Pretty Bay, Malta
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During the initial phase of an acute stress reaction, which of the following physiological responses will occur?
You use an end-tidal carbon dioxide detector as a tool to determine if endotracheal intubation has been correctly obtained. The absence of carbon dioxide in exhaled air after six ventilations indicates that the endotracheal tube has been
In which of the following situations should a paramedic perform an initial assessment first?
The focused history and physical examination of a patient begins after you have
You arrive on the scene and find an elderly male complaining of severe abdominal and back pain. Upon further questioning, he states that the pain is “all over the left side.” On palpation, you feel a pulsating mass in the abdomen.
This patient is most likely suffering from
The hypoxic drive is regulated by
The posterior tibial pulse can be palpated near the
Progressively deeper, faster breathing alternating gradually with shallow, slower breathing is called
Which patient should be transported immediately, with minimal on-scene care and any attempts at stabilization performed en route to the hospital?
The collective change in vital signs associated with the late stages of increasing intracranial pressure consists of
If your patient has an open abdominal wound with a loop of bowel obtruding, you should treat this with
Which of the following patients is most critical in terms of age and mechanism of injury?
An unconscious patient who has one dilated pupil that is reactive to light is showing early signs of
Using your sense of touch during a physical examination is called
A harsh upper-airway sound that can be heard when the patient inhales is called
You suspect that a patient has a complete airway obstruction when he
No breath sounds in one lung field may indicate which of the following conditions?
Why is ventilation of the pediatric patient with a bag-valve mask more difficult than ventilating an adult?
The pharyngo-tracheal lumen airway should be removed if the patient
What do orthostatic vital sign changes suggest for a patient with acute abdominal pain?
A patient with an acute abdomen who shows no signs of hemorrhage and has stable vital signs should be positioned
Focused examination of the abdomen of a patient who is complaining of abdominal pain should consist of
Your patient is a 28-year-old diver who has been using scuba equipment. His diving partner states that he was unconscious when he surfaced after a dive. You should suspect
Drug dosages are lower in elderly patients than in young adults primarily because elderly patients
Which statement about the pain that accompanies a myocardial infarction is incorrect?
Which set of vital signs is consistent with left heart failure?
Which of the following conditions would NOT result in an increase in a patient’s PaCO2?
The volume of air normally inhaled and exhaled during each respiration is called the
Answer questions 30–33 on the basis of the following information.
You are called to the home of an elderly female who is having difficulty breathing. She has a history of chronic congestive heart failure.
Which vital sign pattern is most likely for this patient?
Which of the following are common medications associated with patients with chronic CHF?
You auscultate the patient’s chest. What lung sounds would you would expect to hear from this patient?
Which of the following best describes the pathophysiology of CHF?
What is the purpose of performing the Sellick’s maneuver?
Overinflating the pilot balloon in an endotracheal tube can cause
To ensure proper placement of the endotracheal tube, you should
The digital intubation method is used for patients who
Distended neck veins, diminishing unilateral breath sounds, and progressively worsening compliance are indications of
When suctioning a patient, you should always
Your patient exhibits cold, clammy skin; air hunger; distended neck veins; tracheal displacement; and absent breath sounds on one side. You should suspect
What are the signs of circulatory overload in a patient who is receiving IV fluids?
What is your first action for an adult patient who is conscious but who has a complete airway obstruction?
What is the treatment for someone who is suffering an exacerbation of either emphysema or chronic bronchitis and is not too hypoxic?
What is the most commonly used drug in the prehospital setting for patients with asthma?
Which one of the following methods is recommended when measuring respiratory rate?
Answer questions 46 and 47 on the basis of the following information.
You respond to a college fraternity where you encounter a 19-year-old male with a partially obstructed airway. According to witnesses, he was eating pizza and drinking beer when he began to cough and grab his throat. The patient is able to speak in a hoarse whisper only, and he has been coughing repeatedly for about 20 minutes.
What is the best treatment for this patient?
To perform a needle cricothyrotomy, you should place the patient
Which of the following conditions best suggests respiratory failure?
Which of the following can complicate ventilation in a pediatric patient?
