Mod 4b Exam Practice

The three major parts of the brain are the:

A) Midbrain, cerebellum, and spinal cord.
B) Cerebrum, cerebellum, and brain stem.
C) Brain stem, midbrain, and spinal cord.
D) Cerebellum, medulla, and occiput.

B) Cerebrum, cerebellum, and brain stem.

The anterior aspect of the cerebrum controls:

A) Vision.
B) Touch
Correct Answer
C) Emotion.
D) Movement.

A) Vision.

A transient ischemic attack (TIA) occurs when:

A) The normal body processes destroy a clot in a cerebral artery.
B) Signs and symptoms resolve spontaneously within 48 hours.
C) Medications are given to dissolve a cerebral blood clot.
D) A small cerebral artery ruptures and causes minimal damage.

A) The normal body processes destroy a clot in a cerebral artery.

The mental status of a patient who has experienced a typical seizure:

A) Is likely to improve over a period of 5 to 30 minutes.
B) Progressively worsens over a period of a few hours.
C) Is easily differentiated from that of acute hypoglycemia.
D) Typically does not improve, even after several minutes.

A) Is likely to improve over a period of 5 to 30 minutes.

Which of the following medications is NOT used to treat patients with a history of seizures?

A) phenytoin (Dilantin)
B) carbamazepine (Tegretol)
C) phenobarbital
D) hydromorphone (Dilaudid)

D) hydromorphone (Dilaudid)

You respond to a residence for a child who is having a seizure. Upon arrival at the scene, you enter the residence and find the mother holding her child, a 2-year-old male. The child is conscious and crying. According to the mother, the child had been running a high fever and then experienced a seizure that lasted approximately 3 minutes. You should:

A) Advise the mother to take her child to the doctor the following day.
B) Cover the child with wet towels and give oxygen via nasal cannula.
C) Transport the child to the hospital and reassure the mother en route.
D) Call medical control and request permission to give the child aspirin.

C) Transport the child to the hospital and reassure the mother en route.

You are caring for a semiconscious man with left-sided paralysis. His airway is patent and his respirations are 14 breaths/min with adequate tidal volume. Treatment for this patient should include:

A) Oxygen via a nonrebreathing mask, left lateral recumbent position, and transport.
B) An oral airway, assisted ventilation with a bag-mask device, Fowler’s position, and transport.
C) Assisted ventilation with a bag-mask device, right lateral recumbent position, and transport.
D) Oxygen via a nonrebreathing mask, supine position with legs elevated 6² to 12², and transport.

A) Oxygen via a nonrebreathing mask, left lateral recumbent position, and transport.

You arrive at the residence of a 33-year-old woman who is experiencing a generalized seizure. She has a small amount of vomitus draining from the side of her mouth. After protecting her from further injury, you should:

A) Wait for the seizure to stop, manually open her airway, insert an oropharyngeal airway, and assess her oxygen saturation with the pulse oximeter.
B) Place a bite block in between her teeth, apply high-flow oxygen via a nonrebreathing mask, and consider inserting a nasopharyngeal airway.
C) Maintain her airway with manual head positioning, suction her airway to remove the vomitus, insert a nasopharyngeal airway, and administer high-flow oxygen.
D) Restrain her extremities to prevent her from injuring herself, suction her airway to remove the vomitus, and assist her ventilations with a bag-mask device.

C) Maintain her airway with manual head positioning, suction her airway to remove the vomitus, insert a nasopharyngeal airway, and administer high-flow oxygen.

You are assessing the arm drift component of the Cincinnati Prehospital Stroke Scale on a 60-year-old woman. When she holds both of her arms out in front of her and closes her eyes, both of her arms immediately fall to her sides. You should:

A) Instruct the patient to keep her eyes open and then repeat the arm drift test.
B) Defer this part of the test and assess her for facial droop and slurred speech.
C) Repeat the arm drift test and ensure that her palms are facing downward.
D) Repeat the arm drift test, but move the patient’s arms into position yourself.

D) Repeat the arm drift test, but move the patient’s arms into position yourself.

A patient who is possibly experiencing a stroke is NOT eligible for thrombolytic (fibrinolytic) therapy if he or she:

A) Has had a prior heart attack.
B) Is older than 60 years of age.
C) Has bleeding within the brain.
D) Has a GCS score that is less than 8.

C) Has bleeding within the brain.
You respond to a residence for a child who is having a seizure. Upon arrival at the scene, you enter the residence and find the mother holding her child, a 2-year-old male. The child is conscious and crying. According to the mother, the child had been running a high fever and then experienced a seizure that lasted approximately 3 minutes. You should:
transport the child to the hospital and reassure the mother en route.
Which of the following patients would MOST likely demonstrate typical signs of infection, such as a fever?
a 17-year-old male with depression and anxiety
What Glasgow Coma Scale (GCS) score would you assign to a patient who responds to painful stimuli, uses inappropriate words, and maintains his or her arms in a flexed position?
8
A patient with an altered mental status is:
not thinking clearly or is incapable of being aroused.
Muscle control and body coordination are controlled by the:
cerebellum.
The principal clinical difference between a stroke and hypoglycemia is that patients with hypoglycemia:
usually have an altered mental status or decreased level of consciousness.
Law enforcement has summoned you to a nightclub, where a 22-year-old female was found unconscious in an adjacent alley. Your primary assessment reveals that her respirations are rapid and shallow and her pulse is rapid and weak. She is wearing a medical alert bracelet that identifies her as an epileptic. There is an empty bottle of vodka next to the patient. You should:
assist ventilations, perform a rapid exam, and prepare for immediate transport.
A patient whose speech is slurred and difficult to understand is experiencing:
dysarthria.
Individuals with chronic alcoholism are predisposed to intracranial bleeding and hypoglycemia secondary to abnormalities in the:
liver.
Which of the following medications is NOT used to treat patients with a history of seizures?
hydromorphone (Dilaudid)
Which of the following MOST accurately describes the cause of an ischemic stroke?
blockage of a cerebral artery
The three major parts of the brain are the:
cerebrum, cerebellum, and brain stem.
A patient without a history of seizures experiences a sudden convulsion. The LEAST likely cause of this seizure is:
epilepsy.
A 29-year-old male complains of a severe headache and nausea that has gradually worsened over the past 12 hours. He is conscious, alert, and oriented and tells you that his physician diagnosed him with migraine headaches. He further tells you that he has taken numerous different medications, but none of them seem to help. His blood pressure is 132/74 mm Hg, his pulse is 110 beats/min and strong, and his respirations are 20 breaths/min and adequate. In addition to high-flow oxygen, further treatment should include:
dimming the lights in the back of the ambulance and transporting without lights and siren.
An area of swelling or enlargement in a weakened arterial wall is called:
an aneurysm.
A patient who is possibly experiencing a stroke is NOT eligible for thrombolytic (fibrinolytic) therapy if he or she:
has bleeding within the brain.
During the primary assessment of a semiconscious 70-year-old female, you should:
ensure a patent airway and support ventilation as needed.
You are caring for a 70-year-old female with signs and symptoms of an acute stroke. She is conscious, has secretions in her mouth, and is breathing at a normal rate with adequate depth. You should:
suction her oropharynx and apply 100% oxygen.
You are caring for a semiconscious man with left-sided paralysis. His airway is patent and his respirations are 14 breaths/min with adequate tidal volume. Treatment for this patient should include:
oxygen via a nonrebreathing mask, left lateral recumbent position, and transport.
A transient ischemic attack (TIA) occurs when:
the normal body processes destroy a clot in a cerebral artery.
You arrive at a grocery store shortly after a 35-year-old male stopped seizing. Your assessment reveals that he is confused and incontinent of urine. The patient’s girlfriend tells you that he has a history of seizures and takes carbamazepine (Tegretol). When obtaining further medical history from the girlfriend, it is MOST important to:
obtain a description of how the seizure developed.
When caring for a patient with documented hypoglycemia, you should be MOST alert for:
a seizure.
A 58-year-old male presents with confusion, right-sided weakness, and slurred speech. His wife is present and is very upset. As your partner is applying oxygen, it is MOST important for you to:
ask his wife when she noticed the symptoms.
Which of the following MOST accurately describes a simple partial seizure?
a seizure that begins in one extremity
Which of the following MOST accurately describes what the patient will experience during the postictal state that follows a seizure?
confusion and fatigue

A generalized seizure is characterized by:

A. a blank stare and brief lapse of consciousness.
B. unconsciousness for greater than 30 minutes.
C. a core body temperature of greater than 103°F (40°C).
D. severe twitching of all the body’s muscles.

D. severe twitching of all the body’s muscles.

Interruption of cerebral blood flow may result from all of the following, EXCEPT:

A. a thrombus.
B. an acute arterial rupture.
C. an embolism.
D. cerebral vasodilation.

D. cerebral vasodilation.

The left cerebral hemisphere controls:

A. heart rate and pupil reaction.
B. the right side of the face.
C. the right side of the body.
D. breathing and blood pressure.

C. the right side of the body.

The most basic functions of the body, such as breathing, blood pressure, and swallowing, are controlled by the:

A. cerebrum.
B. brain stem.
C. cerebral cortex.
D. cerebellum.

B. brain stem.

The spinal cord exits the cranium through the:

A. vertebral foramen.
B. foramen magnum.
C. foramen lamina.
D. cauda equina.

B. foramen magnum.

When assessing arm movement of a patient with a suspected stroke, you should:

A. expect to see one arm slowly drift down to the patient’s side.
B. ask the patient to hold his or her arms up with the palms down.
C. observe the patient for approximately 5 minutes.
D. ask the patient to close his or her eyes during the assessment.

D. ask the patient to close his or her eyes during the assessment.

When you are obtaining a medical history from the family of a suspected stroke patient, it is MOST important to determine:

A. if the patient has been hospitalized before.
B. when the patient last appeared normal.
C. the patient’s overall medication compliance.
D. if there is a family history of a stroke.

B. when the patient last appeared normal.

Which of the following conditions is NOT a common cause of seizures?

A. poisoning or overdose
B. severe hypovolemia
C. acute hypoglycemia
D. acute alcohol withdrawal

B. severe hypovolemia
Which of the following medications is NOT used to treat patients with a history of seizures?
Select one:
A. phenobarbital
B. phenytoin (Dilantin)
C. hydromorphone (Dilaudid)
D. carbamazepine (Tegretol)
C. hydromorphone (Dilaudid)

You are assessing a 49-year-old man who, according to his wife, experienced a sudden, severe headache and then passed out. He is unresponsive and has slow, irregular breathing. His blood pressure is 190/94 mm Hg and his pulse rate is 50 beats/min. His wife tells you that he has hypertension and diabetes. He has MOST likely experienced:

A. a ruptured cerebral artery.
B. acute hypoglycemia.
C. an occluded cerebral artery.
D. a complex partial seizure.

A. a ruptured cerebral artery.
1. Solid abdominal organs include the:
A. stomach and small intestine.
B. spleen, kidneys, and pancreas.
C. gallbladder and large intestine.
D. urinary bladder, colon, and ureters
Answer: B
Question Type: General Knowledge
Page: 599
2. Which of the following organs would MOST likely bleed profusely if injured?
A. liver
B. stomach
C. appendix
D. gallbladder
Answer: A Question Type: General Knowledge
Page: 599
3. Which of the following organs lies in the retroperitoneal space?
A. liver
B. spleen
C. pancreas
C. gallbladder
Answer: C
Question Type: General Knowledge
Page: 599
4. Injury to a hollow abdominal organ would MOST likely result in:
A. pain secondary to blood in the peritoneum.
B. profound shock due to severe internal bleeding.
C. impairment in the blood’s clotting abilities.
D. leakage of contents into the abdominal cavity
Answer: D Question Type: General Knowledge
Page: 599
5. Functions of the liver include:
A. storage of bile, which is produced in the gallbladder.
B. production of substances necessary for blood clotting.
C. production of hormones that regulate blood sugar levels.
D. release of amylase, which breaks down starches into sugar.
Answer: B Question Type: General Knowledge
Page: 600
6. Which of the following organs assists in the filtration of blood, serves as a blood reservoir, and produces antibodies?
A. liver
B. kidney
C. spleen
D. pancreas
Answer: C Question Type: General Knowledge
Page: 600
7. The kidneys help to regulate blood pressure by:
A. retaining key electrolytes, such as potassium.
B. eliminating toxic waste products from the body.
C. removing sodium, and thus water, from the body.
D. accommodating a large amount of blood volume.
Answer: C Question Type: General Knowledge
Page: 601
8. The parietal peritoneum lines the:
A. retroperitoneal space.
B. lungs and chest cavity.
C. walls of the abdominal cavity.
D. surface of the abdominal organs.
Answer: C
Question Type: General Knowledge
Page: 602
9. The MOST common and significant complication associated with an acute abdomen is:
A. peritonitis.
B. high fever.
C. severe pain.
D. internal bleeding.
Answer: A
Question Type: General Knowledge
Page: 602
10. In the presence of ileus, the only way the stomach can empty itself is by:
A. diarrhea.
B. vomiting.
C. muscular contraction.
D. spontaneous rupture.
Answer: B
Question Type: General Knowledge
Page: 602
11. Peritonitis may result in shock because:
A. intra-abdominal hemorrhage is typically present.
B. fluid shifts from the bloodstream into body tissues.
C. abdominal distention impairs cardiac contractions.
D. severe pain causes systemic dilation of the vasculature.
Answer: B
Question Type: General Knowledge
Page: 602
12. In contrast to the parietal peritoneum, the visceral peritoneum:
A. is supplied by the same nerves from the spinal cord that supply the skin of the abdomen.
B. lines the walls of the abdominal cavity and is stimulated when the solid abdominal organs contract.
C. is less likely to become inflamed or infected because it lines the abdominal organs themselves.
D. is supplied by nerves of the autonomic nervous system, which are less able to localize pain or sensation.
Answer: D Question Type: General Knowledge
Page: 602
13. Pain that may be perceived at a distant point on the surface of the body, such as the back or shoulder, is called:
A. referred pain.
B. radiating pain.
C. visceral pain.
D. remote pain.
Answer: A
Question Type: General Knowledge
Page: 602
14. A 35-year-old mildly obese woman is complaining of localized pain in the right upper quadrant with referred pain to the right shoulder. The MOST likely cause of her pain is:
A. acute cystitis.
B. acute cholecystitis.
C. appendicitis.
D. pancreatitis.
Answer: B
Question Type: Critical Thinking
Page: 602
15. 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
Answer: B
Question Type: Critical Thinking
Page: 603
16. 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.
Answer: B
Question Type: General Knowledge
Page: 603
17. Which of the following statements regarding the acute abdomen is correct?
A. The most common cause of an acute abdomen is inflammation of the gallbladder and liver.
B. The parietal peritoneum is typically the first abdominal layer that becomes inflamed or irritated.
C. The initial pain associated with an acute abdomen tends to be vague and poorly localized.
D. An acute abdomen almost always occurs as the result of blunt trauma to solid abdominal organs.
Answer: C
Question Type: General Knowledge
Page: 603
18. Erosion of the protective layer of the stomach or duodenum secondary to overactivity of digestive juices results in:
A. ileus.
B. an ulcer.
C. appendicitis.
D. cholecystitis.
Answer: B
Question Type: General Knowledge
Page: 603
19. Which of the following is characteristic of peptic ulcer disease (PUD)?
A. the passage of bright red blood in the stool or coughing up blood
B. symptom relief after taking nonsteroidal anti-inflammatory drugs
C. sharp pain that is typically located in both lower abdominal quadrants
D. burning or pain in the stomach that subsides immediately after eating
Answer: D
Question Type: General Knowledge
Page: 603
20. Pain that radiates to the right lower quadrant from the umbilical area, nausea and vomiting, and anorexia are MOST indicative of:
A. pancreatitis.
B. appendicitis.
C. cholecystitis.
D. gastroenteritis.
Answer: B Question Type: General Knowledge
Page: 604
21. Which of the following statements regarding gastrointestinal bleeding is correct?
A. In the majority of cases, bleeding within the gastrointestinal tract occurs acutely and is severe.
B. Bleeding within the gastrointestinal tract is a symptom of another disease, not a disease itself.
C. Lower gastrointestinal bleeding results from conditions such as Mallory-Weiss syndrome.
D. Chronic bleeding within the gastrointestinal tract is usually more severe than bleeding that occurs acutely.
Answer: B Question Type: General Knowledge
Page: 604
22. Esophageal varices MOST commonly occur in patients who:
A. drink a lot of alcohol.
B. have severe diabetes.
C. have a history of esophagitis.
D. have weak immune systems.
Answer: A Question Type: General Knowledge
Page: 605
23. Which of the following conditions is more common in women than in men?
A. cystitis
B. hepatitis
C. pancreatitis
D. cholecystitis
Answer: A
Question Type: General Knowledge
Page: 606
24. Chronic renal failure is a condition that:
A. can be reversed with prompt treatment.
B. occurs from conditions such as dehydration.
C. is often caused by hypertension or diabetes.
D. causes dehydration from excessive urination.
Answer: C Question Type: General Knowledge
Page: 606
25. A strangulated hernia is one that:
A. spontaneously reduces without any surgical intervention.
B. can be pushed back into the body cavity to which it belongs.
C. is reducible if surgical intervention occurs within 2 hours.
D. loses its blood supply due to compression by local tissues.
Answer: D
Question Type: General Knowledge
Page: 607
26. You are dispatched to an apartment complex for a young male with abdominal pain. Your priority upon arriving at the scene should be to:
A. quickly gain access to the patient.
B. notify the dispatcher of your arrival.
C. assess the scene for potential hazards.
D. place a paramedic ambulance on standby.
Answer: C
Question Type: Critical Thinking
Page: 607
27. Most patients with abdominal pain prefer to:
A. lie on their side with their knees drawn into the abdomen.
B. sit in a semi-Fowler position with their knees slightly bent.
C. lie in a supine position with their knees in a flexed position.
D. sit fully upright because it helps relax the abdominal muscles.
Answer: A Question Type: General Knowledge
Page: 608
28. A 30-year-old woman with a history of alcoholism presents with severe upper abdominal pain and is vomiting large amounts of bright red blood. Her skin is cool, pale, and clammy; her heart rate is 120 beats/min and weak; and her blood pressure is 70/50 mm Hg. Your MOST immediate action should be to:
A. protect her airway from aspiration.
B. keep her supine and elevate her legs.
C. rapidly transport her to the hospital.
D. give her high-flow supplemental oxygen.
Answer: A
Question Type: Critical Thinking
Page: 608
29. Patients with acute abdominal pain should not be given anything to eat or drink because:
A. it will create referred pain and obscure the diagnosis.
B. food will rapidly travel through the digestive system.
C. substances in the stomach increase the risk of aspiration.
D. digestion prevents accurate auscultation of bowel sounds.
Answer: C
Question Type: General Knowledge
Page: 609
30. When assessing a patient with abdominal pain, you should:
A. palpate the abdomen in a clockwise direction beginning with the quadrant after the one the patient indicates is painful.
B. ask the patient to point to the area of pain or tenderness and assess for rebound tenderness over that specific area.
C. visually assess the painful area of the abdomen, but avoid palpation because this could worsen his or her condition.
D. observe for abdominal guarding, which is characterized by sudden relaxation of the abdominal muscles when palpated.
Answer: A
Question Type: General Knowledge
Page: 610
31. 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.
Answer: D
Question Type: General Knowledge
Page: 611
32. An important aspect in the treatment of a patient with severe abdominal pain is to:
A. provide emotional support en route to the hospital.
B. administer analgesic medications to alleviate pain.
C. encourage the patient to remain in a supine position.
D. give 100% oxygen only if signs of shock are present.
Answer: A
Question Type: Critical Thinking
Page: 612
33. A 47-year-old male presents with severe abdominal pain of 3 hours’ duration. His abdomen is distended and guarded. Your MOST important consideration for this patient should be to:
A. transport him in a supine position.
B. be alert for signs and symptoms of shock.
C. assess his blood pressure to determine perfusion adequacy.
D. determine the exact location and cause of his pain.
Answer: B
Question Type: Critical Thinking
Page: 612
34. The MOST important treatment for a patient with severe abdominal pain and signs of shock includes:
A. administering high-flow oxygen.
B. giving oral fluids to maintain perfusion.
C. transporting the patient without delay.
D. positioning the patient on his or her side.
Answer: C
Question Type: Critical Thinking
Page: 612
35. A 59-year-old male presents with a sudden onset of severe lower back pain. He is conscious and alert, but very restless and diaphoretic. Your assessment reveals a pulsating mass to the left of his umbilicus. You should:
A. vigorously palpate the abdomen to establish pain severity.
B. administer oxygen and prepare for immediate transport.
C. place the patient in a sitting position and transport at once.
D. request a paramedic unit to give the patient pain medication.
Answer: B
Question Type: Critical Thinking
Page: 612
36. You are transporting a 49-year-old male with “tearing” abdominal pain. You are approximately 30 miles away from the closest hospital. During your reassessment, you determine that the patient’s condition has deteriorated significantly. You should:
A. assist his ventilations with a bag-mask device.
B. immediately perform a rapid physical examination.
C. continue transporting and alert the receiving hospital.
D. consider requesting a rendezvous with an ALS unit.
Answer: D
Question Type: Critical Thinking
Page: 612
37. Which of the following statements regarding dialysis is correct?
A. Acute hypertension is a common adverse effect of dialysis.
B. Hemodialysis is effective but carries a high risk of peritonitis.
C. Patients who miss a dialysis treatment often present with weakness.
D. The purpose of dialysis is to help the kidneys retain salt and water.
Answer: C Question Type: General Knowledge
Page: 612
38. You respond to the residence of a 70-year-old male who complains of weakness and severe shortness of breath. His wife tells you that he is a dialysis patient, but has missed his last two treatments. After applying high-flow oxygen, you auscultate his lungs and hear diffuse rhonchi. The patient is conscious, but appears confused. His blood pressure is 98/54 mm Hg, his pulse rate is 120 beats/min and irregular, and his respirations are 24 breaths/min and labored. You should:
A. leave him in a sitting position, keep him warm, and prepare for immediate transport.
B. place him in a supine position, elevate his lower extremities, and transport at once.
C. treat for shock and request a paramedic unit to respond to the scene and assist you.
D. perform a detailed secondary assessment and then transport him to a dialysis center.
Answer: A Question Type: Critical Thinking
Page: 613

