EMT Medical Sample Test 2
This is a timed quiz. You will be given 60 seconds per question. Are you ready?
Please answer the following question. You are assessing a 53-year-old female who neighbors discovered acting funny. The patient appears to be fatigued and confused and exhibiting slurred speech. She is breathing and has a pulse and skin that is cool and mottled. Vital signs are pulse 68 beats per minute, respirations 14 per minute, blood pressure 108/60 mmHg, and temperature 92.7 degrees Fahrenheit. There are no signs of trauma to the patient. Patient prescriptions of Verapamil, Digoxin, Synthroid, and nitroglycerin are found in the bedroom. Allergies are unknown. The temperature in her apartment is 55 degrees Fahrenheit. Based on the assessment findings, which of the following conditions is most likely a contributing factor to the patient's condition?
The paramedic must recognize that the patient is hypothermic, based on the body temperature as well as the temperature in the apartment. Furthermore, the paramedic must recognize that the patient suffers from hypothyroidism, as evidenced by her use of Synthroid. Hypothyroidism describes a thyroid that is slow and can only generate minimal cellular metabolism. Since heat generation is a product of cellular metabolism, the patient s body temperature drops accordingly. Neither atrial fibrillation, hypertension, nor seizure would cause the patient to become hypothermic.
Please answer the following question. Your patient has indicated fear about his illness, stating that he is afraid that he may die. This has made the interview difficult, as you have been unable to get the patient to give you many details regarding his symptoms or the events preceding them. Which of the following techniques is an acceptable method to focus the interview and get the needed information?
Repeating your understanding of the situation back to the patient is useful in helping them realize what relevant information they have not yet revealed. It is typically not advisable to take an authoritarian role with a patient, as this may add to their emotional distress and worsen their communication ability. It is also not a good idea to give patients false assurances, such as telling them that they will be fine. Decreasing the physical distance can be intimidating to the patient, as can telling them that they may worsen if you can't get the necessary information. Both of these techniques will increase patient apprehension and will likely have a negative impact on communication.
You are planning a continuing education seminar with your service's medical director. After you both decide that behavioral emergencies need to be addressed, he asks you to define normal behavior. You would reply:
Although a universal definition is difficult to establish, normal behavior is generally defined as behavior that is readily accepted within a society. Behavior that a person thinks is normal for him or herself may not be accepted by society and therefore is not considered normal. An example would be a person who thinks that clothing is optional to wear in a public setting. Just because a particular behavior does not hurt anyone does not make it normal. Again, not wearing clothes in public does not hurt anyone, but is typically frowned upon in modern society. A person’s observable conduct or activity describes behavior in a general sense and does not distinguish between normal and abnormal.
The physiological function of insulin is to promote utilization of glucose by the cells. What would happen to a patient with a low level of insulin?
Insulin is a hormone that is responsible for transporting glucose into the cell where it can be metabolized and made into energy. With a low level of insulin, very little sugar can be metabolized; the result is that the cells' ability to function is drastically reduced.
You have a patient that has suffered frostbite to his fingers. How should you prepare the patient's fingers for transport?
When a patient has suffered frostbite to his fingers, the digits should be wrapped individually to prevent the digits from freezing together and producing more damage. The digits may be submerged in room temperature water if there is no risk of them refreezing. The fingers should never be massaged. This causes the very sharp ice crystals to pierce the cells and cause cellular death.
Please answer the following question. You have been called to the top of a mountain resort for a patient that is complaining of a sudden onset of shortness of breath and coughing. Your assessment of the patient reveals an anxious patient with basilar crackles in his lungs. The patient's vital signs include a heart rate of 136, respirations of 28, and a blood pressure of 176/94 mmHg. What is your field diagnosis of this patient?
High-altitude pulmonary edema (HAPE) usually occurs in an unacclimatized individual who rapidly ascends to an altitude that exceeds 8,000 feet. HAPE develops as a result of increased pulmonary pressure and hypertension caused by changes in blood flow at high altitudes.