One breathing pattern is characterized by periods of apnea followed by periods in which respirations first increase then decrease in both depth and frequency. This pattern is called
What condition is the pathophysiological result of near drowning in sea water?
Answer questions 52–56 on the basis of the following information.
You respond along with fire units to the scene of a structure fire. Firefighters have rescued a 25-year-old female who is unconscious and unresponsive to verbal or painful stimuli. The victim was located in a smoke-filled bedroom on the floor above the actual fire. Vital signs are: blood pressure 146/80; pulse 128, strong and regular; and respiratory rate 40. The ECG monitor shows sinus tachycardia. Auscultation reveals generally clear lung sounds and mild expiratory wheezing. You note no burn injuries to the skin or clothing.
What would account for the patient’s level of consciousness?
Pulse oximetry readings should be scrutinized closely because elevated
Treatment for carbon monoxide poisoning should include which of the following?
Signs of CO exposure include all of the following EXCEPT
Which of the following is a common source of CO?
You have arrived on scene to find a 75-year-old female in respiratory distress. Your assessment reveals: BP 138/90, pulse 136/minute, and RR 34. Upon auscultation, you note diffuse bilateral wheezes in the apices and diminished breath sounds in the bases. Pulse oximetry is 82% on room air, and the patient appears fatigued.
Which of the following treatment guidelines should you follow for this patient?
1. Establish an IV at a KVO rate.
2. Give two 20 cc/kg boluses before establishing an IV at a KVO rate.
3. If possible, ventilate via BVM at a rate of 24/ min to maximize oxygenation.
4. Attempt orotracheal or nasotrachel intubation.
5. Provide oxygen via a nonrebreather mask at 10 lpm.
Which of the following is a disease that is associated with cigarette smoking and is related to, but distinct from, emphysema?
What is the primary drug for the management of acute anaphylaxis?
You have just started an IV lifeline, but the fluid is not flowing properly. What is the first thing you should do to troubleshoot this situation?
Which of the following patients would benefit most from the application of the PASG/MAST?
Care for the patient with cardiac contusion is similar to care for the patient with which of the following conditions?
Which statement about use of Nitronox in the field is correct?
The most common cause of upper-airway obstruction is
Which of the following statements regarding treatment for the care of a patient who is suffering from complications of dialysis is correct?
Knee, femur, and hip dislocation and fracture caused by the knees hitting the firewall and absorbing initial impact are common in frontal collisions with a
A single-lead ECG tracing is useful for obtaining information about the heart. Which of the following can be determined from a single-lead ECG tracing?
What does the actual drawing of the QRS complex on an ECG tracing show?
A QRS complex is considered abnormal if it lasts longer than how many seconds?
What does the treatment for a patient whose ECG shows premature atrial contractions include?
Traumatic aortic rupture usually occurs as a result of transection of the aorta at the
What is the clinical significance of a first degree AV block?
Wolff-Parkinson-White (WPW) syndrome is characterized by which of the following waveform abnormalities?
In which situation would you consider having the patient perform a Valsalva maneuver to slow the heart rate?
Which rhythm is likely to foreshadow the development of other, more serious dysrhythmias?
What does a prolonged sinus tachycardia accompanying an acute myocardial infarction suggest?
How should you position the patient to check for jugular vein distention?
What does a carotid artery bruit indicate?
Hyperextension of the neck, followed by hyperflexion, is common in
The pain of stable angina is brought on by
In the care of a cardiac arrest patient, epinephrine is used to
A patient’s signs and symptoms include orthopnea, spasmodic coughing, agitation, cyanosis, rales, jugular vein distention, and elevated blood pressure, pulse, and respirations. What condition should you suspect?
Your patient is exhibiting the signs and symptoms of right-sided heart failure. There is no evidence of left-sided failure. In addition to ECG monitoring and high-flow oxygen, what additional treatments should he or she receive?
What is sodium nitroprusside (Nipride) used in the treatment of?
Which of the following drugs is an antidysrhythmic agent?
In performing emergency synchronized cardioversion, you would synchronize the electrical shock with which of the following wave forms?
The P wave on an ECG strip reflects what event inside the heart?
What does treatment for a patient who is experiencing stable angina consist of?
