A 19-year-old man presents with a decreased level of consciousness. According to his girlfriend, he has no known medical problems and takes no medications. Initial treatment for this patient involves:
ensuring airway patency and adequate breathing.
A 25-year-old woman presents with acute abdominal pain and vaginal bleeding. She tells you that she has soaked eight high-absorbency tampons in the past 2 hours. Approximately how much blood has she lost externally?
A 30-year-old woman presents with 3 days of generalized weakness, dizziness, and excessive urination. She is conscious but restless, and she tells you that she is extremely thirsty. Her blood pressure is 96/66 mm Hg, her pulse is 110 beats/min and full, and her respirations are increased and somewhat deep. On the basis of this patient's clinical presentation, she will MOST likely require oxygen and:
crystalloid fluid hydration.
A 33-year-old woman had an apparent syncopal episode. According to her husband, she complained of dizziness shortly before the episode. He further states that he caught her before she fell to the ground. Upon your arrival, the patient is conscious but confused and is sitting in a chair. Her blood pressure is 90/60 mm Hg, pulse rate is 110 beats/min and weak, and respirations are 22 breaths/min and regular. Her blood glucose level is 74 mg/dL. The MOST likely cause of her syncopal episode is:
A 51-year-old man complains of chronic headaches that have worsened progressively over the past 3 months. Today, he called 9-1-1 because his headache is severe and he is nauseated. His vital signs are stable and he is breathing adequately. The patient denies any medical problems and states that he has been taking acetaminophen for the headaches. You should be MOST suspicious for:
an intracranial neoplasm.
A 51-year-old man with type 2 diabetes presents with confusion, blurred vision, and signs of significant dehydration. According to the man's wife, he has had a fever and flu-like symptoms for the past few days. She further tells you that he has “stuck to his diet” as advised by his physician. His blood pressure is 90/50 mm Hg, pulse is 120 beats/min and weak, and respirations are rapid and shallow. You assess his blood glucose level, which reads “high.” This patient is MOST likely:
experiencing hyperosmolar nonketotic coma.
A 55-year-old female complains of severe vertigo, tinnitus, nausea, and a sense of fullness in her right ear. You should:
administer an antiemetic and monitor her airway in case she vomits.
A 59-year-old woman presents with acute onset of confusion, left-sided hemiparesis, and a right-sided facial droop. Her airway is patent and she is breathing adequately. Her blood pressure is 150/100 mm Hg and her pulse is 70 beats/min. The cardiac monitor displays atrial fibrillation with a variable rate of 60 to 90 beats/min. When obtaining the patient's medical history from her husband, the MOST important question to ask him is:
“When did you first notice your wife's symptoms?”
A 62-year-old man presents with an acute onset of bright red vomiting. According to his wife, he ingests excessive amounts of alcohol each day. As you are assessing the patient, you note that his level of consciousness has decreased markedly. His mouth is full of blood, and his skin is pale and moist. You should:
turn him on his side and suction his oropharynx, intubate his trachea if the oral bleeding continues, establish at least one large-bore IV with normal saline, and administer enough fluids to maintain adequate perfusion.
A neoplasm is MOST accurately defined as a:
A patient experiences severe, shock-like or stabbing pain to one side of the face. This is consistent with:
A patient who is experiencing agnosia:
may call a knife a fork when he or she is asked to name the object.
A patient who is unable to use a common object is said to be:
A patient who presents with petechiae is MOST likely:
A patient with a unilateral eyelid droop when smiling:
may be experiencing Bell palsy.
A sudden onset of discomfort in the throat, severe dysphagia, and vomiting bright red blood are MOST indicative of:
ruptured esophageal varices
Adrenal insufficiency is characterized by decreased function of the ______________ and consequent underproduction of ______________.
adrenal cortex, cortisol and aldosterone
All of the following are examples of acute cerebrovascular emergencies, EXCEPT:
accumulation of atherosclerotic plaque.
All of the following cranial nerves are responsible for airway control, EXCEPT the:
Among other functions, the medulla oblongata:
controls blood pressure and heart rate.
An elderly man who is a resident of a skilled nursing facility is found unresponsive by a staff nurse. When you and your partner arrive, you assess the patient and note that his respirations are slow and shallow; his heart rate is slow, weak, and irregular; and his skin is cool and clammy. You should:
assist his ventilations and assess his oxygen saturation.
An idiopathic seizure is one in which:
the cause is not known.
As intracranial pressure rises:
cerebral herniation may occur.
Causes of rhinitis may include all of the following, EXCEPT:
Chemicals that relay electrically conducted signals from one neuron to another are called:
Common signs and symptoms of a cerebral abscess include:
high-grade fever, persistent localized headache, confusion, and focal impairment.
