Q&A Hero

Q: You are unsure if a patient's condition requires the administration of an epinephrine auto-injector. Which of the following actions is most appropriate? A) Ask a family member if this is the type of situation when the patient usually takes his auto-injector. B) Administer the epinephrine, just in case. C) Consult with a paramedic on your service for advice. D) None of the above

Q: You are treating a 28-year-old female who is 34 weeks pregnant. She has a history of bee sting anaphylaxis and was stung by a bee while in the garden. She is having severe respiratory distress and her blood pressure is 72/50 mmHg. Which of the following is the BEST option for the EMT? A) Transport rapidly, bypassing the emergency department and taking the patient directly to the obstetrics unit of the hospital. B) Immediately administer the patient's Epi-Pen. C) Do not administer the Epi-Pen under any circumstances. D) Administer the Epi-Pen only on the advice of medical control.

Q: You are on the scene of a 22-year-old female patient who is unresponsive. The patient's mother states that she is deathly allergic to peanuts and accidentally ate stir fry cooked in peanut oil. The patient is unresponsive with agonal respirations at 6 per minute. What is your first action? A) Administer epinephrine with medical control consent. B) Insert an oral airway and apply oxygen at 15 liters per minute by nonrebreather mask. C) Insert an oral airway and apply oxygen at 15 liters per minute by bag-valve mask. D) Perform a complete assessment and confirm that the patient is actually in anaphylaxis.

Q: You are called to a residence for a 60-year-old male complaining of chest pain. You find the patient seated in bed. His past medical history includes hypertension and high cholesterol. The patient presents with hives over the chest, stridor, a swollen tongue, and wheezing in the upper fields. He denies any shortness of breath or respiratory distress, but does so in short two to three word statements. What condition do you suspect? A) Anaphylaxis B) Asthma C) Acute myocardial infarction D) Angina pectoris

Q: You are transporting a 41-year-old female suffering from severe anaphylaxis. Her respiratory rate is 42 per minute, she is cyanotic, and she has a decreased level of responsiveness. Which of the following is the highest priority of care for this patient? A) Elevate the patient's head. B) Transport rapidly. C) Search for an epinephrine auto-injector. D) Assist ventilations with a bag-valve mask.

Q: You are on the scene of a motor vehicle collision in which a car has driven off the roadway and is resting at the bottom of an embankment. The driver is in severe respiratory distress and is unable to speak. His skin is flushed and he has hives. A Medic-Alert bracelet indicates an allergy to peanuts. You notice a candy bar wrapper on the floor of the car. Which of the following should you do first? A) Administer high-concentration oxygen. B) Read the candy wrapper to see if it contains peanuts. C) Perform rapid extrication. D) Search the patient for an epinephrine auto-injector.

Q: Your patient has eaten a casserole that may have contained seafood. The patient is worried because he has a seafood allergy. Upon assessment, you find no signs or symptoms of anaphylaxis. The patient's vital signs are stable and he has an epinephrine auto-injector prescribed to him. Which of the following actions is most appropriate? A) Assist him with the administration of his epinephrine auto-injector. B) Advise the patient that he does not require treatment and transport at this time. C) Try to find out if the casserole contained seafood. D) Transport the patient rapidly before the onset of anaphylaxis.

Q: Which of the following is included in the primary assessment of a conscious patient suffering from anaphylactic shock? A) Assessing whether the patient is able to speak without difficulty B) Finding out how the patient was exposed to the substance to which she is allergic C) Looking for hives and swelling D) Determining whether the patient's systolic blood pressure is over 100 mmHg

Q: As you prepare to enter a patient's room in a nursing home, you see a sign posted on the door indicating that the patient has a latex allergy. Which of the following is the BEST way to care for the patient? A) Only perform a history on this patient, not a physical exam, so you can avoid contacting him with your gloves. B) Ask the nursing staff if the patient has an epinephrine auto-injector available in case of a reaction to your gloves. C) Put on latex gloves anyway; you must protect yourself with BSI. D) Ask the nursing facility staff to find synthetic exam gloves to wear for contact with this patient.

Q: Upon delivering a patient to the emergency department, you remove your gloves and find that your hands are red and itchy. Which of the following is most likely? A) You are showing early signs of an anaphylactic reaction. B) You have come into contact with poison ivy in the patient's yard. C) You have been exposed to an infectious disease through contact with the patient. D) You are having an allergic reaction to the latex in the gloves.

Q: Which of the following does NOT commonly lead to anaphylaxis? A) Peanuts B) Cat dander C) Wasp stings D) Sulfa drugs

Q: Which of the following is a general term for a substance to which the body may have an anaphylactic reaction? A) Pathogen B) Allergen C) Antibody D) Pyrogen

Q: Which of the following is the result of histamine and other chemicals in the body during anaphylaxis? A) Urticaria occurs due to fluid being shunted from the skin, causing dehydration of tissue. B) Blood vessels constrict, capillaries become leaky, and bronchoconstriction occurs. C) Capillaries become leaky, bronchoconstriction occurs, and swelling appears in areas around the vocal cords. D) Bronchodilation occurs, blood vessels dilate, and swelling appears in areas around the vocal cords.

Q: Which of the following is the reason why infants rarely experience anaphylactic reactions? A) Infants have not yet developed antibodies to allergens. B) Infants have received natural immunity to allergens from their mothers before birth. C) Allergens do not affect infants. D) None of the above

Q: Which of the following explains why a patient may experience difficulty breathing during anaphylaxis? A) Swelling in the brain decreases the respiratory drive. B) Swelling of the airway tissues causes difficulty breathing. C) Allergens clump together and block blood flow through the lungs. D) Allergens bind to hemoglobin, preventing it from carrying oxygen.

Q: A 35-year-old female has just eaten lobster and is now complaining of itchy, watery eyes. Her blood pressure is beginning to fall, but she denies difficulty breathing. Which of the following best describes her condition? A) Anaphylaxis B) Dyspnea C) Shock D) Mild allergy

Q: Which of the following changes commonly occurs in the cardiovascular system during anaphylaxis? A) Low blood pressure due to vasodilation B) High blood pressure due to tachycardia C) High blood pressure due to vasoconstriction D) Low blood pressure due to bradycardia

Q: You are called to the local park on a hot summer day for an 8-year-old child in respiratory distress. The child can barely speak and appears to be getting sleepy. Vital signs are blood pressure 90/60, pulse 120, and respiratory rate 32. Your physical exam reveals a swollen tongue, inspiratory stridor, wheezing, and hives on the neck and chest. What condition do you suspect? A) Asthma B) Heat exhaustion C) Allergic reaction D) Anaphylaxis

Q: Your patient is a 7-year-old girl who was prescribed an antibiotic for an ear infection. After 4 days on the antibiotic, the patient is experiencing hives and itching on her face, throat, and neck. Which of the following should you do? A) Advise the parents that these symptoms are related to the ear infection and the antibiotic will take care of these symptoms if taken as directed. B) Provide supportive care and monitor the patient's condition during transport to the hospital. C) Advise the parents to call the pediatrician for a different antibiotic. D) Immediately administer Epi-Pen Jr.

Q: Which of the following occurs to blood vessels during an anaphylactic reaction? A) Constriction B) No change C) Spasm D) Dilation

Q: You have responded to a park where you find a 23-year-old female sitting on a bench near a running trail. She states that she has been running for the past 30 minutes, and all of a sudden she cannot catch her breath. She states that this has never happened before and she usually runs 5 miles a day. Your assessment reveals that she is flushed, her pulse is fast and weak, her respirations are fast and she is wheezing, and she has hives on her arms and chest. She is most likely suffering from which of the following? A) Anaphylaxis B) Heat stroke C) Allergic reaction D) Hyperventilation syndrome

Q: Which of the following would you expect to hear when auscultating the lungs of a patient having an anaphylactic reaction? A) Clear, adequate air movement B) Fine, wet crackles or rales C) Coarse-sounding rhonchi D) Wheezing

Q: Which of the following is MOST likely to be a complaint of a patient suffering from anaphylaxis? A) "I am having severe muscle pains." B) "My legs are numb and I can't move them." C) "My throat feels like it is closing." D) "I can't remember what happened."

Q: You are called to a farmhouse on a sunny spring afternoon. Upon arrival, a frantic mother tells you that her 3-year-old daughter was playing in the yard, accidentally stepped on a hornets' nest, and was stung repeatedly. The patient is alert, screaming and crying, and can follow her mother's commands. Her arms and legs are swollen and show the marks of several stings. Her body is covered in hives. Her vital signs are blood pressure 90/40, pulse 110, respiratory rate 24, and oxygen saturation 99%. Her lung sounds are clear and equal bilaterally. Her mother states she put "nox-a-sting" on the bites but the bites only seemed to get worse. What condition is the patient suffering from? A) Minor anaphylactic reaction B) Moderate anaphylactic reaction C) Allergic reaction from the hornets' stings D) Anaphylactic reaction from the "nox-a-sting" swabs

Q: Which of the following is NOT a sign or symptom of an allergic reaction involving the skin? A) Cyanosis B) Flushing C) Hives D) Itching

Q: Which of the following statements concerning severe allergic reactions is true? A) The quicker the onset of symptoms, the greater the likelihood of a severe allergic reaction. B) A severe allergic reaction can be prevented by the use of an epinephrine auto-injector before exposure to the substance. C) Allergies do not develop until a person is in his late teens to early 20s. D) A severe allergic reaction occurs only when the patient has never been exposed to the substance before.

Q: What is another name for a severe allergic reaction? A) Dermatitis B) Asthma C) Anaphylaxis D) Psychosomatic reaction

Q: Which is NOT one of the steps in managing a patient experiencing dizziness and syncope? A) Administer oxygen. B) Apply cold packs to the patient's head. C) Loosen any tight clothing around the neck. D) Lay the patient flat.

Q: Many factors that cause dizziness and syncope are generally related to the: A) kidneys. B) lungs. C) brain. D) nervous system.

Q: Many stroke patients are candidates for thrombolytic drugs. One of the most important things that an EMT can do to optimize the care of a stroke patient who is a candidate for the drugs is: A) determine the exact time of onset of symptoms. B) transport the patient to a Level I Trauma Center. C) do a thorough physical exam of the patient. D) transport to the closest hospital since the patient must go to the operating room as soon as possible.

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.