AMLS Post Test QUESTIONS AND ANSWERS

AMLS Post Test QUESTIONS AND ANSWERS 1. A 45-year-old patient is found supine on the floor. Healthcare providers note pinpoint pupils, shallow respirations, and vomitus in and around the mouth. What course of action should be taken next? a. Initiate an IV and administer naloxone b. Supplemental oxygen and suction c. Obtain a blood glucose level d. Begin BVM ventilations - ANSWER-b. Supplemental oxygen and suction 2. Patients with a history of COPD that present with an acute onset of shortness of breath are likely to have what condition? a. Pulmonary embolism b. Angina pectoris c. Angioedema d. Hypertensive crisis - ANSWER-a. Pulmonary embolism 3. During compensatory shock, the renin-angiotensin-aldosterone system is activated to cause a/an: a. Increase in preload, afterload, and re-absorption of sodium b. Decrease in preload, afterload, and re-absorption of sodium c. Hypotension and bradycardia d. Vasodilation and sodium retention - ANSWER-a. Increase in preload, afterload, and re-absorption of sodium 4. What clinical findings are most commonly associated with a pulmonary embolus? a. Clear breath sounds with tachypnea b. Rhonchi auscultated bilaterally with hypercarbia c. Crackles heard in the bases with bradycardia d. Fever, tachycardia, and tachypnea with increased work of breathing - ANSWER-a. Clear breath sounds with tachypnea 5. What condition is most likely to cause respiratory acidosis? a. Anxiety/panic attack b. Narcotic overdose c. Methanol ingestion d. Diabetic ketoacidosis - ANSWER-b. Narcotic overdose 6. A 55-year-old complains of an 'aching' chest discomfort that persists over several days. The patient has a temperature of 101F (38.3C). Which finding will help narrow the diagnosis to pericarditis? a. Pain is relieved when supine b. Pulsus alternans is present c. S3 gallop is auscultated d. ST-segment elevation in all leads - ANSWER-d. ST-segment elevation in all leads 7. Anaphylaxis is most associated with which physiological event? a. Hemorrhage b. Vasodilation c. Bradycardia d. Hypertension - ANSWER-b. Vasodilation 8. Acute Respiratory Distress Syndrome (ARDS) is characterized by what pathological change? a. Excessive mucous production b. Inflammation of the visceral pleura c. Breakdown of the alveolar-capillary membrane d. Accumulation of fluid between the pleural layers - ANSWER-c. Breakdown of the alveolar-capillary membrane 9. Continuous positive airway pressure would be most beneficial in treating which patient? a. A 43yo with a decreased LOC with respiratory difficulty b. A 22yo with severe asthma who is not responding to nebulizer treatments c. A 38yo with carpal pedal spasms, clear lung sounds, and respirations of 40/min d. A 55yo with jugular vein distension and a BP of 90/60 - ANSWER-b. A 22yo with severe asthma who is not responding to nebulizer treatments 10. What is the initial treatment for a patient experiencing hyperosmolar hyperglycemic nonketotic coma (HHNC)? a. Crystalloid IV fluid administration b. Administration of dextrose c. Administration of insulin d. Fluid bolus of 5% dextrose in water (D5W) - ANSWER-a. Crystalloid IV fluid administration 11. Your patient has had a seizure secondary to a nerve agent exposure. What medication would be best to diminish the seizure? a. Atropine b. Diphenhydramine c. Midazolam d. Pralidoxime - ANSWER-c. Midazolam 12. Respiratory alkalosis may occur as a result of: a. Fever and anxiety b. Renal failure and dehydration c. Airway obstruction and chest wall pain d. Prolonged vomiting - ANSWER-a. Fever and anxiety 13. An age-related change that increases the risk of respiratory compromise is: a. Increase of mucus production b. Increase in intrathoracic volume c. Decrease in lung compliance d. Decrease in dead space ventilation - ANSWER-c. Decrease in lung compliance 14. Paroxysmal nocturnal dyspnea is most common in patients with a history of: a. Left-sided heart failure b. Pneumonia c. Asthma d. Multiple sclerosis - ANSWER-a. Left-sided heart failure (?) 15. The patient presents with a history of fever and an upper respiratory infection. Historical information reveals increasing water intake, orthostatic hypotension, and an increase in urination. You suspect these symptoms are caused by: a. Hyperglycemia b. Hypoglycemia c. Hypokalemia d. Respiratory acidosis - ANSWER-a. Hyperglycemia 16. You are dispatched to the home of a 32yo patient with a history of Graves' disease. The patient was in the ER earlier today for some "tests for my ulcers." He received contrast and was discharged. He is now complaining of not feeling well, chest pain, and palpitations. You note an anxious patient with fine tremors. He is diaphoretic and has a temperature of 101.5F, BP 100/62, P 156 (sinus tach), R 30, glucose level 133. Which of the following are management considerations for this patient? a. Aspirin (ASA) b. Fluids restriction c. Amiodarone d. Beta blockers - ANSWER-d. Beta Blockers 17. Metabolic acidosis is best described by which arterial blood gas interpretation? a. pH elevated, pCO2 elevated, H2CO3 normal range b. pH decreased, pCO2 decreased, H2CO3 low c. pH decreased, pCO2 elevated, H2CO3 normal range d. pH elevated, pCO2 elevated, H2CO3 normal low - ANSWER-b. pH decreased, pCO2 decreased, H2CO3 low (?) 