Emergency Medical Care: Identifying and Managing Critical Conditions, Exams of Nursing

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final dh paramedic exam questions with complete solutions a 28 year old patient experienced partial thickness chemical burns from battery acid. During your assessment you should assess for which of the following injuries Correct Answers coagulation necrosis a 28 year old patient who is 34 hours postpartum reports lower abdominal and pelvic pain with cramping. you recognize that which of the following conditions are the most common cause of infection following childbirht Correct Answers endometritis a 29 year old patient who is at 32 weeks gestation presents with nausea, dizziness, tachycardia and anxiety. the patient reports that she was placed on bed rest 2 weeks ago. based on the findings you suspect that the patient is showing signs of Correct Answers supine hypotensive syndrome a 32 year old patient has paradoxical movement of the chest wall and penetrating trauma, what is your most immediate priority in treating this patient Correct Answers apply a vented chest seal to the injury a 36 year old female was sexually assaulted and is experiencing intense pain. your assessment reveals several organ lacerations to her vaginal area and a painful distended abdomne. her blood pressure is 86/50 and heart rate is 120 beat/min. in addition to administering o2 you should, Correct Answers cover her open wounds with sterile dressings, establish at least one large bore iv and administer iv fluid

a 38 year old pt is found lying in snow. Upon assessment you are unable to find a pulse. what should you do first Correct Answers start cpr a 4 year old girl pulled a pot of boiling water off of the stove and experienced partial thick ness splash burns to her neck, anterior truck, and both anterior arms. During your assessment you not that the child is conscious but is not crying. She is tachypneic, tachycardia and her skin is cool and moist. other than the burns, there are no other gross injuries. what could she be presenting with Correct Answers the child may be hypoglycemic and requires assessment of her blood glucose a 42 year old female patient presents with burns involving their hands, feet and face. upon assessing the burns, you note that full thickness burns cover about 12 percent and partial thickness burns cover about 26 percent of tbsa. the burns would be classified as Correct Answers major a 45 year old patient who fell off a ladder reports that they landed on their feet. Upon assessing the patient you suspect a pelvic fracture. Which type of injury did the patient experience? Correct Answers indirect a 5 year old patient presents with low grade fever, stridor, and trouble breathing. The parent tells you that the child started having cold symptoms 2 days ago. Based on your assessment and the patient histroy, you suspect the patient is exhibiting signs of Correct Answers croup

a 50 year old patient who expereinced blunt trauma to the chest presents with absent breath sounds on their left side, unequal chest rise, pulsus paradoxus, jugular venous distention, and a narrow pulse pressure. you recognize that these are symptoms of a Correct Answers hemopnemothorax a 68 year old pt reports pain in their extremities and minor nausea after playing tennis. What is your priority? Correct Answers move the pt to a cool environment a 71 year old man slipped on wet grass and landed on his left side. he denies losing consciousness before or after the fall and is presently conscious and alert. he complains of pain to his left hip and in his neck. your assessment reveals a hemotoma to the left side of his head and an external rotation and shortening of his left leg. his vital signs are stable. the most appropriate treatment for this patient inlcudes Correct Answers oxygen if hypoxemic, spinal motion restriction precautions, an iv line of normal saline, stabilization of his hip with pillows, fentanyl if needed and transport a conscious and combative patient with severe facial trauma is fully immobilized on a backboard. During your assessment, the patient begins coughing up large amounts of blood. you suction her oropharynx, but her mouth quickly refill with blood. what should you do Correct Answers roll the backboard on its sides, suction her oropharynx, and prepare to perform pharmacologically assisted intubation a f29 year old female was diagnosed with cystitis but never had her antiobiotic prescription filled. today she presents with fever,

chills and vomiting. what should you suspect? Correct Answers pyelonephritis a hemostatic agent would be used to Correct Answers control serious hemmorhage when application of a tourniquet is not possible a newborn born between how many weeks of gestation is described as term Correct Answers 38-42 weeks a newborn with central cyanosis, adequate respirations, and a heart rate of 120 beats/min should initially be treated with Correct Answers free flow o2 at 5 l/min a patient exhibiting signs of shock has a marked elevated respiratory rate, cold and pale skin, diminsihed urine output, and a thready pulse with heart rate of 125 beats/min. the pt would be characterized as being in which class of hypovolemic shock Correct Answers class III a pregnant patient reports painful itching on her hands and feet. the patient says that she has been more fatigues than normal, and she noticed that the other day her urine was darker than normal. based on these symptoms you suspect that the patient is experiencing Correct Answers cholestasis a pregnant patient who develops hyperemesis gravidarum is most likely to experience Correct Answers dehydration a primigravida women Correct Answers is pregnant for the first time

a pt may be diagnosed with heatstroke if they present with which of the following symptoms Correct Answers delirium and or seizures a trauma patient with suspected internal hemorrhage and inadequate breathing requires Correct Answers ventilation assistance and rapid transport a young man was assaulted and has extensive maxillofacial injuries. your primary assessment reveals that he is semiconscious, has shallow breathing, and has blood draining from the corner of his mouth. initial managements for this patient involves Correct Answers manually stabilizing his head in a neutral position, suctioning his oropharynx, and assisteing ventilations with a bag mask device and 100 oxygen abortion is defined as explusion of the fetus, from any cause, before the end of which week of pregnancy Correct Answers 20th according to the american college of surgeouns, an injured patient should be transported to a level 1 trauma center if their Correct Answers systolic blood pressure is less than 90 mg hg after delivering a baby, it is advantageous to wait how many seconds prior to clamping the umbilical cord Correct Answers 30 seconds

after managing an internal hemmorhage, it is important to monitor and record vital signs at least every Correct Answers 5 minutes all pts with a presumptive diagnosis of a pnemo should be considered to be in unstable condition and reassessed at which frequency for worsening dysmpnea, tachy, and development of jvd Correct Answers every 5 min altitude illness is a problem caused by Correct Answers hypoxia due to low atmospheric pressures an 8 year old patient is found sitting in tripod position. what should you suspect Correct Answers respiratory distress an increase in core body temperature due to inadequate thermolysis is called Correct Answers heat illness an oropharyngeal airway would most likely be indicated for a newborn with Correct Answers pierre robin sequence an untreated patent ductus arteriosus may cause subsequent development of Correct Answers congestive heart failure anatomically the abdominal cavity extends from the Correct Answers diaphragm to the pelvis any patient with significant head injury is presumed to have which injury until proven otherwise Correct Answers cervical spine injury

any patient with significant head injury should be evaluated for the presence of Correct Answers cervical spine injury arterial bleeding may require how many minutes or more of direct pressure to form a clot Correct Answers 5 minutes burn shock is caused by Correct Answers fluid loss across damaged skin and volume shifts within the rest of the body by definition infancy begins at Correct Answers 1 month of age by the age of 1 year, an infants tidal volume ranges from Correct Answers 10-15 ml/kg cerebrospinal fluid drainage from the ears is most indicative of Correct Answers a skull fracture class II hypovolemic shock caused by hemorrhagic trauma would be chacterized by which amount of blood loss from a patient who weighs 154 pounds Correct Answers 15% to 30% classic heatstroke is most likely to be diagnoses in a patient with which of the following symptoms or characteristics Correct Answers moist skin that is paler than baseline tone closed bilaterally fractures femurs can result in internal blood loss of up to Correct Answers 1500 ml compartment syndrome occurs when Correct Answers pressure in the fascial compartment leads to impaired circulation sensory changes and progressive muscle death

cullens signs and grey turner sign are typically found how many hours after the initial intra abdominal injury Correct Answers 12-24 hours cyanosis in a patient with thoracic trauma is a good indication of Correct Answers a problem with ventilation death following a head injury is mos often the result of Correct Answers trauma to the brain decompensated shock in the adult is characterized by Correct Answers falling blood pressure drugs, chemicals or other substances that are potentially harmful to devloping babies aremore likely to cause significant damage during which time period Correct Answers 3-8 weeks gestation dry powder chemicals Correct Answers should be brushed off the skin before irrigation with water during an explosion, secondary blast injuries occur when Correct Answers the patient is struck by the flying debris, such as shrapnel during saturation diving Correct Answers the diver remains at depth for prolonged periods of time during the process of wound healing, hemostasis is Correct Answers temporarily stops bleeding via vasoconstriction and platelet aggregation

during transport of a newborn, timely intervention of acute deterioration is most efffectvely achieved by Correct Answers ongoing observation and frequent reassessment epinephrine is indicated during newborn resuscitation if Correct Answers the heart rate remains below 60 beats/min after 30 seconds of effective ventilation and an additional 30 seconds of chest compressions external bleeding would be the most difficult to control in a patient with a large laceration to the Correct Answers carotid artery externial heatstroke is more likely to occur when relative humidity rises above Correct Answers 75% flexion or extension of the vertebral column beyond which range may damage structural ligaments and allow excess vertebral movement that could expose the spinal cord injury Correct Answers 60-70% for adults who experience a fall, consider immediate transport to a trauma center with falls greater than Correct Answers 20 feet fournier ganagene is a potential complication associated with Correct Answers scrotal lacerations generalized abdominal pain following rupture of a hollow organ is most suggestive of Correct Answers diffuse peritoneal contamination

gestational diabetes is caused by Correct Answers decreased insulin production and decreased cellular sensitivity to insulin heat therapy should generally be avoided how many hours after a musculoskeletal injury because it may increase pain and swelling during this period Correct Answers 48 to 72 hours hypoxia and hypovolemia are major contributors to poor outcomes following trauma and can have devastating effects within how many minutes of onset Correct Answers 4- minutes if an acutely burned patient is in shock in prehospital setting Correct Answers you should look for another injury as the source of shock if blood flow is not restored quickly to the eye of a patient with central retinal artery occlusion which of the following may occur Correct Answers necrosis of the retina if musculoskeletal injuries in the extremities are suspected, you should assess for which of the following before or after any manipulation as well as frequently during transport Correct Answers circulatory changes if the 5 minutes apgar score is less than 7, reassess the newborns condition and assign an additional score every 5 minutes until how many minutes after birth Correct Answers 20 minutes

if you suspect a skull fracture, you should Correct Answers cover the bleeding site loosely with a sterile gauze pad if you suspect internal bleeding during the primary assessment you should Correct Answers keep the patient warm and administer oxygen immediate pain from the heel to the calf and a sudden inability for plantar flexion of the foot is most indicative of Correct Answers achilles tendon rupture in contrast to a child with pulmonary edema secondary to congestive heart failure, the respirations of a hypercarbic child without pulmonary edema would most likely be Correct Answers tachypneic and without retractions in contrast to infancts toddlers Correct Answers have a slower respiratory rate in contrast to osteparthritis, rheumatoid arthritis Correct Answers is a systemic inflammatory disease that affects joints and other body systems in conventional reasoning school age children Correct Answers seek approval from their peers and society in females a decrease in bone density is accelerated Correct Answers after menopause

In general, patients suspected of having a partial tracheal tear should be managed with: Correct Answers the least invasive airway techniques possible in situations where the environment is a factor, the most accurate means of determining a persons core temperature is to Correct Answers use a rectal thermometer that is capable of measuring extremes of temperature infants and children in shock Correct Answers compensate more efficiently than adults by increasing heart rate and peripheral vascular resistance infants and children who experience hermorrhaging may have a normal blood pressure until they have lost what percentage of their blood volume Correct Answers 50% intra abdominal bleeding may produce few signs and symptoms of trauma because Correct Answers the intra abdominal cavity can accommodate large amounts of blood is is important to closely observe the nasal hair, eyebrows, and eyelashes in patient who have experienced burns because damage to them may indicate Correct Answers airway injury isolated musculoskeltal injuries Correct Answers often result in short or long term disability jaundice that persists beyond how many weeks should raise suspicion of biliary obstruction or liver disease in a newborne Correct Answers 2-3 weeks

mildly elevated levels of intercranial pressure would result in which of the following clincical signs Correct Answers cheyne strokes respirations most abdominal injuries Correct Answers involve blunt trauma open soft tissue facial trauma following a significant mechanism of injury Correct Answers suggests that the patient may have a closed head injury or spinal injury ovarian torsion is more common in patients with a history of Correct Answers ovarian cysts penetrating trauma occurs when Correct Answers tissues are disrupted by single or multiple objects percussion of a patients chest can help you assess for Correct Answers hyperrosonance poor peripheral circulation is present in a child if capillary refill is greater than or equal to how many seconds Correct Answers 3 seconds pregnant women in the last two trimesters of pregnancy should be transported in which position Correct Answers left lateral recumbent pregnant women who are bedridden or who spend extended time lying down are in particular of experiencing which of the following conditions Correct Answers deep vein thrombosis

primary treatment in the prehospital setting for an abrasion involves Correct Answers proper treatment for an open wound to the neck with venous bleeding includes Correct Answers sealing the wound with an occlusive dressing ribs four through nine are the most commonly fractured because Correct Answers they are less protected by other bony and muscular structures signs and symptoms of retinal detachment include Correct Answers flashing lights, specks, or floaters in the field of vision. subdural hemotomas occurs between the dura mater and what other part of the brain Correct Answers arachnoid membrane teething is commonly accompanied by Correct Answers a fever the decline in cardiac function associated with aging is largely related to Correct Answers atherosclerosis the dome shaped top of the uterus is called the Correct Answers fundus the first aspect to address in any patient with a soft tissue injury is Correct Answers your safety

