question

As you obtain historical information regarding your patient, you note that the patient's presentation and responses are very similar to several patient complaints you have treated in the past. Integrating this information from past experience to this current experience is known as:

answer

Pattern recognition

question

In which situation has the threat to your personal safety been reduced most significantly?

answer

A barking dog has been secured in a kennel in the yard.

question

You evaluate the patient's environment to assess for:

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all of the above; Safety concerns, Room Temp, Assistive devices

question

An unresponsive patient has a needle in his arm when you arrive. His pupils are pinpoint, and he is breathing four times per minute. You are preparing to administer naloxone. At this point, opioid overdose is your initial:

answer

Differential diagnosis

question

An 18-year-old male had a tonic-clonic seizure. Coworkers report no known seizure history. You can arouse him to voice. P 118, R 20, BP 102/68. The diagnostic test most likely to narrow your differential diagnosis would be:

answer

Blood glucose analysis

question

A 23-year-old female has an acute onset of left flank pain. You should investigate which of the following regarding her pain?

answer

Dysuria

question

When you use an interpreter to question a 42-year-old female about her abdominal pain, what is the best way to ensure information has been conveyed accurately and completely?

answer

Let the patient write her answers, and have the interpreter restate them so you will have a recored of her statements for your report. (yeah right)

question

After you ensure scene safety, your highest priority is to:

answer

Rule out immediate life threats

question

Which of the following physical findings points most specifically to increased intracranial pressure?

answer

Respiratory rate is 8 and irregular.

question

You are transferring a 65-year-old female with renal failure from the nursing home. She has a history of "abnormal lab values" and is drowsy and weak. You note the following lab values: serum calcium 10.0 mg/dL (0.55 mmol/L), pH 7.28, potassium 6.1 mEq/L. The patient goes into cardiac arrest after you load her into the ambulance. After epinephrine, you should first consider giving her:

answer

Magnesium sulfate

question

Which of the following describes a behavior that represents normal mental status? A person who:

answer

Is drowsy and slow to respond to questions after awakening from a nap.

question

Which assessment evaluates at least one aspect of cranial nerve function?

answer

Cincinnati Prehospital Stroke Scale

question

A 72-year-old male had a syncopal episode in church. His wife said he has been complaining of a headache for about a week. He has early Alzheimer's disease. Home medicines include Lipitor and Exelon (rivastigmine). Which of the following questions may help narrow your differential diagnosis?

answer

Did he fall or hit his head recently?

question

A 56-year-old female experiences a sudden onset of headache and blurred vision during yoga class. Her right eyelid is drooping, and the pupil on that side is small compared to the left pupil. You should take her to a hospital with:

answer

Specialized neurologic and vascular capability

question

A 32-year-old complains of headache and dizziness. He vomited once and is walking with a staggering gait. His blood pressure is 148/72, pulse 92, respirations 20. He has a steady stare up toward his right ear. Which sign or symptom makes you consider intracerebral hemorrhage more strongly than migraine headache as a cause of his emergency?

answer

Abnormal gaze

question

Which is the most reliable indicator that ventilation should be assisted in a patient with altered mental status?

answer

End-tidal CO2 is 60 mm Hg

question

A 24-year-old male complains of sudden explosive headache . He asks you to lower the lights. He has vomited once. Which of these findings would increase your index of suspicion for subarachnoid hemorrhage?

answer

Stiff neck

question

Which of the following findings indicates the need to increase the rate of ventilation in a intubated patient you suspect to have an epidural hematoma?

answer

Unilateral blown pupil

question

A 25-year-old helmeted female was thrown from a horse. She is complaining of weakness in her upper extremities. You ask her to close her eyes and identify whether you are moving her thumb up or down. She is unable to do so. This indicates she does not have normal:

answer

Proprioception

question

A 44-year-old male is postictal after a witnessed grand mal seizure. He is arousable to light pain and is presently snoring. His vital signs are BP 142/86, P 120, R 20, Sa02 98%. You should:

answer

Insert a nasopharyngeal airway

question

A 25-year-old woman was involved in a motor vehicle collision. Her initial vital signs were BP 122/80 mm Hg, P 128 bpm, R 20 breath/min. Which of the following findings on repeat assessment would indicate that she is developing shock?

answer

Pulse pressure 32 mm Hg

question

Which gland is responsible for some of the vasoconstriction in shock?

answer

Pituitary

question

The primary mechanism for septic shock is:

answer

Widespread inflammatory response

question

A 24-year-old male injuries in a shallow diving incident. Which assessment finding would you anticipate if he is developing neurogenic shock?

answer

Heart rate 58 bpm

question

Which intervention for patient in shock prevents an increase in myocardial oxygen demand?

answer

Maintain normal body temperature

question

Which diagnostic test most accurately assesses the presence and magnitude of anaerobic metabolism?

answer

Lactic acid

question

Which patient is at highest risk for non traumatic obstructive shock?

answer

22-year-old who is 38 weeks pregnant

question

A 19-year-old female is flushed, itchy, and wheezing after eating crab legs. Her vital signs are BP 90/64 mm Hg, P 128 bpm, R 24 breaths/min. Which intervention is indicated first?

