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Q:
Which of the items below is NOTpart of the Cincinnati Prehospital Stroke Scale?
A) Test for equal grip strength.
B) Ask the patient to smile.
C) Have the patient repeat a simple sentence.
D) Test the patient for arm droop or lack of movement.
Q:
With advances in clot-busting (thrombolytic) drugs, the patient has a window of ________ hours to receive treatment.
A) 6
B) 4
C) 5
D) 3
Q:
A patient who demonstrates any one of the three symptoms from the Cincinnati Prehospital Stroke Scale has a(n) ________% chance of having an acute stroke.
A) 50
B) 60
C) 70
D) 80
Q:
Your patient is a 59-year-old female with a sudden onset of slurred speech and weakness on her right side. Which of the following measures is appropriate?
A) Test the patient's sensation with a series of pinpricks, beginning at the feet and working upward.
B) Keep the patient in a supine position.
C) Immediately transport the patient to a hospital with specialized treatment for stroke patients.
D) Administer oral glucose and then assess the patient's blood sugar.
Q:
Which of the following is NOT a sign or symptom of stroke?
A) Chest pain
B) Vomiting
C) Sudden impairment of vision
D) Seizure
Q:
When assessing a patient for a possible stroke, which of the following three functions should be tested by the EMT?
A) Memory, ability to speak, and ability to track movement with the eyes
B) Ability to walk, control of facial muscles, and balance
C) Control of facial muscles, ability to speak, and ability to hold both arms in an extended position for 10 seconds
D) Ability to walk, ability to hold both arms in an extended position for 10 seconds, and ability to name common objects
Q:
Which of the following is a standardized test to evaluate a conscious patient for possible stroke?
A) Michigan TIA Assessment
B) The Numbness-Aphasia-Paralysis (NAP) Test
C) Cincinnati Prehospital Stroke Scale
D) The Functional Analysis Stroke Test
Q:
You have arrived on the scene of a call for a possible stroke. On your arrival, the patient denies signs and symptoms, is alert and oriented, and moves all extremities well. Her husband states that before you arrived the patient could not move her right arm and the left side of her face seemed to be "slack." Which of the following has most likely occurred?
A) The patient suffered a stroke.
B) The patient is suffering from aphasia.
C) The patient has had a subarachnoid hemorrhage.
D) The patient suffered a transient ischemic attack.
Q:
Your patient is a 70-year-old man whose wife called EMS because her husband began exhibiting unusual behavior. Upon your arrival you introduce yourself to the patient, who responds, "Not until nine o'clock." This phenomenon is BEST described as:
A) receptive aphasia.
B) disorientation to time.
C) unresponsive to verbal stimuli.
D) expressive aphasia.
Q:
Which of the following is one of the most common characteristics of a stroke?
A) Weakness on one side of the body
B) Projectile vomiting
C) Sudden onset of bizarre behavior
D) Sudden, severe headache
Q:
Which of the following is the cause of most strokes?
A) A spasm in an artery supplying part of the brain
B) A ruptured cerebral artery due to an aneurysm
C) A ruptured cerebral artery due to hypertension
D) Blockage of an artery supplying part of the brain
Q:
Treatment of someone with a seizure disorder includes all of the following except:
A) placing the patient on the floor or ground.
B) loosening restrictive clothing.
C) placing a bite block in the patient's mouth so he does not bite his tongue.
D) removing objects that might harm the patient.
Q:
Which of the following is the most critical piece of equipment to have immediately available for the seizure patient who has just stopped convulsing?
A) Suction
B) Cervical collar
C) Glucometer
D) Bite block
Q:
Which of the following is LEAST important for the patient who has stopped seizing before the EMT's arrival at the scene?
A) Checking for mechanism of injury
B) Requesting advanced life support
C) Suctioning
D) Administering oxygen
Q:
Your patient is a 21-year-old female with a history of epilepsy. She is having a convulsion upon your arrival. Which of the following should you do?
