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Insulin shock will MOST likely develop if a patient:

takes too much of his or her prescribed insulin

Chronic renal failure is a condition that:

is often caused by hypertension or diabetes

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

Excessive eating caused by cellular "hunger" is called:


Which of the following is characteristic of peptic ulcer disease (PUD)?

burning or pain in the stomach that subsides immediately after eating

Diabetes is MOST accurately defined as a/an:

disorder of carbohydrate metabolism

Functions of the liver include:

production of substances necessary for blood clotting

In contrast to the parietal peritoneum, the visceral peritoneum:

is supplied by nerves of the autonomic nervous system, which are less able to localize pain or sensation.

Which of the following organs would MOST likely bleed profusely if injured?


Patients with thrombophilia are at an increased risk for:

pulmonary embolism

The MOST common and significant complication associated with an acute abdomen is:


Pain that may be perceived at a distant point on the surface of the body, such as the back or shoulder, is called:

referred pain

During your assessment of a 19-year-old male, you are told that he is being treated with factor VIII. This indicates that:

he has hemophilia A

Patients with type 2 diabetes usually control their disease with all of the following, EXCEPT:

supplemental insulin.

Elderly patients with abdominal problems may not exhibit the same pain response as younger patients because of:

age-related deterioration of their sensory systems.

Erosion of the protective layer of the stomach or duodenum secondary to overactivity of digestive juices results in:

an ulcer

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

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

Hemoglobin is:

found within the red blood cells and is responsible for carrying oxygen

When assessing a patient with abdominal pain, you should:

palpate the abdomen in a clockwise direction beginning with the quadrant after the one the patient indicates is painful

Most patients with abdominal pain prefer to:

lie on their side with their knees drawn into the abdomen

Pain that radiates to the right lower quadrant from the umbilical area, nausea and vomiting, and anorexia are MOST indicative of:


In the presence of ileus, the only way the stomach can empty itself is by:


Insulin functions in the body by:

enabling glucose to enter the cells

A 42-year-old male is found unresponsive on his couch by a neighbor. During your assessment, you find no signs of trauma and the patient's blood glucose level is 75 mg/dL. His blood pressure is 168/98 mm Hg, his heart rate is 45 beats/min and bounding, and his respirations are 8 breaths/min and irregular. The patient is wearing a medical alert bracelet that states he has hemophilia. You should:

suspect that he has intracranial bleeding, assist his ventilations, and transport rapidly to an appropriate hospital.

Type 1 diabetes:

is a condition in which no insulin is produced by the body

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.

Pain that is localized to the lower back and/or lower abdominal quadrants is MOST suggestive of:

an aortic aneurysm

Which of the following statements regarding glucose is correct?

The brain requires glucose as much as it requires oxygen

Which of the following statements regarding the acute abdomen is correct?

The initial pain associated with an acute abdomen tends to be vague and poorly localized.

The parietal peritoneum lines the:

walls of the abdominal cavity.

You are dispatched to an apartment complex for a young male with abdominal pain. Your priority upon arriving at the scene should be to:

assess the scene for potential hazards.

You are transporting a 49-year-old male with "tearing" abdominal pain. You are approximately 30 miles away from the closest hospital. During your reassessment, you determine that the patient's condition has deteriorated significantly. You should:

consider requesting a rendezvous with an ALS unit

When obtaining a SAMPLE history from a patient with diabetes, it would be MOST important to determine:

if he or she has had any recent illnesses or excessive stress.

Classic signs and symptoms of hypoglycemia include:

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

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.


Glutose is a trade name for:

oral glucose.

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:


Patients with acute abdominal pain should not be given anything to eat or drink because:

substances in the stomach increase the risk of aspiration

Which of the following statements regarding dialysis is correct?

Patients who miss a dialysis treatment often present with weakness

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

80 and 120 mg/dL.

A 28-year-old female patient is found to be responsive to verbal stimuli only. Her roommate states that she was recently diagnosed with type 1 diabetes and has had difficulty controlling her blood sugar level. She further tells you that the patient has been urinating excessively and has progressively worsened over the last 24 to 36 hours. On the basis of this patient's clinical presentation, you should suspect that she:

is significantly hyperglycemic.

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

they do not always eat correctly and on schedule.

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

rate and depth of breathing

An important aspect in the treatment of a patient with severe abdominal pain is to:

provide emotional support en route to the hospital.

The kidneys help to regulate blood pressure by:

removing sodium, and thus water, from the body.

Peritonitis may result in shock because:

fluid shifts from the bloodstream into body tissues.

Solid abdominal organs include the:

spleen, kidneys, and pancreas

Which of the following organs assists in the filtration of blood, serves as a blood reservoir, and produces antibodies?


Common signs and symptoms of diabetic coma include all of the following, EXCEPT:

cool, clammy skin.

