MEDIC12 written registry prep

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MEDIC12 written registry prep
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  1. Otitis Media
    • common infection that occurs in the middle ear.
    • ear pain, and possibly dizziness/headache & nausea.
  2. Rhinorrhea
    runny nose, commonly associated with rhinitis or sinusitis.
  3. painful swallowing
    suggestive of an infection and inflammation in the pharynx, and can even indicate a life threatening condition like epiglottitis or croup.
  4. A patient with a tracheostomy tube is in respiratory distress and requires suctioning. To appropriately suction the patient, which of the following pieces of equipment will you need?
    A) Sterile gloves
    B) Uncuffed endotracheal tube
    C) Rigid tip (Yankauer) suction catheter
    D) Petroleum based lubricant
    A) Sterile gloves
    (this multiple choice question has been scrambled)
  5. What is the normal range of respirations for a 4 y/o?
    25-50
  6. Catecholamines
    They are produced in the human body from phenylalanine and tyrosine. Release of of the hormones epinephrine and norepinephrine from the adrenal medulla of the adrenal glands is part of the fight-or-flight response. the most abundant are epinephrine (adrenaline), norepinephrine (noradrenaline) and dopamine.
  7. Hypernatremia
    is an electrolyte disturbance that is defined by an elevated sodium level in the blood. it is generally not caused by an excess of sodium, but rather by a relative deficit of free water in the body. for this reason it is often synonymous with the less precise term, dehydration.
  8. You have been dispatched to the scene for a patient who is actively seizing. Upon your arrival at the scene, you find a 24-year old male who appears to be in a postictal state. As you approach the patient you note that he has sonorous respirations and is breathing at 14 breaths per minute and shallow. The victim's sister stated that she called 911 after she walked in the house and found her brother lying on the ground seizing. Your initial approach to this patient should include:
    A) opening the airway using the modified jaw-thrust maneuver followed by bag-valve assisted ventilations.
    B) performing orotracheal intubation with bag-valve assisted ventilations at a rate of 10 to 12 per minute.
    C)opening the airway using the modified jaw-thrust maneuver followed by the administration of high-flow oxygen through a nonrebreather mask.
    D) performing nasotracheal intubation with bag-valve assisted ventilations at a rate of 10-12 per minute.
    A) opening the airway using the modified jaw-thrust maneuver followed by bag-valve assisted ventilations.
    (this multiple choice question has been scrambled)
  9. Do the vast majority of post ictal patients require long-term airway maintenance?
    No. The vast majority of post ictal patients do not require long-term airway maintenance; rather, they require simple airway maintenance until they can completely regain consciousness and assume control of their own airway.
  10. You, your partner, and several first responders are managing a 54-year-old female with status asthmaticus. The patient is in extreme distress and has proven refractory to all aerosolized treatments as well as subcutaneous epinephrine. She is profoundly hypoxic and starting to exhibit episodic cardiac dysrhythmias on the cardiac monitor. High flow oxygen is being administered through a nonrebreathing facemask and an IV has been established. Given the status of the patient and a long transport time, Medical command has instructed you to perform rapid sequence intubation using midazalom (Versed) and succinylcholine (Anectine). As you prepare the medications and equipment for rapid sequence intubation, it is critical to:
    A) determine the patients blood glucose level.
    B) insert an oropharyngeal airway and hyperventilate.
    C) leave the nonrebreather in place for 3 to 5 minutes.
    D) administer a nebulized treatment of albuterol.
    C) leave the nonrebreather in place for 3 to 5 minutes.
    (this multiple choice question has been scrambled)
  11. You respond for an unresponsive patient at a local festival. Upon your arrival, bystanders indicate that they think he has been drinking heavily. As you assess the patient, you note alcohol odor on the breath, the patient is responsive to painful stimuli, has gurgling respirations, and is breathing shallow at 14 times per minute. What are the initial management priorities for this patient?