A) Insert a bite block, cloth, wallet, or similar item between the patient's teeth to prevent her from biting her tongue.
B) Move furniture and other objects away from the patient to prevent injury.
C) Restrain the patient's extremities to prevent injury from flailing of the arms and legs.
D) Place a tongue depressor or spoon in the back of the mouth to prevent the patient from swallowing her tongue.
Q:
You respond to a 32-year-old female who is having a seizure. You arrive on the scene to find the patient drowsy, confused, and complaining of a headache. This patient is demonstrating the:
A) aura phase.
B) clonic phase.
C) postictal phase.
D) tonic phase.
Q:
Which of the following is the LEAST important question in obtaining the history of a seizure patient in the prehospital setting?
A) How did the patient behave during the seizure?
B) Did the patient lose control of his bladder?
C) Does the patient have a family history of seizures?
D) What was the patient doing before the seizure?
Q:
Which of the following is a typical cause of seizures in children 6 months to 3 years of age?
A) Administration of glucose to a hyperglycemic patient
B) Fever
C) Asthma
D) Chest pain
Q:
Your patient is a 19-year-old female who is 7 months pregnant. She just experienced a seizure. Although she has no previous history of seizures or any other medical condition, she was just diagnosed with pregnancy-induced hypertension. Which of the following is the most likely cause of the seizure?
A) Trauma
B) Hypoglycemia
C) Eclampsia
D) Any of the above
Q:
Which of the following is the most common cause of seizures in adults?
A) Failure to take prescribed medication
B) Withdrawal from alcohol
C) Fever
D) Head trauma
Q:
The signs and symptoms of a transient ischemic attack (TIA) may last up to:
A) 1 hour.
B) 30 minutes.
C) 24 hours.
D) 6 hours.
Q:
What is epilepsy?
A) A condition in which a person has multiple seizures usually controlled by medication.
B) A condition in which a person has an aura followed by seizure usually controlled by medication.
C) A condition caused by congenital brain abnormalities that causes seizures only twice a year.
D) A condition in which a person has general seizures that start in childhood.
Q:
Which statement below is NOT true about seizures?
A) A partial seizure affects one part, or one side, of the brain.
B) A generalized seizure affects the entire brain.
C) The most common seizure that EMTs are likely to be called on is a tonic-clonic seizure.
D) Many seizures are followed by an aura.
Q:
Which of the following refers to difficulty in speaking or understanding speech as a result of a stroke?
A) Hemiparesis
B) Ischemia
C) Ataxia
D) Aphasia
Q:
A seizure that occurs spontaneously from an unknown cause is called:
A) toxinic.
B) hypoxic.
C) idiopathic.
D) hypoglycemic.
Q:
Which of the following conditions may be mimicked by hypoglycemia?
A) Intoxication
B) Respiratory distress
C) Heart attack
D) All of the above
Q:
Many diabetics today have an insulin pump. Which of the following statements about insulin pumps is NOT true?
A) They are about the size of an MP3 player or a pager.
B) They are usually worn on the belt.
C) They have a catheter that enters into the abdomen.
D) They are usually worn around the ankle.
Q:
Which of the following would be an acceptable substitute for the administration of commercially prepared oral glucose solution?
A) Having the patient eat a banana
B) Diet soda
C) Having the patient eat something high in protein, such as a deli sandwich
D) Cake icing
Q:
Which of the following is within the EMT's scope of practice for the treatment of the diabetic patient?
A) Assisting the patient with the administration of his insulin
B) Administration of oral glucose
C) Rectal administration of glucose
D) Both A and B
Q:
For the EMT, which of the following is the most important question to ask of a diabetic patient or his family members?
A) When was the last time you had something to eat?
B) Do you have a fruity taste in your mouth?
C) Do you have a family history of diabetes?
D) What kind of insulin do you take?
Q:
Your patient is an unresponsive 30-year-old male wearing a Medic-Alert bracelet indicating that he is a diabetic. The patient's coworkers came by his house to check on him when he did not show up for work and did not call in sick. Your assessment does not clearly indicate to you whether the patient may be hypoglycemic or hyperglycemic. Which of the following should you do next?
A) Apply oxygen and begin transport without taking further action.
B) Use your glucometer to check his blood sugar level.
C) Use the patient's glucometer to check his blood sugar level.
D) Administer oral glucose, as it will not cause additional harm in hyperglycemia, but may prevent brain damage if the patient is hypoglycemic.
Q:
Your patient is a 44-year-old male with a history of diabetes. He is lying on the living room floor, unresponsive to all stimuli. He has a respiratory rate of 12 breaths per minute, heart rate of 112 beats per minute, and is pale and sweaty. Which of the following should you do to treat this patient?
A) Encourage the patient's family to administer his insulin.
B) Apply oral glucose solution to a tongue depressor and insert it between the patient's cheek and gums.
C) Place the patient in the recovery position to protect the airway and place oral glucose solution under the patient's tongue.
D) Place the patient in the recovery position, administer oxygen, and monitor his airway status.
Q:
Which of the following blood glucose levels is considered normal for an adult?
A) 80 mg/dL
B) 40 mg/dL
C) 180 mg/dL
D) 150 mg/dL
Q:
Compared to hypoglycemia, which of the following is true of hyperglycemia?
A) Its onset is more sudden.
B) Its onset is more gradual.
C) Its onset is preceded by an aura, such as hallucinations or detecting unusual odors.
D) It is more easily treated in the prehospital environment than hypoglycemia.
Q:
Which of the following may result in hypoglycemia in the diabetic patient?
A) Failure to take insulin or oral diabetes medications
B) Lack of exercise
C) Vomiting after eating a meal
D) Overeating
Q:
Most of the diabetic emergencies that you will be called to deal with will be related to hypoglycemia. However, occasionally you will experience an instance of hyperglycemia. In the list below, which item is NOTlikely to be a sign or symptom of hyperglycemia?
A) Chronic thirst
B) Excessive urination
C) Reduced rate of breathing
D) Nausea
Q:
When someone is experiencing hypoglycemia, the body attempts to compensate by using the fight-or-flight mechanism of the autonomic nervous system. Which one of the statements below is NOT one of the fight-or-flight responses?
A) Blood vessels constrict.
B) The heart pumps faster.
C) Breathing accelerates.
D) The skin is hot and dry.
Q:
Looking at the following list, which of the items does NOT correctly compare the signs and symptoms of hypoglycemia and hyperglycemia?
A) Hyperglycemia usually has a slower onset than hypoglycemia.
B) Hyperglycemic patients often have warm, red, dry skin, whereas hypoglycemic patients have cold, pale, moist, or clammy skin.
C) The hyperglycemic patient often has acetone breath, whereas the hypoglycemic patient does not.
D) The hypoglycemic patient is usually complaining of a headache, whereas the hyperglycemic patient is not.
Q:
Which of the following is NOT a sign of a hypoglycemic diabetic emergency?
A) Combativeness
B) Slow heart rate
C) Anxiety
D) Cold, clammy skin
Q:
The most common medical emergency for the diabetic is hypoglycemia, or low blood sugar. Which one of the factors below is NOTa cause of hypoglycemia?
A) Takes too much insulin
B) Reduces sugar intake by eating too much
C) Overexercises or overexerts himself
D) Vomits a meal
Q:
As an EMT, you will be called on frequently to treat diabetic emergencies. Diabetic emergencies are usually caused by:
A) poor management of the patient's diabetes.
B) falls.
C) hypoxia.
D) pancreatitis.
Q:
Which of the following is characteristic of a patient with hyperglycemia?
A) Use of excessive amounts of insulin or lack of adequate food intake
B) A "fruity" odor of the breath
C) Cool, moist skin, agitated behavior, and increased heart rate
D) Sudden onset of altered mental status
Q:
If the blood sugar level is very high, which of the following may result?
A) Excessive urination, excessive thirst, and excessive hunger
B) Polyuria and hyperactivity
C) Excessive insulin, excessive glucose, and excessive urination
D) Hyperactivity, excessive thirst, and polyuria
Q:
Which of the following is an action of insulin?
A) It increases the transfer of sugar from the stomach and small intestine to the bloodstream.
B) It increases the movement of sugar from the bloodstream to the cell.
C) It increases the circulating level of glucose in the blood.
D) It blocks the uptake of sugar by the body's cells.
Q:
Which of the following is the role of glucose in the body?
A) It assists the pancreas in the manufacture of insulin.
B) It provides energy for brain cells and other cells in the body.
C) It allows the body to use insulin.
D) It is an essential building block for body tissues, such as muscle and bone.
Q:
During your primary assessment you find your patient has an altered mental status. This could indicate which of the following?
A) Failing respiratory system
B) Problems with the RAS due to hypertension
C) The need for suctioning of the airway
D) The need to complete a secondary assessment
Q:
Normal consciousness is regulated by a series of neurologic circuits in the brain that comprise the reticular activating system (RAS). The RAS has simple requirements to function properly. Which one of the following items is NOT one of those requirements?
A) Oxygen
B) Glucose
C) Water
D) Sodium
Q:
For the reticular activating system (RAS) to work correctly, what three substances are needed?
A) Oxygen to perfuse brain tissue, insulin to nourish brain tissue, and sodium to keep the brain hydrated
B) Oxygen to perfuse brain tissue, insulin to nourish brain tissue, and water to keep the brain hydrated
C) Oxygen to perfuse brain tissue, glucose to nourish brain tissue, and sodium to keep the brain hydrated
D) Oxygen to perfuse brain tissue, glucose to nourish brain tissue, and water to keep the brain hydrated
Q:
Your patient is a 25-year-old female with a history of diabetes. She is confused, agitated, and verbally abusive to you, and she is very sweaty. Although she refuses to give a history of the present illness, you should suspect which of the following as the likely cause of the patient's presentation?
A) Failure to take her insulin
B) A nondiabetic-related problem, such as a head injury or mental illness
C) Failure to intake sufficient sugar
D) Excessive intake of foods high in sugar, such as soda or candy
Q:
The condition in which there is an insufficient amount of sugar in the blood is called:
A) diabetic coma.
B) hypoglycemia.
C) hyperglycemia.
D) diabetic ketoacidosis.
Q:
There are two types of seizures; if your patient is having a seizure that affects only one body part and does not cause her to lose consciousness, it is called a:
A) tonic-clonic seizure.
B) generalized seizure.
C) postictal seizure.
D) partial seizure.
Q:
A hormone called insulin is secreted by the:
A) islets of Langerhans in the liver.
B) gallbladder found in the pancreas.
C) islets of Langerhans in the pancreas.
D) None of the above.
Q:
The death of brain tissue due to deprivation of oxygen because of a blocked or ruptured artery in the brain is known as which of the following?
A) Transient ischemic attack
B) Stroke
C) Aphasia
D) Seizure
Q:
Your patient is waking up from a seizure; it was the patient's first seizure ever. When you ask what happened, the patient tells you she had the smell of fresh mown grass just before she seized. This sensation is known as a(n):
A) tonic phase.
B) postictal phase.
C) clonic phase.
D) aura.
Q:
Which of the following BEST describes status epilepticus?
A) A seizure involving convulsions on only one side of the body
B) A seizure that occurs without a known cause
C) A period of drowsiness following tonic-clonic seizures
D) Two or more seizures with tonic-clonic activity without an intervening period of consciousness
Q:
The medical term for fainting is:
A) syncope.
B) altered RAS status.
C) dehydration.
D) vertigo.
Q:
Mechanical CPR devices are used by EMS agencies in order to provide ________.
A) a 100% success rate
B) a faster response time to the scene
C) high-quality compressions
D) more efficient breaths
Q:
Which of the following BEST describes the purpose of a continuous quality improvement program for AED?
A) Taking disciplinary action for patient care errors
B) Eliminating the need for medical direction
C) Replacing continuing education
D) Improving patient outcomes in the community
Q:
Which of the following patients should have an automated external defibrillator applied?
A) A 67-year-old man with severe, crushing chest pain that is not relieved by nitroglycerin
B) A 6-month-old in severe respiratory distress
C) A 19-year-old college athlete who collapsed during football practice and is pulseless and apneic
D) A 40-year-old female in cardiac arrest due to chest injuries sustained in a motor vehicle crash
Q:
Automatic defibrillation is NOT appropriate in most cases of infant cardiac arrest due to which of the following?
A) Ventricular fibrillation is not the primary cause of cardiac arrest in the pediatric patient.
B) The energy delivered by the AED would not be effective on an infant.
C) AEDs cannot effectively determine rhythms on patients weighing less than 20 pounds.
D) None of the above
Q:
In which of the following ways does cardiac arrest in children differ from cardiac arrest in adults?
A) Cardiac arrest in children is more likely to be due to respiratory failure.
B) Ventricular fibrillation is common in children.
C) Ventricular fibrillation is not common in adults.
D) Cardiac arrest in adults is more likely to be due to respiratory failure.
Q:
You are on the scene of a 65-year-old female patient in cardiac arrest. CPR is in progress and the AED has been applied. The AED does not advise shock. What is your next intervention?
A) Stop CPR and place the patient in the recovery position.
B) Insert a Combitube.
C) Continue CPR.
D) Replace the malfunctioning AED.
Q:
Your patient is a 66-year-old female who has regained a pulse after a shock with an AED; however, she remains unresponsive and is not breathing adequately. Which of the following should be done next?
A) Assist ventilations with a bag-valve-mask device and supplemental oxygen and anticipate that the patient may go back into cardiac arrest.
B) Deliver a fourth shock to improve the patient's respiratory status.
C) Remove the AED and assist the patient's ventilations with a bag-valve mask and supplemental oxygen, and keep re-assessing the pulse.
D) Apply a nonrebreather mask with high-concentration oxygen and keep reassessing the pulse.
Q:
You are the first on the scene of a 72-year-old patient in cardiac arrest. You have your medical supply kit, oxygen, and an AED. At least 4 to 5 minutes of high-quality CPR has been provided by the police officer who arrived before you. You have confirmed an open airway, apnea, and pulselessness. Which of the following should you do next?
A) Perform one-rescuer CPR until additional personnel arrive.
B) Apply the defibrillator pads and shock as indicated.
C) Perform bag-valve-mask ventilations with supplemental oxygen for 30 seconds before applying the defibrillator pads.
D) Contact medical direction before taking any action.
Q:
You are on the scene of a 65-year-old female patient in cardiac arrest. CPR is in progress and the AED has been applied. The AED advises shock. After defibrillating the patient, what is your next intervention?
A) Place in the recovery position.
B) Insert a Combitube.
C) Check for a pulse.
D) Continue CPR.
Q:
You are transporting a 50-year-old male patient whom you successfully defibrillated at the scene. You are 5 minutes away from the hospital when the patient goes back into cardiac arrest. Which of the following is the best course of action?
A) Analyze the cardiac rhythm and deliver shocks as necessary.
B) Tell the driver to stop, analyze the cardiac rhythm, and deliver a shock as necessary.
C) Tell the driver to stop and assist you with CPR, and request another unit for assistance.
D) Initiate CPR and continue transporting.
Q:
Which of the following BEST describes an appropriate shock sequence for the patient in pulseless VT?
A) Shock, 2 minutes of CPR, analyze, shock again
B) Shock, shock, shock, pulse check, 2 minutes of CPR, shock, shock, shock
C) Shock, pulse check, shock, pulse check, shock, pulse check
D) Shock, shock, shock, shock
Q:
Which of the following people is allowed to continue providing patient care when the patient is to be "cleared" for delivery of a shock via the defibrillator?
A) The EMT performing bag-valve-mask ventilations
B) The provider who is ventilating the patient, so long as the patient has been intubated by a paramedic so the provider does not directly touch the patient
C) Anyone in contact with the patient below the level of the patient's knees
D) None of the above
Q:
When using an AED, which of the following people is responsible for calling to "clear" the patient before delivering a shock?
A) EMT supervising bystanders
B) EMT operating the defibrillator
C) EMT managing the airway
D) EMT doing chest compressions
Q:
Your patient is a 44-year-old female who has collapsed while jogging. She has been unresponsive for 4 to 5 minutes by the time you arrive. Her husband appears to be performing high-quality CPR. Which of the following should be your first action?
A) Insert an oropharyngeal airway and begin ventilations.
B) Load the patient into the ambulance for further assessment.
C) Apply the AED.
D) Stop CPR and check for a pulse.
Q:
Which of the following is NOT a reason that an AED may indicate that there is "no shock advised?"
A) The patient's heart has no electrical activity; he is "flat line," or in asystole.
B) The patient's heart rhythm is normal.
C) The patient has organized electrical activity in the heart but no pulse.
D) The patient is in ventricular fibrillation or pulseless ventricular tachycardia.
Q:
Which of the following should NOT be done during defibrillation?
A) Pressing the defibrillation pads firmly to the chest to ensure good contact
B) Continued ventilation during the analysis phase to prevent hypoxia
C) Shaving the chest before placing the defibrillation pads to improve contact
D) Performing CPR while the AED is being attached
Q:
Defibrillation is indicated for which of the following situations?
A) Pulseless electrical activity
B) Pulseless bradycardia
C) Asystole
D) Pulseless ventricular tachycardia
Q:
You arrive on-scene of a 56-year-old female patient in cardiac arrest. What is the first airway you should administer?
A) Nasopharyngeal airway (NPA)
B) Oropharyngeal airway
C) Combitube
D) Pharyngeal-Tracheal Lumen airway
Q:
All of the following are elements of adult high performance CPR, except:
A) compression rate of at least 100 per minute.
B) spending half of each compression on the downstroke and half on the upstroke.
C) taking no more than 1 second to deliver each ventilation.
D) compressing the patient's chest about 1 inch in depth before allowing full relaxation.
Q:
You are on the scene of a 68-year-old male patient complaining of severe chest pain for the last 20 minutes. He has a previous history of myocardial infarction and states it feels "just like the last time." You have applied oxygen and assisted him in administering aspirin and nitroglycerin with no reduction in the chest pain. Your nearest facility is 5 minutes away, a Level III Trauma Center is 10 minutes away, and a hospital with cardiac catheterization capabilities is 20 minutes away. The patient is requesting to be transported to his cardiologist's hospital, which is 30 minutes away. Which hospital is the best destination?
A) The nearest facility
B) The trauma center
C) The hospital the patient requests
D) The nearest hospital with cardiac catheterization
Q:
Which of the following is NOT a role of the EMT in providing emergency cardiac care?
A) CPR
B) Early defibrillation
C) Administration of epinephrine
D) Airway management
Q:
Which of the following BEST describes the continued need for prehospital advanced cardiac life support, even when EMTs in the community carry AEDs?
A) Not all cardiac arrests are due to problems that respond to defibrillation.
B) The patient may need medications to support his cardiac rhythm and blood pressure prior to attempting defibrillation.
C) In cases of refractory or recurrent ventricular fibrillation, the use of medications may decrease the chances of defibrillating successfully.
D) All of the above
Q:
Which intervention is proven to be the most effective is obtaining a return of spontaneous circulation (ROSC) in a cardiac arrest patient?
A) Combitube
B) Early CPR
C) High-concentration oxygen by bag-valve mask
D) Early defibrillation
Q:
Which of the following BEST describes the EMT's intended role in the ideal provision of emergency cardiac care?
A) Early notification
B) Early advanced cardiac life support
C) Early defibrillation
D) Early CPR