West Coast EMT Block Exam #3 Questions and Answers (2023)

West Coast EMT Block Exam #3 Questions and Answers A 30-year-old male experienced a generalized (tonic-clonic) seizure, which stopped before you arrived at the scene. The patient is conscious, is answering your questions appropriately, and refuses EMS transport. Which of the following would be the MOST compelling reason to disagree with his refusal of transport? Select one: A. His Glasgow Coma Scale (GCS) score is 15 B. His wife states that this was his "usual" seizure C. He has experienced seizures since he was 20 D. He is currently not prescribed any medications - ANSWER D. He is currently not prescribed any medications A patient who is possibly experiencing a stroke is NOT eligible for thrombolytic (fibrinolytic) therapy if he or she: Select one: A. has had a prior heart attack. B. has bleeding within the brain. C. has a GCS score that is less than 8. D. is older than 60 years of age. - ANSWER B. has bleeding within the brain. A patient whose speech is slurred and difficult to understand is experiencing: Select one: A. paraplegia. B. dysphagia. C. dysarthria. D. aphasia. - ANSWER C. dysarthria. A patient with an altered mental status is: Select one: A. typically alert but is confused as to preceding events. B. not thinking clearly or is incapable of being aroused. C. usually able to be aroused with a painful stimulus. D. completely unresponsive to all forms of stimuli. - ANSWER B. not thinking clearly or is incapable of being aroused. During the primary assessment of a semiconscious 70-year-old female, you should: Select one: A. insert a nasopharyngeal airway and assist ventilations. B. ask family members if the patient has a history of stroke. C. immediately determine the patient's blood glucose level. D. ensure a patent airway and support ventilation as needed. - ANSWER D. ensure a patent airway and support ventilation as needed. Interruption of cerebral blood flow may result from all of the following, EXCEPT: Select one: A. an embolism. B. cerebral vasodilation. C. a thrombus. D. an acute arterial rupture. - ANSWER B. cerebral vasodilation. The left cerebral hemisphere controls: Select one: A. heart rate and pupil reaction. B. the right side of the face. C. breathing and blood pressure. D. the right side of the body. - ANSWER D. the right side of the body. The MOST significant risk factor for a hemorrhagic stroke is: Select one: A. diabetes mellitus. B. hypertension. C. heavy exertion. D. severe stress. - ANSWER B. hypertension. The three major parts of the brain are the: Select one: A. midbrain, cerebellum, and spinal cord. B. brain stem, midbrain, and spinal cord. C. cerebellum, medulla, and occiput. D. cerebrum, cerebellum, and brain stem. - ANSWER D. cerebrum, cerebellum, and brain stem. When assessing for arm drift of a patient with a suspected stroke, you should: Select one: A. ask the patient to close his or her eyes during the assessment. B. expect to see one arm slowly drift down to the patient's side. C. observe movement of the arms for approximately 2 minutes. D. ask the patient to hold his or her arms up with the palms down. - ANSWER A. ask the patient to close his or her eyes during the assessment. When caring for a patient with documented hypoglycemia, you should be MOST alert for: Select one: A. a seizure. B. respiratory distress. C. an acute stroke. D. a febrile convulsion. - ANSWER A. a seizure. When you are obtaining medical history from the family of a suspected stroke patient, it is MOST important to determine: Select one: A. if the patient has been hospitalized before. B. if there is a family history of a stroke. C. when the patient last appeared normal. D. the patient's overall medication compliance. - ANSWER C. when the patient last appeared normal. Which of the following conditions would be the LEAST likely to mimic the signs and symptoms of a stroke? Select one: A. Intracranial bleeding B. A postictal state C. Hypoglycemia D. Hypovolemia - ANSWER D. Hypovolemia Which of the following conditions would MOST likely affect the entire brain? Select one: A. Respiratory failure or cardiopulmonary arrest B. Ruptured cerebral artery in the occipital lobe C. Blocked cerebral artery in the frontal lobe D. Reduced blood supply to the left hemisphere - ANSWER A. Respiratory failure or cardiopulmonary arrest Which of the following MOST accurately describes a simple partial seizure? Select one: A. A generalized seizure without incontinence B. A seizure that causes the patient to stare blankly C. A seizure that begins in one extremity D. A seizure that is not preceded by an aura - ANSWER C. A seizure that begins in one extremity Which of the following MOST accurately describes what the patient will experience during the postictal state that follows a seizure? Select one: A. A gradually decreasing level of consciousness B. A rapidly improving level of consciousness C. Hyperventilation and hypersalivation D. Confusion and fatigue - ANSWER D. Confusion and fatigue Which of the following symptoms would lead the EMT to believe that a patient's headache is caused by sinus congestion? Select one: A. The headache began suddenly B. There is associated neck stiffness C. There is numbness in the extremities D. The pain is worse when bending over - ANSWER D. The pain is worse when bending over You are caring for a 68-year-old man with sudden onset of left-sided paralysis and slurred speech. His airway is patent, his respirations are 14 breaths/min with adequate depth, and his oxygen saturation is 98%. Treatment for this patient should include: Select one: A. recovery position and transport. B. oral glucose gel and transport. C. high-flow oxygen and transport. D. ventilatory assistance and transport. - ANSWER A. recovery position and transport. You respond to a residence for a child who is having a seizure. Upon arrival at the scene, you enter the residence and find the mother holding her child, a 2-year-old male. The child is conscious and crying. According to the mother, the child had been running a high fever and then experienced a seizure that lasted approximately 3 minutes. You should: Select one: A. call medical control and request permission to give the child aspirin. B. transport the child to the hospital and reassure the mother en route. C. advise the mother to take her child to the doctor the following day. D. cover the child with wet towels and give oxygen via nasal cannula. - ANSWER B. transport the child to the hospital and reassure the mother en route. Your patient opens his eyes, moans, and pulls away from you when you pinch his trapezius muscle. You should assign a Glasgow Coma Scale (GCS) score of: Select one: A. 7. B. 9. C. 8. D. 6. - ANSWER C. 8. A 29-year-old pregnant woman has had severe vomiting for the last 2 days. Today, she is vomiting large amounts of blood. Her skin is cool and pale and she is tachycardic. The EMT should suspect: Select one: A. Mallory-Weiss tear. B. esophagitis. C. esophageal varices. D. acute pancreatitis. - ANSWER A. Mallory-Weiss tear. A 30-year-old woman with a history of alcoholism presents with severe upper abdominal pain and is vomiting large amounts of bright red blood. Her skin is cool, pale, and clammy; her heart rate is 120 beats/min and weak; and her blood pressure is 70/50 mm Hg. Your MOST immediate action should be to: Select one: A. rapidly transport her to the hospital. B. give her high-flow supplemental oxygen. C. protect her airway from aspiration. D. keep her supine and keep her warm. - ANSWER C. protect her airway from aspiration. A 47-year-old male presents with severe abdominal pain of 3 hours' duration. His abdomen is distended and guarded. Your MOST important consideration for this patient should be to: Select one: A. be alert for signs and symptoms of shock. B. assess his blood pressure to determine perfusion adequacy. C. transport him in a supine position. D. determine the exact location and cause of his pain. - ANSWER