The Stress Response: Phases and Physiological Effects, Exams of Nursing

Download The Stress Response: Phases and Physiological Effects and more Exams Nursing in PDF only on Docsity! NR EMT FINAL EXAM 2024-2025 ACTUAL EXAM 200 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (100% CORRECT AND VERIFIED ANSWERS) |ALREADY GRADED A+ (BRAND NEW!!) Cushing's reflex includes increased blood pressure, bradycardia, and: (A) irregular respirations. (B) irregular pulse. (C) increased respirations. (D) pupil dilation. - ANSWER- (A) irregular respirations. FEEDBACK: Cushing’s reflex is indicative of a head injury with increased intracranial pressure (ICP). You delivered a full-term baby in the back of your ambulance and the initial APGAR score is 5. What treatment should you do? (A) CPR. (B) effective ventilation. (C) vascular access. (D) administration of epinephrine. - ANSWER- (B) effective ventilation. FEEDBACK: Most newborns respond favorably to warming, drying, suctioning, and stimulation. All of the following are phases of the stress response EXCEPT: (A) alarm reaction. (B) resistance. (C) exhaustion. (D) acceptance. - ANSWER- (D) acceptance. FEEDBACK: The 3 phases of the body's response to stress: (1) alarm reaction (fight-or-flight response) (2) resistance: the level of resistance to stress raises (3) exhaustion-as stress continues, coping mechanisms begin to fail Manual maneuvers used to open a client's airway (A) are contraindicated in most clients. (B) are difficult to perform. (C) include head-tilt/chin-lift and jaw thrust. (D) do not usually work without more extensive intervention. - ANSWER- (C) include head-tilt/chin-lift and jaw thrust. A client was struck in the head by a large tree branch while trimming a tree. The next day, he complains of dizziness and vomiting. You suspect? (A) an epidural hematoma. (B) a subdural hematoma. (C) a concussion. (D) a contusion. - ANSWER- (b) subdural hematoma. FEEDBACK:A subdural hematoma is usually due to rupture of small venous vessels. This type of bleeding is slow and the onset of symptoms may take several hours to develop after the injury. Supine hypotensive syndrome occurs from? (A) reduction of cardiac output due to compression of the aorta. (B) reduction of cardiac output due to compression of the inferior vena cava. (C) reduction of cardiac output due to compression of the superior vena cava. (D) the uterus pushing up on the diaphragm. - ANSWER- (B) reduction of cardiac output due to compression of the inferior vena cava. When caring for a child in respiratory distress, you hear a harsh high-pitched sound with each breath. What do you suspect? (A) stridor. (B) wheezing. (C) crackles. (D) rhonchi. - ANSWER- (A) stridor. The documentation of a baseline neurological status should NOT include which of the following: (A) Pulse oximetry (B) Response to sensory stimulation Which of the following can help determine possible injuries that may be sustained in an MVC? (A) Length of skid marks (B) Debris at the scene (C) Client symptoms (D) Mechanism of injury - ANSWER- (D) Mechanism of injury An elderly man is found outside. He is unconscious, unresponsive, apneic, and pulse less. His skin is cold to touch, his muscles are rigid, and his core body temperature is 89.6°F. What is the initial treatment? (A) CPR. (B) Turn the heat up in the ambulance (C) starting passive rewarming. (D) placing in a Trendelenburg position. - ANSWER- (A) CPR. FEEDBACK: CPR is indicated even if signs of death are present. A hypothermic client cannot be presumed dead until they are warm and dead. Remember hypothermia can cause Ventricular Fibrillation so rewarming needs to be done in a controlled setting. Injury to which abdominal organ is most likely to cause death in the pediatric client? (A) Pancreas (B) Liver (C) Spleen (D) Kidney - ANSWER- (B) Liver FEEDBACK:The liver is a solid, vascular organ in the RUQ. Rupture or laceration of the liver can cause severe hemorrhage. Injury to the liver is the most common abdominal injury that leads to death in the pediatric client. Which blood component transports oxygen? (A) plasma. (B) platelets. (C) leukocytes. (D) erythrocytes. - ANSWER- (D) erythrocytes. FEEDBACK:Also known as RBC's. Leukocytes are white blood cells and play a role in fighting infection. Platelets play a role in clotting. Plasma is the liquid that carries the cells throughout the body. Your assessment must be thorough when dealing with an intoxicated client because: (A) alcohol increases pain tolerance. (B) alcohol decreases the client's judgment. (C) alcohol is a CNS stimulant. (D) alcohol can mask signs and symptoms of injury. - ANSWER- (D) alcohol can mask signs and symptoms of injury. FEEDBACK: Alcohol is a central nervous system depressant and, therefore, can