Identifying and Managing Medical Emergencies, Exams of Nursing

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WEST COAST EMT BLOCK EXAM

#3 2024/

WEST COAST EMT BLOCK EXAM

2024/

A 30-year-old male experienced a generalized (tonic-clonic) seizure, which stopped before you arrived at the scene. The patient is conscious, is answering your questions appropriately, and refuses EMS transport. Which of the following would be the MOST compelling reason to disagree with his refusal of transport? Select one: A. His Glasgow Coma Scale (GCS) score is 15 B. His wife states that this was his "usual" seizure C. He has experienced seizures since he was 20 D. He is currently not prescribed any medications - Precise Answer ✔✔D. He is currently not prescribed any medications A patient who is possibly experiencing a stroke is NOT eligible for thrombolytic (fibrinolytic) therapy if he or she: Select one: A. has had a prior heart attack. B. has bleeding within the brain. C. has a GCS score that is less than 8. D. is older than 60 years of age. - Precise Answer ✔✔B. has bleeding within the brain.

A patient whose speech is slurred and difficult to understand is experiencing: Select one: A. paraplegia. B. dysphagia. C. dysarthria. D. aphasia. - Precise Answer ✔✔C. dysarthria. A patient with an altered mental status is: Select one: A. typically alert but is confused as to preceding events. B. not thinking clearly or is incapable of being aroused. C. usually able to be aroused with a painful stimulus. D. completely unresponsive to all forms of stimuli. - Precise Answer ✔✔B. not thinking clearly or is incapable of being aroused. During the primary assessment of a semiconscious 70-year-old female, you should: Select one: A. insert a nasopharyngeal airway and assist ventilations. B. ask family members if the patient has a history of stroke. C. immediately determine the patient's blood glucose level. D. ensure a patent airway and support ventilation as needed. - Precise Answer ✔✔D. ensure a patent airway and support ventilation as needed.

Interruption of cerebral blood flow may result from all of the following, EXCEPT: Select one: A. an embolism. B. cerebral vasodilation. C. a thrombus. D. an acute arterial rupture. - Precise Answer ✔✔B. cerebral vasodilation. The left cerebral hemisphere controls: Select one: A. heart rate and pupil reaction. B. the right side of the face. C. breathing and blood pressure. D. the right side of the body. - Precise Answer ✔✔D. the right side of the body. The MOST significant risk factor for a hemorrhagic stroke is: Select one: A. diabetes mellitus. B. hypertension. C. heavy exertion. D. severe stress. - Precise Answer ✔✔B. hypertension.

The three major parts of the brain are the: Select one: A. midbrain, cerebellum, and spinal cord. B. brain stem, midbrain, and spinal cord. C. cerebellum, medulla, and occiput. D. cerebrum, cerebellum, and brain stem. - Precise Answer ✔✔D. cerebrum, cerebellum, and brain stem. When assessing for arm drift of a patient with a suspected stroke, you should: Select one: A. ask the patient to close his or her eyes during the assessment. B. expect to see one arm slowly drift down to the patient's side. C. observe movement of the arms for approximately 2 minutes. D. ask the patient to hold his or her arms up with the palms down. - Precise Answer ✔✔A. ask the patient to close his or her eyes during the assessment. When caring for a patient with documented hypoglycemia, you should be MOST alert for: Select one: A. a seizure. B. respiratory distress. C. an acute stroke.

D. a febrile convulsion. - Precise Answer ✔✔A. a seizure. When you are obtaining medical history from the family of a suspected stroke patient, it is MOST important to determine: Select one: A. if the patient has been hospitalized before. B. if there is a family history of a stroke. C. when the patient last appeared normal. D. the patient's overall medication compliance. - Precise Answer ✔✔C. when the patient last appeared normal. Which of the following conditions would be the LEAST likely to mimic the signs and symptoms of a stroke? Select one: A. Intracranial bleeding B. A postictal state C. Hypoglycemia D. Hypovolemia - Precise Answer ✔✔D. Hypovolemia Which of the following conditions would MOST likely affect the entire brain? Select one: A. Respiratory failure or cardiopulmonary arrest B. Ruptured cerebral artery in the occipital lobe