A. be alert for signs and symptoms of shock. A 59-year-old male presents with sudden-onset severe lower back pain. He is conscious and alert, but very restless and diaphoretic. Your assessment reveals a pulsating mass to the left of his umbilicus. You should: Select one: A. request a paramedic unit to give the patient pain medication. B. vigorously palpate the abdomen to establish pain severity. C. administer oxygen and prepare for immediate transport. D. place the patient in a sitting position and transport at once. - ANSWER C. administer oxygen and prepare for immediate transport. A young female presents with costovertebral angle tenderness. She is conscious and alert with stable vital signs. Which of the following organs is MOST likely causing her pain? Select one: A. Pancreas B. Liver C. Kidney D. Gallbladder - ANSWER C. Kidney An important aspect in the treatment of a patient with severe abdominal pain is to: Select one: A. provide emotional support en route to the hospital. B. give 100% oxygen only if signs of shock are present. C. encourage the patient to remain in a supine position. D. administer analgesic medications to alleviate pain. - ANSWER A. provide emotional support en route to the hospital. For a patient with a gastrointestinal complaint, it is MOST important for the EMT to _________. Select one: A. avoid transporting the patient if the condition is minor B. perform all interventions prior to transport C. determine the cause of the patient's complaint D. identify whether the patient requires rapid transport - ANSWER D. identify whether the patient requires rapid transport Most patients with abdominal pain prefer to: Select one: A. lie on their side with their knees drawn into the abdomen. B. sit fully upright because it helps relax the abdominal muscles. C. sit in a semi-Fowler position with their knees slightly bent. D. lie in a supine position with their knees in a flexed position. - ANSWER A. lie on their side with their knees drawn into the abdomen. Pain that may be perceived at a distant point on the surface of the body, such as the back or shoulder, is called: Select one: A. visceral pain. B. radiating pain. C. referred pain. D. remote pain. - ANSWER C. referred pain. Peritonitis may result in shock because: Select one: A. abdominal distention impairs cardiac contractions. B. severe pain causes systemic dilation of the vasculature. C. intra-abdominal hemorrhage is typically present. D. fluid shifts from the bloodstream into body tissues. - ANSWER D. fluid shifts from the bloodstream into body tissues. Urinary tract infections are more common in ____________. Select one: A. men B. active adults C. women D. sedentary adults - ANSWER C. women When assessing a patient with abdominal pain, you should: Select one: A. visually assess the painful area of the abdomen, but avoid palpation because this could worsen his or her condition. B. palpate the abdomen in a clockwise direction, beginning with the quadrant after the one the patient indicates is painful. C. ask the patient to point to the area of pain or tenderness and assess for rebound tenderness over that specific area. D. observe for abdominal guarding, which is characterized by sudden relaxation of the abdominal muscles when palpated. - ANSWER B. palpate the abdomen in a clockwise direction, beginning with the quadrant after the one the patient indicates is painful. Which of the following helps filter the blood and has no digestive function? Select one: A. Large intestine B. Spleen C. Stomach D. Small intestine - ANSWER B. Spleen Which of the following is correct about the secondary assessment for a high-priority patient? Select one: A. The secondary assessment must be performed prior to transport. B. Never contact medical direction before completing the secondary assessment. C. You may not have time to complete a secondary assessment. D. Never perform a secondary assessment on a high-priority patient. - ANSWER C. You may not have time to complete a secondary assessment. Which of the following may help reduce your patient's nausea? Select one: A. Low-flow oxygen B. Positive-pressure ventilation C. Cricoid pressure D. Oral glucose - ANSWER A. Low-flow oxygen Which of the following organs lies in the retroperitoneal space? Select one: A. Pancreas B. Gallbladder C. Spleen D. Liver - ANSWER A. Pancreas Which of the following statements regarding dialysis is correct? Select one: A. Acute hypertension is a common adverse effect of dialysis. B. The purpose of dialysis is to help the kidneys retain salt and water. C. Hemodialysis is effective but carries a high risk of peritonitis. D. Patients who miss a dialysis treatment often present with weakness. - ANSWER D. Patients who miss a dialysis treatment often present with weakness. Which of the following statements regarding the acute abdomen is correct? Select one: A. The initial pain associated with an acute abdomen tends to be vague and poorly localized. B. The parietal peritoneum is typically the first abdominal layer that becomes inflamed or irritated. C. The most common cause of an acute abdomen is inflammation of the gallbladder and liver. D. An acute abdomen almost always occurs as the result of blunt trauma to solid abdominal organs. - ANSWER A. The initial pain associated with an acute abdomen tends to be vague and poorly localized. Your patient complains of abdominal pain that occurs mostly at night or after eating fatty foods. You should suspect ____________. Select one: A. cholecystitis B. a hernia C. appendicitis D. kidney stones - ANSWER A. cholecystitis Your patient complains of chronic "burning" stomach pain that improves after eating. You should suspect: Select one: A. pneumonia. B. peptic ulcer disease. C. aortic aneurysm. D. kidney stones. - ANSWER B. peptic ulcer disease. A 37-year-old female with a history of diabetes presents with excessive urination and weakness of 2 days' duration. Her blood glucose level reads 320 mg/dL. If this patient's condition is not promptly treated, she will MOST likely develop: Select one: A. irreversible renal failure. B. severe insulin shock. C. hypoxia and overhydration. D. acidosis and dehydration. - ANSWER A. irreversible renal failure. A 66-year-old woman experienced a sudden onset of difficulty breathing. She has a history of type 2 diabetes and deep vein thrombosis (DVT). On the basis of her medical history, which of the following should the EMT suspect? Select one: A. Pulmonary embolism B. Severe hypoglycemia C. Diabetic ketoacidosis D. Congestive heart failure - ANSWER A. Pulmonary embolism A 75-year-old male with type 1 diabetes presents with chest pain and a general feeling of weakness. He tells you that he took his insulin today and ate a regular meal approximately 2 hours ago. You should treat this patient as though he is experiencing: Select one: A. hyperglycemia. B. hypoglycemia. C. a heart attack. D. an acute stroke. - ANSWER C. a heart attack. A man finds his 59-year-old wife unconscious on the couch. He states that she takes medications for type 2 diabetes. He further tells you that his wife has been ill recently and has not eaten for the past 24 hours. Your assessment reveals that the patient is unresponsive. You should: Select one: A. open and maintain her airway and assess breathing. B. administer 100% oxygen via a nonrebreathing mask. C. assess for the presence of a medical identification tag. D. administer oral glucose between her cheek and gum. - ANSWER A. open and maintain her airway and assess breathing. A patient with an altered mental status; high blood glucose levels; and deep, rapid breathing may have a condition known as __________. Select one: A. hyperosmolar hyperglycemic nonketotic coma B. hypoglycemic crisis C. hyperglycemic crisis D. diabetic ketoacidosis - ANSWER D. diabetic ketoacidosis A patient with hypoglycemia will often present with which of the following signs/symptoms? Select one: A. Warm, red, and dry skin B. Deep, rapid respirations