    A) Open the airway, suction the airway, and ventilate the patient with a bag-valve-mask device
    B) Open the airway, insert an oral airway, and ventilate the patient with a bag-valve-mask device
    C) Open the airway, suction the airway, and place the patient on a nonrebreather mask device
    D) Open the airway, insert an oral airway, and place the patient on a non-rebreather mask device
    A) Open the airway, suction the airway, and ventilate the patient with a bag-valve-mask device
    (this multiple choice question has been scrambled)
  12. Which of the following is an early physiological response to shock that a human body will suffer?
    A) Cessation of peristaltic motion
    B) Decreased urine output
    C) Decreased heart rate
    D) Vasodilatation
    B) Decreased urine output
    (this multiple choice question has been scrambled)
  13. Rule of 9s for an adult...
    • 1) head/neck 9%
    • 2) upper posterior trunk 9%
    • 3) lower posterior trunk 9%
    • 4) upper anterior trunk 9%
    • 5) lower anterior trunk 9%
    • 6) each upper extremity 9%
    • 7) external genitalia 1%
    • 8) posterior lower extremity 9%
    • 9) anterior lower extremity 9%
  14. Rule of 9s for an child...
    • 1) posterior head/neck 9%
    • 2) face 9%
    • 3) posterior trunk upper 9% / lower 9%
    • 4) 9% abdomen
    • 5) 9% chest
    • 6) legs 14% each
    • 7) upper extremities 9% each
    • 8) upper/lower trunk 18%
  15. If an adult patient has sustained a deep laceration with arterial hemorrhage that is difficult to control, at what time should the application of a tourniquet be considered?
    A) After the application of pressure to the proximal pulse site has failed
    B) After diffuse direct pressure to the wound has failed
    C) After application of direct digital pressure at the wound's site of hemorrhage
    D) After wound elevation and application of a cold compress has failed
    C) After application of direct digital pressure at the wound's site of hemorrhage
    (this multiple choice question has been scrambled)
  16. You have responded to the home of a 6-year-old male for a wet cough and general weakness. The mother states that the child has had the cough with a fever for several days. EMS was called today because the child had developed a red-colored rash and spots in his mouth. Your assessment reveals a purulent drainage from the eyes, and swelling of the eyelids. You also note a red, bumpy rash all over the child's body. What is your field diagnosis of this child?
    A) Polio
    B) Measles
    C) Mumps
    D) Chicken pox
    B) Measles
    (this multiple choice question has been scrambled)
  17. What are these the symptoms of?
    1) wet cough
    2) general weakness
    3) fever
    4) red-colored rashspots in mouth
    5) purulent drainage from the eyes
    6) swelling of the eyelids
    7) red, bumpy rash all over the body
    8) sensitivity to light
    Measles
  18. °F to °C
    Deduct 32, then multiply by 5, then divide by 9
  19. °C to °F
    Multiply by 9, then divide by 5, then add 32
  20. What are the rules or standards that govern the conduct of EMS professionals?
    A) Standards
    B) Codes
    C) Ethics
    D) Morals
    C) Ethics
    (this multiple choice question has been scrambled)
  21. What are the individual's perceptions of what is right and wrong?
    A) Standards
    B) Morals
    C) Ethics
    D) Codes
    B) Morals
    (this multiple choice question has been scrambled)
  22. During completion of your patient care report, you write the following statement, “The patient was obviously intoxicated and intentionally uncooperative.” Subjective statements such as this can open the paramedic up to which of the following legal charges?
    A) Libel
    B) Malfeasance
    C) Res ipsa loquitur
    D) Slander
    A) Libel
    (this multiple choice question has been scrambled)
  23. Slander
    Refers to false or malicious statements made verbally.
  24. Malfeasance
    Breach of duty by performing a wrongful or unlawful act.
  25. Res Ipsa Loquitur
    Legal doctrine sometimes used in support of negligence claims.
  26. Libel
    Act of injuring a patient s character through written statements.
  27. Where would you find the anatomical landmark for insertion of the catheter?
    Immediately inferior to the thyroid cartilage just superior to the cricoid ring of the trachea.
  28. left anterior descending artery
    • -branch of the left common coronary artery that perfuses both the septum and anterior wall of the left ventricle
    • -since the bundle branches are embedded within the septum of the heart, occlusion of this artery can cause the precipitation of a bundle branch block
    • -which in turn can lead to an "infranodal" heart block, which is what type the 3rd degree heart block is.
