WEST COAST EMT BLOCK 2 EXAM

The EMT should assess a patient's tidal volume by? A. observing for adequate chest rise B. assessing the facial area for cyanosis C. counting the patient's respiratory rate D. measuring the patient's oxygen saturation - A. Observing for adequate chest rise Tidal volume- the volume of air that is moved in or out of lungs by single breathobserved by adequate chest rise. If rise is shallow, tidal volume is likely reduced. In an otherwise healthy individual, the primary stimulus to breath is a(n): A. increased level of oxygen in the blood B. decreased level of oxygen in the blood C. increased level of carbon dioxide in blood D. decreased level of carbon dioxide in blood - C. increased level of carbon dioxide in blood Under control of the brain stem, rising levels of carbon dioxide in the arterial blood normally stimulate breathing in an otherwise healthy patient. Signs of adequate breathing in the adult include all of the following, EXCEPT: A. pink, warm, dry skin B. shallow chest rise C. symmetrical chest movement D. a respiratory rate of 16 breaths/min - B. shallow chest rise shallow chest rise= reduced tidal volume During insertion of an oropharyngeal airway into an unconscious patient, she begins to vomit. The first thing you should do is: A. turn the patient on her side. B. remove the airway at once. C. suction the patient's mouth. D. use a smaller-sized oral airway. - A. turn the patient on their side allows vomit to drain In which of the following patients would a nasopharyngeal airway be contraindicated? A. a semiconscious patient with a gag reflex B. an unconscious patient with an intact gag reflex C. a patient who fell 20 feet and lander on their head D. an unconscious patient who gags when you insert an oral airway - C. a patient who fell 20 feet and lander on their head contraindication with patients with severe head or facial injuries You are delivering oxygen to a patient with a nasal cannula at 4L/min when he begins to complain of a burning sensation in his nose. You should: A. remove the nasal cannula B. apply a nonrebreathing masks C. attach oxygen humidifier D. increase the flow rate to 6 L/min - C. attach an oxygen humidifier administering "dry" oxygen especially over a prolonged period can results in drying of nasal membranes A patient is found unconscious after falling from a third floor window. His respirations are slow and irregular. You should: A. place him in the recovery position B. apply oxygen via a nonrebreathing mask C. suction his airway for up to 15 seconds D. assist his breathing with a bag-valve mask device - D. assist his breathing with a bag-valve mask device slow/irregular breaths= inadequate oxygen When ventilating an apneic adult with a simple barrier device, you should squeeze the bag: A. until its empty B. over a period of 2 seconds C. at a rate of 20 breaths/min D. until visible chest rise is noted - D. until visible chest rise is noted You and your partner are ventilating an apneic adult when you notice that is stomach is becoming distended. You should: A. suction his airy for up to 15 seconds B. reposition his head C. increase the rate and volume D. decreased ventilation rate but increase the volume - B. reposition his head gastric distention occurs when air enters the stomach You are managing a 62yr old who complains of crushing chest pain. Her BP is 84/64 with HR of 110. Medical control advises you to assist in her taking her prescribed nitroglycerin. You should: A. reassess the HR then assisted with nitro B. repeat the BP to DR and confirm order C. wait 10 mins, reassess BP, then give nitro D. administer the nitro and reassess BP - B. Repeat the BP to DR and confirm order Nitroglycerin is a vasodilator and lowers BP, contraindication in BP <100 Activated charcoal is indicated for patients who ingested certain drugs/toxins because it: A. acts as direct reversal agent for most meds B. induces vomiting C. detoxifies the drug before it can cause harm D. binds the chemicals in stomach and delays absorption - D. Binds to the chemicals in the stomach and delays absorption activated charcoal=an adsorbent With regard to pharmacology, the term "action" refers to the: A. ability of drug to cause harm B. ability of drug to produce side effects C. amount of time it will take the drug to work D. expected effect of drug on the patient's body - D. expected effect of drug on the patient's body Which patient is the BEST candidate for oral glucose? A. a conscious patient who is showing signs of hypoglycemia B. an unconscious diabetic C. conscious diabetic with suspected hyperglycemia D. a semiconscious patient with signs/symptoms of low BG - A. a conscious patient who is showing signs of hypoglycemia Epi is given to patients with anaphylactic