For a patient with a gastrointestinal complaint, it is MOST important for the EMT to _________.

A. determine the cause of the patient’s complaint
B. perform all interventions prior to transport
C. identify whether the patient requires rapid transport
D. avoid transporting the patient if the condition is minor.

C. identify whether the patient requires rapid transport

Urinary tract infections are more common in ____________.

A. sedentary adults
B. men
C. active adults
D. women

D. women

Which of the following helps filter the blood and has no digestive function?

A. Stomach
B. Small intestine
C. Large intestine
D. Spleen

D. Spleen

Which of the following is correct about the secondary assessment for a high-priority patient?

A. Never perform a secondary assessment on a high-priority patient.
B. The secondary assessment must be performed prior to transport.
C. You may not have time to complete a secondary assessment.
D. Never contact medical direction before completing the secondary assessment.

C. You may not have time to complete a secondary assessment.

Which of the following may help reduce your patient’s nausea?

A. positive-pressure ventilation.
B. cricoid pressure.
C. low-flow oxygen.
D. oral glucose.

C. low-flow oxygen.

Your patient complains of abdominal pain that occurs mostly at night or after eating fatty foods. You should suspect ____________.

A. cholecystitis
B. a hernia
C. appendicitis
D. kidney stones

A. cholecystitis

Your patient complains of chronic “burning” stomach pain that improves after eating. You should suspect:

