A 70-year-old male who has a history of emphysema complains of difficulty breathing. He has four-word dyspnea, and you auscultate a slight wheeze in his lower lung fields. His vital signs are P 102, R 22, and BP 152/88. His SpO2 is 92% on home oxygen 2 L/minute by nasal cannula attached to 100 feet of extension tubing. You should:
Select one:
A.
administer oxygen 8 L/minute by your nasal cannula.
B.
increase his home oxygen flow rate to 4 L/minute.
C.
administer oxygen by simple face mask.
D.
administer oxygen by non-rebreather mask.
increase his home oxygen flow rate to 4 L/minute.
An 18-year-old male complains of abdominal pain and diarrhea. He tells you he has a history of cystic fibrosis. You auscultate rhonchi in his lower lungs. His vital signs are P 88, R 22, BP 126/78, and SpO2 is 93% on room air. You should:
Select one:
A.
administer oxygen by non-rebreather mask.
B.
administer oxygen by nasal cannula.
C.
assist with the administration of an OTC antiemetic.
D.
assist with the administration of an OTC antidiarrheal.
administer oxygen by nasal cannula.
An unresponsive 76-year-old female is lying in bed, and you hear snoring respirations. What should you suspect is partially occluding her airway?
Select one:
A.
Food
B.
Laryngotracheobronchitis
C.
Her tongue
D.
Liquid
Her tongue
An 86-year-old male tells you that after a coughing episode, he had a sudden onset of right-sided chest pain and difficulty breathing. He has a history of emphysema. He describes a pleuritic-type chest pain that stops him from taking a deep breath. You auscultate decreased breath sounds over his right apex. His vital signs are P 76, R 20, BP 130/78, and SpO2 is 92% on room air. You should:
A.
administer oxygen.
B.
administer aspirin.
C.
assist with the administration of his nebulizer.
D.
assist with the administration of his nitroglycerin.
administer oxygen.
A 65-year-old male who has a history of congestive heart failure is slumped in a chair not responding to you. His wife tells you that his difficulty breathing started an hour ago and has been getting worse. He is tachypneic, and you auscultate rales in all fields. You should first:
Select one:
A.
administer oxygen by non-rebreather mask.
B.
assist his ventilation.
C.
assess his vital signs.
D.
apply CPAP.
assist his ventilation.
An unresponsive 75-year-old female was struck by lightning. EMRs tell you she was apneic and pulseless, so they began CPR. They tell you they have been resuscitating her for five minutes. You should next:
Select one:
A.
apply the AED while they continue compressions.
B.
have them stop CPR so you can assess her.
C.
apply a mechanical CPR device.
D.
look for entry and exit wounds.
apply the AED while they continue compressions.
An 83-year-old female complains of a headache. She tells you that she has felt tired all week. Her face is symmetrical, and her speech is clear. Her grips are equal, and she does not have arm drift. Her vital signs are P 84, R 16, BP 188/100, and SpO2 is 97% on room air. You should:
Select one:
A.
administer aspirin.
B.
activate a Stroke Alert.
C.
transport her to the hospital.
D.
administer oxygen.
transport her to the hospital.
Why would a 20-year-old male who has a regular pulse less than 50 have signs of hypoperfusion?
Select one:
A.
Diastole is decreased.
B.
Coronary artery filling time is reduced.
C.
His atrial filling time is too long.
D.
His cardiac output is too low.
His cardiac output is too low.
An 85-year-old male tells you that he woke up sweaty and nauseated. He tells you he has a funny feeling in his chest that he cannot specifically describe. He tells you he has a history of diabetes and hypertension. His lungs are clear to auscultation. His vital signs are P 104 and irregular, R 14, BP 102/88, and SpO2 is 91% on room air. You should first:
Select one:
A.
administer oxygen.
B.
assess his blood glucose level.
C.
assist with the administration of nitroglycerin.
D.
assess for orthostatic hypotension.
administer oxygen.
A 93-year-old female complains of a sudden onset of sweating and fatigue. She denies chest pain or difficulty breathing but tells you she feels like she is going to die. Her vital signs are P 78, R 16, BP 142/86, and SpO2 is 94% on room air. You should suspect:
Select one:
A.
influenza.
B.
acute coronary syndrome.
C.
gastroenteritis.
D.
sepsis.
acute coronary syndrome.
An unresponsive 71-year-old male is lying in his bed. His wife tells you that she last saw him normal last night when he went to bed. You should first:
Select one:
A.
move him to the floor.
B.
assess his breathing and pulse.
C.
assess his blood glucose level.
D.
perform a stroke assessment.
assess his breathing and pulse.
An unresponsive 88-year-old female is apneic and pulseless. You are performing chest compressions. Your partner attaches the AED and analyzes her rhythm. The AED announces, “No shock advised.” You should suspect:
Select one:
A.
the patient was moving while the AED was analyzing the rhythm.
B.
ventricular fibrillation.
C.
pulseless electrical activity.
D.
your partner did wait until after two minutes of compressions before analyzing her rhythm.
pulseless electrical activity.