shock because of its effects of: A. bronchodilation and vasodilation B. bronchodilation and vasoconstriction C. vasodilation and bronchoconstriction D. bronchoconstriction and vasoconstriction - B. bronchodilation and vasoconstriction anaphylactic shock= bronchoconstriction and vasodilation A diabetic patient has polydipsia. This means: A. is excessively thirsty B. urinates frequently C. has low blood sugar D. is unable to swallow - A. is excessively thirsty After applying a tourniquet, the injury from a patient's leg stops bleeding. This is called: A. hemolysis B. hemiplegia C. hemostasis D. hematemesis - C. hemostasis Enlargement of the liver is called: A. hydrocephalus B. pneumonitis C. nephritis D hepatomegaly - D. hepatomegaly The ___ of the heart is the inferior portion of the ventricles. A. apex B. base C. septum D. dorsum - A. apex The topographic term used to describe the parts of the body that are nearer to the feet is: A. superior B. internal C. inferior D. dorsal - C. inferior As the bronchus divides into smaller bronchioles, the terminal ends of these smaller passages form the: A. pleura B. capillaries C. bronchi D. alveoli - D. alveoli Dead space is the portion of the respiratory system that: A. includes the alveoli and capillaries surrounding the alveoli B. contains no alveoli and does not participate in gas exchange C. must be filled with air before has exchange can take place D. receives oxygen but is unable to release carbon dioxide - B. contains no alveoli and does not participate in gas exchange Oxygen and carbon dioxide pass across the alveolar membrane in the lungs through a process called: A. diffusion B. breathing C. ventilation D. osmosis - A. diffusion Skeletal muscle is also called: A. smooth muscle B. autonomic muscle C. involuntary muscle D. voluntary muscle - D. voluntary muscle Carpal bones form the ____: A. ankle B. wrist C. foot D. hand - B. wrist The electrical impulse of the heart normally begins at the: A. bundle of His B. atrioventricular node C. sinoatrial node D. purkinje fibers - C. sinoatrial node The left side of the heart receives oxygenated blood from the lungs through the: A. pulmonary veins B. inferior venae cavae C. superior venae cavae D. pulmonary arteries - A. pulmonary veins The most distal four spinal vertebrae, which are fused together, form the: A. ilium B. ischium C. coccyx D. sacrum - C. coccyx Which of the following glands regulates function of all other endocrine glands in the body? A. parathyroid B. pituitary C. adrenal D. thyroid - B. pituitary Which is not a facial bone? A. mandible B. maxilla C. zygoma D. mastoid - D. mastoid Age-related changes in the renal system result in: A. formation of large amounts of urine secondary to an increase in kidney mass B. significant increase in filtration, which causes the excretion of large amounts of water C. dilation of the blood vessels that supply the nephrons, which allows the kidneys to maintain their function D. a decreased ability to clear wastes from the body and a decreased ability to conserve fluids when needed - D. a decreased ability to clear wastes from the body and a decreased ability to conserve fluids when needed An infant or small child's airway an be occluded if it is overextended or over flexed because: A. the back of the head is flat, which prevents neutral position B. the tongue is proportionately small and can fall back into the throat C. the occiput is proportionately large and the trachea is flexible D. he or she has a long neck, which makes the trachea prone to collapse - C. the occiput is proportionately large and the trachea is flexible At what age does the separation anxiety typically peak in infants and small children? A. 24-36 months B. 6-8 months C. 10-18 months D. 18-24 months - C. 10-18 months Breathing is often more difficult in older adults because the: A. overall size of airway decreases B. surface area of the alveoli increases C. diaphragm and intercostal muscles enlarge D. elasticity of the lungs decreases - D. elasticity of the lungs decreases Factors that contribute to a decline in the vital capacity of an elderly patient include all of the following, except: A. decreased residual volume B. increased stiffness of the thoracic cage C. a loss of respiratory muscle mass D. increased surface area available for air exchange - D. increased surface area available for air exchange In preconventional reasoning, children: A. blame their actions on what they have observed in older children B. look for approval from their peers and society C. make decisions based on their conscience D. act almost purely to avoid punishment and to get what they want - D. act almost purely to avoid punishment and to get what they want Which of the following is an anatomic difference between