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Of the following, which item is acceptable and productive to ask a 14 year old female in the presence of her parents - - correct ans- - History of childhood illness You are treating an 82 year old female who is having difficulty breathing in a nursing home. Her only history is of a fever yesterday and frequent UTI. While listening to her chest you hear rhonci and slight cradles in all fields. BP is 110/80 Pulse is 100 & regular RR- 30. Temp is 102F. Her jugular veins are flat and there is no pedal edema. She denies chest pain or pressure. What condition is most likely causing her symptoms - - correct ans- - Pneumonia You are treating an 82 year old female who is having difficulty breathing in a nursing home. Her only history is of a fever yesterday and frequent UTI. While listening to her chest you hear rhonci and slight cradles in all fields. BP is 110/80 Pulse is 100 & regular RR- 30. Temp is 102F. Her jugular veins are flat and there is no pedal edema. She denies chest pain or pressure. What will be your treatment? - - correct ans- - High flow oxygen, IV fluid bolus, & transport You are treating an 82 year old female who is having difficulty breathing in a nursing home. Her only history is of a fever yesterday and frequent UTI. While listening to her chest you hear rhonci and slight cradles in all fields. BP is 110/80 Pulse is 100 & regular RR- 30. Temp is 102F. Her jugular veins are flat and there is no pedal edema. She denies chest pain or pressure. After your initial treatment of the patient she becomes unconscious. She is using accessory muscles to breath. How would you treat her next? - - correct ans- - Attempt insertion of an oral airway Which of the following is least likely to cause crackles - - correct ans- - Asthma
Which of the following medications is least likely to be a part of standard therapy for a patient suffering from exacerbated emphysema - - correct ans- - Nitrates Which of the following is true about respiratory physiology? - - correct ans- - Changes in PO2, PCO2, or pH stimulate chemoreceptors What is the purpose of the Good Samaritan laws - - correct ans- - Offer legal protection yo people who stop at an emergency scene You are treating a thin elderly male complaining of SOB. He looks older than his stated age of 65, leaning forward in a chair. You notice that he has an oxygen generator in the room and is on 2 rpm of o2 via NC. RR is 20 and shallow. BP- 105/60. Pulse 125 & irregular. You are unable to hear any breath sounds in the bases, with slight air movement & wheezing noted in the apices (top part of lung). the patient has pink cheeks, takes short puffy breaths, and can only speak in short sentences. His medications include Proventil inhalers and Theo- duer. He us unable to give you a complete history. What condition would you suspect? - - correct ans- - Exacerbated emphysema You are treating a thin elderly male complaining of SOB. He looks older than his stated age of 65, leaning forward in a chair. You notice that he has an oxygen generator in the room and is on 2 rpm of o2 via NC. RR is 20 and shallow. BP- 105/60. Pulse 125 & irregular. You are unable to hear any breath sounds in the bases, with slight air movement & wheezing noted in the apices (top part of lung). the patient has pink cheeks, takes short puffy breaths, and can only speak in short sentences. His medications include Proventil inhalers and Theo- duer. He us unable to give you a complete history. What should you do? - - correct ans- - Switch him over to high flow oxygen You are called to a junior high soccer game to evaluate a student who became acutely SOB during the game. on exam, you note inspiratory & expiratory wheezes throughout the lungs. BP- 130/80, pulse 120 & Regular, RR- 30. Which medication will you consider using? - - correct ans- - Oxygen, albuterol, and epi
Continue with back blows & abdominal thrusts until the food is dislodged or the obstruction becomes complete You have just intubated an adult patient. You believe you have been successful. you are listening for sounds in the epigastric area and hear nothing. What would you do? - - correct ans- - Attach an ETCO2 monitoring device What changes in blood gasses occur when a patient is hyperventilating - - correct ans- - Decreased CO2: Increased PaO First responders are applying unusually long ventilations with oxygen resuscitator to an apnea adult female. they are also passing in between breaths. What negative effects can this increased pressure create? - - correct ans- - Increased pulmonary elasticity You are treating a cardiac arrest patient who you have successfully resuscitated. The patient is still unconscious, apneic, and he is endotracheally intubated. The patient suddenly becomes cyanotic and his SpO2 decreases from 98% to 82%. His heart rate decreases from 110 to 40. What caused these sudden changes? - - correct ans- - Dislodged endotracheal tube What is the primary danger to the infant during a precipitous delivery - - correct ans- - Cerebral Trauma You are treating a 26 year old male victim of an assault. The patient was struck in the chest and abdomen with a baseball bat. Vital Signs: P- 110, R- 6 with sonorous respirations. The patient is place on high flow O2. While attempting an oral airway the patient gags. The oral airway is removed. How are you attempting to secure his airway next? - - correct ans- - Place an NPA and ventilate with a BVM What effects does morphine sulfate have on the venous system? - - correct ans- - increases venous pooling, resulting in decreased preload and after load