A. aortic aneurysm.
B. pneumonia.
C. kidney stones.
D. peptic ulcer disease.

D. peptic ulcer disease.
1. Diabetes is MOST accurately defined as a(n):
A. disorder of carbohydrate metabolism.
B. abnormally high blood glucose level.
C. mass excretion of glucose by the kidneys.
D. lack of insulin production in the pancreas.
Answer: A
Question Type: General Knowledge
Page: 621
2. Type 1 diabetes:
A. is typically treated with medications such as metformin (Glucophage).
B. is a condition in which no insulin is produced by the body.
C. typically occurs in patients between 50 and 70 years of age.
D. is defined as a blood sugar level that is less than 120 mg/dL.
Answer: B
Question Type: General Knowledge
Page: 622
3. Patients with type 2 diabetes usually control their disease with all of the following, EXCEPT:
A. diet and exercise.
B. tolbutamide (Orinase).
C. glyburide (Micronase).
D. supplemental insulin.
Answer: D
Question Type: General Knowledge
Page: 622
4. Glipizide, a non-insulin-type medication, is another name for:
A. Glucophage.
B. Glucotrol.
C. Micronase.
D. Diabinese.
Answer: B
Question Type: General Knowledge
Page: 622
5. Which of the following statements regarding glucose is correct?
A. Most cells will function normally without glucose.
B. Blood glucose levels decrease in the absence of insulin.
C. The brain requires glucose as much as it requires oxygen.
D. The brain requires insulin to allow glucose to enter the cells.
Answer: C
Question Type: General Knowledge
Page: 622
6. Insulin functions in the body by:
A. producing new glucose as needed.
B. enabling glucose to enter the cells.
C. increasing circulating blood glucose.
D. metabolizing glucose to make energy.
Answer: B
Question Type: General Knowledge
Page: 622
7. Patients with uncontrolled diabetes experience polyuria because:
A. they drink excess amounts of water due to dehydration.
B. excess glucose in the blood is excreted by the kidneys.
C. low blood glucose levels result in cellular dehydration.
D. high blood sugar levels cause permanent kidney damage.
Answer: B
Question Type: General Knowledge
Page: 622
8. Excessive eating caused by cellular “hunger” is called:
A. polyphagia.
B. polydipsia.
C. dysphasia.
D. dyspepsia.
Answer: A
Question Type: General Knowledge
Page: 622
9. Ketone production is the result of:
A. acidosis when blood glucose levels are low.
B. blood glucose levels higher than 120 mg/dL.
C. fat metabolization when glucose is unavailable.
D. rapid entry of glucose across the cell membrane.
Answer: C
Question Type: General Knowledge
Page: 623
10. A 37-year-old female with a history of diabetes presents with excessive urination and weakness of 2 days’ duration. You apply 100% oxygen and assess her blood glucose level, which reads 320 mg/dL. If this patient’s condition is not promptly treated, she will MOST likely develop:
A. severe insulin shock.
B. acidosis and dehydration.
C. complete renal failure.
D. hypoxia and overhydration.
Answer: B
Question Type: Critical Thinking
Page: 623
11. 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.
Answer: A
Question Type: General Knowledge
Page: 623
12. The normal blood glucose level, as measured by a glucometer, is between:
A. 60 and 80 mg/dL.
B. 80 and 120 mg/dL.
C. 130 and 150 mg/dL.
D. 160 and 200 mg/dL.
Answer: B
Question Type: General Knowledge
Page: 623
13. Diabetic ketoacidosis occurs when:
A. blood glucose levels rapidly fall.
B. the cells rapidly metabolize glucose.
C. the pancreas produces excess insulin.
D. insulin is not available in the body.
Answer: D
Question Type: General Knowledge
Page: 623
14. A 28-year-old female patient is found to be responsive to verbal stimuli only. Her roommate states that she was recently diagnosed with type 1 diabetes and has had difficulty controlling her blood sugar level. She further tells you that the patient has been urinating excessively and has progressively worsened over the last 24 to 36 hours. On the basis of this patient’s clinical presentation, you should suspect that she:
A. is significantly hyperglycemic.
B. has a low blood glucose level.
C. has a urinary tract infection.
D. has overdosed on her insulin
Answer: A
Question Type: Critical Thinking
Page: 624-625
15. Diabetic coma is a life-threatening condition that results from:
A. hypoglycemia, excess insulin, and dehydration.
B. hyperglycemia, ketoacidosis, and dehydration.
C. hypoglycemia, dehydration, and ketoacidosis.
D. hyperglycemia, excess insulin, and ketoacidosis.
Answer: B
Question Type: General Knowledge
Page: 625
16. 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.
Answer: B
Question Type: General Knowledge
Page: 625
17. Common signs and symptoms of diabetic coma include all of the following, EXCEPT:
A. warm, dry skin.
B. cool, clammy skin.
C. rapid, thready pulse.
D. acetone breath odor.
Answer: B
Question Type: General Knowledge
Page: 625
18. The signs and symptoms of insulin shock are the result of:
A. increased blood glucose levels.
B. fat metabolism within the cells.
C. decreased blood glucose levels.
D. prolonged and severe dehydration.
Answer: C
Question Type: General Knowledge
Page: 625
19. Insulin shock will MOST likely develop if a patient:
A. takes too much of his or her prescribed insulin.
B. markedly overeats and misses an insulin dose.
C. eats a regular meal followed by mild exertion.
D. misses one or two prescribed insulin injections.
Answer: A
Question Type: General Knowledge
Page: 626
20. Hypoglycemic crisis tends to develop more often and more severely in children because:
A. they have larger glucose stores than adults do.
B. they do not always eat correctly and on schedule.
C. their cells do not uptake glucose as fast as adults’ do.
D. their low activity levels cause rapid glucose depletion.
Answer: B
Question Type: General Knowledge
Page: 626
21. Classic signs and symptoms of hypoglycemia include:
A. warm, dry skin; irritability; bradycardia; and rapid respirations.
B. cool, clammy skin; weakness; tachycardia; and rapid respirations.
C. warm, dry skin; hunger; abdominal pain; and deep, slow respirations.
C. cold, clammy skin; bradycardia; hunger; and deep, rapid respirations.
Answer: B
Question Type: General Knowledge
Page: 626
22. Assessment of a patient with hypoglycemia will MOST likely reveal:
A. sunken eyes.
B. hyperactivity.
C. warm, dry skin.
D. combativeness.
Answer: D
Question Type: General Knowledge
Page: 626
23. In contrast to insulin shock, diabetic coma:
A. is rapidly reversible if oral glucose is given.
B. commonly results in excess water retention.
C. can only be corrected in the hospital setting.
D. is a rapidly developing metabolic disturbance.
Answer: C
Question Type: General Knowledge
Page: 626
24. A 75-year-old male with type 1 diabetes presents with chest pain and a general feeling of weakness. He tells you that he took his insulin today and ate a regular meal approximately 2 hours ago. You should treat this patient as though he is experiencing:
A. hypoglycemia.
B. an acute stroke.
C. hyperglycemia.
D. a heart attack.
Answer: D
Question Type: Critical Thinking
Page: 626
25. You respond to a residence for a patient who is “not acting right.” As you approach the door, the patient, a 35-year-old male, begins shouting profanities at you and your partner while holding a baseball bat. The man is confused and diaphoretic, and is wearing a medical identification bracelet. You should:
A. calm him down so you can assess him.
B. be assertive and talk the patient down.
C. contact medical control for instructions.
D. retreat at once and call law enforcement.
Answer: D
Question Type: Critical Thinking
Page: 626
26. A 29-year-old female presents with confusion and disorientation. Her respirations are rapid and shallow and her pulse is 120 beats/min and thready. She is markedly diaphoretic and has an oxygen saturation of 89%. You should:
A. transport immediately.
B. administer oral glucose.
C. provide ventilatory support.
D. treat her for hyperglycemia.
Answer: C
Question Type: Critical Thinking
Page: 627
27. A man finds his 59-year-old wife unconscious on the couch. He states that she takes medications for type 2 diabetes. He further tells you that his wife has been ill recently and has not eaten for the past 24 hours. Your assessment reveals that the patient is unresponsive. You should:
A. quickly assess for the presence of a medical identification tag.
B. administer 100% oxygen via a nonrebreathing mask.
C. open and maintain her airway and assess breathing.
D. administer oral glucose between her cheek and gum.
Answer: C
Question Type: Critical Thinking
Page: 627
28. You respond to a movie theater for a 70-year-old male who is confused. His wife tells you he has type 2 diabetes but refuses to take his pills. Your assessment reveals that the patient is diaphoretic, tachycardic, and tachypneic. Initial management for this patient should include:
A. administering one to two tubes of oral glucose.
B. applying a nonrebreathing mask at 15 L/min.
C. assisting the patient with his diabetic medication.
D. performing a rapid exam and obtaining vital signs.
Answer: B
Question Type: Critical Thinking
Page: 627
29. 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.
Answer: A
Question Type: General Knowledge
Page: 628
30. When assessing an unconscious diabetic patient, the primary visible difference between hyperglycemia and hypoglycemia is the:
A. patient’s mental status.
B. rate of the patient’s pulse.
C. presence of a medical identification tag.
D. rate and depth of breathing.
Answer: D
Question Type: General Knowledge
Page: 629
31. You are treating a 40-year-old male with a documented blood sugar reading of 300 mg/dL. The patient is semiconscious and breathing shallowly, and is receiving assisted ventilation from your partner. You should recognize that definitive treatment for this patient includes:
A. oxygen.
B. glucagon.
C. insulin.
D. dextrose.
Answer: C
Question Type: Critical Thinking
Page: 629
32. A 19-year-old male complains of “not feeling right.” His insulin and a syringe are on a nearby table. The patient says he thinks he took his insulin and cannot remember whether he ate. He is also unable to tell you the time or what day it is. The glucometer reads “error” after several attempts to assess his blood glucose level. In addition to administering oxygen, you should:
A. contact medical control and administer oral glucose.
B. assist him with his insulin injection and reassess him.
C. request a paramedic ambulance to administer IV glucose.
D. transport only with close, continuous monitoring en route.
Answer: A
Question Type: Critical Thinking
Page: 629
33. Which of the following conditions is the diabetic patient at an increased risk of developing?
A. blindness
B. depression
C. alcoholism
D. hepatitis B
Answer: A
Question Type: General Knowledge
Page: 630
34. Glutose is a trade name for:
A. glucotrol.
B. oral glucose.
C. micronase.
D. glucophage.
Answer: B
Question Type: General Knowledge
Page: 630
35. To which of the following diabetic patients should you administer oral glucose?
A. an unconscious 33-year-old male with cool, clammy skin
B. a conscious 37-year-old female with nausea and vomiting
C. a semiconscious 40-year-old female without a gag reflex
D. a confused 55-year-old male with tachycardia and pallor
Answer: D
Question Type: General Knowledge
Page: 630-631
36. Proper procedure for administering oral glucose to a patient includes all of the following, EXCEPT:
A. assessing the patient’s mental status.
B. ensuring the absence of a gag reflex.
C. checking the medication’s expiration date.
D. requesting permission from medical control.
Answer: B
Question Type: General Knowledge
Page: 631
37. Hemoglobin is:
A. the fluid portion of the blood that transports cells throughout the body.
B. essential for the formation of clots, such as when vessel damage occurs.
C. found within the red blood cells and is responsible for carrying oxygen.
D. a key component of the blood and is produced in response to an infection.
Answer: C Question Type: General Knowledge
Page: 633
38. Which of the following statements regarding sickle cell disease is correct?
A. Sickle cell disease is an inherited blood disorder that causes the blood to clot too quickly.
B. In sickle cell disease, the red blood cells are abnormally shaped and are less able to carry oxygen.
C. The red blood cells of patients with sickle cell disease are round and contain hemoglobin A.
D. Because of their abnormal shape, red blood cells in patients with sickle cell disease are less apt to lodge in a blood vessel.
Answer: B Question Type: General Knowledge
Page: 633
39. A 30-year-old female presents with severe acute pain to the left upper quadrant of her abdomen. During your assessment, she tells you that she has sickle cell disease. You should suspect that:
A. her spleen is enlarged because of red blood cell engorgement.
B. the pain in her abdomen is referred pain from an enlarged liver.
C. she has gastrointestinal bleeding due to large blood vessel rupture.
D. she is experiencing an aplastic crisis and needs a blood transfusion.
Answer: A Question Type: Critical Thinking
Page: 633
40. An acute accelerated drop in the hemoglobin level, which is caused by red blood cells breaking down at a faster rate than normal, occurs during a(n) __________ crisis.
A. aplastic
B. hemolytic
C. vaso-occlusive
D. splenic sequestration
Answer: B Question Type: General Knowledge
Page: 634
41. Patients with thrombophilia are at an increased risk for:
A. various cancers.
B. hemorrhagic stroke.
C. acute arterial rupture.
D. pulmonary embolism.
Answer: D Question Type: General Knowledge
Page: 634
42. During your assessment of a 19-year-old male, you are told that he is being treated with factor VIII. This indicates that:
A. he has a thrombosis.
B. he has hemophilia B.
C. he has hemophilia A.
D. his blood clots too quickly.
Answer: C Question Type: General Knowledge
Page: 635
43. A 42-year-old male is found unresponsive on his couch by a neighbor. During your assessment, you find no signs of trauma and the patient’s blood glucose level is 75 mg/dL. His blood pressure is 168/98 mm Hg, his heart rate is 45 beats/min and bounding, and his respirations are 8 breaths/min and irregular. The patient is wearing a medical alert bracelet that states he has hemophilia. You should:
A. administer oxygen via a nonrebreathing mask, apply oral glucose in between his cheek and gum, and transport.
B. suspect that he has internal bleeding and is in shock, administer high-flow oxygen, and transport at once.
C. administer high-flow oxygen, perform a detailed secondary assessment at the scene, and transport promptly.
D. suspect that he has intracranial bleeding, assist his ventilations, and transport rapidly to an appropriate hospital
Answer: D Question Type: Critical Thinking
Page: 635
14. A 28-year-old female patient is found to be responsive to verbal stimuli only. Her roommate states that she was recently diagnosed with type 1 diabetes and has had difficulty controlling her blood sugar level. She further tells you that the patient has been urinating excessively and has progressively worsened over the last 24 to 36 hours. On the basis of this patient’s clinical presentation, you should suspect that she:
A. is significantly hyperglycemic.
B. has a low blood glucose level.
C. has a urinary tract infection.
D. has overdosed on her insulin
Answer: A
Question Type: Critical Thinking
Page: 624-625
15. Diabetic coma is a life-threatening condition that results from:
A. hypoglycemia, excess insulin, and dehydration.
B. hyperglycemia, ketoacidosis, and dehydration.
C. hypoglycemia, dehydration, and ketoacidosis.
D. hyperglycemia, excess insulin, and ketoacidosis.
Answer: B
Question Type: General Knowledge
Page: 625

A patient with an altered mental status, high blood glucose levels, and deep, rapid breathing may have a condition known as __________.

A. hypoglycemic crisis
B. hyperosmolar hyperglycemic nonketotic coma
C. hyperglycemic crisis
D. diabetic ketoacidosis

D. diabetic ketoacidosis

A patient with hypoglycemia will often present with which of the following signs/symptoms?

A. Hypertension
B. Deep, rapid respirations
C. Warm, red and dry skin
D. Pale, cool and clammy skin

D. Pale, cool and clammy skin

The main function of the endocrine system is to _________.

A. produce glandular secretions.
B. regulate glucose and calcium.
C. maintain homeostasis.
D. regulate blood flow.

C. maintain homeostasis.

The main types of sickle cell crises that a patient may experience include _________.

A. aplastic crisis
B. vaso-occlusive crisis
C. splenic sequestration crisis
D. all of the above

D. all of the above

The two main types of cells contained in blood are called _________.

