Neurological and Endocrine Emergencies, Exams of Nursing

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West Coast EMT Block Exam #3 questions more tested

/frequently/with correct answers

1.A 30-year-old male experienced a generalized (tonic-clonic) seizure, which stopped before you arrived at the scene. The patient is conscious, is answer- ing 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: D. He is currently not pre- scribed any medications 2.A patient who is possibly experiencing a stroke is NOT eligible for throm- bolytic (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.: B. has bleeding within the brain. 3.A patient whose speech is slurred and difficult to understand is experienc- ing: Select one: A. paraplegia. B. dysphagia. C. dysarthria. D. aphasia.: C. dysarthria. 4.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.: B. not thinking clearly or is incapable of being aroused. 5.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.

2 / 38 D. ensure a patent airway and support ventilation as needed.: D. ensure a patent airway and support ventilation as needed. 6.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.: B. cerebral vasodilation. 7.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.: D. the right side of the body. 8.The MOST significant risk factor for a hemorrhagic stroke is: Select one: A. diabetes mellitus. B. hypertension. C. heavy exertion. D. severe stress.: B. hypertension. 9.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.: D. cerebrum, cerebellum, and brain stem. 10.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.: A. ask the patient to close his or her eyes during the assessment. 11.When caring for a patient with documented hypoglycemia, you should be MOST alert for: Select one:

3 / 38 A. a seizure. B. respiratory distress. C. an acute stroke. D. a febrile convulsion.: A. a seizure. 12.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.: C. when the patient last ap- peared normal. 13.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: D. Hypovolemia 14.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: A. Respiratory failure or car- diopulmonary arrest 15.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: C. A seizure that begins in one extremity 16.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

4 / 38 B. A rapidly improving level of consciousness C. Hyperventilation and hypersalivation D. Confusion and fatigue: D. Confusion and fatigue 17.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: D. The pain is worse when bending over 18.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.: A. recovery position and transport. 19.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.: B. transport the child to the hospital and reassure the mother en route. 20.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.: C. 8.

5 / 38 21.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.: A. Mallory-Weiss tear. 22.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.: C. protect her airway from aspiration. 23.A 47-year-old male presents with severe abdominal pain of 3 hours' dura- tion. His abdomen is distended and guarded. Your MOST important consider- ation 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.: A. be alert for signs and symptoms of shock. 24.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.: C. administer oxygen and prepare for immediate transport. 25.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?

6 / 38 Select one: A. Pancreas B. Liver C. Kidney D. Gallbladder: C. Kidney 26.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.: A. provide emotional support en route to the hospital. 27.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: D. identify whether the patient requires rapid transport 28.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.: A. lie on their side with their knees drawn into the abdomen. 29.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.: C. referred pain. 30.Peritonitis may result in shock because: Select one: A. abdominal distention impairs cardiac contractions. B. severe pain causes systemic dilation of the vasculature.

7 / 38 C. intra-abdominal hemorrhage is typically present. D. fluid shifts from the bloodstream into body tissues.: D. fluid shifts from the bloodstream into body tissues. 31.Urinary tract infections are more common in. Select one: A. men B. active adults C. women D. sedentary adults: C. women 32.When assessing a patient with abdominal pain, you should: Select one: A. visually assess the painful area of the abdomen, but avoid palpation be- cause 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 relax- ation of the abdominal muscles when palpated.: B. palpate the abdomen in a clockwise direction, beginning with the quadrant after the one the patient indicates is painful. 33.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: B. Spleen 34.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 assess- ment. C. You may not have time to complete a secondary assessment. D. Never perform a secondary assessment on a high-priority patient.: C. You may not have time to complete a secondary assessment. 35.Which of the following may help reduce your patient's nausea? Select one: A. Low-flow oxygen

8 / 38 B. Positive-pressure ventilation C. Cricoid pressure D. Oral glucose: A. Low-flow oxygen 36.Which of the following organs lies in the retroperitoneal space? Select one: A. Pancreas B. Gallbladder C. Spleen D. Liver: A. Pancreas 37.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.: D. Patients who miss a dialysis treatment often present with weakness. 38.Which of the following statements regarding the acute abdomen is cor- rect? 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.: A. The initial pain associated with an acute abdomen tends to be vague and poorly localized. 39.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: A. cholecystitis 40.Your patient complains of chronic "burning" stomach pain that improves after eating. You should suspect: Select one: A. pneumonia.