Common signs and symptoms of infection with the cytomegalovirus include:
prolonged high fever.
Common signs of bleeding in the upper gastrointestinal tract include all of the following, EXCEPT:
Common symptoms of type 2 diabetes include all of the following, EXCEPT:
Components of the diencephalon include the:
thalamus and hypothalamus.
is a more severe finding than decorticate posturing, as it indicates damage in or near the brainstem.
Diabetic ketoacidosis occurs when:
the cells metabolize fat and produce ketones.
During a generalized tonic/clonic seizure, the patient is rigid and his back is arched. This represents the _________ phase of the seizure.
During normal menstruation, approximately ____ to ____ mL of blood is discharged from the vagina.
Dysmenorrhea that occurs before, during, and after menstrual flow:
may signal an underlying illness.
Emotions such as rage and anger are generated in the:
Excessive alcohol consumption can lead to low blood glucose levels because:
alcohol depletes glycogen stores in the liver.
Filtering of blood and recycling of dead red blood cells are functions of the:
Formed elements of the blood account for approximately ___% of the total blood volume.
Hypotension during an episode of dehydration indicates that the body is:
no longer capable of effectively pulling fluid from the interstitial space and the cellular area.
If an individual has A-positive blood:
his or her blood contains the Rh antigen
If the body experiences a drop in volume or blood pressure:
aldosterone secretion stimulates the kidneys to reabsorb sodium from the urine.
In contrast to a patient with peritonitis, a patient with hepatitis would MOST likely initially experience:
right upper quadrant pain.
In contrast to primary adrenal insufficiency, secondary adrenal insufficiency is caused by:
decreased cortisol secretion secondary to a lack of adrenocorticotropic hormone secretion from the pituitary gland.
In contrast to syncope, a seizure:
can occur when the patient is in any position.
In the average female, the menstrual cycle lasts ___ days.
the movement of CSF decreases, but the production of CSF does not.
Initial signs and symptoms of toxic shock syndrome include all of the following, EXCEPT:
Mittelschmerz is defined as:
unilateral abdominal pain and cramping that occur during the ovulatory process.
Most of the digestive process occurs in the:
Myelin functions by:
allowing the neuron to send its signal consistently along the axon without losing its electricity.
Pelvic inflammatory disease commonly affects all of the following organs, EXCEPT the:
are more susceptible to atherosclerosis and osteoporosis.
Regulatory functions of blood include:
transporting hormones to their target organs.
Reiter syndrome is:
a rare complication associated with untreated chlamydia and is characterized by arthritis and skin lesions.
Secretion of the parathyroid hormone is regulated by blood levels of:
Spasmodic torticollis is characterized by:
neck muscle contraction, which twists the head to one side.
The adrenal cortex produces hormones called _______________, which:
corticosteroids, regulate the body's metabolism.
The Candida albicans fungus is the causative agent in:
vaginal yeast infections.
The headache commonly experienced by women during their menstrual cycle is caused by:
The lesions associated with genital herpes:
initially appear as small red bumps.
The MOST common cause of amenorrhea is:
The MOST common underlying cause of a tubo-ovarian abscess is:
The MOST important aspect in the care of a woman with severe vaginal bleeding is:
treating for shock and transporting rapidly.
The pancreas, liver, and gallbladder connect to the digestive system at the:
The peripheral nervous system is responsible for:
sending messages to and receiving messages from the brain.
The volume of plasma in an adult with a total blood volume of 6.5 liters is approximately:
The __________ are cone-shaped fossae that enclose and protect the eyes.
There is evidence that a 21-year-old woman was given Rohypnol before being raped. She presents with alcohol on her breath, drowsiness, and memory loss. Her blood pressure is 98/68 mm Hg, pulse is 58 beats/min and weak, and respirations are decreased and shallow. You attempt to administer high-flow oxygen, but she resists. What should you do now?
Consider administering naloxone in case she was also given a narcotic drug.
Thirty minutes of hypoglycemia in a patient:
is more dangerous than an equivalent period of hyperglycemia.
Tremors that increase as the patient's hand gets closer to an object that he or she is trying to grab are called _________ tremors and are MOST common in patients with _________.
intention, multiple sclerosis
Unlike exocrine glands, endocrine glands:
release chemicals directly into the bloodstream.
When a neuron generates an electrical impulse, it first sends the signal:
along its axon to the axon terminal.
When auscultating bowel sounds, borborygmi is characterized by:
loud gurgles occurring greater than 30/min.
When conducting the scene size-up of a call involving a gynecologic emergency, it is MOST important to:
assess for danger because any scene should be considered volatile.
