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. Your assessment of a depressed 7-pound newborn reveals tachypnea, pallor, weak peripheral pulses, a heart rate of 120 beats/min, and a blood glucose level of 58 mg/dL. Which of the following interventions will MOST likely cause improvement in this newborn's condition?
A) 0.3 mg of naloxone
B) 32 mL of normal saline
C) 6.5 mL of 10% dextrose
D) 0.06 mg of epinephrine
A) 0.3 mg of naloxone
B) 32 mL of normal saline
C) 6.5 mL of 10% dextrose
D) 0.06 mg of epinephrine
You receive a call for a "sick child." When you arrive at the scene, the child's mother tells you that her 5-year-old son has had vomiting and diarrhea for the past day and will not eat or drink anything. On exam, the child's level of consciousness appears consistent with his age. His skin is cool and pale, he is tachypneic, his capillary refill time is 4 seconds, and his heart rate is 150 beats/min. The MOST appropriate treatment for this child involves:
A) applying high-flow oxygen via pediatric nonrebreathing mask, assessing his blood glucose level, elevating his legs 12 inches, and transporting at once.
B) establishing IV access and administering a 20-mL/kg normal saline bolus, applying high-flow oxygen, administering 25% dextrose, and transporting.
C) administering supplemental oxygen, keeping the child warm, assessing his blood glucose level, transporting, and establishing vascular access en route.
D) administering supplemental oxygen, starting an IV line, assessing his blood glucose level, delivering at least two 20-mL/kg normal saline boluses, and transporting.C) administering supplemental oxygen, keeping the child warm, assessing his blood glucose level, transporting, and establishing vascular access en route.Which cranial nerve innervates the muscles that cause motion of the eyeballs and upper eyelids?
A) Optic
B) Trigeminal
C) Oculomotor
D) HypoglossalC) OculomotorWhich of the following statements regarding anisocoria is correct?
A) Anisocoria is a condition in which the pupils are unequal.
B) Anisocoria is a normal finding in the majority of the population.
C) Physiologic anisocoria indicates significant intracranial pressure.
D) Anisocoria is a condition characterized by bilateral pupillary dilation.A) Anisocoria is a condition in which the pupils are unequal.A patient with a left-hemispheric stroke would be expected to have:
A) contralateral facial drooping.
B) ipsilateral facial drooping.
C) ipsilateral extremity weakness.
D) contralateral pupillary changes.B) ipsilateral facial drooping.Asymmetry of the pupils:
A) is a normal finding in up to 40% of the population.
B) indicates a significant ocular or neurologic pathology.
C) is normal when a light is shone into one of the pupils.
D) must be correlated with the patient's overall presentation.D) must be correlated with the patient's overall presentation.. A patient with a unilateral eyelid droop when smiling:
A) has a condition called miosis.
B) may be experiencing Bell palsy.
C) likely has an intracerebral hemorrhage.
D) is experiencing transient cerebral ischemia.B) may be experiencing Bell palsy.Because the facial nerve does not decussate, a stroke to the right cerebral hemisphere would MOST likely cause:
A) left-sided weakness and a left-sided facial droop.
B) left-sided weakness and a right-sided facial droop.
C) right-sided weakness and a left-sided facial droop.
D) right-sided weakness and a right-sided facial droop.B) left-sided weakness and a right-sided facial droop.A 59-year-old woman presents with acute onset of confusion, left-sided hemiparesis, and a right-sided facial droop. Her airway is patent and she is breathing adequately. Her blood pressure is 150/100 mm Hg and her pulse is 70 beats/min. The cardiac monitor displays atrial fibrillation with a variable rate of 60 to 90 beats/min. When obtaining the patient's medical history from her husband, the MOST important question to ask him is:
A) "Does your wife have a history of diabetes?"
B) "Is your wife allergic to aspirin or contrast dye?"
C) "When did your wife last see her physician?"
D) "When did you first notice your wife's symptoms?"D) "When did you first notice your wife's symptoms?"An elderly man presents with slurred speech, confusion, and unilateral facial asymmetry. When asked to squeeze your hands, the strength in his left hand is markedly less than the strength in his right hand. The patient's wife tells you that her husband has type 2 diabetes and hypertension. On the basis of your clinical findings, you should:
A) consider him a candidate for fibrinolytic therapy if his symptoms began less than 12 hours ago.
B) rule out hypoglycemia by assessing his blood sugar, but suspect a right-sided ischemic stroke.
C) start an IV and administer crystalloid fluid boluses if his systolic blood pressure is less than 110 mm Hg.
D) suspect that he is experiencing a hemorrhagic stroke, begin immediate transport, and start an IV en route.B) rule out hypoglycemia by assessing his blood sugar, but suspect a right-sided ischemic stroke.. You are dispatched to a residence for a middle-aged woman with generalized weakness of approximately 18 hours' duration. Your primary assessment reveals right-sided hemiparesis, a left-sided facial droop, and bilaterally equal and reactive pupils. Further assessment reveals that her blood glucose level is 70 mg/dL. En route to the hospital, you note increased movement of her right arm. She is receiving oxygen via nasal cannula and has a patent IV line in place. Which of the following statements regarding this scenario is correct?
A) You should administer nitroglycerin or labetalol if her systolic blood pressure is greater than 150 mm Hg.
B) The patient will likely receive fibrinolytic therapy in the emergency department if no contraindications exist.
C) Although the patient is likely experiencing a TIA, you should treat her as though she is experiencing a stroke.
D) The patient's signs and symptoms are likely the result of her blood sugar and will resolve with dextrose.C) Although the patient is likely experiencing a TIA, you should treat her as though she is experiencing a stroke.. According to the Los Angeles Prehospital Stroke Screen, the possibility of a stroke is increased if:
A) the patient is younger than 45 years of age.
B) the blood glucose is between 60 and 400 mg/dL.
C) at baseline, the patient is normally bedridden.
D) a bilateral facial droop is present during the exam.B) the blood glucose is between 60 and 400 mg/dL.A patient experiences severe, shock-like or stabbing pain to one side of the face. This is consistent with:
A) an acoustic neuroma.
B) hemifacial spasm.
C) trigeminal neuralgia.
D) glossopharyngeal neuralgia.C) trigeminal neuralgia.. An elderly man presents with slurred speech, confusion, and unilateral facial asymmetry. When asked to squeeze your hands, the strength in his left hand is markedly less than the strength in his right hand. The patient's wife tells you that her husband has type 2 diabetes and hypertension. On the basis of your clinical findings, you should:
A) consider him a candidate for fibrinolytic therapy if his symptoms began less than 12 hours ago.
B) rule out hypoglycemia by assessing his blood sugar, but suspect a right-sided ischemic stroke.
C) start an IV and administer crystalloid fluid boluses if his systolic blood pressure is less than 110 mm Hg.
D) suspect that he is experiencing a hemorrhagic stroke, begin immediate transport, and start an IV en route.B) rule out hypoglycemia by assessing his blood sugar, but suspect a right-sided ischemic stroke.Which of the following cranial nerves are assessed when you ask a patient to follow your finger as you move it in an "H" shape?
A) Trochlear, oculomotor, abducens
B) Facial, accessory, glossopharyngeal
C) Accessory, olfactory, hypoglossal
D) Optic, trigeminal, glossopharyngealA) Trochlear, oculomotor, abducensAsymmetry of the pupils:
A) is a normal finding in up to 40% of the population.
B) indicates a significant ocular or neurologic pathology.
C) is normal when a light is shone into one of the pupils.
D) must be correlated with the patient's overall presentation.D) must be correlated with the patient's overall presentation.When performing a cranial nerve assessment of a patient with a suspected spinal injury, you note that the patient's pupil is constricted and the upper eyelid droops. This indicates an injury to:
A) C3.
B) C4.
C) C5.
D) C6.A) C3.Paralysis of cranial nerve ____ can cause unilateral facial and gag reflex paralysis.
A) V
B) VI
C) VII
D) XC) VIIWhich of the following cranial nerves innervates the muscles that cause motion of the eyeballs and upper eyelids?
A) Optic
B) Ophthalmic
C) Oculomotor
D) TrigeminalC) OculomotorProtocols, or standing orders, specify the paramedic's performance parameters, which:
A) allow the paramedic to function autonomously on every EMS call.
B) outline the care that is provided after contacting online medical control.
C) limit the skills that the paramedic can perform in his or her EMS system.
D) define what the paramedic can or cannot do without direct medical control.
Ans: DD) define what the paramedic can or cannot do without direct medical control.Which of the following scenarios is the BEST example of independent decision making?
A) Controlling severe bleeding from an open wound, establishing an IV to maintain perfusion, and contacting medical control en route to the hospital
B) Selecting the appropriate patient care algorithm from your protocol book when treating a middle-aged male patient with symptomatic bradycardia
C) Definitively diagnosing a patient with cholecystitis who has right upper quadrant abdominal pain and nausea that began shortly after eating a meal
D) Contacting medical control and requesting permission to administer adenosine to a patient with a heart rate of 190 beats/min and a stable blood pressureA) Controlling severe bleeding from an open wound, establishing an IV to maintain perfusion, and contacting medical control en route to the hospitalWhich of the following is one of the 10 system elements developed by the National Highway Traffic Safety Administration (NHTSA) in an effort to sustain EMS systems?
