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Unlike endocrine hormones, exocrine hormones:
A) are carried to their target organs or cell groups via the blood.
B) reach their targets via a specific duct that opens into an organ.
C) diffuse through intracellular spaces to reach their target organs.
D) move through body water and act upon the cell that secreted them.
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Terms in this set (250)
Unlike endocrine hormones, exocrine hormones:
A) are carried to their target organs or cell groups via the blood.
B) reach their targets via a specific duct that opens into an organ.
C) diffuse through intracellular spaces to reach their target organs.
D) move through body water and act upon the cell that secreted them.
B) reach their targets via a specific duct that opens into an organ.
The movement of water and a dissolved substance from an area of high pressure to an area of low pressure is called:
A) filtration.
B) active transport.
C) facilitated diffusion.
D) passive transport diffusion.
A) filtration.
Acute pulmonary edema:
A) commonly results from right-sided heart failure.
B) results in excess elimination of carbon dioxide.
C) is characterized by progressively worsening dyspnea.
D) impairs oxygen diffusion into the pulmonary capillaries.
D) impairs oxygen diffusion into the pulmonary capillaries.
The tension exerted on a cell due to water movement across the cell membrane is referred to as:
A) osmosis.
B) tonicity.
C) diffusion.
D) active transport.
B) tonicity.
Cerebrospinal fluid and synovial fluid are MOST appropriately classified as ____________ fluids.
A) interstitial
B) intravascular
C) intracellular
D) extracellular
A) interstitial
Cerebrospinal fluid is manufactured in the:
A) subarachnoid space.
B) ventricles of the brain.
C) posterior pituitary gland.
D) anterior pituitary gland.
B) ventricles of the brain.
Changes in the rate and depth of breathing are regulated primarily by the:
A) pH of venous blood.
B) pH of the CSF.
C) saturation of oxygen and hemoglobin.
D) amount of oxygen in the blood plasma.
B) pH of the CSF.
The hypoxic drive is a phenomenon in which:
A) a chronically hypoxic patient's primary respiratory drive is stimulated by increased levels of carbon dioxide in the arterial blood.
B) a relatively large percentage of patients with COPD become acutely apneic after receiving high-flow oxygen.
C) high levels of oxygen rapidly depress a COPD patient's respiratory rate and depth, leading to worsened hypoxia and severe acidosis.
D) bicarbonate ions migrate into the cerebrospinal fluid of a chronically hypoventilating patient, making the brain think that acid and base are in balance.
D) bicarbonate ions migrate into the cerebrospinal fluid of a chronically hypoventilating patient, making the brain think that acid and base are in balance.
Hydrocephalus may occur if:
A) too much cerebrospinal fluid is forced into the spinal canal.
B) cerebrospinal fluid absorption into the bloodstream is reduced.
C) bleeding in the brain causes an increase in intracranial pressure.
D) the brain produces less than 500 mL of cerebrospinal fluid per day.
B) cerebrospinal fluid absorption into the bloodstream is reduced.
Which of the following signs of a basilar skull fracture would MOST likely be observed in the prehospital setting?
A) Battle's sign
B) cerebrospinal fluid drainage from the ear
C) Ecchymosis around the eyes
D) Bruising over the mastoid process
B) cerebrospinal fluid drainage from the ear
The net effect of osmosis is to: A) equalize the amount of water on both sides of the cell membrane. B) shift extracellular fluid to the intracellular and intravascular fluids. C) passively transport a solution to an area of lower solute concentration. D)equalize the concentrations of a solute on both sides of the cell membraneD) equalize the concentrations of a solute on both sides of the cell membrane.When blood osmolarity increases: A) the kidneys excrete more water from the body through diuresis in an attempt to normalize the blood's osmolarity. B) osmoreceptors located in the hypothalamus stimulate the release of vasopressin, which causes the body to retain water. C) the pituitary gland releases antidiuretic hormone (ADH), which stimulates the kidneys to resorb water and decrease the blood's osmolarity. D) volume-sensitive receptors in the atria stretch, causing the release of natriuretic proteins that normalize the blood's osmolarity.C) the pituitary gland releases antidiuretic hormone (ADH), which stimulates the kidneys to resorb water and decrease the blood's osmolarity.When comparing two solutions, the solution that has a higher solute concentration and a higher osmotic pressure is referred to as a(n) __________ solution. A) isotonic B) hypotonic C) hypertonic D) crystalloidC) hypertonicWhat type of pressure is generated by dissolved proteins in the plasma that are too large to penetrate the capillary membrane? A) Capillary hydrostatic pressure B) Tissue hydrostatic pressure C) Capillary colloidal osmotic pressure D) Tissue colloidal osmotic pressureC) Capillary colloidal osmotic pressureThe tension exerted on a cell due to water movement across the cell membrane is referred to as: A) osmosis. B) tonicity. C) diffusion. D) active transport.B) tonicity.The movement of a solute from an area of higher concentration to an area of lower concentration is called: A) osmosis. B) endocytosis. C) exocytosis. D) diffusion.D) diffusion.Osmosis is the movement of a: A) solvent from an area of low solute concentration to one of high concentration. B) solvent from an area of high solute concentration to one of low concentration. C) solute from an area of high solvent concentration to one of low concentration. D) solute from an area of low solvent concentration to one of high concentration.A) solvent from an area of low solute concentration to one of high concentration.The movement of a substance against a concentration or gradient that requires energy is called: A) endocytosis. B) osmotic pressure. C) active transport. D) facilitated diffusion.C) active transport.The brain and spinal cord are connected through a large opening at the base of the skull called the: A) foramen magnum. B) lamboid suture. C) vertebral foramen. D) mastoid process.A) foramen magnum.What is the cribriform plate? A) Superior surface of the cranial vault that protects the cerebrum B) Saddle-shaped depression in the middle of the sphenoid bone C) Opening through which the brainstem passes from the cerebrum D) Horizontal bone through which the olfactory nerve filaments passD) Horizontal bone through which the olfactory nerve filaments passThe reticular activating system is located in the __________ and regulates: A) occipital lobe, sight. B) brainstem, breathing. C) midbrain, consciousness. D) cerebellum, motor function.C) midbrain, consciousness.The diencephalon, a region of the brain, contains which of the following structures? A) Pons and medulla B) Cerebellum and pons C) Medulla and thalamus D) Thalamus and hypothalamusD) Thalamus and hypothalamusWhat portion of the brain is a relay center that filters important signals from routine signals? A) Thalamus B) Prefrontal area C) Hypothalamus D) Temporal lobeA) ThalamusEfferent nerves of the peripheral nervous system are responsible for: A) carrying impulses from the body to the brain. B) sensations such as pain, temperature, and pressure. C) involuntary functions such as breathing and heart rate. D)carrying commands from the brain to the muscles.D) carrying commands from the brain to the muscles.Of the 12 cranial nerves, which 2 do NOT exit from the brainstem? A) Phrenic and vagus B) Olfactory and optic C) Trochlear and abducens D) Hypoglossal and oculomotorThe _______________ is a deep ridge of nerve fibers, which is separated by a layer of dura mater and connects the two cerebral hemispheres. A) cerebral cortex B) corpus collosum C) presynaptic terminal D)coroid plexusThe limbic system, a portion of the cerebrum and diencephalon, contains structures that: A) regulate sleeping and breathing. B) influence emotions and mood. C) control heart rate and blood pressure. D) regulate a person's level of consciousness.B) influence emotions and mood.The respiratory center of the brain is located in the: A) medulla. B) cerebrum. C) cerebellum. D) hypothalamus.A) medulla.The main pacemaker for breathing that is responsible for initiating respiration is called the: A) apneustic center. B) pneumotaxic center. C) dorsal respiratory group. D) ventral respiratory group.C) dorsal respiratory group.Decreases in the PaCO2 result in _____________ pH levels in the respiratory center and a(n) _____________ in ventilation. A) decreased, decrease B) increased, increase C) decreased, increase D) increased, decreaseD) increased, decreaseThe primary respiratory stimulus in a healthy adult is a(n): A) decreased arterial oxygen level. B) increased arterial carbon dioxide level. C) increased pH level of the venous blood. D) decreased venous level of carbon dioxide.B) increased arterial carbon dioxide level.What happens when the PaCO2 of the arterial blood increases? A) pH increases and respirations increase B) pH decreases and respirations decrease C) pH increases and respirations decrease D) pH decreases and respirations increaseD) pH decreases and respirations increaseThe dorsal respiratory group is primarily responsible for: A) motor control of the inspiratory and expiratory muscles. B) decreasing the respiratory rate when the blood pH is above 7.45. C) terminating inspiration in order to prevent pulmonary overexpansion. D) initiating respiration based on information received from the chemoreceptors.D) initiating respiration based on information received from the chemoreceptors.When oxygen does not reach the cell, the cell reverts to: A) anaerobic metabolism and produces lactic acid. B) aerobic metabolism and produces carbon dioxide. C) fat