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A 20 year old female is being evaluated for an acute onset of an alteration in mentation. She She complained of a stiff neck and persistent headache. Vital signs are P 112, R22 and regular BP 144/88, SpO2 95% and T 102.3F. The healthcare provider should observe for which complication?
A. Sepsis
B. Seizure
C. Cardiac arrest
D. Internal bleeding - CORRECT ANSWERS B. Seizure
A 45 year old patient is found supine on the floor of the Triage area. Healthcare providers note pinpoint pupils, shallow respirations and vomitus in and around the mouth. What course of action should be implemented next?
A. Initiate an IV and administer naloxone
B. Supplemental oxygen and suction
C. Obtain a blood glucose level
D. Being bag-mask ventilation - CORRECT ANSWERS B. Supplemental O2 and suction
Patients with a history of chronic bronchitis that present with shortness of breath are likely to have which condition?
A. Pulmonary embolism
B. Angina pectoris
C. Angioedema
D. Hypertensive crisis - CORRECT ANSWERS A. Pulmonary Embolism
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Acute respiratory distress syndrome (ARDS) is characterized by what pathological change?
A. Excessive mucus production
B. Inflammation of the visceral pleura
C. Breakdown of the alveolar-capillary membrane
D. Accumulation of fluid between the pleural layers - CORRECT ANSWERS C. Breakdown of the alveolar-capillary membrane
An anxious male complains of a sore throat, fever, chills, dental pain and dyspnea. The patient has a firm, red pronounced swelling in the sublingual anterior throat area and tongue. What diagnosis is most likely?
A. Croup
B. Tonsilitis
C. Angioedema
D. Ludwig's Angina - CORRECT ANSWERS D. Ludwig's angina
Patients on mechanical ventilation may have hypoxemia due to alveolar collapse from mucous plugging. The best treatment for this is:
A. Increase oxygen concentration to 100%
B. Increase tidal volume
C. Increase respiratory rate
D. Administer PEEP - CORRECT ANSWERS D. Administer PEEP
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During compensatory shock, the renin-angiotensin-aldosterone system is activated to cause a/an:
A. Increase in preload, afterload and re-absorption of sodium
B. Decrease in preload, afterload and re-absorption of sodium
C. Increase in myocardial contractility
D. Vasodilation and sodium retention - CORRECT ANSWERS A. Increase in preload, afterload and re-absorption of sodium
A 42 year old patient with a history of rheumatoid arthritis is taking glucocorticoids. Over the past two weeks, she complains of chronic fatigue, weakness, and loss of appetite with weight loss. Lab results indicate hyponatremia and hyperkalemia. What underlying diagnosis is suspected?
A. Adrenal insufficiency
B. Diabetic ketoacidosis
C. Hypothyroidism
D. Rhabdomyolysis - CORRECT ANSWERS A. Adrenal insufficiency
Which condition should the healthcare provider consider to usually be a non- emergent, non-life threatening illness?
A. Acute coronary syndrome
B. Thoracic outlet syndrome
C. Esophageal rupture
D. Aortic dissection - CORRECT ANSWERS B. Thoracic outlet syndrome
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Healthcare providers should use extreme caution with nitroglycerin when ST elevation is present in which ECG leads?
A. V1, V
B. V3, V
C. 1, aVL
D. II, III, aVF - CORRECT ANSWERS D. II, III, aVF
Which is a high-risk factor for intracerebral hemorrhage?
A. Marijuana
B. Coronary artery syndrome
C. Bradycardia
D. Cocaine drug abuse - CORRECT ANSWERS D. Cocaine drug abuse
WhatistheinitialtreatmentforapatientexperiencingHHNS?