    • -other infranodal block common to left anterior descending occlusion is the 2nd degree Type II (Mobitz II) heart block
  29. electrical alternans
    Finding seen on the ECG machine of a patient who has significant pericardial tamponade. What happens is the heart cannot accommodate a good preload due to the tamponade, and the ECG waveform amplitude is lower. Then, because the ventricles are essentially empty from the ventricular contraction, a larger preload is delivered by the atria which requires a stronger ventricular contraction. This stronger contraction results in an ECG tracing of higher QRS amplitude. The process repeats itself with an ECG showing an alternating height and depth of the QRS (hence electrical alternans).
  30. You are called to a private residence following a domestic dispute to care for a patient who was "stabbed with a kitchen knife." Upon arrival, you find a 36-year-old male patient seated on the front porch holding a towel to his anterior abdomen. He states that he was stabbed in his abdomen with a "steak knife." His skin is pale, cool, and clammy, airway is open and patent, breath sounds are clear and equal bilaterally, respiratory rate is 36 with adequate tidal volume, radial pulse is thready at a rate of 114, and blood pressure is 96/70 mmHg. You note a 6-cm laceration to the right lower quadrant at an 8 o'clock position from his navel. A small portion of intestine is found to be protruding from the injury site. Which of the following is an acceptable plan for management of this patient?
    A) Administer oxygen at 15 lpm via nonrebreather mask, initiate a 14 gauge intravenous line, administer a 250 ml bolus of lactated ringers solution at a wide-open rate, and begin transport to a trauma center.
    B) Administer oxygen at 6 lpm via nasal cannula, begin transport to a trauma center, initiate a 14 gauge intravenous line, and administer a 100 ml bolus of lactated ringers solution at a wide-open rate.
    C) Administer oxygen at 15 lpm via nonrebreather mask, begin transport to a trauma center, and initiate a 14 gauge intravenous line of normal saline.
    D) Administer oxygen at 6 lpm via nasal cannula, begin transport to a trauma center, initiate an 18 gauge intravenous line and administer a 250 ml bolus of normal saline at a wide-open rate.
    C) Administer oxygen at 15 lpm via nonrebreather mask, begin transport to a trauma center, and initiate a 14 gauge intravenous line of normal saline.
    (this multiple choice question has been scrambled)
  31. Neurogenic Shock
    caused by a disruption in the function of the spinal cord, and typically presents with hypotension, slow or normal heart rate, and skin that is warm, dry, and flushed
  32. Sprain
    tearing of a ligament
  33. Grades I and II sprains
    partial ligament tear
  34. Grade III Sprain
    injuries to tendons and muscles are actually referred to as strains
  35. Subluxation
    partial dislocation of a bone end
  36. Anterior Hip Dislocation
    outward foot rotation and the ability to palpate the head of the femur in the inguinal area of the affected side
  37. Posterior Hip Dislocations
    the knee is typically flexed and the foot is rotated internally. the head of the femur typically cannot be palpated in posterior hip dislocations, as it is buried in the muscle of the buttocks.
  38. It is very important when assessing the anterior chest to...
    Look, listen and then palpate the chest. One must always look and listen before palpating to prevent guarding. Guarding may lead to false observation of the patient's respiratory status.
  39. hyperpyrexia
    elevated temperature
  40. muscular dystrophies (MD)
    are a group of genetic diseases characterized by progressive weakness and degeneration of the skeletal muscles which control movement
  41. What should the vacuum be set at when suctioning the oropharynx using a rigid catheter?
    A) Less than 100 mmHg
    B) Greater than -120 mmHg
    C) At least -100 mmHg
    D) Less than 80 mmHg
    B) Greater than -120 mmHg
    (this multiple choice question has been scrambled)
  42. A patient that presents with unilateral diminished breath sounds to the apical region, bilaterally equal resonance to percussion, mild respiratory distress, and a history of obstructive lung disorders is most likely suffering from:
    A) simple pneumothorax.
