quizes 4

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To which of the following diabetic patients should you administer oral glucose?

a confused 55-year-old male with tachycardia and pallor

You are treating a 40-year-old male with a documented blood sugar reading of 300 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:

insulin

The normal blood glucose level, as measured by a glucometer, is between:

80 and 120 mg/dL.

Diabetic ketoacidosis occurs when:

insulin is not available in the body.

An acute accelerated drop in the hemoglobin level, which is caused by red blood cells breaking down at a faster rate than normal, occurs during a __________ crisis.

hemolytic

Which of the following statements regarding glucose is correct?

The brain requires glucose as much as it requires oxygen.

A 19-year-old male complains of "not feeling right." His insulin and a syringe are on a nearby table. The patient says he thinks he took his insulin and cannot remember whether he ate. He is also unable to tell you the time or what day it is. The glucometer reads "error" after several attempts to assess his blood glucose level. In addition to administering oxygen, you should:

contact medical control and administer oral glucose.

Ketone production is the result of:

fat metabolization when glucose is unavailable.

Which of the following conditions is the diabetic patient at an increased risk of developing?

blindness

You respond to a residence for a patient who is "not acting right." As you approach the door, the patient, a 35-year-old male, begins shouting profanities at you and your partner while holding a baseball bat. The man is confused and diaphoretic, and is wearing a medical identification bracelet. You should:

retreat at once and call law enforcement.

Patients with uncontrolled diabetes experience polyuria because:

excess glucose in the blood is excreted by the kidneys.

Excessive eating caused by cellular "hunger" is called:

polyphagia.

When assessing an unconscious diabetic patient, the primary visible difference between hyperglycemia and hypoglycemia is the:

rate and depth of breathing.

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:

heart attack.

Insulin functions in the body by:

enabling glucose to enter the cells.

A 37-year-old female with a history of diabetes presents with excessive urination and weakness of 2 days' duration. You apply 100% oxygen and assess her blood glucose level, which reads 320 mg/dL. If this patient's condition is not promptly treated, she will MOST likely develop:

acidosis and dehydration.

Patients with thrombophilia are at an increased risk for:

pulmonary embolism.

Glutose is a trade name for:

oral glucose.

Hypoglycemic crisis tends to develop more often and more severely in children because:

they do not always eat correctly and on schedule.

Diabetes is MOST accurately defined as a/an:

disorder of carbohydrate metabolism.

A 29-year-old female presents with confusion and disorientation. Her respirations are rapid and shallow and her pulse is 120 beats/min and thready. She is markedly diaphoretic and has an oxygen saturation of 89%. You should:

provide ventilatory support.

Classic signs and symptoms of hypoglycemia include:

cool, clammy skin; weakness; tachycardia; and rapid respirations.

When using an auto-injector to give epinephrine, the primary injection site is the:

lateral portion of the thigh.

Most patients who die of anaphylaxis do so within the first __________ following exposure.

30 minutes

A 48-year-old male is found unconscious in the garden by his wife. When you arrive at the scene and assess the man, you find that he is unresponsive, has severely labored breathing, and has hives over his entire trunk. You should:

maintain his airway and assist his ventilations.

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?

Administer oxygen, transport at once, and request a paramedic intercept.

A 50-year-old male was stung by a honeybee approximately 15 minutes ago. He presents with respiratory distress, facial swelling, and hypotension. After placing him on oxygen and administering his epinephrine via auto-injector, you note that his breathing has improved. Additionally, his facial swelling is resolving and his blood pressure is stable. Your next action should be to:

record the time and dose of the injection, and transport promptly.

While auscultating breath sounds of a patient who was stung multiple times by a yellow jacket, you hear bilateral wheezing over all lung fields. This indicates:

narrowing of the bronchioles in the lungs.

Which of the following patients would MOST likely have a delayed onset of an allergic reaction?

45-year-old male who ingested penicillin

Epinephrine is indicated for patients with an allergic reaction when:

wheezing and hypotension are present.

After administering 0.3 mg of epinephrine via auto-injector to a 22-year-old female with an allergic reaction, you note improvement in her breathing and dissipation of her hives. However, she is still anxious and tachycardic. You should:

monitor her closely but recall that anxiety and tachycardia are side effects of epinephrine.

Because the stinger of a honeybee remains in the wound following a sting:

it can continue to inject venom for up to 20 minutes.

When administering epinephrine via auto-injector, you should hold the injector in place for:

10 seconds.

Which of the following statements regarding fire ants is correct?

Fire ants often bite a person repeatedly.

You are assessing a young male who was stung on the leg by a scorpion. He is conscious and alert, his breathing is regular and unlabored, and his blood pressure is 122/64 mm Hg. Assessment of his leg reveals a wheal surrounded by an area of redness. He states that he had a "bad reaction" the last time he was stung by a scorpion, and carries his own epinephrine auto-injector. You should:

apply oxygen as needed, clean the area with soap and water or a mild antiseptic, and transport him to the hospital.