answer

Epinephrine intramuscular

question

A 62-year-old male is vomiting coffee-ground emissions. Which of his home medicines may make it more difficult to control his bleeding?

answer

Plavix

question

Shock related to tension pneumothorax is most directly secondary to:

answer

Decreased preload

question

The most common sign or symptom found in patients with pulmonary embolism is:

answer

increased respiratory rate

question

A 52-year-old male with a history of alcoholism complains of pleuritic chest pain. He states the pain increases when he swallows. He appears very ill and has subcutaneous emphysema around his neck. You suspect:

answer

Boerhaave's syndrome

question

A 73-year-old male awakens suddenly at 0200 complaining of dyspnea. You find him in tripod position. Crackles are audible around his scapulae. He has a history of hypertension. You suspect his symptoms are related to:

answer

Left heart failure

question

A 70-year-old male suspected to have a dissecting aortic aneurysm has a blood pressure of 170/102 mm Hg. This sign may indicate:

answer

The renal arteries are involved

question

Which of the following patients is at highest risk for pericardial tamponade?

answer

55-year-old with end-stage lung cancer

question

If you administer nitroglycerin to a patient with ST-elevation in leads II, III and aVF, you should be prepared to:

answer

Administer a bolus of normal saline if the blood pressure drops

question

A 45-year-old male with a history of hypertension complains of chest "pressure," about a 5 on a scale of 1 to 10, for 20 minutes. He just "wants to be checked out." Vitals signs and 12-lead ECG are normal. You have already administered oxygen and aspirin. You should next:

answer

Administer nitroglycerin 0.4 mg sublingual.

question

An 82-year-old female complains of chest heaviness. She has sinus tachycardia. Her vital signs are BP 108/72 (equal in both arms), P 98, R 20. Her breath sounds are clear in all fields. Aside from myocardial infarction, what should you suspect her chest pain could be related to?

answer

Pulmonary embolism

question

A 40-year-old male has chest pain reported as an "elephant sitting on my chest." He confides that he snorted cocaine 5 minutes before his pain began. You should first administer:

answer

Lorazepam, 2 mg IV

question

A 65-year-old female complains of chest pain that feels like "aching" in her chest. It has become progressively worse over several days. Her temperature is 38.3 degrees C (101F). Which finding will help narrow your differential diagnosis to pericarditis?

answer

ST-segment elevation in everylead

question

Your patient is agitated and sweaty. Her vital signs are BP 107/108 mmHG, P 132 bpm, and R 20/min. Her pupils are dilated, and her hands are trembling. These signs and symptoms may be associated with:

answer

Alcohol withdrawal

question

Which source provides the most detailed information related to hazardous materials?

answer

Material Safety Data Sheets

question

A 2-year-old male is found chewing on berries from a lily of the valley plant. Predict his vital signs.

answer

BP 70/50 P 70 bpm

question

A 24-year-old female took 24 diphenhydramine tablets. Her vital signs are BP 86/54 mm Hg, P 110 bpm, R 20/min. What other sign or symptom should you anticipate.

answer

Seizures

question

The family of a 72-year-old male is worried about their father. His blood glucose is 80 mg/dL (4.4 mmol/L). His rate and depth of breathing are increased, and he is sleepy and weak. He take metformin (Glucophage). You suspect his signs and symptoms may be related to:

answer

Lactic acidosis

question

A farmer was spraying his barn when he became ill. His heart rate is 60 bpm, and his blood pressure is 88/50 mm Hg. Tears are streaming down his cheeks, and he is vomiting. What toxidrome does this clinical picture fit?

answer

Cholinergic

question

Which of the following biological warfare agents causes serious neurologic symptoms that may include paralysis?

answer

botulism

question

A 22-year-old female is found at a party unresponsive and breathing approximately 8 breaths/min. Her skin is gray. Which of the following signs or symptoms will confirm your suspicion that the opioid toxidrome is causing her emergency?

answer

Pupils 2 mm and equal

question

Your patient is reported is reported to have taken an overdose. She has a history of anxiety disorder and depression. She is unresponsive, and vital signs are BP 110/70, P 125 bpm, R 20/min. Her ECG shows right bundle branch block. You expect she has taken:

answer

Amilytriptyline

question

You respond to a warehouse for "multiple patients with difficulty breathing." From a hallway, you see your patient lying in a room with two other people who don't seem to be breathing. He calls out to you, saying he can't breathe. You should first:

answer

Stage at a safe distance.

question

Which agency oversees the compliance, tracking and reporting, and guidelines for preventing transmission of bloodborne pathogens in the workplace?

answer

OSHA

question

You are treating a patient who has been diagnosed with herpes simplex type 1. He exhibits no signs or symptoms at this time. He is in which stage of the communicable disease?

answer

Latent

question

Which of the following is an occupational exposure incident?

answer

Blood sprays in your face when a child with a face laceration sneezes

question

Antibodies that are produced from lymphocytes are known as what kind of immunity?

answer

Humoral

question

Hepatitis A (HAV) is transmitted by which route?