C. Pale, cool, and clammy skin D. Hypertension - ANSWER C. Pale, cool, and clammy skin Classic signs and symptoms of hypoglycemia include: Select one: A. cool, clammy skin; weakness; tachycardia; and rapid respirations. B. warm, dry skin; hunger; abdominal pain; and deep, slow respirations. C. warm, dry skin; irritability; bradycardia; and rapid respirations. D. cold, clammy skin; bradycardia; hunger; and deep, rapid respirations. - ANSWER A. cool, clammy skin; weakness; tachycardia; and rapid respirations. During your assessment of a 19-year-old male, you are told that he is being treated with factor VIII. This indicates that: Select one: A. his blood clots too quickly. B. he has thrombophilia. C. he has hemophilia A. D. he has a thrombosis. - ANSWER C. he has hemophilia A. Excessive eating caused by cellular "hunger" is called: Select one: A. dyspepsia. B. polyphagia. C. dysphasia. D. polydipsia. - ANSWER B. polyphagia. In contrast to type 1 diabetes, type 2 diabetes: Select one: A. occurs when antibodies attack insulin-producing cells. B. is caused by a complete lack of insulin in the body. C. is caused by resistance to insulin at the cellular level. D. is commonly diagnosed in children and young adults. - ANSWER C. is caused by resistance to insulin at the cellular level. Proper procedure for administering oral glucose to a patient includes all of the following, EXCEPT: Select one: A. ensuring the absence of a gag reflex. B. requesting permission from medical control. C. checking the medication's expiration date. D. assessing the patient's mental status. - ANSWER A. ensuring the absence of a gag reflex. Symptomatic hypoglycemia will MOST likely develop if a patient: Select one: A. markedly overeats and misses an insulin dose. B. takes too much of his or her prescribed insulin. C. misses one or two prescribed insulin injections. D. eats a regular meal followed by mild exertion. - ANSWER B. takes too much of his or her prescribed insulin. The EMT should assess for hypoglycemia in small children with a severe illness or injury because: Select one: A. children overproduce insulin during severe illness or injury. B. children cannot store excess glucose as effectively as adults. C. a child's cells do not uptake glucose as rapidly as adults' do. D. illness or injury causes the pancreas to produce less insulin. - ANSWER B. children cannot store excess glucose as effectively as adults. The main function of the endocrine system is to _________. Select one: A. regulate blood flow B. regulate glucose and calcium C. produce glandular secretions D. maintain homeostasis - ANSWER D. maintain homeostasis The normal blood glucose level is between: Select one: A. 30 and 150 mg/dL. B. 60 and 80 mg/dL. C. 160 and 200 mg/dL. D. 80 and 120 mg/dL. - ANSWER D. 80 and 120 mg/dL. The two main types of cells contained in blood are called _________. Select one: A. erythrocytes and leukocytes B. transport and clotting C. platelets and plasma D. hemoglobin A and S - ANSWER A. erythrocytes and leukocytes Which of the following conditions is the diabetic patient at an increased risk of developing? Select one: A. Alcoholism B. Hepatitis B C. Depression D. Blindness - ANSWER D. Blindness Which of the following statements regarding glucose is correct? Select one: A. The brain requires insulin to allow glucose to enter the cells. B. The brain requires glucose as much as it requires oxygen. C. Blood glucose levels decrease in the absence of insulin. D. Most cells will function normally without glucose. - ANSWER B. The brain requires glucose as much as it requires oxygen. Which of the following statements regarding sickle cell disease is correct? Select one: A. Because of their abnormal shape, red blood cells in patients with sickle cell disease are less apt to lodge in a blood vessel. B. In sickle cell disease, the red blood cells are abnormally shaped and are less able to carry oxygen. C. The red blood cells of patients with sickle cell disease are round and contain hemoglobin. D. Sickle cell disease is an inherited blood disorder that causes the blood to clot too quickly. - ANSWER B. In sickle cell disease, the red blood cells are abnormally shaped and are less able to carry oxygen. You are treating a 40-year-old male with a documented blood sugar reading of 480 mg/dL. The patient is semiconscious and breathing shallowly, and is receiving assisted ventilation from your partner. You should recognize that definitive treatment for this patient includes: Select one: A. glucagon. B. dextrose. C. insulin. D. oxygen. - ANSWER C. insulin. A 19-year-old female was stung multiple times on the legs by fire ants. She states that she is allergic to fire ants, but does not carry her own epinephrine. The patient is conscious and alert and complains of pain to the area of the bites. Her blood pressure is 122/70 mm Hg, her pulse is 100 beats/min and strong, and her respirations are 18 breaths/min and unlabored. You should: Select one: A. administer oxygen and transport her to the hospital. B. request a paramedic unit to administer epinephrine. C. position her legs well above the level of her heart. D. advise her to see her physician as soon as possible. - ANSWER A. administer oxygen and transport her to the hospital. A 37-year-old male is having a severe allergic reaction to penicillin. He does not have an epinephrine auto-injector and your protocols do not allow you to carry epinephrine on the ambulance. How should you proceed with the treatment of this patient? Select one: A. Quickly determine if there are any bystanders who may carry epinephrine. B. Administer oxygen, transport at once, and request a paramedic intercept. C. Remain at the scene with the patient and request a paramedic ambulance. D. Ask the patient if he has any diphenhydramine tablets that you can administer. - ANSWER B. Administer oxygen, transport at once, and request a paramedic intercept. After administering 0.3 mg of epinephrine via auto-injector to a 22-year-old woman with an allergic reaction, you note improvement in her breathing and dissipation of her hives. However, she is still anxious and tachycardic. You should: Select one: A. contact medical control and obtain authorization to administer another 0.3 mg of epinephrine. B. consider administering 0.15 mg of epinephrine to completely resolve her allergic reaction. C. transport her rapidly, as it is obvious that she is having a severe reaction to the epinephrine. D. monitor her closely but recall that anxiety and tachycardia are side effects of epinephrine. - ANSWER D. monitor her closely but recall that anxiety and tachycardia are side effects of epinephrine. Anaphylaxis caused by stinging insects is typically an allergic reaction to ____________ rather than the bite or sting itself. Select one: A. injected poison B. irritating toxin C. deadly venom D. All of these answers are correct. - ANSWER D. All of these answers are correct. Anaphylaxis is MOST accurately defined as a(n): Select one: A. moderate allergic reaction that primarily affects the vasculature. B. extreme allergic reaction that may affect multiple body systems. C. severe allergic reaction that typically resolves without treatment. D. allergic reaction that causes bronchodilation and vasoconstriction. - ANSWER B. extreme allergic reaction that may affect multiple body systems. At the site of the injury, signs and symptoms of an animal or insect bite or sting may include pain, localized heat, and a wheal, which appears as __________. Select one: A. an uncomfortable depression in the skin B. a large area of red, blotchy skin C. a series of small, raised pustules D. a raised, well-defined area of the skin - ANSWER D. a raised, well-defined area of the skin Care for a victim of an immunologic emergency who is severely hypotensive should include which of the following? Select one: A. Position the patient's airway and initiate positive-pressure ventilations. B. Initiate basic life support measures, including