NREMT Practice Test Bank - Multiple Choice
When dealing with an emotionally disturbed patient, You selected C; This is correct!
you should be MOST concerned with:
• A:gathering all of the patient's medications. Reason: When managing any patient with an emotional or psychiatric crisis,
• B:safely transporting to the hospital. your primary concern is your own safety. Safely transporting the patient to the
• C:whether the patient could harm you. hospital is your ultimate goal. If possible, you should attempt to obtain a
• D:obtaining a complete medical history. medical history and should take any of the patient's prescribed medications to
the hospital. However, this should not supercede your own safety or interfere
with safely transporting the patient.
You are at the scene where a man panicked while You selected B; This is correct!
swimming in a small lake. Your initial attempt to rescue
him should include: Reason: General rules to follow when attempting to rescue a patient from the
• A:rowing a small raft to the victim. water include "reach, throw, row, and then go." In this case, you should attempt
• B:reaching for the victim with a long stick. to reach the victim by having him grab hold of a large stick or similar object. If
• C:throwing a rope to the victim. this is unsuccessful, throw the victim a rope or flotation device (if available). If
• D:swimming to the victim to rescue him. these are not available, row to the patient in a small raft (if available). Going into
the water to retrieve the victim is a last resort. The rescuer must be a strong
swimmer because patients who are in danger of drowning are in a state of
blind panic and will make every attempt to keep themselves afloat, even if it
means forcing the rescuer underwater.
How should you classify a patient's nature of illness if The correct answer is B;
he or she has a low blood glucose level, bizarre
behavior, and shallow breathing? Reason: The nature of illness (NOI) is the medical equivalent to mechanism of
• A:Behavioral emergency injury (MOI). Altered mental status should be the suspected NOI in any patient
• B:Altered mental status with any fluctuation in level of consciousness, which can range from bizarre
• C:Respiratory emergency behavior to complete unresponsiveness. Causes of an altered mental status
• D:Cardiac compromise include hypo- or hyperglycemia, head trauma, stroke, behavioral crises, drug
overdose, and shock, among others.
A young female is unresponsive after overdosing on an The correct answer is C;
unknown type of drug. Her respirations are slow and
shallow and her pulse is slow and weak. Which of the Reason: Of the drugs listed, cocaine would be the least likely cause of the
following drugs is the LEAST likely cause of her patient's condition. Cocaine is a central nervous system (CNS) stimulant; you
condition? would expect her to be hypertensive, tachycardic, tachypneic, and perhaps
• A:Seconal even violent. Heroin, Valium, and Seconal are all CNS depressants and could
• B:Heroin explain her condition. Heroin is an illegal narcotic (opiate), Valium is a
• C:Cocaine benzodiazepine sedative-hypnotic drug, and Seconal is a barbiturate.
• D:Valium Narcotics, benzodiazepines, and barbiturates are all CNS depressants. When
taken in excess, they cause a decreased level of consciousness, respiratory
depression, bradycardia, and hypotension.
, NREMT Practice Test Bank - Multiple Choice
Activated charcoal is contraindicated for a patient who You selected D; This is correct!
is:
• A:conscious and alert and has ingested a large Reason:Activated charcoal adsorbs (sticks to) many ingested substances,
amount of Motrin. preventing them from being absorbed into the body by the stomach or
• B:emotionally upset and has ingested two bottles of intestines. In some cases, you may give activated charcoal to patients who have
aspirin. ingested certain substances, if approved by medical control or local protocol.
• C:agitated and claims to have ingested a bottle of Activated charcoal is contraindicated for patients who have ingested an acid or
Tylenol. alkali (ie, drain cleaner) or a petroleum product (ie, gasoline), who have a
• D:awake and alert and has swallowed a commercial decreased level of consciousness and cannot protect their own airway, or who
drain cleaner. are unable to swallow.