    B) a pulmonary emboli.
    C) unilateral pneumonia.
    D) exacerbation of emphysema.
    A) simple pneumothorax.
    (this multiple choice question has been scrambled)
  43. You are seated at a restaurant with your EMT partner when a 40-year-old woman at the next table begins to choke. You immediately proceed to her table and find her in a standing position, in obvious distress, and coughing forcefully. All other efforts to clear the airway obstruction have failed and you have decided to perform a surgical cricothyrotomy. Which of the following is true regarding this procedure?
    A) The initial incision is a 1-2 cm vertical incision in the region of the supra-sternal notch.
    B) Only an uncuffed endotracheal tube should be used.
    C) The incision is made just superior to the cricoid ring of the trachea.
    D) This procedure can only be performed on patients older than 8 years of age.
    C) The incision is made just superior to the cricoid ring of the trachea.
    (this multiple choice question has been scrambled)
  44. What is the correct landmark for performing an surgical cricothyrotomy?
    The cricothyroid membrane, also known as the cricothyroid ligament, located immediately inferior to the larynx and immediately superior to the cricoid ring of the trachea.
  45. What size endotracheal tube should be used for a surgical cricothyrotomy?
    Either a size 6.0 or 7.0 mm cuffed endotracheal tube or a size 6 or 8 Shiley tracheostomy tube should be utilized.
  46. What age patient should surgical cricothyrotomy not be done and why?
    The procedure should not be performed on patients under the age of 12 because the cricothyroid membrane is small and underdeveloped in children.
  47. Descrie the incision for a surgical cricothyrotomy?
    The initial incision is typically a 1 to 2 cm vertical incision immediately over the cricothyroid membrane.
  48. You respond to the scene of a possible overdose. On your arrival, you find a 19-year-old male patient lying supine and unresponsive on his bed with snoring respirations. His pupils are sluggish to light and dilated. His friend stated that he only drank a small amount of alcohol this evening, but they believe he might have taken something else. His vital signs are as follows: blood pressure 80/40 mm Hg, heart rate 44/minute, and respiratory rate 6/minute. His EKG is as follows: What is your initial treatment in the care of this patient?
    A) intravenous line of normal saline and a 20cc/kg bolus
    B) 1g/kg of activated charcoal
    C) 1mg of intravenous atropine
    D) PPV with endotracheal Intubation
    D) PPV with endotracheal Intubation
    (this multiple choice question has been scrambled)
  49. You are assessing the ECG rhythm of a patient with symptomatic hypoperfusion secondary to a bradycardic rhythm. The ECG tracing demonstrates normal sinus discharge with a progressively lengthening PR interval and occasional dropped QRS complexes. The conducted QRS complexes are 0.10 seconds in duration. What is your initial field impression of this patient's problem?
    A) Evolving myocardial infarction
    B) Prinzmetal's angina
    C) Unstable angina
    D) Stable angina
    D) Stable angina
    (this multiple choice question has been scrambled)
  50. What is the diference in the presentation between stable angina and myocardial ischemia or infarction?
    Stable angina presents the same as the clinical indications of myocardial ischemia or infarction, the difference being that angina typically subsides within minutes of ceasing physical activity and resting. This is because resting diminishes myocardial work load and provides a closer match between oxygen supply and demand to the heart. Since the signs of angina are initially the same as myocardial ischemia or infarction, management should still be geared towards treating the MI as long as the symptoms persist.
  51. What are electrical alternans?
    The QRS axis alternates between beats. The QRS direction alternates and points in different directions!
  52. A patient who displays electrical alternans, chest pain, hypotension, and tachycardia is most likely experiencing:
    A) mitral valve prolapse.
    B) angina pectoris.
    C) pericardial tamponade.
    D) a myocardial infarction.
    C) pericardial tamponade.
    (this multiple choice question has been scrambled)
  53. retroperitoneal space (retroperitoneum)
    anatomical space in the abdominal cavity behind (retro) the peritoneum. It has no specific delineating anatomical structures.
  54. A patient presents with hypotension, tachycardia, altered mental status, and poor peripheral perfusion. The patient was injured when he fell about 20 feet from a tree. If the patient exhibits no visual signs of trauma, what region of the body would most likely contain the hemorrhage?
    A) Pericardial sac
    B) Esophageal
    C) Intracranial
    D) Retroperitoneal
    D) Retroperitoneal
    (this multiple choice question has been scrambled)
  55. You are called to a parking lot for an approximately 40-year-old male who was found lying behind a dumpster. Assessment reveals an open and patent airway, respirations of 28 breaths per minute with inadequate tidal volume, radial pulse of 64 beats per minute, and a blood pressure of 78/46 mHg. The patient's skin is warm, dry, and flushed. Based upon this limited information, what condition do you suspect that the patient is suffering from?
    A) Anaphylactic shock
    B) Cardiogenic shock
    C) Neurogenic shock
    D) Hypovolemic shock
    C) Neurogenic shock
    (this multiple choice question has been scrambled)
  56. You are called to care for a patient who has fallen down a flight of stairs. Upon arrival, you find a 9-year-old male patient lying at the base of a flight of 15 stairs. The patient's father calmly states that the patient was “screwing around again” and must have “just slipped.” The patient is very calm and hesitant to answer your questions. His only complaint is that of pain to his pelvic region, respiratory rate is 24 with adequate tidal volume, radial pulse is 110 beats per minute, and blood pressure is 98/60 mmHg. During your exam, you notice that the patient has bruises located on multiple areas of his body that appear to be in various stages of healing, palpation of the pelvis causes an acute increase in pain, instability of the pelvis is noted, and abdominal guarding is present. Based upon your assessment findings, what poses the most significant immediate threat to this patient?
    A) Spinal trauma
    B) Internal hemorrhage
    C) Injury to hollow abdominal organs
    D) Airway compromise
    B) Internal hemorrhage
    (this multiple choice question has been scrambled)
  57. sprain
    tearing of a ligament
  58. Grade I & II sprains
    partial ligament tear
  59. Grade III sprain
    complete tear of a ligament
  60. strains
    injuries to tendons and muscles
  61. subluxation
    partial dislocation of a bone end
  62. You are called to a local park for a 24-year-old female who has fallen while rollerblading. She is complaining of extreme pain to her left ankle. While obtaining a medical history, your patient informs you that she recently suffered a Grade II sprain of her left ankle. How would you describe this previous injury?
    A) Overstretching of muscle tissue
    B) Incomplete tear of a tendon
    C) Partial dislocation of a bone
    D) Incomplete tear of a ligament
    D) Incomplete tear of a ligament
    (this multiple choice question has been scrambled)
  63. You are called to a local skilled nursing facility to care for a fall victim. Upon arrival, you find a 78-year-old male patient lying in a left lateral recumbent position on the floor. Nursing staff states that he was found in this position during morning medication rounds. Physical assessment reveals that the patient's right leg is outwardly rotated with a large palpable mass found in the right inguinal area. No pelvic instability is noted. Pedal pulses, sensation, and motor response are all present in the affected limb. The patient complains of extreme pain in the right hip and an inability to move his right leg. Based upon your physical exam findings, what condition is the patient most likely to be experiencing?
    A) Anterior hip dislocation
    B) Rotational fracture of the right femur
    C) Fracture of the ischium
    D) Posterior hip dislocation
    A) Anterior hip dislocation
    (this multiple choice question has been scrambled)
  64. You are called to a local skilled nursing facility to care for a fall victim. Upon arrival, you find a 78-year-old male patient lying in a left lateral recumbent position on the floor. Nursing staff states that he was found in this position during morning medication rounds. Physical assessment reveals that the patient's right leg is outwardly rotated with a large palpable mass found in the right inguinal area. No pelvic instability is noted. Pedal pulses, sensation, and motor response are all present in the affected limb. The patient complains of extreme pain in the right hip and an inability to move his right leg. Your treatment plan for this patient should include which of the following?
    a) Pad and splint in position found.
    b) Re-align leg to anatomical position,
    pad and splint to backboard.
    c) Attempt reduction of dislocation prior
    to splinting.
    d) Apply traction splint.
    a) Pad and splint in position found.