A. transport and clotting
B. hemoglobin A and S
C. erythrocytes and leukocytes
D. platelets and plasma

C. erythrocytes and leukocytes
Immediately after giving an epinephrine injection, you should:
properly dispose of the syringe.
While auscultating breath sounds of a patient who was stung multiple times by a yellow jacket, you hear bilateral wheezing over all lung fields. This indicates:
narrowing of the bronchioles in the lungs.
Common signs and symptoms of an allergic reaction include all of the following, EXCEPT:
drying of the eyes.
The two MOST common signs of anaphylaxis are:
wheezing and widespread urticaria.
After administering 0.3 mg of epinephrine via auto-injector to a 22-year-old female with an allergic reaction, you note improvement in her breathing and dissipation of her hives. However, she is still anxious and tachycardic. You should:
monitor her closely but recall that anxiety and tachycardia are side effects of epinephrine.
Most patients who die of anaphylaxis do so within the first __________ following exposure.
30 minutes
Chemicals that are responsible for the signs and symptoms of an allergic reaction to a bee sting include:
histamines and leukotrienes.
The stinger from a honeybee should be:
scraped away from the skin.
Urticaria is the medical term for:
hives.
Which of the following medications blocks the release of histamines?
diphenhydramine (Benadryl)
A raised, swollen, well-defined area on the skin that is the result of an insect bite or sting is called:
a wheal.
A 37-year-old male is having a severe allergic reaction to penicillin. He does not have an epinephrine auto-injector and your protocols do not allow you to carry epinephrine on the ambulance. How should you proceed with the treatment of this patient?
Administer oxygen, transport at once, and request a paramedic intercept.
Which of the following MOST accurately defines an allergic reaction?
an exaggerated immune system response to any substance
The effects of epinephrine are typically observed within _________ following administration.
1 minute
The adult epinephrine auto-injector delivers ______ mg of epinephrine, and the pediatric auto-injector delivers ______ mg.
0.3, 0.15
Anaphylaxis is MOST accurately defined as a(n):
extreme allergic reaction that may affect multiple body systems.
Which of the following patients would MOST likely have a delayed onset of an allergic reaction?
a 45-year-old male who ingested penicillin
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:
contact medical control if needed, transport the patient, and monitor him for signs of deterioration.
Which of the following would MOST likely provide clues regarding the source of a patient’s allergic reaction?
the environment in which the patient is found
A 48-year-old male is found unconscious in the garden by his wife. When you arrive at the scene and assess the man, you find that he is unresponsive, has severely labored breathing, and has hives over his entire trunk. You should:
maintain his airway and assist his ventilations.
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:
assist her ventilations with 100% oxygen.
The foreign substance responsible for causing an allergic reaction is called a(n):
allergen.
Because the stinger of a honeybee remains in the wound following a sting:
it can continue to inject venom for up to 20 minutes.
A 19-year-old female was stung multiple times on the legs by fire ants. She states that she is allergic to fire ants, but does not carry her own epinephrine. The patient is conscious and alert and complains of pain to the area of the bites. Her blood pressure is 122/70 mm Hg, her pulse is 100 beats/min and strong, and her respirations are 18 breaths/min and unlabored. You should
administer oxygen and transport her to the hospital.
You have administered one dose of epinephrine to a 40-year-old female to treat an allergic reaction that she developed after being stung by a scorpion. Your reassessment reveals that she is still having difficulty breathing, has a decreasing mental status, and has a blood pressure of 80/50 mm Hg. You should:
request permission from medical control to give another dose of epinephrine.
Which of the following physiologic actions does epinephrine produce when given for an allergic reaction?
vasoconstriction and bronchodilation
Common side effects of epinephrine include all of the following, EXCEPT:
drowsiness.
Epinephrine is indicated for patients with an allergic reaction when:
wheezing and hypotension are present

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 oxygen as needed, clean the area with soap and water or a mild antiseptic, and transport him to the hospital.
B) Assess his ABCs and vital signs in 15 minutes and allow him to drive himself to the hospital if he remains stable.
C) Apply high-flow oxygen, apply a chemical cold pack directly to the injection site, and transport at once.
D) Apply high-flow oxygen, obtain approval from medical control to assist him with his epinephrine, and transport.

A) Apply oxygen as needed, clean the area with soap and water or a mild antiseptic, and transport him to the hospital.

At the site of the injury, signs and symptoms of an animal or insect bite or sting may include pain, localized heat, and a wheal, which appears as __________.

A. an uncomfortable depression in the skin
B. a raised, well-defined area of the skin
C. a series of small, raised pustules
D. a large area of red, blotchy skin

B. a raised, well-defined area of the skin

Epinephrine stimulates the ________ response, increasing blood pressure and relieving bronchospasm.

A. sympathetic
B. respiratory
C. parasympathetic
D. cardiac

A. sympathetic

The goal of invaders such as bacterium and viruses is to __________.

A. cause an immune response.
B. kill their human host
C. spread disease and destruction
D. use a human body as a home

D. use a human body as a home

When a foreign substance invades the body, the body will __________.

A. protect itself
B. go on alert
C. attempt to inactivate the foreign substance
D. All of the above

D. All of the above

When an allergic reaction proceeds to life-threatening anaphylaxis, it will usually do so __________.

A. quickly, within less than 30 minutes.
B. quickly, within less than 30 seconds.
C. slowly, over several hours.
D. slowly, over more than 30 minutes.

A. quickly, within less than 30 minutes.

When an auto-injector is used to administer epinephrine, the primary injection site is the:

A. lateral part of the arm.
B. lateral part of the thigh.
C. medial part of the buttocks.
D. medial part of the thigh.

B. lateral part of the thigh.

Which of the following signs/symptoms are indicative of respiratory involvement of an allergic reaction?

A. Flushed, itching, or burning skin
B. A sense of impending doom
C. Tightness in the chest or throat
D. All of the above

C. Tightness in the chest or throat

Which of the following statements regarding fire ants is correct?

A. Fire ant bites rarely cause anaphylaxis.
B. Fire ants often bite a person repeatedly.
C. Fire ant bites typically occur on the face.
D. Most people are allergic to fire ant toxin.

B. Fire ants often bite a person repeatedly.

You respond to the residence of a 55-year-old woman with a possible allergic reaction to peanuts that she ate approximately 30 minutes ago. The patient is conscious and alert, but has diffuse urticaria and the feeling that she has a lump in her throat. As your partner applies oxygen to the patient, you should:

A. ask her if she has prescribed epinephrine.
B. ask her when her last allergic reaction occurred.
C. obtain a complete set of baseline vital signs.
D. ascertain if she has a family history of allergies.

A. ask her if she has prescribed epinephrine.
1. ____________ is what you can see of a person’s response to the environment.
A. Affect
B. Behavior
C. Neurosis
D. Psychosis
Answer: B
Question Type: General Knowledge
Page: 702
2. The term “behavioral crisis” is MOST accurately defined as:
A. a sudden, violent outburst of an otherwise mentally stable person toward a family member.
B. any reaction that interferes with activities of daily living or is deemed unacceptable by others.
C. a situation in which a patient demonstrates bizarre behavior and becomes a risk to other people.
D. a period of severe depression that lasts longer than 2 weeks and cannot be controlled with medications.
Answer: B
Question Type: General Knowledge
Page: 702
3. From a mental health standpoint, an abnormal or disturbing pattern of behavior is a matter of concern if it lasts for at least:
A. 1 week.
B. 2 weeks.
C. 3 weeks.
D. 1 month.
Answer: D
Question Type: General Knowledge
Page: 702
4. In contrast to a behavioral crisis, a psychiatric emergency occurs when a person:
A. demonstrates agitation or violence or becomes a threat to himself or herself, or to others.
B. experiences feelings of sadness and despair for longer than a month.
C. exhibits impaired functioning due to a chemical or genetic disturbance.
D. experiences a sudden attack of panic secondary to a stressful situation.
Answer: A
Question Type: General Knowledge
Page: 702
5. When assessing a patient who is displaying bizarre behavior, the EMT should:
A. consider that an acute medical illness may be causing the patient’s behavior.
B. avoid asking questions about suicide because this may give the patient ideas.
C. check his or her blood glucose level only if he or she has a history of diabetes.
D. carefully document his or her perception of what is causing the patient’s behavior.
Answer: A Question Type: General Knowledge
Page: 702
6. Organic brain syndrome is MOST accurately defined as:
A. bizarre behavior secondary to a chemical imbalance or disturbance in the brain.
B. a dysfunction of the brain caused by abnormal physical or physiological function.
C. a disorder that cannot be traced to the abnormal structure or function of an organ.
D. a change in behavior or mental status secondary to inadequate cerebral blood flow.
Answer: B
Question Type: General Knowledge
Page: 703
7. A 78-year-old female presents with an acute change in her behavior. The patient’s son tells you that his mother has type 2 diabetes and was diagnosed with Alzheimer’s disease 6 months ago. The patient’s speech is slurred and she is not alert to her surroundings. You should:
A. transport the patient to a psychiatric facility.
B. inquire about the possibility of head trauma.
C. conclude that the patient’s blood sugar is high.
D. allow the patient to refuse transport if she wishes.
Answer: B
Question Type: Critical Thinking
Page: 703
8. Which of the following conditions or factors would be the LEAST likely to result in a change in behavior?
A. low blood glucose levels
B. antihypertensive medications
C. exposure to excess heat or cold
D. inadequate blood flow to the brain
Answer: B
Question Type: General Knowledge
Page: 703
9. Which of the following is an example of a functional behavioral disorder?
A. head trauma
B. drug addiction
C. schizophrenia
D. Alzheimer’s disease
Answer: C
Question Type: General Knowledge
Page: 703
10. The first step in assessing a patient with a behavioral emergency is to:
A. take vital signs.
B. restrain the patient.
C. ensure your safety.
D. obtain proper consent
Answer: C
Question Type: General Knowledge
Page: 704
11. You respond to a call for an unknown emergency. When you arrive at the scene, the patient’s husband meets you at the door and states that his wife has been depressed and has locked herself in an upstairs bedroom. He further tells you that he keeps his handgun in the bedroom. You should:
A. ask the husband to attempt to reason with his wife.
B. remain in a safe place and request law enforcement.
C. get in your ambulance and leave the scene immediately.
D. go upstairs with caution and attempt to talk to the patient.
Answer: B
Question Type: Critical Thinking
Page: 704
12. General guidelines for managing a patient with a behavioral emergency include:
A. firmly identifying yourself as an EMS provider.
B. placing the patient between yourself and an exit.
C. allowing the patient to be alone if he or she wishes.
D. being prepared to spend extra time with the patient.
Answer: D
Question Type: General Knowledge
Page: 704
13. A 40-year-old male intentionally cut his wrist out of anger after losing his job. Law enforcement has secured the scene prior to your arrival. As you enter the residence and visualize the patient, you can see that he has a towel around his wrist and a moderate amount of blood has soaked through it. You should:
A. approach the patient with caution.
B. quickly tend to the bleeding wound.
C. tell the patient that you want to help.
D. calmly identify yourself to the patient.
Answer: D
Question Type: Critical Thinking
Page: 704
14. When assessing a patient with a behavioral crisis, you should:
A. be direct and clearly state your intentions.
B. frisk the patient for the presence of weapons.
C. spend as little time with the patient as possible.
D. ask the police to handcuff the patient for safety.
Answer: A
Question Type: General Knowledge
Page: 704
15. A 22-year-old male with a history of clinical depression called 9-1-1 and stated that he has attempted to kill himself. Your unit and law enforcement officers arrive at the scene simultaneously. You find the patient lying supine on the living room floor. He is unconscious and cyanotic. An empty bottle of hydromorphone (Dilaudid) is found on an adjacent table. You should:
A. open the patient’s airway and assess his respirations.
B. ask the police to handcuff the patient for safety purposes.
C. provide care after determining what Dilaudid is used for.
D. wait for the police to examine him before providing care
Answer: A
Question Type: Critical Thinking
Page: 705
16. A 66-year-old male presents with bizarre behavior. His daughter states that he did not seem to recognize her and was very rude to her. The patient is conscious, and has a patent airway and adequate breathing. You should:
A. conclude that the patient has Alzheimer’s disease.
B. ask the daughter how her father normally behaves.
C. carefully restrain the patient and transport at once.
D. advise the patient that his behavior is unacceptable.
Answer: B
Question Type: Critical Thinking
Page: 705
17. A technique used to gain insight into a patient’s thinking, which involves repeating in question form what the patient has said, is called:
A. active listening.
B. passive listening.
C. intuitive listening.
D. reflective listening.
Answer: D
Question Type: General Knowledge
Page: 705-706
18. Which of the following statements regarding the physical examination of a patient with a behavioral problem is correct?
A. It is only appropriate to perform a physical examination on a patient with a behavioral problem if he or she is unconscious or is being physically restrained.
B. A physical examination for a behavioral problem may be difficult to perform but may provide clues to the patient’s state of mind and thought processes.
C. The physical examination of a patient with a behavioral problem often yields crucial information and should always be performed, even if the patient is violent.
D. Performing a physical examination on a patient with a behavioral problem will likely cause him or her to become violent and should be avoided in the field.
Answer: B
Question Type: General Knowledge
Page: 706
19. You are assessing a conscious 55-year-old male with a sudden change in behavior. Which of the following clinical findings would be MOST suggestive of dysfunction of this patient’s central nervous system?
A. an irregular pulse
B. rapid eye movement
C. excessive tearing or crying
D. consistent eye contact
Answer: B
Question Type: Critical Thinking
Page: 706
20. Assessing the blood pressure and oxygen saturation of a patient with a behavioral crisis should be performed:
A. within the first few minutes after making patient contact.
B. at least every 5 minutes in order to detect signs of shock.
C. only if you will be transporting the patient to the hospital.
D. if doing so will not worsen his or her emotional distress.
Answer: D Question Type: General Knowledge
Page: 706
21. In addition to ensuring his or her own safety, the EMT’s responsibility when caring for a patient with a behavioral emergency is to:
A. diffuse and control the situation and safely transport the patient.
B. diagnose the patient’s problem and provide definitive treatment.
C. transport the patient directly to a specialized psychiatric facility.
D. determine the underlying cause of the problem and offer advice.
Answer: A
Question Type: Critical Thinking
Page: 707
22. Common causes of acute psychotic behavior include all of the following, EXCEPT:
A. intense stress.
B. schizophrenia.
C. Alzheimer’s disease.
D. mind-altering substance use.
Answer: C Question Type: General Knowledge
Page: 708
23. The single most significant factor that contributes to suicide is:
A. depression.
B. drug abuse.
C. advanced age.
D. a chronic illness.
Answer: A
Question Type: General Knowledge
Page: 708
24. You are assessing a 45-year-old female who is severely depressed. She states that it seems as though her entire world is crashing down around her. She further states that she has had frequent thoughts of suicide, but is not sure if she can actually go through with it. How should you manage this situation?
A. Ask the patient if she has developed a suicidal plan.
B. Leave the scene and have a neighbor check in on her.
C. Have law enforcement place her in protective custody.
D. Encourage the patient to remain quiet during transport.
Answer: A
Question Type: Critical Thinking
Page: 708-709
25. People at risk for suicide include all of the following, EXCEPT:
A. married males older than 30 years.
B. those with a recent diagnosis of a serious illness.
C. children with parents addicted to alcohol.
D. substance abusers.
Answer: A
Question Type: General Knowledge
Page: 709
26. It is MOST important for the EMT to remember that suicidal patients may:
A. inject illicit drugs.
B. be self-destructive.
C. be homicidal as well.
D. have a definitive plan.
Answer: C
Question Type: General Knowledge
Page: 709
27. Signs of agitated delirium include:
A. pallor, hypotension, and constricted pupils.
B. diaphoresis, tachycardia, and hallucinations.
C. slurred speech, bradycardia, and a high fever.
D. subdued behavior, crying, and suicidal thoughts.
Answer: B
Question Type: General Knowledge
Page: 709
28. Law enforcement personnel request your assistance for a 30-year-old man who they pulled over for erratic driving. The patient became acutely violent while he was being questioned, which required one of the officers to subdue him with a Taser. When you arrive and assess the patient, you find that he is very agitated and is experiencing apparent hallucinations. His skin is flushed and diaphoretic. You should:
A. quickly rule out any life-threatening conditions and then perform a detailed secondary assessment as he is being restrained.
B. suspect that he is acutely hypoglycemic, consider giving him one tube of oral glucose, and transport with lights and siren.
C. limit physical contact with the patient as much as possible and avoid interrupting him if he is attempting to communicate with you.
D. recognize that he is experiencing a complex psychiatric crisis, quickly load him into the ambulance, and transport without delay.
Answer: C Question Type: Critical Thinking
Page: 710
29. A 38-year-old male with a history of schizophrenia is reported by neighbors to be screaming and throwing things in his house. You are familiar with the patient and have cared for him in the past for unrelated problems. Law enforcement officers escort you into the residence when you arrive. The patient tells you that he sees vampires and is attempting to ward them off by screaming and throwing things at them. He has several large lacerations to his forearms that are actively bleeding. The MOST appropriate way to manage this situation is to:
A. try to gain the patient’s trust by telling him that you see the vampires too.
B. request that the police officers arrest him and take him to the hospital.
C. restrain the patient with appropriate force in order to treat his injuries.
D. approach the patient and calm him by placing your hand on his shoulder.
Answer: C
Question Type: Critical Thinking
Page: 712
30. You receive a call for a domestic dispute. When you arrive at the scene, you find a young male standing on the front porch of his house. You notice that an adjacent window is broken. The patient has a large body, is clenching his fists, and is yelling obscenities at you. Which of the following findings is LEAST predictive of this patient’s potential for violence?
A. his clenched fists
B. the broken window
C. his shouting of obscenities
D. his large body
Answer: D
Question Type: Critical Thinking
Page: 713-714

A general impression of the patient is formed by an EMT:

A. when the patient is in the ambulance.
B. speaking with family members or bystanders first.
C. at a distance when the patient is first seen.
D. speaking privately with the patient

C. at a distance when the patient is first seen.

The two basic categories of diagnosis that a physician will use for behavioral crises or psychiatric emergencies are ____________.

A. organic brain syndrome and altered mental status.
B. functional and nonfunctional.
C. physical and psychological.
D. All of the above

C. physical and psychological.

What is the most common misconception surrounding mental illness?

A. Everyone has some form of mental illness.
B. All persons with mental disorders are physically violent and dangerous.
C. Feeling “bad” or “depressed” means that you must be “sick.”
D. Many mental illnesses stem from drug or alcohol abuse.

C. Feeling “bad” or “depressed” means that you must be “sick.”

When a psychiatric emergency arises, a patient is most likely to exhibit which of the following behaviors?

A. any behaviors unacceptable to the patient, family, or community
B. visual or auditory hallucinations
C. disruptions to activities of daily living
D. any behaviors that are a violent threat to the patient, EMTs, or others

D. any behaviors that are a violent threat to the patient, EMTs, or others
Which of the following is an example of a psychiatric emergency?
Select one:
A. a person who is depressed and no longer caring for himself
B. a person violently attacking family members
C. a person going on a week-long “bender” after losing a job
D. a person who is experiencing a panic attack
B. a person violently attacking family members

Which of the following is considered an organic brain syndrome?

A. depression
B. anxiety conditions
C. schizophrenia
D. Alzheimer disease

D. Alzheimer disease

Which of the following terms applies to a state of delusion in which the patient is out of touch with reality?

A. psychosis
B. schizophrenia
C. agitated delirium
D. suicidal

A. psychosis

Why might EMTs encounter a larger proportion of violent patients than the population at large?

A. EMTs respond with law enforcement.
B. It is a common misperception; EMTs do NOT encounter a larger proportion of violent patients than the population at large.
C. EMTs respond to patients who, by definition, are having an emergency.
D. EMTs have to restrain patients.

C. EMTs respond to patients who, by definition, are having an emergency.
1. A dysbarism injury refers to the signs and symptoms related to changes in:
A. rapid ascent.
B. rapid descent.
C. decompression.
D. barometric pressure.
Answer: D
Question Type: General Knowledge
Page: 1061
2. When a warm hand is immersed in water that is 70°F (21°C), heat is transferred from the hand to the water through a process called:
A. radiation.
B. conduction.
C. convection.
D. evaporation.
Answer: B
Question Type: General Knowledge
Page: 1062
3. The transfer of heat to circulating air, such as when cool air moves across the body’s surface, is called:
A. radiation.
B. conduction.
C. convection.
D. evaporation.
Answer: C
Question Type: General Knowledge
Page: 1062
4. The body’s natural cooling mechanism, in which sweat is converted to a gas, is called:
A. radiation.
B. convection.
C. conduction.
D. evaporation.
Answer: D
Question Type: General Knowledge
Page: 1062
5. Heat loss from the body through respiration occurs when:
A. warm air is exhaled into the atmosphere.
B. the core body temperature is greater than 98°F (37°C).
C. cool air is inhaled and displaces warm air.
D. air temperature is greater than body temperature.
Answer: A
Question Type: General Knowledge
Page: 1062
6. Shivering is a mechanism in which the body generates heat by:
A. increasing the metabolic rate.
B. decreasing the use of oxygen.
C. decreasing the metabolic rate.
D. retaining excess carbon dioxide.
Answer: A
Question Type: General Knowledge
Page: 1062
7. Covering a patient’s _________ will significantly minimize radiation heat loss.
A. head
B. chest
C. abdomen
D. extremities
Answer: A
Question Type: General Knowledge
Page: 1062
8. Hypothermia occurs when the core body temperature falls below:
A. 98°F (37°C).
B. 95°F (35°C).
C. 90°F (32°C).
D. 88°F (31°C).
Answer: B
Question Type: General Knowledge
Page: 1063
9. The body’s natural protective mechanisms against heat loss are:
A. shivering and vasodilation.
B. vasodilation and respiration.
C. respiration and vasoconstriction.
D. vasoconstriction and shivering.
Answer: D
Question Type: General Knowledge
Page: 1063
10. Compared to adults, infants and children are at higher risk for hypothermia for all of the following reasons, EXCEPT:
A. a decreased ability to shiver.
B. a relatively small surface area.
C. a smaller amount of body fat.
D. a smaller overall muscle mass.
Answer: B
Question Type: General Knowledge
Page: 1063
11. Which of the following conditions would be the LEAST likely to increase a person’s risk of hypothermia?
A. hypoperfusion
B. severe infection
C. hyperglycemia
D. spinal cord injury
Answer: C
Question Type: General Knowledge
Page: 1063
12. To assess a patient’s general temperature, pull back on your glove and place the back of your hand on his or her skin at the:
A. neck.
B. chest.
C. abdomen.
D. forehead.
Answer: C
Question Type: General Knowledge
Page: 1063
13. To obtain the MOST accurate reading of a patient’s core body temperature, you should place a special hypothermia thermometer:
A. into the patient’s rectum.
B. under the patient’s tongue.
C. behind the patient’s knee.
D. under the patient’s armpit.
Answer: A
Question Type: General Knowledge
Page: 1063
14. A patient with a core body temperature of 95°F (35°C) will MOST likely experience:
A. a slow pulse.
B. rapid breathing.
C. muscle stiffness.
D. loss of consciousness.
Answer: B
Question Type: General Knowledge
Page: 1063
15. Which of the following would be the LEAST likely to occur in a patient with a core body temperature of between 89°F (32°C) and 92°F (33°C)?
A. bradypnea
B. confusion
C. stiff muscles
D. tachycardia
Answer: D
Question Type: General Knowledge
Page: 1063
16. A person’s ability to shiver is lost when his or her body temperature falls below:
A. 90°F (32°C).
B. 92°F (33°C).
C. 94°F (34°C).
D. 95°F (35°C).
Answer: A
Question Type: General Knowledge
Page: 1064
17. All of the following terms are used to describe a cold body part that is not frozen, EXCEPT:
A. frostnip.
B. frostbite.
C. chilblains.
D. trench foot.
Answer: B
Question Type: General Knowledge
Page: 1064
18. Patients with generalized hypothermia are at an increased risk of a local cold injury because:
A. blood is shunted away from the extremities to the body’s core.
B. peripheral vasodilation brings warm blood to the skin’s surface.
C. the major muscles of the body become rigid during hypothermia.
D. the patient is usually unable to escape the cold ambient temperature.
Answer: A
Question Type: General Knowledge
Page: 1065
19. A frostbitten foot can be identified by the presence of:
A. gross deformity.
B. soft, smooth skin.
C. mottling and blisters.
D. blanching of the skin.
Answer: C
Question Type: General Knowledge
Page: 1065
20. A 30-year-old male was rescued after being lost in the woods for approximately 18 hours. The outside temperature is 30°F (−1°C). He is immediately placed in the warmed ambulance, where you perform a primary assessment. He is unconscious, pale, and apneic. You should:
A. apply an AED and assess his cardiac rhythm.
B. assess for a carotid pulse for up to 45 seconds.
C. open his airway and give two rescue breaths.
D. apply chemical heat packs to his groin and axillae.
Answer: B
Question Type: Critical Thinking
Page: 1066
21. Hypothermia can worsen internal bleeding secondary to:
A. cardiac arrhythmias.
B. a decreased heart rate.
C. severe muscular rigidity.
D. blood clotting abnormalities.
Answer: D
Question Type: General Knowledge
Page: 1067
22. Rough handling of a hypothermic patient with a pulse may cause:
A. profound bradycardia.
B. ventricular fibrillation.
C. ventricular tachycardia.
D. pulseless electrical activity.
Answer: B
Question Type: General Knowledge
Page: 1067
23. Your assessment of a 23-year-old female reveals a core body temperature of 93.4°F (34°C). She is conscious, answers your questions appropriately, is shivering, and complains of nausea. Her skin is cold and pale, her muscles appear rigid, and her respirations are rapid. In addition to monitoring her ABCs, administering oxygen, and turning up the heat in the back of the ambulance, you should:
A. apply the AED in case she develops cardiopulmonary arrest, cover her with layers of blankets, and transport carefully.
B. place heat packs to her groin, axillae, and behind her neck; cover her with warm blankets; and avoid rough handling.
C. cover her with warm blankets and let her move about on the stretcher in order to generate body heat and increase her temperature.
D. sit her up and give her small sips of warm water to drink, place heat packs to her axillae and groin, and cover her with blankets.
Answer: B
Question Type: Critical Thinking
Page: 1068
24. You are transporting a 28-year-old man with a frostbitten foot. The patient’s vital signs are stable and he denies any other injuries or symptoms. The weather is treacherous and your transport time to the hospital is approximately 45 minutes. During transport, you should:
A. rewarm his foot in 100°F to 105°F (38°C to 40°C) water.
B. administer oxygen via a nonrebreathing mask.
C. cover his foot with chemical heat compresses.
D. protect the affected part from further injury.
Answer: D
Question Type: Critical Thinking
Page: 1069
25. The two MOST efficient ways for the body to eliminate excess heat are:
A. respiration and bradycardia.
B. perspiration and tachycardia.
C. sweating and dilation of skin blood vessels.
D. hyperventilation and tachycardia.
Answer: C
Question Type: General Knowledge
Page: 1070
26. Which of the following MOST accurately describes hyperthermia?
A. The core body temperature exceeds 99.5°F (37°C).
B. The body is exposed to more heat than it can lose.
C. Heat evaporates a significant amount of body water.
D. The body eliminates more heat than it can generate.
Answer: B
Question Type: General Knowledge
Page: 1070
27. High air temperature reduces the body’s ability to lose heat by:
A. radiation.
B. convection.
C. conduction.
D. evaporation.
Answer: A
Question Type: General Knowledge
Page: 1070
28. Geriatric patients, newborns, and infants are especially prone to hyperthermia because they:
A. have relatively smaller heads.
B. have less body fat.
C. exhibit poor thermoregulation.
D. have smaller body surface areas.
Answer: C
Question Type: General Knowledge
Page: 1070
29. When the body loses sweat, it also loses:
A. plasma.
B. nutrients.
C. erythrocytes.
D. electrolytes.
Answer: D
Question Type: General Knowledge
Page: 1070
30. In order for sweating to be an effective cooling mechanism:
A. several layers of clothing must be worn.
B. it must be able to evaporate from the body.
C. the relative humidity must be above 90%.
D. the body must produce at least 1 L per hour.
Answer: B
Question Type: General Knowledge
Page: 1070
31. High humidity reduces the body’s ability to lose heat through:
A. radiation.
B. convection.
C. conduction.
D. evaporation.
Answer: D
Question Type: General Knowledge
Page: 1070
32. Common signs and symptoms of heat exhaustion include all of the following, EXCEPT:
A. nausea.
B. headache.
C. tachycardia.
D. hot, dry skin.
Answer: D
Question Type: General Knowledge
Page: 1071
33. Heatstroke occurs when:
A. a person’s core body temperature rises above 103°F (39°C).
B. the body’s heat-eliminating mechanisms are overwhelmed.
C. a person becomes dehydrated secondary to excess water loss.
D. the ambient temperature exceeds 90°F (32°C) and the humidity is high.
Answer: B
Question Type: General Knowledge
Page: 1071
34. Signs of late heatstroke include:
A. hot, moist skin.
B. nausea and vomiting.
C. a weak, rapid pulse.
D. a change in behavior.
Answer: C
Question Type: General Knowledge
Page: 1071
35. Which of the following medications increases a person’s risk of a heat-related emergency?
A. Motrin
B. Tylenol
C. Aspirin
D. diuretics
Answer: D
Question Type: General Knowledge
Page: 1072
36. You receive a call to a residence for a sick patient. Upon your arrival, you find the patient, a 53-year-old diabetic male, lying down on his front porch. His wife tells you that he had been mowing the lawn in the heat for the past 3 hours. The patient is confused and has hot, moist skin. His pulse is weak and thready, and his blood pressure is 90/50 mm Hg. In addition to administering 100% oxygen, you should:
A. perform a rapid assessment and look for signs of trauma.
B. place him in a sitting position and have him drink 1 L of water.
C. load him into the ambulance and begin rapid cooling interventions.
D. administer one tube of oral glucose and reassess his mental status.
Answer: C
Question Type: Critical Thinking
Page: 1073
37. You are dispatched to a local high school track and field event for a 16-year-old male who fainted. The outside temperature is approximately 95°F (35°C) with high humidity. Upon your arrival, the patient is conscious, alert, and complains of nausea and a headache. His skin is cool, clammy, and pale. You should:
A. give him a liquid salt solution to drink.