The MOST obvious way to reduce heat loss from you selected D; This is correct!
radiation and convection is to:
• A:move away from a cold object. Reason:In a cold environment, the body has two ways of staying warm:
• B:increase metabolism by shivering. generating heat (thermogenesis) and reducing heat loss. Radiation is the
• C:wear a thick wind-proof jacket. transfer of heat by radiant energy. The body can lose heat by radiation, such as
• D:move to a warmer environment. when a person stands in a cold room. Convection occurs when heat is
transferred to circulating air, as when cool air moves across the body's surface.
A person standing in windy cold weather, wearing lightweight clothing, is
losing heat to the environment mostly by convection. The quickest and most
obvious way to decrease heat loss from radiation and convection is to move
out of the cold environment and seek shelter from wind. Shivering increases
the body's metabolism and is a mechanism for generating heat, not reducing
heat loss. Layers of clothing trap air and provide excellent insulation; thus,
layered clothing decreases heat loss better than a single, thick jacket.
Conduction is the direct transfer of heat from a part of the body to a colder
object by direct contact, as when a warm hand touches cold metal or ice. The
most obvious way to decrease heat loss by conduction is to remove your hand
from the cold object.
A near-drowning is MOST accurately defined as: You selected C; This is correct!
• A:complications within 24 hours following submersion
in water. Reason:Collectively, drowning and near-drowning are referred to as
• B:immediate death due to prolonged submersion in submersion injuries. Drowning is defined as death after submersion in a liquid
water. medium, usually water. In a drowning, death is either immediate or occurs
• C:survival for at least 24 hours following submersion in within 24 hours following submersion. Near-drowning is defined as survival, at
water. least temporarily (24 hours), after submersion. It should be noted, however, that
• D:death greater than 24 hours following submersion in complications such as pneumonia and pulmonary edema can cause death
water. greater than 24 hours following submersion. For this reason, all patients with a
submersion injury should be transported to the hospital, even if they appear
fine at the scene.
A young woman reports significant weight loss over the You selected B; This is correct!
last month, persistent fever, and night sweats. When you
assess her, you note the presence of dark purple Reason:Weight loss, fever, and night sweats could indicate tuberculosis or
lesions covering her trunk and upper extremities. You HIV/AIDS; however, the dark purple lesions on the skin, which are called
should suspect: Kaposi's sarcoma, are malignant skin tumors and are a classic finding in patients
• A:end-stage cancer. in the later stages of AIDS.
• B:HIV/AIDS.
• C:tuberculosis.
• D:rheumatic fever.
, NREMT Practice Test Bank - Multiple Choice
A 48-year-old male became acutely hypoxic, You selected C; This is correct!
experienced a seizure, and is now postictal. The MOST
effective way to prevent another seizure is to: Reason:You should administer high-flow oxygen to all patients who are actively
• A:dim the lights in the back of the ambulance. seizing and to patients who experienced a seizure and are postictal. This is
• B:place him in the recovery position. especially true if the seizure was caused by hypoxia. Increasing the oxygen
• C:administer high-flow supplemental oxygen. content of the blood, which minimizes hypoxia, may prevent another seizure.
• D:give him oral glucose if he can swallow. The recovery position is appropriate for uninjured patients with a decreased
level of consciousness and adequate breathing; it will help maintain the airway
and facilitate drainage of secretions from the mouth, but will not prevent
another seizure. Oral glucose may prevent another seizure if hypoglycemia was
the cause of the seizure. You should dim the lights in the back of the ambulance
to help prevent any seizure, not just those that are caused by hypoxia.