A.CrystalloidIVfluidresuscitation
B.Administrationof*dextrose
C.Administrationof*insulin
D.Fluidbolusof5%dextroseinwater(D5W)- CORRECTANSWERS* * A.CrystalloidIVfluid *resuscitation
Whatconditionismostlikelytocauserespiratoryacidosis?*
A.Ansiety/panicattack
B.NarcoticOverdose
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A* 24 yearoldhascompletedatriathalononahot,humidday.Theathletecomplainsofa severeheadache,musclecrampsandabdominalpain.Asthepatienthistoryis obtained,theathlete becomeslethargic.Whatunderlyingelectrolytedisturbance shouldthehealthcare* providermostlikelysuspect?
A.*Magnesemia
B.*Hyponatremia
C.*Hypocalcemia
D.Hypokalemia-* CORRECTANSWERS* * B.Hyponatremia
WhatisthesignontheECGthatwillindicateapatientisexperiencinghyperkalemia?*
A.FlattenedT*waves
B.PeakedT*waves
C.NarrowingQRS*complex
D.PresenceofOsbornewaves- CORRECTANSWERS* * B.PeakedTwaves
An* 82 yearoldalcoholiccomplainsofnausea,non-bloodyvomitingandsevere epigastricandrightupperquadrantpainthe radiatestotheback.Palpationreveals epigatrictendernesswithoutperitonealsigns.Whatworkingdiagnosisshouldbe consideredmostlikely?*
A.Acutepancreatitis
B.Intestinal(bowel)*obstruction
C.Pepticulcer
D.Mallory-Weisssyndrome- CORRECTANSWERS* * A.Acute*pancreatitis
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A* 23 yearoldmalecomplainsofaproductivecough,fever,chillsandpleuriticchestpain thathasworsenedover* 3 days.Aphysicalexamrevealsunilateralwheezingwith shallowrespirations.VitalsareP128,R26,BP144/88,SpO290%,andT102F.What treatmentshouldbeperformed?*
A.* 12 *lead
B.Betablockers
C.InitiateSTEMI*protocols
D.SupplementalO2andimmediatetransport-* CORRECTANSWERS* * D.Supplemental oxygenandimmediatetransport
Apatientwithsuspectedgallbladderdiseaseisaskedtotakeadeepbreathwhilethe providerpressesupwardintotheupperrightquadrant.Ifthepatientceases inspirationduetoincreasedpainwhilebeingexamined,thisisknownas:*
A.Cullen'ssign
B.Rovsing'ssign
C.Murphy'ssign
D.Kehr'ssign- CORRECTANSWERS* * C.Murphy's*sign
Thepatientisalertandorientedpresentingwithhypotension,bradycardia,normal capillaryrefillandwarm,dryskin.Thesearecardinalsignsofwhichtypeof*distributive *shock?
A.*Anaphylactic
B.*Neurogenic
C.*Septic
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Organophosphatepoisoiningwillpresentwithwhichsignsandsymptoms?*
A.Drymucousmembranesand*shock
B.Alteredmentalstatusandflushedskin
C.Euphoriaand*tachycardia
D.Salivationandincontinenceofurineandliquidstool- CORRECTANSWERS* * D. Salivationandincontinenceofurineandliquid*stool
Whatmedicationclassificationshouldbeadministeredtoanuncooperative,*agitated patient?
A.*Opioid
B.*Nitrate
C.*Benzodiazepine
D.Sympathomimetic-* CORRECTANSWERS* * C.Benzos
Apatientpresentswithmildlydecreasedmentalstatus,slowrespirations, bradycardia,hypotension,hasabloodsugarof42.Thisismostlikelycausedfrom excessiveingestionof:*
A.Calciumchannel*blockers
B.Tricyclicantidepressents
C.Betablockers
D.Salicylates-* CORRECTANSWERS* * C.Beta*blockers
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Thepatientcomplains* ofadeepburningdiscomfortdiffuselythroughoutthe epigastrium.Thisisanexampleofwhichtypeofpain?
A.*Somatic
B.Visceral
C.*Referred
D.Radiating-* CORRECTANSWERS* * B.Visceral
A* 24 yearoldfemalepresentswithlowerrightquadrantabdominal pain.Herskinishot tothetouchandsheexhibitsaPsoaSign.Shecomplainsofnauseaandvomitingfor* 2 days.Whatdiagnosisis*suspected?