metabolism and begins producing ketoacids. D) anaerobic metabolism and produces bicarbonate.A) anaerobic metabolism and produces lactic acid.When oxygen levels are low or absent, the cells revert to a process of: A) aerobic metabolism. B) anaerobic metabolism. C) anaerobic anabolism. D) aerobic catabolism.B) anaerobic metabolism.Which of the following statements regarding anaerobic metabolism is correct? A) The waste products of anaerobic metabolism are carbon dioxide and water. B) Anaerobic metabolism can be supported in most cells for only 1 to 3 minutes. C) The lactic acid produced by anaerobic metabolism is needed to make energy. D)Anaerobic metabolism is a normal process that occurs in the presence of oxygenB) Anaerobic metabolism can be supported in most cells for only 1 to 3 minutes.All of the following conditions will cause an increase in the circulating levels of carbon dioxide in the blood, EXCEPT: A) lactic acidosis. B) increased metabolism. C) anaerobic metabolism. D) acute hyperventilation.D) acute hyperventilation.Decreases in the PaCO2 result in _____________ pH levels in the respiratory center and a(n) _____________ in ventilation. A) decreased, decrease B) increased, increase C) decreased, increase D) increased, decreaseD) increased, decreaseWhich of the following physiologic responses would you expect to see in a patient with a pH of 7.50? A) Bicarbonate retention B) Increased respirations C) Decreased respirations D) Hydrogen ion excretionC) Decreased respirationsWhat happens when the PaCO2 of the arterial blood increases? A) pH increases and respirations increase B) pH decreases and respirations decrease C) pH increases and respirations decrease D) pH decreases and respirations increaseD) pH decreases and respirations increaseA pH of 7.30 indicates: A) a neutral pH. B) a basic pH. C) alkalosis. D) acidosis.D) acidosis.During an acidotic state, the kidneys attempt to maintain a normal pH by: A) excreting bicarbonate. B) retaining bicarbonate. C) retaining hydrogen ions. D) secreting hydrogen ions.B) retaining bicarbonate.Acid-base balance normally remains in a physiologic pH range of: A) 7.25-7.35. B) 7.35-7.45. C) 7.45-7.55. D) 7.55-8.25.B) 7.35-7.45.The MOST major challenge to pH homeostasis is: A) hyperventilation. B) CO2 elimination. C) acute fluid loss. D) acid production.D) acid production.A hyperventilating patient: A) may be acidotic and is trying to decrease his or her pH level. B) is most effectively treated by administering a sedative drug. C) should rebreathe his or her carbon dioxide to effect resolution. D) presents with tachypnea and marked use of accessory muscles.A) may be acidotic and is trying to decrease his or her pH level.A(n) __________________ agent is used to increase the pH of the serum or urine? A) antacid B) alkalinizing C) anticoagulant D) antihistamineB) alkalinizingA patient who overdosed on heroin and is unconscious with slow, shallow respirations would MOST likely experience: A) increased CO2 retention. B) acute metabolic acidosis. C) excess CO2 elimination. D) a pH well above 7.45.A) increased CO2 retention.During an allergic reaction, basophils release histamines and heparin. What respective roles do these chemicals play? A) Reduce inflammation and facilitate blood clotting B) Increase tissue inflammation and inhibit blood clotting C) Reduce inflammation and inhibit blood clotting D) Reduce tissue inflammation and inhibit blood clottingB) Increase tissue inflammation and inhibit blood clottingForeign material such as bacteria and other microorganisms are engulfed and destroyed by: A) basophils. B) phagocytes. C) eosinophils. D) lymphocytes.B) phagocytes._____________ are the MOST abundant white blood cells, are largely responsible for protecting the body against infection, and are key components of the first response to foreign body invasion. A) Neutrophils B) Eosinophils C) B lymphocytes D) BasophilsA) NeutrophilsWhich of the following statements regarding basophils is correct? A) Basophils release chemicals that destroy parasitic invaders. B) Basophils account for approximately 70% of the leukocytes. C) Basophils travel to the tissues, where they become macrophages. D) Basophils release histamine and other chemicals that dilate blood vessels.D) Basophils release histamine and other chemicals that dilate blood vessels.Unlike basophils, mast cells: A) do not release leukotrienes. B) do not circulate in the blood. C) circulate freely in the bloodstream. D) play a major role in allergic reactions.B) do not circulate in the blood.. ____ antibodies respond in allergic reactions and are located _______. A) IgD, in the lymph and blood B) IgE, on the mast and basophil cells C) IgG, in the blood, lymph, and intestines D) IgA, in tears, saliva, blood, and lymphB) IgE, on the mast and basophil cellsWhat is the function of the lymphatic system? A) Prevention of viruses from entering the body B) Filtration of debris and bacteria from the blood C) Production of antibodies that destroy bacteria D) Secretion of hormones to regulate other body functionsB) Filtration of debris and bacteria from the bloodThe chemical mediators that initiate and maintain the immune response are: A) heparin and T cells. B) basophils and mast cells. C) macrophages and cytokines. D) eosinophils and neutrophils.B) basophils and mast cells.Which of the following organs contain(s) the greatest number of lymphocytes? A) Liver B) Pancreas C) Spleen D) KidneysC) SpleenThe chief white blood cell of the immune response is the: A) lymphocyte. B) neutrophil. C) monocyte. D) eosinophil.A) lymphocyte.After T lymphocytes leave the bone marrow, they mature in the: A) thymus gland. B) lymph nodes. C) hypothalamus. D) liver and spleen.A) thymus gland._____________ are the MOST abundant white blood cells, are largely responsible for protecting the body against infection, and are key components of the first response to foreign body invasion. A) Neutrophils B) Eosinophils C) B lymphocytes D) BasophilsA) NeutrophilsB lymphocytes produce antibodies when they are activated by: A) mast cells. B) eosinophils. C) helper T cells. D) phagocytes.C) helper T cells.The primary component of the immune system is the: A) leukocyte. B) neutrophil. C) eosinophil. D) lymphocyte.A) leukocyte.In contrast to chronic leukemia, acute leukemia occurs when: A) bone marrow is replaced with abnormal lymphoblasts. B) abnormal lymphoid cells accumulate in the bone marrow. C) the patient experiences easy bruising and frequent bleeding. D)mutated fibroblasts rapidly accumulate in the circulatory systemA) bone marrow is replaced with abnormal lymphoblasts.Which of the following is NOT a type of white blood cell? A) Eosinophil B) Neutrophil C) Granulocyte D) HistamineD) HistamineEnlargement of the left ventricle due to chronically elevated blood pressure is called: A) atrophy. B) dysplasia. C) hyperplasia. D) hypertrophy.D) hypertrophy.An alteration in the size, shape, and organization of cells is called: A) atrophy. B) metaplasia. C) dysplasia. D) hypertrophy.C) dysplasia.The heart hypertrophies with age, MOST likely in response to: A) a progressive increase in preload and chronic myocardial stretching. B) left-sided heart failure that results in chronic pulmonary hypertension. C) a chronically increased afterload caused by arteriosclerotic blood vessels. D) a significant decline in cardiac output due to a reduction in stroke volume.C) a chronically increased afterload caused by arteriosclerotic blood vessels.Which of the following describes the shock position? A) The head and torso are supine and the legs are elevated 6" to 12". B) The head is elevated at a 45° angle and the legs are elevated 8". C) The body is supine with the head down and the legs elevated. D) The body is laterally recumbent and the head is lowered.A) The head and torso are supine and the legs are elevated 6" to 12".In response to shock or stress, sympathetic nervous system stimulation causes: A) vasoconstriction. B) slowing of the heart rate. C) increased gastrointestinal function. D) shunting of blood to the body's periphery.vasoconstrictionThe MOST common cause of cardiogenic shock is: A) untreated hypertension. B) blunt force chest trauma. C) acute myocardial infarction. D) sustained pulmonary hypertension.C) acute myocardial infarction.What type of shock occurs when blood flow becomes blocked in the heart or great vessels? A) Cardiogenic B) Peripheral C) Distributive D) ObstructiveD) ObstructiveThe MOST common type of exogenous hypovolemic shock is: A) severe diarrhea. B) internal hemorrhage. C) excess plasma loss. D) external bleeding.D) external bleeding.Which of the following occurs during compensated shock? A) Cerebral hypoperfusion causes pupillary constriction B) Increased rate of breathing causes respiratory alkalosis C) Urine output decreases to less than 20 mL/hour D) Vasomotor failure leads to a drop in systolic blood pressureIncreasedDistributive shock occurs when: A) central vasoconstriction forces blood from the core of the body. B) blood pools in expanded vascular beds and tissue perfusion decreases. C) microorganisms attack the blood vessels, resulting in vasodilation. D) a significant decrease in cardiac contractility causes decreased perfusion.B) blood pools in expanded vascular beds and tissue perfusion decreases.Anaphylactic shock is characterized by: A) labored breathing and hypertension. B) wheezing and widespread vasodilation. C) intracellular hypovolemia and hives. D) a deficiency of circulating histamines.B) wheezing and widespread vasodilation.A loss of normal sympathetic nervous system tone causes: A) neurogenic shock. B) obstructive shock. C) profound vasoconstriction. D) a reduced absolute blood volume.A) neurogenic shock.In decompensated shock, systolic blood pressure is: A) less than 90 mm Hg in adult males. B) less than 80 mm Hg in adult females. C) less than the fifth percentile for the