A) Medical direction
B) Fully enhanced 9-1-1
C) Paramedic supervisors
D) Continued federal fundingA) Medical directionIf you must deviate from your protocols because of unusual circumstances, you should FIRST:
A) advise the patient.
B) document the event.
C) notify medical control.
D) apprise the receiving hospital.C) notify medical control.. Which of the following is an example of a protocol?
A) Radio orders
B) Standing orders
C) Online medical control
D) Verbal order by a physicianB) Standing orders. If a conflict arises between a paramedic and a physician bystander in the field, the paramedic should:
A) become subordinate to the physician.
B) involve law enforcement in the incident.
C) contact medical control to seek resolution.
D)politely ask the physician to leave the sceneC) contact medical control to seek resolution.. When faced with a situation that is not addressed in your EMS system's protocols, you should:
A) contact the nurse at the receiving facility.
B) radio your medical director to obtain orders.
C) proceed with basic life support and transport.
D) let experience guide further care of the patient.B) radio your medical director to obtain orders.Which of the following is NOT a typical function of the EMS medical director?
A) Interfacing between EMS systems and other agencies
B) Responding to an emergency scene with the paramedics
C) Participating in the hiring process of new EMS personnel
D) Developing protocols in cooperation with other EMS expertsB) Responding to an emergency scene with the paramedicsThe MAIN benefit to online medical control is that it:
A) affords the paramedic better protection against a lawsuit.
B) provides an immediate and specific patient care resource.
C) allows the physician and paramedic to develop a rapport.
D) facilitates a faster transport to the emergency department.B) provides an immediate and specific patient care resource.Specific functions that the paramedic should perform prior to contacting medical control are called:
A) standing orders.
B) online protocols.
C) physician directives.
D) predefined standards.A) standing orders.. It is important for the paramedic to consult with medical control prior to administering analgesia to a patient with severe flank pain and suspected acute renal failure because:
A) patients with renal failure often require high doses of analgesia.
B) renal failure may cause analgesics to accumulate to toxic levels.
C) most patients who are given analgesia will experience hypotension.
D) analgesia will mask the patient's pain and skew further examination.B) renal failure may cause analgesics to accumulate to toxic levels.. If a severely injured patient who will likely not survive is identified as being an organ donor, the paramedic:
A) must keep the patient warm to keep his or her organs viable.
B) must determine whether or not the patient is legally brain dead.
C) should recall that severe trauma disqualifies a patient as a donor.
D) should contact medical control for guidance as to how to proceed.D) should contact medical control for guidance as to how to proceed.You arrive at a convenience store to find a middle-aged male in cardiac arrest. Your protocols provide for standing orders in this type of scenario. This means that you should:
A) contact medical control before providing advanced-level care.
B) perform certain interventions prior to contacting medical control.
C) begin CPR and then contact medical control for further direction.
D) pronounce the patient dead if there is no response after 10 minutes.B) perform certain interventions prior to contacting medical control.When providing patient care, it is MOST important that you maintain effective communication with:
A) the dispatcher.
B) bystanders.
C) medical control.
D) your partner.D) your partner.. If a patient with decision-making capacity adamantly refuses treatment for an injury or condition that clearly requires immediate medical attention, the paramedic should:
A) request law enforcement assistance at once.
B) contact online medical control for guidance.
C) make other arrangements for patient transport.
D) ask the patient to sign a refusal of treatment form.B) contact online medical control for guidance.A 77-year-old man with end-stage COPD and renal failure is found unresponsive by his daughter. Your assessment reveals that the patient is apneic and pulseless. The daughter presents you with an out-of-hospital DNR order; however, the document expired 3 months ago. You should:
A) begin CPR only and contact medical control for further guidance.
B) realize that the patient cannot be resuscitated and notify the coroner.
C) begin full resuscitative efforts because the DNR order is no longer valid.
D) confirm that the order has expired before initiating any patient treatment.A) begin CPR only and contact medical control for further guidance.If you receive a medication order from on-line medical control that seems inappropriate to you, you should:
A) refuse to administer the medication.
B) ask the physician to repeat the order.
C) look up the correct dose in your field guide.
D) administer the drug as ordered and document it.B) ask the physician to repeat the order.Which of the following is NOT always considered a mandatory action after administering a medication via the enteral or parenteral route?
A) Contacting on-line medical control
B) Monitoring the patient's condition
C) Immediately disposing of any sharps
D) Documenting the time of administrationA) Contacting on-line medical controlThe thermolytic tissues in the hypothalamus are mediated by the:
A) endocrine system.
B) sympathetic nervous system.
C) parasympathetic nervous system.
D) signals of the adrenergic nervous system.C) parasympathetic nervous system.. The primary anatomic link between the endocrine system and the nervous system is/are the:
A) pancreas.
B) adrenal glands.
C) hypothalamus.
D) adrenal cortex.C) hypothalamus.. An increase in core temperature causes the:
A) anterior pituitary gland to send signals via afferent pathways in the sympathetic nervous system to increase the heart rate.
B) hypothalamus to send signals via efferent pathways in the autonomic nervous system, causing vasodilation and sweating.
C) anterior pituitary gland to send signals via efferent pathways in the sympathetic nervous system, causing widespread vasoconstriction.
D) hypothalamus to send signals via afferent pathways in the parasympathetic nervous system, resulting in vasoconstriction and sweat production.B) hypothalamus to send signals via efferent pathways in the autonomic nervous system, causing vasodilation and sweating.. A sick or injured child's general appearance is MOST reflective of:
A) the etiology of the problem.
B) his or her cardiovascular status.
C) his or her central nervous system function.
D) his or her ability to be consoled.C) his or her central nervous system function.. Clinical indicators of sympathetic nervous system discharge include:
A) diffuse wheezing.
B) pupillary dilation.
C) hypoventilation.
D) increased salivation.B) pupillary dilation.Parasympathetic nervous system stimulation results in:
A) a negative dromotropic effect.
B) increased myocardial contractility.
C) a decreased inotropic effect.
D) decreased gastrointestinal motility.A) a negative dromotropic effect.Under normal conditions, the strength of cardiac contraction is regulated by:
A) the heart rate.
B) the nervous system.
C) physical exertion.
D) the Frank-Starling mechanism.B) the nervous system.The tissues of the central nervous system:
A) can metabolize fat and proteins to make energy.
B) are able to store glucose and use just what is needed.
C) can only survive for about an hour without glucose.
D) depend entirely on glucose as their source of energy.D) depend entirely on glucose as their source of energy.The sympathetic and parasympathetic nerves arise from the:
A) somatic nervous system.
B) autonomic nervous system.
C) voluntary nervous system.
D) adrenal nervous system.B) autonomic nervous system.. During your assessment of a patient, you note that he is bradycardic, hypotensive, and salivating. These clinical findings suggest:
A) sympathetic nervous system stimulation.
B) parasympathetic nervous system stimulation.
C) sympathetic nervous system depression.
D) parasympathetic nervous system depression.B) parasympathetic nervous system stimulation.. Stimulation of alpha receptors of the sympathetic nervous system results in:
A) tachycardia.
B) bronchodilation.
C) peripheral vasodilation.
D) peripheral vasoconstriction.D) peripheral vasoconstriction.Which of the following substances are vital in the function of the sympathetic nervous system?
A) Epinephrine and norepinephrine
B) Aldosterone and dopamine
C) Cortisol and epinephrine
D) Aldosterone and cortisolA) Epinephrine and norepinephrineBradycardia that occurs shortly after you have dressed and bandaged an open neck wound is MOST likely the result of:
A) decreased vagal tone secondary to direct injury to the vagus nerve.
B) decreased venous return from the brain and an increase in intracranial pressure.
C) an acute pulmonary embolism due to the entrainment of air into one of the jugular veins.
D) parasympathetic nervous system stimulation due to excessive pressure on the carotid artery.D) parasympathetic nervous system stimulation due to excessive pressure on the carotid artery.. The effects of hypothermia are MOST dramatically apparent in the:
A) integumentary system.
B) cardiovascular system.
C) central nervous system.
D) hematopoietic system.C) central nervous system.. Stimulation of the parasympathetic nervous system:
A) completely blocks the AV node, preventing ventricular depolarization.
B) causes a decrease in the production of epinephrine and norepinephrine.
C) is characterized by a large P wave and a PR interval that is shorter than normal.
D) slows SA nodal discharge and decreases conduction through the AV node.D) slows SA nodal discharge and decreases conduction through the AV node.. Stimulation of the parasympathetic nervous system causes all of the following effects, EXCEPT:
A) negative inotropy.
B) increased salivation.
C) dilation of the pupils.