  65. You are dispatched to a local nightclub where a 21-year-old male has been assaulted with a baseball bat. After the police department notifies you that it is safe to approach the scene, you find the patient in a small alley beside the club. He appears to be motionless and supine on the ground surrounded by 3 police officers. Upon examination of this patient, you should follow which of the following sequences to examine the patient's anterior
    chest.
    A) Listen to his breath sounds and heart
    B) Palpate for stability, listen to his breath sounds and heart tones, and then look for obvious injuries.
    C) Look for obvious injuries, listen to breath sounds and heart tones, and palpate for stability.
    D) Look for obvious injuries, palpate for stability, and then listen to breath sounds and heart tones.
    tones, palpate for stability, and then look for obvious injuries.
    C) Look for obvious injuries, listen to breath sounds and heart tones, and palpate for stability.
    (this multiple choice question has been scrambled)
  66. hyperpyrexia
    elevated temperature
  67. Trismus
    inability to normally open the mouth due to one of many causes
  68. cyanide exposure treatment
    utilization of a cyanide antidote kit should be considered. Sodium Nitrite at a dose of 300 mg intravenously is one of the components of the antidote kit, along with Amyl Nitrite inhalants and Sodium Thiosulfate injectable.
  69. You are called to a private residence for a patient experiencing difficulty breathing. Upon arrival you find a 74-year-old female patient with a history of emphysema in a full-Fowler position on a kitchen chair. Assessment reveals accessory muscle usage, cyanosis to the lips and fingertips, and a pulse oximeter reading of 74%. Respiratory rate is 32 with decreased tidal volume, pulse is irregular at a rate of 118 beats per minute, and blood pressure is 104/82 mmHg. The patient is on home oxygen at 4 lpm via nasal cannula. The cardiac monitor displays the following rhythm: Which of the following describes the correct approach to oxygen therapy in this patient?
    A) Oxygen should be withheld in order to prevent further depression of the respiratory drive.
    B) The patient should remain on her physician-prescribed oxygen dose of 4 liters per minute via nasal cannula.
    C) Apply high-flow oxygen via nonrebreather at 12-15 liters per minute.
    Immediate endotracheal intubation is indicated.
    C) Apply high-flow oxygen via nonrebreather at 12-15 liters per minute.
    (this multiple choice question has been scrambled)
  70. You are called to a private residence for an unresponsive diabetic patient. Upon arrival, you find an unresponsive 44-year-old female patient supine in bed. Her husband states that she has been ill for several days with influenza and has gotten progressively worse over the past 12 hours. Respiratory rate is 36 breaths per minute with an increased tidal volume, radial pulse is regular at a rate of 124 beats per minute, and blood pressure is 96/64 mmHg. A blood glucometer reading shows a blood glucose level of 548 mg/dl, and you notice a fruity odor to the patient's breath. Skin is pink, warm and dry. The patient has been placed on oxygen via nonrebreather mask at 12 liters per minute and an intravenous line has been initiated utilizing 0.9% sodium chloride at a keep vein open rate. Further treatment of this patient may include intravenous administration of which of the following?
    A) 25 grams of 50% dextrose
    B) 100 mg thiamine
    C) Fluid resuscitation with 0.9% sodium chloride
    D) 1 mEq/kg sodium bicarbonate
    C) Fluid resuscitation with 0.9% sodium chloride
    (this multiple choice question has been scrambled)
  71. You are in the process of delivering twins in the field setting. Which of the following indicates the most appropriate management of the umbilical cords?
    A) Leave the cords attached to the placenta(s) until arrival at the hospital.
    B) Clamp and cut both cords prior to
    C) Clamp and cut the first baby's cord prior to the delivery of the second baby.
    D) Wait until the delivery of the second baby to cut both cords.
    the delivery of either baby.
    C) Clamp and cut the first baby's cord prior to the delivery of the second baby.