The wheezing associated with left-sided heart failure results from
A patient is found in a back bedroom lying supine on the bed with a hunting knife embedded in her anterior chest, midline below the right breast. The patient is in obvious respiratory distress. She is cold, clammy, and diaphoretic with flat neck veins. You hear no breath sounds on the right side. This patient most likely is suffering from
A primary reason for administering oxygen to a patient with AMI is to
Which of the following is the most appropriate treatment for an adult patient who has a head injury and is seizing?
Answer questions 93–96 on the basis of the following information.
You respond to a 22-year-old male who is complaining of rapid onset of chest pain. The patient states that the pain is tearing and sharp and that it started when he surfaced from a scuba dive from 60 feet down. The patient’s diving partner states that the patient surfaced too rapidly.
What is this patient most likely suffering from?
What does treatment for this patient consist of?
Due to his rapid ascent, this patient may also be suffering from which other diving-related emergency?
What is an additional possible problem associated with this injury?
The normal gestational period is
During delivery, a loop of umbilical cord presents from the birth canal. You should
For which of the following conditions would you be likely to receive an order to administer intravenous thiamine?
During delivery, you notice that the amniotic fluid is discolored and has a foul odor. What should you do first?
How should you control bleeding after the normal delivery of an infant?
A greenstick fracture is one that is
What should you do to care for a patient with a suspected pelvic fracture?
Your patient has a chemical burn to her face and eyes. How should you treat this?
The first step in managing a burn patient is to
A burn wound that blisters is an example of a
An adult who has burns over both sides of one arm and both sides of one leg would be estimated to have total burns over what percentage of body surface area?
Your patient is a comatose 56-year-old male. His breath smells fruity and sweet, and his respirations are very deep and rapid. After the initial assessment, you should provide which of the following treatments?
Signs of hypoglycemia include which of the following?
Naloxone is given to patients who are suspected of having which of the following conditions?
Patients who are found in a hazardous-materials incident should be initially treated in which containment zone?
A patient presents with symptoms of flushing, itching, hives, difficulty breathing, decreased blood pressure, and dizziness. What should you suspect?
After administration of epinephrine, what may be given to help epinephrine stop an allergic reaction?
What is the reason for giving inhaled beta agonists to patients with severe allergic reactions?
A patient is covered with alpha-radioactive material after an accidental spill. An adequate level of shielding would be
What are the classic symptoms of narcotic overdose?
Your patient is a farmer who has employed a crop duster to spray his fields. The fields were sprayed earlier today and now the farmer has teary eyes, nausea and vomiting, diarrhea, and excessive salivation. What was he most likely poisoned with?
Shivering ceases in a hypothermic patient when the body temperature drops below
Which patient presents the signs and symptoms of moderate hypothermia?
What is the correct field treatment for a frostbitten body part?
Which of the following areas of physical examination of an elderly patient is often the most difficult to accurately perform?
Signs and symptoms of radiation sickness include
Your patient is a 46-year-old male with a long history of mental illness. He appears depressed and withdrawn. Suddenly, he begins to sob uncontrollably. What should you do?
Depression is an example of a(n)
What would be the reason for a paramedic to give Benadryl (diphenhydramine) to a schizophrenic patient in the field?
Which of the following represents a significant mechanism of injury?
Your patient is a 10-year-old boy who has fallen off his bicycle. What should you do when obtaining the history of the accident?
Answer questions 128–132 on the basis of the following information.
You arrive to find a 6-year-old boy on the floor of his classroom, unconscious, incontinent, and responsive to pain only. The school nurse states that the child shook violently for approximately two minutes and has been unconscious ever since. She knows
that he takes phenobarbital because she gave him one at lunch, but she is unable to provide further medical history.
This child most likely suffers from
Phenobarbital is an example of what class or type of medication?
If this child is on medication, why did he have this episode at school?
Treatment for this patient should include
This patient should be transported to a hospital because
The ideal helicopter landing zone should
What is the approximate weight of the average 6-year-old?
What is the paramedic’s primary goal in cases of suspected child abuse?
All pediatric patients who have had seizures should be
Your patient is 10 months old. He has tachypnea and wheezing and a fever of 100.6° F. What do you suspect is wrong with your patient?
