Q&A Hero

Q: The most frequently transplanted organ is the: A) liver. B) heart. C) kidney. D) pancreas.

Q: You are dispatched to a private residence for a sick person. When you arrive you are told by the patient that due to the snow storm yesterday he missed his scheduled appointment at the dialysis center and is not feeling well. Your assessment does not reveal anything remarkable outside of the fact that he has missed his dialysis. Which of the steps below would NOT be part of your care? A) Assess the ABCs. B) When you obtain vital signs, obtain a blood pressure on an arm that does not have a fistula. C) Place the patient in a supine position. D) Administer oxygen at 15 lpm by nonrebreather mask.

Q: Why might you consider contacting medical direction before applying a tourniquet in the case of uncontrollable bleeding from an AV fistula? A) Damage to the fistula may occur. B) The patient may be in danger of losing the limb. C) Medical direction should be contacted before any use of tourniquets by the EMT. D) Hemodialysis anticoagulants may make bleeding more severe.

Q: Once you encounter uncontrolled bleeding from an AV fistula, which of the following methods would you consider using to control bleeding in addition to direct pressure and elevation? A) Internal wound management B) Tourniquet C) Hemostatic dressings D) Pressure points

Q: You are dispatched to an unconscious hemodialysis patient. On arrival to the dialysis clinic, the patient is unresponsive, apneic, and pulseless. You secure the ABCs, begin ventilation, and initiate chest compressions. However, the patient's cardiac arrest rhythm is continuously unresponsive to defibrillations with your AED. The best approach is to: A) call online medical control to terminate the code. The probability of survival is too low to continue resuscitation efforts. B) begin transporting and contact an ALS intercept. The patient's dysrhythmia may be related to kidney failure. C) run a "no-electricity" code in which compressions and ventilation are continued. No additional defibrillations are necessary. D) continue defibrillating as the monitor recommends. The myocardium becomes increasingly responsive to successive defibrillations.

Q: You are attending to an end-stage renal disease (ESRD) patient who has missed dialysis. Which of the following statements is most accurate? A) Patients who have missed dialysis and who become unresponsive and pulseless respond very well to the use of an AED. B) Patients who have missed dialysis and who become unresponsive and pulseless do not respond very well to the use of an AED. C) Calling for ALS would not be very helpful since they cannot really do anything that an EMT cannot do in these situations. D) You should delay transport if necessary to wait for ALS.

Q: A patient with renal disease who is currently on dialysis and missed an appointment may present with dangerously high levels of the electrolyte: A) phosphorous. B) potassium. C) sodium. D) calcium.

Q: One of the more serious diseases of the body is called renal failure. Renal failure occurs when the: A) adrenal glands stop working. B) kidneys fail to function as required. C) liver fails to function properly. D) pancreas stops working.

Q: Dialysis patients who have missed an appointment may present with signs of ________, which is a similar presentation to ________. A) pulmonary edema; congestive heart failure B) shortness of breath; pneumonia C) chest pain; acute myocardial infarction D) neurological disturbances; stroke

Q: Two chronic medical conditions that dialysis patients frequently have in addition to kidney failure are ________ and ________. A) blood clots; COPD B) high cholesterol; cerebral aneurysms C) heart failure; stroke D) hypertension; diabetes

Q: You are dispatched to a private residence for a sick person. You arrive and find a 47-year-old male patient who recently completed his peritoneal dialysis and complains of severe abdominal pain that is worsened by movement. One of the more serious complications of this type of dialysis is a bacterial infection within the peritoneal cavity. What would be the tell-tale sign that this is what is happening in this case? A) The patient's dialysis fluid appears cloudy when it is drained from the peritoneal cavity rather than its normal clear appearance. B) The patient's dialysis fluid appears clear when it is drained from the peritoneal cavity rather than its normal cloudy appearance. C) The patient has trouble urinating. D) The patient has swollen ankles.

Q: Patients who dialyze at home are at high risk for what type of infection? A) Peritonitis B) Decubitus ulcers C) Cellulitis D) Fistula infection

Q: How frequently does the majority of peritoneal dialysis require treatment? A) Three to five times a week B) Once a day C) Multiple treatments a day D) Once a week

Q: There are two main types of dialysis, hemodialysis and peritoneal dialysis. The main difference between them is hemodialysis: A) is usually done at a special facility and peritoneal dialysis is usually done at home. B) is usually done at home and peritoneal dialysis is usually done at a special facility. C) filters the blood and peritoneal dialysis filters the urine. D) filters the urine and peritoneal dialysis filters the blood.

Q: How many times a week do the majority of American hemodialysis patients receive treatment? A) Five B) Three C) Seven D) One

Q: How long does a typical hemodialysis treatment last? A) 7 to 8 hours B) 3 to 4 hours C) 1 to 2 hours D) 10 to 12 hours

Q: What is a cycle of filling and draining of the abdominal cavity during peritoneal dialysis called? A) Exchange B) Set C) Rotation D) Trade

Q: Peritoneal dialysis allows patients to dialyze at home through: A) a dialysis machine. B) the abdomen. C) an AV fistula. D) the urethra.

Q: Hemodialysis is used to help the kidneys filter ________ and remove excess ________. A) electrolytes; hormones B) urine; poisons C) blood; cholesterol D) toxins; fluids

Q: Approximately what percentage of United States dialysis patients treat themselves at home? A) 50% B) 8% C) 25% D) 16%

Q: Approximately how many Americans are currently on some type of dialysis? A) 200,000 B) 50,000 C) 100,000 D) 400,000

Q: You are dispatched to a sick call. The patient was just extricated from a bathtub where he was trapped under the shower door for 2 weeks. This 72-year-old male had limited access to water from the bathtub faucet. The patient is complaining of disorientation, nausea, and vomiting. What do you think is the underlying cause for the illness? A) Chronic renal failure B) End-stage renal disease C) Acute renal failure D) Gastrointestinal infection

Q: Which of the following pathologies make patients at high risk for acute renal failure? A) Polycystic kidney disease B) Shock C) Uncontrolled diabetes D) Hypertension

Q: The kidney's major function(s) include(s): A) maintaining blood volume. B) balancing electrolytes. C) excreting urea. D) All of the above

Q: What is one of the most common diseases to affect the renal and urinary system? A) Urinary tract infections B) Acute renal failure C) End-stage renal disease D) Kidney stones

Q: You are dispatched to a private residence for a 52-year-old African American male sitting in his living room complaining of chest pain. During your assessment, he discloses that he has the sickle cell trait. Because of this you should: A) administer high-concentration oxygen. B) monitor for signs of inadequate respiration. C) be prepared to treat for shock if he also has a high fever. D) treat the patient as any other 52-year-old with chest pain.

Q: Patients with a history of chronic sickle cell anemia (SCA) may present with which of the following signs and symptoms? A) Bluish discoloration of the skin and shortness of breath B) Yellowing of the skin and dyspnea on exertion C) Flushed appearance and shortness of breath D) Pale appearance and dyspnea on exertion

Q: A patient with a medical history of sickle cell anemia is complaining of chest pain and shortness of breath. The patient is breathing 26 times a minute in short, shallow respirations. However, the patient's oxygen saturation via pulse oximetry is 100% on room air. The best approach regarding supplemental oxygen is to: A) do nothing; no supplemental oxygen is necessary. B) place the patient on a nonrebreather mask. C) place the patient on a nasal cannula. D) place the patient on a simple face mask.

Q: You encounter a patient who has been having diffuse abdominal pain for one week. The patient has a pulse rate of 86, a blood pressure of 140/90, and a respiratory rate of 20. However, the patient appears pale, and complains of generalized weakness and shortness of breath during everyday activities. You suspect the patient is experiencing: A) anxiety disorder. B) chronic anemia. C) sickle cell anemia. D) acute anemia.

Q: Because of abnormally shaped hemoglobin, sickle cell anemia (SCA) patients may occasionally experience ________, causing a blockage of small blood vessels. A) sludging B) aggregation C) clotting D) clumping

Q: ________ patients are at high risk for acquiring the inherited disorder called sickle cell anemia. A) Native American B) African American C) Eastern European D) Hispanic

Q: Which of the following organs may seriously be damaged in sickle cell anemia, and often subsequently leads to severe infections? A) Lungs B) Kidneys C) Liver D) Spleen

Q: Certain drugs are commonly referred as "blood thinners" or drugs that inhibit clotting. Which of the following would NOT be considered such a drug? A) Coumadin (warfarin) B) Lovenox (enoxaparin) C) Aspirin D) Prilosec

Q: Platelets are actually fragments of larger cells that are crucial to the formation of clots. Clumping (called aggregation) of platelets is the body's most rapid response to stop bleeding from an injured site. However, in some situations the clumping of platelets is not desirable, such as when a plaque in a coronary artery ruptures. In this situation, the rapid clumping of platelets can cause a clot that then completely blocks the coronary artery and results in a heart attack (myocardial infarction). One of the most effective and widely available drugs to prevent the aggregation of platelets is: A) aspirin. B) plasma. C) hemoglobin. D) anemia.

Q: You suspect a patient who has been having a difficult time controlling the bleeding following a small laceration to the foot may have a history of: A) sickle cell anemia. B) taking blood thinners. C) high blood pressure. D) poorly controlled diabetes.

Q: Which of the following medications does NOT interfere with the blood-clotting process? A) Acetaminophen B) Warfarin C) Aspirin D) Clopidogrel

Q: What is the purpose of the red blood cells? A) They are responsible for the delivery of oxygen to the cells. B) They are responsible for the removal of oxygen from the cells. C) They are critical in response to infection and are mediators of the body's immune response. D) They are crucial in the formation of clots.

Q: The blood has many functions critical to a patient's health. Which one of the listed items below is NOT a function of the blood? A) Control of bleeding by clotting B) Delivery of oxygen to the cells C) Removal and delivery of other waste products to organs that provide filtration and removal, such as the kidneys and liver D) Removal of carbon monoxide from the cells

Q: Which of the following abbreviations is NOT correct? A) SCA for sickle cell anemia B) RBC for red blood cells C) WBC for white blood cells D) CAPD for continuous acute peripheral disease

Q: What is continuous ambulatory peritoneal dialysis? A) A gravity exchange process for peritoneal dialysis in which a bag of dialysis fluid is raised above the level of an abdominal catheter to fill the abdominal cavity and lowered below the level of the abdominal catheter to drain the fluid out B) A gravity exchange process for peritoneal dialysis in which a bag of dialysis fluid is lowered below the level of an abdominal catheter to fill the abdominal cavity and raised above the level of the abdominal catheter to drain the fluid out C) A mechanical process for peritoneal dialysis in which a machine fills and empties the abdominal cavity of dialysis solution D) A type of dialysis that is performed while walking

Q: How would you define anemia? A) An inherited disease in which a genetic defect in the hemoglobin results in abnormal structure of the red blood cells B) The loss of the kidneys' ability to filter the blood and remove toxins and excess fluid from the body C) The process by which toxins and excess fluid are removed from the body by a medical system independent of the kidneys D) A lack of a normal number of red blood cells in the circulation

Q: The sensation felt when palpating an arterial-venous fistula or shunt is known as a: A) bruit. B) frill. C) thrill. D) fluttering.

Q: The correct terminology used for patients whose kidneys are damaged to the point where they require dialysis to survive is: A) acute renal failure. B) end-stage renal disease. C) hepatic failure. D) terminal kidney disease.

Q: Your patient is a 22-year-old male who has ingested a large amount of alcohol and is vomiting. He is conscious but uncooperative. He allows you to examine him but refuses transport to the hospital. You have sought assistance from law enforcement on scene. Which of the following is the BEST action? A) Contact medical control for further advice. B) Stay with the patient until he has stopped vomiting. C) Find a relative or neighbor to come over and stay with the patient. D) Obtain a witnessed refusal.

Q: Your patient is a 24-year-old male who is severely depressed. He tells you that he can't "handle the pressure" anymore and that he wants to die. He is refusing transport. Which of the following is the most appropriate decision regarding this patient's care? A) Transport the patient against his will with the assistance of law enforcement. B) Contact the patient's family to find out what their wishes are. C) Leave the scene and allow law enforcement to handle the situation. D) Respect the patient's wishes; he is alert, oriented, and capable of giving consent.

Q: Which of the following situations generally allows the EMT to transport a patient with a behavioral emergency against his or her wishes? A) The patient's personal physician gives you permission. B) A family member gives consent and is willing to accompany the patient. C) The patient is a threat to himself or others. D) The patient's insurance company agrees to pay, even though the patient has not given consent.

Q: Which of the following is NOT an acceptable method or adjunct in restraining a patient? A) Hog-tying the patient B) Placing a surgical mask over the patient's face to prevent spitting C) Restraining the patient face-up D) Securing all four limbs with leather restraints

Q: It is important that, as an EMS provider, you avoid creating a situation where positional asphyxia could occur. Which of the following is positional asphyxia? A) Positional asphyxia is the position the person is seated in when you approach him. B) Positional asphyxia is a birth defect that causes psychiatric issues and is initiated because of the way the fetus was positioned in the uterus. C) Positional asphyxia is inadequate breathing or respiratory arrest caused by a body position that restricts breathing. D) Positional asphyxia is the name for the position someone assumes after she has been hit with a taser.

Q: When restraining a patient, which of the following is NOT a consideration? A) Number of people available to carry out the required actions B) Patient's size and strength C) Patient's informed consent D) How to position the patient

Q: Concerning behavioral emergencies, which of the following statements is true? A) Only a licensed psychiatrist can apply crisis management techniques with a patient having a behavioral emergency. B) A diabetic problem never mimics signs of a behavioral emergency. C) It is relatively easy to determine if the underlying cause of a behavioral emergency is related to drug abuse. D) A patient who does not respond to crisis management techniques may be restrained for transport to a psychiatric facility.

Q: Which of the following statements concerning forcible restraint of patients is true? A) It is easily accomplished by two EMTs with a good plan. B) This is necessary only with mentally ill individuals. C) It causes irreparable emotional harm to most patients. D) This is normally considered to be within the jurisdiction of law enforcement.

Q: You respond to the scene of a private residence for a patient who is a known insulin-dependant diabetic patient. The patient is combative and cursing as you approach. Should this patient be restrained? A) Yes, he likely has a medical condition that requires treatment. B) No, this patient is not likely experiencing a behavioral emergency. C) Yes, he is combative and all combative patients can be restrained. D) There is not enough information to answer this question.

Q: Your patient is a 37-year-old male sitting on the kitchen floor. His wife is attempting to talk with him, but he does not look at her or answer. He is fidgeting and has apparently thrown some dishes against the wall. What should be your first consideration? A) Ask the wife to step outside with you so you can get information from her. B) Ask the wife to step into the other room so you can speak with the patient alone. C) Quickly check the patient's carotid pulse. D) Stay a safe distance away.

Q: Which of the following does NOT indicate that a patient may be about to become violent? A) Tense body posture or clenched fists B) Crying C) Profane language D) Loud voice and rapid pacing

Q: You are dispatched to a suicide attempt. You arrive to find a 16-year-old, who is extremely agitated and pacing up and down in the living room of his house. Apparently, he had threatened to go out, get a gun, and shoot himself. The parents called it in as an attempted suicide. The scene is safe and there are apparently no weapons accessible to the patient. Which of the following would NOT be appropriate in caring for this patient? A) Do not take any action that may be considered threatening by the patient. To do so may bring about hostile behavior directed against you or others. B) Always be on the watch for weapons. C) Do not isolate yourself from your partner or other sources of help. D) Make certain the patient gets between you and the door. The patient should always feel he has an escape route.

Q: You are on the scene where a 23-year-old female has attempted suicide by cutting her forearms with a razor. She is sitting in the front yard and has lost a large amount of blood. She is conscious and holding a small razor blade, and tells you to get away from her. Which of the following should NOT be done? A) Use Body Substance Isolation (BSI). B) Keep bystanders away from the patient. C) Call law enforcement for assistance. D) Take the razor blade away from her by force.

Q: Which of the following statements concerning people who have made prior suicide attempts is true? A) They are at an increased risk for a subsequent successful suicide. B) They do not require psychological counseling like a person who is truly depressed. C) They should be allowed to sign a release if their injuries are not serious. D) They are usually just making a cry for help but do not want to die.

Q: You are called to the scene of an attempted suicide. You arrive to find a 25-year-old man sitting on the sofa who apparently cut his wrists. Family members have bandaged them, and there does not appear to be any bleeding risk at this time. The scene is secure. Which action would you NOT take in treating this patient? A) As soon as possible, perform a history and physical exam and provide emergency care on the wrist, if necessary. B) Perform a detailed physical exam only if it is safe and you suspect the patient may have an injury. C) Contact the receiving hospital and report on current mental status and other essential information. D) Make sure you take charge of the situation. Let the patient know that what he has done is wrong. Tell him he is coming with you whether he likes it or not. Do not worry about gaining the patient's confidence. Take charge. The patient must know that you are the boss.

Q: You have responded to a call about a "psychiatric patient" to find a 24-year-old woman talking to herself in her home. She is rocking back and forth and you can see from a distance that she is perspiring profusely. You also see an empty medication bottle on the floor. She does not acknowledge your presence. When you attempt to speak to her, she continues to talk to herself as if you were not there. Which of the following should be included in your actions at the scene? A) Distract her so your partner can look around the house. B) Look through the house with your partner to try to find some clues to the patient's problem. C) Ensure that law enforcement is responding and wait for their arrival. D) Shake the patient's shoulder to check for responsiveness to physical stimuli.

Q: When responding to an attempted suicide, which of the following is the EMT's primary concern? A) Personal safety B) Determining whether the patient suffers from clinical depression C) Contacting law enforcement since suicide is illegal D) Managing the patient's airway

Q: Management of the suicidal patient includes all of the following except: A) a physical examination. B) psychoanalysis of the patient by the EMT. C) a SAMPLE history. D) communication.

Q: Why is it important to gather a detailed medical history when dealing with a psychiatric emergency? A) It is not. You want to get the call resolved as quickly as possible and this will just delay it. B) It will alert you to past issues as well as medication. C) It will help you to determine if the police are needed. D) It will help you to determine if you need to restrain the patient.

Q: Which of the following patients would be considered to be at the greatest risk for suicide? A) 22-year-old man who has lost his job and is getting divorced B) 35-year-old female who has a child with a serious illness C) Married, 30-year-old man who has just learned that his employer is transferring him to a different state D) 44-year-old woman who has just recovered from a serious illness

Q: Which of the following factors suggest that a patient is at risk for suicide? A) Recent emotional trauma B) Sudden improvement in depression C) Alcohol and drug abuse D) All of the above

Q: Concerning attempted suicide, which of the following statements is true? A) Truly suicidal patients nearly always leave a note. B) All suicide attempts must be taken seriously, even if the method seems insincere. C) There is always an indication that a suicide attempt is imminent. D) Attempted suicide is a matter for law enforcement, not EMS.

Q: All of the following are general rules in dealing with a psychiatric patient except: A) speak slowly and clearly, and use a calm and reassuring tone. B) make eye contact with the patient. C) listen to the patient, showing you are listening by repeating part of what the patient says back to him. D) do not be judgmental; instead, show pity, as he needs to know that you understand him.

Q: You are dispatched to a local fast-food restaurant for a "nature unknown" call. You arrive on-scene and find a 47-year-old male in front of the counter repeatedly singing "Happy Birthday" to himself. Police are on-scene and the scene is safe. Which of the following would be considered appropriate care? A) Quickly approach the patient and take charge. Tell him he has to come with you to be evaluated. B) Quietly and carefully evaluate the situation and keep your emotions under control. Be as unhurried as you can. C) Have the police take charge, restrain the patient, and have him brought into your ambulance. D) Have your partner join you in approaching the patient and explain to him that he has to stop singing or you will have him arrested.

Q: Which of the following is the BEST defense for an EMT when facing allegations of misconduct from a mentally ill patient? A) Hiring a background investigator to discredit the accuser B) Having a clean employment record and lack of a criminal background C) Providing accurate and complete documentation, supported by a third-party witness D) Making sure you and your partner get your stories straight before talking to anyone

Q: Your patient is a 15-year-old female who has n diagnosed with a personality disorder. She has no history of violent behavior. The staff at her residential care facility wants her to be transported for evaluation of a possible urinary tract infection. Which of the following is the BEST way to handle this situation? A) Have a female EMT attend to the patient. B) Transport the patient, but do not speak to her or perform an assessment. C) Refuse to transport the patient without a police escort. D) Ask that the patient be given a tranquilizer injection prior to transport.

Q: Which of the following must be treated by the EMT if present in a patient with an apparent behavioral emergency? A) Acute alcohol intoxication B) Hypoglycemia C) Suicidal ideology D) Severe clinical depression

Q: Once you have established with reasonable certainty that your patient is suffering from a behavioral emergency, which of the following is the best course of action? A) Establish the best way to restrain the patient before he has the opportunity to become violent. B) Begin intense individual counseling with the patient. C) Attempt to determine if there is a possible physical cause for the patient's behavior. D) There is no need to assess for medical conditions if the patient does not have a history of past medical problems.

Q: You are dispatched to a psychiatric emergency for a 68-year-old male. Dispatch provides no other information and, when questioned by you, they do not have any more information. Although all steps are important in dealing with this situation, which step is the MOST important? A) Scene size-up B) Primary assessment C) Vital signs and SAMPLE history D) Secondary assessment

Q: Which of the following should NOT be included in documentation of an incident involving a patient with a behavioral or psychiatric emergency? A) Description of the patient's behavior B) Whether or not you think the patient is mentally ill C) Your observations of the patient's surroundings at the scene D) Your actions

Q: As an EMT, it is important that you be able to do all of the following except: A) control your own emotions when dealing with patients who say upsetting things to you. B) provide counseling and advice to patients with personal problems. C) ensure your safety and that of others at the scene. D) deal with a wide variety of emotions and behaviors.

Q: When providing emergency care to an aggressive or hostile patient, what is the highest priority? A) Checking the patient for possible physical causes of the behavior B) Finding out if the patient is oriented to person, time, and place C) Calming the patient down D) Performing a scene size-up

Q: Neurotransmitters are chemicals within the body that transmit the message from the distal end of one neuron (presynaptic neuron) to the proximal end of the next neuron (postsynaptic neuron). While it sounds like a complicated process, it takes only milliseconds. Which one of the following sentences is false? A) Neurotransmitters are released from a neuron, then travel across the synapse to the next neuron. B) The receptors on the postsynaptic neuron receive the neurotransmitter. C) This is the mechanism by which the impulse is moved along the nervous system. D) After the impulse is transmitted, the neurotransmitter goes through a process called reuptake, in which the neurotransmitter is returned to the postsynaptic neuron.

Q: Which of the following is appropriate when assessing an emotionally disturbed patient? A) Establish eye and verbal contact. B) Avoid arguing with the patient. C) Make it clear that you are in control of the situation, not the patient. D) Both A and B

Q: You are on the scene of a possible overdose. You find a 30-year-old man pacing about his living room. There is evidence of illicit drug use and the apartment is in disarray. The patient seems agitated and nervous. Attempts at calming the patient should include which of the following? A) Speak quickly to give the patient all of the important information without delay. B) Repeat part of what the patient is saying to show that you are listening to him. C) Stand still with your arms crossed to instill a sense of control and authority. D) Sit close to him with your arm around his shoulders to show that you are truly concerned.

Q: There are general rules when dealing with psychiatric emergencies. Which of the following is NOT one of those rules and would be considered inappropriate? A) Identify yourself and your role. B) Speak slowly and clearly, using a calm and reassuring tone. C) Never make eye contact with the patient, as it will just increase his nervousness. D) Listen to the patient. You can show you are listening by repeating part of what the patient says back to him.

Q: When dealing with a psychiatric emergency, which one of the following would generally be inappropriate behavior on your part? A) Be as hurried as you can. It is extremely important to resolve the call and get the patient to the hospital as soon as possible. B) Act in a calm manner, giving the patient time to gain control of his emotions. C) Let the patient know that you are listening to what he is saying, and explain things to the patient honestly. D) Stay alert for sudden changes in behavior.