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A 22-year-old female fell on her knee and is in severe pain. Her
knee is flexed and severely deformed. Her leg is cold to the
touch and you are unable to palpate a distal pulse. You should:
• A:carefully straighten her leg until you restore a distal pulse
and then apply padded board splints.
• B:apply gentle longitudinal traction as you straighten her leg
and then apply a traction splint.
• C:manually stabilize her injury and contact medical control for
further stabilization instructions.
• D:place a pillow behind her knee and stabilize the injury by
applying padded board splints. - ANSWER-The correct answer
is C;
Reason:
A dislocated knee occurs when the proximal end of the tibia
completely displaces from its juncture with the distal femur. In
some cases, the popliteal artery behind the knee may be
compressed, resulting in compromised distal blood flow. Signs
of this include absent distal pulses and a pale extremity that is
,cool or cold. Manually stabilize the knee and assess for distal
pulses. If distal pulses are absent, contact medical control
immediately for further stabilization instructions. Medical
control may instruct you to make ONE attempt to realign the
knee to reduce compression of the popliteal artery and restore
distal circulation. If you are unable to restore distal circulation
or medical control advises you not to manipulate the injury,
splint the knee in the position it was found and transport
promptly. Traction splints are contraindicated in any injury to
or near the knee
Which of the following is a common side effect of
nitroglycerin?
• A:Nausea
• B:Headache
• C:Hypertension
• D:Anxiety - ANSWER-You selected B; This is correct!
Reason:
Because nitroglycerin (NTG) causes vasodilation, including the
vessels within the brain, cerebral blood flow increases
following the administration of NTG. This often causes a
pounding headache for the patient. As uncomfortable as it is
for the patient, headaches are a common and expected side
effect of the drug. The vasodilatory effects of nitroglycerin
could result in hypotension; therefore, the patient's blood
pressure should be carefully monitored. Nausea and anxiety
are common symptoms of acute coronary syndrome; they are
not common side effects of nitroglycerin.
,While assessing a patient with chest pain, you note that his
pulse is irregular. This indicates:
• A:acute myocardial infarction or angina pectoris.
• B:high blood pressure that is increasing cardiac workload.
• C:a dysfunction in the left side of the patient's heart
• D:abnormalities in the heart's electrical conduction system. -
ANSWER-You selected D; This is correct!
Reason:
An irregular pulse indicates abnormalities in the electrical
conduction system of the heart. The electrical conduction
system, beginning with the sinoatrial node as the primary
pacemaker, is responsible for initiating the electrical impulses
that stimulate the myocardium to contract. An irregular pulse
could indicate potentially lethal arrhythmias that could result in
cardiac arrest. You should document an irregular pulse and
report this important finding to the emergency department.
Which of the following statements regarding the automated
external defibrillator (AED) is correct?
• A:AEDs can safely be used in infants and children less than 8
years of age
• B:AEDs will analyze the patient's rhythm while CPR is in
progress
• C:The AED should be applied to patients at risk for cardiac
arrest
• D:The AED should not be used in patients with an implanted
defibrillator - ANSWER-You selected A; This is correct!
, Reason:
According to the 2010 guidelines for CPR and Emergency
Cardiac Care (ECC), the AED can safely be used in infants and
children less than 8 years of age. Although a manual
defibrillator is preferred in infants, an AED can be used. When
using the AED in infants and children, you should use pediatric
pads and a dose-attenuating system (energy reducer);
however, if these features are not available, adult AED pads
should be used. The AED should only be applied to patients in
cardiac arrest; if a patient is at risk for cardiac arrest, have the
AED ready but not applied. The AED will not analyze the
cardiac rhythm if the patient is moving (ie, CPR is in progress).
AEDs can be used in patients with an automated implanted
cardioverter/defibrillator (AICD) or implanted pacemaker;
ensure that the pads are at least 1" away from the implanted
device.
Which of the following is an abnormal finding when using the
Cincinnati stroke scale to assess a patient who presents with
signs of a stroke?
• A:One arm drifts down compared with the other side.
• B:Both arms drift slowly and equally down to the patient's
side.
• C:The patient's face is symmetrical when he or she smiles.
• D:One of the pupils is dilated and does not react to light. -
ANSWER-The correct answer is A;
Reason: