AMLS Pretest II questions and answers (All Correct) 2022, Exams of Nursing

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AMLS Pretest II questions and answers (All Correct)

1. 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?: Epinephrine intramuscular
2. A 2 - year-old male is found chewing on berries from a lily of the valley plant. Predict his vital signs.: BP 70/50 P 70 bpm
3. 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?: Pupils 2 mm and equal
4. 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:: Infuse normal saline rapid IV
5. 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?: Illness began about 10 minutes after eating

6. A 23-year-old female has an acute onset of left flank pain. You should investigate which of the following regarding her pain?: Dysuria
7. 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.: Seizures
8. 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?: Stiff neck
9. A 24 - year-old male injuries in a shallow diving incident. Which assessment finding would you anticipate if he is developing neurogenic shock?: Heart rate 58 bpm
10. A 25 - year-old helmeted female was thrown from a horse. She is complain- ing 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:: Proprioception

11. 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?: Pulse pressure 32 mm Hg

12. 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?: Abnormal gaze
13. A 33-year-old male has right lower quadrant abdominal pain and vom- iting. 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:: Vagal stimulation
14. 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:: Lorazepam, 2 mg IV

15. 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
16. Your highest priority intervention would be to administer:: Normal saline, 250 mL bolus
17. A 43-year-old male with diffuse abdominal pain and vomiting has a yel- lowish discoloration of his sclera. This indicates he has excess serum:: Biliru- bin
18. A 44 - year-old male is postictal after a witnessed grand mal seizure. He is arousable to light pain and is presently snoring. His vital signs are BP 142/86, P 120, R 20, Sa02 98%. You should:: Insert a nasopharyngeal airway
19. A 45-year-old female complains of right upper quadrant abdominal pain. To help confirm your differential if you suspect cholecystitis you should:: Ask her to take a deep breath as you press upward into her right upper quadrant
20. A 45-year-old male complains of severe epigastric pain radiating to his back. He has vomited several times. His history is significant for alcohol abuse and hypertension. You suspect an inflammatory condition of a gastric accessory

organ. To confirm your differential on physical exam you should assess for:: Psoas sign

20. A 45-year-old male with a history of hypertension complains of chest "pressure," about a 5 on a scale of 1 to 10, for 20 minutes. He just "wants to be checked out." Vitals signs and 12 - lead ECG are normal. You have already

administered oxygen and aspirin. You should next:: Administer nitroglycerin 0.4 mg sublingual.

21. A 47-year-old female is anxious and complaining of heart palpitations. She reports a recent diagnosis of "thyroid problems." On exam you note exophthalmos. Her vital signs are BP 108/72 mm Hg, P 128 bpm, R 20/min. Interventions should include administration of:: Intravenous fluids
22. A 52-year-old male with a history of alcoholism complains of pleuritic chest pain. He states the pain increases when he swallows. He appears very ill and has subcutaneous emphysema around his neck. You suspect:: Boer- haave's syndrome
23. A 56-year-old female experiences a sudden onset of headache and blurred vision during yoga class. Her right eyelid is drooping, and the pupil on that side is small compared to the left pupil. You should take her to a hospital with:: Specialized neurologic and vascular capability
24. A 62-year-old hunter was lost in a swampy area. When you begin to care for him, he is lethargic, disoriented, and has a body temperature of

31 degrees C (87.8F). His ECG shows bradycardia. What should be your treatment priority?: Rapid rewarming

25. A 62-year-old male is vomiting coffee-ground emissions. Which of his home medicines may make it more difficult to control his bleeding?: Plavix
26. A 65-year-old female complains of chest pain that feels like "aching" in her chest. It has become progressively worse over several days. Her temperature is 38.3 degrees C (101F). Which finding will help narrow your differential diagnosis to pericarditis?: ST-segment elevation in everylead
27. A 70 - year-old male suspected to have a dissecting aortic aneurysm has a blood pressure of 170/102 mm Hg. This sign may indicate:: The renal arteries are involved
28. A 72 - year-old complains of a headache and being depressed, intermittent twitching in the facial muscles, and general weakness over the past 2 weeks. She has a medical history of hypoparathyroidism. The ECG reveals a pro- longed QT segment. During transport she has a seizure. Which electrolyte imbalance is most likely?: Hypocalcemia
29. A 72 - year-old male had a syncopal episode in church. His wife said he has been complaining of a headache for about a

week. He has early Alzheimer's disease. Home medicines include Lipitor and Exelon (rivastigmine). Which

of the following questions may help narrow your differential diagnosis?: Did he fall or hit his head recently?

30. A 73-year-old male awakens suddenly at 0200 complaining of dyspnea. You find him in tripod position. Crackles are audible around his scapulae. He has a history of hypertension.You suspect his symptoms are related to:: Left heart failure
31. A farmer was spraying his barn when he became ill. His heart rate is 60 bpm, and his blood pressure is 88/50 mm Hg. Tears are streaming down his cheeks, and he is vomiting. What toxidrome does this clinical picture fit?: Cholinergic
32. A patient infected with which disease should be assessed for pneumonia, encephalitis, and myocarditis?: Rubeola
33. After you ensure scene safety, your highest priority is to:: Rule out imme- diate life threats
34. 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:: Blood glucose analysis

35. An 18-year-old, 35 - kg female is vomiting copious amounts of bright red blood. The most likely diagnosis would be:: Mallory-Weiss syndrome
36. An 82-year-old female complains of chest heaviness. She has sinus tachycardia. Her vital signs are BP 108/7 2 (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?: Pulmonary embolism
37. 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:: Infuse normal saline at 250 mL/h.
38. 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:: Differential diagnosis
39. Antibodies that are produced from lymphocytes are known as what kind of immunity?: Humoral

40. 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:: Pattern recognition
41. Hepatitis A (HAV) is transmitted by which route?: Oral- fecal
42. If you administer nitroglycerin to a patient with ST-elevation in leads II, III and aVF, you should be prepared to:: Administer a bolus of normal saline if the blood pressure drops
43. In which situation has the threat to your personal safety been reduced most significantly?: A barking dog has been secured in a kennel in the yard.
44. Shock related to tension pneumothorax is most directly secondary to:: - Decreased preload
45. The best measures you can take to reduce your risk of acquiring hepatitis C from an occupations exposure is to:: Use standard precautions

46. 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:: Lactic acidosis
47. The most common sign or symptom found in patients with pulmonary embolism is:: increased respiratory rate
48. The primary mechanism for septic shock is:: Widespread inflammatory response
49. What findings should you anticipate on the physical examination of a patient with Cushing's syndrome?: Blood glucose 180 mg/dL (10 mmol/L)
50. What treatment should you anticipate in a patient with a history of Addi- son's disease who has the following vital signs: BP 94/58 mm Hg, P 124 bpm, R 20/min?: Hydrocortisone
51. When assessing your patient's medication history, which would indicate the patient may have a preexisting ulcer?: Famotidine
52. When serum glucose drops below 70 mg/dL (3.9 mmol/L), which of the following occurs?: Epinephrine secretion increases

53. 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?: 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)

54. Which agency oversees the compliance, tracking and reporting, and guidelines for preventing transmission of bloodborne pathogens in the work- place?: OSHA
55. Which assessment evaluates at least one aspect of cranial nerve func- tion?: Cincinnati Prehospital Stroke Scale
56. Which assessment finding(s) should you anticipate in a patient who has myxedema?: Dry yellow skin
57. Which diagnostic test most accurately assesses the presence and mag- nitude of anaerobic metabolism?: Lactic acid
58. Which gland is responsible for some of the vasoconstriction in shock?- : Pituitary
59. Which intervention for patient in shock prevents an increase in myocar- dial oxygen demand?: Maintain normal body temperature

60. Which is the most reliable indicator that ventilation should be assisted in a patient with altered mental status?: End-tidal CO2 is 60 mm Hg
61. Which of the following biological warfare agents causes serious neuro- logic symptoms that may include paralysis?: botulism
62. Which of the following describes a behavior that represents normal mental status? A person who:: Is drowsy and slow to respond to questions after awakening from a nap.
63. 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?: Unilateral blown pupil
64. Which of the following is an occupational exposure incident?: Blood sprays in your face when a child with a face laceration sneezes
65. Which of the following patients is at highest risk for pericardial tampon- ade?: 55 - year-old with end-stage lung cancer
66. Which of the following physical findings points most specifically to in- creased intracranial pressure?: Respiratory rate is 8 and irregular.

67. Which patient is at highest risk for non traumatic obstructive shock?: - 22 - year-old who is 38 weeks pregnant

68. Which patient would be an appropriate candidate for immediate intra- venous administration of sodium bicarbonate?: 45 - year-old who complained of chest pain and is now in cardiac arrest and unresponsive to treatment
69. Which sign or symptom can help diagnose headache from meningococ- cal meningitis?: Petechial rash
70. Which source provides the most detailed information related to haz- ardous materials?: Material Safety Data Sheets
71. While treating a trauma patient, you lacerate your hand. Your bleeding hand comes in contact with the blood of the patient. What action is most im- portant to increase your chance of appropriate follow-up?: Notify the receiving facility and your designated infection control officer immediately.
72. You are transferring a 65-year-old female with renal failure from the nursing home. She has a history of "abnormal lab values" and is drowsy and weak. You note the following lab values: serum calcium 10.0 mg/dL (0.55 mmol/L), pH 7.28, potassium 6.1 mEq/L. The patient goes into cardiac arrest after you load her into the ambulance. After epinephrine, you should first consider giving her:: Magnesium sulfate

73. You are treating a patient who has been diagnosed with herpes simplex type 1. He exhibits no signs or symptoms at this time. He is in which stage of the communicable disease?: Latent
74. You evaluate the patient's environment to assess for:: all of the above; Safety concerns, Room Temp, Assistive devices
75. You respond to a warehouse for "multiple patients with difficulty breath- ing." From a hallway, you see your patient lying in a room with two other people who don't seem to be breathing. He calls out to you, saying he can't breathe. You should first:: Stage at a safe distance.
76. Your adolescent patient presents with a fever, malaise, sneezing, and paroxysmal spasmodic coughing phases. Which infectious disease would you suspect?: Pertussis
77. Your patient complains of discomfort in his hand as you inflate the cuff to asses the blood pressure. You note flexion of the wrist and adduction of his fingers. What endocrine disorder do you suspect?: Hypoparathyroidism
78. Your patient is agitated and sweaty. Her vital signs are BP 107/108 mmHG, P 132 bpm, and R 20/min. Her pupils are dilated, and her hands are trembling. These signs and symptoms may be associated with:: Alcohol withdrawal

79. Your patient is complaining of a cramping pain around her umbilical area that "won't let up." This is most suggestive of disease involving the:: Appen- dix
80. Your patient is reported is reported to have taken an overdose. She has a history of anxiety disorder and depression. She is unresponsive, and vital signs are BP 110/70, P 125 bpm, R 20/min. Her ECG shows right bundle branch block. You expect she has taken:: Amilytriptyline