You are transporting a patient that is having night sweats, mild fever, and a productive cough. He states that the health department has been treating him at home for a respiratory condition. How should the patient be transported to the hospital?
The patient that has possible TB and should wear either a surgical mask or a nonrebreather mask. This is used to prevent the spread of the disease and to protect the safety of the health care provider.
Which of the following vital signs would be most indicative of a patient who has entered the decompensated stage of shock?
Decompensated shock physiologically occurs as the precapillary sphincters that guard the peripheral capillary beds relax secondary to local blood chemistry changes due to shock. The opening of these sphincters allows blood to flow back into the stagnant capillary beds which decreases the available blood volume for core perfusion, and, results in a significant drop in systemic vascular resistance. Thus the clinical finding consistent with decompensated drop is a sudden decrease in blood pressure, tachypnea, and continued elevation of the heart rate.
Please answer the following question. You have responded for a 17 year-old male who has had a sudden onset of shortness of breath. During your evaluation of the patient, he tells you that he has a history of Marfan's syndrome. The patient is dyspneic and has decreased lung sounds on the left side of his chest. What do you think is the most likely cause of this patient's shortness of breath?
A common complication seen in the patient with Marfan's syndrome is a spontaneous pneumothorax. Marfan's syndrome is a connective tissue disorder that results in weak organ and tissue structure. Along with spontaneous pneumothoracies, they are also more likely to develop aortic aneurysms.
Which of the following substances is the most common cause of anaphylaxis?
Penicillin and other antibiotics are the most common causal agents for anaphylaxis. Authorities estimate penicillin produces an allergic or anaphylactic reaction 1 out of every 10,000 times it is used and causes an estimated 500 deaths per year. By contrast, bee stings are responsible for less than 100 deaths annually. Anaphylactic reactions to aspiring and fungi and molds are infrequent and therefore not common causal agents.
You have responded to a juvenile detention center for a teenager who has reportedly injected himself with some form of opiates. Which of the following drugs would be classified as an opiate?
Heroin is classified as an opiate. The other drugs, although there is an abuse potential for each, are not opiates.
Which of the following medications would you expect to find a patient who is being treated for peptic ulcer disease to be taking?
It is estimated that about 80 percent of all cases of peptic ulcer disease are caused by the presence of Helicobacter pylori (H pylori) bacteria. The bacteria damage the protective mucosal lining of the stomach and/or duodenum, allowing it to be damaged by the strong gastric acids used for digestion. Consequently, ulcerations in the mucosal lining and tissue occur. Antibiotic therapy can control the population of H pylori and definitively treat the ulcerative disease. Non-steroidal anti-inflammatory medications, including aspirin, increase acid production and can worsen or exacerbate peptic ulcer disease. While calcium channel blockers can be used in the treatment of gastro-esophageal reflux disease (decrease spasm of the lower esophageal sphincter), they are not indicated in the management of peptic ulcer disease.
Status epilepticus is a seizure that:
Status epilepticus is defined as a seizure that lasts longer than 10 minutes or a seizure that begins again after one seizure stops without that patient regaining consciousness. It is a dire medical emergency, as the patient may sustain bone fractures, airway occlusion, and possible death.
Please answer the following question. You are assessing a 32-year-old male complaining of abdominal pain and weakness. The patient informs you that he has Addison's disease as a result of steroid use as a teenager. No life-threatening conditions are noted to the airway, breathing, or circulation. Vital signs are pulse 110 beats per minute, respirations 16 per minute, blood pressure 110/72 mmHg, and SpO2 98% on room air. Given the patient's past medical history, you would:
Always check the blood glucose level of any patient with adrenal insufficiency.
A 65-year-old male with terminal brain cancer calls 911 for shortness of breath. The patient has a Do Not Resuscitate order. What should you do for this patient?
The patient has the right to comfort care even if he is a DNR. This means that the patient has the right to receive oxygen and medications for pain. The patient has the right to make his own medical decisions unless his family has the medical power of attorney to decide if the patent is transported. Patients have the right to die with dignity.