C. Blocked cerebral artery in the frontal lobe D. Reduced blood supply to the left hemisphere - Precise Answer ✔✔A. Respiratory failure or cardiopulmonary arrest Which of the following MOST accurately describes a simple partial seizure? Select one: A. A generalized seizure without incontinence B. A seizure that causes the patient to stare blankly C. A seizure that begins in one extremity D. A seizure that is not preceded by an aura - Precise Answer ✔✔C. A seizure that begins in one extremity Which of the following MOST accurately describes what the patient will experience during the postictal state that follows a seizure? Select one: A. A gradually decreasing level of consciousness B. A rapidly improving level of consciousness C. Hyperventilation and hypersalivation D. Confusion and fatigue - Precise Answer ✔✔D. Confusion and fatigue Which of the following symptoms would lead the EMT to believe that a patient's headache is caused by sinus congestion? Select one: A. The headache began suddenly

B. There is associated neck stiffness C. There is numbness in the extremities D. The pain is worse when bending over - Precise Answer ✔✔D. The pain is worse when bending over You are caring for a 68-year-old man with sudden onset of left-sided paralysis and slurred speech. His airway is patent, his respirations are 14 breaths/min with adequate depth, and his oxygen saturation is 98%. Treatment for this patient should include: Select one: A. recovery position and transport. B. oral glucose gel and transport. C. high-flow oxygen and transport. D. ventilatory assistance and transport. - Precise Answer ✔✔A. recovery position and transport. You respond to a residence for a child who is having a seizure. Upon arrival at the scene, you enter the residence and find the mother holding her child, a 2-year-old male. The child is conscious and crying. According to the mother, the child had been running a high fever and then experienced a seizure that lasted approximately 3 minutes. You should: Select one: A. call medical control and request permission to give the child aspirin. B. transport the child to the hospital and reassure the mother en route. C. advise the mother to take her child to the doctor the following day.

D. cover the child with wet towels and give oxygen via nasal cannula. - Precise Answer ✔✔B. transport the child to the hospital and reassure the mother en route. Your patient opens his eyes, moans, and pulls away from you when you pinch his trapezius muscle. You should assign a Glasgow Coma Scale (GCS) score of: Select one: A. 7. B. 9. C. 8. D. 6. - Precise Answer ✔✔C. 8. A 29-year-old pregnant woman has had severe vomiting for the last 2 days. Today, she is vomiting large amounts of blood. Her skin is cool and pale and she is tachycardic. The EMT should suspect: Select one: A. Mallory-Weiss tear. B. esophagitis. C. esophageal varices. D. acute pancreatitis. - Precise Answer ✔✔A. Mallory-Weiss tear. A 30-year-old woman with a history of alcoholism presents with severe upper abdominal pain and is vomiting large amounts of bright red blood. Her skin is cool, pale, and clammy; her heart rate is 120 beats/min and

weak; and her blood pressure is 70/50 mm Hg. Your MOST immediate action should be to: Select one: A. rapidly transport her to the hospital. B. give her high-flow supplemental oxygen. C. protect her airway from aspiration. D. keep her supine and keep her warm. - Precise Answer ✔✔C. protect her airway from aspiration. A 47-year-old male presents with severe abdominal pain of 3 hours' duration. His abdomen is distended and guarded. Your MOST important consideration for this patient should be to: Select one: A. be alert for signs and symptoms of shock. B. assess his blood pressure to determine perfusion adequacy. C. transport him in a supine position. D. determine the exact location and cause of his pain. - Precise Answer ✔✔A. be alert for signs and symptoms of shock. A 59-year-old male presents with sudden-onset severe lower back pain. He is conscious and alert, but very restless and diaphoretic. Your assessment reveals a pulsating mass to the left of his umbilicus. You should: Select one: A. request a paramedic unit to give the patient pain medication.

B. vigorously palpate the abdomen to establish pain severity. C. administer oxygen and prepare for immediate transport. D. place the patient in a sitting position and transport at once. - Precise Answer ✔✔C. administer oxygen and prepare for immediate transport. A young female presents with costovertebral angle tenderness. She is conscious and alert with stable vital signs. Which of the following organs is MOST likely causing her pain? Select one: A. Pancreas B. Liver C. Kidney D. Gallbladder - Precise Answer ✔✔C. Kidney An important aspect in the treatment of a patient with severe abdominal pain is to: Select one: A. provide emotional support en route to the hospital. B. give 100% oxygen only if signs of shock are present. C. encourage the patient to remain in a supine position. D. administer analgesic medications to alleviate pain. - Precise Answer ✔✔A. provide emotional support en route to the hospital. For a patient with a gastrointestinal complaint, it is MOST important for the EMT to _________.

Select one: A. avoid transporting the patient if the condition is minor B. perform all interventions prior to transport C. determine the cause of the patient's complaint D. identify whether the patient requires rapid transport - Precise Answer ✔✔D. identify whether the patient requires rapid transport Most patients with abdominal pain prefer to: Select one: A. lie on their side with their knees drawn into the abdomen. B. sit fully upright because it helps relax the abdominal muscles. C. sit in a semi-Fowler position with their knees slightly bent. D. lie in a supine position with their knees in a flexed position. - Precise Answer ✔✔A. lie on their side with their knees drawn into the abdomen. Pain that may be perceived at a distant point on the surface of the body, such as the back or shoulder, is called: Select one: A. visceral pain. B. radiating pain. C. referred pain. D. remote pain. - Precise Answer ✔✔C. referred pain.

Peritonitis may result in shock because: Select one: A. abdominal distention impairs cardiac contractions. B. severe pain causes systemic dilation of the vasculature. C. intra-abdominal hemorrhage is typically present. D. fluid shifts from the bloodstream into body tissues. - Precise Answer ✔✔D. fluid shifts from the bloodstream into body tissues. Urinary tract infections are more common in ____________. Select one: A. men B. active adults C. women D. sedentary adults - Precise Answer ✔✔C. women When assessing a patient with abdominal pain, you should: Select one: A. visually assess the painful area of the abdomen, but avoid palpation because this could worsen his or her condition. B. palpate the abdomen in a clockwise direction, beginning with the quadrant after the one the patient indicates is painful. C. ask the patient to point to the area of pain or tenderness and assess for rebound tenderness over that specific area. D. observe for abdominal guarding, which is characterized by sudden relaxation of the abdominal muscles when palpated. - Precise Answer

✔✔B. palpate the abdomen in a clockwise direction, beginning with the quadrant after the one the patient indicates is painful. Which of the following helps filter the blood and has no digestive function? Select one: A. Large intestine B. Spleen C. Stomach D. Small intestine - Precise Answer ✔✔B. Spleen Which of the following is correct about the secondary assessment for a high-priority patient? Select one: A. The secondary assessment must be performed prior to transport. B. Never contact medical direction before completing the secondary assessment. C. You may not have time to complete a secondary assessment. D. Never perform a secondary assessment on a high-priority patient. - Precise Answer ✔✔C. You may not have time to complete a secondary assessment. Which of the following may help reduce your patient's nausea? Select one: A. Low-flow oxygen

B. Positive-pressure ventilation C. Cricoid pressure D. Oral glucose - Precise Answer ✔✔A. Low-flow oxygen Which of the following organs lies in the retroperitoneal space? Select one: A. Pancreas B. Gallbladder C. Spleen D. Liver - Precise Answer ✔✔A. Pancreas Which of the following statements regarding dialysis is correct? Select one: A. Acute hypertension is a common adverse effect of dialysis. B. The purpose of dialysis is to help the kidneys retain salt and water. C. Hemodialysis is effective but carries a high risk of peritonitis. D. Patients who miss a dialysis treatment often present with weakness. - Precise Answer ✔✔D. Patients who miss a dialysis treatment often present with weakness. Which of the following statements regarding the acute abdomen is correct? Select one:

A. The initial pain associated with an acute abdomen tends to be vague and poorly localized. B. The parietal peritoneum is typically the first abdominal layer that becomes inflamed or irritated. C. The most common cause of an acute abdomen is inflammation of the gallbladder and liver. D. An acute abdomen almost always occurs as the result of blunt trauma to solid abdominal organs. - Precise Answer ✔✔A. The initial pain associated with an acute abdomen tends to be vague and poorly localized. Your patient complains of abdominal pain that occurs mostly at night or after eating fatty foods. You should suspect ____________. Select one: A. cholecystitis B. a hernia C. appendicitis D. kidney stones - Precise Answer ✔✔A. cholecystitis Your patient complains of chronic "burning" stomach pain that improves after eating. You should suspect: Select one: A. pneumonia. B. peptic ulcer disease. C. aortic aneurysm.