mask signs and symptoms of injury. What would you suspect in a 22yo female complaining of severe, stabbing, unilateral pain in the lower abdomen. Vital signs are BP 88/64, HR 128, RR 22. Her skin is cool and she missed her menstrual cycle. (A) a ruptured ectopic pregnancy. (B) endometriosis. (C) pelvic inflammatory disease. (D) amenorrhea. - ANSWER- (A) a ruptured ectopic pregnancy. FEEDBACK:The classic triad of symptom includes abdominal pain, vaginal bleeding, and amenorrhea. Other symptoms include referred pain to the shoulder, nausea, vomiting, or syncope. Signs of shock may be present if the ectopic ruptures. An indicator of severe abdominal trauma after an MVC may include: (A) absent bowel sounds. (B) back pain. (C) referred pain to the clavicle. (D) unexplained shock. - ANSWER- (D) unexplained shock. Shaken Baby Syndrome can cause which of the following conditions? (A) Hypoglycemia (B) Abdominal bruising (C) Subdural hematoma (D) Lower extremity fracture - ANSWER- (C) Subdural hematoma Which law protects an EMT if the EMT acts in good faith, is not negligent, acts within the scope of practice, and does not accept payment for service? (A) implied consent laws. (B) Good Samaritan laws. (C) malfeasance laws. (D) absolute immunity laws. - ANSWER- (B) Good Samaritan laws You arrive at a two car accident and the driver of the 1st car is unconscious. Consent for this client would be? (A) informed. (B) implied. (C) expressed. (D) involuntary. - ANSWER- (B) implied Organ responsible for insulin production. (A) adrenal (B) pancreas (C) thyroid (D) thymus - ANSWER- (B) pancreas Which federal agency regulates telecommunications in the United States? (A) FBI. (B) FDIC. (C) FCC. (D) FACEP. - ANSWER- (C) FCC. What is the rate of chest compressions for a two-year-old in cardiac arrest? (A) 80/minute. (B) 100/minute. (C) 110/minute. The Sellick maneuver (A) is used to clear a foreign body airway obstruction in an infant or child. (B) is used to clear blood or mucus from the nasopharynx. (C) may be used to minimize gastric distention. (D) is the preferred method for opening the airway of an unconscious client when cervical spine injury is suspected. - ANSWER- (C) may be used to minimize gastric distention. Posterior pressure exerted on the cricoid cartilage (the Sellick maneuver) will effectively compress the esophagus, minimizing the potential for gastric distention. This maneuver will also reposition the vocal cords for clearer visualization of anatomic structures A small child fell through ice when skating. After 20 minutes, the child is pulled out of the water apneic and pulseless. What is your first action? (A) keep the child cool to maintain the mammalian dive reflex. (B) defibrillate the child immediately. (C) pronounce the child dead at the scene. (D) secure the child's airway and control the cervical spine. - ANSWER- (D) secure the child's airway and control the cervical spine Since it is unknown if there are any c-spine injuries from the fall through the ice, you must secure the airway and control the cervical spine during resuscitation. What are the three parameters of the pediatric assessment triangle? (A) airway, breathing, circulation. (B) appearance, breathing, circulation. (C) airway, respiratory rate, pulses. (D) appearance, lung sounds, skin color. - ANSWER- (B) appearance, breathing, circulation. The pediatric assessment triangle is based on appearance, which includes mental status and muscle tone; breathing, which includes visible movement, effort, and audible sounds; and circulation, which includes skin color. All are obtained as part of the initial assessment to formulate a rapid determination of the child's stability. You arrive on the scene of a multiple vehicle crash. Upon arrival, each of the following actions are appropriate EXCEPT to: (A) establish scene command. (B) treat and transport the most critically ill client. (C) perform a scene size up. (D) control scene hazards. - ANSWER- (B) treat and transport the most critically ill client. The first unit to arrive on the scene should begin the scene size up which includes establishing command, calling for back-up units, controlling any hazards and locating and triaging clients. It would not be appropriate for the primary unit to locate and transport the most critically injured client. The large vessel of the body that carries oxygenated blood is the (A) coronary sinus. (B) pulmonary vein. (C) superior vena cava. (D) femoral vein. - ANSWER- (B) pulmonary vein Veins carry blood from the body back to the heart. The pulmonary vein carries oxygen-rich blood from the lungs back to the heart. Where should you place your hands on the chest of an adult victim when you are performing chest compressions? (A) On the top of the sternum (B) On the lower one-third of the sternum (C) On the lower half of the sternum, at the nipple line (D) Over the very bottom of the sternum - ANSWER- (C) On the lower half of the sternum, at the nipple line During your assessment, you find crepitus and instability to the right rib cage. Lung sounds are equal but there is paradoxical chest movement. You suspect: (A) a tension pneumothorax. (B) a massive hemothorax. (C) a flail chest. (D) an abdominal aneurysm. - ANSWER- (C) a flail chest Flail chest is defined as three or more adjacent ribs that are fractured in two or more places. This segment of the chest is free to move with the pressure changes of respirations. A high-pitched noise associated with upper airway constriction is known as (A) wheezes. (B) rhonchi. (C) stridor. (D) rales. - ANSWER- (C) Stridor Stridor is defined as a high-pitched sound associated caused by obstruction in the trachea or larynx. Which statement correctly relates to pediatric seizures? (A) Febrile seizures typically occur on the 1st day of a febrile illness and have tonic-clonic activity. (B) Always suspect a fever to be the cause of a seizure if the temperature is more than 101°F. (C) Infants and children between the ages of 4 months and 8 years commonly suffer from febrile seizures. (D) Febrile seizures do not require transport if the client can be cooled. - ANSWER- (A) Febrile seizures typically occur on the 1st day of a febrile illness and have tonic-clonic activity. A client was burned and has blisters to the chest, abdomen, entire right arm, and front of the right leg. According to the rule of nines, what is the percent of burns? (A) 40.5% (B) 36% (C) 45% (D) 31.5% - ANSWER- (B) 36% (chest = 9%, abdomen = 9%, entire arm 9%, front of the leg = 9%) When using the rule of nines for calculating burns, which of the following is a correct modification for a child? (A) The front of each arm for a child is 7% compared to 9% for an adult. Nasal flaring, elevated respiratory rate, grunting, and head bobbing all indicate respiratory distress. The development of poor muscle tone indicates the client is tiring and is an ominous sign of respiratory failure. The elements of a negligence claim include all of the following EXCEPT: (A) duty to act. (B) breach of duty. (C) code of conduct. (D) proximate cause. - ANSWER- (C) Code of conduct. The four elements of a negligence claim include: the duty to act, breach of duty, actual damages, and proximate cause. An incomplete or illegible client care report: (A) may be acceptable in some situations. (B) may cause subsequent caregivers to provide inappropriate treatment. (C) is of no use. (D) is useful in the ongoing care and treatment. - ANSWER- (B) may cause subsequent caregivers to provide inappropriate treatment. The accuracy and completeness of the client care report may have a significant impact on ongoing care and treatment of the client. What are the anatomical differences in the pediatric airway compared to the adult airway. (A) The airway diameter is larger, the larynx is more anterior, the tongue is proportionally smaller. (B) The airway diameter is larger, the larynx is more posterior, the tongue is proportionally smaller. (C) The airway diameter is smaller, the larynx is more anterior, the tongue is proportionally larger. (D) The airway diameter is smaller, the larynx is more posterior, the tongue is proportionally larger. - ANSWER- (C) The airway diameter is smaller, the larynx is more anterior, the tongue is proportionally larger. A 21-year-old female has open, midshaft fractures of her radius and ulna. Bleeding is severe. After applying direct pressure, which one of the following steps would be most appropriate to help control the bleeding? A.Place an occlusive dressing over the wound. B.Apply an ice pack to the wound. C.Straighten and splint the arm. D.Apply pressure to the distal radial artery pressure point. - ANSWER- C A 50-year-old male has suffered a deep laceration to his leg in an industrial accident and has lost a great deal of blood. You initiate hemorrhage control and stop the bleeding with a pressure dressing. You should next: A. administer high-concentration oxygen via nonrebreather mask. B. complete a rapid trauma assessment. C. initiate rapid transport. D. wrap the client in blankets to retain body temperature. - ANSWER- A What detrimental side effect occurs at the cellular level when the body's metabolism shifts from aerobic to anaerobic metabolism? A. Diminished liberation of lysosomal enzymes B. Hyperactivity of sodium/potassium pump C. Creation of high levels of ATP that damages cellular walls D. Lactic acid production - ANSWER- D A 70-year-old female is complaining of chest pain and shortness of breath. Which one of the following detailed assessment