A.*Pancreatitis
B.*Appendicitis
C.*Gastroenteritis
D.Ectopicpregnancy- CORRECTANSWERS* * B.Appendicitis
Aknownalcoholiccomplainsoftheconstant,severemid-epigastricpain,nauseaand blood-streakedemesis.Thepatienthasatemperatureof101.9Fandsevere abdominaltenderness.Whatunderlyingdiagnosisshouldbesuspected?*
A.*Gastritis
B.*Pancreatitis
C.*Diverticulitis
D.Perforatedgastriculcer-* CORRECTANSWERS* * B.Pancreatitis
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Whichinfectiousdiseasemusthaveoxygenpresenttosurvive?*
A.*Tuberculosis
B.Lungabscess
C.*Botulism
D.Tetanus-* CORRECTANSWERS* * A.Tuberculosis
Whichbestpracticeshelptotopreventthespreadofinfectiousdisease?
A.Alcoholbasedantimicrobialequipment* cleaningandhandwashing
B.Goggles,gown,andglovesforallpatientcontact
C.Facialprotectionandglovesforallpatientcontact
D.Handwashingbeforeandafterallpatientcontactandstandardprecautions*-
- CORRECTANSWERS* * A.Alcoholbasedantimicrobialequipment cleaning*and *handwashing
Continuouspositiveairwaypressurewouldbemostappropriateintreatingwhich patient?
A.* 43 yearoldwithdecreasedLOCwithrespiratorydifficulty
B.* 22 yearoldwithsevereasthmaandnotrespondingtonebulizer*treatments
C.* 38 yearoldwithcarpalpedalspasms,clearlungsoundsandrespirations 40 timesper *minute
D.* 55 yearoldjugularveindistentionandBP90/60- CORRECTANSWERS* * B. 22 yearold withsevereasthmaandnotrespondingtonebulizer*treatments
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Apatienthasattemptedsuicidebyingesting* ethyleneglycolabout* 20 hourspriorto arrivingfortreatment.Lungsoundsrevealbilateralcrackelsandrespirationsof* 30 with symptomsofpulmonaryedemaandcyanosisofthelips.TheECGrevealsventricular tachycardia.Whichstageofethyleneglycolpoisoninghasoccurred?
A.* 1
B.* 2
C.* 3
D.* 4 - CORRECTANSWERS* * B. 2
ApatientwithahistoryofGrave'sdiseasepresentswithanxiety,profusesweatingand apalpablegoiter.VitalsareP151,R 35 andlabored,BP84/42.Whichworkingdiagnosis ismostlikely?*
A.*Myxedema
B.CocaineToxicity
C.*Thyrotoxicosis
D.Diabetesinsipidus- CORRECTANSWERS* * C.Thyrotoxicosis
Apatientexperiencesunilateralfacialweaknessanddroop,garbledspeech,altered senseoftasteandnoextremityweakness.ThepatienthasahistoryofLyme'sdisease. Whatconditionisthepatientlikelyexperiencing?*
A.*Meningitis
B.Bell'spalsy
C.Ischemicstroke
D.Hemorrhagicstroke- CORRECTANSWERS* * B.Bell's*palsy
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A.Adequatelycommunicatetopeersregardingevidence-based*practice
B.Orderandinterpretdiagnostictestingresults
C.Adequatelyperformaphysical*assessment
D.Processrelevantinformation,filteroutirrelevantinformation-* CORRECTANSWERS* * D.Processrelevantinformation,filteroutirrelevantinformation
AccordingtotheAMLSAssessmentPathway,determiningwhetherapatientis"Sickor NotSick"isinitiallydoneduringwhichcomponentoftheassessmentprocess?*
A.Detailedassessment
B.Firstimpression
C.Initialobservation
D.Ongoingmanagement- CORRECTANSWERS* * B.First*impression
Selectanexampleofacommunicationbarrierthatimpairsanefficientandthorough assessmentprocess.*
A.Thepatientspeaksclearlyandis*shy
B.Thepatient'sfamilyispresentinthehome
C.YouandyourpatientcommunicatefluentlyintheSpanishlanguage
D.Thepatientcantfindhishearingaid-* CORRECTANSWERS* * D.Thepatientcan'tfindhis hearingaid
Healthcareprovidersaretreatinganunresponsivepatientwhooverdosedon lorazepam.Whatinterventionshouldbeinitiated?