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:

be alert for signs and symptoms of shock.

Diabetic ketoacidosis occurs when:

insulin is not available in the body.

The MOST important treatment for a patient with severe abdominal pain and signs of shock includes:

transporting the patient without delay.

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:

protect her airway from aspiration

Proper procedure for administering oral glucose to a patient includes all of the following, EXCEPT:

ensuring the absence of a gag reflex.

A strangulated hernia is one that:

loses its blood supply due to compression by local tissues.

Glipizide, a non-insulin-type medication, is another name for:


A 59-year-old male presents with a sudden onset of 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:

administer oxygen and prepare for immediate transport

Patients with uncontrolled diabetes experience polyuria because:

excess glucose in the blood is excreted by the kidneys.

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


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.

Which of the following statements regarding diabetic coma is correct?

Diabetic coma typically develops over a period of hours or days.

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:

transport the child to the hospital and reassure the mother en route.

Successful treatment of a stroke depends on whether:

thrombolytic therapy is given within 3 hours after symptoms began.

An area of swelling or enlargement in a weakened arterial wall is called:

an aneurysm

You arrive at a local grocery store approximately 5 minutes after a 21-year-old female stopped seizing. She is confused and disoriented; she keeps asking you what happened and tells you that she is thirsty. Her brother, who witnessed the seizure, tells you that she takes phenytoin (Dilantin) for her seizures, but has not taken it in a few days. He also tells you that she has diabetes. In addition to applying high-flow oxygen, you should:

monitor her airway and breathing status and assess her blood glucose level.

Which of the following conditions would be the LEAST likely to mimic the signs and symptoms of a stroke?


When obtaining medical history information from the family of a suspected stroke patient, it is MOST important to determine:

. when the patient last appeared normal.

During the primary assessment of a semiconscious 70-year-old female, you should:

ensure a patent airway and support ventilation as needed

A 58-year-old male presents with confusion, right-sided weakness, and slurred speech. His wife is present and is very upset. As your partner is applying oxygen, it is MOST important for you to:

ask his wife when she noticed the symptoms.

The MOST significant risk factor for a hemorrhagic stroke is:


You are caring for a 70-year-old female with signs and symptoms of an acute stroke. She is conscious, has secretions in her mouth, and is breathing at a normal rate with adequate depth. You should:

suction her oropharynx and apply 100% oxygen.

You arrive at the residence of a 33-year-old woman who is experiencing a generalized seizure. She has a small amount of vomitus draining from the side of her mouth. After protecting her from further injury, you should:

maintain her airway with manual head positioning, suction her airway to remove the vomitus, insert a nasopharyngeal airway, and administer high-flow oxygen.

A patient without a history of seizures experiences a sudden convulsion. The LEAST likely cause of this seizure is:


Law enforcement has summoned you to a nightclub, where a 22-year-old female was found unconscious in an adjacent alley. Your primary assessment reveals that her respirations are rapid and shallow and her pulse is rapid and weak. She is wearing a medical alert bracelet that identifies her as an epileptic. There is an empty bottle of vodka next to the patient. You should:

assist ventilations, perform a rapid exam, and prepare for immediate transport.

Muscle control and body coordination are controlled by the:


Which of the following is NOT an assessment parameter included in the Cincinnati Prehospital Stroke Scale?


Individuals with chronic alcoholism are predisposed to intracranial bleeding and hypoglycemia secondary to abnormalities in the:


Which of the following conditions would MOST likely affect the entire brain?

respiratory failure or cardiopulmonary arrest

Status epilepticus is characterized by:

prolonged seizures without a return of consciousness

Febrile seizures:

are usually benign but should be evaluated.

You are assessing the arm drift component of the Cincinnati Prehospital Stroke Scale on a 60-year-old woman. When she holds both of her arms out in front of her and closes her eyes, both of her arms immediately fall to her sides. You should:

. repeat the arm drift test, but move the patient's arms into position yourself.

The three major parts of the brain are the:

cerebrum, cerebellum, and brain stem.

Which of the following MOST accurately describes what the patient will experience during the postictal state that follows a seizure?

confusion and fatigue

Interruption of cerebral blood flow may result from all of the following, EXCEPT:

cerebral vasodilation.

The mental status of a patient who has experienced a typical seizure:

is likely to improve over a period of 5 to 30 minutes.

Which of the following clinical signs is MOST suggestive of a ruptured cerebral artery?

sudden, severe headache

A generalized seizure is characterized by:

severe twitching of all the body's muscles.

A patient who is experiencing aphasia is:

unable to produce or understand speech

Which of the following is a metabolic cause of a seizure?