findings might be relevant to her current condition? A. Equal and reactive pupils B. Pedal edema C. Normal distal sensory and motor function D. Bruising on her forearms - ANSWER- B A 28-year-old female has ingested about 30 unknown pills. She is semiconscious and her vital signs are pulse 128, respiration 12, blood pressure 88/40. Poison control notes that activated charcoal should be administered. In this case charcoal is contraindicated because: A. the pills are unknown. B. she has an altered mental status. C. her blood pressure is too low. D. her breathing is too slow. - ANSWER- B A 17-year-old pregnant female presents with altered mental status. Her boyfriend notes she is 40 weeks pregnant with twins and states, "I can't wake her up." She presents confused and is flushed with obvious swelling in her hands and face. Her vital signs are pulse 90, respiration 28, blood pressure 200/112. What is the most likely immediate complication for this client? A. Stroke B. Internal bleeding C. Seizures D. Imminent delivery - ANSWER- C A one-year-old male has had a fever for three days and now has developed wheezing and severe respiratory distress. You notice his skin is hot and cyanotic around the lips. The client suddenly begins to seize. The most likely cause of the seizure in this client would be: A. fever B. toxic ingestion C. hypoxia D. epilepsy - ANSWER- C An adult female client was cooking when there was a flare up that resulted in burns to the following areas: entire chest, entire abdomen, and circumferential to lower part (elbow to hands) of both arms. Using the "rule of nines," what percentage of body surface area is burned on this client? A. 45% B. 18% C. 36% D. 27% - ANSWER- D. The "rule of nines" assigns the following percentages for an adult: head, 9%; chest, 9%; abdomen, 9%; upper back, 9%; lower back, 9%; each arm, 9%; each leg, 18%; and groin, 1%. Applying the rule of nines to this scenario gives us the following: smoking. During what stage of the fetal development would these habits have the greatest potential for malformation? A. Embryonic stage B. Fertilization C. Fetal stage D. Implantation - ANSWER- A A six-year-old male client is ventilated through a home respirator. You were called today because the client's oxygen saturations have been low. As you assess the client, you notice many secretions in the tracheostomy tube and gurgling on inhalation. You should: A. use positive pressure ventilations to clear the tracheostomy tube. B. ask the client's parents to assist you with suctioning the tracheostomy tube. C. contact medical control for instructions on suctioning a tracheostomy tube. D. attempt to suction the tube using a standard rigid suction catheter. - ANSWER- B You are caring for a pediatric trauma client who was not properly belted into their car seat and was thrown from the vehicle when it exited the road and rolled multiple times. Given what is known about pediatric trauma and pediatric arrest situations, if this client does go into cardiopulmonary arrest, what is the most likely cause of this? A. Uncontrolled hemorrhage B. Loss of airway patency C. Spinal trauma D. Loss of vascular tone - ANSWER- D A 26-year-old male is unconscious after a motor-vehicle crash. His airway is patent but he is breathing very rapidly. His respiratory rate is 58, and you notice he is slightly cyanotic. In this case the most important reason to initiate positive pressure ventilation is to: A. treat rising intracranial pressure. B. slow the respiratory rate. C. increase tidal volume. D. treat apnea. - ANSWER- C A client diagnosed with bone cancer will typically experience what other types of problem? A. Gastrointestinal distress B. Bone fractures C. Cardiac emergencies D. Respiratory distress - ANSWER- B You respond to a known hazardous-materials incident. A harmful gas has been released. Which one of the following describes the most appropriate placement for the ambulance? A. Down wind and downhill B. Down wind and uphill C. Upwind and uphill D. Upwind and downhill - ANSWER- C A 90-year-old female is complaining of sharp, steady abdominal pain. When you palpate her abdomen, you feel a pulsating mass in the lower left quadrant. This finding most likely indicates a(n): A. bleeding ulcer. B. enlarged spleen. C. aortic aneurism. D. bowel obstruction. - ANSWER- C Which one of the following reasons explains why you might have a higher index of suspicion for spine injury in a pregnant female compared to a nonpregnant female? A. Hormones released during pregnancy cause bones to become more brittle. B. Hormones released during pregnancy cause ligaments to stretch. C. The spinal column is stretched during pregnancy. D. A large fetus makes falling backwards more likely. - ANSWER- B Your client is a cross-country motorcycle racer who crashed his motorcycle into a group of trees. Although he was helmeted, he sustained blunt trauma to the anterior neck and is now dyspneic. Damage to what structure in the neck can cause airway occlusion and death to the client? A. Trachea B. Cervical vertebrae C. Mandible D. Larynx - ANSWER- D A 64-year-old male complains of steady abdominal pain radiating across both upper quadrants. He also complains of nausea. His vital signs are: pulse 100, respiration 20, blood pressure 158/90. Given his presentation, you should first: A. administer antacids to treat the nausea B. initiate transport to rule out acute myocardial infarction C. examine the abdomen more carefully to determine the cause of the pain D. conduct a thorough client history to identify prior medical conditions - ANSWER- B Which one of the following best describes why blind finger sweeps should be avoided in pediatric obstructed airway procedures? A. The upper part of the trachea is funnel shaped. B. The tongue is proportionately larger in pediatric clients. C. The windpipe is soft and pliable in pediatric clients. D. The mouth is much smaller in pediatric clients. - ANSWER- A During your pre-shift ambulance inspection, you notice that one of the box warning flashers has burnt out. You should: A. notify your relief of the problem and let them handle it. B. remove the light because it is not necessary. C. keep the ambulance in service and make an appointment with maintenance as soon as possible. D. immediately take the ambulance out of service and notify maintenance. - ANSWER- C After a particularly bad call involving a pediatric trauma arrest, you notice your partner to be extremely agitated, sweating, verbally aggressive, and pacing about the station muttering to himself. These findings may be indicative of what kind of stress reaction? A. Acute B. Delayed C. Progressive Which of the following is the highest priority client? - ANSWER- a. 57 year old male with chest pain and systolic blood pressure of 80 OPQRST - ANSWER- O-onset P-Provocation Q-quality R-Radiation S-Severity T-Time DCAP-BTLS - ANSWER- D- DEFORMITIES C-CONFUSIONS A-ABRASIONS P-PUNCTURES B-BURNS T-TENDERNESS L-LACERATIONS S-SWELLING SAMPLE - ANSWER- S-SIGNS AND SYMPTOMS A-ALLERGIES M-MEDICATION P-PAST PERTINENT HISTORY L-LAST ORAL INTAKE E-EVENTS LEADING TO INJURY AVPU scale - ANSWER- A-Alert V-Voice P-Pain U-Unresponsive Ecchymosis - ANSWER- bruising or discoloration The valve between right atrium and right ventricle is the ? - ANSWER- Tricuspid valve Glottis - ANSWER- opening between the pharynx and the trachea correct order of cardiopulmanary circulation - ANSWER- aorta, right ventricle, right atrium, pulmanary arteries, lungs, , pulmonary veins, left ventricle, left atrium, vena cava perfusion - ANSWER- the exchange of gases, nutrients and waste between the cells and the capillaries pericardium - ANSWER- The outer layer of the heart The myocardium is perfused by the? - ANSWER- coronary arteries The endocrine system is primarily responsible for doing which of the following actions? - ANSWER- Maintaining homeostasis in the body You arrive to find a 65-year-old male complaining of weakness. During your assessment, the client continues to ask you the same questions over and over again and begins to lapse in and out of consciousness. You also notice the client has become diaphoretic and tachycardiac. You believe this client is suffering from? - ANSWER- Hypoglycemia This client is presenting with altered mental status, sweating and increased heart rate, which are classic for hypoglycemia. You should immediately check the client's blood sugar. The spinal column is made up of how many cervical vertebrae? - ANSWER- There are 7 cervical vertebrae in the neck. 12 thoracic vertebrae. 5 sacral vertebrae, and 5 lumbar vertebrae. The disease resulting in demyelination of the neurons in the brain and spinal cord is known as? - ANSWER- Multiple Sclerosis, or MS, is a nervous system disease that results in demyelination of the neurons in the brain and spinal cord. It affects women more than men and symptoms usually appear between the ages of 20 to 40. You respond to a private residence for a 23-year-old male complaining of shortness of breath. As you place oxygen on the client, you gather a medical history from his mother. She states the client has a history of cystic fibrosis. Cystic Fibrosis, or CF, is a genetic disorder affecting which two systems? - ANSWER- Respiratory and Digestive If you are assessing the client's sense of smell, which cranial nerve is being tested? - ANSWER- Olfactory, I During pregnancy, what changes occur to the mother's body? - ANSWER- During pregnancy, the blood volume is going to increase to compensate for for the growing fetus. With that will come an increase in the heart rate, an increase in plasma volume and an increase in the stroke volume. Remember, stroke volume is the amount of blood expelled from the heart each time the heart beats. After arriving at the residence of a woman in active labor, you determine that the delivery is imminent. The mother is full-term and received prenatal care throughout her pregnancy. As an EMT, what is your biggest concern for the mother? - ANSWER- Blood loss You are assisting in the field delivery of a newborn. The head has just been delivered and you notice that the umbilical cord is wrapped tightly, several times around the newborn's neck. Which of the following would be the most appropriate primary action while attempting to free the cord from around the newborn's neck? - ANSWER- You should immediately try to unloop the cord from around the newborn's neck. If you are unable to free the cord, you will need to clamp and cut the cord. Never pull on the umbilical cord. In this situation, it is not appropriate to push the newborn back into the vagina. You have just helped deliver a healthy infant on the side of a highway. The mother's husband was driving her to the hospital when they had to pull over and call 911. You load the client onto the gurney and initiate transport. During transport, the placenta delivers. Following placental delivery, the client continues to experience vaginal bleeding. The bleeding persists despite performing a fundal massage. A blood loss of more than how many mL is considered life-threatening in this setting? - ANSWER- Blood loss of more than 500 mL after delivery of the placenta is considered life-threatening. The pediatric respiratory system differs from the adult system in several important aspects. Which of the following is not correct? - ANSWER- **Infants less than 1- month-old do not breath through their nose Very young infants have not yet developed the ability to breath through their mouth. You are managing a client who is in the process of delivering her full-term baby. When the baby's head emerges, you notice that the amniotic sac is still intact. What should you do? - ANSWER- You need to rupture the amniotic sac immediately. Do so gently with your fingers to avoid harm to the baby and then suction the airway. How does activated charcoal eliminate ingested poisons? - ANSWER- Through adsorption Which of the following changes would you most likely NOT see with a pregnant adult female? - ANSWER- Decrease in heart rate The fetus' umbilical cord is made up of how many arteries and how many veins? - ANSWER- 2 arteries and 1 vein Acrocyanosis refers to which of the following? - ANSWER- Pink core and cyanotic extremities Acro = extremity Cyano = blue Osis = condition of Your client is a 5-year-old male who hit his head on a rock after falling from a tree. Compared to an adult with head trauma, he is more likely to exhibit which of the following signs or symptoms? - ANSWER- It is relatively common for children to experience nausea and vomiting after head trauma. In adults, it usually only occurs in cases of severe trauma. The last stage of labor is called? - ANSWER- The placental stage Begins after the fetus is delivered and ends with the delivery of the placenta. Which of the following events occurs during the luteal phase of the menstrual cycle? - ANSWER- Menstruation You are called to a 36-year-old female who is having labor pains. She appears to be in active labor and as you inspect the vagina, she begins to bleed excessively prior to crowning. You should immediately? - ANSWER- Treat with high-flow O2 and rapid transportation. Place a sanitary napkin over the vaginal opening. Due to the potential for life-threatening hemorrhage, clients presenting with possible placenta previa should be treated for? - ANSWER- Clients with active hemorrhage should always be treated for shock. Which of the following is not an anatomically correct difference between adult and pediatric clients? - ANSWER- The trachea is more flexible in adults Respiratory Syncytial Virus - ANSWER- common pediatric illness that occurs during winter and early spring. It is characterized by cold-like symptoms early on that progress to moderate-to-severe respiratory symptoms including increased respiratory rate, wheezing, and respiratory distress. You are on scene with a 28-year-old female client involved in a head-on motor vehicle crash. She is 34 weeks pregnant. The engine company has placed your client in full C-spine precautions and she is ready to be transported. In what position should you transport your client? - ANSWER- Pregnant women should be transported the left lateral recumbent position. If you place a pregnant woman on her back, you risk causing supine hypotension (the weight of the fetus rests on the vena cava which prevents blood return to the heart). If your client is immobilized, slightly elevate the right side of the spinal board 4-6" above the left side. The second stage of labor begins after what has occurred? - ANSWER- Full dilation of cervix The most common reason for bradycardia in a newborn is? - ANSWER- Hypoxia In newborns, bradycardia is almost always an event secondary to hypoxia. In most cases, it can easily be reversed with positive-pressure ventilation. The most common cause of seizures in the pediatric client is? - ANSWER- Fever A fracture for which the bone is broken into more than two fragments is? - ANSWER- comminuted fracture A traumatic injury cause by fragments will most likely occur in what blast phase? - ANSWER- secondary The upper airway includes which of the following structures? - ANSWER- Nasopharynx, tongue, oropharynx and larynx How is the nasopharyngeal measured? - ANSWER- from the tip of the clients nose to the earlobe When assessing breathing, look for? - ANSWER- rate,rhythm, depth, effort - ANSWER- A 69-year-old female client complains of difficulty speaking and an inability to move her right arm. She notes the symptoms came on about two hours ago but have since subsided. She is most likely suffering from a(n): A. seizure. B. transient ischemic event C. acute stroke D. syncopal episode - ANSWER- B A 22-year-old female is having an asthma attack. She is 31 weeks pregnant. Which one of the following reasons explains why asthma might affect this client more profoundly than a nonpregnant client? A. Pregnancy creates high pressures in the cardiovascular system B. Pregnancy causes an increased blood volume C. Pregnancy causes slowed gastric motility D. Pregnancy increases the consumption of oxygen - ANSWER- D An 18-year-old male diabetic client has been sick for one week. His family states he has complained of nausea and vomiting, but has been taking his insulin properly. Today they note he is "acting drunk." You note the client is pale and diaphoretic and his vital signs are: pulse 116, respiration 28, blood pressure 132/80. What is the most likely cause of his condition? A. Sepsis B. Dehydration C. Hypoglycemia D. Hyperglycemia - ANSWER- C What term is used to describe the exchange of respiratory gases between the alveoli and the pulmonary capillary bed? A. Heart rate B. Respiratory rate C. Pulse oximeter D. Blood pressure - ANSWER- D You and your partner are checking your ambulance prior to your shift. Which one of the following oxygen cylinder pressures would be the minimum safe residual pressure for operational use? A. 2000 psi B. 1000 psi C. 500 psi D. 200 psi - ANSWER- D You are departing the scene of a 2 car MVC from which you are transporting a critical trauma client. Your partner is in the back and you are going to drive the ambulance to the hospital. As you conceptualize the route you wish to take to the hospital, which of the factors below is LEAST important to the actual route you'll take? A. Traffic patterns B. Freeway versus city road C. Road surface D. Travel time - ANSWER- B A mother states her seven-week-old infant has not been feeding well and may have had a fever over the last four days. The baby is listless, and when you examine his head, you notice its fontanels are sunken. What does this finding most likely indicate? A. Rising intracranial pressure B. Hypovolemia C. Traumatic brain injury D. Meningitis - ANSWER- B A 21-year-old male has been involved in a serious motor-vehicle crash. You begin your primary assessment in the vehicle as rescue crews prepare for mechanical extrication. After checking airway and breathing, you find spurting blood coming from a laceration on his leg. Your jump kit is outside the car. You should: A. wait for the client to be extricated to initiate bleeding control. B. immediately apply the tourniquet you carry in your pocket. C. use your gloved hand to initiate direct pressure. D. wait for a crew member to bring you a sterile dressing. - ANSWER- C You are addressing a person who is angry at you because his wife was pronounced dead on scene and he thinks you should have started treatment and transport. You are trying to gather specific client information from him so you can contact appropriate authorities. During this exchange, what client communication strategy could you possibly employ? A. Reflection B. Confrontation C. Anger D. Clarification - ANSWER- A A 31-year-old female has been found unconscious by the side of the road. Bystanders state that they do not know what happened. The client does not appear to be breathing. After ensuring scene safety, you should next: A. interview bystanders for further information. B. check her carotid pulse C. open her airway using a jaw-thrust