Which of the following conditions would be the LEAST You selected C; This is correct!
likely to be present in a patient who was submerged in
water? Reason: Many factors can contribute to or result from a submersion injury (eg,
• A:Spinal injury drowning, near-drowning). It is not uncommon for a person to experience a
• B:Gastric distention spinal injury after diving head first into shallow water, especially if he or she is
• C:Hyperglycemia under the influence of alcohol. When a swimmer panics, he or she initially
• D:Laryngospasm swallows large amounts of water, resulting in gastric distention. Gastric
distention can cause aspiration if the patient regurgitates water during rescue
breathing; protect the airway! During the panic phase, the victim expends a
tremendous amount of energy (and glucose) from flailing around in the water,
possibly resulting in hypoglycemia. Inhaling even a small amount of fresh or
salt water can severely irritate the larynx, which sends the muscles of the larynx
and vocal cords into spasm (laryngospasm), resulting in airway blockage and
hypoxia.
A 42-year-old male presents with fever, a severe You selected C; This is correct!
headache, and a stiff neck. He is conscious, but
confused. His wife tells you that he does not have any Reason:Meningitis is an inflammation of the protective coverings of the brain
medical problems and does not take any medications. and spinal cord (meninges). Common signs and symptoms of meningitis include
You should be MOST suspicious for: fever, headache, neck stiffness (nuchal rigidity), and vomiting. An altered mental
• A:acute stroke. status is common in severe cases. Meningococcal meningitis, caused by a
• B:influenza. bacterium, is the most contagious and potentially fatal type of meningitis. The
• C:meningitis. patient's signs and symptoms are not consistent with acute stroke, tuberculosis
• D:tuberculosis. (TB), or influenza (the flu). Although fever is common with both TB and the flu,
( neither causes neck stiffness. Acute stroke may be associated with a headache,
especially a hemorrhagic stroke; however, stroke patients typically do not have
a fever.
All of the following are signs of gastrointestinal You selected D; This is correct!
bleeding, EXCEPT: Reason:Signs and symptoms of gastrointestinal (GI) bleeding include
• A:melena. abdominal pain; vomiting blood (hematemesis); the passage of dark, tarry
• B:hematemesis. stools (melena); and bright red rectal bleeding (hematochezia). If blood loss is
• C:tachycardia. significant, the patient may have signs of shock (eg, tachycardia, diaphoresis,
• D:hemoptysis. tachypnea, hypotension). Hemoptysis (coughing up blood) is a sign of a
pulmonary injury, not GI bleeding.
, NREMT Practice Test Bank - Multiple Choice
A 24-year-old female presents with a rash to her left You selected C; This is correct!
leg and swollen, painful knee joints. She tells you that Reason:The patient's symptoms and her history of a recent hiking trip are
she and her friends returned from a hiking trip in the consistent with Lyme disease, which was the result of a tick bite. Ticks can carry
mountains a week ago. She is conscious and alert with a two infectious diseases: Lyme disease and Rocky Mountain spotted fever. Both
blood pressure of 112/62 mm Hg, a pulse of 84 are spread through the tick's saliva, which is injected into the skin when the tick
beats/min, and respirations of 14 breaths/min. Her attaches itself. The first symptom of Lyme disease, a rash that may spread to
symptoms are MOST likely the result of: several parts of the body, begins about 3 days after the bite of an infected tick.
• A:Rocky Mountain spotted fever. The rash may eventually resemble a target bull's-eye pattern in one third of
• B:tetanus. patients. After a few more days or weeks, painful swelling of the joints,
• C:Lyme disease. particularly the knees, occurs. If recognized and treated promptly with
• D:a localized allergic reaction. antibiotics, many patients recover completely. Rocky Mountain spotted fever,
which is not limited to the Rocky Mountains, occurs within 7 to 10 days after
being bitten by an infected tick. Its symptoms include nausea, vomiting,
headache, weakness, paralysis, and possibly cardiopulmonary failure.
A 50-year-old woman who is conscious and alert You selected B; This is correct!
complains of a severe migraine headache. When caring Reason:Patients with migraine or cluster headaches typically have photophobia
for her, you should generally avoid: (light sensitivity). Any type of bright light, especially if shone directly into the
• A:transporting her in a supine position. eyes, will cause the patient with a headache unnecessary severe pain. Dimming
• B:shining a light into her pupils. the lights in the ambulance and making the patient as comfortable as possible
• C:dimming the lights in the ambulance. are the treatments of choice for a patient with a headache. Some patients
• D:applying ice packs to her forehead. benefit from ice packs applied to the forehead; just be sure to wrap the ice
pack with roller gauze. Oxygen also should be administered as needed.