D) negative chronotropy.C) dilation of the pupils.. Unlike the parasympathetic nervous system, the sympathetic nervous system:
A) is not under the direct control of the autonomic nervous system.
B) provides a mechanism for the body to adapt to changing demands.
C) is blocked when drugs such as atropine are administered.
D) constricts the pupils and increases gastrointestinal function when stimulated.B) provides a mechanism for the body to adapt to changing demands.A physiologic effect of sympathetic nervous stimulation includes:
A) dilation of the bronchioles.
B) decreased conduction velocity.
C) a negative dromotropic effect.
D) dilation of the blood vessels.A) dilation of the bronchioles.Sympathetic nerves are regulated primarily by:
A) adrenaline.
B) epinephrine.
C) cholinesterase.
D) norepinephrine.D) norepinephrine.The fight-or-flight response is characterized by all of the following physiologic responses, EXCEPT:
A) an increased flow of blood to the skeletal muscles.
B) decreased sympathetic tone and pupil constriction.
C) mobilization of glucose and an increased heart rate.
D) shunting of blood away from the gastrointestinal tract.B) decreased sympathetic tone and pupil constriction.The part of the nervous system that prepares the body to deal with an emergency is the __________ nervous system.
A) somatic
B) voluntary
C) sympathetic
D) parasympatheticC) sympatheticExcessive stimulation of the parasympathetic nervous system will result in:
A) hypertension.
B) bradycardia.
C) hyperactivity.
D) diaphoresis.B) bradycardia.. 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.. Beginning with the outermost layer, the three meningeal layers of the central nervous system are the:
A) dura mater, pia mater, and arachnoid.
B) arachnoid, pia mater, and dura mater.
C) dura mater, arachnoid, and pia mater.
D) pia mater, dura mater, and arachnoid.C) dura mater, arachnoid, and pia mater.Efferent 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.Stimulation of the sympathetic nervous system causes:
A) sweating.
B) bradycardia.
C) vasodilation.
D) warm, moist skin.A) sweating.. 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.A) vasoconstriction.. All of the following are functions of the parasympathetic nervous system, EXCEPT:
A) constriction of the pupils.
B) lowering of the blood pressure.
C) decreased gastrointestinal function.
D) mediating arousal in males and females.C) decreased gastrointestinal function.. The peripheral nervous system is responsible for:
A) memory, understanding, and thought processes.
B) feeling and autonomic sensory and motor functions.
C) thought, perception, and voluntary motor functions.
D) sending messages to and receiving messages from the brain.D) sending messages to and receiving messages from the brain.Which of the following central nervous system functions does NOT change as a person ages?
A) Postural stability
B) Cognitive speed
C) Memory retrieval
D) Intelligence levelD) Intelligence levelBecause stimulation of the parasympathetic nervous system and bradycardia can occur during intubation of a child, you should:
A) closely monitor the child's cardiac rhythm.
B) premedicate with 0.04 mg/kg of atropine.
C) limit your intubation attempt to 10 seconds.
D) use a curved blade instead of a straight blade.A) closely monitor the child's cardiac rhythm.Which of the following conditions is a neural tube defect in which part of the nervous system remains outside the body?
A) Multiple sclerosis
B) Spina bifida
C) Poliomyelitis
D) Cerebral palsyB) Spina bifidaRelative 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.. Management for an ingested poison focuses mainly on:
A) the prompt induction of vomiting.
B) administering a counteracting agent.
C) neutralizing the poison in the stomach.
D) treating the systemic effects that result.C) neutralizing the poison in the stomach.Unlike an opioid, an opiate:
A) is a natural product derived from opium.
B) produces a distinctly different toxidrome.
C) is not reversed by naloxone administration.
D) is a synthetic, non-opium-derived narcotic.A) is a natural product derived from opium.You would NOT expect a person using methamphetamine to present with:
A) insomnia.
B) bradypnea.
C) restlessness.
D) hypertension.B) bradypnea.. Exposure to sarin or tabun would result in:
A) hyperthermia.
B) pupillary dilation.
C) severe tachycardia.
D) excessive lacrimation.D) excessive lacrimation.. Your FIRST priority when dealing with a patient who may have overdosed is to:
A) ascertain what the patient took.
B) enter the scene carefully.
C) request law enforcement.
D) assess the patient's airway.C) request law enforcement.Appropriate prehospital treatment for a patient who has overdosed on a stimulant and is excessively tachycardic and violent includes all of the following, EXCEPT:
A) IM haloperidol.
B) beta-adrenergic antagonists.
C) benzodiazepines if seizures occur.
D) fluid boluses if hypotension occurs.B) beta-adrenergic antagonists.. Priority care for an unresponsive patient who has overdosed on phenobarbital includes:
A) administering oxygen and giving naloxone.
B) administering diazepam to prevent seizures.
C) securing the airway and preventing aspiration.
D) observing the ECG closely for lethal dysrhythmias.C) securing the airway and preventing aspiration.Fluid-refractory hypotension following a barbiturate overdose is treated MOST effectively with:
A) dopamine.
B) naloxone.
C) atropine.
D) calcium.A) dopamine.Which of the following interventions generally is preferred for a patient who overdosed on a barbiturate more than 1 hour ago?
A) Gastric lavage
B) Syrup of ipecac
C) Urine alkalinization
D) Activated charcoalD) Activated charcoalIf you are treating a patient with a suspected benzodiazepine overdose and find that the patient is hypotensive, bradycardic, and comatose:
A) avoid administering flumazenil and transport the patient immediately.
B) you should consider concomitant overdose with another CNS depressant.
C) it is likely that the patient is also under the influence of methamphetamine.
D) you should rapidly administer 2 mg of naloxone via the IV, IO, or IM route.B) you should consider concomitant overdose with another CNS depressant.Cardiac arrest following a narcotic overdose is usually the result of:
A) seizures.
B) renal failure.
C) respiratory arrest.
D) a cardiac dysrhythmia.C) respiratory arrest.The recommended dose and method for administering naloxone to a patient who overdosed on a narcotic and is unresponsive and hypoventilating is:
A) 0.1 mg/kg rapidly until the patient's respirations improve.
B) 0.4 to 2 mg rapidly until the patient regains consciousness.
C) 5 to 10 mg via the endotracheal tube until the pupils dilate.
D) 2 mg injected slowly until the patient's respirations improve.D) 2 mg injected slowly until the patient's respirations improve.. Which of the following cardiac rhythm disturbances MOST commonly results from inadvertent overdose of a prescribed cardiac medication?
A) Atrial flutter
B) Bradycardia
C) Tachycardia
D) Atrial fibrillationB) BradycardiaCommon signs and symptoms of a tricyclic antidepressant overdose include:
A) excessive salivation and diarrhea.
B) tachypnea and severe hypertension.
C) altered mental status and tachycardia.
D) constricted pupils and AV heart block.C) altered mental status and tachycardia.The MOST common cause of death following a tricyclic antidepressant overdose is:
A) respiratory failure.
B) a cardiac dysrhythmia.
C) intracerebral hemorrhage.
D) pulmonary aspiration.B) a cardiac dysrhythmia.Early signs of MAOI overdose include all of the following, EXCEPT:
A) nystagmus.
B) tachycardia.
C) hyperactivity.
D) hypoventilation.D) hypoventilation.Prehospital treatment for a patient who overdosed on aspirin may include:
A) flumazenil.
B) an antipyretic.
C) calcium chloride.
D) sodium bicarbonate.D) sodium bicarbonate.Death from acetaminophen overdose is MOST often caused by:
A) metabolic alkalosis.
B) acute splenic rupture.
C) progressive liver failure.
D) gastrointestinal bleeding.C) progressive liver failure.. Patients with primary pulmonary hypertension may experience acute decompensation if they are given a:
A) salicylate.
B) vasopressor.
C) diuretic.
D) bronchodilator.B) vasopressor.. A loud S3 heart sound, when heard in older adults, often signifies:
A) emphysema.
B) valve rupture.
C) heart failure.
D) pulmonary hypertension.C) heart failure.. In a patient with left heart failure and pulmonary edema:
A) the right atrium and ventricle pump against lower pressures, resulting in the systemic pooling of venous blood.
B) diffusely collapsed alveoli cause blood from the right side of the heart to bypass the alveoli and return to the left side of the heart.
C) increased pressure in the left atrium and pulmonary veins forces serum out of the pulmonary capillaries and into the alveoli.
D) an acute myocardial infarction or chronic hypertension causes the left ventricle to pump against decreased afterload, resulting in hypoperfusion.C) increased pressure in the left atrium and pulmonary veins forces serum out of the pulmonary capillaries and into the alveoli.. Unlike Schedule I drugs, Schedule II drugs have:
A) accepted medical uses.
B) a higher abuse potential.
C) limited dependence potential.
D) no accepted medical application.A) accepted medical uses.. Compared to Schedule III drugs, Schedule IV drugs:
A) include medications such as Vicodin and have a high potential for psychological dependence.
B) have a moderate potential for physical dependence and include cough syrups that contain codeine.