age. D) usually undetectable due to vasodilation.C) less than the fifth percentile for the age.Which of the following is the BEST indicator of tissue perfusion during compensated shock? A) Systolic blood pressure B) Pulse rate and quality C) Skin color and condition D) Level of responsivenessD) Level of responsiveness. When an adult patient with hemorrhagic shock loses more than 40% of his or her blood volume: A) blood flow is diverted away from the skin to the liver, kidneys, and lungs. B) cardiovascular deterioration cannot be reversed by compensatory mechanisms. C) vital organ damage can be repaired if a blood transfusion is started promptly. D) immediate IV fluid replacement can rapidly restore adequate tissue perfusion.B) cardiovascular deterioration cannot be reversed by compensatory mechanisms.Fibrinolysis may be contraindicated in all of the following, EXCEPT: A) major trauma or surgery within the past 4 weeks. B) a history of structural central nervous system disease. C) a history of anaphylactic shock caused by salicylates. D) significant closed head trauma within the past 3 weeks.C) a history of anaphylactic shock caused by salicylates.Epinephrine is used to treat patients in anaphylactic shock because of its effects of: A) vasodilation and bronchoconstriction. B) bronchodilation and vasoconstriction. C) increased heart rate and automaticity. D) parasympathetic nervous system blockade.B) bronchodilation and vasoconstriction.Cardiogenic shock occurs when: A) blood backs up into the pulmonary circulation. B) more than 40% of the left ventricle has infarcted. C) left ventricular ejection fraction is less than 50%. D) any condition causes an increase in atrial preload.B) more than 40% of the left ventricle has infarcted.A patient with cardiogenic shock and pulmonary edema should be positioned: A) in the Trendelenburg position. B) in a semi-Fowler's position. C) supine with the legs elevated. D) in a lateral recumbent position.B) in a semi-Fowler's position.A patient in cardiogenic shock without cardiac arrhythmias will benefit MOST from: A) supplemental oxygen. B) a high-dose vasopressor infusion. C) a 250-mL bolus of a crystalloid solution. D) rapid transport to an appropriate hospital.D) rapid transport to an appropriate hospital.Infants and children in shock: A) typically become hypotensive sooner than adults because of a relative decrease in total blood volume. B) generally remain alert for longer periods than adults despite a significant decrease in cerebral perfusion. C) compensate more efficiently than adults by increasing heart rate and peripheral vascular resistance. D) maintain end-organ perfusion longer than adults, making capillary refill time a less reliable perfusion indicator.C) compensate more efficiently than adults by increasing heart rate and peripheral vascular resistance.A patient in shock due to internal bleeding will benefit MOST from: A) oxygen and thermal management. B) limited scene time and rapid transport. C) a comprehensive physical examination. D) two large-bore IV lines of normal saline.B) limited scene time and rapid transport.A patient with quiet tachypnea is MOST likely experiencing: A) shock. B) asthma. C) alkalosis. D) airway swelling.A) shock.Patients with trismus often require: A) premedication with lidocaine before being intubated. B) hyperventilation to reduce severe intracranial pressure. C) sedation or chemical paralysis to facilitate airway control. D) immediate tracheal intubation before the airway swells shut.C) sedation or chemical paralysis to facilitate airway control.In contrast to patients in shock, patients with increased intracranial pressure MOST often experience: A) systolic hypotension. B) an increased diastolic blood pressure. C) a widened pulse pressure. D) tachycardia and tachypnea.C) a widened pulse pressure.A vagus nerve-mediated form of cardiogenic shock without compensatory vasoconstriction that may be seen following a blast injury would MOST likely present with: A) syncope and hypertension. B) hypertension and bradycardia. C) hypotension and tachycardia. D) bradycardia and hypotension.D) bradycardia and hypotension.A patient with hemorrhagic shock would be expected to have: A) warm, flushed skin. B) flattened jugular veins. C) a widened pulse pressure. D) an increased hematocrit.B) flattened jugular veins.Which of the following injuries or mechanisms would MOST likely lead to nonhemorrhagic shock? A) Fractures B) Blunt trauma C) Hemothorax D) Severe burnsD) Severe burnsWhich of the following types of medication would MOST likely reduce a patient's ability to compensate when in shock? A) Tricyclic antidepressants B) Calcium channel blockers C) Nasal decongestants D) Beta-2 adrenergic agonistsB) Calcium channel blockersIn contrast to a patient with compensated shock, a patient with decompensated shock would be expected to present with: A) polyuria and weak pulses. B) bounding radial pulses. C) mottled skin and dilated pupils. D) restlessness and pale cool skin.C) mottled skin and dilated pupils.When caring for an infant or child who is in compensated shock, you should: A) intubate at the earliest sign of altered mentation. B) administer a 10-mL/kg normal saline fluid bolus. C) assist ventilations to improve tissue oxygenation. D)establish IV or IO access en route to the hospitalD) establish IV or IO access en route to the hospital.. Distributive shock in children is MOST often the result of: A) sepsis. B) spinal injury. C) heart failure. D) anaphylaxis.A) sepsis.. A child in decompensated shock with hypotension should: A) be intubated to protect his or her airway. B) receive initial fluid resuscitation at the scene. C) be given 25% dextrose to prevent hypoglycemia. D) receive volume expansion with 5% dextrose in water.B) receive initial fluid resuscitation at the scene.. Early distributive shock in children is characterized by: A) warm, flushed skin. B) weak peripheral pulses. C) pallor and diaphoresis. D) gross neurologic deficits.A) warm, flushed skin.A child in anaphylactic shock: A) should receive 0.1 mg/kg of epinephrine IM. B) is treated primarily with saline fluid boluses. C) may require a low-dose epinephrine infusion. D) should receive epinephrine 1:1,000 via the IV route.C) may require a low-dose epinephrine infusion.Unlike other types of shock, a child in cardiogenic shock would MOST likely present with: A) an enlarged spleen. B) unlabored tachypnea. C) increased work of breathing. D) a primary cardiac dysrhythmia.C) increased work of breathing.. You should be MOST suspicious for cardiogenic shock in an infant or child if: A) he or she appears listless or lethargic. B) his or her heart rate varies with activity. C) his or her heart rate is greater than 150 beats/min. D) perfusion decreases following a fluid bolus.D) perfusion decreases following a fluid bolus.Which of the following types of shock is caused by poor blood vessel function?A) SepticWhich of the following conditions poses the LEAST risk for shock due to vaginal bleeding? A) Metrorrhagia B) Dysmenorrhea C) Polymenorrhea D) Hypermenorrhea Ans: BB) DysmenorrheaWhich of the following statements regarding endometritis is correct? A) Untreated endometritis may result in septic shock. B) Endometritis is defined as an enlargement of the uterus. C) Endometritis is most commonly caused by an intrauterine device. D) Endometritis results when endometrial tissue grows outside the uterus.A) Untreated endometritis may result in septic shock.The MOST important aspect in the care of a woman with severe vaginal bleeding is: A) controlling the vaginal bleeding. B) administering crystalloid fluid boluses. C) giving oxygen via nonrebreathing mask. D) treating for shock and transporting rapidly.A) Untreated endometritis may result in septic shock.The MOST important aspect in the care of a woman with severe vaginal bleeding is: A) controlling the vaginal bleeding. B) administering crystalloid fluid boluses. C) giving oxygen via nonrebreathing mask. D) treating for shock and transporting rapidly.D) treating for shock and transporting rapidly.The paramedic's MAIN goal in treating a patient with shock is to: A) administer oxygen in a concentration sufficient to maintain an oxygen saturation greater than 95%. B) start two large-bore IV lines and infuse enough isotonic crystalloid solution to maintain adequate tissue perfusion. C) recognize the signs and symptoms of shock in its earliest phase and begin immediate treatment before permanent damage occurs. D) maintain body temperature and elevate the patient's legs 6 to 12 inches in order to improve blood flow to the core of the body.C) recognize the signs and symptoms of shock in its earliest phase and begin immediate treatment before permanent damage occurs.. Etomidate should be avoided as an induction agent in pediatric intubation in the presence of: A) hypovolemia. B) tachycardia. C) hypotension. D) septic shock.D) septic shock.Decompensated shock in the adult is characterized by: A) increased tidal volume. B) bounding radial pulses. C) 15% blood loss or more. D) a falling blood pressure.D) a falling blood pressure.Which of the following signs would you MOST likely observe in a patient with compensated shock? A) Anxiety or agitation B) Dilation of the pupils C) Absent peripheral pulses D) Response to painful stimuliA) Anxiety or agitationBurn shock is caused by: A) a massive infection that occurs when microorganisms breach burned skin. B) renal failure secondary to excess myoglobin production from burned muscle. C) fluid loss across damaged skin and volume shifts within the rest of the body. D) acute dehydration, and it commonly manifests within 30 minutes after the burn.C) fluid loss across damaged skin and volume shifts within the rest of the body.If an acutely burned patient is in shock in the prehospital setting: A) it is likely that he or she is experiencing burn shock. B) you should look for another