You are treating a 48 year old female with chest pain. On scene you administer oxygen, aspirin, and two nitro tablets. En route to the hospital your patient states her pain decreases to a 1 on a scale of 0-10. To provide the best care, you should: - - correct ans- - continue high flow oxygen and repeat vitals, consider 12 lead EKG if pain persists A 52 yom is compelling of constant, severe pain and pressure in his chest, which he says started about 4 hours ago. The patient has bilateral rales, and his skin is cool to the touch. Vital signs are: BP- 72/52, P- 124, R-28. No JVD or Edema in lower extremities. What condition is most likely responsible for his signs and symptoms. - - correct ans- - Myocardial infraction with cariogenic shock Which of the following patients has the best cerebral oxygenation? - - correct ans- - 45 yom, disoriented, BP 140/80, skin warm and dry What term best describes the ability of cardiac cells to spontaneously depolarize without being stimulated by a nerve? - - correct ans- - Automaticity A 72 yom with a history of atherosclerosis complains of a sudden onset of sharp pain in his right leg and foot which has grown worse over the past 2 hours. Objective data includes an anxious patient with vital signs: BP- 124/60, P-70, R-18. He has a pale, waxy, cool right leg. No pedal pulses are present in the right foot. The left leg is normal. What is the patients probable diagnosis? - - correct ans- - Acute arterial occlusion The gradual blockage of an artery due to cholesterol and hardened deposits - - correct ans-
- Gradual blockage of an artery by cholesterol and hardened deposits Your patient is a 22 y/o female without medical history. She was sitting at her office desk where she had an acute onset of dyspnea and pleuritic type chest pain. Presently she is awake and agitated. upon exam she is pale cool and diaphoretic. BP- 92/40, HR- 142, RR- 36 Shallow but clear bilaterally. Only medications taken are tylenol and birth control. What condition do you suspect? - - correct ans- - Pulmonary Embolism
An elderly female is found unresponsive by a neighbor. Your crew has initiate CPR. The cardiac monitor show VFib How would you treat this patient? - - correct ans- - continue CPR, then prepare to defibrillate at 360J What is the electrical axis of the heart? - - correct ans- - the average of all depolarizations of the heart Under which conditions does a Type II AV block have a very serious prognosis? - - correct ans- - AV dissociation exists What are the primary causes of symptoms in patients experiencing tachydysrhythmias? - - correct ans- - decreased ventricular filling and stroke volume Your patient is a 58 yom with a history of alcoholism and and cirrhosis of the liver. The patient is vomiting copious amounts of blood. Which is most likely the cause? - - correct ans- - Esophageal Varices Correct bolus amount for a 44 lb child in hemorrhagic shock? - - correct ans- - 400 mL You are treating a 80 yom who complains of headache, blurred vision, and left sided weakness. He has a history of heart problems and takes digoxin. Which of these is the most likely cause of his symptoms? - - correct ans- - embolic stroke caused by afib You are caring for a patient with a heart rate of 50. He is alert and oriented. His BP is 126/ and he denies chest pain or respiratory distress. How would you initially treat this patient? -
- correct ans- - gather a complete history and physical assessment Which is the ion responsible for determining the resting membrane potential of a cardiac cell? - - correct ans- - Potassium
A 55 yom complains of sudden onset of acute shortness of breath. He denies chest pain and is alert and oriented but anxious. Skin is pale (with cyanosis), cool, and diaphoretic. BP 230/110, P 110, R 28. No JVD. Crackles are heard bilaterally. He has a hx of heart attack 5 years ago. The patient is most likely suffering from? - - correct ans- - Left sided heart failure A 55 yom complains of sudden onset of acute shortness of breath. He denies chest pain and is alert and oriented but anxious. Skin is pale (with cyanosis), cool, and diaphoretic. BP 230/110, P 110, R 28. No JVD. Crackles are heard bilaterally. He has a hx of heart attack 5 years ago. Besides increasing oxygen levels, what is the next step for this patient? - - correct ans- - Decrease preload A 55 yom complains of sudden onset of acute shortness of breath. He denies chest pain and is alert and oriented but anxious. Skin is pale (with cyanosis), cool, and diaphoretic. BP 230/110, P 110, R 28. No JVD. Crackles are heard bilaterally. He has a hx of heart attack 5 years ago. What medication and dosage would you use? - - correct ans- - Nitro 0.4mg SL Sally, a 72 yof, called EMS because of severe lower back pain that will not go away. She states that she has arthritis, but this is much worse. She has a hx of hypertension and takes medication for it. She is extremely pale and diaphoretic. BP- 90 by palpation, P- 104, R-24. After oxygen, how would you initially treat. - - correct ans- - Rapid transport to ER Sally, a 72 yof, called EMS because of severe lower back pain that will not go away. She states that she has arthritis, but this is much worse. She has a hx of hypertension and takes medication for it. She is extremely pale and diaphoretic. BP- 90 by palpation, P- 104, R- 24 What condition is most likely affecting the patient. - - correct ans- - Tripple A You are treating a 59 yom who is complaining of 7/10 chest pain. BP- 130/80, P- 130, R-18. ECG reveals sinus tach with occasional PVC's what drug should you administer? - - correct ans- - Aspirin You are treating a patient who complains of dizziness when sitting up or standing up. She has just come home from running a marathon. BP- 130/80, P-70, RR-18 WHILE SITTING.
with arching of the back, forced jaw opening, facial grimacing, and profusion of his tongue. What is the most appropriate medication? - - correct ans- - Diphenhydramine You are treating a 16 year old boy at the local zoo who has severe respiratory distress, swelling in his neck, a rash and hives all over his body. Symptoms started when he took a few bites of an ice cream cone topped with peanuts and was stung by a bee. pts mom states he is lactose intolerant and eats peanuts all the time without a problem. Pt has never been stung before by a bee. Which allergen is most likely causing his symptoms? - - correct ans- - Bee Sting You are treating a 16 year old boy at the local zoo who has severe respiratory distress, swelling in his neck, a rash and hives all over his body. Symptoms started when he took a few bites of an ice cream cone topped with peanuts and was stung by a bee. pts mom states he is lactose intolerant and eats peanuts all the time without a problem. Pt has never been stung before by a bee. How would you best treat the patient - - correct ans- - Epinephrine Which of the following conditions causes the symptoms of altitude sickness - - correct ans-
- Decrease in oxygen concentration You patient is a 16 y/o female found responsive to pain. Her mom states she's been increasingly sluggish over the last week, she has been eating and drinking more than normal. Her skin is warm and dry & there is a fruity odor on her breath, her BP is 110/4 0 Pulse is 120 and regular RR- 32 and deep. Which of the following is most likely causing her presentation? - - correct ans- - You patient is a 16 y/o female found responsive to pain. Her mom states she's been increasingly sluggish over the last week, she has been eating and drinking more than normal. Her skin is warm and dry & there is a fruity odor on her breath, her BP is 110/4 0 Pulse is 120 and regular RR- 32 and deep. How would you treat patient. - - correct ans- - Oxygen, IV, Observation, Transportation
Which of the following is characteristics of type 1 diabetes - - correct ans- - The beta cells of the Islets of Langerhans secrete little or no insulin Your patient is a 44 year old female complaining of right upper quadrant abdominal pain with radiation to the right shoulder. She is nauseated and has a temperature of 99.9F. The pain began 4 hours ago, after she ate dinner that contained very fatty foods. Her abdomen is soft with gurgling over the right upper quadrant. BP 136/84, P 96, R 24. Which of the following is the most likely cause of the patient's presentation - - correct ans- - Cholecystitis Your patient is a 29 year old male who has been stung by a bee in his thumb. His thumb is swollen, red, and painful, but he has no other complaints. He denies any medical history but states that he has a family history of bee sting allergy. How would you remove the stinger? - - correct ans- - Gentle scraping with the edge of a card A 29 year old male who has been stung by a wasp on his thumb. He is short of breath. His vitals are BP 90/60, P 120, R 24 and labored. What should you do? - - correct ans- - Administer 0.3mg of 1:1000 epinephrine & 25mg of diphenhydramine Your patient is a 26 year old female who has ingested 150 amitriptyline tablets. She responds to painful stimuli and has an intact gag reflex, has a BP 88/50, P 130, weak, but regular, R 16. What medications would you consider using to treat this patient? - - correct ans- - Sodium Bicarb Your patient is a 26 year old female who has ingested 150 amitriptyline tablets. She responds to painful stimuli and has an intact gag reflex, has a BP 88/50, P 130, weak, but regular, R 16. Which of the following assessments is likely to give you the most useful information? - - correct ans- - Cardiac Monitoring Which of the following statements conserning elderly emergency medical care of the elderly is tru - - correct ans- - Alcohol and drug use may be a cause of altered mental status