the use of an automated external defibrillator, if necessary. C. Routine spinal immobilization due to the potential for traumatic injury D. Apply high-flow oxygen therapy, place the patient in a shock position, and help maintain the patient's body temperature. - ANSWER D. Apply high-flow oxygen therapy, place the patient in a shock position, and help maintain the patient's body temperature. Epinephrine stimulates the ________ response, increasing blood pressure and relieving bronchospasm. Select one: A. parasympathetic B. cardiac C. sympathetic D. respiratory - ANSWER C. sympathetic Patients may experience allergic reactions to which of the following substances? Select one: a. Food and medications b. Insect or animal bites and stings c. Plant material d. All of these answers are correct. - ANSWER d. All of these answers are correct. The adult epinephrine auto-injector delivers ______ mg of epinephrine, and the infant-child auto-injector delivers ______ mg. Select one: A. 0.1; 0.01 B. 0.03; 0.3 C. 0.3; 0.15 D. 0.01; 0.1 - ANSWER C. 0.3; 0.15 The effects of epinephrine are typically observed within _________ following administration. Select one: A. 1 minute B. 30 seconds C. 1 hour D. 30 minutes - ANSWER A. 1 minute The goal of invaders such as bacteria and viruses is to __________. Select one: A. use a human body as a home B. kill their human host C. cause an immune response D. spread disease and destruction - ANSWER A. use a human body as a home The stinger from a honeybee should be: Select one: A. Left in place and covered. B. scraped away from the skin. C. irrigated with copious amounts of water. D. squeezed with tweezers and removed. - ANSWER B. scraped away from the skin. Urticaria is the medical term for: Select one: A. swelling. B. a wheal. C. hives. D. burning. - ANSWER C. hives. When a foreign substance invades the body, the body will __________. Select one: A. protect itself B. go on alert C. attempt to inactivate the foreign substance D. All of these answers are correct. - ANSWER D. All of these answers are correct. When an allergic reaction proceeds to life-threatening anaphylaxis, it will usually do so __________. Select one: A. quickly, within 30 minutes. B. slowly, over several hours. C. slowly, over more than 30 minutes. D. quickly, within 30 seconds. - ANSWER A. quickly, within 30 minutes. Which of the following medications blocks the release of histamines? Select one: A. Acetaminophen (Tylenol) B. Albuterol (Ventolin) C. Epinephrine (Adrenalin) D. Diphenhydramine (Benadryl) - ANSWER D. Diphenhydramine (Benadryl) Which of the following signs/symptoms are indicative of respiratory involvement of an allergic reaction? Select one: A. Flushed, itching, or burning skin B. A sense of impending doom C. Tightness in the chest or throat D. All of these answers are correct. - ANSWER C. Tightness in the chest or throat Which of the following sounds indicates swelling of the upper airway? Select one: A. Rales B. Wheezing C. Stridor D. Rhonchi - ANSWER C. Stridor Which of the following would MOST likely provide clues regarding the source of a patient's allergic reaction? Select one: A. The time of year in which the exposure occurred B. The patient's family history C. The environment in which the patient is found D. The patient's general physical appearance - ANSWER C. The environment in which the patient is found A 49-year-old male presents with confusion, sweating, and visual hallucinations. The patient's wife tells you that he is a heavy drinker and she thinks he had a seizure shortly before your arrival. This patient is MOST likely experiencing: Select one: A. acute schizophrenia. B. delirium tremens. C. alcohol intoxication. D. acute hypovolemia. - ANSWER B. delirium tremens. A person who routinely misuses a substance and requires increasing amounts to achieve the same effect is experiencing: Select one: A. tolerance. B. withdrawal. C. dependence. D. addiction. - ANSWER A. tolerance. Activated charcoal is given to patients who have ingested certain substances because it: Select one: A. decreases absorption of poisons into the lungs. B. binds to the substance and prevents absorption. C. is a direct antidote for many toxic substances. D. induces vomiting and empties the stomach. - ANSWER B. binds to the substance and prevents absorption. An overdose of acetaminophen, the active ingredient in Tylenol, will MOST likely cause: Select one: A. liver failure. B. kidney failure. C. gastric ulcers. D. CNS depression. - ANSWER A. liver failure. As you enter the residence of a patient who has possibly overdosed, you should: Select one: A. quickly gain access to the patient. B. be alert for personal hazards. C. look for drug paraphernalia. D. observe the scene for drug bottles. - ANSWER B. be alert for personal hazards. Heroin is an example of a(n): Select one: A. hypnotic. B. sympathomimetic. C. cholinergic. D. opioid. - ANSWER D. opioid. How do poisons typically act to harm the body? Select one: A. By causing a slowing of nearly all bodily functions B. By changing the normal metabolism of cells or by destroying them C. By interfering with normal neurologic function D. By causing burns and damage to either external or internal organs - ANSWER B. By changing the normal metabolism of cells or by destroying them Hypotension, hypoventilation, and pinpoint pupils would be expected following an overdose of: Select one: A. oxycodone (Percocet). B. ecstasy. C. amphetamine sulfate (Benzedrine). D. crack cocaine. - ANSWER A. oxycodone (Percocet). If the victim of a toxicologic emergency vomits, an EMT should _________. Select one: A. have the patient enclose the vomitus in a container and take it to the emergency department. B. not approach the vomitus. C. safely dispose of the vomitus as soon as possible and decontaminate the vehicle as necessary. D. use appropriate personal protective equipment and examine the vomitus for pill fragments or other clues for patient care. - ANSWER D. use appropriate personal protective equipment and examine the vomitus for pill fragments or other clues for patient care. In an apparent suicide attempt, a 19-year-old female ingested a full bottle of amitriptyline (Elavil). At present, she is conscious and alert and states that she swallowed the pills approximately 30 minutes earlier. Her blood pressure is 90/50 mm Hg, her pulse is 140 beats/min and irregular, and her respirations are 22 breaths/min with adequate depth. When transporting this patient, you should be MOST alert for: Select one: A. acute respiratory depression. B. seizures and cardiac arrhythmias. C. an increase in her blood pressure. D. a sudden outburst of violence. - ANSWER B. seizures and cardiac arrhythmias. Most poisonings occur via the __________ route. Select one: A. injection B. absorption C. inhalation D. ingestion - ANSWER D. ingestion Of the four avenues of poisoning, generally ___________ is the most worrisome in terms of treatment to the EMS provider. Select one: A. injection B. absorption C. ingestion D. inhalation - ANSWER A. injection The recommended treatment for absorbed or contact poisons includes _________. Select one: A. neutralizing the poisonous substance with a chemical B. transporting the patient to the emergency department with the poisonous substance in place C. safely removing or diluting the poisonous substance D. collecting and transporting the poisonous substance to the emergency department for identification - ANSWER C. safely removing or diluting the poisonous substance Victims of inhaled poisoning will require which of the following? Select one: A. Suctioning to clear the airway B. Transport to an emergency department for evaluation C. Ventilation with a bag-valve mask D. An oropharyngeal or nasopharyngeal device to maintain an airway - ANSWER B. Transport to an emergency department for evaluation When caring for a known alcoholic patient with severe trauma to the chest and abdomen, you should be concerned that: Select one: A. internal bleeding may be profuse because prolonged alcohol use may impair the blood's ability to clot. B. delirium tremens (DTs) are commonly induced by physical trauma and can lead to life-threatening seizures. C. long bone fractures are likely because chronic alcohol consumption weakens the structure of the bones. D. signs and symptoms of shock may be masked by the stimulant effects produced by alcohol. - ANSWER A. internal bleeding may be profuse because prolonged alcohol use may impair the blood's ability to clot. Which of the following questions would be LEAST pertinent during the initial questioning of a patient who ingested a substance? Select one: A. How long ago was the substance taken? B. Why was the substance ingested? C. What type of substance was taken? D. How much of the substance was taken? - ANSWER B. Why was the substance ingested? Which of the following sets of vital signs would the EMT MOST likely encounter in a patient with acute cocaine overdose? Select one: A. BP, 180/100 mm Hg; pulse, 50 beats/min B. BP, 200/100 mm Hg; pulse, 150 beats/min C. BP, 190/90 mm Hg; pulse, 40 beats/min D. BP, 60/40 mm Hg; pulse, 140 beats/min - ANSWER B. BP, 200/100 mm Hg; pulse, 150 beats/min Which of the following statements regarding the Salmonella bacterium is correct? Select one: A. The Salmonella bacterium produces toxins that cause food poisoning. B. The Salmonella bacterium itself causes food poisoning. C. Symptoms of salmonellosis appear within 12 hours. D. Refrigeration of food will prevent salmonellosis. - ANSWER B. The Salmonella bacterium itself causes food poisoning. You and your paramedic partner are caring for a patient who ingested codeine, acetaminophen (Tylenol), and hydrocodone (Vicodin). The patient is unresponsive, his breathing is slow and shallow, and his pulse is slow and weak. Treatment for this patient should include: Select one: A. assisted ventilation and naloxone (Narcan). B. assisted ventilation and flumazenil (Romazicon). C. oxygen via a nasal cannula and atropine sulfate. D. high-flow oxygen via a nonrebreathing mask. - ANSWER A. assisted ventilation and naloxone (Narcan). You receive a call to a residence where a man found his wife unresponsive on the couch. The patient's respiratory rate is 8 breaths/min, her breathing is shallow, her heart rate is 40 beats/min, and her pulse is weak. The husband hands you an empty bottle of hydrocodone (Vicodin), which was refilled the day before. You should: Select one: A. perform a rapid head-to-toe exam. B. apply oxygen via a nonrebreathing mask. C. ventilate her with a BVM. D. contact the poison control center. - ANSWER C. ventilate her with a BVM. A 38-year-old male with a history of schizophrenia is reported by neighbors to be screaming and throwing things in his house. You are familiar with the patient and have cared for him in the past for unrelated problems. Law enforcement officers escort you into the residence when you arrive. The patient tells you that he sees vampires and is attempting to ward them off by screaming and throwing things at them. He has several large lacerations to his forearms that are actively bleeding. The MOST appropriate way to manage this situation is to: Select one: A. try to gain the patient's trust by telling him that you see the vampires too. B. approach the patient and calm him by placing your hand on his shoulder. C. request that the police officers arrest him and take him to the hospital. D. restrain the patient with appropriate force in order to treat his injuries. - ANSWER D. restrain the patient with appropriate force in order to treat his injuries. A 40-year-old male intentionally cut his wrist out of anger after losing his job. Law enforcement has secured the scene prior to your arrival. As you enter the residence and visualize the patient, you can see that he has a towel around his wrist and a moderate amount of blood has soaked through it. You should: Select one: A. tell the patient that you want to help. B. calmly identify yourself to the patient. C. approach the patient with caution. D. quickly tend to the bleeding wound. - ANSWER B. calmly identify yourself to the patient. A behavioral crisis interferes with which of the following? Select one: A. Activities of daily living B. Behavior that is acceptable to the community C. Dressing, eating, or bathing D. All of these answers are correct. - ANSWER D. All of these answers are correct. A general impression of the patient is formed by an EMT: Select one: A. speaking privately with the patient. B. at a distance when the patient is first seen. C. when the patient is in the ambulance. D. speaking with family members or bystanders first. - ANSWER B. at a distance when the patient is first seen. Everyone exhibits some signs and symptoms of mental illness at some point in life ____________. Select one: A. and needs medication administered to control them B. but that does not mean a person is mentally ill C. because mental illness affects everyone D. and should be physically restrained for their own safety and the safety of the EMT - ANSWER B. but that does not mean a person is mentally ill From a mental health standpoint, an abnormal or disturbing pattern of behavior is a matter of concern if it lasts for at least: Select one: A. 3 weeks. B. 1 week. C. 1 month. D. 2 weeks. - ANSWER C. 1 month. Signs of excited delirium include: Select one: A. subdued behavior, crying, and suicidal thoughts. B. slurred speech, bradycardia, and a high fever. C. diaphoresis, tachycardia, and hallucinations. D. pallor, hypotension, and constricted pupils. - ANSWER C. diaphoresis, tachycardia, and hallucinations. The two basic categories of diagnosis that a physician will use for behavioral crises or psychiatric emergencies are ____________. Select one: A. organic brain syndrome and altered mental status B. functional and nonfunctional C. physical and psychological D. All of these answers are correct. - ANSWER C. physical and psychological What is the most common misconception surrounding mental illness? Select one: A. Many mental illnesses stem from drug or alcohol abuse. B. Everyone has some form of mental illness. C. All persons with mental disorders are physically violent and dangerous. D. Feeling "bad" or "depressed" means that you must be "sick." - ANSWER D. Feeling "bad" or "depressed" means that you must be "sick." When a psychiatric emergency arises, a patient is most likely to exhibit which of the following behaviors? Select one: A. Any behaviors that are a violent threat to the patient, EMTs, or others B. Disruptions to activities of daily living C. Visual or auditory hallucinations D. Any behaviors unacceptable to the patient, family, or community - ANSWER A. Any behaviors that are a violent threat to the patient, EMTs, or others When caring for a patient experiencing excited delirium, the EMT should remember that: Select one: A. most patients will have low blood pressure and hyperglycemia. B. lights and siren are effective in redirecting the patient's behavior. C. excited delirium is worsened by nervous system depressant drugs. D. sudden death can occur if the patient's violence is not controlled. - ANSWER D. sudden death can occur if the patient's violence is not controlled. Which of the following is a good guideline for physical examination of any patient? Select one: A. Always work toe-to-head. B. Complete the physical exam first, then check the ABCs. C. Examine extremities first. D. Avoid touching without permission. - ANSWER D. Avoid touching without permission. Which of the following is an example of a psychiatric emergency? Select one: A. A person who is depressed and no longer caring for himself B. A person going on a week-long "bender" after losing a job C. A person violently attacking family members D. A person who is experiencing a panic attack - ANSWER C. A person violently attacking family members Which of the following is considered an organic brain syndrome? Select one: A. Alzheimer