D. kidney stones. - Precise Answer ✔✔B. peptic ulcer disease. A 37-year-old female with a history of diabetes presents with excessive urination and weakness of 2 days' duration. Her blood glucose level reads 320 mg/dL. If this patient's condition is not promptly treated, she will MOST likely develop: Select one: A. irreversible renal failure. B. severe insulin shock. C. hypoxia and overhydration. D. acidosis and dehydration. - Precise Answer ✔✔A. irreversible renal failure. A 66-year-old woman experienced a sudden onset of difficulty breathing. She has a history of type 2 diabetes and deep vein thrombosis (DVT). On the basis of her medical history, which of the following should the EMT suspect? Select one: A. Pulmonary embolism B. Severe hypoglycemia C. Diabetic ketoacidosis D. Congestive heart failure - Precise Answer ✔✔A. Pulmonary embolism A 75-year-old male with type 1 diabetes presents with chest pain and a general feeling of weakness. He tells you that he took his insulin today

and ate a regular meal approximately 2 hours ago. You should treat this patient as though he is experiencing: Select one: A. hyperglycemia. B. hypoglycemia. C. a heart attack. D. an acute stroke. - Precise Answer ✔✔C. a heart attack. A man finds his 59-year-old wife unconscious on the couch. He states that she takes medications for type 2 diabetes. He further tells you that his wife has been ill recently and has not eaten for the past 24 hours. Your assessment reveals that the patient is unresponsive. You should: Select one: A. open and maintain her airway and assess breathing. B. administer 100% oxygen via a nonrebreathing mask. C. assess for the presence of a medical identification tag. D. administer oral glucose between her cheek and gum. - Precise Answer ✔✔A. open and maintain her airway and assess breathing. A patient with an altered mental status; high blood glucose levels; and deep, rapid breathing may have a condition known as __________. Select one: A. hyperosmolar hyperglycemic nonketotic coma B. hypoglycemic crisis C. hyperglycemic crisis

D. diabetic ketoacidosis - Precise Answer ✔✔D. diabetic ketoacidosis A patient with hypoglycemia will often present with which of the following signs/symptoms? Select one: A. Warm, red, and dry skin B. Deep, rapid respirations C. Pale, cool, and clammy skin D. Hypertension - Precise Answer ✔✔C. Pale, cool, and clammy skin Classic signs and symptoms of hypoglycemia include: Select one: A. cool, clammy skin; weakness; tachycardia; and rapid respirations. B. warm, dry skin; hunger; abdominal pain; and deep, slow respirations. C. warm, dry skin; irritability; bradycardia; and rapid respirations. D. cold, clammy skin; bradycardia; hunger; and deep, rapid respirations.

• Precise Answer ✔✔A. cool, clammy skin; weakness; tachycardia; and rapid respirations. During your assessment of a 19-year-old male, you are told that he is being treated with factor VIII. This indicates that: Select one: A. his blood clots too quickly. B. he has thrombophilia.

C. he has hemophilia A. D. he has a thrombosis. - Precise Answer ✔✔C. he has hemophilia A. Excessive eating caused by cellular "hunger" is called: Select one: A. dyspepsia. B. polyphagia. C. dysphasia. D. polydipsia. - Precise Answer ✔✔B. polyphagia. In contrast to type 1 diabetes, type 2 diabetes: Select one: A. occurs when antibodies attack insulin-producing cells. B. is caused by a complete lack of insulin in the body. C. is caused by resistance to insulin at the cellular level. D. is commonly diagnosed in children and young adults. - Precise Answer ✔✔C. is caused by resistance to insulin at the cellular level. Proper procedure for administering oral glucose to a patient includes all of the following, EXCEPT: Select one: A. ensuring the absence of a gag reflex. B. requesting permission from medical control. C. checking the medication's expiration date.