Typically, the patient will prefer to lie supine or on the side
A patient who overdosed on heroin would be expected The correct answer is C;
to present with:
• A:tachycardia. Reason:Heroin is a Schedule I (illegal) narcotic that is typically injected. As with
• B:hyperpnea. all narcotics, legal or illegal, overdose causes depression of the central
• C:hypotension. nervous system (CNS), resulting in a decreased level of consciousness;
• D:dilated pupils. bradycardia; hypotension; and slow, shallow (reduced tidal volume) breathing.
Hyperpnea (deep breathing) would not be present in a patient who overdosed
on a narcotic. In a narcotic overdose, the pupils are typically constricted
(miosis). Barbiturates, such as phenobarbital, are also CNS depressants and
cause the same symptoms seen with narcotic overdose. The patient's pupils,
however, are typically dilated (mydriasis), not constricted.
When caring for any patient with a decreased level of You selected A; This is correct!
consciousness, your primary concern should be the:
• A:potential for airway compromise. Reason:Altered mental status could be caused by a high or low blood glucose
• B:patient's blood glucose level. level, drug overdose, or head injury, among other causes. Furthermore, the
• C:possibility of a spinal injury. possibility of a spinal injury should be considered if the patient was injured.
• D:possibility of a drug overdose. However, your primary concern should be the status of the patient's airway.
Patients with a decreased level of consciousness are at risk for aspiration if
vomiting occurs. Unless spinal trauma is present or the patient is breathing
inadequately (eg, fast or slow rate, shallow breathing [reduced tidal volume]),
place him or her in the recovery position to facilitate drainage if vomiting
occurs. Remember this: no airway, no patient!
When dealing with an emotionally disturbed patient, You selected C; This is correct!
you should be MOST concerned with:
• A:gathering all of the patient's medications. Reason: When managing any patient with an emotional or psychiatric crisis,
• B:safely transporting to the hospital. your primary concern is your own safety. Safely transporting the patient to the
• C:whether the patient could harm you. hospital is your ultimate goal. If possible, you should attempt to obtain a
• D:obtaining a complete medical history. medical history and should take any of the patient's prescribed medications to
the hospital. However, this should not supercede your own safety or interfere
with safely transporting the patient.
You are at the scene where a man panicked while You selected B; This is correct!
swimming in a small lake. Your initial attempt to rescue
him should include: Reason: General rules to follow when attempting to rescue a patient from the
• A:rowing a small raft to the victim. water include "reach, throw, row, and then go." In this case, you should attempt
• B:reaching for the victim with a long stick. to reach the victim by having him grab hold of a large stick or similar object. If
• C:throwing a rope to the victim. this is unsuccessful, throw the victim a rope or flotation device (if available). If
• D:swimming to the victim to rescue him. these are not available, row to the patient in a small raft (if available). Going into
the water to retrieve the victim is a last resort. The rescuer must be a strong
swimmer because patients who are in danger of drowning are in a state of
blind panic and will make every attempt to keep themselves afloat, even if it
means forcing the rescuer underwater.
How should you classify a patient's nature of illness if The correct answer is B;
he or she has a low blood glucose level, bizarre
behavior, and shallow breathing? Reason: The nature of illness (NOI) is the medical equivalent to mechanism of
• A:Behavioral emergency injury (MOI). Altered mental status should be the suspected NOI in any patient
• B:Altered mental status with any fluctuation in level of consciousness, which can range from bizarre
• C:Respiratory emergency behavior to complete unresponsiveness. Causes of an altered mental status
• D:Cardiac compromise include hypo- or hyperglycemia, head trauma, stroke, behavioral crises, drug
overdose, and shock, among others.