the hymenoptera family of insects usually cause death secondary to Correct Answers anaphylaxis the law of conservation of energy states that Correct Answers energy can be neither created nor destoryed it can only change form the most critical factor determining the seriousness of a gunshot wound is Correct Answers the type of tissue through which the projectile passes the most effective method for decreasing morbidity and mortality associated with spinal cord injury is Correct Answers public education and prevention strategies the most important aspect in the care of woman with severe vaginal bleeding is Correct Answers treating for shock and transporting rapidly the most significant immediate threat to a patient with a soft tissue injury is Correct Answers hemorrhage the only indication for administering glucose to a patient with a head injury is a glucometer reading of which value or lower Correct Answers 45 the platinum 10 minutes refers to the Correct Answers maxiumum time spent at a scene for a trauma patient the primary source of heat production in the newborn is Correct Answers nonshivering thermogenesis

the swelling that occurs in conjunction with a contusion is caused by Correct Answers leakage of fluid into spaces between the damaged cells the use of wet dressings in the field is usually limited to Correct Answers superficial burns traumatic injuries to the aorta are most commonly the result of Correct Answers shearing forces unlike cerebral concussion, a cerebral contusion is Correct Answers associated with physical brain damage and more pronounced neurologic deficits upon arriving on the scene of a motor vehicle accident, you notice the vehicle has a deformed front end and cracked windshield. the patients head and face are bruised and heavily lacerated. based on these findings, which of the following injuries woudl you expect Correct Answers cervical spine injury upon assessing a 72 year old patient who fell down steps you note that they have a distended and tender abdomen. your priority is to Correct Answers treat for shock and transport immediately upon transport to the hospital, a 48 year old patient with a suspected tbi experiences a sudden drop in systolic blood pressure. you recognize that it is critical to infuse fluids as

needed to maiintain a systolic pressure of at least Correct Answers 90 mg HG vascular compensation for changes in blood pressure decreses with age due to Correct Answers reduced elasticity of the peripheral vessels secondary to decreases in elastin and collagen what is a concern when a patient with maxillofacial trauma has blood in the oropharynx Correct Answers aspiration what is the normal range for systolic blood pressure for a 4 year old patient Correct Answers 89 to 112mm what is the normal range of rr for a 7 year old Correct Answers 18- what membranous tissue functions as the point of attachment for the various abdominal organs Correct Answers mesentery what type of chest injury is characterized by air accumulation in the pleural space when a perforation in the lung paranchyma acts as a one way valve Correct Answers tension pnemothorax when a patient has multiple open wounds to an extremity, you should consider the use of which of the following to allow for constant pressure over large areas that may not be possible using hands alone Correct Answers air splint when an object impaled in the cheek interferes with airway patency, you should Correct Answers promptly remove the object and control the bleeding

when applying a bandage to an open wound that does not have active bleeding, what should you do first, Correct Answers irrigate the wound with normal saline or sterile water when assessing school age children it is imperative to do which of the following Correct Answers earn their trust when you examine the infancts abdomen, the infant opens their eyes and begins to cry. What is gcs for eye opening Correct Answers 2 which of the following clinical findings is most suggestive of inadequate oxygen Correct Answers altered mental status which of the following factors predispose patients to uterine prolapse Correct Answers obesity which of the following injury mechanisms would most likely result in blunt trauma Correct Answers the pressure wave caused by a blast which of the following is the most common cause of necrotizing fascititis Correct Answers group a STREPTOCOCCUS which of the following statements regarding diaphragmatic injury is correct Correct Answers because the disphragm is protected by the liver on the right side, most diaphragmatic injuries causes by blunt force trauma occur on the left side

which of the following statments regarding growth spurts in adolescents is correct Correct Answers boys generally experience this stage of growth later in life than girls do which of the part of the body is particulary vulnerable to deceleration injuries Correct Answers head which type of motor vehicle accidents have the most survivors if the driver and passenger are properly restrained Correct Answers rear impact within a few days after having a miscarrage, a 33 year old presents with malaise, fever, constipation and pelvic pain. her blood pressure is 124/84 pulse rate is 104 and strong and respirations 22 min. you should be suspiciuos for Correct Answers endometritis you should suspect which type of injury when you see a cracked windshield bent steering wheel, dashboard damage, intrusion into a vehicle or an open ankle frature after a fall Correct Answers spinal