9 / 38 B. peptic ulcer disease. C. aortic aneurysm. D. kidney stones.: B. peptic ulcer disease. 41.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.: A. irreversible renal failure. 42.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: A. Pulmonary embolism 43.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.: C. a heart attack. 44.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.: A. open and maintain her airway and assess breathing.

10 / 38 45.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: D. diabetic ketoacidosis 46.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: C. Pale, cool, and clammy skin 47.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.: A. cool, clammy skin; weakness; tachycardia; and rapid respirations. 48.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.: C. he has hemophilia A. 49.Excessive eating caused by cellular "hunger" is called: Select one: A. dyspepsia. B. polyphagia. C. dysphasia. D. polydipsia.: B. polyphagia. 50.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.

11 / 38 D. is commonly diagnosed in children and young adults.: C. is caused by resistance to insulin at the cellular level. 51.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.: A. ensuring the absence of a gag reflex. 52.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.: B. takes too much of his or her prescribed insulin. 53.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.: B. children cannot store excess glucose as effectively as adults. 54.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: D. maintain homeostasis 55.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.: D. 80 and 120 mg/dL. 56.The two main types of cells contained in blood are called. Select one: A. erythrocytes and leukocytes

12 / 38 B. transport and clotting C. platelets and plasma D. hemoglobin A and S: A. erythrocytes and leukocytes 57.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: D. Blindness 58.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.: B. The brain requires glucose as much as it requires oxygen. 59.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.: B. In sickle cell disease, the red blood cells are abnormally shaped and are less able to carry oxygen. 60.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.: C. insulin. 61.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.

13 / 38 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.: A. administer oxygen and transport her to the hospital. 62.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 admin- ister.: B. Administer oxygen, transport at once, and request a paramedic intercept. 63.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.: D. monitor her closely but recall that anxiety and tachycardia are side effects of epinephrine. 64.Anaphylaxis caused by stinging insects is typically an allergic reaction to rather than the bite or sting itself. Select one: A. injected poison B. irritating toxin

14 / 38 C. deadly venom D. All of these answers are correct.: D. All of these answers are correct. 65.Anaphylaxis is MOST accurately defined as a(n): Select one: A. moderate allergic reaction that primarily affects the vasculature. B. extreme allergic reaction that may affect multiple body systems. C. severe allergic reaction that typically resolves without treatment. D. allergic reaction that causes bronchodilation and vasoconstriction.: B. ex- treme allergic reaction that may affect multiple body systems. 66.At the site of the injury, signs and symptoms of an animal or insect bite or sting may include pain, localized heat, and a wheal, which appears as . Select one: A. an uncomfortable depression in the skin B. a large area of red, blotchy skin C. a series of small, raised pustules D. a raised, well-defined area of the skin: D. a raised, well-defined area of the skin 67.Care for a victim of an immunologic emergency who is severely hypoten- sive should include which of the following? Select one: A. Position the patient's airway and initiate positive-pressure ventilations. B. Initiate basic life support measures, including the use of an automated external defibrillator, if necessary. C. Routine spinal immobilization due to the potential for traumatic injury D. Apply high-flow oxygen therapy, place the patient in a shock position, and help maintain the patient's body temperature.: D. Apply high-flow oxygen therapy, place the patient in a shock position, and help maintain the patient's body temperature. 68.Epinephrine stimulates the response, increasing blood pressure and relieving bronchospasm. Select one: A. parasympathetic B. cardiac C. sympathetic D. respiratory: C. sympathetic 69.Patients may experience allergic reactions to which of the following sub- stances? Select one: a. Food and medications

15 / 38 b. Insect or animal bites and stings c. Plant material d. All of these answers are correct.: d. All of these answers are correct.