Which of the following is the underlying cause of the pain associated with a sickle cell crisis? - - correct ans- - Tissue ischemia The correct dose of naloxone for a 6lb 8oz neonate suffering respiratory depression secondary to in utero exposure to narcotics is - - correct ans- - 0.3mg The correct placement for a needle throacostomy would be - - correct ans- - The second intercostal space, over the third rib, midclavicular line. What is the most common cause of pulmonary embolism? - - correct ans- - DVT You are treating a 6 yo who weighs 40lbs. He is unresponsive with a weak pulse, delayed capillary refill. His vital signs are BP 60/0, P240, R6. EKG shows a narrow complex tachycardia at a rate of 250. What is your initial treatment? - - correct ans- - Synchronous at 20 joules What is the most common cause of death in children over the age of 1 year? - - correct ans-
- Trauma Which of the following has the greatest potential to prevent pediatric deaths? - - correct ans- - Car seats, seat belts, and seat belt positioning boosters When assessing the mental status of an 8 month old child, which of the following is expected behavior in a patient with a normal mental state? - - correct ans- - Recognizes familiar caretakers Which of the following is the most common concern to the adolescent trauma patient? - - correct ans- - Parental reprimand
How can you reduce gastric distention during ventilation? - - correct ans- - The patient is ventilated slow with large volumes of oxygen Which of the following pulse rates would be cause for concern in an 18 month old child? - - correct ans- - 150 Which of the following is the recommended location for assessment of the pulse in an unresponsive 6 month old child? - - correct ans- - Brachial artery When responding to the scene of an injured 5yo child, child abuse should be expected in which of the following circumstances? - - correct ans- - Injury pattern does not match the history of the mechanism of injury A 5yo boy who awoke with a sore throat and fever is found sitting at the kitchen table. He appears quite ill and is leaning forward with his head in his hands. His voice is muffled and he is drooling. What illness do you suspect the child is suffering from? - - correct ans- - Epiglottis Which of the following is true concerning pediatric febrile seizures? - - correct ans- - Febrile seizures are more likely to occur when the temp raises rapidly Which isn't the correct location for placement of an IO needle in a pediatric patient? - - correct ans- - Which isn't the correct location for placement of an IO needle in a pediatric patient? You are treating a pregnant woman in her third trimester. She is suffering from a headache. Her vitals, BP 220/108, P 80, R18. She tells you her ankles are more swollen than normal. What illness is most likely causing her signs and symptoms? - - correct ans- - Preeclampsia
A 31 yo G3 P1 AB1 is in labor at term at home. She's been in labor for 24 hr without dilation. The midwife called for an ambulance. Upon arrival Pt is having strong contractions 2min apart. As you prepare to transport the mother complains of sudden tearing abdominal pain and becomes pale diaphoretic and agitated. Upon palpating the abdomen you feel the outline of the fetus. You should suspect - - correct ans- - Uterine rupture Upon examining a 27 yo in labor at 32 weeks gestation you notice that the umbilical cord is prolapsed. Which of the following would you NOT do? - - correct ans- - Immediately clamp cord in 2 places and cut between When the monitor is configured to display lead II, what is the polarity of each lead? - - correct ans- - Left leg is positive right arm negative What is the earliest gestational age at which a fetus may survive if born early? - - correct ans- - 26 weeks You have been called to a fitness club where a 28 year old female experienced a sudden onset of lower right quadrant abdominal pain while running in a treadmill. She states she had a normal period 3 weeks ago. Assessment reveals that she is pale and wet with RLQ abdominal pain and tenderness to palpating. Vitals are BP 88/64 P 116. Which of the following conditions is LEAST likely to be causing the patients signs/symptoms? - - correct ans- - PID 40 yo female who has been sexually assaulted. She is conscious but has multiple injuries. In addition to management of the patients injuries and attention to her psychological needs which of the following is appropriate? - - correct ans- - Place each article of clothing removed in a separate paper bag 5yo was awakened with severe respiratory distress. She has a seal bark cough, fever, and finds it hard to swallow. What do you suspect? - - correct ans- - Croup