B. administer 100% supplemental oxygen.
C. apply chemical ice packs to his axillae.
D. move him into the cooled ambulance.
Answer: D
Question Type: Critical Thinking
Page: 1074
38. Geriatric patients are at a higher risk for heatstroke because:
A. circulation to the skin is reduced.
B. most geriatric patients are obese.
C. their ability to sweat is enhanced.
D. their ability to shiver is reduced.
Answer: A
Question Type: General Knowledge
Page: 1076
39. Drowning is MOST accurately defined as:
A. temporary survival after submersion in water.
B. death from suffocation after submersion in water.
C. water in the lungs following submersion in water.
D. death beyond 24 hours after submersion in water.
Answer: B
Question Type: General Knowledge
Page: 1076
40. Which of the following statements regarding drowning is correct?
A. Hypoxia in the drowning victim initially occurs due to water in the lungs.
B. Artificial ventilations can easily be performed in patients with a laryngospasm.
C. Large amounts of water enter the lungs in a small number of drowning victims.
D. Laryngospasm following submersion in water makes rescue breathing difficult.
Answer: D
Question Type: General Knowledge
Page: 1076
41. A 20-year-old male was pulled from cold water by his friends. The length of his submersion is not known and was not witnessed. You perform a primary assessment and determine that the patient is apneic and has a slow, weak pulse. You should:
A. suction his airway for 30 seconds, provide rescue breathing, keep him warm, and transport at once.
B. ventilate with a bag-mask device, apply a cervical collar, remove his wet clothing, and transport rapidly.
C. provide rescue breathing, remove wet clothing, immobilize his spine, keep him warm, and transport carefully.
D. apply 100% oxygen via a nonrebreathing mask, immobilize his spine, keep him warm, and transport rapidly.
Answer: C
Question Type: Critical Thinking
Page: 1076
42. The EMT must assume that any unwitnessed water-related incident is accompanied by:
A. an air embolism.
B. alcohol intoxication.
C. possible spinal injury.
D. cold water immersion.
Answer: C
Question Type: General Knowledge
Page: 1076-1077
43. You and your partner are standing by at a large social event at a river resort when a frantic woman tells you that she found a young male floating face-down in the water. Nobody claims to have witnessed the event. After you and your partner enter the water and reach the patient, you should:
A. move him as a unit to a supine position.
B. begin ventilations with a barrier device.
C. immediately secure him to a longboard.
D. perform a jaw-thrust maneuver to open his airway.
Answer: A
Question Type: Critical Thinking
Page: 1078
44. The diving reflex may allow a person to survive extended periods of submersion in cold water secondary to:
A. bradycardia and a slowing of the metabolic rate.
B. laryngospasm that protects the lungs from water.
C. tachycardia and a lowering of the blood pressure.
D. increases in the metabolic rate and oxygen demand.
Answer: A
Question Type: General Knowledge
Page: 1079
45. Most of the serious injuries associated with scuba diving are caused by:
A. water temperature lower than 70°F (21°C).
B. too rapid of a descent.
C. alcohol consumption.
D. too rapid of an ascent.
Answer: D
Question Type: General Knowledge
Page: 1080
46. An air embolism associated with diving occurs when:
A. the diver hyperventilates prior to entering the water.
B. the diver holds his or her breath during a rapid ascent.
C. the alveoli completely collapse due to high pressure.
D. high water pressure forces air into the mediastinum.
Answer: B
Question Type: General Knowledge
Page: 1080
47. Signs and symptoms of an air embolism include all of the following, EXCEPT:
A. dysphasia.
B. pale skin.
C. dizziness.
D. joint pain.
Answer: B
Question Type: General Knowledge
Page: 1080
48. The MOST prominent symptom of decompression sickness is:
A. tightness in the chest.
B. difficulty with vision.
C. dizziness and nausea.
D. abdominal or joint pain.
Answer: D
Question Type: General Knowledge
Page: 1080
49. You respond to a local lake where a diver complains of difficulty breathing that occurred immediately after rapidly ascending from a depth of approximately 30′. On assessment, you note that he has cyanosis around his lips and has pink froth coming from his nose and mouth. You should:
A. suction his mouth and nose, apply high-flow oxygen, position him on his left side with his head down, and contact medical control regarding transport to a recompression facility.
B. place him in a semi-sitting position, suction his mouth and nose, apply a continuous positive airway pressure (CPAP) device, and transport to the closest emergency department.
C. suction his mouth and nose, keep him supine and elevate his legs to prevent air bubbles from entering his brain, administer high-flow oxygen, and transport to a hyperbaric chamber.
D. position him supine with his head elevated 30°, suction his mouth and nose, hyperventilate him with a bag-mask device, and contact medical control for further guidance.
Answer: A
Question Type: Critical Thinking
Page: 1084
50. Breath-holding syncope is caused by a decreased stimulus to breathe and occurs when:
A. a swimmer breathes shallowly before entering the water.
B. a diver holds his or her breath during a staged ascent.
C. a swimmer hyperventilates prior to entering the water.
D. a diver holds his or her breath for a long period of time.
Answer: C
Question Type: General Knowledge
Page: 1084
51. Burns associated with lightning strikes are typically:
A. superficial.
B. third-degree.
C. full-thickness.
D. partial-thickness.
Answer: A
Question Type: General Knowledge
Page: 1085
52. Which of the following statements regarding lightning strikes is correct?
A. Lighting often results in a brief period of asystole that resolves spontaneously.
B. The tissue damage pathway caused by lightning usually occurs through the skin.
C. Victims who are struck by lightning often experience severe full-thickness burns.
D. Cervical spine fractures are the most common cause of lightning-related deaths.
Answer: A
Question Type: General Knowledge
Page: 1085
53. You and your partner respond to a park where several people were reportedly struck by lightning. When you arrive, you find three patients. The first patient is lying supine on the ground; he is unresponsive and does not appear to be breathing. The second patient is ambulatory, appears confused, and is holding his arm against his chest. The third patient is sitting on the ground holding the sides of his head. After calling for backup, you should:
A. immediately begin CPR on the unresponsive patient, but cease resuscitation efforts if there is no response after 5 minutes of treatment.
B. focus your initial treatment efforts on the patients who are conscious because the unresponsive patient is likely in irreversible cardiac arrest.
C. assess the unresponsive patient’s pulse, begin CPR starting with chest compressions if he is pulseless, and attach the AED as soon as possible.
D. recognize that the patients who are conscious are at high risk for developing cardiac arrest and quickly assess them for potentially life-threatening injuries.
Answer: C
Question Type: Critical Thinking
Page: 1085
54. The venom of a black widow spider is toxic to the:
A. renal system.
B. nervous system.
C. respiratory system.
D. cardiovascular system.
Answer: B
Question Type: General Knowledge
Page: 1086
55. In contrast to the brown recluse spider, the black widow spider:
A. is very small and has a violin-shaped marking on its back.
B. is large and has a red-orange hourglass mark on its abdomen.
C. has a bite that is typically painless until a blister develops.
D. has a bite that usually produces local pain but no systemic signs or symptoms.
Answer: B
Question Type: General Knowledge
Page: 1086
56. The venom of a brown recluse spider is cytotoxic, meaning that it:
A. suppresses the respiratory drive.
B. destroys the body’s red blood cells.
C. weakens the structure of the bones.
D. causes severe local tissue damage.
Answer: D
Question Type: General Knowledge
Page: 1086
57. You are assessing a 33-year-old male who complains of severe abdominal pain, weakness, and nausea. He tells you that he was gathering wood to build a fire when he felt a sudden, sharp pain on the back of his hand. Your assessment reveals that the patient’s abdomen is rigid and painful to palpation. You should suspect:
A. a black widow spider bite.
B. envenomation from a pit viper.
C. a brown recluse spider bite.
D. Rocky Mountain spotted fever.
Answer: A
Question Type: Critical Thinking
Page: 1086
58. All of the following snakes are pit vipers, EXCEPT for the:
A. copperhead.
B. rattlesnake.
C. coral snake.
D. cottonmouth.
Answer: C
Question Type: General Knowledge
Page: 1088
59. Which of the following is an early sign of pit viper envenomation?
A. local swelling and ecchymosis
B. general weakness and diaphoresis
C. syncope and bleeding at distal sites
D. signs and symptoms of hypoperfusion
Answer: A
Question Type: General Knowledge
Page: 1089
60. While drinking beer with his friends near a creek, a 31-year-old male was bitten on the leg by an unidentified snake. The patient is conscious and alert and in no apparent distress. Your assessment of his leg reveals two small puncture marks with minimal pain and swelling. In addition to administering oxygen and providing reassurance, further care for this patient should include:
A. applying ice to the wound and transporting quickly.
B. transporting only with close, continuous monitoring.
C. elevating the lower extremities and giving antivenin.
D. supine positioning, splinting the leg, and transporting.
Answer: D
Question Type: Critical Thinking
Page: 1090
61. You are dispatched to a residence for a young female who is sick. The patient complains of a rash to her lower extremities and truncal area. Your assessment reveals a small, painful blister on her inner thigh. As your partner is taking the patient’s vital signs, she states that she and her family returned from a camping trip two days ago. On the basis of this patient’s presentation, you should suspect:
A. Lyme disease.
B. an allergic reaction.
C. exposure to poison ivy.
D. Rocky Mountain spotted fever.
Answer: A
Question Type: Critical Thinking
Page: 1091
62. A 48-year-old male was stung on the leg by a jellyfish while swimming in the ocean. He is conscious and alert, but complains of intense pain at the wound site. Specific treatment for this patient includes:
A. irrigating the wound with vinegar and immersing his leg in hot water.
B. pulling the nematocysts out with tweezers and bandaging the wound.
C. immersing his leg in fresh cold water and scraping away the stingers.
D. applying a chemical ice pack to the wound and encouraging movement.
Answer: A
Question Type: Critical Thinking
Page: 1091-1092

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