D. assessing the patient's mental status. - Precise Answer ✔✔A. ensuring the absence of a gag reflex. Symptomatic hypoglycemia will MOST likely develop if a patient: Select one: A. markedly overeats and misses an insulin dose. B. takes too much of his or her prescribed insulin. C. misses one or two prescribed insulin injections. D. eats a regular meal followed by mild exertion. - Precise Answer ✔✔B. takes too much of his or her prescribed insulin. The EMT should assess for hypoglycemia in small children with a severe illness or injury because: Select one: A. children overproduce insulin during severe illness or injury. B. children cannot store excess glucose as effectively as adults. C. a child's cells do not uptake glucose as rapidly as adults' do. D. illness or injury causes the pancreas to produce less insulin. - Precise Answer ✔✔B. children cannot store excess glucose as effectively as adults. The main function of the endocrine system is to _________. Select one: A. regulate blood flow B. regulate glucose and calcium

C. produce glandular secretions D. maintain homeostasis - Precise Answer ✔✔D. maintain homeostasis The normal blood glucose level is between: Select one: A. 30 and 150 mg/dL. B. 60 and 80 mg/dL. C. 160 and 200 mg/dL. D. 80 and 120 mg/dL. - Precise Answer ✔✔D. 80 and 120 mg/dL. The two main types of cells contained in blood are called _________. Select one: A. erythrocytes and leukocytes B. transport and clotting C. platelets and plasma D. hemoglobin A and S - Precise Answer ✔✔A. erythrocytes and leukocytes Which of the following conditions is the diabetic patient at an increased risk of developing? Select one: A. Alcoholism B. Hepatitis B C. Depression

D. Blindness - Precise Answer ✔✔D. Blindness Which of the following statements regarding glucose is correct? Select one: A. The brain requires insulin to allow glucose to enter the cells. B. The brain requires glucose as much as it requires oxygen. C. Blood glucose levels decrease in the absence of insulin. D. Most cells will function normally without glucose. - Precise Answer ✔✔B. The brain requires glucose as much as it requires oxygen. Which of the following statements regarding sickle cell disease is correct? Select one: A. Because of their abnormal shape, red blood cells in patients with sickle cell disease are less apt to lodge in a blood vessel. B. In sickle cell disease, the red blood cells are abnormally shaped and are less able to carry oxygen. C. The red blood cells of patients with sickle cell disease are round and contain hemoglobin. D. Sickle cell disease is an inherited blood disorder that causes the blood to clot too quickly. - Precise Answer ✔✔B. In sickle cell disease, the red blood cells are abnormally shaped and are less able to carry oxygen. You are treating a 40-year-old male with a documented blood sugar reading of 480 mg/dL. The patient is semiconscious and breathing

shallowly, and is receiving assisted ventilation from your partner. You should recognize that definitive treatment for this patient includes: Select one: A. glucagon. B. dextrose. C. insulin. D. oxygen. - Precise Answer ✔✔C. insulin. A 19-year-old female was stung multiple times on the legs by fire ants. She states that she is allergic to fire ants, but does not carry her own epinephrine. The patient is conscious and alert and complains of pain to the area of the bites. Her blood pressure is 122/70 mm Hg, her pulse is 100 beats/min and strong, and her respirations are 18 breaths/min and unlabored. You should: Select one: A. administer oxygen and transport her to the hospital. B. request a paramedic unit to administer epinephrine. C. position her legs well above the level of her heart. D. advise her to see her physician as soon as possible. - Precise Answer ✔✔A. administer oxygen and transport her to the hospital. A 37-year-old male is having a severe allergic reaction to penicillin. He does not have an epinephrine auto-injector and your protocols do not allow you to carry epinephrine on the ambulance. How should you proceed with the treatment of this patient? Select one:

A. Quickly determine if there are any bystanders who may carry epinephrine. B. Administer oxygen, transport at once, and request a paramedic intercept. C. Remain at the scene with the patient and request a paramedic ambulance. D. Ask the patient if he has any diphenhydramine tablets that you can administer. - Precise Answer ✔✔B. Administer oxygen, transport at once, and request a paramedic intercept. After administering 0.3 mg of epinephrine via auto-injector to a 22-year- old woman with an allergic reaction, you note improvement in her breathing and dissipation of her hives. However, she is still anxious and tachycardic. You should: Select one: A. contact medical control and obtain authorization to administer another 0.3 mg of epinephrine. B. consider administering 0.15 mg of epinephrine to completely resolve her allergic reaction. C. transport her rapidly, as it is obvious that she is having a severe reaction to the epinephrine. D. monitor her closely but recall that anxiety and tachycardia are side effects of epinephrine. - Precise Answer ✔✔D. monitor her closely but recall that anxiety and tachycardia are side effects of epinephrine. Anaphylaxis caused by stinging insects is typically an allergic reaction to ____________ rather than the bite or sting itself.