C) may lead to severe addiction and include short-acting barbiturates, amphetamines, and opiates.
D) have a lower abuse potential and include medications such as diazepam (Valium) and lorazepam (Ativan).D) have a lower abuse potential and include medications such as diazepam (Valium) and lorazepam (Ativan).All of the following are Schedule II substances, EXCEPT:
A) Ritalin.
B) fentanyl.
C) cocaine.
D) heroin.D) heroin.. Fentanyl citrate (Sublimaze) is a(n):
A) opiate antagonist.
B) sedative-hypnotic.
C) Schedule I narcotic.
D) opioid analgesic.D) opioid analgesic.Lorazepam (Ativan) is a:
A) Schedule I long-acting opioid.
B) benzodiazepine receptor antagonist.
C) short-/intermediate-acting benzodiazepine.
D) barbiturate with analgesic properties.C) short-/intermediate-acting benzodiazepine.. Phenobarbital is classified as a:
A) Schedule II narcotic.
B) Schedule III benzodiazepine.
C) Schedule V sedative-hypnotic.
D) Schedule IV barbiturate.D) Schedule IV barbiturate.Hyperventilating a patient who has increased intracranial pressure (ICP) will:
A) dilate the cerebral vasculature and cause further increases in ICP.
B) constrict the cerebral vasculature and decrease cerebral perfusion.
C) increase the carbon dioxide levels in the brain through vasodilation.
D) decrease ICP and maintain adequate cerebral perfusion.B) constrict the cerebral vasculature and decrease cerebral perfusion.As intracranial pressure rises:
A) the heart rate acutely increases.
B) the brain becomes hypocarbic.
C) cerebral herniation may occur.
D) mean arterial pressure decreases.C) cerebral herniation may occur.. The MOST immediate and significant complication associated with a hemorrhagic stroke is:
A) acute hypovolemic shock.
B) hypertension and bradycardia.
C) mean arterial pressure increase.
D) increased intracranial pressure.D) increased intracranial pressure.What is the cerebral perfusion pressure of a patient with a mean arterial pressure of 80 mm Hg and an intracranial pressure of 5 mm Hg?
A) 60 mm Hg
B) 75 mm Hg
C) 90 mm Hg
D) 95 mm HgB) 75 mm HgWhich of the following would MOST likely cause a sustained increase in intracranial pressure?
A) Bearing down
B) Frequent coughing
C) Projectile vomiting
D) Intracranial tumorD) Intracranial tumorWhich of the following would have the MOST negative effect on the outcome of a patient with an intracranial hemorrhage?
A) Hypotension
B) Tachycardia
C) Hypertension
D) Slow rise in intracranial pressureA) Hypotension. For any patient with an increase in intracranial pressure, the paramedic must:
A) avoid administering IV fluid boluses.
B) give glucose to prevent hypoglycemia.
C) maintain an adequate blood pressure.
D) take measures to lower blood pressure.C) maintain an adequate blood pressure.Hyperventilating a patient who has increased intracranial pressure (ICP) will:
A) dilate the cerebral vasculature and cause further increases in ICP.
B) constrict the cerebral vasculature and decrease cerebral perfusion.
C) increase the carbon dioxide levels in the brain through vasodilation.
D) decrease ICP and maintain adequate cerebral perfusion.B) constrict the cerebral vasculature and decrease cerebral perfusion.Decerebrate posturing:
A) is characterized by abnormal flexion of the arms and extension of the lower extremities.
B) is considered less severe than decorticate posturing, because it indicates that the brainstem is intact.
C) is an early clinical finding, because it occurs with minimal increases in intracranial pressure.
D) is a more severe finding than decorticate posturing, as it indicates damage in or near the brainstem.D) is a more severe finding than decorticate posturing, as it indicates damage in or near the brainstem.. 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.The MOST disastrous consequence of a severe traumatic brain injury is:
A) an increase in intracranial pressure.
B) an increase in mean arterial pressure.
C) severe hypertension and bradycardia.
D) a decrease in cerebral perfusion pressure.D) a decrease in cerebral perfusion pressure.Early signs and symptoms of increased intracranial pressure include:
A) headache and vomiting.
B) hypertension and bradycardia.
C) widening of the pulse pressure.
D) arm flexion and leg extension.A) headache and vomiting.Increased intracranial pressure hydrocephalus occurs when:
A) the movement of CSF in the brain exceeds the production of CSF.
B) the movement of CSF decreases, but the production of CSF does not.
C) CSF production increases, which causes increased pressure in the skull.
D) total CSF volume decreases, which leads to excessive cerebral edema.B) the movement of CSF decreases, but the production of CSF does not.Pupils that differ in size by less than 1 mm:
A) indicate increased intracranial pressure.
B) may be a normal variant in some patients.
C) are a sign of methamphetamine abuse.
D) are a sign of optic nerve compression.B) may be a normal variant in some patients.. A high level of oxygen to the brain of a patient with a hemorrhagic stroke and increased intracranial pressure:
A) dilates the blood vessels and can cause brain herniation.
B) lowers intracranial pressure and oxygenates the brain.
C) increases intracranial pressure, but oxygenates the brain.
D) causes vasoconstriction and can impair brain perfusion.D) causes vasoconstriction and can impair brain perfusion.. Ventricular shunts are typically placed in children who:
A) are born with a congenital condition in which the ventricles of the brain produce excessive amounts of cerebrospinal fluid.
B) have experienced a severe traumatic brain injury that results in chronic cerebral edema and increased intracranial pressure.
C) are born with an abnormally small brain, which results in a relative increase in the amount of circulating cerebrospinal fluid.
D) have impaired circulation and absorption of cerebrospinal fluid, leading to increased size of the ventricles of the brain and increased intracranial pressure.D) have impaired circulation and absorption of cerebrospinal fluid, leading to increased size of the ventricles of the brain and increased intracranial pressure.Abnormal neurologic signs that accompany hypertensive encephalopathy occur when:
A) pressure in the brain causes transient dysfunction of the parietal lobe and cerebral vasodilation.
B) the mean arterial pressure exceeds 100 mm Hg and blood is forced from the brain and into the spinal cord.
C) neurons sustain permanent damage secondary to a single increase in blood pressure above 200/130 mm Hg.
D) pressure causes a breach in the blood-brain barrier and fluid leaks out, causing an increase in intracranial pressure.D) pressure causes a breach in the blood-brain barrier and fluid leaks out, causing an increase in intracranial pressure.. You receive a call to a residence for a 6-year-old girl with a decreased level of consciousness. The child has hydrocephalus following surgery to remove a brain tumor and has a ventricular shunt in place. The child's level of consciousness is markedly decreased from its baseline, and the child's caregiver tells you that she thinks the shunt is obstructed. Which of the following sets of vital signs is MOST indicative of shunt obstruction and increased intracranial pressure?
A) Blood pressure 140/92 mm Hg; pulse 58 beats/min; respirations 8 breaths/min
B) Blood pressure 106/66 mm Hg; pulse 80 beats/min; respirations 14 breaths/min
C) Blood pressure 90/50 mm Hg; pulse 110 beats/min; respirations 10 breaths/min
D) Blood pressure 130/68 mm Hg; pulse 70 beats/min; respirations 28 breaths/minA) Blood pressure 140/92 mm Hg; pulse 58 beats/min; respirations 8 breaths/minWhich of the following medications has been shown to blunt the increase in intracranial pressure associated with suctioning and laryngeal stimulation?
A) Atropine
B) Lidocaine
C) Amiodarone
D) FurosemideB) Lidocaine. MOST age-related visual disturbances are the result of:
A) diabetic retinopathy.
B) cataracts or glaucoma.
C) macular degeneration.
D) retinal artery occlusion.B) cataracts or glaucoma.Glaucoma is a condition caused by:
A) a loss of peripheral vision.
B) retinal artery occlusion.
C) increased intraocular pressure.
D) decreased vitreous humor.C) increased intraocular pressure.Patients with glaucoma often complain of:
A) a blind spot toward the center of vision.
B) a sudden painless complete loss of vision.
C) specks or floaters in the field of vision.
D) intense burning or itching around the eyes.A) a blind spot toward the center of vision.Headaches, nausea and vomiting, narrowing vision fields, and a "graying" in the field of vision are consistent with:
A) glaucoma.
B) papilledema.
C) corneal abrasion.
D) anterior uveitis.B) papilledema.For which of the following conditions is diphenhydramine contraindicated?
A) Severe motion sickness
B) Narrow-angle glaucoma
C) Acute dystonic reaction
D) Phenothiazine toxicityB) Narrow-angle glaucomaA patient presents with a sudden onset of unilateral eye pain and blurred vision. You should suspect:
A) acute optic nerve hypoplasia.
B) acute angle-closure glaucoma.
C) central retinal arterial occlusion.
D) spontaneous retinal detachment.B) acute angle-closure glaucoma.Esophageal varices are a direct result of:
A) esophageal erosion.
B) alcohol consumption.
C) portal hypertension.