injury as the source of shock. C) administer a 250-mL bolus of normal saline and reassess. D) avoid IV fluids unless the systolic BP is below 80 mm Hg.B) you should look for another injury as the source of shock.Signs of neurogenic shock include all of the following, EXCEPT: A) bradycardia. B) flushed skin. C) diaphoresis. D) hypothermia.C) diaphoresis.Which of the following assessment findings is MOST suggestive of intraabdominal hemorrhage? A) Signs of shock B) Palpable pain C) Diffuse tenderness D) Nausea and vomitingA) Signs of shockTreatment for a patient with neurogenic shock may include all of the following, EXCEPT: A) a vagolytic medication. B) a vasopressor medication. C) prevention of hyperthermia. D) fluid volume to maintain perfusion.C) prevention of hyperthermia.Spinal cord injuries that cause neurogenic shock generally produce: A) cool, clammy skin distal to the site of the spinal cord injury. B) reflex tachycardia due to sympathetic nervous system stimulation. C) flaccid paralysis and complete loss of sensation distal to the injury. D) signs and symptoms that are identical to those of hypovolemic shock.C) flaccid paralysis and complete loss of sensation distal to the injury.A robbery suspect was shot once in the left anterior chest by law enforcement personnel when he pulled a gun on them. The patient is exhibiting obvious signs of shock, is in significant respiratory distress, and is coughing up blood. Further assessment reveals collapsed jugular veins and absent breath sounds over the left hemithorax. After covering the gunshot wound with the appropriate dressing, you should: A) perform a needle thoracentesis to the left side of the chest, initiate rapid transport, and administer 20-mL/kg fluid boluses en route. B) administer 100% oxygen, administer 1 to 2 L of normal saline, and transport to a trauma center for an emergency pericardiocentesis. C) provide oxygenation and ventilation support, transport at once, and maintain adequate perfusion with IV fluids while en route to a trauma center. D) ventilate the patient with a demand valve, transport to a trauma center, and run two large-bore IV lines wide open while en route to the hospital.C) provide oxygenation and ventilation support, transport at once, and maintain adequate perfusion with IV fluids while en route to a trauma center.Cardiac arrest following an electrical shock: A) typically presents as pulseless atrial fibrillation or atrial flutter. B) is most often caused by an electrical current stronger than 1 ampere. C) may occur secondarily from hypoxia or as a direct result of the shock. D) is typically of short duration and is often reversed with 2 minutes of CPR.C) may occur secondarily from hypoxia or as a direct result of the shock.. In trauma patients with shock, hypothermia: A) decreases internal hemorrhage. B) enhances the shivering response. C) facilitates the process of hemostasis. D) interferes with the coagulation of blood.D) interferes with the coagulation of blood.. It is important to remember that blood pressure is only one component in the overall assessment of a child because: A) it is an unreliable measurement of perfusion in all children. B) hypotension is seen much earlier in children than in adults. C) blood pressure may remain adequate in compensated shock. D) it generally yields a falsely low reading in agitated children.C) blood pressure may remain adequate in compensated shock.In addition to IV fluids, treatment for a patient in neurogenic shock may include: A) atropine. B) amiodarone. C) epinephrine 1:1,000. D) low-dose dopamine.B) amiodarone.. An adult patient presents with a blood pressure of 78/60 mm Hg, a pulse rate of 120 beats/min and irregular, and labored breathing. Further assessment reveals pale, cool, moist skin and diffuse crackles in all lung fields. You should suspect: A) septic shock. B) neurogenic shock. C) hypovolemic shock. D) cardiogenic shock.D) cardiogenic shock.Which of the following hemodynamic parameters decreases, regardless of the etiology of the shock? A) Pulse rate B) Mean arterial pressure C) Central venous pressure D) Peripheral vascular resistanceB) Mean arterial pressure. When administering IV fluid boluses to an elderly patient in shock, it is especially important to monitor his or her: A) lung sounds. B) mental status. C) pulse rate. D) blood pressure.A) lung sounds.. Which of the following solutions is preferred for fluid resuscitation of a patient in shock in the prehospital setting? A) Dextran or Plasmanate B) Isotonic crystalloid C) Hypertonic saline D) Dextrose in waterB) Isotonic crystalloidWhich of the following is a disadvantage of using a crystalloid solution when treating a patient with hemorrhagic shock? A) They cause platelets to clump together. B) They do not expand the circulating volume. C) They do not have oxygen-carrying capacity. D) They increase the viscosity of the blood.C) They do not have oxygen-carrying capacity.Which of the following assessment findings should increase your index of suspicion for obstructive shock? A) Low blood pressure B) Jugular venous distention C) Increased lung compliance D) Generalized edemaB) Jugular venous distention. Intrinsic causes of cardiogenic shock include: A) pleural effusion. B) cardiomyopathy. C) pulmonary embolus. D) tension pneumothorax.B) cardiomyopathy.. Which of the following is the MOST accurate definition of distributive shock? A) Widespread dilation of the resistance and capacitance vessels B) Decreased perfusion due to sympathetic nervous system failure C) Sustained constriction of the small venules and small arterioles D) Shunting of blood from the periphery to the body's vital organsA) Widespread dilation of the resistance and capacitance vessels. By which of the following mechanisms do patients with septic shock become hypovolemic? A) Sustained systemic vascular dilation B) Fluid leakage out of the vascular space C) Spontaneous destruction of red blood cells D) Frequent and severe vomiting and diarrheaB) Fluid leakage out of the vascular spaceWhich of the following clinical signs would differentiate septic shock from hypovolemic shock? A) Severe hypotension B) Altered mental status C) Weak, thready pulse D) Warm or hot skinD) Warm or hot skinRelative bradycardia during neurogenic shock occurs because: A) systemic venous pooling of the blood overstimulates the vagus nerve. B) the parasympathetic nervous system does not release acetylcholine. C) the sympathetic nervous system is not stimulated to release catecholamines. D) the brainstem does not receive messages to increase the heart rate.C) the sympathetic nervous system is not stimulated to release catecholamines.A characteristic sign of neurogenic shock caused by a spinal injury is: A) pink, warm, dry skin above the level of the injury. B) an absence of sweating below the level of the injury. C) a reflex tachycardia secondary to vascular dilation. D) irregular breathing secondary to brainstem insult.B) an absence of sweating below the level of the injury.The negative target-organ effects of anaphylactic shock are reversed with: A) epinephrine. B) methylprednisolone. C) diphenhydramine. D) low-dose dopamine.A) epinephrine.. Hypotension during anaphylactic shock is caused primarily by: A) vascular damage. B) relative hypovolemia. C) cardiac muscle injury. D) capillary leakage.B) relative hypovolemia.. A young woman experiences a sudden nervous system reaction that produces temporary, generalized vasodilation and causes her to faint. This is MOST descriptive of _____________ shock A) neurogenic B) obstructive C) psychogenic D) hypovolemicC) psychogenicThe chief clinical manifestation of Addisonian crisis is: A) shock. B) dehydration. C) lower back pain. D) an elevated temperature.A) shock.. Signs of neurogenic shock include all of the following, EXCEPT: A) bradycardia. B) flushed skin. C) diaphoresis. D) hypothermia.C) diaphoresis.. Hypotension that is associated with neurogenic shock is the result of: A) loss of alpha receptor stimulation. B) concomitant internal hemorrhage. C) increased peripheral vascular tone. D) profound peripheral vasoconstriction.A) loss of alpha receptor stimulation.Treatment for a patient with neurogenic shock may include all of the following, EXCEPT: A) a vagolytic medication. B) a vasopressor medication. C) prevention of hyperthermia. D) fluid volume to maintain perfusion.C) prevention of hyperthermia.Spinal cord injuries that cause neurogenic shock generally produce: A) cool, clammy skin distal to the site of the spinal cord injury. B) reflex tachycardia due to sympathetic nervous system stimulation. C) flaccid paralysis and complete loss of sensation distal to the injury. D) signs and symptoms that are identical to those of hypovolemic shock.C) flaccid paralysis and complete loss of sensation distal to the injury.A vagus nerve-mediated form of cardiogenic shock without compensatory vasoconstriction that may be seen following a blast injury would MOST likely present with: A) syncope and hypertension. B) hypertension and bradycardia. C) hypotension and tachycardia. D) bradycardia and hypotension.D) bradycardia and hypotension.. What physiologic effect of anaphylactic shock is seen MOST commonly in patients with neurogenic shock? A) Profound tachycardia B) Decreased cardiac contractility C) Widespread vasodilation D) Fluid leakage into the tissuesC) Widespread vasodilationThe MOST ominous respiratory sign in a patient with anaphylactic shock is: A) diminished lung sounds. B) loud expiratory wheezing. C) diffuse coarse crackles. D) labored tachypnea.A) diminished lung sounds.Which of the following general statements regarding anaphylactic shock is correct? A) In order to provide appropriate treatment, you must first determine what caused the allergic reaction. B) In the presence of anaphylaxis, intervention takes precedence over identifying the offending antigen. C) Anaphylactic shock would most