    (this multiple choice question has been scrambled)
  72. While assessing a 7-year-old patient involved in a motor vehicle collision, you note that the patient is waning in and out of consciousness and she has obvious deformity to both of her upper legs. Based on just this information, what is the most appropriate facility to which to transport this patient?
    A) Level I trauma center
    B) Closest hospital
    C) Pediatric hospital
    D) Pediatric trauma center
    C) Pediatric hospital
    (this multiple choice question has been scrambled)
  73. What is the single most preventable cause of cardiac dysrhythmia and death in the pediatric patient?
    A) Trauma
    B) Hypothermia
    C) Drug toxicity
    D) Hypoxia
    D) Hypoxia
    (this multiple choice question has been scrambled)
  74. Bulging fontanels in an infant are a sign of what condition?
    A) High fever
    B) Dehydration
    C) Infantile hypertension
    D) Meningitis
    D) Meningitis
    (this multiple choice question has been scrambled)
  75. Pelvic Inflammatory Disease
    • 1) infection of the female reproductive tract
    • often caused by gonorrhea or chlamydia.
    • 2) typically presents with diffuse lower abdominal pain that can be severe, often increasing with sexual activity.
    • 3) pain may also intensify either immediately before
    • or after menstrual period.
    • 4) other associated symptoms include fever,
    • chills, nausea, vomiting, and sepsis.
  76. Your patient is a 29-year-old woman complaining of severe, diffuse, lower abdominal pain. The patient states that her menstrual periods have been occurring at normal intervals. Additionally, she states that pain increases during sexual activity and following her menstrual period, and that she has recently experienced a yellow, vaginal discharge. Her skin is warm and slightly diaphoretic, respiratory rate is 14 breaths per minute with adequate tidal volume, radial pulse is 112 beats per minute, and blood pressure is 110/90 mmHg. What is the most likely cause of this patient's symptoms?
    A) Pelvic inflammatory disease
    B) Spontaneous abortion
    C) Cystitis
    D) Endometriosis
    A) Pelvic inflammatory disease
    (this multiple choice question has been scrambled)
  77. You are called to a private residence for a 42-year-old female patient with vaginal bleeding. Upon arrival you find your patient supine on the bed, complaining of moderate-to-severe vaginal bleeding for several hours. The patient is pregnant and states that her due date is in approximately 2 weeks, however she has had no prenatal care. Patient is gravida 4, para 2. Assessment reveals moderate vaginal bleeding, however the patient denies pain and is experiencing no contractions. Respiratory rate is 18 breaths per minute with adequate tidal volume, radial pulse is 110 beats per minute, and blood pressure is 126/94 mmHg. What condition is the patient likely experiencing?
    A) Uterine rupture
    B) Cephalopelvic disproportion
    C) Abruptio placenta
    D) Placenta previa
    D) Placenta previa
    (this multiple choice question has been scrambled)
  78. Placenta Previa
    Characterized by bright red vaginal blood flow without pain or uterine contractions. It is associated with both increasing age and multiparity.
  79. Abruptio Placenta
    Typically presents with third trimester bleeding, an acute alteration in the contraction pattern, and symptoms of shock inconsistent with amount of visible bleeding. In addition, the uterus is typically tender and potentially board like.
  80. Cephalopelvic Disproportion
    Characterized by a lack of progress through stages of delivery and frequent, prolonged contractions.
  81. Uterine Rupture
    Characterized by severe, sudden, shearing pain occurring during strong contraction. Typically the uterus can be palpated as hard mass next to fetus, and rapid onset of shock is not uncommon.
  82. You are called to a private residence for a 36-year-old female patient in labor. Upon arrival, you find your patient supine on the bed, complaining of severe abdominal pain. The patient states that her pregnancy is full-term, and that her contractions started approximately 45 minutes prior to your arrival. As she was preparing to leave for the hospital, she suddenly felt a sharp tearing pain in her abdomen. The patient is gravida 3, para 3. Currently, the patient complains of generalized pain to the lower abdomen and lower back. The patient's abdomen is stiff and board-like, no vaginal bleeding is present, and contractions appear to be continuing in a rhythmic manner that the patient states is much slower than it was prior to the tearing pain. Respiratory rate is 22 breaths per minute with adequate tidal volume, radial pulse is 98 beats per minute, and blood pressure is 116/84 mmHg. What condition is the patient likely experiencing
    A) Ruptured ectopic pregnancy
    B) Braxton-Hicks contractions
    C) Abruptio placenta
    D) Placenta previa
    C) Abruptio placenta
    (this multiple choice question has been scrambled)
  83. Braxton-Hicks Contractions
    Irregular, painless contractions that occur prior to actual labor.