D) cirrhosis of the liver.C) portal hypertension.A sudden onset of discomfort in the throat, severe dysphagia, and vomiting bright red blood are MOST indicative of:
A) ruptured esophageal varices.
B) gastroesophageal reflux disease.
C) a malignancy in the esophagus.
D) hemorrhage from a peptic ulcer.A) ruptured esophageal varices.The presentation of Mallory-Weiss syndrome is linked to _________ and is caused by _________.
A) eating spicy foods, erosion of the lining of the gastrointestinal tract
B) spastic coughing, rupture of esophageal veins due to portal hypertension
C) severe vomiting, a tear at the junction between the esophagus and stomach
D) blunt trauma, rupture of hollow organs with resultant peritoneal inflammationC) severe vomiting, a tear at the junction between the esophagus and stomachWhat disease is characterized by erosions in the mucous membrane lining of the gastrointestinal tract, specifically the stomach?
A) Peptic ulcer disease
B) Crohn's disease
C) Cholethiasis
D) CholecystitisA) Peptic ulcer disease. An obese 52-year-old woman who presents with severe pain in the right upper quadrant of her abdomen and pain in her right shoulder is MOST likely experiencing:
A) cholecystitis.
B) acute hepatitis.
C) Crohn disease.
D) Mallory-Weiss syndrome.A) cholecystitis.The MOST likely cause of Crohn disease is:
A) autoantibody destruction of the intestinal wall.
B) precancerous lesions in the lower intestinal tract.
C) chronically high triglyceride levels in the blood.
D) infection of the gastrointestinal tract with Helicobacter pylori.A) autoantibody destruction of the intestinal wall.A common cause of intrarenal acute renal failure is:
A) hypovolemia.
B) type 1 diabetes.
C) a renal calculus.
D) myocardial infarction.B) type 1 diabetes.A patient with prerenal acute renal failure would MOST likely present with:
A) confusion and hypertension.
B) joint pain and bladder distention.
C) hypotension and tachycardia.
D) peripheral edema and hematuria.C) hypotension and tachycardia.Which of the following statements regarding postrenal acute renal failure (ARF) is correct?
A) Patients with postrenal ARF typically develop severe hypokalemia.
B) Postrenal ARF involves damage to the renal parenchyma or tubules.
C) Postrenal ARF typically results in decreased pressure on the nephrons.
D) Postrenal ARF is caused by obstruction of urine flow from the kidneys.D) Postrenal ARF is caused by obstruction of urine flow from the kidneys.. Acute renal failure is MOST accurately defined as:
A) a sudden decrease in filtration through the glomeruli.
B) irreversible damage to the nephrons and renal tubules.
C) an acute drop in urine output to less than 750 mL/day.
D) sudden damage to the renal parenchyma due to sepsis.A) a sudden decrease in filtration through the glomeruli.It is important for the paramedic to consult with medical control prior to administering analgesia to a patient with severe flank pain and suspected acute renal failure because:
A) patients with renal failure often require high doses of analgesia.
B) renal failure may cause analgesics to accumulate to toxic levels.
C) most patients who are given analgesia will experience hypotension.
D) analgesia will mask the patient's pain and skew further examination.B) renal failure may cause analgesics to accumulate to toxic levels.. Renal failure, a key complication of crush syndrome, can be prevented by:
A) administering calcium chloride.
B) giving 40 mL/kg of lactated Ringer's.
C) giving the patient 25 g of glucose.
D) aggressively infusing normal saline.D) aggressively infusing normal saline.The main filter for blood in the kidney is the:
A) hilus.
B) calyces.
C) renal pyramid.
D) glomerulus.D) glomerulus.The structural and functional unit of the kidney is the:
A) nephron.
B) medulla.
C) renal cortex.
D) podocyte.A) nephron.The glomerular filtration rate is defined as the:
A) percentage of filtrate that remains in the kidneys.
B) amount of filtrate produced by the kidneys per minute.
C) volume of blood that flows through the kidneys per minute.
D) pressure in the glomerulus that forces filtrate from the blood.B) amount of filtrate produced by the kidneys per minute.Which of the following statements regarding pyelonephritis is correct?
A) Untreated pyelonephritis typically heals spontaneously.
B) Most cases of pyelonephritis occur in the lower urinary tract.
C) Pyelonephritis is an inflammation of the linings of the kidney.
D) In pyelonephritis, the ureters become inflamed and infected.C) Pyelonephritis is an inflammation of the linings of the kidney.All of the following conditions may cause urinary retention, EXCEPT:
A) testicular torsion.
B) nerve damage.
C) urinary tract infections.
D) benign prostatic hypertrophy.A) testicular torsion.In males, infection with Chlamydia trachomatis would MOST likely lead to:
A) hepatitis.
B) prostatitis.
C) bladder cancer.
D) testicular torsion.B) prostatitis.. Pelvic inflammatory disease commonly affects all of the following organs, EXCEPT the:
A) uterus.
B) ovaries.
C) urinary bladder.
D) fallopian tubes.C) urinary bladder.Pelvic inflammatory disease MOST commonly affects:
A) the external genitalia.
B) sexually active women.
C) postmenopausal women.
D) women over 30 years of age.B) sexually active women.Which of the following is a potential complication of pelvic inflammatory disease?
A) Uterine rupture
B) Ectopic pregnancy
C) Respiratory failure
D) Urinary tract infectionB) Ectopic pregnancy. Risk factors for pelvic inflammatory disease include all of the following, EXCEPT:
A) monogamy.
B) an intrauterine device.
C) heterosexual sex with multiple partners.
D) 20- to 24-year-old age group.A) monogamy.Reiter syndrome is:
A) an acute life-threatening condition that has been linked directly to the use of high-absorbency tampons.
B) a rare complication associated with untreated chlamydia and is characterized by arthritis and skin lesions.
C) a far more common and serious complication of untreated chlamydia than pelvic inflammatory disease.
D) a relatively common complication of untreated gonorrhea, and is characterized by low-grade fever and myalgia.B) a rare complication associated with untreated chlamydia and is characterized by arthritis and skin lesions.If a young female with a known history of gonorrhea presents with abdominal pain, nausea and vomiting, and bleeding between periods:
A) you should suspect disseminated gonococcemia.
B) one of her ovaries is probably grossly enlarged.
C) it is likely that she has an ectopic pregnancy.
D) she most likely has pelvic inflammatory disease.D) she most likely has pelvic inflammatory disease.Within a few days after having a therapeutic abortion, a 33-year-old woman presents with malaise, fever, constipation, and pelvic pain. Her blood pressure is 124/84 mm Hg, pulse rate is 104 beats/min and strong, and respirations are 22 breaths/min and regular. You should be MOST suspicious for:
A) acute cystitis.
B) endometritis.
C) a ruptured ovarian cyst.
D) pelvic inflammatory disease.B) endometritis.You are dispatched to a residence for a 34-year-old woman who is "sick." Upon your arrival, the patient greets you at the door. She tells you that she began experiencing a dull aching pain in the left lower quadrant of her abdomen. She further states that she recently had her menstrual period, which was accompanied by more pain than usual. Her vital signs are stable, she is conscious and alert, and she denies vaginal bleeding or fever. This patient MOST likely has:
A) an ectopic pregnancy.
B) a ruptured ovarian cyst.
C) a tubo-ovarian abscess.
D) pelvic inflammatory disease.B) a ruptured ovarian cyst.. During the menstrual cycle:
A) numerous follicles begin the process of maturation, but only one ultimately matures and releases an ovum.
B) all of the follicles that are released begin to mature and then ultimately die in a process called atresia.
C) the anterior pituitary gland releases luteinizing hormone, which facilitates the process of oocyte maturation.
D) the glands of the endometrium decrease in size and secrete the materials on which the egg will implant and grow.A) numerous follicles begin the process of maturation, but only one ultimately matures and releases an ovum.As the preovulatory phase of the menstrual cycle progresses:
A) the maturation of an oocyte occurs when follicle cells respond to follicle-stimulating hormone.
B) the anterior pituitary gland releases luteinizing hormone, which stimulates the release of an ovum.
C) gonadotropin-releasing factor stimulates the hypothalamus to release follicle-stimulating hormone.
D) follicle-stimulating hormone is released by the hypothalamus, which stimulates the process of ovulation.B) the anterior pituitary gland releases luteinizing hormone, which stimulates the release of an ovum.Which of the following conditions, if it remains undetected until puberty, can result in acute pain, severe constipation, and low back pain at the onset of menses?
A) Ovarian cyst
B) Endometriosis
C) Ectopic pregnancy
D) Imperforate hymenD) Imperforate hymen. The onset of menses is called ___________, and typically occurs between the ages of ___________.
A) menorrhea, 10 and 12 years
B) menarche, 11 and 14 years
C) menopause, 12 and 15 years
D) the climacteric, 14 and 16 yearsB) menarche, 11 and 14 yearsIn the average female, the menstrual cycle lasts ___ days.
A) 21
B) 24
C) 28
D) 35C) 28The headache commonly experienced by women during their menstrual cycle is caused by:
A) acute stress.
