Medical / Obstetrics / Gynecology
Cardiology and Resuscitation
ALS and Advanced Questions Only
Trauma
Potpourri
100
Which of the following would cause a person to become hypovolemic? Dehydration on a hot day Cut to the hand that is uncontrolled Slow GI bleed All of the above
What is All of the above Rationale: All of these have the potential for lowering the level of fluid in the body thus resulting in Hypovolemia.
100
Interventions are _____________. Things that are done to correct a problem Not part of pre-hospital care Can be treated in the pre hospital setting A very late sign of shock
What is Things that are done to correct a problem Rationale: From a c-collar, airway devices, splints, and morphine, all would be considered interventions.
100
You and your partner Warren arrive at a house where a woman in her 50's has been reported unconscious. Her pulse is 80 and she is apneic. Warren inserts an oropharyngeal and you begin ventilating her at ____________________. After about 1 minute of ventilations, the patient begins to have seizures and is gagging. What would be the most appropriate thing to do? 10-12 breaths per minute/ Remove the oropharyngeal 10-12 breaths per minute / insert a nasopharyngeal 12-20 breaths per minute / Prepare to suction 12-20 breaths per minute / Begin suctioning her airway
What is 10-12 breaths per minute/ Remove the oropharyngeal Rationale: The AHA says that with a simple oral adjunct, this patient should get 10-12 ventilations per minute. If the patient has a gag reflex, you must remove the OPA. There is a good possibility they may vomit as well, so having suction ready is a good idea.
100
If someone had a fracture of the zygomatic bone as the result of a rock throwing fight you would ____________. Support the heel Put their arm in a sling Splint the lower leg avoiding the knee Look at their cheek
What is Look at their cheek Rationale: It is also known as the cheek.
100
Which of the following would not be considered an early sign of respiratory depression in a 7 year old girl? Rapid respirations Bobbing of the head Cyanosis of the lips Retraction of the intercostals
What is Cyanosis of the lips Rationale: All of the answer choices are EARLY signs of breathing problems in a child with the exception of Cyanosis. Cyanosis is a LATE sign.
200
What does the suffix "dynia" mean? Lacking Painful Dizziness Respiratory related
What is Painful Rationale: It means a painful condition. The first part of the word will tell you what part of the body is in question.
200
Which of the following would be a sign that CPR may not be necessary? Core cyanosis No pulse or respirations The patient is unconscious Stiff neck and jaw
What is Stiff neck and jaw Rationale: A stiff neck and jaw may be a sign of rigor mortis and CPR would not be initiated if the patient were pulseless and apneic as well as having rigor mortis. Remember to assess for rigor mortis in at least 2 joints. The other answer choices would all be indications of a possible need to begin CPR.
200
Standing orders are? Usually given over the radio or phone by medical direction Interventions completed in the field before calling medical direction Created by the DOT to guide EMTs in the field The same for all ambulance agencies nation wide
What is Interventions completed in the field before calling medical direction Rationale: Standing orders are interventions that should be completed in the field before calling medical direction for guidance.
200
The GCS scale used in assessing consciousness measures what three things? Eye opening, verbal response, and motor response Motor response, eye opening, and arm drift Facial droop, verbal response, and motor coordination Motor response, eye opening, patient movement, and patient's speech
What is Eye opening, verbal response, and motor response Rationale: The Glasgow Coma Scale is based upon eye opening, verbal response, and motor response. Each has a possibility of from 6 to 4 points with no reaction being awarded 1 point.
200
You were just hired with Westlake Fire as an EMT and you are on your first call. Are you covered by Good Samaritan Laws? Yes, All EMT's are covered by these laws No, Good Samaritan Laws are no longer used No, If you are a paid EMT, you are not covered while you are on shift Yes, Anyone who gives assistance is covered
What is No, If you are a paid EMT, you are not covered while you are on shift Rationale: Only volunteers who assist during an emergency are covered by these laws. As long as you act within the boundaries of your training, you cannot be held liable.