70. The adult epinephrine auto-injector delivers mg of epinephrine, and the infant-child auto-injector delivers mg. Select one: A. 0.1; 0. B. 0.03; 0. C. 0.3; 0. D. 0.01; 0.1: C. 0.3; 0. 71.The effects of epinephrine are typically observed within follow- ing administration. Select one: A. 1 minute B. 30 seconds C. 1 hour D. 30 minutes: A. 1 minute 72.The goal of invaders such as bacteria and viruses is to. Select one: A. use a human body as a home B. kill their human host C. cause an immune response D. spread disease and destruction: A. use a human body as a home 73.The stinger from a honeybee should be: Select one: A. Left in place and covered. B. scraped away from the skin. C. irrigated with copious amounts of water. D. squeezed with tweezers and removed.: B. scraped away from the skin. 74.Urticaria is the medical term for: Select one: A. swelling. B. a wheal. C. hives. D. burning.: C. hives. 75.When a foreign substance invades the body, the body will. Select one: A. protect itself B. go on alert

16 / 38 C. attempt to inactivate the foreign substance D. All of these answers are correct.: D. All of these answers are correct. 76.When an allergic reaction proceeds to life-threatening anaphylaxis, it will usually do so . Select one: A. quickly, within 30 minutes. B. slowly, over several hours. C. slowly, over more than 30 minutes. D. quickly, within 30 seconds.: A. quickly, within 30 minutes. 77.Which of the following medications blocks the release of histamines? Select one: A. Acetaminophen (Tylenol) B. Albuterol (Ventolin) C. Epinephrine (Adrenalin) D. Diphenhydramine (Benadryl): D. Diphenhydramine (Benadryl) 78.Which of the following signs/symptoms are indicative of respiratory in- volvement of an allergic reaction? Select one: A. Flushed, itching, or burning skin B. A sense of impending doom C. Tightness in the chest or throat D. All of these answers are correct.: C. Tightness in the chest or throat 79.Which of the following sounds indicates swelling of the upper airway? Select one: A. Rales B. Wheezing C. Stridor D. Rhonchi: C. Stridor 80.Which of the following would MOST likely provide clues regarding the source of a patient's allergic reaction? Select one: A. The time of year in which the exposure occurred B. The patient's family history C. The environment in which the patient is found D. The patient's general physical appearance: C. The environment in which the patient is found 81.A 49-year-old male presents with confusion, sweating, and visual hallu- cinations. The patient's wife tells you that he is a heavy drinker and she thinks he had a seizure shortly before your arrival. This patient is MOST likely

17 / 38 experiencing: Select one: A. acute schizophrenia. B. delirium tremens. C. alcohol intoxication. D. acute hypovolemia.: B. delirium tremens. 82.A person who routinely misuses a substance and requires increasing amounts to achieve the same effect is experiencing: Select one: A. tolerance. B. withdrawal. C. dependence. D. addiction.: A. tolerance. 83.Activated charcoal is given to patients who have ingested certain sub- stances because it: Select one: A. decreases absorption of poisons into the lungs. B. binds to the substance and prevents absorption. C. is a direct antidote for many toxic substances. D. induces vomiting and empties the stomach.: B. binds to the substance and prevents absorption. 84.An overdose of acetaminophen, the active ingredient in Tylenol, will MOST likely cause: Select one: A. liver failure. B. kidney failure. C. gastric ulcers. D. CNS depression.: A. liver failure. 85.As you enter the residence of a patient who has possibly overdosed, you should: Select one: A. quickly gain access to the patient. B. be alert for personal hazards. C. look for drug paraphernalia. D. observe the scene for drug bottles.: B. be alert for personal hazards. 86.Heroin is an example of a(n): Select one: A. hypnotic. B. sympathomimetic.