likely occur following initial exposure to an offending antigen. D) Most patients who carry a prescribed EpiPen are not completely aware of what substances they are allergic to.B) In the presence of anaphylaxis, intervention takes precedence over identifying the offending antigen.. Adults in anaphylactic shock should receive the ________ concentration of epinephrine via the ____ route in a dose of ____ mg. A) 1:1,000, IM, 1 B) 1:1,000, IV, 0.5 C) 1:10,000, IV, 0.1 D) 1:10,000, IM, 0.5C) 1:10,000, IV, 0.1A patient in shock due to internal bleeding will benefit MOST from: A) oxygen and thermal management. B) limited scene time and rapid transport. C) a comprehensive physical examination. D) two large-bore IV lines of normal saline.B) limited scene time and rapid transport.. If an adult patient is in hypovolemic shock, you should attempt to insert a(n) ______ over-the-needle catheter into the _______. A) 14-gauge, antecubital vein B) 16-gauge, metacarpal vein C) 14-gauge, metacarpal vein D) 18-gauge, external jugular veinA) 14-gauge, antecubital vein. In hypovolemic shock, lactated Ringer's solution should be: A) mixed with normal saline solution. B) titrated to the patient's physiologic response. C) given until a systolic BP of 110 mm Hg is achieved. D) avoided if the patient's shock is caused by blood loss.B) titrated to the patient's physiologic response.How does the body respond to hypoperfusion? A) Decreased preload, stroke volume, and heart rate B) Catecholamine release and increased systemic vascular resistance C) Splenic retention of red blood cells secondary to systemic hypoxia D) A compensatory decrease in cardiac output and cardiac oxygen demandB) Catecholamine release and increased systemic vascular resistanceThe term perfusion is BEST defined as: A) the production of waste products from metabolism. B) effective exchange of O2 and CO2 in the lungs. C) adequate circulation of blood to the body's cells. D) sufficient removal of waste products from the body.C) adequate circulation of blood to the body's cells.A pulse oximetry reading would be LEAST accurate in a patient: A) with chronic hypoxia. B) whose extremities are cool. C) with persistent tachycardia. D) with poor peripheral perfusion.D) with poor peripheral perfusion.. What is "warm ischemic time"? A) The period of time that organs and tissues can survive without perfusion, assuming a normal body temperature B) The preservation of ischemic organs and tissues when the patient's body temperature is reduced by 1°F per hour C) The period of time in which perfusion can be restored to ischemic organs and tissues before permanent damage occurs D) The preservation of ischemic organs and tissues when the patient's body temperature is increased to at least 101°FA) The period of time that organs and tissues can survive without perfusion, assuming a normal body temperature. Perfusion is defined as: A) the effective exchange of oxygen and carbon dioxide within the lungs and at the cellular level. B) the circulation of blood through an organ or tissue in amounts adequate to meet the body's demands. C) an ejection fraction that is adequate to maintain radial pulses or a systolic blood pressure of at least 90 mm Hg. D) the circulation of an adequate volume of blood to ensure uninterrupted cerebral and myocardial oxygenation.B) the circulation of blood through an organ or tissue in amounts adequate to meet the body's demands.Which of the following organs can sustain the longest period of inadequate perfusion? A) Gastrointestinal tract B) Kidneys C) Spinal cord D) Skeletal muscleA) Gastrointestinal tractPerfusion is defined as: A) the effective exchange of oxygen and carbon dioxide within the lungs and at the cellular level. B) the circulation of blood through an organ or tissue in amounts adequate to meet the body's demands. C) an ejection fraction that is adequate to maintain radial pulses or a systolic blood pressure of at least 90 mm Hg. D) the circulation of an adequate volume of blood to ensure uninterrupted cerebral and myocardial oxygenation.B) the circulation of blood through an organ or tissue in amounts adequate to meet the body's demands.Which of the following organs can sustain the longest period of inadequate perfusion? A) Gastrointestinal tract B) Kidneys C) Spinal cord D) Skeletal muscleA) Gastrointestinal tractWhich of the following components represent the perfusion triangle? A) Red blood cells and oxygen B) Heart, blood, blood vessels C) Oxygen, lungs, red blood cells D) Organs, oxygen, carbon dioxideB) Heart, blood, blood vessels. Circulation of blood within an organ or tissue in adequate amounts to meet the cells' current needs is called: A) perfusion. B) respiration. C) oxygenation. D) metabolism.A) perfusion.. Tissue perfusion is primarily a function of the: A) endocrine system. B) cardiovascular system. C) respiratory system. D) peripheral nervous system.B) cardiovascular system.In the context of cardiac compromise, syncope occurs due to: A) an increase in vagal tone. B) a drop in cerebral perfusion. C) a sudden cardiac dysrhythmia. D) an acute increase in heart rate.B) a drop in cerebral perfusion.An organ or tissue that is considerably colder than 98.6°F is better able to resist damage from hypoperfusion because: A) the body's metabolic rate is slower. B) cells shrink as body temperature falls. C) hypothermia promotes oxygen metabolism. D) hypothermia protects hemoglobin molecules.A) the body's metabolic rate is slower.Under normal conditions, the renin-angiotensin system functions by: A) dilating the systemic vasculature and reducing cardiac afterload when arterial blood pressure increases. B) stimulating alpha-1 receptors, thereby increasing the blood pressure in response to acute blood loss. C) blocking alpha-2 receptors, thereby increasing the release of norepinephrine and raising blood pressure. D) promoting vasoconstriction and fluid retention in response to hypotension or hypoperfusion.D) promoting vasoconstriction and fluid retention in response to hypotension or hypoperfusion.Which of the following is a normal response of the body to hypoperfusion? A) Antidiuretic hormone is released by the pituitary gland. B) Vasodilation causes increased blood flow to the kidneys. C) Sodium and water are excreted to maintain the blood's pH. D) Peripheral vasoconstriction preserves blood flow to the skin.A) Antidiuretic hormone is released by the pituitary gland.Which of the following is a normal response of the body to hypoperfusion? A) Antidiuretic hormone is released by the pituitary gland. B) Vasodilation causes increased blood flow to the kidneys. C) Sodium and water are excreted to maintain the blood's pH. D) Peripheral vasoconstriction preserves blood flow to the skin.A) Antidiuretic hormone is released by the pituitary gland.Which of the following is the BEST indicator of tissue perfusion during compensated shock? A) Systolic blood pressure B) Pulse rate and quality C) Skin color and condition D) Level of responsivenessD) Level of responsivenessThe skin becomes _________ when red blood cell perfusion to the capillary beds of the skin is poor. A) pale B) flushed C) cyanotic D) mottledA) paleExamples of steroid hormones are: A) epinephrine and prolactin. B) cortisol and testosterone. C) oxytocin and growth hormone. D) norepinephrine and antidiuretic hormone.B) cortisol and testosterone.Adrenal insufficiency is characterized by decreased function of the ______________ and consequent underproduction of ______________. A) adrenal glands, catecholamines B) adrenal medulla, norepinephrine C) adrenal cortex, cortisol and aldosterone D) adrenal glands, epinephrine and norepinephrineC) adrenal cortex, cortisol and aldosteroneThe primary role of cortisol is to: A) maintain an adequate blood pressure. B) assist with the body's response to stress. C) regulate the metabolism of carbohydrates. D) decrease the body's inflammatory response.B) assist with the body's response to stress.Which of the following statements regarding Addison disease is MOST correct? A) Addison disease most often occurs when the immune system creates antibodies that attack and destroy the adrenal cortex. B) Addison disease is also known as secondary adrenal insufficiency and is most often the result of a viral infection. C) The signs and symptoms of Addison disease are a direct result of the overproduction of cortisol and aldosterone. D) Hallmark signs of Addison disease are hypertension and fluid retention that result from excess sodium reabsorption.A) Addison disease most often occurs when the immune system creates antibodies that attack and destroy the adrenal cortex.In contrast to primary adrenal insufficiency, secondary adrenal insufficiency is caused by: A) idiopathic atrophy of both of the adrenal glands that results in a deficiency of all the steroid hormones they secrete. B) adrenal gland destruction caused by tuberculosis; viral, bacterial, or fungal infections; or cancer of the adrenal gland. C) acute hypertension and overhydration due to excess sodium reabsorption. D) decreased cortisol secretion secondary to a lack of adrenocorticotropic hormone secretion from the pituitary gland. Ans: DD) decreased cortisol secretion secondary to a lack of adrenocorticotropic hormone secretion from the pituitary gland.The most common solvent in the body, in which solutes or other substances will dissolve, is: A) blood. B) water. C) plasma. D) bile.B) water.When comparing two solutions, the solution that has a higher solute concentration and a higher osmotic pressure is referred to as a(n) __________ solution. A) isotonic B) hypotonic C) hypertonic D) crystalloidC) hypertonicLactated Ringer's is a(n) __________ solution because its solute concentration is equal to that of the inside of the cell. A) colloid B) isotonic C) hypotonic D) crystalloidB) isotonicThe tension exerted on a cell due to water movement across the cell membrane is referred