AMLS PRE&POST TEST LATEST 2023-2024 REAL EXAM 200+QUESTIONS AND CORRECT ANSWERS /ADVANCED, Exams of Nursing

Download AMLS PRE&POST TEST LATEST 2023-2024 REAL EXAM 200+QUESTIONS AND CORRECT ANSWERS /ADVANCED and more Exams Nursing in PDF only on Docsity! 1 AMLS PRE&POST TEST LATEST 2023-2024 REAL EXAM 200+QUESTIONS AND CORRECT ANSWERS /ADVANCED MEDICAL LIFE SUPPORT, AMLS PRETEST & POSTEST EXAM(AGRADE) A 19-year-old female is flushed, itchy, and wheezing after eating crab legs. Her vital signs are BP 90/64 mm Hg, P 128 bpm, R 24 breaths/min. Which intervention is indicated first? - ANSWER- Epinephrine intramuscular A 2-year-old male is found chewing on berries from a lily of the valley plant. Predict his vital signs. - ANSWER- BP 70/50 P 70 bpm A 22-year-old female is found at a party unresponsive and breathing approximately 8 breaths/min. Her skin is gray. Which of the following signs or symptoms will confirm your suspicion that the opioid toxidrome is causing her emergency? - ANSWER- Pupils 2 mm and equal A 22-year-old male complains of a 2-day history of abdominal pain. His skin is flushed, and he has a fruity odor on his breath. Assessment reveals BP 106/54 mm Hg, P 128, R 28, glucose 568 mg/dL. Your highest priority intervention would be to: - ANSWER- Infuse normal saline rapid IV A 22-year-old patient at a restaurant is complaining of abdominal pain and diarrhea. Her skin is flushed, and she feels faint. Her vital signs are: BP 98/50, P 124, R 24. Which finding in her SAMPLER history is most likely to guide your differential diagnosis for this patient? - ANSWER- Illness began about 10 minutes after eating A 23-year-old female has an acute onset of left flank pain. You should investigate which of the following regarding her pain? - ANSWER- Dysuria A 24-year-old female took 24 diphenhydramine tablets. Her vital signs are BP 86/54 mm Hg, P 110 bpm, R 20/min. What other sign or symptom should you anticipate. - ANSWER- Seizures 2 A 24-year-old male complains of sudden explosive headache . He asks you to lower the lights. He has vomited once. Which of these findings would increase your index of suspicion for subarachnoid hemorrhage? - ANSWER- Stiff neck A 24-year-old male injuries in a shallow diving incident. Which assessment finding would you anticipate if he is developing neurogenic shock? - ANSWER- Heart rate 58 bpm A 25-year-old helmeted female was thrown from a horse. She is complaining of weakness in her upper extremities. You ask her to close her eyes and identify whether you are moving her thumb up or down. She is unable to do so. This indicates she does not have normal: - ANSWER- Proprioception A 25-year-old woman was involved in a motor vehicle collision. Her initial vital signs were BP 122/80 mm Hg, P 128 bpm, R 20 breath/min. Which of the following findings on repeat assessment would indicate that she is developing shock? - ANSWER- Pulse pressure 32 mm Hg A 32-year-old complains of headache and dizziness. He vomited once and is walking with a staggering gait. His blood pressure is 148/72, pulse 92, respirations 20. He has a steady stare up toward his right ear. Which sign or symptom makes you consider intracerebral hemorrhage more strongly than migraine headache as a cause of his emergency? - ANSWER- Abnormal gaze A 33-year-old male has right lower quadrant abdominal pain and vomiting. Five minutes after you administer a dose of ondansetron, he vomits forcefully. His vitals are now BP 102/72, P 52, R 20. The alteration in his vital signs is likely related to: - ANSWER- Vagal stimulation A 40-year-old male has chest pain reported as an "elephant sitting on my chest." He confides that he snorted cocaine 5 minutes before his pain began. You should first administer: - ANSWER- Lorazepam, 2 mg IV A 42-year-old male complains of a gnawing, sever pain in the epigastric area that radiates to his back. His vital signs are T 102*F, BP 94/68, P 128, R 24. Your highest priority intervention would be to administer: - ANSWER- Normal saline, 250 mL bolus 5 After you ensure scene safety, your highest priority is to: - ANSWER- Rule out immediate life threats An 18-year-old male had a tonic-clonic seizure. Coworkers report no known seizure history. You can arouse him to voice. P 118, R 20, BP 102/68. The diagnostic test most likely to narrow your differential diagnosis would be: - ANSWER- Blood glucose analysis An 18-year-old, 35-kg female is vomiting copious amounts of bright red blood. The most likely diagnosis would be: - ANSWER- Mallory-Weiss syndrome An 82-year-old female complains of chest heaviness. She has sinus tachycardia. Her vital signs are BP 108/72 (equal in both arms), P 98, R 20. Her breath sounds are clear in all fields. Aside from myocardial infarction, what should you suspect her chest pain could be related to? - ANSWER- Pulmonary embolism An 88-year-old female complains of nausea, vomiting, and constipation. Her abdomen is tender to palpation and appears distended. Her lungs are clear, and her vital signs are: BP 104/76, P 120, R 20. An appropriate action would be to: - ANSWER- Infuse normal saline at 250 mL/h. An unresponsive patient has a needle in his arm when you arrive. His pupils are pinpoint, and he is breathing four times per minute. You are preparing to administer naloxone. At this point, opioid overdose is your initial: - ANSWER- Differential diagnosis Antibodies that are produced from lymphocytes are known as what kind of immunity? - ANSWER- Humoral As you obtain historical information regarding your patient, you note that the patient's presentation and responses are very similar to several patient complaints you have treated in the past. Integrating this information from past experience to this current experience is known as: - ANSWER- Pattern recognition Hepatitis A (HAV) is transmitted by which route? - ANSWER- Oral-fecal If you administer nitroglycerin to a patient with ST-elevation in leads II, III and aVF, you should be prepared to: - ANSWER- Administer a bolus of normal saline if the blood pressure drops 6 In which situation has the threat to your personal safety been reduced most significantly? - ANSWER- A barking dog has been secured in a kennel in the yard. Shock related to tension pneumothorax is most directly secondary to: - ANSWER- Decreased preload The best measures you can take to reduce your risk of acquiring hepatitis C from an occupations exposure is to: - ANSWER- Use standard precautions The family of a 72-year-old male is worried about their father. His blood glucose is 80 mg/dL (4.4 mmol/L). His rate and depth of breathing are increased, and he is sleepy and weak. He take metformin (Glucophage). You suspect his signs and symptoms may be related to: - ANSWER- Lactic acidosis The most common sign or symptom found in patients with pulmonary embolism is: - ANSWER- increased respiratory rate The primary mechanism for septic shock is: - ANSWER- Widespread inflammatory response What findings should you anticipate on the physical examination of a patient with Cushing's syndrome? - ANSWER- Blood glucose 180 mg/dL (10 mmol/L) What treatment should you anticipate in a patient with a history of Addison's disease who has the following vital signs: BP 94/58 mm Hg, P 124 bpm, R 20/min? - ANSWER- Hydrocortisone When assessing your patient's medication history, which would indicate the patient may have a preexisting ulcer? - ANSWER- Famotidine When serum glucose drops below 70 mg/dL (3.9 mmol/L), which of the following occurs? - ANSWER- Epinephrine secretion increases When you use an interpreter to question a 42-year-old female about her abdominal pain, what is the best way to ensure information has been conveyed accurately and completely? - ANSWER- Let the patient write her answers, and have the interpreter restate them so you will have a recored of her statements for your report. (yeah right) 7 Which agency oversees the compliance, tracking and reporting, and guidelines for preventing transmission of bloodborne pathogens in the workplace? - ANSWER- OSHA Which assessment evaluates at least one aspect of cranial nerve function? - ANSWER- Cincinnati Prehospital Stroke Scale Which assessment finding(s) should you anticipate in a patient who has myxedema? - ANSWER- Dry yellow skin Which diagnostic test most accurately assesses the presence and magnitude of anaerobic metabolism? - ANSWER- Lactic acid Which gland is responsible for some of the vasoconstriction in shock? - ANSWER- Pituitary Which intervention for patient in shock prevents an increase in myocardial oxygen demand? - ANSWER- Maintain normal body temperature Which is the most reliable indicator that ventilation should be assisted in a patient with altered mental status? - ANSWER- End-tidal CO2 is 60 mm Hg Which of the following biological warfare agents causes serious neurologic symptoms that may include paralysis? - ANSWER- botulism Which of the following describes a behavior that represents normal mental status? A person who: - ANSWER- Is drowsy and slow to respond to questions after awakening from a nap. Which of the following findings indicates the need to increase the rate of ventilation in a intubated patient you suspect to have an epidural hematoma? - ANSWER- Unilateral blown pupil Which of the following is an occupational exposure incident? - ANSWER- Blood sprays in your face when a child with a face laceration sneezes Which of the following patients is at highest risk for pericardial tamponade? - ANSWER- 55-year-old with end-stage lung cancer 10 P 112, R22 and regular, BP 144/88, SpO2 95% and T 102.3 F. The healthcare provider should observe for which complication? - ANSWER- seizure A 42 year-old patient with a history of rheumatoid arthritis is taking glucocorticoids. Over the past two weeks, she complains of chronic fatigue, weakness, and loss of appetite with weight loss. Lab results indicate hyponatremia and hyperkalemia. What underlying diagnosis is suspected? - ANSWER- Adrenal insufficiency A 45 year-old patient is found supine on the floor of the Triage area. Healthcare providers note pinpoint pupils, shallow respirations and vomitus in and around the mouth. What course of action should be implemented next? - ANSWER- Supplemental oxygen and suction A known chronic alcoholic complains of the constant, severe mid-epigastric pain, nausea and blood-streaked emesis. The patient has a temperature of 101.9F and severe abdominal tenderness. What underlying diagnosis should be suspected? - ANSWER- pancreatitis A lethargic patient presents with dilated pupils and vital signs of P122, R26, and BP 130/80. He admits to excessive ingestion of diphenhydramine. What response is the cause for the presenting signs and symptoms? - ANSWER- Anticholinergic A patient describes an "aching" sensation in his chest. It occurred suddenly while resting and radiates to the jaw. He self-administered 1 nitroglycerin tablet without relief and the 12-lead reveals a normal sinus rhythm with ST elevation in leads II, III, and aVF. What working diagnosis is most likely? - ANSWER- inferior wall myocardial injury A patient experiences unilateral facial weakness and droop, garbled speech, altered sense of taste and no extremity weakness. The patient has a history of Lyme's disease. What condition is the patient likely experiencing? - ANSWER- Bell's palsy A patient has attempted suicide by ingesting ethylene glycol about 20 hours prior to arriving for treatment. Lung sounds reveal bilateral crackles and respirations of 30 with symptoms of pulmonary edema and cyanosis of the lips. The ECG reveals ventricular tachycardia. Which stage of ethylene glycol poisoning has occurred? - ANSWER- 2 11 A patient presents with mildly decreased mental status, slow respirations, bradycardia, hypotension, has a blood sugar 42 mg/dl. This is most likely caused from excessive ingestion of: - ANSWER- beta blockers A patient with a history of Grave's disease presents with anxiety, profuse sweating and a palpable goiter. Vitals are P151, R35 and labored, BP 84/42. Which working diagnosis is most likely? - ANSWER- Thyrotoxicosis A patient with suspected gallbladder disease is asked to take a deep breath while the provider presses upward into the upper right quadrant. If the patient ceases inspiration due to increase pain while being examined, this is known as: - ANSWER- Murphy's sign According to the AMLS Assessment Pathway, determining whether a patient is "Sick or Not Sick" is initially done which component of the assessment process? - ANSWER- First impression Acute Respiratory Distress Syndrome (ARDS) is characterized by what pathological change? - ANSWER- Breakdown of the alveolar-capillary membrane An 82 year-old alcoholic complains of nausea, non-bloody vomiting and severe epigastric and right upper quadrant pain that radiates to the back. Palpation reveals epigastric tenderness without peritoneal signs. What working diagnosis should be considered most likely? - ANSWER- Acute pancreatitis An anxious male complains of a sore throat, fever, chills, dental pain and dyspnea. The patient has a firm, red pronounced swelling in the sublingual anterior anterior throat area and tongue. What diagnosis is most likely? - ANSWER- Ludwig's angina An autoimmune disease which produces antibodies that mimic the role of TSH and cause an increase in thyroid hormones is: - ANSWER- Grave's disease An elderly patient is an assisted living presents with a diminished level of consciousness and elevated white blood count. Assessment reveals pale, clammy skin and a urinary catheter with dark colored urine. Vital signs are P132, R38 and shallow, BP 78/46, SpO2 91% and T 100.8F. What classification of shock is the patient most likely experiencing? - ANSWER- Distributive 12 Anaphylaxis is most associated with which physiological event? - ANSWER- Vasodilation Clinical reasoning requires the healthcare provider to: - ANSWER- Process relevant information, filter out irrelevant information Continuous positive airway pressure would be most appropriate in treating which patient? - ANSWER- 22 year old with severe asthma and not responding to nebulizer treatments During compensatory shock, the renin-angiotensin-aldosterone system is activate to cause a/an: - ANSWER- increase in preload, afterload and reabsorption of sodium During what period of the communicable disease process will antibodies begin to reach detectable levels and the infected blood will test positive for exposure to a pathogen? - ANSWER- incubation Glucagon may not be effective treatment for a patient with hypoglycemia if they also have which underlying illness? - ANSWER- alcoholism Healthcare providers are assessing a patient with pronounced jugular vein distention and muffled heart tones. Vitals are P128, R26, BP 74/52. What classification of shock should be suspected? - ANSWER- Obstructive Healthcare providers are managing a patient presenting with substernal chest discomfort. They describe the pain as "pressure-like" and it radiates to the jaw and left arms. The discomfort subsides with rest, oxygen and administration of nitroglycerin. What is the most likely working diagnosis? - ANSWER- Angina pectoris Healthcare providers are treating an unresponsive patient who overdosed on lorazepam. What intervention should be initiated? - ANSWER- Airway support Healthcare providers should use extreme caution with nitroglycerin when ST elevation is present in which ECG leads? - ANSWER- II, III, aVF Organophosphate poisoning will present with which signs and symptoms? - ANSWER- Salivation and incontinence of urine and liquid stool 15 D. Begin bag-mask ventilation - CORRECT ANSWER- B. Patients with a history of chronic bronchitis that present with shortness of breath are likely to have which condition? A. Pulmonary embolism B. Angina pectoris C. Angioedema D. Hypertensive crisis - CORRECT ANSWER- A. Acute Respiratory Distress Syndrome (ARDS) us characterized by what pathological change? A. Excessive mucus production B. Inflammation of the visceral pleura C. Breakdown of the alveolar-capillary membrane D. Accumulation of fluid between the pleural layers - CORRECT ANSWER- C. An anxious male complains of a sore throat, fever, chills, dental pain and dyspnea. the patient has a firm, red pronounced swelling in the sublingual anterior throat area and tongue. What diagnosis is most likely? A. Croup B. Tonsillitis C. Angioedema D. Ludwig's angina - CORRECT ANSWER- D. 16 Patients on mechanical ventilation may have hypoxemia due to alveolar collapse from mucous plugging. The best treatment for this is: A. Increase oxygen concentration to 100% B. Increase tidal volume C. Increase respiratory rate D. Administer PEEP - CORRECT ANSWER- D. Anaphylaxis is most associated with which physiological event? A. Hemorrhage B. Vasodilation C. Bradycardia D. Hypertension - CORRECT ANSWER- B. An elderly patient in an assisted living facility presents with a diminished level of consciousness and elevated white blood count. Assessment reveals pale, clammy skin and a urinary catherter with dark colored urine. Vital signs are P132, R 38 and shallow, BP 78/46, SpO2 91% and T 100.8°F (32.8°C). What classification of shock is the patient most likely experiencing? A. Hypovolemic B. Cardiogenic C. Distributive D. Obstuctive - CORRECT ANSWER- C. Healthcare providers are assessing a patient with pronounced jugular vein distention and muffled heart tones. Vitals are P 128, R 26, BP 74/52. What classification of shock should be suspected? A. Hypovolemic B. Cardiogenic C. Distributive D. Obstuctive - CORRECT ANSWER- D. During compensatory shock, the renin-angiotensin-aldosterone system is activated to cause a/an: A. Increase in preload, afterload and re-absorption of sodium B. Decrease in preload, afterload and re-absorption of sodium C. Increase in myocardial contractility D. Vasodilation and sodium retention - CORRECT ANSWER- A. 17 A 42 year old patient with a history of rheumatoid arthritis is taking glucocorticoids. Over the past two weeks, she complains of chronic fatigue, weakness, and loss of appetite with weight loss. Lab results indicate hyponatremia and hyperkalemia. What underlying diagnosis is suspected? A. Adrenal insuffiency B. Diabetic ketoacidosis C. Hypothryoidism D. Rhabdomyolysis - CORRECT ANSWER- A. Which condition should the healthcare provider consider to usually be a non- emergent, non-life threatening illness? A. Acute coronary syndrome B. Thoracic outlet syndrome C. Esophageal tear D. Aortic dissection - CORRECT ANSWER- B. Healthcare providers should use extreme caution with nitroglycerin when ST elevation is present in which ECG leads? A. V1, V2 B. V3, V4 C. I, aVL D. II, III, aVF - CORRECT ANSWER- D. Which is a high-risk factor for intracerebral hemorrhage? A. Marijuana B. Coronary artery spasm C. Bradycardia D. Cocaine drug abuse - CORRECT ANSWER- D. What is the initial treatment for a patient experiencing Hyperosmolar Hyperglycemic Nonketotic Syndrome (HHNS)? A. Crystalloid IV fluid resuscitation B. Administration of dextrose C. Administration of insulin D. Fluid bolus of 5% Dextrose in Water (D5W) - CORRECT ANSWER- A. What condition is most likely to cause respiratory acidosis? A. Anxiety/panic attack B. narcotic overdose C. Methanol ingestion 20 D. Latent - CORRECT ANSWER- B. The patient presents with a history of headache, weight loss, chest discomfort, night sweats and a persistent cough for several weeks. Which infectious disease is most likely occurring? A. Novel H1N1 influenza B. Meningoccal meningitis C. Tuberculosis D. Malaria - CORRECT ANSWER- C. A lethargic patient presents with dilated pupils and vital signs of P 122, R 26 and BP 130/80. He admits to excessive ingestion of diphenhydramine. What response is the cause for the presenting signs and symptoms? A. Sympathomimetic B. Anticholinergic C. Cholinergic D. Opioid - CORRECT ANSWER- B. Organophosphate poisoning will present with which signs and symptoms? A. Dry mucous membranes and shock B. Altered mental status and flushed skin C. Euphoria and tachycardia D. Salivation and incontinence of urine and liquid stool - CORRECT ANSWER- D. What medication classification should be administered to an uncooperative, agitated patient? A. Opioid B. Nitrate C. Benzodizepine D. Sympathomimetic - CORRECT ANSWER- C. A patient presents with mildly decreased mental status, slow respirations, bradycardia, hypotension, has a blood sugar of 42mg/dl (2.3mmol). This is most likely caused from excessive ingestion of: A. Calcium channel blockers B. Tricyclic antidepressants C. Beta blockers D. Salicylates - CORRECT ANSWER- C. 21 The patient complains of a deep burning discomfort diffusely throughout the epigastrium. This is an example of which type of pain? A. Somatic B. Visceral C. Referred D. Radiating - CORRECT ANSWER- B. A 24 year old female presents with lower right quadrant abdominal pain. Her skin is hot to the touch and she exhibits a Psoas Sign. She complains of nausea and vomiting for 2 days. What diagnosis is suspected? A. Pancreatitis B. Appendicitis C. Gastroenteritis D. Ectopic pregnancy - CORRECT ANSWER- B. A known chronic alcoholic complains of the constant, severe mid-epigastric pain, nausea and blood-streaked emesis. The patient has a temperature of 101.9°F (38.8°C) and severe abdominal tenderness. What underlying diagnosis should be suspected? A. Gastritis B. Pancreatitis C. Diverticulitis D. Perforated gastric ulcer - CORRECT ANSWER- B. What component of a patient's past medical history is most helpful in considering myocardial infarction as a working diagnosis? A. Daily intake of an aspirin B. History of CHF C. Recent hip surgery D. Familial heart disease history - CORRECT ANSWER- D. A patient describes an "aching" sensation in his chest. It occurred suddenly while resting and radiates to the jaw. He self administered 1 nitroglycerin tablet without relief and the 12 lead reveals a normal sinus rhythm with ST elevation in leads II, III, and aVF. What working diagnosis is most likely? A. Anterior wall myocardial injury B. Inferior wall myocardial injury C. Costochondritis D. Pericarditis - CORRECT ANSWER- B. 22 Healthcare providers are managing a patient presenting with substernal chest discomfort. They describe the pain as "pressure-like" and it radiates to the jaw and left arm. The discomfort subsides with rest, oxygen and administration of nitroglycerin. What is the most likely working diagnosis? A. Pleurisy B. Angina pectoris C. Myocardial infarction D. Pulmonary embolism - CORRECT ANSWER- B. Which infectious disease must have oxygen present to survive? A. Tuberculosis B. Lung abscess C. Botulism D. Tetanus - CORRECT ANSWER- A. Which best practices help to prevent the spread of infectious disease? A. Alcohol based antimicrobial equipment cleaning and handwashing B. Goggles, gown and gloves for all patient contact C. Facial protection and gloves for all patient contact D. Handwashing before and after all patient contact and standard precautions. - CORRECT ANSWER- D. Continuous positive airway pressure would be most appropriate in treating which patient? A. 43 year old with decreased level of consciousness with respiratory difficulty B. 22 year old with severe asthma and not responding to nebulizer treatments C. 38 year old with carpal pedal spasms, clear lung sounds and respirations 40 times per minute D. 55 year old with jugular vein distention and BP 90/60 - CORRECT ANSWER- B. A patient has attempted suicide by ingesting ethylene glycol about 20 hours prior to arriving for treatment. Lung sounds reveal bilateral crackles and respirations of 30 with symptoms of pulmonary edema and cyanosis of the lips. The ECG reveals ventricular tachycardia. Which stage of ethylene glycol poisoning has occurred? A. 1 B. 2 C. 3 D. 4 - CORRECT ANSWER- B.