You are assessing a 49-year-old man who, according to his wife, experienced a sudden, severe headache and then passed out. He is unresponsive and has slow, irregular breathing. His blood pressure is 190/94 mm Hg and his pulse rate is 50 beats/min. His wife tells you that he has hypertension and diabetes. He has MOST likely experienced:

a ruptured cerebral artery

The principal clinical difference between a stroke and hypoglycemia is that patients with hypoglycemia:

usually have an altered mental status or decreased level of consciousness.

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.

Activated charcoal administration is contraindicated in patients who have ingested:

acids or alkalis.

You have administered one dose of epinephrine to a 40-year-old female to treat an allergic reaction that she developed after being stung by a scorpion. Your reassessment reveals that she is still having difficulty breathing, has a decreasing mental status, and has a blood pressure of 80/50 mm Hg. You should:

request permission from medical control to give another dose of epinephrine.

The MOST commonly abused drug in the United States is:


Which of the following statements regarding fire ants is correct?

Fire ants often bite a person repeatedly.

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.

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

lateral portion of the thigh

Your paramedic partner administers atropine to a 49-year-old male with bradycardia. Which of the following side effects would you expect the patient to experience?

dry mucous membranes

Which of the following negative effects of anaphylaxis will be the MOST rapidly fatal if not treated immediately?

upper airway swelling

The stinger from a honeybee should be:

scraped away from the skin.

During your assessment of a 50-year-old male who was found unconscious in an alley, you note that he has slow, shallow respirations; significant bradycardia; facial cyanosis; and pinpoint pupils. As your partner begins assisting the patient's ventilations, he directs your attention to the patient's arms, which have multiple needle tracks on them. This patient's clinical presentation is MOST consistent with:

a heroin overdose.

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


Substance abuse is MOST accurately defined as:

knowingly misusing a substance to produce a desired effect.

A hypnotic drug is one that:

induces sleep.

In general, injected poisons are impossible to dilute or remove because they:

are usually absorbed quickly into the body.

Signs and symptoms of a sympathomimetic drug overdose include:


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 73-year-old man presents with a generalized rash, which he thinks may have been caused by an antibiotic that he recently began taking. He has a history of coronary artery disease, hypertension, and emphysema. He is conscious and alert, his blood pressure is 144/94 mm Hg, and his pulse is 64 beats/min and regular. You auscultate his breath sounds and hear scattered wheezing, although he is not experiencing respiratory distress. In addition to administering oxygen, you should:

contact medical control if needed, transport the patient, and monitor him for signs of deterioration.

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

30 minutes

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

vasoconstriction and bronchodilation

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

a 45-year-old male who ingested penicillin

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.

Most poisonings occur via the __________ route.


Which of the following would MOST likely provide clues regarding the source of a patient's allergic reaction?

the environment in which the patient is found

DTs is a syndrome associated with withdrawal from:


An overdose on acetaminophen, the active ingredient in Tylenol, will MOST likely cause:

liver failure.

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

histamines and leukotrienes.

Which of the following statements regarding the Salmonella bacterium is correct?

The Salmonella bacterium itself causes food poisoning.

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).

Hypotension, hypoventilation, and pinpoint pupils would be expected following an overdose of:

oxycodone (Percocet).

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:

seizures and cardiac arrhythmias.

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

10 seconds.

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.

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.

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:


Urticaria is the medical term for:


Heroin is an example of a:


When caring for a known alcoholic patient with severe trauma to the chest and abdomen, you should be concerned that:

internal bleeding may be profuse because prolonged alcohol use may impair the blood's ability to clot.

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.

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.

After administering activated charcoal to a patient, it is MOST important to:

be alert for vomiting.

The major side effect associated with ingestion of activated charcoal is:

black stools.

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

avoid contaminating yourself.

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

0.3, 0.15

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.

Which of the following medications blocks the release of histamines?

diphenhydramine (Benadryl)

The two MOST common signs of anaphylaxis are:

wheezing and widespread urticaria.

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

drying of the eyes.

The usual dose for activated charcoal is up to ______ for a pediatric patient and up to ______ for an adult patient.

25 g, 50 g

Your unit is dispatched to the county jail for an intoxicated inmate. Upon arrival, you find the patient, a 33-year-old male, lying supine in a jail cell. He is responsive to painful stimuli only and has slow, shallow respirations. You should be MOST concerned that this patient:

may vomit and aspirate.

Epinephrine is indicated for patients with an allergic reaction when:

wheezing and hypotension are present.

Anaphylaxis is MOST accurately defined as an:

extreme allergic reaction that may affect multiple body systems.

A poison that enters the body by __________ is the MOST difficult to treat.


Syrup of ipecac is no longer recommended to treat patients who have ingested a poisonous substance because it:

may result in aspiration of vomitus.

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

activated charcoal is given based on a patient's weight.

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

binds to the substance and prevents absorption.

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

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

Atropine sulfate and pralidoxime chloride are antidotes for:

nerve gas agents.

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