to as: A) osmosis. B) tonicity. C) diffusion. D) active transport.B) tonicity.A patient with kidney or liver failure would MOST likely develop: A) severe dehydration. B) an increase in isotonic fluid. C) cellular shrinkage and death. D) excessive hypertonic fluid levels.B) an increase in isotonic fluid.. Lactated Ringer's (LR) solution should not be given to patients with liver problems because: A) LR is a hypertonic solution and cannot be metabolized by the liver. B) the lactate contained within LR can cause necrosis of the liver tissue. C) patients with liver disease commonly experience renal insufficiency. D) the liver cannot metabolize the lactate in the solution.D) the liver cannot metabolize the lactate in the solution.. Lactated Ringer's (LR) solution may be beneficial to patients who have lost large amounts of blood because: A) it takes less LR to effectively expand the intravascular compartment than any other isotonic solution. B) LR has the ability to carry oxygen and can maintain cellular perfusion until the patient receives definitive care. C) the lactate contained within LR is converted to bicarbonate in the liver and can help combat intracellular acidosis. D) the likelihood of causing acute circulatory overload is minimal relative to other hypertonic solutions.C) the lactate contained within LR is converted to bicarbonate in the liver and can help combat intracellular acidosis.A hypertonic solution has an osmolarity higher than that of serum, meaning that the solution: A) may cause the cells to expand and rupture due to the increased intracellular osmotic pressure exerted by the solution. B) has more ionic concentration than serum and pulls fluid and electrolytes from the intracellular and interstitial compartments into the intravascular compartment. C) contains high concentrations of proteins and can result in fluid overloading in patients with impaired cardiac function or renal insufficiency. D) has a lower ionic concentration than serum and pulls fluid and electrolytes from the intravascular compartment into the intracellular and interstitial compartments.B) has more ionic concentration than serum and pulls fluid and electrolytes from the intracellular and interstitial compartments into the intravascular compartment.Dextran is classified as a(n): A) natural colloid. B) isotonic crystalloid. C) artificial colloid. D) hypertonic crystalloid.C) artificial colloid.A 30-year-old woman presents with 3 days of generalized weakness, dizziness, and excessive urination. She is conscious but restless, and she tells you that she is extremely thirsty. Her blood pressure is 96/66 mm Hg, her pulse is 110 beats/min and full, and her respirations are increased and somewhat deep. On the basis of this patient's clinical presentation, she will MOST likely require oxygen and: A) 25 g of 50% dextrose. B) in-hospital antibiotics. C) 0.5 to 1 mg of glucagon. D) crystalloid fluid hydration.D) crystalloid fluid hydration.In hypovolemic shock, lactated Ringer's solution should be: A) mixed with normal saline solution. B) titrated to the patient's physiologic response. C) given until a systolic BP of 110 mm Hg is achieved. D) avoided if the patient's shock is caused by blood loss.B) titrated to the patient's physiologic response.Once D5W is infused into the body: A) the body metabolizes the dextrose quickly and the solution becomes hypotonic. B) it causes fluid to shift from the intracellular space into the vascular space. C) cellular uptake of dextrose occurs and the solution quickly becomes isotonic. D) it rapidly expands the vascular space and effectively increases blood pressure.A) the body metabolizes the dextrose quickly and the solution becomes hypotonic.. Hypotonic solutions: A) include normal saline and lactated Ringer's solution. B) draw fluid from the cells and into the vascular space. C) hydrate the cells while depleting the vascular compartment. D) are the preferred solutions to use in patients with head trauma.C) hydrate the cells while depleting the vascular compartment.. In the prehospital setting, the MOST commonly used IV solutions are: A) colloid solutions. B) hypotonic crystalloids. C) hetastarch and saline. D) isotonic crystalloids.D) isotonic crystalloids.The use of 0.9% sodium chloride (normal saline) should NOT be considered for patients with: A) freshwater drowning. B) diabetic ketoacidosis. C) shock due to blood loss. D) congestive heart failure.D) congestive heart failure.A foreign-body airway obstruction should be suspected in a child who presents with: A) diffuse wheezing and nasal flaring. B) a productive cough and flushed skin. C) acute respiratory distress without fever. D) progressive respiratory distress and hoarseness.C) acute respiratory distress without fever.Several cycles of basic life support maneuvers have failed to relieve a severe airway obstruction in an unresponsive 44-year-old woman. You should: A) intubate the patient and attempt to push the foreign body into one of the mainstem bronchi. B) continue basic life support maneuvers and transport the patient to the hospital immediately. C) perform direct laryngoscopy and attempt to remove the obstruction with Magill forceps. D) place the patient's head in a neutral position and perform an emergency cricothyrotomy.C) perform direct laryngoscopy and attempt to remove the obstruction with Magill forceps.If chest compressions and repositioning of the airway are unsuccessful in removing a severe airway obstruction in an unconscious patient, you should: A) perform a blind finger sweep of the mouth. B) alternate chest compressions and abdominal thrusts. C) perform laryngoscopy and use Magill forceps. D) gain airway access via the cricothyroid membrane.C) perform laryngoscopy and use Magill forceps.Needle cricothyrotomy is contraindicated in patients with: A) uncontrolled oropharyngeal bleeding. B) obstruction above the catheter insertion site. C) massive maxillofacial trauma and trismus. D) a suspected injury to the cervical spine.obstructionWith respect to CPR and foreign body airway obstruction procedures, the child should be treated as an adult once: A) he or she reaches the age of 8 to 10 years. B) resting vital signs are consistent with an adult. C) his or her body weight is estimated at 55 pounds. D) secondary sexual characteristics have developed.D) secondary sexual characteristics have developed.If you have reason to believe that an unresponsive child has a foreign body airway obstruction, you should: A) assess for a pulse and then begin chest compressions. B) perform 30 chest compressions and then look in the mouth. C) administer abdominal thrusts until the object is expelled. D) try to remove it by performing a finger sweep of the mouth. Ans: BB) perform 30 chest compressions and then look in the mouth.If a 2-year-old child with a foreign body airway obstruction becomes unresponsive, you should position him or her supine and then: A) visualize the upper airway. B) perform chest compressions. C) assess for a carotid pulse. D) perform abdominal thrusts.B) perform chest compressions.. Several cycles of chest compressions have failed to remove a foreign body airway obstruction in an unresponsive infant. Your next action should be to: A) perform laryngoscopy and try to visualize the foreign body. B) continue chest compressions and perform a cricothyrotomy. C) open the infant's airway and sweep the infant's mouth with your finger. D) perform back slaps and chest thrusts and then look in the mouth.A) perform laryngoscopy and try to visualize the foreign body.If an infant or small child swallowed a rigid foreign body, he or she would MOST likely experience respiratory distress because: A) a foreign body in the esophagus would cause reflux and aspiration. B) when an infant or child is stressed, he or she tends to swallow a lot of air. C) the feeling of a foreign body in the throat would cause severe anxiety. D) the esophageal foreign body can compress the relatively pliable trachea.D) the esophageal foreign body can compress the relatively pliable trachea.. Why are children more prone to croup when they acquire a viral infection than adults infected with the same virus? A) Children's immune systems are not as developed as adults', so they are more prone to infection. B) Adults were vaccinated against the virus that causes croup, whereas most children were not. C) A child's airway is narrower than an adult's, and even minor swelling can result in obstruction. D) The virus that causes croup replicates far more aggressively in children than it does in adults.C) A child's airway is narrower than an adult's, and even minor swelling can result in obstruction.. With respect to CPR and foreign body airway obstruction procedures, the child should be treated as an adult once: A) he or she reaches the age of 8 to 10 years. B) resting vital signs are consistent with an adult. C) his or her body weight is estimated at 55 pounds. D) secondary sexual characteristics have developed.D) secondary sexual characteristics have developed.CPAP in the emergency setting is used to treat patients with certain obstructive airway diseases by: A) improving patency of the lower airway through the use of positive-end expiratory pressure. B) maintaining stability of the posterior pharynx, thereby preventing upper airway obstruction. C) increasing the rate and depth of ventilation, thus improving minute volume and mitigating hypoxia. D) delivering one pressure during the inspiratory phase and a different pressure during the expiratory phase.A) improving patency of the lower airway through the use of positive-end expiratory pressure.A critical step when using a CPAP unit to treat a patient with severe respiratory distress is: A) ensuring an adequate mask seal with minimal leakage. B) holding the mask to the noncompliant patient's face. C) starting with CPAP levels above 10 to 15 cm of water. D) setting the oxygen flow rate