maneuver. D. obtain a blood glucose level. - ANSWER- B Alveolar ventilation refers to the amount of: A. air that does not reach the alveoli during normal inhalation. B. carbon dioxide transferred from the blood to the alveoli each minute. C. air moved in and out of the alveoli per minute. D. oxygen transferred to the blood from the alveoli each minute. - ANSWER- C You and your partner are on a lunch break when you hear a scream from across the room: "My child is choking!" You immediately go to help. The mother quickly tells you she thinks the 10-month-old swallowed a coin. You note that the baby is cyanotic with no cough. What is the appropriate way to clear the obstruction? A. Try a blind finger sweep to dislodge the coin. B. Immediately attempt artificial ventilation. C. Use back slaps and chest thrusts. D. Deliver abdominal thrusts and back blows. - ANSWER- C You are caring for a 19 year old female who is complaining of an acute onset of abdominal pain with dizziness. You find the client to be tachypneic, tachycardic, nervous, and very scared. Skin is pale and diaphoretic. She admits to being sexually active, but "always" uses some type of prophylactic. Her last menstrual cycle was 25 days previously. Abdominal assessment is benign other than slight tenderness to palpation. The most likely reason for the client's pain is? A. Sexually transmitted disease B. Pelvic inflammatory disease C. Ectopic pregnancy D. Menstrual cramps - ANSWER- C A four-month-old male is in respiratory arrest. Before initiating positive pressure ventilations, you should: A. pad behind his occiput to place him in the sniffing position. B. pad behind his shoulders to account for his large occiput. C. flex his neck to put him in the neutral position. D. hyperextend his neck to open the airway. - ANSWER- B You and your partner are preparing to transport a 56-year-old man with hand pain. The client states he does not wish to sit on the stretcher and "just wants to sit on the bench." Your partner says, "Sure, that's fine." You should: A. tell your partner you are uncomfortable with transporting a client on the bench seat. B. require the client to lie flat on the bench seat and use multiple seat belts to secure him. C. transport the client on the bench seat and discuss your concerns with your partner later. D. be sure the bench seat has seatbelts and transport the client. - ANSWER- A A client has a gastrointestinal bleed that is resulting in a drop in his circulating blood volume. In order for the body to try and compensate for this volume loss while attempting to maintain adequate peripheral perfusion, what might the negative feedback systems of the body employ? A. before administering high-flow oxygen. B. only if there are obvious additional injuries. C. immediately following the primary assessment. D. only after transport has been initiated. - ANSWER- D A 20-year-old female complains of severe headache and photophobia. She notes she has had a fever and a stiff neck for the last two days. To manage this client you should first: A. complete a Cincinnati Prehospital Stroke Scale B. administer 324 mg of aspirin. C. turn down the lights in the ambulance D. don gloves and respiratory protection - ANSWER- D A 15-year-old male has been stabbed in the abdomen. As you examine the client's abdomen, you see a small loop of intestine protruding from the wound. After completing your client assessment, you should next: A. push the intestine back into the wound. B. cover the exposed intestine with moistened sterile dressing. C. apply an occlusive dressing over the wound. D. initiate rapid transport. - ANSWER- D A 21-year-old female states that she has taken 25 Librium capsules approximately 30 minutes ago. After completing a primary assessment and initiating transport, you should next: A. contact poison control. B. complete a detailed assessment. C. induce vomiting. D. administer activated charcoal. - ANSWER- A A 48-year-old female was recently prescribed an antibiotic. Upon taking her first pill, she noted watery eyes, itching, and now complains of shortness of breath. She is alert, her skin is flushed, and you hear wheezes bilaterally. Her vital signs are: pulse 110, respiration 30, blood pressure 112/74. You should first: A. conduct a detailed assessment. B. arrange for ALS to meet you en route to the hospital. C. contact poison control for further instructions. D. identify the type of pill she took. - ANSWER- B Given any type of cellular, digital, or radio communication between the EMS providers and dispatch, what is one consistent limitation across these technologies the EMT must be aware of and try to avoid in order to assure smooth communication occurs? A. Language barriers B. Dead batteries C. Dead spots D. High costs - ANSWER- C