300
Your patient is a 46 year male with Type 1 diabetes. His girlfriend called 911 after she came home late from work and found him curled up on the floor of the bathroom with a towel under his head. There is no visible sign of trauma. He will not respond to you and his respirations are adequate depth and rate at 16 per minute. The girlfriend tells you that she just spoke to him on the phone a few hours ago and he seemed fine. What is the most likely cause of the this man's altered LOC He took his insulin, but has not eaten. He is hypoglycemic. He has been eating too much sugar and it has caused him to become hyperglycemic. He has not taken his insulin and has become hypoglycemic as a result. He is in a diabetic coma resulting from an over abundance of insulin secreted from the pancreas
What is He took his insulin, but has not eaten. He is hypoglycemic. Rationale: The most likely scenario is that he is hypoglycemic as a result of not having eaten. Answer 1 is not likely as hyperglycemia is slow onset and the girlfriend just spoke to him a few hours ago and he was fine. Additionally, his respirations are normal, meaning he is not attempting to blow off excess CO2 as would be the case in a hyperglycemic person. Answer 2 is incorrect as "not" taking a prescribed dosage of insulin will not cause hypoglycemia or low blood sugar. It will cause the blood sugar to be high. Answer 3 is incorrect because you know he has type one diabetes and his pancreas either does not produce enough insulin...or any at all. Additionally an over abundance of insulin will cause insulin shock (hypoglycemia,',',',',2), not diabetic coma (hyperglycemia)
300
You and your partner Gwen are called to the scene of an unknown injury accident involving a 50ish male patient. En route dispatch again radios you and reports that the man does not have a pulse and family members are doing CPR. When you arrive on scene a bystander tells you that the patient was fine and then just dropped like a rock. According to AHA AED Guidelines with CPR in progress, which of the following answers contains the most appropriate action for you to take? Question the bystanders, direct them to continue CPR, and analyze the man's rhythm Hook up the AED, open the man's airway, and insert an oral adjunct Attach the AED, tell everyone to stand back, and analyze the man's rhythm Open the man's airway, tell the bystander to stop CPR, and shock him
What is Attach the AED, tell everyone to stand back, and analyze the man's rhythm Rationale: If CPR is being performed on a patient with a sudden collapse, then AHA guidelines say to hook up the AED and analyze the patient's rhythm.
300
You have been dispatched to an 81 year old female complaining of difficulty breathing and chest pain. You are auscultating her lungs and discover rales. Which of the following conditions would you suspect? Cardiac arrest Failure of the left ventricle Coronary hyperfusion Failure of the right ventricle
What is Failure of the left ventricle Rationale: These are signs and symptoms of a possible failure of the left ventricle. The pump portion of the heart is unable to pump efficiently, and fluid begins to back up into the lungs, causing the rales.
300
Tenderness and pain in the abdomen upon palpation could likely mean? Intestinal leakage into the pleural space Pericardial hemorrhage Blood irritating the peritoneal lining Blood pooling in the pletal space
What is Blood irritating the peritoneal lining Rationale: Blood leaking into the peritoneal space would be the best choice for abdominal pain and tenderness. There is no pletal space and pericardial irritation refers to the sack around the heart.
300
A diabetic emergency where the patient had a headache would likely point to it being ___________. A hyperglycemic event A hypoglycemic event A hypotensive event A hyposucrose event
What is A hypoglycemic event Rationale: Hypoglycemic events can often be accompanied by a headache where hyperglycemic events are rarely seen with a headache.
400
Your patient is a 29 year old female mountain climber from New Orleans, Louisiana, who just ascended Mt. Schnell (elevation 12,000 ft.) in a single day. Search and rescue is bringing her to rendezvous with your unit at 8,500 ft and ETA is 10 minutes. Initial reports said that about half way down the mountain, the woman began complaining of a headache and then vomited a few times saying she was dizzy. When the patient arrives at your unit, she reports the same signs and symptoms. What is likely wrong with this woman and what is the best choice of treatment? She has High Altitude Pulmonary Edema (HAPE). Apply high flow O2 via NRB and transport to the nearest appropriate facility. She has High altitude Cerebral Edema (HACE). Medivac transport to the nearest hyperbaric chamber for repressurization She has Subacute Descent Reasor (SDR). Application of high flow O2 while remaining at rendezvous point for 1 hour to facilitate patient acclimation. After acclimation, transport to lower elevation and definitive care. She has Acute Mountain Sickness (AMS). Apply oxygen via nasal canula at 6 liters per minute and transport patient immediately to nearest appropriate facility.
What is She has Acute Mountain Sickness (AMS). Apply oxygen via nasal canula at 6 liters per minute and transport patient immediately to nearest appropriate facility. Rationale: Signs point to Acute Mountain Sickness beginning with the rapid ascent by a person who normally lives at sea level. She does not likely have HAPE as there is no cough, dyspnea, disorientation, lethargy etc. Though the line between Acute Mountain Sickness and HACE is blurry, HACE is much more severe and has additional signs and symptoms. Answer 2 is incorrect because treatment does not include use of a hyperbaric chamber. Answer 4 is a made up syndrome and lists the improper treatment of remaining above 8,000 feet rather than transporting immediately to a lower altitude care facility.
400
During a stroke, the cells of the brain that are deprived of oxygen too long will die. These cells are called? Nephrotic cells Dead cells Eschiel cells Infarcted cells
What is Infarcted cells Rationale: A cell that is dead is termed infarcted.
400
Your patient is in a diabetic coma because she did not take enough insulin to deal with the enormous amount of chocolate cake she ate this morning. Without enough insulin to break down the excess sugars, the body? Begins to go into metabolic alkalosis Triggers the pancreas to create more insulin Begins to consume fat stores Produces more fatty acids through anaerobic metabolism
What is Begins to consume fat stores Rationale: The body will consume the fat stores in the body producing lactic acid which will result in metabolic acidosis.
400
You respond to Bigrock High School where there has been an accident in the science lab. A heated test tube exploded and one of the students has injured his eye. You enter the nurses office to find an 18 yr old male lying on the examination table with a towel on his face. Upon removing the towel, you find he has glass embedded in his face, and his eye is bleeding. Which is the best choice of action? Cover the eye with a paper cup and bandage without pressure Bandage the eye with moderate pressure to control the bleeding Remove any visible glass pieces in the eye and cover with an occlusive dressing High flow O2 and rapid transport
What is Cover the eye with a paper cup and bandage without pressure Rationale: Injuries to eyes can be very serious and your job is to minimize any further injury to the eye. Do not put pressure on an eye injury and do not remove any glass unless it is in your protocols or is causing a life threat. High flow O2 and transport while appropriate, do not deal with treating the injury. The best answer is to cover the eye with something that will protect it for the trip to the hospital. You should cover the uninjured eye as well.
400
You and your partner Cynthia are beginning the initial assessment of a 43 yr old female with abdominal pain. Which of the following choices would NOT normally be included when formulating your general impression of this patient? Her age and gender Her appearance What race the woman is Treating any life threats
What is Treating any life threats Rationale: Your general impression of the patient is your first visual impressions of him or her. It includes the patient's gender, race, age, appearance, distress level, and other visual clues that can help you anticipate possible treatment. As is the case here, seeing a woman with abdominal pain brings about many more possibilities than a man with abdominal pain.
500
The protrusion of cartilage from the anterior neck area is known as? The cricoid cartilage The thyroid cartilage The vallecula The mastoid cartilage
What is The thyroid cartilage Rationale: That protrusion superior to the cricoid cartilage in the neck is called the thyroid cartilage or Adam's apple.
500
You and your partner Larry are dispatched to the call of a man with sever stomach pain. When you arrive on scene you find him lying on the floor of the kitchen in the fetal position. There is vomit on his face and he says he is going to throw up again. He denies falling and says the only thing wrong is that his stomach is killing him. Assessing his abdomen you find it to be very tender to the touch and he moans when you palpate his stomach. He is also breathing very fast at 30 a minute. What other signs and symptoms might you find with this patient? Rebound tenderness - metabolic acidosis Tachycardia - hypotension - fever Bottle of poison, cyanosis, and crepitus Broken ribs, hypertension, and deep, rapid breathing
What is Tachycardia - hypotension - fever Rationale: The patient is not likely to have crepitus, having no pain and denying that they fell. A person with broken ribs is unlikely to be breathing fast and deep and if a person has been vomiting copius amounts it is likely they would be in metabolic alkalosis rather than acidosis.
500
You arrive on scene to find a man in his 20's lying in a pool of vomit. You can see that he is breathing at about 16 breaths per minute and the depth of respiration is adequate. He has a small laceration on his forehead. You try getting a response by calling "Hey man can you hear me?" but he does not answer. Your partner gives him a quick sternal rub and his eyes pop open along with a whimper under his breath and then they close again. You ask him to perform several motor functions but he does not comply. He does not answer any of your questions. This man has a GCS of what? 4 14 9 7
What is 4 Rationale: Opening the eyes for pain nets 2 points, no verbal response gets 1 point, and no motor response nets 1 point for a total of 4 points.
500
Dispatch has reported 2 people injured in a gang fight. The reporting party says that a man and a woman were stabbed and that the assailant has fled on foot. You arrive at the scene and see several people standing around the patients yelling at each other. The male patient is in obvious respiratory distress and the female patient has blood all over her face. What would be the best way to treat these patients? Do a rapid trauma assessment to determine if there are any life threats that need to be addressed Cautiously approach the patient with the worst wounds and tell them you are there to help Quickly triage the two patients and begin treating the one with the worst injuries Call for law enforcement and wait for them to secure the scene before approaching the patients
What is Call for law enforcement and wait for them to secure the scene before approaching the patients Rationale: As much as you want to help the injured, you must be sure the scene is safe first. Given the arguing of the bystanders and the nature of the call it would be best to wait for law enforcement to secure the scene before entering it to treat the patients.
500
Which type of history and physical examination would be appropriate for a patient who is having trouble breathing with no signs of physical injury? Rapid: Focused Focused: Focused Rapid: Detailed Detailed: Detailed
What is Focused: Focused Rationale: You know the chief complaint and life threat is likely the respiratory distress, so you can FOCUS on gathering history of breathing difficulty as well as do a FOCUSED exam of the affected body system, which in this case is the lungs and airway.
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