B) vasoconstriction.
C) hormonal release.
D) transient cerebral edema.C) hormonal release.A ruptured ovarian cyst typically presents with:
A) a sudden onset of abdominal pain that can be related to the menstrual cycle.
B) chronic waxing and waning abdominal cramping between menstrual periods.
C) dull or aching epigastric pain that radiates to the shoulders or lower back.
D) a sudden onset of upper abdominal pain and nausea without vomiting.A) a sudden onset of abdominal pain that can be related to the menstrual cycle.During normal menstruation, approximately ____ to ____ mL of blood is discharged from the vagina.
A) 25, 65
B) 50, 75
C) 65, 80
D) 75, 100A) 25, 65Which of the following does NOT occur after the ovum is not fertilized?
A) The endometrium breaks down and is shed as menstrual flow.
B) The secretory phase increases the size of the endometrial glands.
C) The ovum dies and degenerates 36 to 48 hours after being released.
D) The corpus luteum degenerates 10 to 12 days after lack of fertilization.B) The secretory phase increases the size of the endometrial glands.Which of the following medications would MOST likely be used in the prehospital setting to treat some women with severe premenstrual syndrome?
A) Haldol and Tylenol
B) Glucose and fentanyl
C) Valium and ibuprofen
D) Insulin and acetaminophenB) Glucose and fentanyl. Dysmenorrhea that occurs before, during, and after menstrual flow:
A) affects about 80% of women.
B) is called primary dysmenorrhea.
C) is generally hormonal in nature.
D) may signal an underlying illness.D) may signal an underlying illness.. After 35 years of age, age-related decrease in bone density is accelerated in females because:
A) females have an inherently weak bone structure.
B) of decreased estrogen levels secondary to menopause.
C) excess estrogen levels destroy the bone's periosteum.
D) of decreased bone marrow levels in the medullary canal.B) of decreased estrogen levels secondary to menopause.. In contrast to endometritis, endometriosis:
A) may present without abdominal pain.
B) is an inflammation of the uterine lining.
C) generally causes light menstrual periods.
D) is often the result of gynecologic surgery.A) may present without abdominal pain.By the end of the third week after conception, all of the following processes occur, EXCEPT:
A) the embryo is officially referred to as the fetus.
B) the embryonic process of forming specialized body systems.
C) the appearance of rudimentary functions of various body systems.
D) the woman has missed her menstrual period and suspects pregnancy.A) the embryo is officially referred to as the fetus.Which of the following questions is the MOST important to ask when obtaining a patient's gynecologic history?
A) "Do you have any abdominal pain?"
B) "When was your last sexual encounter?"
C) "When was your last menstrual period?"
D) "Is there a chance that you are pregnant?"C) "When was your last menstrual period?"A 30-year-old woman complains of an "achy" pain to both lower abdominal quadrants, which she states is made worse by walking. She further tells you that she recently finished her menstrual period. She has a fever of 101.9°F. Her blood pressure is 122/62 mm Hg, pulse rate is 84 beats/min and strong, and respirations are 14 breaths/min and unlabored. After gathering the rest of her medical history, you should:
A) provide emotional support, make her as comfortable as possible, and safely transport her to an appropriate hospital.
B) advise her that she can probably go to the hospital via personal vehicle since she is not showing signs of shock.
C) visually inspect her vagina for bleeding or discharge, start an IV line and set it to keep the vein open, and transport.
D) establish vascular access and give her a 250-mL normal saline bolus, consider analgesia for her pain, and transport.A) provide emotional support, make her as comfortable as possible, and safely transport her to an appropriate hospital.You are caring for a young woman with constant, diffuse abdominal pain, referred pain to both shoulders, and vaginal bleeding. She states that her last menstrual period was 2 months ago, but she adamantly denies being pregnant. Her blood pressure is 86/50 mm Hg, pulse rate is 120 beats/min and weak, and respirations are 24 breaths/min and regular. Which of the following interventions is NOT appropriate for this patient?
A) IV fluid boluses
B) Thermal management
C) Cardiac monitoring
D) Narcotic analgesiaD) Narcotic analgesiaYou are dispatched to a residence for a 34-year-old woman who is "sick." Upon your arrival, the patient greets you at the door. She tells you that she began experiencing a dull aching pain in the left lower quadrant of her abdomen. She further states that she recently had her menstrual period, which was accompanied by more pain than usual. Her vital signs are stable, she is conscious and alert, and she denies vaginal bleeding or fever. This patient MOST likely has:
A) an ectopic pregnancy.
B) a ruptured ovarian cyst.
C) a tubo-ovarian abscess.
D) pelvic inflammatory disease.B) a ruptured ovarian cyst.Which of the following conditions is characterized by a lack of progesterone and increased androgen levels, and can lead to gestational diabetes and cardiac problems?
A) Polycystic ovaries
B) Ectopic pregnancy
C) Corpus luteum cyst
D) Tubo-ovarian abscessA) Polycystic ovaries. The MOST common underlying cause of a tubo-ovarian abscess is:
A) vaginitis.
B) gonorrhea.
C) an ectopic pregnancy.
D) a ruptured ovarian cyst.B) gonorrhea.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) ThalamusThermoregulation is a function of the:
A) diencephalon.
B) anterior hypothalamus.
C) peripheral vasculature.
D) posterior pituitary gland.B) anterior hypothalamus.Components of the diencephalon include the:
A) pons and medulla.
B) brainstem and midbrain.
C) thalamus and hypothalamus.
D) cerebellum and cerebral cortex.C) thalamus and hypothalamus.The thermolytic tissues in the hypothalamus are mediated by the:
A) endocrine system.
B) sympathetic nervous system.
C) parasympathetic nervous system.
D) signals of the adrenergic nervous system.C) parasympathetic nervous system.. The primary anatomic link between the endocrine system and the nervous system is/are the:
A) pancreas.
B) adrenal glands.
C) hypothalamus.
D) adrenal cortex.C) hypothalamus.. Which of the following statements regarding the hypothalamus is correct?
A) The hypothalamus works in conjunction with the subthalamus and regulates motor functions of the body.
B) The hypothalamus is located in the inferior portion of the diencephalon and influences body movement in response to fear.
C) The hypothalamus is located between the brainstem and cerebrum and is solely responsible for maintaining body temperature.
D)The hypothalamus is the most inferior portion of the diencephalon and controls functions such as hunger, sleep, and vomitingD) The hypothalamus is the most inferior portion of the diencephalon and controls functions such as hunger, sleep, and vomiting.The adrenal medulla secretes norepinephrine following stimulation from the:
A) brainstem.
B) diencephalon.
C) hypothalamus.
D) pituitary gland.C) hypothalamus.. Renin is a protein that is released into the bloodstream by the _________ in response to changes in __________.
A) kidneys, blood pressure
B) liver, acid-base balance
C) pancreas, insulin levels
D) hypothalamus, body temperatureA) kidneys, blood pressureAs multiple myeloma progresses, the patient would MOST likely experience:
A) frequent nosebleeds.
B) spontaneous fractures.
C) acute intracranial bleeding.
D) atrophy of large muscle groups.B) spontaneous fractures.. 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 system.A) bone marrow is replaced with abnormal lymphoblasts.Assessment of patients with collagen vascular diseases should focus on:
A) ruling out life threats.
B) high-dose analgesia.
C) crystalloid fluid boluses.
D) high-flow oxygen therapy.A) ruling out life threats.Vascular compensation for changes in blood pressure decreases with age due to:
A) a 60% to 70% decrease in sympathetic nervous system stimulation and catecholamine release.
B) a marked reduction in renal function with increased sodium reabsorption in the renal tubules.
C) left ventricular hypertrophy and the subsequent decrease in cardiac output that it causes.
D) reduced elasticity of the peripheral vessels secondary to decreases in elastin and collagen.D) reduced elasticity of the peripheral vessels secondary to decreases in elastin and collagen.. Systemic lupus erythematosus is a disease caused by:
A) a multisystem autoimmune disorder.
B) a marked deficiency of neutrophils.
C) primary immune system failure.
D) excessive IgE antibody production.A) a multisystem autoimmune disorder.Patients with systemic lupus erythematosus:
A) are routinely treated with high-dose antibiotic therapy.
B) often take medications that suppress their immune system.
C) have increases in their red blood cell and platelet counts.
D) are typically males between the ages of 50 and 75 years.B) often take medications that suppress their immune system.A 26-year-old female presents with a fever, rash, and joint pain. Which of the following should you suspect?
A) Lupus
B) Anaphylaxis
C) Scleroderma
D) Allergic reactionA) LupusAn antigen is MOST accurately defined as a:
A) chemical the immune system produces to destroy an allergen.
B) substance that causes the immune system to produce antibodies.
C) chemical mediator that deactivates foreign substances in the body.
D) harmless substance that the body does not recognize as being foreign.B) substance that causes the immune system to produce antibodies.The term anaphylaxis is MOST accurately defined as:
A) overprotection.
B) atopic disease.
C) without protection.
D) immune suppression.C) without protection.An increase in blood pressure that commonly occurs with aging is physiologically exacerbated by:
A) a compensatory increase in preload and cardiac ejection fraction.
B) a decrease in stroke volume due to age-induced cardiomyopathy.
C) an overproduction of collagen and decreased quantities of elastin.
D) the patient's noncompliance with his or her antihypertensive drugs.C) an overproduction of collagen and decreased quantities of elastin.The 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.When a person is vaccinated against a disease:
A) the body develops antibodies in response to the vaccine and produces an immune response before the disease can enter the body and cause damage.
B) the immune system does not produce any antibodies against that particular disease unless the person is directly or indirectly exposed to it.
C) a secondary response occurs, as antibodies are produced and the vaccinated person experiences a milder form of the disease against which he or she has been vaccinated.
D) smaller titers of the disease are injected into the person, which results in the production of antibodies that cause histamine release and a mild allergic reaction.A) the body develops antibodies in response to the vaccine and produces an immune response before the disease can enter the body and cause damage.. Unlike an allergic reaction, an autoimmune reaction:
A) targets an antigen or allergen.
B) is generally predictable.
C) targets a person's own tissues.
D) does not involve antibodies.C) targets a person's own tissues.All of the following diseases are autoimmune diseases, EXCEPT:
A) rheumatoid arthritis.
B) type 1 diabetes.
C) HIV infection.
D) myasthenia gravis.C) HIV infection.. Anemia resulting from an autoimmune disorder occurs when:
A) the body's red blood cells destroy certain white blood cells.
B) a patient receives blood of a type different than his or her own.
C) hemoglobin becomes desaturated due to a massive infection.
D) red blood cells are destroyed by the body's own antibodies.D) red blood cells are destroyed by the body's own antibodies.While assessing a 59-year-old man with an acute onset of crushing chest pain and diaphoresis, the patient tells you that he recently tested positive to a tuberculin skin test. His vital signs reveal hypertension and tachycardia. You should be MOST concerned with:
A) applying a mask to the patient to reduce your chance of exposure.
B) reporting this to your supervisor and receiving a tuberculin skin test.
C) establishing vascular access and rapidly transporting to the hospital.
D) the fact that he may be experiencing an acute myocardial infarction.D) the fact that he may be experiencing an acute myocardial infarction.. Which of the following is NOT included in the Centers for Disease Control and Prevention's list of recommended immunizations and tests for health care providers?
A) Annual HIV testing
B) Hepatitis B vaccine
C) TB testing
D) Measles, mumps, and rubellaA) Annual HIV testingA person with TB infection:
A) poses a significant health risk to others.
B) has active TB and is highly contagious.
C) usually has a negative chest radiograph.
D) has tested positive for exposure to TB.D) has tested positive for exposure to TB.Common signs and symptoms of TB include all of the following, EXCEPT:
A) hemoptysis.
B) photophobia.
C) weight loss.
D) a persistent cough.B) photophobia.A paramedic would MOST likely be infected with TB if he or she:
A) was close to a coughing patient who had a positive TB skin test.
B) performed mouth-to-mouth on a patient with active untreated TB.
C) was exposed to blood-stained vomitus of a patient with active TB.
D) received a needlestick from a person suspected of having active TB.B) performed mouth-to-mouth on a patient with active untreated TB.A person who is taking antibiotic therapy following a positive TB skin test and chest radiograph should not consume alcohol because:
A) this increases the risk of active TB.
B) alcohol can cause a violent reaction.
C) the antibiotics are toxic to the liver.
D) alcohol causes immunocompromise.C) the antibiotics are toxic to the liver.. Which of the following statements regarding TB is correct?
A) A surgical mask should be worn when caring for any patient with TB.
B) N95 respirators do not provide protection against TB as once thought.
C) The number of patients with TB has been declining over the last 5 years.
D) It is one of the most common diseases contracted by breathing in germs.D) It is one of the most common diseases contracted by breathing in germs.Postexposure prophylaxis is available for all of the following diseases, EXCEPT:
A) HIV.
B) hepatitis C.
C) syphilis.
D) gonorrhea.B) hepatitis C.The MOST common underlying cause of a tubo-ovarian abscess is:
A) vaginitis.
B) gonorrhea.
C) an ectopic pregnancy.
D) a ruptured ovarian cyst.B) gonorrhea.If a young female with a known history of gonorrhea presents with abdominal pain, nausea and vomiting, and bleeding between periods:
A) you should suspect disseminated gonococcemia.
B) one of her ovaries is probably grossly enlarged.
C) it is likely that she has an ectopic pregnancy.
D) she most likely has pelvic inflammatory disease.D) she most likely has pelvic inflammatory disease.. Transmission of gonorrhea occurs when contact is made with:
A) the infected person's blood through an area where the skin is not intact.
B) pus-containing fluid from the mucous membranes of the infected person.
C) any portion of the infected person's genitalia during sexual intercourse.
D) all of the infected person's bodily fluids, with or without sexual contact.B) pus-containing fluid from the mucous membranes of the infected person.Gonorrhea in females:
A) is usually more acute and pronounced than it is in males.
B) typically manifests as dysuria within 24 hours of infection.
C) often goes unnoticed until signs of acute abdomen appear.
D) remains communicable for up to 48 hours after treatment.C) often goes unnoticed until signs of acute abdomen appear.You are dispatched to an apartment complex for a 20-year-old woman who is sick. When you arrive at the scene and begin assessing the patient, she tells you that she has been experiencing a purulent vaginal discharge, but denies vaginal bleeding or a fever. Her blood pressure is 104/64 mm Hg, pulse rate is 88 beats/min and strong, and respirations are 14 breaths/min and regular. This patient MOST likely has:
A) syphilis.
B) chlamydia.
C) gonorrhea.
D) pelvic inflammatory disease.C) gonorrhea.Which of the following factors would MOST likely produce a falsely normal pulse oximetry reading?
A) Carboxyhemoglobin
B) Peripheral vasodilation
C) A dimly lit environment
D) Heart rate above 120 beats/minA) CarboxyhemoglobinCarboxyhemoglobin:
A) is a combination of oxygen and hemoglobin.
B) effectively carries oxygen to the body's cells.
C) is the chemical by-product of cyanide poisoning.
D) is hemoglobin combined with carbon monoxide.D) is hemoglobin combined with carbon monoxide.Pulse oximetry will not provide a true assessment of arterial oxygenation in patients with carbon monoxide toxicity because:
A) the device falsely interprets oxyhemoglobin as carboxyhemoglobin.
B) carbon monoxide damages the computer chip inside the pulse oximeter.
C) the device cannot determine whether carbon monoxide or oxygen is bound to the hemoglobin.
D) carbon monoxide turns the blood dark red, which indicates low oxygen content.C) the device cannot determine whether carbon monoxide or oxygen is bound to the hemoglobin.The toxicity of carbon monoxide arises primarily from:
A) its destructive properties on ferric ions.
B) its affinity for hemoglobin in red blood cells.
C) the fact that carbon monoxide destroys hemoglobin molecules.
D) its ability to markedly decrease the metabolic rate.B) its affinity for hemoglobin in red blood cells.Cyanide blocks the utilization of oxygen at the cellular level by:
A) binding to monoamine oxidase.
B) directly destroying red blood cells.
C) binding to the hemoglobin molecule.
D) combining with cytochrome oxidase.D) combining with cytochrome oxidase.What is formed when carbon monoxide binds to the hemoglobin molecule?
A) Myoglobin
B) Oxyhemoglobin
C) Methemoglobin
D) CarboxyhemoglobinD) CarboxyhemoglobinYou would expect a person to be hypertensive and tachycardic following exposure to all of the following, EXCEPT:
A) cocaine.
B) parathion.
C) phenobarbital.
D) pseudoephedrine.C) phenobarbital.Crack is a combination of:
A) cocaine, baking soda, and water.
B) marijuana, heroin, and baking soda.
C) heroin, cocaine, and distilled water.
D) ecstasy, marijuana, and alcohol.A) cocaine, baking soda, and water.Which of the following ECG abnormalities is MOST suggestive of cocaine toxicity?
A) Narrowing of the PR interval
B) Marked flattening of the T wave
C) Narrowing of the QRS complex
D) Prolongation of the QT intervalD) Prolongation of the QT intervalA person who is "speedballing" is:
A) highly addicted to methamphetamine, cocaine, and marijuana and mixes all three drugs together to achieve various levels of euphoria.
B) using cocaine in combination with heroin, by injecting them either underneath the skin or directly into a vein, in order to regulate the high.
C) packaging cocaine in small plastic bags and swallowing them for the purpose of transporting the cocaine from one location to another location.
D) using heroin to withdraw or detoxify himself or herself from cocaine by gradually increasing the amounts of heroin taken while decreasing the amounts of cocaine used.B) using cocaine in combination with heroin, by injecting them either underneath the skin or directly into a vein, in order to regulate the high.. Unlike the effects of cocaine, the effects of methamphetamine:
A) last much longer.
