WCC EMS Exam 4 (Ch. 11-20) Spring 2017 M. Greenberg Friday, February 24, 2017

WCC EMS Exam 4 (Ch. 11-20) Spring 2017 M. Greenberg Friday, February 24, 2017

Name: ______Date: ______

___ 1. / A drug is contraindicated for a patient when it:
a) / is used to treat a multitude of conditions.
b) / may cause harm or have no positive effect.
c) / produces actions other than the desired ones.
d) / is used to treat a specific medical condition.
___ 2. / Which of the following statements regarding parenteral medications is correct?
a) / Tylenol is an example of a parenteral medication because it is taken orally.
b) / Parenteral medications are absorbed more quickly than enteral medications.
c) / Compared to enteral medications, parenteral medications have fewer side effects.
d) / Parenteral medications are absorbed by the body through the digestive system.
___ 3. / A mucosal atomizer device (MAD) is used to deliver certain medications via the:
a) intranasal route. b) inhalation route. c) sublingual route. d) transdermal route.
___ 4. / A 49-year-old male with an extensive cardiac history presents with 2 hours of crushing chest pain and shortness of breath. He is pale and diaphoretic and tells you that he feels like he is going to die. His medications include nitroglycerin, sildenafil (Viagra), and enalapril (Vasotec). His blood pressure is 140/90 mm Hg and his heart rate is 110 beats/min. In addition to administering 100% oxygen, you should:
a) / obtain physician approval to give the nitroglycerin.
b) / place him in a supine position and transport at once.
c) / administer one nitroglycerin and call medical control.
d) / ask him if he took his Viagra within the past 24 hours.
___ 5. / Aspirin is beneficial to patients suspected of having a heart attack because it:
a) / reduces the associated chest pain. / c) / causes direct coronary vasodilation.
b) / dissolves the coronary artery clot. / d) / prevents the aggregation of platelets.
___ 6. / When the body senses a state of hypoperfusion, the sympathetic nervous system releases epinephrine, the effects of which include:
a) tachypnea. b) tachycardia. c) vasodilation. d) restlessness.
___ 7. / You respond to a residence for a patient with a severe leg injury following an accident with a chainsaw. When you arrive, you find the patient, a 44-year-old male, lying supine in the backyard. He has a partial amputation of his right lower leg that is actively bleeding. The patient is conscious and breathing adequately; however, he is restless and his skin is diaphoretic. You should:
a) / immediately evaluate his airway. / c) / assess the rate and quality of his pulse.
b) / apply direct pressure to the wound. / d) / administer 100% supplemental oxygen.
___ 8. / Cardiogenic shock may result from all of the following, EXCEPT:
a) heart attack. b) increased afterload. c) increased preload. d) poor contractility.
___ 9. / A 19-year-old male was stung multiple times by fire ants. He is experiencing obvious signs and symptoms of anaphylactic shock. You administer 100% oxygen and give him epinephrine via subcutaneous injection. Upon reassessment, you determine that his condition has not improved. You should:
a) / transport him immediately and provide supportive care while en route.
b) / consider that he may actually be experiencing an acute asthma attack.
c) / repeat the epinephrine injection after consulting with medical control.
d) / request a paramedic unit that is stationed approximately 15 miles away.
___ 10. / A 25-year-old unrestrained female struck the steering wheel with her chest when her car hit a tree while traveling at a high rate of speed. She has signs and symptoms of shock, which you suspect are the result of intrathoracic bleeding. Which of the following interventions will provide this patient with the greatest chance for survival?
a) / 100% oxygen administration
b) / full immobilization of her spine
c) / application of the pneumatic antishock garment (PASG)
d) / rapid transport to a trauma center
___ 11. / Several attempts to adequately open a trauma patient's airway with the jaw-thrust maneuver have been unsuccessful. You should:
a) / try opening the airway by lifting up on the chin.
b) / carefully perform the head tilt–chin lift maneuver.
c) / tilt the head back while lifting up on the patient's neck.
d) / suction the airway and reattempt the jaw-thrust maneuver.
___ 12. / Your partner is performing one-rescuer CPR on a middle-aged woman in cardiac arrest. When you apply the AED pads, you note that she has a medication patch over the same area where one of the AED pads will be placed. You should:
a) / apply the AED pad at least 1 away from the medication patch to avoid skin burns.
b) / continue CPR until you can determine the name of the medication contained in the patch.
c) / move the patch to another area of the patient's chest and then properly apply the AED pads.
d) / remove the medication patch, wipe away any medication residue, and apply the AED pads.
___ 13. / You and your partner arrive at the side of a 60-year-old woman who suddenly collapsed about 7 minutes ago. She is unresponsive, apneic, and pulseless. You should:
a) / begin CPR and apply the AED as soon as it is available.
b) / immediately apply the AED and analyze her cardiac rhythm.
c) / begin CPR at a compression to ventilation ratio of 15:2.
d) / apply the AED if there is no response after 10 cycles of CPR.
___ 14. / Basic life support (BLS) is defined as:
a) / invasive emergency medical interventions such as intravenous therapy, manual defibrillation, and advanced airway management.
b) / any form of emergency medical treatment that is performed by advanced EMTs, paramedics, physicians, and emergency nurses.
c) / basic lifesaving treatment that is performed by bystanders while EMS providers are en route to the scene of an emergency.
d) / noninvasive emergency care that is used to treat conditions such as airway obstruction, respiratory arrest, and cardiac arrest.
___ 15. / Which of the following is NOT a BLS intervention?
a) / abdominal thrusts / c) / cardiac monitoring
b) / chest compressions / d) / automated defibrillation
___ 16. / You and your EMT partner arrive at the residence of a 50-year-old man who complains of weakness. Your primary assessment reveals that he is critically ill and will require aggressive treatment. The closest hospital is 25 miles away. You should:
a) / perform a detailed secondary assessment, assess his vital signs, and then transport rapidly.
b) / manage all threats to airway, breathing, and circulation and consider requesting an ALS unit.
c) / administer oxygen via nonrebreathing mask and obtain as much of his medical history as possible.
d) / load him into the ambulance, begin transport, and perform all treatment en route to the hospital.
___ 17. / A 58-year-old man complains of chest discomfort and nausea. He is conscious and alert; his blood pressure is 140/90 mm Hg, his pulse is 104 beats/min, and his respirations are 16 breaths/min. Your partner has applied supplemental oxygen. Prior to assisting the patient with one of his prescribed nitroglycerin tablets, you ask him if he takes medication to treat erectile dysfunction and he tells you that he does. You should:
a) / avoid giving him nitroglycerin and transport him at once.
b) / ask him what he takes, how much, and when he last took it.
c) / recall that erectile dysfunction drugs can cause hypertension if given with nitroglycerin.
d) / administer his nitroglycerin and then reassess his blood pressure.
___ 18. / Typical chief complaints in patients with an infectious disease include:
a) / fever, rash, nausea, and difficulty breathing.
b) / crushing chest pain, vomiting, and weakness.
c) / headache, low back pain, and arm numbness.
d) / joint pain, muscle aches, and blurred vision.
___ 19. / Which of the following medications would the EMT LEAST likely administer to a patient with a medical complaint?
a) naloxone (Narcan) b) aspirin c) albuterol d) oral glucose
___ 20. / In which of the following situations would it be MOST appropriate to utilize an air medical transportation service?
a) / 29-year-old woman who is 18 weeks pregnant, has light vaginal bleeding, and stable vital signs
b) / 43-year-old man experiencing a heart attack, and the closest appropriate hospital is 15 minutes away
c) / 50-year-old conscious woman with severe nausea and vomiting, fever, and chills of 3 days' duration
d) / 61-year-old man with signs and symptoms of a stroke and your ground transport time is 50 minutes
___ 21. / Hyperventilation could be associated with all of the following, EXCEPT:
a) / a narcotic overdose. / c) / an overdose of aspirin.
b) / a respiratory infection. / d) / high blood glucose levels.
___ 22. / Harsh, high-pitched inspiratory sounds are characteristic of:
a) rales. b) stridor. c) rhonchi. d) wheezing.
___ 23. / Common signs and symptoms of acute hyperventilation syndrome include:
a) / altered mental status and bradycardia. / c) / anxiety, dizziness, and severe bradypnea.
b) / unilateral paralysis and slurred speech. / d) / tachypnea and tingling in the extremities.
___ 24. / Which of the following statements regarding the hypoxic drive is MOST correct?
a) / The hypoxic drive stimulates a person to breathe on the basis of low oxygen levels.
b) / Chronic carbon dioxide elimination often results in activation of the hypoxic drive.
c) / The hypoxic drive serves as the primary stimulus for breathing in healthy individuals.
d) / 100% supplemental oxygen will always cause apnea in patients with a hypoxic drive.
___ 25. / Paroxysmal nocturnal dyspnea (PND), rales, and dependent edema are clinical indicators of:
a) / emphysema. / c) / bronchitis or asthma.
b) / severe pneumonia. / d) / congestive heart failure.
___ 26. / Signs and symptoms of a hypertensive emergency would MOST likely be delayed in patients who:
a) / have chronic hypertension. / c) / have had a stroke in the past.
b) / regularly take illegal drugs. / d) / are older than 40 years of age.
___ 27. / Prior to defibrillating a patient with an AED, it is MOST important that you:
a) / properly position the defibrillation pads. / c) / confirm that the patient is in cardiac arrest.
b) / perform up to 5 minutes of effective CPR. / d) / ensure that no one is touching the patient.
___ 28. / A patient with atherosclerotic heart disease experiences chest pain during exertion because the:
a) / coronary arteries suddenly spasm and cause a marked reduction in myocardial blood flow.
b) / lumen of the coronary artery is narrowed and cannot accommodate increased blood flow.
c) / tissues of the myocardium undergo necrosis secondary to a prolonged absence of oxygen.
d) / ragged edge of a tear in the coronary artery lumen causes local blood clotting and arterial narrowing.
___ 29. / The electrical impulse generated by the heart originates in the:
a) / bundle of His. / c) / sinoatrial (SA) node.
b) / coronary sinus. / d) / atrioventricular (AV) node.
___ 30. / The EMT should use an AED on a child between 1 month and 8 years of age if:
a) / he or she is not breathing and has a weakly palpable pulse.
b) / his or her condition is rapidly progressing to cardiac arrest.
c) / pediatric pads and an energy-reducing device are available.
d) / special pads are used and the child has profound tachycardia.
___ 31. / A patient with an altered mental status is:
a) / completely unresponsive to all forms of stimuli.
b) / typically alert but is confused as to preceding events.
c) / usually able to be aroused with a painful stimulus.
d) / not thinking clearly or is incapable of being aroused.
___ 32. / A patient whose speech is slurred and difficult to understand is experiencing:
a) aphasia. b) dysarthria. c) dysphagia. d) paraplegia.
___ 33. / Which of the following MOST accurately describes a simple partial seizure?
a) / a seizure that begins in one extremity
b) / a seizure that causes the patient to stare blankly
c) / a seizure that is not preceded by an aura
d) / a generalized seizure without incontinence
___ 34. / The left cerebral hemisphere controls:
a) / the right side of the face. / c) / the right side of the body.
b) / heart rate and pupil reaction. / d) / breathing and blood pressure.
___ 35. / Which of the following medications is NOT used to treat patients with a history of seizures?
a) / phenytoin (Dilantin) / c) / carbamazepine (Tegretol)
b) / hydromorphone (Dilaudid) / d) / phenobarbital
___ 36. / A young female presents with costovertebral angle tenderness. She is conscious and alert with stable vital signs. Which of the following organs is MOST likely causing her pain?
a) liver b) kidney c) pancreas d) gallbladder
___ 37. / The MOST important treatment for a patient with severe abdominal pain and signs of shock includes:
a) / administering high-flow oxygen. / c) / transporting the patient without delay.
b) / giving oral fluids to maintain perfusion. / d) / positioning the patient on his or her side.
___ 38. / Pain that is localized to the lower back and/or lower abdominal quadrants is MOST suggestive of:
a) acute pancreatitis. b) an aortic aneurysm. c) a kidney infection. d) acute appendicitis.
___ 39. / Elderly patients with abdominal problems may not exhibit the same pain response as younger patients because of:
a) / chronic dementia, which inhibits communication.
b) / interactions of the numerous medications they take.
c) / progressive deterioration of abdominal organ function.
d) / age-related deterioration of their sensory systems.