A young female is unresponsive after overdosing on an The correct answer is C;
unknown type of drug. Her respirations are slow and
shallow and her pulse is slow and weak. Which of the Reason: Of the drugs listed, cocaine would be the least likely cause of the
following drugs is the LEAST likely cause of her patient's condition. Cocaine is a central nervous system (CNS) stimulant; you
condition? would expect her to be hypertensive, tachycardic, tachypneic, and perhaps
• A:Seconal even violent. Heroin, Valium, and Seconal are all CNS depressants and could
• B:Heroin explain her condition. Heroin is an illegal narcotic (opiate), Valium is a
• C:Cocaine benzodiazepine sedative-hypnotic drug, and Seconal is a barbiturate.
• D:Valium Narcotics, benzodiazepines, and barbiturates are all CNS depressants. When
taken in excess, they cause a decreased level of consciousness, respiratory
depression, bradycardia, and hypotension.
, NREMT Practice Test Bank - Multiple Choice
Activated charcoal is contraindicated for a patient who You selected D; This is correct!
is:
• A:conscious and alert and has ingested a large Reason:Activated charcoal adsorbs (sticks to) many ingested substances,
amount of Motrin. preventing them from being absorbed into the body by the stomach or
• B:emotionally upset and has ingested two bottles of intestines. In some cases, you may give activated charcoal to patients who have
aspirin. ingested certain substances, if approved by medical control or local protocol.
• C:agitated and claims to have ingested a bottle of Activated charcoal is contraindicated for patients who have ingested an acid or
Tylenol. alkali (ie, drain cleaner) or a petroleum product (ie, gasoline), who have a
• D:awake and alert and has swallowed a commercial decreased level of consciousness and cannot protect their own airway, or who
drain cleaner. are unable to swallow.
The MOST obvious way to reduce heat loss from you selected D; This is correct!
radiation and convection is to:
• A:move away from a cold object. Reason:In a cold environment, the body has two ways of staying warm:
• B:increase metabolism by shivering. generating heat (thermogenesis) and reducing heat loss. Radiation is the
• C:wear a thick wind-proof jacket. transfer of heat by radiant energy. The body can lose heat by radiation, such as
• D:move to a warmer environment. when a person stands in a cold room. Convection occurs when heat is
transferred to circulating air, as when cool air moves across the body's surface.
A person standing in windy cold weather, wearing lightweight clothing, is
losing heat to the environment mostly by convection. The quickest and most
obvious way to decrease heat loss from radiation and convection is to move
out of the cold environment and seek shelter from wind. Shivering increases
the body's metabolism and is a mechanism for generating heat, not reducing
heat loss. Layers of clothing trap air and provide excellent insulation; thus,
layered clothing decreases heat loss better than a single, thick jacket.
Conduction is the direct transfer of heat from a part of the body to a colder
object by direct contact, as when a warm hand touches cold metal or ice. The
most obvious way to decrease heat loss by conduction is to remove your hand
from the cold object.
A near-drowning is MOST accurately defined as: You selected C; This is correct!
• A:complications within 24 hours following submersion
in water. Reason:Collectively, drowning and near-drowning are referred to as
• B:immediate death due to prolonged submersion in submersion injuries. Drowning is defined as death after submersion in a liquid
water. medium, usually water. In a drowning, death is either immediate or occurs
• C:survival for at least 24 hours following submersion in within 24 hours following submersion. Near-drowning is defined as survival, at
water. least temporarily (24 hours), after submersion. It should be noted, however, that
• D:death greater than 24 hours following submersion in complications such as pneumonia and pulmonary edema can cause death
water. greater than 24 hours following submersion. For this reason, all patients with a
submersion injury should be transported to the hospital, even if they appear
fine at the scene.