children and adults? A. an infant's head accounts for less body weight than an adult's head B. the trachea of an infant is less flexible than an adults rib cage C. the rib cage of an infant is less flexible than an adults rib cage D. an infant's tongue is proportionately larger than an adult's tongue - D. an infant's tongue is proportionately larger than an adult's tongue Which of the following statements regarding age-related changes in the nervous system is correct? A. because a decrease in the number of brain cells, a persons level of intelligence decreases with age B. generally speaking, the brain increases in size 10-20% by the time a person reaches 80 yrs C. interconnections between brain cells often prevent a loss of knowledge or skill, despite of loss of neurons D. the metabolic rate in the brain increases with age, but the consumption of oxygen decreases significantly - C. interconnections between brain cells often prevent a loss of knowledge or skill, despite of loss of neurons A 29 yr old male with head injury opens his eyes when you speak, is confused to time and date, and is able to move all extremities on command. His Glasgow coma score is: A. 10 B. 14 C. 12 D. 13 - D. 13 Eye: spontaneous: 4 sound: 3 pressure: 2 none: 1 Verbal: oriented: 5 confused: 4 words: 3 sounds: 2 none: 1 Motor: obey commands: 6 localizing: 5 normal flexion: 4 abnormal flexion: 3 extension: 2 none: 1 A blood pressure cuff that is too small for a patient's arm will give a: A. falsely high systolic but low diastolic B. falsely low systolic and diastolic C. falsely low systolic but high diastolic D. falsely high systolic and diastolic - A patient's short-term memory is MOST likely intake if they correctly answer questions regarding: A. event and person B. day and event C. person and place D. time and place - B. day and event After performing a primary assessment, a rapid exam of the body should be performed to: A. find and treat injuries or conditions that do not pose a threat to life B. determine the need for spinal motion restriction precautions C. look specifically for signs and symptoms of inadequate perfusion D. identify less-obvious injuries that require immediate treatment - D. identify lessobvious injuries that require immediate treatment In the adult, bradycardia is defined as a pulse rate less than _______ beats/min, and tachycardia is defined as a heart rate greater than _______ beats/min. A. 60, 100 B. 40, 120 C. 50, 110 D. 30, 130 - A. 60, 100 Treatment and transport priorities at the scene of a mass-casualty incident should be determined after: A. all patients have been triaged B. a physician arrives on scene C. area hospitals have been notified D. medical control has been contacted - A. all patients have been triaged Which of the following medical history questions would be LEAST pertinence in an acute situation? A. "does your mom have diabetes?" B. "are there meds that you cannot take?" C. "has this ever happened to you before?" D. "does the pain stay in your chest?" - A. "does your mom have diabetes?" A patient who is suspected of being hypoxic and is breathing adequately should be given supplemental oxygen with A. nasal cannula B. mouth to mask device C. bag-mask device D. nonrebreathing mask - D. nonrebreathing mask At a flow rate of 6 L/min, a nasal cannula can deliver an approx O2 concentration up to: A. 52% B. 44% C. 35% D. 24% - B. 44% Gas exchange in the lungs is facilitated by: A. adequate amounts of surfactant. B. surfacant-destorying organisms C. pulmonary capillary constriction D. water or blood within the alveoli - A. adequate amounts of surfactant. High flow O2 with nasal cannula during preoxygenation phase of endotracheal intubation is called: A. active ventilation B. apneic oxygenation C. denitrogenation D. passive ventilation - B. apneic oxygenation O2 toxicity is a condition in which: A. excessive blood oxygen levels cause the hypoxic patient to stop breathing B. decreased levels of oxygen in the blood result in free radical production C. significantly low levels of oxygen in the blood damage the cellular tissue D. cellular tissue damage occurs from excessive oxygen levels in blood - D. cellular tissue damage occurs from excessive oxygen levels in blood The hypoxic drive is influenced by: A. high blood oxygen levels B. high blood carbon dioxide levels C. low blood carbon dioxide levels D. low blood oxygen levels - D. low blood oxygen levels The presence of elevated carbon dioxide levels in the blood is called: A. hypoxemia B. acidosis C. hypercarbia D. hypoxia - C. hypercarbia The pressure of gas in a full cylinder of oxygen is approx. _____ pounds per inch (psi): A. 2,000 B. 500 C. 3,000 D. 1,000 - A. 2,000 What is the MOST common cause of airway obstruction in an unconscious