dementia B. Schizophrenia C. Depression D. Anxiety conditions - ANSWER A. Alzheimer dementia Which of the following terms applies to a state of delusion in which the patient is out of touch with reality? Select one: A. Agitated delirium B. Psychosis C. Schizophrenia D. Suicidal - ANSWER B. Psychosis Why might EMTs encounter a larger proportion of violent patients than the population at large? Select one: A. EMTs respond to patients who, by definition, are having an emergency. B. EMTs respond with law enforcement. C. It is a common misperception; EMTs do NOT encounter a larger proportion of violent patients than the population at large. D. EMTs have to restrain patients. - ANSWER A. EMTs respond to patients who, by definition, are having an emergency. You are assessing a 45-year-old female who is severely depressed. She states that it seems as though her entire world is crashing down around her. She further states that she has had frequent thoughts of suicide, but is not sure if she can actually go through with it. How should you manage this situation? Select one: A. Ask the patient if she has developed a suicidal plan. B. Have law enforcement place her in protective custody. C. Encourage the patient to remain quiet during transport. D. Leave the scene and have a neighbor check in on her. - ANSWER A. Ask the patient if she has developed a suicidal plan. You are attending to a 27-year-old patient with a history of depression. The patient's family tells you that she has been openly talking about harming herself and suicide, and they got scared when she tried to overdose on some medications. The patient did not take the pills and is alert and oriented. Despite all of your best efforts to convince her, the patient refuses to go to hospital for treatment. Based on this information, you should: Select one: A. call for the police to attend the scene and, once they arrive, release responsibility for patient transport to them B. ensure that the patient is competent and completes the required documentation, and leave her in the care of her family. C. stay with the patient while you arrange for other transport options as a potentially life-threatening emergency exists. D. restrain the patient and transport her to the hospital as she represents a threat to her safety. - ANSWER C. stay with the patient while you arrange for other transport options as a potentially life-threatening emergency exists. You are attending to a 32-year-old male patient. The patient's wife tells you that he returned from Afghanistan last year. While he initially seemed fine, lately he has become withdrawn and distanced himself from his family and friends. He does not talk about it, but she knows that he has been having terrible nightmares that wake him up. The most appropriate question to ask regarding his experience in Afghanistan is: Select one: A. Can you tell me about your experience? B. Have you ever been diagnosed with PTSD? C. Were you shot at or under fire? D. Were you in combat? - ANSWER C. Were you shot at or under fire? You receive a call for a domestic dispute. When you arrive at the scene, you find a young male standing on the front porch of his house. You notice that an adjacent window is broken. The patient has a large body, is clenching his fists, and is yelling obscenities at you. Which of the following findings is LEAST predictive of this patient's potential for violence? Select one: A. The broken window B. His large body size C. His clenched fists D. His shouting of obscenities - ANSWER B. His large body size A 30-year-old male was rescued after being lost in the woods for approximately 18 hours. The outside temperature is 30°F (-1°C). He is immediately placed in the warmed ambulance, where you perform a primary assessment. He is unresponsive, pale, and apneic. You should: Select one: A. assess for a carotid pulse for up to 60 seconds. B. apply chemical heat packs to his groin and axillae. C. apply an AED and assess his cardiac rhythm. D. open his airway and give two rescue breaths. - ANSWER A. assess for a carotid pulse for up to 60 seconds. A 31-year-old male was bitten on the leg by an unidentified snake. The patient is conscious and alert and in no apparent distress. Your assessment of his leg reveals two small puncture marks with minimal pain and swelling. In addition to administering oxygen and providing reassurance, further care for this patient should include: Select one: A. elevating the lower extremities and giving antivenin. B. supine positioning, splinting the leg, and transporting. C. applying ice to the wound and transporting quickly. D. transporting only with close, continuous monitoring. - ANSWER B. supine positioning, splinting the leg, and transporting. All of the following terms refer to a body part that is cold but not frozen, EXCEPT: Select one: A. trench foot. B. frostnip. C. frostbite. D. immersion foot. - ANSWER C. frostbite. Burns associated with lightning strikes are typically: Select one: A. full-thickness. B. superficial. C. partial-thickness. D. third-degree. - ANSWER B. superficial. Common signs and symptoms of heat exhaustion include all of the following, EXCEPT: Select one: A. headache. B. hot, dry skin. C. nausea. D. tachycardia. - ANSWER Drowning is MOST accurately defined as: Select one: A. water in the lungs following submersion in water. B. death beyond 24 hours after submersion in water. C. temporary survival after submersion in water. D. death from suffocation after submersion in water. - ANSWER D. death from suffocation after submersion in water. Hypothermia occurs when the core body temperature falls below: Select one: A. 88°F (31°C). B. 98°F (37°C). C. 95°F (35°C). D. 90°F (32°C). - ANSWER C. 95°F (35°C). In contrast to Lyme disease, Rocky Mountain spotted fever: Select one: A. causes painful joint swelling after a few days or weeks. C. may be confused with rheumatoid arthritis. D. presents with flu-like symptoms and a bull's-eye rash. - ANSWER B. can cause paralysis and cardiorespiratory collapse. Most of the serious injuries associated with scuba diving are caused by: Select one: A. alcohol consumption. B. cold water temperature. C. too rapid of an ascent. D. too rapid of a descent. - ANSWER C. too rapid of an ascent. The body's natural cooling mechanism, in which sweat is converted to a gas, is called: Select one: A. convection. B. radiation. C. evaporation. D. conduction. - ANSWER C. evaporation. The EMT must assume that any unwitnessed water-related incident is accompanied by: Select one: A. cold-water immersion. B. an air embolism. C. alcohol intoxication. D. possible spinal injury. - ANSWER D. possible spinal injury. The MOST prominent symptom of decompression sickness is: Select one: A. abdominal or joint pain. B. difficulty with vision. C. tightness in the chest. D. dizziness and nausea. - ANSWER A. abdominal or joint pain. The venom of a black widow spider is toxic to the: Select one: A. cardiovascular system. B. renal system. C. respiratory system. D. nervous system. - ANSWER D. nervous system. When a warm hand is immersed in water that is 70°F (21°C), heat is transferred from the hand to the water through a process called: Select one: A. evaporation. B. conduction. C. radiation. D. convection. - ANSWER B. conduction. Which of the following is an early sign of pit viper envenomation? Select one: A. Signs and symptoms of hypoperfusion B. Syncope and bleeding at distal sites C. General weakness and diaphoresis D. Local swelling and ecchymosis - ANSWER D. Local swelling and ecchymosis Which of the following MOST accurately describes hyperthermia? Select one: A. Heat evaporates a significant amount of body water. B. The body eliminates more heat than it can generate. C. The core body temperature exceeds 99.5°F (37°C). D. The body is exposed to more heat than it can lose. - ANSWER D. The body is exposed to more heat than it can lose. You and your partner respond to a park where several people were reportedly struck