  84. Trendelenburg
    knee-chest position
  85. You are called to a private residence for a 36-year-old female patient in labor. Upon arrival, you find your patient supine on the bed. A rapid assessment for crowning reveals a prolapes of the umbilical cord. The mother's respiratory rate is 22 breaths per minute with adequate tidal volume, radial pulse is 98 beats per minute, and blood pressure is 116/84 mmHg. What position should this patient be placed in for transport?
    A) Prone
    B) Trendelenburg
    C) Semi-Fowler
    D) Left-lateral recumbent
    B) Trendelenburg
    (this multiple choice question has been scrambled)
  86. You are called to a private residence for a child who has been burned. Upon arrival, the patient's mother presents you with a 16-month-old female patient who was burned by boiling water when she pulled a pot from the stove-top. Your patient is conscious, you note erythema and blistering to the anterior aspects of both legs, and the anterior thorax and abdomen. Based upon your assessment, what percentage of the patient's body surface area would you estimate has been burned?
    A) 36%
    B) 32%
    C) 28%
    D) 40%
    B) 32%
    (this multiple choice question has been scrambled)
  87. Melena
    stools that are dark, tarry, and foul smelling, indicating the presence of partially digested blood in the stool.
  88. Hematochezia
    stool that contains bright red blood, indicating the presence of blood which has not passed through the digestive process.
  89. Hematochezia
    typically associated with lower gastrointestinal bleeding.
  90. Hematemesis
    bloody vomitus
  91. Cullen's
    periumbilical ecchymosis, usually associated with hemorrhage within the abdominal cavity.
  92. primary intracellular ion
    potassium
  93. primary extracellular ion
    sodium
  94. If a newborn is breech during the delivery, what position should the mother should be placed in?
    the knee to chest position or she should have her pelvis elevated several inches
  95. Radiation Protection
    • Alpha - paper
    • Beta - wood
    • Gamma - concrete
  96. Upon your assessment, you find an infants temperature to be 41.1 degrees Celsius, according to a tympanic membrane thermometer. You know that the infant's temperature is:
    a) four degrees above normal.
    b) at least six degrees above normal.
    c) two degrees above normal.
    d) normal.
    a) four degrees above normal.
  97. anterior cord syndrome
    decreased pain sensation and paralysis below the level of the cord injury with preserved light touch sensation
  98. Brown Sequard syndrome
    loss of feeling of pain and temperature on the contralateral side of the spinal injury and weakness on the ipsilateral side are signs of an incomplete spinal cord lesion
  99. central cord syndrome
    presents with paralysis of the upper extremities with preserved motor or sensory function to the sacral area and less impairment of motor function to the lower extremities as compared to upper extremities
  100. Heroin
    • 1) opioid
    • 2) respiratory depression
    • 3) pinpoint pupils
  101. Cocaine
    1) dilated pupils
  102. Valium
    • 1) barbiturate
    • 2) tends to cause dilated, non-reactive pupils
  103. Ecstasy
    may cause pupillary changes, but will not cause them to become pinpoint and non-reactive
  104. nonfeasance
    failure to perform a required act or duty
  105. You obtain a 12-lead EKG on this patient and find ST elevation in leads V1-V6. This corresponds to a blockage of which of the coronary arteries?
    A) Left circumflex artery
    B) Left coronary artery
    C) Right coronary artery
    D) Left anterior descending
    B) Left coronary artery
    (this multiple choice question has been scrambled)
  106. blockage of the proximal left coronary artery
    myocardial ischemia to the septal, anterior, and lateral walls of the heart that are viewed in leads V1-V6

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