Cardiac arrest in young children is most commonly associated with which of the following?
Assessment and care of a patient who is a victim of sexual assault should include which of the following?
A patient begins to have a generalized seizure while running a marathon on a hot day. Which of the following procedures should you do first?
Which statement characterizes normal physiologic changes that occur in vital signs during pregnancy?
You are recording vital signs for a 34-year-old woman who is eight months pregnant. Her blood pressure is 100/70, pulse rate is 80, and respirations are 17 per minute and normal. Upon auscultation of her chest, you hear a mild systolic flow murmur. How should you treat this patient?
Your patient is a 29-year-old woman who is nine months pregnant with her third child. She reports the onset of painless bright red vaginal bleeding in the last half hour. How should you treat this patient?
Your patient is a 35-year-old woman who is eight months pregnant. You note that her blood pressure is 140/90 and edema is present all over her body. The patient is anxious and complains of seeing spots and having a headache. From this information, what condition should you suspect is present?
You are assisting in a delivery in the field. As the baby’s head is born, you realize that the umbilical cord is wrapped around the baby’s neck. What is your first step in the management of this problem?
You are assessing a neonate who has a pink body and blue extremities, a pulse rate of 90, positive grimace response, active motion, and irregular respiratory efforts. What is the Apgar score for this infant?
What is the order of care for a newborn born with evidence of meconium staining?
Which of the following characteristics is the criterion for administering positive pressure ventilations to a newborn?
Answer questions 149–151 on the basis of the following information.
You respond to the home of a 2-year-old girl who is experiencing labored and difficult breathing. The child’s mother states that she has had a cold for the past several days and a seal-like bark for the past 20 minutes. Physical exam reveals she has a fever of 102° F and hot, dry skin. Inspiratory stridor is heard upon auscultation of lung sounds. Vital signs are blood pressure 100/70, pulse rate of 100, and respiratory rate of 40 that is labored and with sternal retractions noted.
This patient is most likely suffering from
What is the appropriate treatment for this child?
A related disease or condition that can result in rapid and total airway obstruction is
The term ethics refers to
A tiered response system is one that does which of the following?
A victim is unresponsive after possible exposure to carbon monoxide in a closed garage. Which of the following procedures should you do first?
With whom does ultimate responsibility for patient care in the field always rest?
The rhythm that appears in the ECG shown in Figure 3.1 is which of the following?
Which of the following situations represents expressed consent?
An intoxicated person refuses treatment or transport. How should you proceed?
Your radio report to the hospital about the patient’s medical condition should include which of the following?
What is the function of a safety officer at a multi-casualty incident?
Patients who have overdosed and have altered mental status are best transported
At a mass-casualty incident (MCI), which sector should the incident commander establish first?
Which sector officer will coordinate with police to block streets and provide access at an MCI?
What is the purpose of the START method?
The first step in triage at an MCI is to
The three primary parameters assessed when using the START triage system are
Continual reexperiencing of a traumatic event is a characteristic of which of the following?
What communications system has the capability to send and receive voice and telemetry simultaneously?
Which of the following correctly describes pulsus paradoxus?
Ventilating a patient at 30 breaths per minute with a bag-valve mask and high-flow oxygen may result in
You can reduce gastric distention during artificial ventilations by
To adequately ventilate a patient with a partial laryngectomy through a stoma, you should
Which patient is most likely to require immediate transport?
Answer questions 174–175 on the basis of the following information.
You respond to a 25-patient mass-casualty incident at a store. The 911 caller stated that she smelled something “funny” and then started to feel weak and nauseous. You are the second unit on the scene. The initial unit is nowhere to be seen, and they do
not answer their radios.
What should you determine first in this situation?
After you are instructed by the HAZMAT team to begin treating decontaminated patients, you should
For which of the following procedures is a gown most necessary?
Which of the following requires intermediate level disinfection through the use of a solution of bleach and water?
Which infection is transmitted through contact with blood or body secretions?
What is a major concern when dealing with a patient with organophosphate poisoning?
Which of the following medications is commonly used to treat patients who are victims of organophosphate poisoning?