by lightning. When you arrive, you find three patients. The first patient is lying supine on the ground; he is unresponsive and does not appear to be breathing. The second patient is ambulatory, appears confused, and is holding his arm against his chest. The third patient is sitting on the ground holding the sides of his head. After calling for backup, you should: Select one: A. assess the unresponsive patient's pulse, begin CPR starting with chest compressions if he is pulseless, and attach the AED as soon as possible. B. immediately begin CPR on the unresponsive patient, but cease resuscitation efforts if there is no response after 5 minutes of treatment. C. focus your initial treatment efforts on the patients who are conscious because the unresponsive patient is likely in irreversible cardiac arrest. D. recognize that the patients who are conscious are at high risk for developing cardiac arrest and quickly assess them for potentially life-threatening injuries. - ANSWER A. assess the unresponsive patient's pulse, begin CPR starting with chest compressions if he is pulseless, and attach the AED as soon as possible. You are transporting a 28-year-old man with a frostbitten foot. The patient's vital signs are stable and he denies any other injuries or symptoms. The weather is treacherous and your transport time to the hospital is approximately 45 minutes. During transport, you should: Select one: A. administer oxygen via a nonrebreathing mask. B. cover his foot with chemical heat compresses. C. protect the affected part from further injury. D. rewarm his foot in 102°F to 104°F (38.9°C to 40°C) water. - ANSWER C. protect the affected part from further injury. You receive a call to a residence for a sick patient. Upon your arrival, you find the patient, a 53-year-old diabetic male, lying down on his front porch. His wife tells you that he had been mowing the lawn in the heat for the past 3 hours. The patient is confused and has hot, moist skin. His pulse is weak and thready, and his blood pressure is 90/50 mm Hg. You should: Select one: A. administer one tube of oral glucose and reassess his mental status. B. perform a head-to-toe assessment and look for signs of trauma. C. place him in a sitting position and have him drink 1 L of water. D. load him into the ambulance and begin rapid cooling interventions. - ANSWER D. load him into the ambulance and begin rapid cooling interventions. You respond to a local lake where a diver complains of difficulty breathing that occurred immediately after rapidly ascending from a depth of approximately 30 feet. On assessment, you note that he has cyanosis around his lips and has pink froth coming from his nose and mouth. You should: Select one: A. suction his mouth and nose, keep him supine and elevate his legs to prevent air bubbles from entering his brain, administer high-flow oxygen, and transport to a hyperbaric chamber. B. place him in a semi-sitting position, suction his mouth and nose, apply a continuous positive airway pressure (CPAP) device, and transport to the closest emergency department. C. suction his mouth and nose, apply high-flow oxygen, monitor the patient's breath sounds for a pneumothorax, and contact medical control regarding transport to a recompression facility. D. position him supine with his head elevated 30°, suction his mouth and nose, hyperventilate him with a bag-valve mask, and contact medical control for further guidance. - ANSWER C. suction his mouth and nose, apply high-flow oxygen, monitor the patient's breath sounds for a pneumothorax, and contact medical control regarding transport to a recompression facility. A 77-year-old female presents with an acute onset of altered mental status. Her son is present and advises that she has a history of hypertension, atrial fibrillation, type 2 diabetes, and glaucoma. He further advises that she takes numerous medications and that she is normally alert. When you assess this patient, it is important to note that: Select one: A. her mental status is likely the result of hypoglycemia and you should give her sugar. B. because of her age and medical history, you should suspect Alzheimer disease. C. the patient is experiencing delirious behavior, which suggests a new health problem. D. dementia typically presents as an acute onset of deterioration of cognitive function. - ANSWER C. the patient is experiencing delirious behavior, which suggests a new health problem. A specific legal document that directs relatives and caregivers regarding the medical treatment that may be given to patients who cannot speak for themselves is called a(n): Select one: A. advance directive. B. physician directive. C. power of attorney. D. statute of care. - ANSWER A. advance directive. An 84-year-old male fell a week ago and has been bedridden since then. Today, he presents with an altered mental status. His skin is pale and cold and his respirations are rapid and shallow. The EMT should suspect: Select one: A. hypovolemic shock. B. acute hyperglycemia. C. a subdural hematoma. D. a systemic infection. - ANSWER D. a systemic infection. An abdominal aortic aneurysm: Select one: A. is usually not repairable, even if discovered early. B. causes dull pain that often radiates to the shoulders. C. is often the result of hypertension and atherosclerosis. D. can sometimes be palpated as a mass in the groin area. - ANSWER C. is often the result of hypertension and atherosclerosis. Because of the complexity of the older patient and the vagueness of his or her complaint, you should: Select one: A. rely exclusively on family members for the medical history. B. attempt to differentiate between chronic and acute problems. C. perform a rapid assessment on all geriatric patients you treat. D. limit your physical examination to the area of pain or injury. - ANSWER B. attempt to differentiate between chronic and acute problems. Blood levels of medications may rise in the elderly, sometimes to toxic levels. This is MOST likely due to: Select one: A. splenic dysfunction. B. intentional overdose. C. pancreatic failure. D. renal insufficiency. - ANSWER D. renal insufficiency. Clouding of the lenses of the eyes is called: Select one: A. retinitis. B. cataracts. C. conjunctivitis. D. glaucoma. - ANSWER B. cataracts. Common causes of depression in the elderly include all of the following, EXCEPT: Select one: A. prescription medication use. B. alcohol abuse and dependence. C. chronic medical conditions. D. an acute onset of dementia. - ANSWER D. an acute onset of dementia. During the natural process of aging, the number of functional cilia in the respiratory system decreases, resulting in: Select one: A. air-trapping within the alveoli. B. baseline respiratory distress. C. a decreased ability to cough. D. an increased risk of COPD. - ANSWER C. a decreased ability to cough. In contrast to younger patients, older patients are more prone to a decrease in blood pressure (BP) upon standing because: Select one: A. the body is less able to adapt the BP to rapid postural changes. B. any change in position causes blood to be shunted to the brain. C. their red blood cells are destroyed at a faster than normal rate. D. the aging process results in an overall increase in blood volume. - ANSWER A. the body is less able to adapt the BP to rapid postural changes. Poor maintenance of home, poor personal care, and dietary neglect are all possible indicators of ____________ elder abuse. Select one: A. financial B. psychological C. emotional D. physical - ANSWER D. physical Sedentary behavior while healing from a hip fracture would MOST likely predispose the older patient to: Select one: A. ischemic stroke. B. heart failure. C. pneumonia. D. osteoporosis. - ANSWER C. pneumonia. Talking about an elderly patient in front of him or her to other members of the family: Select one: A. is usually beneficial because the patient's cognitive skills are typically impaired. B. often causes the patient to become paranoid and untrusting of your help. C. will anger the patient and result in his or her refusal to accept care or transport. D. may cause the patient to think that he or she has no say in making decisions. - ANSWER D. may cause the patient to think that he or she has no say in making decisions. The EMT should suspect left-sided heart failure in the geriatric patient who presents with: Select one: A. fever and a cough that produces green sputum. B. tachypnea and paroxysmal nocturnal dyspnea. C. swelling of the lower extremities and weakness. D. jugular venous distention and peripheral edema. - ANSWER B. tachypnea and paroxysmal nocturnal dyspnea. The leading cause of death in the geriatric patient is: Select one: A. hypertension. B. heart disease. C. arthritis. D. altered mental status. - ANSWER B. heart disease. The stooped posture of some older people, which gives them a humpback appearance, is called: Select one: A. arthritis. B. scoliosis. C. kyphosis. D. miosis. - ANSWER C. kyphosis. To minimize distractions and confusion when assessing an older patient, you should: Select one: A. have only one EMT speak to the patient at a time. B. dismiss the family members from the room or area. C. elevate your voice and speak directly to the patient. D. perform a physical exam and then talk to the patient. - ANSWER A. have only one EMT speak to the patient at a time. When immobilizing a patient with a kyphotic spine to a long backboard, the EMT would MOST likely have to: Select one: A. use a scoop stretcher instead of a log roll. B. force the head into a neutral alignment. C. place blankets behind the patient's head. D. secure the patient's head before the torso. - ANSWER C. place blankets behind the patient's head. Which of the following observations or statements represents the "E" in the GEMS diamond? Select one: A. A patient is assisted with his or her activities of daily living. B. The patient's residence is cold due to a malfunctioning heater. C. Elderly patients present atypically and deserve your respect. D. The patient's medications have not been filled in 2 months. - ANSWER B. The patient's residence is cold due to a malfunctioning heater. You are assessing a 70-year-old female who complains of intense thirst, frequent urination, and dizziness. She has a history of type 2 diabetes, heart disease, rheumatoid arthritis, and gout. Her blood glucose reads "high." She is conscious, but confused. Her blood pressure is 92/52 mm Hg, her pulse rate is 130 beats/min and weak, and her respirations are 22 breaths/min and shallow. This patient's clinical presentation is MOST consistent with: Select one: A. diabetic ketoacidosis. B. hyperosmolar hyperglycemic nonketotic syndrome. C. hyperglycemia with moderate dehydration. D. acute renal failure with associated hyperglycemia. - ANSWER B. hyperosmolar hyperglycemic nonketotic syndrome. A 13-year-old child is on a home ventilator. The parents called because the mechanical ventilator is malfunctioning and the child has increasing respiratory distress. You should: Select one: A. reset the ventilator by unplugging it for 30 to 60 seconds. B. disconnect the ventilator and apply a tracheostomy collar. C. place a call to the home health agency treating this patient. D. attempt to troubleshoot the mechanical ventilator problem. - ANSWER B. disconnect the ventilator and apply a tracheostomy collar. A 70-year-old male complains of shortness of breath. During your assessment, you note that he has bilateral hearing aids. When you ask him questions related to his chief complaint, he does not answer you. You can hear a whistling sound coming from his hearing aids. You should: Select one: A. try repositioning the hearing aid or remove it and turn down the volume. B. recognize that the batteries in his hearing aids are probably depleted. C. remove his hearing aids, turn up the volume, and replace them in his ears. D. remove both of his hearing aids and use pencil and paper to communicate. - ANSWER A. try repositioning the hearing aid or remove it and turn down the volume. A person is said to be obese when he or she is ________ over his or her ideal weight. Select one: A. 30% or more B. 10% or more C. 20% or more D. 40% or more - ANSWER A. 30% or more A surgical procedure that creates an opening between the intestine and the surface of the body that allows for elimination of waste products is called a(n): Select one: A. intestinal shunt. B. colostomy. C. gastric stoma. D. gastrostomy. - ANSWER B. colostomy. According to the "E" in the DOPE mnemonic, which of the following actions should you perform to troubleshoot inadequate ventilation in a patient with a tracheostomy tube? Select one: A. Attempt to pass a suction catheter into the tube. B. Listen to breath sounds to assess for a pneumothorax. C. Look for blood or other secretions in the tube. D. Check the mechanical ventilator for malfunction. - ANSWER D. Check the mechanical ventilator for malfunction. According to the Emergency Medical Treatment and Active Labor Act (EMTALA): Select one: A. a patient maintains the legal right to recant his or her consent to emergency treatment, even after signing in to the emergency department. B. all health care facilities are legally obligated to provide assessment and care only if the patient is critically ill or injured. C. all health care facilities must provide a medical assessment and required treatment, regardless of the patient's ability to pay. D. a health care facility has the right to refuse assessment and treatment to a patient, but only if his or her condition is not deemed critical. - ANSWER C. all health care facilities must provide a medical assessment and required treatment, regardless of the patient's ability to pay. Because a tracheostomy tube bypasses the nose and mouth: Select one: A. severe swelling of the trachea and bronchi can occur. B. secretions can build up in and around the tube. C. the risk of a local infection is significantly high. D. bleeding or air leakage may occur around the tube. - ANSWER B. secretions can build up in and around the tube. Cerebral palsy is characterized by poorly controlled ________ movement. Select one: A. neck B. eye C. body D. extremity - ANSWER C. body Common complications associated with central venous catheters include all of the following, EXCEPT: Select one: A. clotting of the line. B. a local infection. C. bleeding around the line. D. rupture of a central vein. - ANSWER D. rupture of a central vein. Down syndrome is a genetic defect that occurs as the result of: Select one: A. a separation of chromosome 21. B. an extra pair of chromosomes. C. a sperm that contains 24 chromosomes. D. a triplication of chromosome 21. - ANSWER D. a triplication of chromosome 21. Spina bifida is defined as: Select one: A. chronic pressure on the brain caused by excess cerebrospinal fluid. B. congenital inflammation of the spinal cord, usually in the neck. C. a birth defect in which the child is born without spinal vertebrae. D. a birth defect caused by incomplete closure of the spinal column. - ANSWER D. a birth defect caused by incomplete closure of the spinal column. The purpose of a ventricular peritoneum shunt is to: Select one: A. prevent excess cerebrospinal fluid from accumulating in the brain. B. monitor pressure within the skull in patients with a head injury. C. remove fluid from the abdomen of patients with right-sided heart failure. D. divert excess cerebrospinal fluid to the ventricles of the brain. - ANSWER A. prevent excess cerebrospinal fluid from accumulating in the brain. Under what circumstances is a left ventricular assist device used? Select one: A. To permanently replace the function of one or both of the ventricles B. To reduce ventricular pumping force in patients with aortic aneurysms C. To ensure that the ventricles contract at an adequate and consistent rate D. As a bridge to heart transplantation while a donor heart is being located - ANSWER D. As a bridge to heart transplantat