A young woman reports significant weight loss over the You selected B; This is correct!
last month, persistent fever, and night sweats. When you
assess her, you note the presence of dark purple Reason:Weight loss, fever, and night sweats could indicate tuberculosis or
lesions covering her trunk and upper extremities. You HIV/AIDS; however, the dark purple lesions on the skin, which are called
should suspect: Kaposi's sarcoma, are malignant skin tumors and are a classic finding in patients
• A:end-stage cancer. in the later stages of AIDS.
• B:HIV/AIDS.
• C:tuberculosis.
• D:rheumatic fever.
, NREMT Practice Test Bank - Multiple Choice
A 48-year-old male became acutely hypoxic, You selected C; This is correct!
experienced a seizure, and is now postictal. The MOST
effective way to prevent another seizure is to: Reason:You should administer high-flow oxygen to all patients who are actively
• A:dim the lights in the back of the ambulance. seizing and to patients who experienced a seizure and are postictal. This is
• B:place him in the recovery position. especially true if the seizure was caused by hypoxia. Increasing the oxygen
• C:administer high-flow supplemental oxygen. content of the blood, which minimizes hypoxia, may prevent another seizure.
• D:give him oral glucose if he can swallow. The recovery position is appropriate for uninjured patients with a decreased
level of consciousness and adequate breathing; it will help maintain the airway
and facilitate drainage of secretions from the mouth, but will not prevent
another seizure. Oral glucose may prevent another seizure if hypoglycemia was
the cause of the seizure. You should dim the lights in the back of the ambulance
to help prevent any seizure, not just those that are caused by hypoxia.
Which of the following conditions would be the LEAST You selected C; This is correct!
likely to be present in a patient who was submerged in
water? Reason: Many factors can contribute to or result from a submersion injury (eg,
• A:Spinal injury drowning, near-drowning). It is not uncommon for a person to experience a
• B:Gastric distention spinal injury after diving head first into shallow water, especially if he or she is
• C:Hyperglycemia under the influence of alcohol. When a swimmer panics, he or she initially
• D:Laryngospasm swallows large amounts of water, resulting in gastric distention. Gastric
distention can cause aspiration if the patient regurgitates water during rescue
breathing; protect the airway! During the panic phase, the victim expends a
tremendous amount of energy (and glucose) from flailing around in the water,
possibly resulting in hypoglycemia. Inhaling even a small amount of fresh or
salt water can severely irritate the larynx, which sends the muscles of the larynx
and vocal cords into spasm (laryngospasm), resulting in airway blockage and
hypoxia.
A 42-year-old male presents with fever, a severe You selected C; This is correct!
headache, and a stiff neck. He is conscious, but
confused. His wife tells you that he does not have any Reason:Meningitis is an inflammation of the protective coverings of the brain
medical problems and does not take any medications. and spinal cord (meninges). Common signs and symptoms of meningitis include
You should be MOST suspicious for: fever, headache, neck stiffness (nuchal rigidity), and vomiting. An altered mental
• A:acute stroke. status is common in severe cases. Meningococcal meningitis, caused by a
• B:influenza. bacterium, is the most contagious and potentially fatal type of meningitis. The
• C:meningitis. patient's signs and symptoms are not consistent with acute stroke, tuberculosis
• D:tuberculosis. (TB), or influenza (the flu). Although fever is common with both TB and the flu,
( neither causes neck stiffness. Acute stroke may be associated with a headache,
especially a hemorrhagic stroke; however, stroke patients typically do not have
a fever.
All of the following are signs of gastrointestinal You selected D; This is correct!
bleeding, EXCEPT: Reason:Signs and symptoms of gastrointestinal (GI) bleeding include
• A:melena. abdominal pain; vomiting blood (hematemesis); the passage of dark, tarry
• B:hematemesis. stools (melena); and bright red rectal bleeding (hematochezia). If blood loss is
• C:tachycardia. significant, the patient may have signs of shock (eg, tachycardia, diaphoresis,
• D:hemoptysis. tachypnea, hypotension). Hemoptysis (coughing up blood) is a sign of a
pulmonary injury, not GI bleeding.