answer

Oral-fecal

question

The best measures you can take to reduce your risk of acquiring hepatitis C from an occupations exposure is to:

answer

Use standard precautions

question

Which sign or symptom can help diagnose headache from meningococcal meningitis?

answer

Petechial rash

question

A patient infected with which disease should be assessed for pneumonia, encephalitis, and myocarditis?

answer

Rubeola

question

While treating a trauma patient, you lacerate your hand. Your bleeding hand comes in contact with the blood of the patient. What action is most important to increase your chance of appropriate follow-up?

answer

Notify the receiving facility and your designated infection control officer immediately.

question

Your adolescent patient presents with a fever, malaise, sneezing, and paroxysmal spasmodic coughing phases. Which infectious disease would you suspect?

answer

Pertussis

question

A 33-year-old male has right lower quadrant abdominal pain and vomiting. Five minutes after you administer a dose of ondansetron, he vomits forcefully. His vitals are now BP 102/72, P 52, R 20. The alteration in his vital signs is likely related to:

answer

Vagal stimulation

question

Your patient is complaining of a cramping pain around her umbilical area that "won't let up." This is most suggestive of disease involving the:

answer

Appendix

question

A 43-year-old male with diffuse abdominal pain and vomiting has a yellowish discoloration of his sclera. This indicates he has excess serum:

answer

Bilirubin

question

A 42-year-old male complains of a gnawing, sever pain in the epigastric area that radiates to his back. His vital signs are T 102*F, BP 94/68, P 128, R 24. Your highest priority intervention would be to administer:

answer

Normal saline, 250 mL bolus

question

A 22-year-old patient at a restaurant is complaining of abdominal pain and diarrhea. Her skin is flushed, and she feels faint. Her vital signs are: BP 98/50, P 124, R 24. Which finding in her SAMPLER history is most likely to guide your differential diagnosis for this patient?

answer

Illness began about 10 minutes after eating

question

A 45-year-old female complains of right upper quadrant abdominal pain. To help confirm your differential if you suspect cholecystitis you should:

answer

Ask her to take a deep breath as you press upward into her right upper quadrant

question

An 18-year-old, 35-kg female is vomiting copious amounts of bright red blood. The most likely diagnosis would be:

answer

Mallory-Weiss syndrome

question

An 88-year-old female complains of nausea, vomiting, and constipation. Her abdomen is tender to palpation and appears distended. Her lungs are clear, and her vital signs are: BP 104/76, P 120, R 20. An appropriate action would be to:

answer

Infuse normal saline at 250 mL/h.

question

A 45-year-old male complains of severe epigastric pain radiating to his back. He has vomited several times. His history is significant for alcohol abuse and hypertension. You suspect an inflammatory condition of a gastric accessory organ. To confirm your differential on physical exam you should assess for:

answer

Psoas sign

question

When assessing your patient's medication history, which would indicate the patient may have a preexisting ulcer?

answer

Famotidine

question

Your patient complains of discomfort in his hand as you inflate the cuff to asses the blood pressure. You note flexion of the wrist and adduction of his fingers. What endocrine disorder do you suspect?

answer

Hypoparathyroidism

question

A 47-year-old female is anxious and complaining of heart palpitations. She reports a recent diagnosis of "thyroid problems." On exam you note exophthalmos. Her vital signs are BP 108/72 mm Hg, P 128 bpm, R 20/min. Interventions should include administration of:

answer

Intravenous fluids

question

Which assessment finding(s) should you anticipate in a patient who has myxedema?

answer

Dry yellow skin

question

What treatment should you anticipate in a patient with a history of Addison's disease who has the following vital signs: BP 94/58 mm Hg, P 124 bpm, R 20/min?

answer

Hydrocortisone

question

What findings should you anticipate on the physical examination of a patient with Cushing's syndrome?

answer

Blood glucose 180 mg/dL (10 mmol/L)

question

When serum glucose drops below 70 mg/dL (3.9 mmol/L), which of the following occurs?

answer

Epinephrine secretion increases

question

A 22-year-old male complains of a 2-day history of abdominal pain. His skin is flushed, and he has a fruity odor on his breath. Assessment reveals BP 106/54 mm Hg, P 128, R 28, glucose 568 mg/dL. Your highest priority intervention would be to:

answer

Infuse normal saline rapid IV

question

Which patient would be an appropriate candidate for immediate intravenous administration of sodium bicarbonate?

answer

45-year-old who complained of chest pain and is now in cardiac arrest and unresponsive to treatment

question

A 72-year-old complains of a headache and being depressed, intermittent twitching in the facial muscles, and general weakness over the past 2 weeks. She has a medical history of hypoparathyroidism. The ECG reveals a prolonged QT segment. During transport she has a seizure. Which electrolyte imbalance is most likely?

answer

Hypocalcemia

question

A 62-year-old hunter was lost in a swampy area. When you begin to care for him, he is lethargic, disoriented, and has a body temperature of 31 degrees C (87.8F). His ECG shows bradycardia. What should be your treatment priority?

answer

Rapid rewarming

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