When neurons are deprived of oxygen and glucose:
they convert to anaerobic metabolism.
Which cranial nerve provides taste sensation to the posterior portions of the tongue and carries parasympathetic fibers to the salivary glands?
Which of the following causes of altered mental status is NOT an acute process?
Which of the following conditions is a neural tube defect in which part of the nervous system remains outside the body?
Which of the following conditions is characterized by a lack of progesterone and increased androgen levels, and can lead to gestational diabetes and cardiac problems?
Which of the following conditions poses the LEAST risk for shock due to vaginal bleeding?
Which of the following conditions would be the LEAST likely to result in peritonitis?
Which of the following cranial nerves are assessed when you ask a patient to follow your finger as you move it in an “H” shape?
Trochlear, oculomotor, abducens
Which of the following cranial nerves regulates movement of the head and shoulders?
Which of the following is an example of receptive aphasia?
You ask a patient who the president is and he or she says, “January.”
Which of the following medications would MOST likely be used in the prehospital setting to treat some women with severe premenstrual syndrome?
Glucose and fentanyl
Which of the following statements regarding Addison disease is MOST correct?
Addison disease most often occurs when the immune system creates antibodies that attack and destroy the adrenal cortex.
Which of the following statements regarding ectopic pregnancy is MOST correct?
In ectopic pregnancy, a fertilized egg implants somewhere other than the uterus.
Which of the following statements regarding endometritis is correct?
Untreated endometritis may result in septic shock.
Which of the following would MOST likely cause a sustained increase in intracranial pressure?
Which of the following would NOT cause hypoglycemia in the patient with type 1 diabetes?
Within a few days after having a therapeutic abortion, a 33-year-old woman presents with malaise, fever, constipation, and pelvic pain. Her blood pressure is 124/84 mm Hg, pulse rate is 104 beats/min and strong, and respirations are 22 breaths/min and regular. You should be MOST suspicious for:
You are assessing a man who was boxing with his friend. He complains of seeing flashing lights and “floaters” in his field of vision. The MOST important intervention is:
You are assessing an unresponsive 66-year-old man with a history of two prior strokes. According to the patient's wife, he complained of a severe headache and then passed out. His respiratory effort is poor, blood pressure is elevated markedly, and pulse is slow and bounding. The glucometer reads “error.” You should:
assist ventilations, apply the cardiac monitor, start an IV line with normal saline, administer 12.5 g of 50% dextrose, and reassess his level of consciousness.
You are caring for a young woman with constant, diffuse abdominal pain, referred pain to both shoulders, and vaginal bleeding. She states that her last menstrual period was 2 months ago, but she adamantly denies being pregnant. Her blood pressure is 86/50 mm Hg, pulse rate is 120 beats/min and weak, and respirations are 24 breaths/min and regular. Which of the following interventions is NOT appropriate for this patient?
You are dispatched to a local pharmacy, where a 24-year-old woman experienced an apparent seizure. During your assessment, you note that the patient is conscious but combative. The patient's supervisor states that she has a history of seizures and takes Tegretol. The patient's blood pressure is 146/90 mm Hg, pulse rate is 110 beats/min and regular, and respirations are 24 breaths/min with adequate depth. The MOST appropriate treatment for this patient includes:
administering oxygen as tolerated, establishing an IV line, padding the rails of the ambulance cot, and transporting without lights and siren.
You are dispatched to a residence for a middle-aged woman with generalized weakness of approximately 18 hours' duration. Your primary assessment reveals right-sided hemiparesis, a left-sided facial droop, and bilaterally equal and reactive pupils. Further assessment reveals that her blood glucose level is 70 mg/dL. En route to the hospital, you note increased movement of her right arm. She is receiving oxygen via nasal cannula and has a patent IV line in place. Which of the following statements regarding this scenario is correct?
Although the patient is likely experiencing a TIA, you should treat her as though she is experiencing a stroke
You are dispatched to a residence for an elderly woman who is “sick.” When you arrive and assess her, you note that she is responsive to pain only and has hot, moist skin and rapid, shallow respirations. You find prednisone, Paxil, and multivitamins on her nightstand. Further assessment of this patient will MOST likely reveal:
hypoglycemia, hypotension, and ECG evidence of hyperkalemia.
You arrive at the scene shortly after a 7-year-old girl experienced a seizure. According to the child's mother, she was sitting at the dinner table and then suddenly stopped speaking and started blinking her eyes very rapidly. The episode lasted less than 1 minute, after which the child's condition rapidly improved. This clinical presentation is consistent with a(n) _____________ seizure.
__________ is a term used to describe changes in a person's ability to perform coordinated motions, such as walking.
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