, NREMT Practice Test Bank - Multiple Choice
A 24-year-old female presents with a rash to her left You selected C; This is correct!
leg and swollen, painful knee joints. She tells you that Reason:The patient's symptoms and her history of a recent hiking trip are
she and her friends returned from a hiking trip in the consistent with Lyme disease, which was the result of a tick bite. Ticks can carry
mountains a week ago. She is conscious and alert with a two infectious diseases: Lyme disease and Rocky Mountain spotted fever. Both
blood pressure of 112/62 mm Hg, a pulse of 84 are spread through the tick's saliva, which is injected into the skin when the tick
beats/min, and respirations of 14 breaths/min. Her attaches itself. The first symptom of Lyme disease, a rash that may spread to
symptoms are MOST likely the result of: several parts of the body, begins about 3 days after the bite of an infected tick.
• A:Rocky Mountain spotted fever. The rash may eventually resemble a target bull's-eye pattern in one third of
• B:tetanus. patients. After a few more days or weeks, painful swelling of the joints,
• C:Lyme disease. particularly the knees, occurs. If recognized and treated promptly with
• D:a localized allergic reaction. antibiotics, many patients recover completely. Rocky Mountain spotted fever,
which is not limited to the Rocky Mountains, occurs within 7 to 10 days after
being bitten by an infected tick. Its symptoms include nausea, vomiting,
headache, weakness, paralysis, and possibly cardiopulmonary failure.
A 50-year-old woman who is conscious and alert You selected B; This is correct!
complains of a severe migraine headache. When caring Reason:Patients with migraine or cluster headaches typically have photophobia
for her, you should generally avoid: (light sensitivity). Any type of bright light, especially if shone directly into the
• A:transporting her in a supine position. eyes, will cause the patient with a headache unnecessary severe pain. Dimming
• B:shining a light into her pupils. the lights in the ambulance and making the patient as comfortable as possible
• C:dimming the lights in the ambulance. are the treatments of choice for a patient with a headache. Some patients
• D:applying ice packs to her forehead. benefit from ice packs applied to the forehead; just be sure to wrap the ice
pack with roller gauze. Oxygen also should be administered as needed.
Typically, the patient will prefer to lie supine or on the side
A patient who overdosed on heroin would be expected The correct answer is C;
to present with:
• A:tachycardia. Reason:Heroin is a Schedule I (illegal) narcotic that is typically injected. As with
• B:hyperpnea. all narcotics, legal or illegal, overdose causes depression of the central
• C:hypotension. nervous system (CNS), resulting in a decreased level of consciousness;
• D:dilated pupils. bradycardia; hypotension; and slow, shallow (reduced tidal volume) breathing.
Hyperpnea (deep breathing) would not be present in a patient who overdosed
on a narcotic. In a narcotic overdose, the pupils are typically constricted
(miosis). Barbiturates, such as phenobarbital, are also CNS depressants and
cause the same symptoms seen with narcotic overdose. The patient's pupils,
however, are typically dilated (mydriasis), not constricted.
When caring for any patient with a decreased level of You selected A; This is correct!
consciousness, your primary concern should be the:
• A:potential for airway compromise. Reason:Altered mental status could be caused by a high or low blood glucose
• B:patient's blood glucose level. level, drug overdose, or head injury, among other causes. Furthermore, the
• C:possibility of a spinal injury. possibility of a spinal injury should be considered if the patient was injured.
• D:possibility of a drug overdose. However, your primary concern should be the status of the patient's airway.
Patients with a decreased level of consciousness are at risk for aspiration if
vomiting occurs. Unless spinal trauma is present or the patient is breathing
inadequately (eg, fast or slow rate, shallow breathing [reduced tidal volume]),
place him or her in the recovery position to facilitate drainage if vomiting
occurs. Remember this: no airway, no patient!