An unresponsive 20-year-old male is taking occasional, gasping breaths. You are unable to palpate a carotid pulse. His skin is cyanotic, and his pupils are pinpoint. You should first:
Select one:
A.
attach the AED and analyze his rhythm.
B.
administer naloxone.
C.
begin chest compressions.
D.
ventilate him.
begin chest compressions.
An unresponsive 55-year-old male is apneic and pulseless. While you are performing chest compressions, you observe him opening his eyes, blinking, and looking at you. You should suspect:
Select one:
A.
ROSC.
B.
levator palpebrae superioris relaxation.
C.
reflexive eye-opening.
D.
death.
You should suspect ROSC. The acronym ROSC is an abbreviation for the return of spontaneous circulation. Levator palpebrae superioris is the muscle that opens the upper eyelid when it contracts. When it is relaxed the upper eyelid is closed. Reflexive eye-opening can occur in comatose patients when the arm is flexed.
You are resuscitating an 84-year-old male who is in cardiac arrest. Why is it important that you allow his chest to fully recoil while performing chest compressions?
Select one:
A.
It helps improve exhalation.
B.
It helps decrease electrical impedance across the chest.
C.
It helps improve blood flow to the heart.
D.
It helps decrease rescuer fatigue.
It helps improve blood flow to the heart.
A healthy 32-year-old female just delivered a full-term neonate. She tells you she had no problems with the pregnancy and received prenatal care. After delivery of the placenta, she continues to have significant bleeding. You feel a grapefruit-sized mass in her lower abdomen that is painful when palpated. You should suspect the mass is:
Select one:
A.
retained placental tissue.
B.
a second fetus.
C.
a tumor.
D.
her uterus.
her uterus.
A 59-year-old male has superficial lacerations across both wrists. He tells you he cut himself seeking attention and doesn’t want to go to the hospital. He has minor bleeding from the wounds. You should apply sterile dressings to the wounds and:
Select one:
A.
have a family member transport him to an urgent care center.
B.
advise him of the possible consequences and allow him to refuse.
C.
transport him to the hospital.
D.
allow him to go to his primary care physician’s office.
transport him to the hospital.
An unresponsive 67-year-old male is lying next to a bag of pesticide that spilled powder on his legs. You observe clonic seizure activity and copious nasal and oral secretions. After assuring you are wearing proper PPE, you should next:
Select one:
A.
brush the dry chemical off him.
B.
suction his airway.
C.
administer oxygen by non-rebreather mask.
D.
assess his vital signs.
brush the dry chemical off him.
A 3-year-old male is lethargic and does not respond appropriately. His mother tells you he has constantly been tired and drinking more fluid than normal for several weeks. His conjunctivae appear dry. His vital signs are P 130, R 40, BP 58 systolic, and SpO2 is 98% on room air. You should suspect:
Select one:
A.
carbon monoxide exposure.
B.
organophosphate exposure.
C.
hyperglycemia.
D.
anaphylactic shock.
hyperglycemia.
A 70-year-old female complains of lower abdominal pain. She tells you she has frequently been urinating, and that it burns when she urinates. She denies any other complaints. You should suspect:
Select one:
A.
pelvic inflammatory disease.
B.
renal calculi.
C.
urinary tract infection.
urinary tract infection.
A 37-year-old female is 36 weeks pregnant. She tells you that she has a severe headache and blurred vision. She describes decreased fetal activity today. Her vital signs are P 86, R 14, BP 138/90, and SpO2 is 96% on room air. You should transport her:
Select one:
A.
with her hips elevated.
B.
supine.
C.
on her left side.
on her left side.
An unresponsive 27-year-old female vomited after she ingested a bottle of aspirin. Her skin is diaphoretic and hot. Her vital signs are P 114, R 24 and deep, BP 82/60, and SpO2 is 95% on room air. Which of the following will provide the most accurate, up-to-date information on how to manage her condition?
Select one:
A.
Referring to your written protocols
B.
Referring to a pocket reference guide
C.
Contacting medical control
D.
Contacting Poison Control
Contacting Poison Control
An 8-year-old female who has a history of autism fractured her lower leg. Before applying the splint, you should:
Select one:
A.
tell her that the splint will immobilize her leg, so she doesn’t feel any more pain.
B.
tell her the splint will be tight to keep her leg from moving.
C.
ask her father to hold her down while you and your partner apply the splint.
D.
ask her father to distract her by turning the lights off and on while you apply the splint.
tell her the splint will be tight to keep her leg from moving.
A 73-year-old female complains of pain in her lower abdomen and pelvis. She tells you the pain increases during intercourse. Recently, she has had a foul-smelling vaginal discharge. You should suspect:
Select one:
A.
nephrolithiasis.
B.
pelvic inflammatory disease.
C.
inflammatory bowel disease.
D.
urinary tract infection.
You should suspect pelvic inflammatory disease. The incidence of sexually transmitted diseases in the elderly population has increased with the advent of erectile dysfunction medications. A urinary tract infection or inflammatory bowel disease may cause lower abdominal and pelvic pain, but not a foul-smelling vaginal discharge. The term nephrolithiasis refers to a kidney stone that is still in the kidney.