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:

administer oxygen and transport her to the hospital.

You respond to the residence of a 55-year-old female with a possible allergic reaction to peanuts that she ate approximately 30 minutes ago. The patient is conscious and alert, but has diffuse urticaria and the feeling that she has a lump in her throat. As your partner applies oxygen to the patient, you should:

ask her if she has prescribed epinephrine.

Which of the following sounds indicates swelling of the upper airway?

stridor

Which of the following MOST accurately defines an allergic reaction?

an exaggerated immune system response to any substance

The adult epinephrine auto-injector delivers ______ mg of epinephrine, and the pediatric auto-injector delivers ______ mg

0.3, 0.15

Which of the following medications blocks the release of histamines?

diphenhydramine (Benadryl)

The foreign substance responsible for causing an allergic reaction is called a:

allergen.

The stinger from a honeybee should be:

scraped away from the skin.

Common signs and symptoms of an allergic reaction include all of the following, EXCEPT:

drying of the eyes.

Chemicals that are responsible for the signs and symptoms of an allergic reaction to a bee sting include

B. histamines and leukotrienes.

A raised, swollen, well-defined area on the skin that is the result of an insect bite or sting is called:

a wheal.

Urticaria is the medical term for:

hives.

Which of the following physiologic actions does epinephrine produce when given for an allergic reaction?

vasoconstriction and bronchodilation

Airborne substances are diluted with:

Oxygen

A poison that enters the body by _____ is the MOST difficult to treat:

Injection

As you enter the residence of a patient who has possibly overdosed, you should:

Be alert for personal hazards

The usual dose for activated charcoal is up to _____ for a pediatric patient and up to _____ for an adult patient:

25g, 50g

You receive a call to a residence where a man found his wife unconscious on the couch. The patient is unresponsive, her respiratory rate is 9 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:

Initiate ventilatory assistance

You respond to a local motel for a young female who was sexually assaulted. The patient is conscious but confused. She tells you that the last thing she remembers was drinking beer at a club with her friends the night before. When she awoke, she was in the bed of the motel room. You should be MOST suspicious that this patient:

Was given flunitrazepam (Rohypnol)

It is MOST important to determine a patients weight when asking questions pertaining to a toxic ingestion because:

Activated charcoal is given based on a patients weight

Which of the following drugs is NOT a sedative-hypnotic?

cocaine

Which of the following statements regarding inhaled poisons is correct?

Lung damage may progress after the patient is removed from the environment

Substance abuse is MOST accurately defined as:

Knowingly misusing a substance to produce a desired effect

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 mmHg, 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:

Seizures and cardiac arrhythmias

The MOST commonly abused drug in the United States is:

Alcohol

A 49 year old male presents with confusion, sweating, and visual hallucinations. The patients 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:

DTs

A patient who presents with rapid breathing, nausea and vomiting, ringing in the ears, and a high fever should be suspected of ingesting a significant quantity of:

aspirin

DT's is a syndrome associated with withdrawl from:

Alcohol

A 3 year old female ingested several leaves from a plant in the living room. The child's mother is not sure what type of plant it is, stating that she bought it because it was pretty. After completing your initial assessment of the child, you should:

Contact the regional poison control center

Your priority in caring for a patient with a surface contact poisoning is to:

Avoid contaminating yourself

Activated charcoal is given to patients who have ingested certain substances because it:

Binds to the substance and prevents absorbtion

Phosphorus or elemental sodium should be brushed off of the skin instead of irrigated with water because:

These chemicals may ignite upon contact with water

The EMT's primary responsibility to the patient who has been poisoned is to:

Recognize that a poisoning occurred

You and your paramedic partner are caring for a patient who ingested codeine, acetaminophen (Tylenol), and propoxyphene (Darvon). The patient is unresponsive, his breathing is slow and shallow, and his pulse is slow and weak. Treatment for this patient will include:

Assisted ventilation, naloxone (Narcan) and rapid transport

Before giving activated charcoal, you should:

Obtain approval from medical control

Heroin is an example of:

Opioid

Signs of agitated delirium include:

Diaphoresis, tachycardia, and hallucinations

You respond to a call for an unknown emergency. When you arrive at the scene, the patients husband meets you at the door and states that his wife has been depressed and has locked herself in an upstairs bedroom. He further tells you that he keeps his handgun in the bedroom. You should:

Remain in a safe place and request law enforcement.

The single most significant factor that contributes to suicide is:

Depression

Which of the following statements regarding the physical examination of a patient with
Behavioral problem is correct?

A physical exam for a behavioral problem may be difficult to perform but may provide clues to the patients state of mind and thought process.