18. The AMLS Assessment Pathway first advises safety and initial observations of the scene. The second process described in this pathway asks the healthcare provider to: a. Perform a focused physical exam b. Obtain diagnostic information c. Identify and manage life threats d. Reassess and refine the diagnosis - ANSWER-c. Identify and manage life threats 19. Observing a patient's body positioning can be an early indicator that the patient is: a. Sick or not sick b. Does not speak the same language as the provider c. Has family who can provide historical information d. Diagnosed with multiple underlying medical conditions - ANSWER-a. Sick or not sick 20. Which assessment finding is crucial to obtain from a patient suspected of a stroke? a. Last oral intake b. Medication allergies c. Onset of symptoms d. Risk factors - ANSWER-c. Onset of symptoms 21. A 62yo patient presents with a severe headache. It is described as a "thunderclap" accompanied with nausea, blurred vision, and an elevated blood pressure. What neurologic condition is most likely the cause of this patient's presentation? a. Brain abscess b. Ischemic stroke c. Epidural hematoma d. Subarachnoid hemorrhage - ANSWER-d. Subarachnoid hemorrhage 22. A 38yo presents with mild chest tightness and urticaria after mowing the lawn. He felt a "sting" in his left lower leg and states the symptoms came on suddenly. BP 130/82, P 100, R 20 with a normal work of breathing and clear lung sounds. The healthcare provider should: a. Immediately transport to the receiving facility b. Initiate an IV with 0.9% NS and monitor the patient carefully c. Initiate an IV with 0.9% NS and administer 0.5mg of epinephrine d. Obtain a blood glucose level - ANSWER-b. Initiate an IV with 0.09% NS and monitor the patient carefully 23. Healthcare providers are treating a patient complaining of substernal chest pain accompanied with nausea and one episode of vomiting. The patient has had two cardiac stents placed within the last year. He has a familial history of heart disease and takes a baby aspirin daily. What information is most concerning? a. Familial history of heart disease b. Recent stent placement c. Nausea and vomiting d. Daily use of aspirin - ANSWER-b. Recent stent placement 24. The patient complains of sharp chest pain that worsens when supine. He is bed ridden due to complications from a recent hip surgery. The patient is tachypneic and the ECG reveals sinus tachycardia. What is the patient's working diagnosis? a. Cardiac tamponade b. Gastroenteritis c. Pneumothorax d. Pulmonary embolism - ANSWER-d. Pulmonary embolism 25. A patient is a resident in an assisted living facility to obtain physical therapy after a knee replacement surgery. She complains of a rash that is red and has small bumps. She has been feeling ill for several days. What is the most likely working diagnosis? a. Escherichia coli b. Shigellosis c. Methicillin-resistant Staphylococcus aureus d. Clostridum difficile - ANSWER-c. Methicillin-resistant Staphylococcus aureus 26. A foreign exchange university student is found by his roommate and EMS is dispatched. The patient presents with an unusual flat red rash on his chest and arms. He has been ill with fever, nausea, and vomiting. Physical exam reveals stiffness of the neck. The healthcare provider will anticipate which diagnosis? a. Chicken pox (varicella) b. Meningitis c. Encephalitis d. H5, N1 (avian) influenza - ANSWER-b. Meningitis 27. Healthcare providers are treating a 49yo male complaining of diffuse abdominal cramping. He has been ill with vomiting for 3 days. What working diagnosis is most probable? a. Appendicitis b. Cholecystitis c. Diverticulitis d. Gastroenteritis - ANSWER-d. Gastroenteritis 28. While assessing your patient, you note he involuntary flexes the legs in response to flexing his neck. The patient is presenting with: a. A positive Murphy's sign indicating possible cholecystitis b. A positive Brudzinski's sign indicating possible meningitis c. A positive Psoas sign indicating possible meningitis d. The presence of a Babinski reflex indicating possible spinal cord lesion - ANSWER-b. A positive Brudzinski's sign indicating possible meningitis 29. Healthcare providers are assessing an obese 49yo who is lethargic and has not been feeling well for several days. His family reports a history of extreme thirst. Vital sings are P 143, R 14, and BP 88/58. He takes medication for type 2 diabetes daily. What is the most probably working diagnosis? a. Thyroid storm b. Cushing's syndrome c. Diabetic ketoacidosis d. Hyperosmolar hyperglycemic nonketotic coma - ANSWER-d. Hyperosmolar hyperglycemic nonketotic coma 30. A firefighter has been working a fire for 4 hours on a humid, hot day. He suddenly becomes nauseated and restless. The provider observes pupil dilation and an almond odor to his breath. The vital signs are P 56, R 22, BP 140/86. The ECG reveals sinus bradycardia with occasional PACs. Which toxin exposure has occurred? a. Carbon monoxide poisoning b. Cocaine overdose c. Ethanol poisoning d. Cyanide poisoning - ANSWER-d. Cyanide poisoning