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A.Airwaysupport
B.Administrationof*naloxone
C.GatheraSAMPLEhistory
D.Supplementaloxygenwithanasalcannula- CORRECTANSWERS* * A.Airway*support
Whileperformingacomprehensiveassessment,theproviderrecognizesthepatient's assessmentanddiagnosticfindingsaresimilartopatientcomplainsshehastreatedin thepast.Integratingnewpatientpresentaitoninformationwithpastexperiencesto determinemanagementstrategiescanbedefinedas:*
A.Activelistening
B.Clinicalreasoning
C.Therapeuticcommunication
D.Clinicaldecisionmaking-* CORRECTANSWERS* * B.Clinical*reasoning
Whenapproachingthepatientinanapartmentthathasbeensecuredbylaw enforcement,theprovidersfindasemiconsciouspatientwhohasaneedleinherarm. Thepatientmoanswithverbalstimulation,pupilsarepinpoint,and* respirationsare notedasshallowat 4 breaths/min.Theinitialobservationindicatesthepatient's presentationis:
A.*Nonemergent
B.*Emergent
C.Apotentiallifethreat
D.Alifethreat-* CORRECTANSWERS* * D.Alifethreat
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Wheninitiallyapproachingthepatient,the provideruseswhichofthefollowing relevantquestionstoformaninitialimpression?*
A.Isthispatientlikelytodienow?
B.Hasthepatienttraveledoutsidethecountry?
C.Isthecomplaintgradualorsuddeninonset?*
D.Hasthepatientingestedover-the-countermedications?- CORRECTANSWERS* * a.Is thepatientlikelytodienow?
OneoftheessentialcomponentsintheinitialobservationoftheAMLSassessment pathwayisidentificationofthe:
A.cardinalpresentation/chief*complaint
B.focusedphysical*exam
c.medicalhistory*information
d.interpretationofdiagnosticinformation- CORRECTANSWERS* * A.Cardinal presentation/chiefcomplaint
Theproviderfindsanunconsciouspatientwithnogagreflex.Whichwouldbemost appropriatedevicetobeingtomanagetheairway?
A.Nasopharyngealairway
B.Endotrachealtube
C.Oropharyngealairway
D.needledecompression- CORRECTANSWERS* * C.Oropharyngeal*airway
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Theproviderperformsafocusedphysicalexamandobservesanimplantedvascular accessdevice.Thisfindingismostindicativeof:
A.*COPD
B.Chemotherapyregimens
C.tensionpneumothorax
D.GIbleeding- CORRECTANSWERS* * B.Chemotherapy*regimens
Theproviderisassessingasmokerwhopresentswithdyspnea,chestdiscomfort,anda productivecough.Thepatientexhibitspedaledemaandcoarse,scatteredrhonchi. Thepatient'soxygensaturationis88%andhisrespiratoryrateis 28 breaths/min. Whichworkingdiagnosiswouldbemostlikelyconsideredtobeginimmediate *treatment?
A.*FBAO
B.*COPD
C.Ludwig'sangina
D.Cardiactamponade- CORRECTANSWERS* * B.COPD
Aspiration*
Signsandtreatment- CORRECTANSWERS* * Whatisthescenariosurroundingyour patient?Diditoccurimmediatelyafterfeeding?Doesthepthaveagastricfeeding tube?Isthere particulatematterinthesuctionedmaterial?
NGtubetopreventgastricdistentionwhileventilating,monitorpt'sabilitytomanage airway,intubateifneeded,aggressivelysuction
Anaphylactic*Reactions