to at least 6 L/min.A) ensuring an adequate mask seal with minimal leakage.A 29-year-old woman is experiencing a severe asthma attack. Her husband reports that she was admitted to an intensive care unit about 6 months ago, and had a breathing tube in place. Prior to your arrival, the patient took 3 puffs of her rescue inhaler without effect. She is anxious and restless, is tachypneic, and has audible wheezing. You should: A) apply a CPAP unit, transport immediately, and attempt to establish vascular access en route to the hospital. B) begin assisting her ventilations with a bag-mask device and 100% oxygen and prepare to intubate her trachea. C) start an IV of normal saline, administer methylprednisolone via IV push, and transport as soon as possible. D) attempt to slow her breathing with respiratory coaching, administer a nebulized bronchodilator, and transport.A) apply a CPAP unit, transport immediately, and attempt to establish vascular access en route to the hospital.You are transporting a middle-aged man on a CPAP unit for severe pulmonary edema. An IV line of normal saline is in place. Prior to applying the CPAP device, the patient was tachypneic and had an oxygen saturation of 90%. When you reassess him, you note that his respirations have increased and his oxygen saturation has dropped to 84%. You should: A) continue the CPAP treatment and administer a diuretic to remove fluids from his lungs quickly. B) remove the CPAP unit, assist his ventilations with a bag-mask device, and prepare to intubate him. C) suspect that he has developed a pneumothorax and prepare to perform a needle chest decompression. D) decrease the amount of positive-end expiratory pressure that you are delivering and reassess.B) remove the CPAP unit, assist his ventilations with a bag-mask device, and prepare to intubate him.Physiologic effects of CPAP include: A) increased intrathoracic pressure. B) forcing of fluid into the alveoli. C) increased alveolar surface tension. D) opening of collapsed alveoli.D) opening of collapsed alveoli.Indications for CPAP include: A) cardiopulmonary arrest. B) acute pulmonary edema. C) severe opiate toxicity. D) acute bacterial pneumonia.B) acute pulmonary edema.CPAP is NOT appropriate for patients with: A) acute or chronic bronchospasm. B) slow, shallow respiratory effort. C) an oxygen saturation less than 90%. D) evidence of congestive heart failure.B) slow, shallow respiratory effort.Which of the following patients may benefit from CPAP? A) Alert patient with respiratory distress following submersion in water B) Comatose patient with shallow breathing after overdosing on heroin C) Trauma patient with labored breathing and extensive chest wall bruising D) Patient with pulmonary edema who is unable to follow verbal commandsA) Alert patient with respiratory distress following submersion in waterWhen administering CPAP therapy to a patient, it is important to remember that: A) acute symptomatic bradycardia has been directly linked to CPAP therapy. B) SpO2 of 100% must be achieved as quickly as possible. C) the increased intrathoracic pressure caused by CPAP can result in hypotension. D) the head straps must be secured immediately in order to achieve an adequate seal.C) the increased intrathoracic pressure caused by CPAP can result in hypotension.Signs of clinical improvement during CPAP therapy include: A) a decrease in systolic BP. B) an increase in the heart rate. C) increased ETCO2. D) increased ease of speaking.D) increased ease of speaking.Poor lung compliance during your initial attempt to ventilate an unconscious, apneic adult should be treated by: A) sweeping the patient's mouth with your fingers. B) reopening the airway and reattempting to ventilate. C) performing 30 chest compressions and reassessing. D) administering 15 subdiaphragmatic thrusts at once.B) reopening the airway and reattempting to ventilate.When ventilating an apneic adult with a pulse with a bag-mask device, you should: A) deliver 8 to 10 breaths/min and make the chest wall rise visibly. B) make the chest rise visibly and deliver one breath every 8 seconds. C) deliver each breath over 1 second at a rate of 10 to 12 breaths/min. D) squeeze the bag once every 3 seconds until the chest expands widely.C) deliver each breath over 1 second at a rate of 10 to 12 breaths/min.Hyperventilating an apneic patient: A) is appropriate if the patient is an adult. B) may decrease venous return to the heart. C) is beneficial if the pulse rate is too slow. D) reduces the incidence of gastric distention.B) may decrease venous return to the heart.When two paramedics are ventilating an apneic patient with a bag-mask device, the paramedic not squeezing the bag should: A) apply posterior cricoid pressure. B) manually position the patient's head. C) continually auscultate breath sounds. D) maintain an adequate mask-to-face seal.D) maintain an adequate mask-to-face seal.Which of the following is an indicator of inadequate artificial ventilation when ventilating an apneic, tachycardic adult with a bag-mask device? A) The patient's heart rate slows down. B) One breath is given every 10 to 12 seconds. C) About 12 to 20 breaths/min are being delivered. D) Each ventilation is delivered over 1 second.C) About 12 to 20 breaths/min are being delivered.Which of the following statements regarding the automatic transport ventilator (ATV) is correct? A) The ATV should not be used to ventilate a patient who is intubated and in cardiac arrest. B) Inadvertent variations in the rate and duration of ventilations often occur when the ATV is used. C) The paramedic can control an apneic patient's minute volume with accuracy when using an ATV. D) Most ATVs are large and cumbersome and are therefore impractical to use in the prehospital setting.C) The paramedic can control an apneic patient's minute volume with accuracy when using an ATV.A 66-year-old woman is found to be unresponsive and apneic. Her carotid pulse is weak and rapid. When ventilating this patient, you should deliver: A) each breath over 2 seconds at a rate of 8 to 10 breaths/min. B) one breath over 1 second every 3 to 5 seconds C) one breath over 2 seconds every 5 to 6 seconds. D) each breath over 1 second at a rate of 10 to 12 breaths/min.D) each breath over 1 second at a rate of 10 to 12 breaths/min.You have been providing bag-mask ventilations to an unresponsive, apneic patient with facial trauma for approximately 10 minutes. After intubating the patient, you should: A) hyperventilate the patient with 100% oxygen. B) insert a nasogastric tube to decompress the stomach. C) insert an orogastric tube to relieve gastric distention. D) ventilate the patient at a rate of 12 to 20 breaths/min.C) insert an orogastric tube to relieve gastric distention.After you have intubated an apneic patient with chest trauma, your partner is auscultating breath sounds and tells you that breath sounds are faint on the right side of the chest. You should: A) slightly withdraw the tube as your partner auscultates breath sounds. B) suspect that the patient has a pneumothorax on the right side of the chest. C) immediately remove the ET tube and oxygenate the patient for 30 seconds. D) increase the force of your ventilations as your partner reauscultates the lungs.B) suspect that the patient has a pneumothorax on the right side of the chest.B) suspect that the patient has a pneumothorax on the right side of the chest. Several attempts to orotracheally intubate an unresponsive, apneic young man have failed. You resume bag-mask ventilations and begin transport to a hospital located 25 miles away. En route, you begin having difficulty maintaining an adequate mask-to-face seal with the bag-mask device. Assuming that you have the proper equipment, which of the following techniques to secure a patent airway would be MOST appropriate? A) Transillumination intubation B) Blind nasotracheal intubation C) An open or needle cricothyrotomy D) Further attempts at orotracheal intubationA) Transillumination intubationUse of an automated transport ventilator is NOT appropriate for patients who are: A) in cardiac arrest. B) apneic with a pulse. C) chemically paralyzed. D) breathing spontaneously.D) breathing spontaneously.. The correct positive-pressure ventilation rate for an apneic newborn is: A) 12 to 20 breaths/min. B) 20 to 30 breaths/min. C) 30 to 40 breaths/min. D) 40 to 60 breaths/min.D) 40 to 60 breaths/min.. A 39-year-old man's car broke down, stranding him out in the country for approximately 18 hours. The outside temperature is 23°F. When you arrive and assess the man, you determine that he is pulseless and apneic; his core body temperature is estimated to be below 86°F. CPR is immediately initiated and the man is loaded into the ambulance quickly. The ECG reveals ventricular fibrillation. How should you proceed with the treatment of this patient? A) Give a single monophasic shock at 360 joules, reassess the rhythm and pulse, continue CPR, place advanced airway, hyperventilate at 20 breaths/min, establish vascular access, give 300 mg of amiodarone, and provide rapid transport B) Perform CPR for 2 minutes, give up to three stacked shocks, immediately resume CPR, reassess in 30 seconds, place advanced airway, ventilate at 8 to 10 breaths/min, establish vascular access, give a saline bolus, and provide rapid transport C) Give a single shock, immediately resume CPR, place advanced airway, provide ventilations at 8 to 10 breaths/min with warm humidified oxygen if possible, establish vascular access, and provide rapid transport D) Provide immediate defibrillation with maximum energy, reassess the rhythm and pulse, continue CPR, place advanced airway, give one breath every 3 to 5 seconds, establish vascular access, administer a vasopressor, and provide rapid transportC) Give a single shock, immediately resume CPR, place advanced airway, provide ventilations at 8 to 10 breaths/min with warm humidified