18 / 38 C. cholinergic. D. opioid.: D. opioid. 87.How do poisons typically act to harm the body? Select one: A. By causing a slowing of nearly all bodily functions B. By changing the normal metabolism of cells or by destroying them C. By interfering with normal neurologic function D. By causing burns and damage to either external or internal organs: B. By changing the normal metabolism of cells or by destroying them 88.Hypotension, hypoventilation, and pinpoint pupils would be expected fol- lowing an overdose of: Select one: A. oxycodone (Percocet). B. ecstasy. C. amphetamine sulfate (Benzedrine). D. crack cocaine.: A. oxycodone (Percocet). 89.If the victim of a toxicologic emergency vomits, an EMT should. Select one: A. have the patient enclose the vomitus in a container and take it to the emergency department. B. not approach the vomitus. C. safely dispose of the vomitus as soon as possible and decontaminate the vehicle as necessary. D. use appropriate personal protective equipment and examine the vomitus for pill fragments or other clues for patient care.: D. use appropriate personal protective equipment and examine the vomitus for pill fragments or other clues for patient care. 90.In an apparent suicide attempt, a 19-year-old female ingested a full bottle of amitriptyline (Elavil). At present, she is conscious and alert and states that she swallowed the pills approximately 30 minutes earlier. Her blood pressure is 90/50 mm Hg, her pulse is 140 beats/min and irregular, and her respirations are 22 breaths/min with adequate depth. When transporting this patient, you should be MOST alert for: Select one: A. acute respiratory depression. B. seizures and cardiac arrhythmias. C. an increase in her blood pressure. D. a sudden outburst of violence.: B. seizures and cardiac arrhythmias.

19 / 38 91.Most poisonings occur via the route. Select one: A. injection B. absorption C. inhalation D. ingestion: D. ingestion 92.Of the four avenues of poisoning, generally is the most worrisome in terms of treatment to the EMS provider. Select one: A. injection B. absorption C. ingestion D. inhalation: A. injection 93.The recommended treatment for absorbed or contact poisons includes . Select one: A. neutralizing the poisonous substance with a chemical B. transporting the patient to the emergency department with the poisonous substance in place C. safely removing or diluting the poisonous substance D. collecting and transporting the poisonous substance to the emergency de- partment for identification: C. safely removing or diluting the poisonous substance 94.Victims of inhaled poisoning will require which of the following? Select one: A. Suctioning to clear the airway B. Transport to an emergency department for evaluation C. Ventilation with a bag-valve mask D. An oropharyngeal or nasopharyngeal device to maintain an airway: B. Transport to an emergency department for evaluation 95.When caring for a known alcoholic patient with severe trauma to the chest and abdomen, you should be concerned that: Select one: A. internal bleeding may be profuse because prolonged alcohol use may impair the blood's ability to clot. B. delirium tremens (DTs) are commonly induced by physical trauma and can lead to life- threatening seizures. C. long bone fractures are likely because chronic alcohol consumption weak- ens the structure of the bones. D. signs and symptoms of shock may be masked by the stimulant effects

20 / 38 produced by alcohol.: A. internal bleeding may be profuse because prolonged alcohol use may impair the blood's ability to clot. 96.Which of the following questions would be LEAST pertinent during the initial questioning of a patient who ingested a substance? Select one: A. How long ago was the substance taken? B. Why was the substance ingested? C. What type of substance was taken? D. How much of the substance was taken?: B. Why was the substance ingested? 97.Which of the following sets of vital signs would the EMT MOST likely encounter in a patient with acute cocaine overdose? Select one: A. BP, 180/100 mm Hg; pulse, 50 beats/min B. BP, 200/100 mm Hg; pulse, 150 beats/min C. BP, 190/90 mm Hg; pulse, 40 beats/min D. BP, 60/40 mm Hg; pulse, 140 beats/min: B. BP, 200/100 mm Hg; pulse, 150 beats/min 98.Which of the following statements regarding the Salmonella bacterium is correct? Select one: A. The Salmonella bacterium produces toxins that cause food poisoning. B. The Salmonella bacterium itself causes food poisoning. C. Symptoms of salmonellosis appear within 12 hours. D. Refrigeration of food will prevent salmonellosis.: B. The Salmonella bacteri- um itself causes food poisoning. 99.You and your paramedic partner are caring for a patient who ingested codeine, acetaminophen (Tylenol), and hydrocodone (Vicodin). The patient is unresponsive, his breathing is slow and shallow, and his pulse is slow and weak. Treatment for this patient should include: Select one: A. assisted ventilation and naloxone (Narcan). B. assisted ventilation and flumazenil (Romazicon). C. oxygen via a nasal cannula and atropine sulfate. D. high-flow oxygen via a nonrebreathing mask.: A. assisted ventilation and naloxone (Narcan).