___ 40. / Solid abdominal organs include the:
a) / stomach and small intestine. / c) / gallbladder and large intestine.
b) / spleen, kidneys, and pancreas. / d) / urinary bladder, colon, and ureters.
___ 41. / Which of the following statements regarding diabetic coma is correct?
a) / Diabetic coma can be prevented by taking smaller insulin doses.
b) / Diabetic coma typically develops over a period of hours or days.
c) / Patients with low blood glucose levels are prone to diabetic coma.
d) / Diabetic coma rapidly progresses once hyperglycemia develops.
___ 42. / Kussmaul respirations are an indication that the body is:
a) / attempting to eliminate acids from the blood.
b) / trying to generate energy by breathing deeply.
c) / severely hypoxic and is eliminating excess CO2.
d) / compensating for decreased blood glucose levels.
___ 43. / When assessing an unconscious diabetic patient, the primary visible difference between hyperglycemia and hypoglycemia is the:
a) / patient's mental status. / c) / presence of a medical identification tag.
b) / rate of the patient's pulse. / d) / rate and depth of breathing.
___ 44. / Diabetes is MOST accurately defined as a(n):
a) / disorder of carbohydrate metabolism. / c) / mass excretion of glucose by the kidneys.
b) / abnormally high blood glucose level. / d) / lack of insulin production in the pancreas.
___ 45. / When obtaining a SAMPLE history from a patient with diabetes, it would be MOST important to determine:
a) / if he or she has had any recent illnesses or excessive stress.
b) / approximately how much water the patient drank that day.
c) / if there is a family history of diabetes or related conditions.
d) / the name of the physician who prescribed his or her insulin.
___ 46. / Chemicals that are responsible for the signs and symptoms of an allergic reaction to a bee sting include:
a) / the bee venom itself. / c) / leukocytes and epinephrine.
b) / adrenaline and histamines. / d) / histamines and leukotrienes.
___ 47. / A 73-year-old man presents with a generalized rash, which he thinks may have been caused by an antibiotic that he recently began taking. He has a history of coronary artery disease, hypertension, and emphysema. He is conscious and alert, his blood pressure is 144/94 mm Hg, and his pulse is 64 beats/min and regular. You auscultate his breath sounds and hear scattered wheezing, although he is not experiencing respiratory distress. In addition to administering oxygen, you should:
a) / contact medical control if needed, transport the patient, and monitor him for signs of deterioration.
b) / ask him if he has epinephrine and request approval from medical control to administer it to the patient.
c) / avoid the use of epinephrine because of his cardiac history, even if his symptoms become severe.
d) / begin transport and request to administer epinephrine if his systolic blood pressure falls below 110 mm Hg.
___ 48. / A 38-year-old female was bitten by fire ants while at the park with her kids. Your primary assessment reveals that she is semiconscious, has profoundly labored breathing, and has a rapid, thready pulse. She has a red rash on her entire body and her face is very swollen. You should:
a) / perform a rapid secondary assessment.
b) / assist her ventilations with 100% oxygen.
c) / administer 0.3 mg of epinephrine.
d) / place her supine with her legs elevated 6 to 12.
___ 49. / The effects of epinephrine are typically observed within ______following administration.
a) 30 seconds b) 1 minute c) 30 minutes d) 1 hour
___ 50. / You are assessing a young male who was stung on the leg by a scorpion. He is conscious and alert, his breathing is regular and unlabored, and his blood pressure is 122/64 mm Hg. Assessment of his leg reveals a wheal surrounded by an area of redness. He states that he had a “bad reaction” the last time he was stung by a scorpion, and carries his own epinephrine auto-injector. You should:
a) / apply high-flow oxygen, apply a chemical cold pack directly to the injection site, and transport at once.
b) / apply high-flow oxygen, obtain approval from medical control to assist him with his epinephrine, and transport.
c) / assess his ABCs and vital signs in 15 minutes and allow him to drive himself to the hospital if he remains stable.
d) / apply oxygen as needed, clean the area with soap and water or a mild antiseptic, and transport him to the hospital.

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