oxygen if possible, establish vascular access, and provide rapid transport. Appropriate bag-mask ventilation for an apneic 3-year-old child involves: A) ensuring a consistently delivered tidal volume of 400 mL. B) providing hyperventilation to ensure carbon dioxide elimination. C) hyperextending the head to ensure an adequate mask-to-face seal. D) delivering each breath over 1 second until the chest rises visibly.D) delivering each breath over 1 second until the chest rises visibly.. When ventilating an apneic child with a bag-mask device, it is important for the paramedic to remember that: A) each ventilation should be delivered over a period of 2 to 3 seconds. B) the presence of chest rise is an unreliable indicator of proper ventilation. C) regurgitation and aspiration may occur, even with proper ventilation technique. D) posterior cricoid pressure will virtually eliminate the risk of pulmonary aspiration.C) regurgitation and aspiration may occur, even with proper ventilation technique.Neuromuscular blocking agents achieve chemical paralysis by: A) agonizing muscarinic receptor sites and increasing acetylcholine production. B) binding to nicotinic receptor sites on muscle cells and antagonizing acetylcholine. C) inhibiting cerebellar activity, thereby decreasing voluntary muscle movement. D) blocking the action of the sodium-potassium pump, causing muscle paralysis.B) binding to nicotinic receptor sites on muscle cells and antagonizing acetylcholine.Succinylcholine should not be used in patients with: A) a closed head injury. B) known hyperkalemia. C) a rapid heart rate. D) suspected hypokalemia.B) known hyperkalemia.Compared to succinylcholine, rocuronium: A) has a rapid (30 to 60 seconds) onset of action and a relatively brief (3 to 8 minutes) duration of action. B) binds with nicotinic receptors on muscles and causes a brief activation known as fasciculation. C) has a rapid onset of action, a longer (up to 60 minutes) duration of action, and fewer adverse effects. D) does not bind with nicotinic receptor sites on muscle cells and does not antagonize acetylcholine.C) has a rapid onset of action, a longer (up to 60 minutes) duration of action, and fewer adverse effects.Rocuronium bromide (Zemuron) is classified as a: A) depolarizing neuromuscular blocker. B) nondepolarizing neuromuscular agonist. C) depolarizing neuromuscular agonist. D) nondepolarizing neuromuscular blocker.D) nondepolarizing neuromuscular blocker.Prior to administering vecuronium bromide (Norcuron), or any other neuromuscular blocker, it is important for the paramedic to remember that: A) neuromuscular blockers have no effect on a patient's level of consciousness. B) chemical paralysis should be achieved prior to administering a sedative drug. C) the airway should be secured with an ET tube or other advanced airway device. D) neuromuscular blockers are potent analgesics and may cause severe hypotension.A) neuromuscular blockers have no effect on a patient's level of consciousness.Succinylcholine (Anectine) is contraindicated for patients with: A) head trauma. B) major burns. C) tachycardia. D) blunt force trauma.B) major burns.Succinylcholine (Anectine) is preferred by many paramedics because it: A) has a short duration of action. B) is a nondepolarizing paralytic. C) does not cause fasciculations. D) has a slow onset of action.A) has a short duration of action.The onset of action of rocuronium bromide (Zemuron) is: A) 30 seconds. B) 1 to 2 minutes. C) 3 to 5 minutes. D) about 10 minutes.B) 1 to 2 minutes.After administering rocuronium bromide (Zemuron), you can expect its effects to last for at least: A) 45 minutes. B) 60 minutes. C) 90 minutes. D) 120 minutes.A) 45 minutes.The peak effect of pancuronium bromide (Pavulon) is: A) 30 seconds. B) 3 to 5 minutes. C) 5 to 10 minutes. D) 45 minutes.B) 3 to 5 minutes.Pancuronium bromide (Pavulon) is contraindicated if: A) the patient has a severe head injury and is hypertensive. B) you have reason to believe that the patient is hypovolemic. C) you cannot provide adequate ventilation and oxygenation. D) the patient has had his or her spleen surgically removed.C) you cannot provide adequate ventilation and oxygenation.Which of the following represents the correct dose for pancuronium bromide (Pavulon) for a 140-pound adult? A) 3.2 mg B) 6.4 mg C) 7.7 mg D) 8.3 mgB) 6.4 mgNeuromuscular blocking agents: A) are most commonly used as the sole agent to facilitate placement of an ET tube. B) convert a breathing patient with a marginal airway into an apneic patient with no airway. C) induce total body paralysis within 10 to 15 minutes following administration via IV push. D) have a negative effect on both cardiac and smooth muscle and commonly cause dysrhythmias.B) convert a breathing patient with a marginal airway into an apneic patient with no airway.Paralytic medications exert their effect by: A) blocking the release of epinephrine and norepinephrine from the sympathetic nervous system. B) competitively binding to the motor neurons in the brain, thus blocking their ability to send messages. C) functioning at the neuromuscular junction and relaxing the muscle by impeding the action of acetylcholine. D) blocking the function of the autonomic nervous system and impeding the action of acetylcholinesterase.C) functioning at the neuromuscular junction and relaxing the muscle by impeding the action of acetylcholine.Nondepolarizing neuromuscular blocking agents include all of the following, EXCEPT: A) vecuronium bromide. B) rocuronium bromide. C) pancuronium bromide. D) succinylcholine chloride.D) succinylcholine chloride.Which of the following is NOT characteristic of a depolarizing neuromuscular blocking agent? A) Bradycardia B) Tachycardia C) Muscle fasciculations D) Short duration of actionB) TachycardiaYou are assessing a young woman who was struck in the head with a baseball bat. The patient is semiconscious and has slow, irregular respirations. Further assessment reveals CSF drainage from her nose and periorbital ecchymosis. She has blood in her mouth, but clenches her teeth and becomes combative when you attempt to suction her oropharynx. The MOST appropriate airway management for this patient involves: A) sedating her with a benzodiazepine, chemically paralyzing her with a neuromuscular blocker, and intubating her trachea. B) suctioning along the inside of her cheek with a whistle-tip catheter and then performing blind nasotracheal intubation. C) opening her mouth with a dental prod, suctioning her oropharynx for 15 seconds, and intubating her trachea via direct laryngoscopy. D) inserting a nasopharyngeal airway, administering supplemental oxygen via nonrebreathing mask, and continuing suction attempts.A) sedating her with a benzodiazepine, chemically paralyzing her with a neuromuscular blocker, and intubating her trachea.To prevent muscular fasciculations associated with the use of succinylcholine, you should administer: A) 0.5 mg of atropine sulfate via rapid IV push. B) 10% of the usual dose of a nondepolarizing paralytic. C) an infusion of potassium chloride set at 5 mEq per hour. D) 1 to 1.5 mg/kg of lidocaine over 10 to 15 minutes.B) 10% of the usual dose of a nondepolarizing paralytic.What point(s) on the capnographic waveform represent(s) a mixture of alveolar gas and dead space gas? A) A-B B) B C) B-C D) DB) BWhat phase of the capnographic waveform is called the expiratory upslope? A) A-B B) B-C C) C-D D) D-EB) B-COn a capnographic waveform, point ___ is the maximal ETCO2 and is the best reflection of the alveolar CO2 level. A) B B) C C) D D) EC) DAccording to the most current guidelines for emergency cardiac care, the MOST reliable method for monitoring correct ET tube placement is: A) pulse oximetry. B) the esophageal detector device. C) waveform capnography. D) colorimetric capnography.C) waveform capnography.Capnography can serve as an indicator of: A) proper ventilatory depth. B) cerebral perfusion pressure. C) coronary perfusion pressure. D) chest compression effectiveness.D) chest compression effectiveness.Capnography is a reliable method for confirming proper ET tube placement because: A) carbon dioxide is not present in the esophagus. B) it is a reliable indicator of the patient's PaO2 level. C) capnographers measure the amount of exhaled oxygen. D) capnographers measure the amount of carbon dioxide in inhaled air.A) carbon dioxide is not present in the esophagus.The use of capnography in patients with prolonged cardiac arrest may be limited because: A) of an excess buildup of nitrogen in the blood. B) the paramedic often ventilates the patient too slowly. C) of acidosis and minimal carbon dioxide elimination. D) metabolic alkalosis damages the colorimetric paper.C) of acidosis and minimal carbon dioxide elimination.. If the ET tube is placed in the trachea properly, the colorimetric paper inside the ETCO2 detector should: A) not change colors. B) turn yellow during inhalation. C) turn yellow during exhalation. D) remain purple during ventilations.C) turn yellow during exhalation.Which of the following statements regarding sympathomimetic chemicals is correct? A) They are not synthetically manufactured. B) They block the release of acetylcholine. C) They only stimulate alpha-1 receptors. D) They are not found naturally in the body.D) They are not found naturally in the body.Catecholamines and sympathomimetic medications should be administered with caution because they: A) can increase cardiac workload and myocardial oxygen demand. B) have an average duration of action of between 24 and 48 hours. C) are associated with paradoxical bradycardia in younger patients. D) have a tendency to cause a significant decrease in cardiac output.A) can increase cardiac workload and myocardial oxygen demand.Albuterol is a(n): A) selective beta-1 agonist. B) beta-adrenergic blocker. C) parasympatholytic drug. D) sympathomimetic drug.D) sympathomimetic drug.