100. You receive a call to a residence where a man found his wife unresponsive on the couch. The patient's respiratory rate is 8 breaths/min, her breathing is shallow, her heart rate is 40 beats/min, and her pulse is weak. The husband hands you an empty bottle of hydrocodone (Vicodin), which was refilled the

21 / 38 day before. You should: Select one: A. perform a rapid head-to-toe exam. B. apply oxygen via a nonrebreathing mask. C. ventilate her with a BVM. D. contact the poison control center.: C. ventilate her with a BVM.

101. A 38-year-old male with a history of schizophrenia is reported by neigh- bors to be screaming and throwing things in his house. You are familiar with the patient and have cared for him in the past for unrelated problems. Law enforcement officers escort you into the residence when you arrive. The patient tells you that he sees vampires and is attempting to ward them off by screaming and throwing things at them. He has several large lacerations to his forearms that are actively bleeding. The MOST appropriate way to manage this situation is to: Select one: A. try to gain the patient's trust by telling him that you see the vampires too. B. approach the patient and calm him by placing your hand on his shoulder. C. request that the police officers arrest him and take him to the hospital. D. restrain the patient with appropriate force in order to treat his injuries.: D. restrain the patient with appropriate force in order to treat his injuries.
102. A 40-year-old male intentionally cut his wrist out of anger after losing his job. Law enforcement has secured the scene prior to your arrival. As you enter the residence and visualize the patient, you can see that he has a towel around his wrist and a moderate amount of blood has soaked through it. You should: Select one: A. tell the patient that you want to help. B. calmly identify yourself to the patient. C. approach the patient with caution. D. quickly tend to the bleeding wound.: B. calmly identify yourself to the patient.
103. A behavioral crisis interferes with which of the following? Select one: A. Activities of daily living B. Behavior that is acceptable to the community C. Dressing, eating, or bathing D. All of these answers are correct.: D. All of these answers are correct.
104. A general impression of the patient is formed by an EMT: Select one: A. speaking privately with the patient. B. at a distance when the patient is first seen.

22 / 38 C. when the patient is in the ambulance. D. speaking with family members or bystanders first.: B. at a distance when the patient is first seen.

105. Everyone exhibits some signs and symptoms of mental illness at some point in life. Select one: A. and needs medication administered to control them B. but that does not mean a person is mentally ill C. because mental illness affects everyone D. and should be physically restrained for their own safety and the safety of the EMT: B. but that does not mean a person is mentally ill
106. From a mental health standpoint, an abnormal or disturbing pattern of behavior is a matter of concern if it lasts for at least: Select one: A. 3 weeks. B. 1 week. C. 1 month. D. 2 weeks.: C. 1 month.
107. Signs of excited delirium include: Select one: A. subdued behavior, crying, and suicidal thoughts. B. slurred speech, bradycardia, and a high fever. C. diaphoresis, tachycardia, and hallucinations. D. pallor, hypotension, and constricted pupils.: C. diaphoresis, tachycardia, and hallucinations.
108. The two basic categories of diagnosis that a physician will use for behav- ioral crises or psychiatric emergencies are. Select one: A. organic brain syndrome and altered mental status B. functional and nonfunctional C. physical and psychological D. All of these answers are correct.: C. physical and psychological
109. What is the most common misconception surrounding mental illness? Select one: A. Many mental illnesses stem from drug or alcohol abuse. B. Everyone has some form of mental illness. C. All persons with mental disorders are physically violent and dangerous. D. Feeling "bad" or "depressed" means that you must be "sick.": D. Feeling "bad" or "depressed" means that you must be "sick."