patient? A. blood clots B. the tongue C. vomitus D. aspirated fluid - B. the tongue Which of the following organs or tissues can survive the longest without oxygen? A. kidneys B. muscle C. heart D. liver - B. muscle With a good mask to face seal and an oxygen flow rate of 15 L/min, the nonrebreathing mask is capable of delivering up to _____% inspired oxygen A. 100 B. 80 C. 90 D. 70 - C. 90 An EMT may administer aspirin to a patient if: A. the patient is believed to be experiencing an acute stroke B. transport time to hospital is more than 30 mins C. authorization from medical control has been obtained D. the patient is currently experiencing hypotension - C. authorization from medical control has been obtained Nitroglycerin, when given to patients with cardiac-related chest pain: A. constricts the veins throughout the body B. relaxes the walls of the coronary arteries C. increases blood return to the right atrium D. increases myocardial contraction force - B. relaxes the walls of the coronary arteries cardiac tamponade - acute compression of the heart caused by fluid accumulation in the pericardial cavity Asthma - A chronic allergic disorder characterized by episodes of severe breathing difficulty, coughing, and wheezing. Airway can become inflamed and narrow-air harder to flow in and out COPD (chronic obstructive pulmonary disease) - A group of lung diseases that block airflow and make it difficult to breathe. Meningitis - inflammation of the meninges of the brain and spinal cord CHF right vs left - - Right: Heart failure occurs when the fluid backs up into the body. - Left: Fluids backs up into the lungs. The excess fluid in the lungs causes pulmonary edema, and the patient will have severe shortness of breath and hypoxia with crackles in the lungs. S&S of compensated shock - Apprehensiveness Irritability Unexplained tachycardia Normal blood pressure Narrowing pulse pressure Thirst Pallor Diminished urinary output Reduced perfusion of extremities s/s of decompensated shock - Confusion and somnolence Tachypnea Moderate metabolic acidosis Oliguria Cool, pale extremities Decreased skin turgor Poor capillary filling Layers of skin - epidermis, dermis, hypodermis 12 lead ECG - Limb leads: I, II, II, AVR, AVL, AVF Chest leads: V₁ , V₂ , V₃ , V₄ , V₅ , V₆ start at 4th intercostal right to left then 5th and lateral, etc Airway obstruction treatment - adult: heimlich peds: 5 back slaps obese: chest thrusts how can cardiac output decrease of the heart rate beats too fast - allows less time for the ventricle to fill with blood after each heartbeat Vertebrae - Cervical spine: 7 vertebrae (C1-C7) Thoracic spine: 12 vertebrae (T1-T12) Lumbar spine: 5 vertebrae (L1-L5) Sacrum: 5 (fused) vertebrae (S1-S5) Coccyx: 4 (3-5) (fused) vertebrae (Tailbone) Sternal notch - a medial notch at the superior end of the sternum xiphoid process - lower, narrow portion of the sternum Types of shock - Hypovolemic: severe blood or fluid loss, hemorrhagic (trauma) or nonhemorragic (v/d-no blood loss) Distributive: blood vessels dilate and your body can't get blood to heart, brain, kidneys. (ie. septic, anaphylactic, neurogenic) Cardiogenic: heart cannot pump enough blood and oxygen to heart and vital organs. (ie. MI) Obstructive: prevents blood and oxygen from getting to organs (ie. tamponade, pneumothorax) Surfactant - released from lung cells, spreads across tissue around alveoli, this lowers surface tension, keeps alveoli from collapsing after exhalation i.e make breathing easy Types of lung sounds - Rales. Small clicking, bubbling, or rattling sounds in the lungs. They are heard when a person breathes in (inhales). ... Rhonchi. Sounds that resemble snoring. ... Stridor. Wheeze-like sound heard when a person breathes. ... Wheezing. High-pitched sounds produced by narrowed airways. respiratory alkalosis vs acidosis - alkalosis: ventilator setting may be too high (overvent)- CO2 drops too low causing blood pH to rise becoming too alkaline acidosis: ventilator setting may too low (undervent): blood becomes too acidic Abdominal Aortic Aneurysm - When the large blood vessel (aorta) that supplies blood to the abdomen, pelvis, and legs becomes abnormally large or balloons outward. -weakness in wall of aorta nasal cannula - A device that delivers low concentrations of oxygen through two prongs that rest in the patient's nostrils. stable pt. mild hypoxia. O2 rate 1-6L/min= 24-44% NRB vs. BVM - NRB (10-5L/min=up to 90%) if the patient is breathing, BVM if the patient is not. The NRB is an oxygen delivery device only. The patient has to moving air adequately for it to be effective. The BVM (15L/min=nearly 100%) is a ventilatory device. It provides assisted ventilations to a patient without an adequate minute volume or not moving air at all.