A 66 year old male presents with bizarre behavior. His daughter states that he did not seem to recognize her and was very rude to her. The pt is conscious, and has a patent airway and adequate breathing. You should:

Ask the daughter how her father normally behaves

General guidelines for managing a pt with behavioral emergency include:

Being prepared to spend extra time with the pt

Law enforcement personnel request your assistance for a 30 year old man who they pulled over for erratic driving. The pt became acutely violent while he was being questioned, which required one of the officers to subdue him with a Taser. When you arrive and assess the pt, you find that he is very agitated and is experiencing apparent hallucinations. His skin is flushed and diaphoretic. You should:

Limit physical contact with the pt as much as possible and avoid interrupting him if he is attempting to communicate with you.

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 pt and have cared for him in the past for unlrelated problems. Law enforcement officers escort you into the residence when you arrive. The pt 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:

Restrain the pt with appropriate force in order to treat his injuries.

When assessing a pt with a behavioral crisis, you should:

Be direct and clearly state you intentions

You are assessing a 45 year old female who is severly depressed. She states that it seems as though her entire world is crashing down around her. She further states that she has had a frequent thoughts of suicide, but is not sure if she can actually go through with it. How should you manage this situation?

Ask the pt if she has developed a suicidal plan

A 78 year old female presents with an acute change in her behavior. The pts son tells you that his mother has type 2 diabetes and was diagnosed with Alzheimer's disease 6 months ago. The pts speech is slurred and she is not alert to her surroundings. You should:

Inquire about the possibility of head trauma

People at risk for suicide include all of the following, EXCEPT:

Married males older than 30 years

Which of the following conditions or factors would be the LEAST likely to result in a change in behavior?

Antihypertensive medications

In addition to ensuring his or her own safety, the EMTs responsibility when caring for a pt with a behavioral emergency is to:

Diffuse and control the situation and safely transport the pt

A 22 year old male with a history of clinical depression called 911 and stated that he has attempted to kill himself. Your unit and law enforcement officers arrive at the scene simultaneously. You find the pt lying supine on the living room floor. He is unconscious and cyanotic. An empty bottle of hydromorphone (Dialaudid) is found on an adjacent table. You should:

Open the pts airway and assess his respirations

It is MOST important for the EMT to remember that suicidal pts may:

Be homicidal as well

Common causes of acute psychotic behavior include all of the following.

Mind altering substance abuse
Intense stress
Schizophrenia

Common causes of acute psychotic behavior include all of the following, EXCEPT:

Alzheimers disease

The term "behavioral crisis" is MOST accurately defined as:

Any reaction that interferes with activities of daily living or is deemed unacceptable by others.

Assessing the blood pressure and oxygen saturation of a pt with a behavioral crisis should be performed:

if doing so will not worsen his or her emotional stress

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 pt has a large body, is clenching his fists, and is yelling obscenities at you. Which of the following findings is LEAST predictive of this pts potential for violence?

His large body

Toxicology is the

study of toxic or poisonous substances

A poison is a

Any substance whose chemical action can damage body structures or impair body function.

activated charcoal

The usual dose for an adult or child is 1 g of activated charcoal per kilogram of body weight. i. 25 to 50 g for adults ii. 12.5 to 25 g for children

(DTs) stand for

delirium tremens

The signs and symptoms of cholinergic drug poisoning are easy to remember with the mnemonic DUMBELS

: . Defecation . Urination Miosis (constriction of the pupils) Bronchorrhea (discharge of mucus from the lungs) emesis Lacrimation (tearing) . Salivation

Organic(physical)

brain syndrome is a temporary or permanent dysfunction of the brain caused by a disturbance in the physical or physiologic functioning of the brain tissue.

functional (psychological).

disorder is one in which the abnormal operation of an organ cannot be traced to an obvious change in the actual structure or physiology of the organ or organ system.

Psychosis is a

state of delusion in which the person is out of touch with reality.

Three concepts of energy are typically associated with injury:

Potential energy
Kinetic energy
Work

Work is defined as force acting over a distance.

Forces that bend, pull, or compress tissues beyond their inherent limits result in the work that causes injury.

Kinetic energy reflects

the relationship between the mass (weight) of the object and the velocity (speech) at which it is traveling.

Blunt trauma is the

result of force to the body that causes injury without penetrating the soft tissues or internal organs and cavities.

Penetrating trauma causes injury by

objects that primarily pierce and penetrate the surface of the body and cause damage to soft tissues, internal organs, and body cavities.

Primary blast injuries

These are due entirely to the blast itself.

Secondary blast injuries

Damage to the body results from being struck by flying debris.

Tertiary blast injuries

The victim is hurled by the force of the explosion, sometimes against a stationary object.

Miscellaneous blast injuries

Burns from hot gases or fires started by the blast
. Respiratory injury from inhaling toxic gases
Crush injury from the collapse of buildings

Organs that contain air,

such as the middle ear, lung, and gastrointestinal tract, are the most susceptible to pressure changes.

The tympanic membrane evolved to detect minor changes in pressure and will rupture at pressures of ?

5 to 7 pounds per square inch above atmospheric pressure.

Solid organs include

liver, spleen, pancreas, and kidneys.

Hollow organs include

stomach, large and small intestines, and urinary bladder.

Air EMS units or critical care transport units are staffed by

critical care nurses and paramedics.

Level I facility

i. Generally serves large cities or heavily populated areas
ii. Provides every aspect of trauma care
iii. Most Level I facilities are university-based teaching hospitals.

Level II facility

i. Located in less population-dense areas
ii. Provides initial definitive care

Level III facility

i. Provides assessment, resuscitation, emergency care, and stabilization
ii. Transfers patients to Level I or Level II facility when necessary

Level IV facility

i. Typically found in remote outlying areas where no higher level of care is available
ii. Provides advanced trauma life support
iii. Transfers to a higher-level trauma center

Bacterial vaginosis is a condition that occurs when:

Normal bacteria in the vagina are replaced by an overgrowth of other bacterial forms

Which of the following clinical presentations is MOST consistant with PID?

Lower abdominal pain, fever, general malaise and fowl smelling vaginal discharge

3. When caring for a female patient who has been sexually assaulted, you should:

Place any bloodstained clothes or other articles in separate paper bags

If a woman with vaginal bleeding reports syncope, the EMT must assume that she:

Is in shock

As a woman approaches menopause:

Her menstrual periods may become irregular and vary in severity

Which of the following statements regarding pelvic inflammatory disease (PID) is correct?

PID can scar the fallopian tubes, which increases the risk of an ectopic pregnancy

Each ovary produces an ovum in alternating months and releases it into the:

Fallopian tube

A 26 year old female presents with heavy vaginal bleeding. She is conscious, but restless. Her blood pressure is
85/43 mm Hg, her pulse is 120 beats/min and weak, and her respirations are 22 breaths/min with adequate
depth. She tells you that she inserted a tampon about 2 hours ago. You should:

administer high flow oxygen, place a sterile pad over her vagina, keep her warm, elevate her lower
extremities, and transport without delay.

When caring for a woman who is experiencing a gynecologic emergency, the EMTs main focus should be to:

Maintain her ABCs and transport without delay

Potentially life threatening consequences of PID include:

Ovarian abscess and ectopic pregnancy

The physical examination of a sexual assault victim should be:

Limited to a brief survey for life threatening injuries

General treatment for a woman with vaginal bleeding and shock following sexual assault includes all of the
following EXCEPT:

Carefully removing any foreign bodies from the vagina

It is not uncommon for you females who experience their first menstrual period to:

Experience abdominal cramping, which may be misinterpreted

Law enforcement personnel request your assistance to assess a 31 year old female who was sexually assaulted.
When you arrive at the scene, you find the pt sitting on a curb outside her apartment. She is conscious, alert,
And crying. When you ask her what happened, she tells you that she does not want to be treated or transported
to the hospital. She further tells you that all she wants to do is clean up. You should:

provide emotional support and visually assess her for obvious trauma

Which of the following conditions does NOT typically present with vaginal discharge

Genital herpes

Which of the following statements regarding gonorrhea is correct?

Painful urination is a common symptom of gonorrhea in men and women

In contrast to bleeding caused by external trauma to the vagina, bleeding caused by conditions such as polyps or cancer:

may be relatively painless

The onset of menstruation is called menarche and usually occurs in women who are:

Between 11 and 16 years of age

When a woman presents with abdominal pain or other vague symptoms, the EMT is often unable to determine
the nature of the problem until he or she:

has gathered pt history information

Which of the following statements regarding rape is correct?

Rape is a legal diagnosis, not a medical diagnosis

Whenever possible, a female sexual assault victim should be:

Given the option of being treated by a female EMT

The perineum is the

the area of skin between the vagina and the anus.

Menopause usually occurs around

age 50 years.

(PID)

Pelvic inflammatory disease

Gonorrhea

Caused by a bacterium.Cervix, uterus, fallopian tubes in women, Urethra in men and women.These symptoms indicate it has progressed to PID.
vi. Untreated, it can enter the bloodstream and spread to other parts of the body, including the brain.

If fertilization of the ovum does not occur within

about 14 days of ovulation,

The brain and spinal cord may last?

4 to 6 minutes without perfusion.

Kidneys may survive

45 minutes.

Skeletal muscles may

last 2 hours.

normal body temperature

(98.6°F [37.0°C])

Hemorrhage

bleeding.

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