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110. When a psychiatric emergency arises, a patient is most likely to exhibit which of the following behaviors? Select one: A. Any behaviors that are a violent threat to the patient, EMTs, or others B. Disruptions to activities of daily living C. Visual or auditory hallucinations D. Any behaviors unacceptable to the patient, family, or community: A. Any behaviors that are a violent threat to the patient, EMTs, or others
111. When caring for a patient experiencing excited delirium, the EMT should remember that: Select one: A. most patients will have low blood pressure and hyperglycemia. B. lights and siren are effective in redirecting the patient's behavior. C. excited delirium is worsened by nervous system depressant drugs. D. sudden death can occur if the patient's violence is not controlled.: D. sudden death can occur if the patient's violence is not controlled.
112. Which of the following is a good guideline for physical examination of any patient? Select one: A. Always work toe-to-head. B. Complete the physical exam first, then check the ABCs. C. Examine extremities first. D. Avoid touching without permission.: D. Avoid touching without permission.
113. Which of the following is an example of a psychiatric emergency? Select one: A. A person who is depressed and no longer caring for himself B. A person going on a week-long "bender" after losing a job C. A person violently attacking family members D. A person who is experiencing a panic attack: C. A person violently attacking family members
114. Which of the following is considered an organic brain syndrome? Select one: A. Alzheimer dementia B. Schizophrenia C. Depression D. Anxiety conditions: A. Alzheimer dementia
115. Which of the following terms applies to a state of delusion in which the patient is out of touch with reality? Select one:

24 / 38 A. Agitated delirium B. Psychosis C. Schizophrenia D. Suicidal: B. Psychosis

116. Why might EMTs encounter a larger proportion of violent patients than the population at large? Select one: A. EMTs respond to patients who, by definition, are having an emergency. B. EMTs respond with law enforcement. C. It is a common misperception; EMTs do NOT encounter a larger proportion of violent patients than the population at large. D. EMTs have to restrain patients.: A. EMTs respond to patients who, by definition, are having an emergency.
117. You are assessing a 45-year-old female who is severely depressed. She states that it seems as though her entire world is crashing down around her. She further states that she has had frequent thoughts of suicide, but is not sure if she can actually go through with it. How should you manage this situation? Select one: A. Ask the patient if she has developed a suicidal plan. B. Have law enforcement place her in protective custody. C. Encourage the patient to remain quiet during transport. D. Leave the scene and have a neighbor check in on her.: A. Ask the patient if she has developed a suicidal plan.
118. You are attending to a 27-year-old patient with a history of depression. The patient's family tells you that she has been openly talking about harming herself and suicide, and they got scared when she tried to overdose on some medications. The patient did not take the pills and is alert and oriented. Despite all of your best efforts to convince her, the patient refuses to go to hospital for treatment. Based on this information, you should: Select one: A. call for the police to attend the scene and, once they arrive, release respon- sibility for patient transport to them B. ensure that the patient is competent and completes the required documen- tation, and leave her in the care of her family. C. stay with the patient while you arrange for other transport options as a potentially life-threatening emergency exists. D. restrain the patient and transport her to the hospital as she represents a

25 / 38 threat to her safety.: C. stay with the patient while you arrange for other transport options as a potentially life-threatening emergency exists.

119. You are attending to a 32-year-old male patient. The patient's wife tells you that he returned from Afghanistan last year. While he initially seemed fine, lately he has become withdrawn and distanced himself from his family and friends. He does not talk about it, but she knows that he has been having terrible nightmares that wake him up. The most appropriate question to ask regarding his experience in Afghanistan is: Select one: A. Can you tell me about your experience? B. Have you ever been diagnosed with PTSD? C. Were you shot at or under fire? D. Were you in combat?: C. Were you shot at or under fire?
120. You receive a call for a domestic dispute. When you arrive at the scene, you find a young male standing on the front porch of his house. You notice that an adjacent window is broken. The patient has a large body, is clenching his fists, and is yelling obscenities at you. Which of the following findings is LEAST predictive of this patient's potential for violence? Select one: A. The broken window B. His large body size C. His clenched fists D. His shouting of obscenities: B. His large body size
121. A 30-year-old male was rescued after being lost in the woods for approx- imately 18 hours. The outside temperature is 30°F (-1°C). He is immediately placed in the warmed ambulance, where you perform a primary assessment. He is unresponsive, pale, and apneic. You should: Select one: A. assess for a carotid pulse for up to 60 seconds. B. apply chemical heat packs to his groin and axillae. C. apply an AED and assess his cardiac rhythm. D. open his airway and give two rescue breaths.: A. assess for a carotid pulse for up to 60 seconds.
122. A 31-year-old male was bitten on the leg by an unidentified snake. The patient is conscious and alert and in no apparent distress. Your assessment of his leg reveals two small puncture marks with minimal pain and swelling. In addition to administering oxygen and providing reassurance, further care for this patient should include: Select one: