WITH REAL EXAM QUESTIONS AND
CORRECT ANSWERS WITH DETAILED
RATIONALES GRADED A+
A 48-year-old man became acutely hypoxic, experienced a
seizure, and is now postictal. The MOST effective way to prevent
another seizure
is to:
A) place him in the recovery position.
B) give him oral glucose if he can swallow.
C) administer high-flow supplemental oxygen.
D) dim the lights in the back of the ambulance. Correct Answer C)
administer high-flow supplemental oxygen.
You should administer high-flow oxygen to all patients who
are actively seizing and to patients who experienced a
seizure and are postictal. This is especially true if the seizure
was caused by hypoxia. Increasing the oxygen content of the
blood, which minimizes hypoxia, may prevent another
seizure. 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.
What is the correct dose, concentration, and route of epinephrine
via EpiPen for anaphylactic shock in an adult?
A) 0.3 mg; 1:1,000; intramuscular
B) 0.15 mg; 1:1,000; intravascular
C) 0.3 mg; 1:10,000; intramuscular
D) 0.15 mg; 1:10,000; intravascular Correct Answer A) 0.3 mg;
1:1,000; intramuscular
In some EMS systems, EM Ts are trained to draw up and
administer epinephrine from an ampule or a vial. In this case,
the dose is 0.2 to 0.5 mg of a n ,000
solution (1 mg/mL) for adults and 0.01 mg/kg for children.
Other systems carry epinephrine auto-injectors, or assist
patients who have a prescription. The
adult EpiPen delivers 0.3 mg of a J:1 ,000 solution, and the
pediatric EpiPen delivers 0.15 mg of a J:2 ,000 solution.
Whether drawn from an ampule or vial or
,delivered via EpiPen, the drug is administered via the
intramuscular route. The J:1 ,000 concentration is very
concentrated compared to J:10 ,000, and is
therefore NOT administered by the intravascular route.
A woman with type 1 diabetes presents with deep, rapid
breathing; tachycardia, dehydration; and an altered mental status.
Which of the
following would MOST likely explain her clinical presentation?
A) Her blood sugar level is less than 60 mg/dL.
B) She has not taken her insulin in several days.
C) She took her insulin but has not eaten today.
D) She has an infection that lead to dehydration. Correct Answer
B) She has not taken her insulin in several days.
The patient's clinical presentation is consistent with
hyperglycemic ketoacidosis. Of the options listed, the only
logical explanation is that she has not taken
her insulin in several days. Without insulin, glucose cannot
enter the cell to make energy, so it pools in the blood to
excessive levels (hyperglycemia). Excess
blood glucose levels cause the body to eliminate large
amounts of water via the kidneys, resulting in dehydration. In
the absence of glucose, the cells will
, metabolize fat, which produces ketoacids. The respiratory
system will attempt to eliminate these ketoacids from the
body by increasing the rate and depth of breathing
(Kussmaul respirations). Had she taken her insulin but did
not eat, her blood glucose level would be lower than normal.
Although an underlying infection cannot be ruled out, the
primary cause of her problem is failure to take her prescribed
insulin.
A 32-year-old man who was stung by a bee has diffuse hives,
facial swelling, and difficulty breathing. When he breathes, you
hear audible
stridor. What does this indicate?
A) Swelling of the upper airway structures
B) Swelling of the lower airway structures
C) Narrowing of the two mainstem bronchi
D) Narrowing of the bronchioles in the lungs Correct Answer A)
Swelling of the upper airway structures
This patient is experiencing a severe allergic reaction
(anaphylaxis). Strid or, which is a high-pitched sound heard
on inhalation, indicates swelling of the
structures and tissues of the upper airway. If not promptly
treated, the patient's airway may close completely, resulting
in respiratory arrest. Narrowing of