You are treating a 4 year old who is lethargic. Her vitals are BP 50/0, P 50, R 8. After the airway has been secured how would you treat her next? - - correct ans- - CPR You are caring for a 4 yo who took four tablets of her mothers elavil. Her vitals are BP 60/palp, P 140, R 6 and she is lethargic. What intervention would you perform first? - - correct ans- - BVM with O Which of the following are early signs of dehydration in an infant? - - correct ans- - Dry mucus membranes In what zone do EMS units at the scene of a hazardous materials, tactical or other dangerous situation operate? - - correct ans- - Cold What type of radio system uses transmissions and reception that occur on two frequencies? - - correct ans- - Duplex What is the function of the medical practice act? - - correct ans- - Provide state legislation that governs the practice of medicine within that state The term "ethics" is best described as - - correct ans- - Moral, rather than legal, standard of behavior The process by which an agency or association grants recognition to an individual who has met certain predetermined qualifications specified by that agency is called - - correct ans- - Certification Which of the following is least likely to result in an accusation of negligence? - - correct ans-
The medical command physician orders 20mg of lasix IVP for your patient who is short of breath. After receiving the order, what should you do first? - - correct ans- - Repeat the order back to the physician to confirm You have just finished a run. You are completing a run report and discover an error as you are writing. What should you do? - - correct ans- - Draw a line through the error, initial it Which of the following is the best example of a subjective and possibly libelous statement?
- correct ans- - "The Pt was drunk and disorderly" You have arrived at the scene of a MVC. The Pt head is flexed forward, and she does not appear to be breathing. What is your immediate concern? - - correct ans- - Safety of the rescuers You and your partner respond to a full arrest. During the arrest, you are unable to defib the Pt because it won't charge. Later the Pt dies, and the family learns that you forgot to replace the defib battery that morning according to routine procedures. What can the family sue you for? - - correct ans- - Negligence You have been called to check and alert and oriented diabetic patient who is sweating. He refuses treatment, but you forcibly proceed to give him an injection of glucagon. What legal charge will be most applicable? - - correct ans- - Committing battery What is a radio "PL" (private line) tone? - - correct ans- - Allows 2 ambulances to talk to each other privately You are at the scene of a riot. The IC has assigned you to the task of triage. Which of the following patients can wait the longest for transportation? - - correct ans- - 34 yo near amputation of a leg R18; strong radial; mental status: Alert
A police officer at the scene of a traffic stop has requested that you medically clear the driver who was arrested for driving erratically. The other claims he's a diabetic. Refusing transport. The officer asks what his BGL was, what will you answer the officer? - - correct ans- - Apologize to the officer and explain that you can not divulge that information Your partner Colleen, is assisting you with a premature delivery. Colleen is wearing gloves but no gown or face/eye protection. During the delivery amniotic fluid squirts up onto colleens face. After the shift ends, Colleen tells you she is embarrassed about getting amniotic fluid in her mouth and is not planning on reporting the incident. What should you do? - - correct ans- - Strongly encourage her to report the exposure You are on scene of a mci you are expecting 40 Pt from a building collapse. A patient walks up to you and shows you a 3in laceration on his forearm. What triage priority would you give this patient? - - correct ans- - Green Your ambulance has malfunctioned? En route to a non emergency call at a clinic. It stalled and will not restart. What is you best action to take next? - - correct ans- - Request another unit to respond you respond to the local pool where a maintenance worker just spilled chlorine. You are the first to arrive. The lifeguards are treating your patient with oxygen and fresh air. What is your first course of action? - - correct ans- - Stop and do not approach What do apparently mild electrical burns and hydrofluric acid burns have in common? - - correct ans- - They can be worse than initially expected What does neurogenic shock due to spinal injury create? - - correct ans- - Decreased cardiac output