B) often result in paranoia.
C) can be reversed with naloxone.
D) predispose the patient to violence.A) last much longer.Which of the following clinical presentations is MOST consistent with cocaine ingestion in a child?
A) Diaphoresis, miosis, tachycardia, and bronchospasm
B) Miosis, bradycardia, hypoventilation, and hypotension
C) Mydriasis, diarrhea, hypothermia, and hallucinations
D) Hypertension, tachycardia, diaphoresis, and mydriasisD) Hypertension, tachycardia, diaphoresis, and mydriasisYou arrive at the scene of an unknown drug-related emergency. Law enforcement is present and has ensured scene security. The patient, a young male, is found sitting at the kitchen table. He is laughing uncontrollably and tells you, "Life sure is good!" Your partner finds a basin of water and an empty box of baking soda on the counter. You should be MOST suspicious that this patient:
A) is speedballing.
B) has injected heroin.
C) was snorting cocaine.
D) has smoked crack cocaine.D) has smoked crack cocaine.Gross distortions of reality, withdrawal from social contacts, and bizarre behavior are MOST characteristic of:
A) depression.
B) schizophrenia.
C) bipolar disorder.
D) obsessive-compulsive disorder.B) schizophrenia.Prolonged or excessive stress has been proven to be a strong contributor to:
A) depression.
B) hypotension.
C) schizophrenia.
D) bipolar disorder.D) bipolar disorder.Patients who alternate between mania and depression:
A) are referred to as bipolar.
B) present with a flat affect.
C) have multiple personalities.
D) have a history of schizophrenia.A) are referred to as bipolar.. Manic patients may report that their thoughts are racing and they may rapidly skip from one topic to another. This is called:
A) confabulation.
B) tangential thinking.
C) circumstantial thinking.
D) thought broadcasting.B) tangential thinking.A state of delusion in which a person is out of touch with reality is MOST appropriately termed:
A) psychosis.
B) derealization.
C) schizophrenia.
D) tangential thinking.A) psychosis.A psychotic person may have thought insertions, which are defined as:
A) a gross distortion of your comments into what he or she believes to be true.
B) the belief that thoughts are being thrust into his or her mind by another person.
C) the fear that his or her thoughts are being broadcast aloud and heard by others.
D) strange or pressured speech because of unusual words the patient has invented.B) the belief that thoughts are being thrust into his or her mind by another person.When caring for a patient experiencing a psychotic episode, you should:
A) involve people the patient trusts.
B) be calm, direct, and straightforward.
C) first assess the situation for danger.
D) clearly identify yourself to the patient.C) first assess the situation for danger.You are assessing a middle-aged woman who is acutely disoriented. According to her husband, she has bipolar disorder and, to the best of his knowledge, has been compliant with her medication. Her blood pressure is 106/66 mm Hg, pulse rate is 100 beats/min and strong, and respirations are 14 breaths/min and regular. During your care of this patient, it is MOST important to:
A) establish vascular access and administer naloxone.
B) assess her oxygen saturation and blood glucose level.
C) attempt to assist her breathing with a bag-mask device.
D) ask her simple questions that can be answered yes or no.B) assess her oxygen saturation and blood glucose level.. Lithium is MOST commonly used to treat patients with:
A) depression.
B) schizophrenia.
C) chronic anxiety.
D) bipolar disorder.D) bipolar disorder.During your assessment of an unresponsive 70-year-old man, the patient's wife tells you that he takes Luvox and BuSpar, among other medications. From this limited information, you should conclude that the patient suffers from:
A) bipolar disorder.
B) paranoid schizophrenia.
C) chronic manic behavior.
D) depression and anxiety.depressionYou are called to a community center for a 40-year-old woman who is "acting strange." Upon your arrival, you assess the patient and determine that she is conscious, alert, and oriented to person, place, time, and event. She does not appear to be mentally impaired. Her oxygen saturation is 99% on room air and her blood glucose level is 112 mg/dL. The patient's husband tells you that his wife has bipolar disorder and takes medication for it. The patient tells you that she is fine and does not want to go to the hospital. You should:
A) contact online medical control and request permission to transport the patient against her will because of her bipolar disorder.
B) recognize that this patient has decision-making capacity at the present time and that you cannot force her to go to the hospital.
C) transport the patient against her will, but only if it can be established that she has been noncompliant with her bipolar medication.
D) advise the patient that, because of her history of bipolar disorder, she does not have the legal capacity to refuse EMS treatment and transport.B) recognize that this patient has decision-making capacity at the present time and that you cannot force her to go to the hospital.According to the American College of Surgeons, an injured patient should be transported to a Level I trauma center if his or her:
A) heart rate is greater than 100 beats/min.
B) systolic blood pressure is less than 90 mm Hg.
C) respiratory rate is less than 14 breaths/min.
D) Glasgow Coma Scale score is less than 15.B) systolic blood pressure is less than 90 mm Hg.Which of the following injuries would MOST likely require transport to a Level I trauma center?
A) Two or more proximal long bone fractures
B) Superficial burns to an entire lower extremity
C) Lateral neck pain following a motor vehicle crash
D) Penetrating injury that is distal to the elbow or kneeA) Two or more proximal long bone fracturesIf the mechanism of injury does not appear to be significant, you should consider transporting an injured patient to a Level I trauma center if he or she:
A) is older than 45 years of age.
B) takes any kind of medication.
C) is emotionally upset or angry.
D) has a known bleeding disorder.D) has a known bleeding disorder.. A specific attribute of a Level I trauma center is that it:
A) is involved in an injury prevention program.
B) can initiate definitive care for all injured patients.
C) has 24-hour in-house coverage by general surgeons.
D) has rapid access to an off-site anesthesiologist.C) has 24-hour in-house coverage by general surgeons.. At a minimum, a Level II trauma center should:
A) have an in-house neurosurgeon 24 hours a day.
B) be able to initiate definitive care for all injured patients.
C) have access to an emergency physician within 20 minutes.
D) provide total care for every aspect of a patient's injuries.B) be able to initiate definitive care for all injured patients.If a Level I trauma center is 30 miles away, and a Level II trauma center is 10 miles away, it would be MOST appropriate to transport a patient with a severe traumatic brain injury:
A) by ground to the Level I trauma center.
B) to the closest hospital for stabilization.
C) via air transport to the Level I trauma center.
D) by ground to the Level II trauma center.C) via air transport to the Level I trauma center.. You arrive at the scene of a major motor vehicle crash. The patient, a 29-year-old man, is in cardiac arrest from a severe head injury and has been receiving bystander CPR for approximately 10 minutes. A law enforcement official advises you that the patient's driver's license identifies him as an organ donor. You should:
A) recognize that none of the patient's vital organs are appropriate for donation and ask the bystanders to stop CPR.
B) continue to attempt resuscitation of the patient because his liver, kidneys, and heart are likely viable for harvesting.
C) begin full resuscitative efforts and transport the patient to a trauma center because certain tissues may be viable for harvesting.
D) continue basic life support only until law enforcement can notify a family member of the patient and obtain consent for organ donation.C) begin full resuscitative efforts and transport the patient to a trauma center because certain tissues may be viable for harvesting.Penetrating abdominal trauma MOST commonly results from:
A) flying debris following an explosion.
B) high-powered rifles or military weapons.
C) low-velocity gunshot or stab wounds.
D) crush forces that separate the abdominal wall.C) low-velocity gunshot or stab wounds.Which of the following factors does NOT contribute to the extent of injury from a gunshot wound to the abdomen?
A) Size of the patient
B) Profile of the bullet
C) Trajectory of the bullet
D) Distance the bullet traveledA) Size of the patientWhich of the following injury mechanisms would MOST likely result in blunt trauma?
A) Small-caliber gunshot wound
B) Explosion involving shards of glass
C) Falling from a tree onto a fence
D) The pressure wave caused by a blastD) The pressure wave caused by a blastHow can you BEST assist law enforcement at the scene of a crime involving a gunshot wound or stabbing?
A. Begin patient care after all evidence has been collected.
B. Examine an expended gun casing to identify the caliber.
C. Avoid cutting through bullet holes or knife cuts on a shirt.
D. Collect blood on a 4-inch by 4-inch dressing and give it to the policeC. Avoid cutting through bullet holes or knife cuts on a shirt.. You receive a call to a residence in a rural area of your jurisdiction for a patient with an acute COPD exacerbation. Upon arriving at the scene, you knock on the door and identify yourself. The patient, an elderly-sounding man, tells you that you took too long to get to him, and that he has a shotgun. You should:
A. look inside a nearby window to see if he really does have a gun.
B. immediately retreat to the ambulance and notify law enforcement.
C. advise the patient that you got to the scene as quickly as possible.
D. stay at a safe distance from the door and ask the man to walk outside.
Sets found in the same folder
Final
250 terms
Final PT.2
250 terms
Final PT.4
250 terms
Final Pt.5
233 terms
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