after the generalized seizure?

    1. The patient is in a postictal state

39. How long is the postictal period?

    1. 5-30 minutes, depending on the initial seizure

40. Have a patient with surface contact poisoning, have poison on their body. What is the main concern with this?

    1. That it does not get on the EMS provider

41. My patient has polypharmacy. They took multiple drugs and one of the drugs is an opiate. The person’s breathing is bad. What are the two steps for treatment?

    1. Ventilate and give Narcan/naloxone

42. How to treat a vomiting patient experiencing a tonic-clonic seizure?

    1. Turn them to their side

    2. Move them out of the way of objects

    3. Suction them

    4. Give them a nasal airway

    5. NEVER put anything into their mouths

43. How do you treat shock?

    1. Nonrebreather at 15 L/min

    2. Trendelenberg/shock position

    3. Keep them warm with a blanket

    4. Rapid transport, if possible beat the cause of shock

    5. Ex: if bleeding, stop the breathing

    6. Ex: if anaphylactic, give an EpiPen

44. What do I do after treating a patient?

    1. Reassess every 5 minutes if unstable

    2. Reassess every 15 minutes if stable

45. Have a patient who is yelling, cursing, calling people names, etc. Would you say that is a behavioral crisis? When does it become a psychological emergency?

    1. When the patient becomes a threat to themselves or others

46. What is the difference between allergies and anaphylaxis?

    1. Anaphylaxis deals with multiple body systems

    2. At least one system has to be under a life threat

    3. Anaphylaxis is life-threatening

    4. Allergies are merely annoying

47. What tells you that a person might become violent?

    1. Changes in body language

    2. Fists clenched, jaw clenched

    3. Holding a bat and smashing windows

48. A person has shortness of breath. Their pulse ox reads at 92%. What should you do right away for them?

    1. Give them a nasal cannula at 4-6 L/min

    2. Whatever is appropriate

49. A person has shortness of breath. Their pulse ox reads at 88%. They are slightly cyanotic, maybe hypoxic. What should you do right away for them?

    1. Give them a nonrebreather mask at 10-15 L/min

    2. Whatever is appropriate

50. A person has shortness of breath. They are in severe respiratory distress and are very hypoxic. What should you do right away for them?

    1. Give them a BVM mask at 15 L/min

    2. Whatever is appropriate

51. In the primary assessment, ABCs C stands for circulation. What are the three things to check for?

    1. Bleeding

    2. Capillary refill/radial pulse

    3. Skin tone, temperature

52. Common signs of severe/symptomatic hypoglycemia:

    1. Sudden altered mental status

    2. Severe hypoglycemia

    3. Needs glucose immediately

    4. This will result in loss of consciousness, brain damage, and death

    5. More critical than hyperglycemia or diabetic ketoacidosis

53. Common signs of severe/symptomatic hyperglycemia:

    1. Acidosis

    2. Dehydration: needs IV fluid therapy

    3. Severe hyperglycemia

    4. Needs insulin immediately