Emergency Medical Technician Test 5 Answer Key

1. Diabetes is MOST accurately defined as a(n): 1. 2. 3. 4. disorder of carbohydrate metabolism. abnormally high blood glucose level. mass excretion of glucose by the kidneys. lack of insulin production in the pancreas. 2. Type 1 diabetes: 1. 2. 3. 4. is typically treated with medications such as metformin (Glucophage). is a condition in which no insulin is produced by the body. typically occurs in patients between 50 and 70 years of age. is defined as a blood sugar level that is less than 120 mg/dL. 3. Patients with type 2 diabetes usually control their disease with all of the following, EXCEPT: 1. 2. 3. 4. diet and exercise. tolbutamide(Orinase). glyburide(Micronase). supplemental insulin. 4. Glipizide, a non–insulin-type medication, is another name for: 1. 2. 3. 4. Glucophage. Glucotrol. Micronase. Diabinese. 5. Which of the following statements regarding glucose is correct? 1. 2. 3. 4. Most cells will function normally without glucose. Blood glucose levels decrease in the absence of insulin. The brain requires glucose as much as it requires oxygen. The brain requires insulin to allow glucose to enter the cells. 6. Insulin functions in the body by: 1. 2. 3. 4. producing new glucose as needed. enabling glucose to enter the cells. 3. increasing circulating blood glucose. 4. metabolizing glucose to make energy. 7. Patients with uncontrolled diabetes experience polyuria because: 1. 2. 3. 4. they drink excess amounts of water due to dehydration. excess glucose in the blood is excreted by the kidneys. low blood glucose levels result in cellular dehydration. high blood sugar levels cause permanent kidney damage. 8. Excessive eating caused by cellular “hunger” is called: 1. 2. 3. 4. polyphagia. polydipsia. dysphasia. dyspepsia. 9. Ketone production is the result of: 1. 2. 3. 4. acidosis when blood glucose levels are low. blood glucose levels higher than 120 mg/dL. fat metabolization when glucose is unavailable. rapid entry of glucose across the cell membrane. 10. A 37-year-old female with a history of diabetes presents with excessive urination and weakness of 2 days’ duration. You apply 100% oxygen and assess her blood glucose level, which reads 320 mg/dL. If this patient’s condition is not promptly treated, she will MOST likely develop: 1. 2. 3. 4. severe insulin shock. acidosis and dehydration. completerenalfailure. hypoxia and overhydration. 11. Kussmaul respirations are an indication that the body is: 1. 2. 3. 4. attempting to eliminate acids from the blood. trying to generate energy by breathing deeply. severely hypoxic and is eliminating excess CO2. compensating for decreased blood glucose levels. 12. The normal blood glucose level, as measured by a glucometer, is between: 1. 2. 3. 4. 60 and 80 mg/dL. 80 and 120 mg/dL. 130 and 150 mg/dL. 160 and 200 mg/dL. 13. Diabetic ketoacidosis occurs when: A. blood glucose levels rapidly fall. B. the cells rapidly metabolize glucose. C. the pancreas produces excess insulin. D. insulin is not available in the body. 14. A 28-year-old female patient is found to be responsive to verbal stimuli only. Her roommate states that she was recently diagnosed with type 1 diabetes and has had difficulty controlling her blood sugar level. She further tells you that the patient has been urinating excessively and has progressively worsened over the last 24 to 36 hours. On the basis of this patient’s clinical presentation, you should suspect that she: A. is significantly hyperglycemic. 2. has a low blood glucose level. 3. has a urinary tract infection. 4. has overdosed on her insulin. 15. Diabetic coma is a life-threatening condition that results from: 1. 2. 3. 4. hypoglycemia, excess insulin, and dehydration. hyperglycemia, ketoacidosis, and dehydration. hypoglycemia, dehydration, and ketoacidosis. hyperglycemia, excess insulin, and ketoacidosis. 16. Which of the following statements regarding diabetic coma is correct? 1. 2. 3. 4. Diabetic coma can be prevented by taking smaller insulin doses. Diabetic coma typically develops over a period of hours or days. Patients with low blood glucose levels are prone to diabetic coma. Diabetic coma rapidly progresses once hyperglycemia develops. 17. Common signs and symptoms of diabetic coma include all of the following, EXCEPT: 1. 2. 3. 4. warm, dry skin. cool, clammy skin. rapid, thready pulse. acetone breath odor. 18. The signs and symptoms of insulin shock are the result of: 1. 2. 3. 4. increased blood glucose levels. fat metabolism within the cells. decreased blood glucose levels. prolonged and severe dehydration. 19. Insulin shock will MOST likely develop if a patient: 1. 2. 3. 4. takes too much of his or her prescribed insulin. markedly overeats and misses an insulin dose. eats a regular meal followed by mild exertion. misses one or two prescribed insulin injections. 20. Hypoglycemic crisis tends to develop more often and more severely in children because: 1. 2. 3. 4. they have larger glucose stores than adults do. they do not always eat correctly and on schedule. their cells do not uptake glucose as fast as adults’ do. their low activity levels cause rapid glucose depletion. 21. Classic signs and symptoms of hypoglycemia include: 1. warm, dry skin; irritability; bradycardia; and rapid respirations. 2. cool, clammy skin; weakness; tachycardia; and rapid respirations. 3. warm, dry skin; hunger; abdominal pain; and deep, slow respirations. C. cold, clammy skin; bradycardia; hunger; and deep, rapid respirations 22. Assessment of a patient with hypoglycemia will MOST likely reveal: 1. 2. 3. 4. sunken eyes. hyperactivity. warm, dry skin. combativeness. 23. In contrast to insulin shock, diabetic coma: 1. 2. 3. 4. is rapidly reversible if oral glucose is given. commonly results in excess water retention. can only be corrected in the hospital setting. is a rapidly developing metabolic disturbance. 24. A 75-year-old male with type 1 diabetes presents with chest pain and a general feeling of weakness. He tells you that he took his insulin today and ate a regular meal approximately 2 hours ago. You should treat this patient as though he is experiencing: 1. 2. 3. 4. hypoglycemia. an acute stroke. hyperglycemia. a heart attack. 25. You respond to a residence for a patient who is “not acting right.” As you approach the door, the patient, a 35-year-old male, begins shouting profanities at you and your partner while holding a baseball bat. The man is confused and diaphoretic, and is wearing a medical identification bracelet. You should: 1. calm him down so you can assess him. 2. be assertive and talk the patient down. 3. contact medical control for instructions. 4. retreat at once and call law enforcement. 26. A 29-year-old female presents with confusion and disorientation. Her respirations are rapid and shallow and her pulse is 120 beats/min and thready. She is markedly diaphoretic and has an oxygen saturation of 89%. You should: 1. 2. 3. 4. transport immediately. administer oral glucose. provide ventilatory support. treat her for hyperglycemia. 27. A man finds his 59-year-old wife unconscious on the couch. He states that she takes medications for type 2 diabetes. He further tells you that his wife has been ill recently and has not eaten for the past 24 hours. Your assessment reveals that the patient is unresponsive. You should: 1. 2. 3. 4. quickly assess for the presence of a medical identification tag. administer 100% oxygen via a nonrebreathing mask. open and maintain her airway and assess breathing. administer oral glucose between her cheek and gum. 28. You respond to a movie theater for a 70-year-old male who is confused. His wife tells you he has type 2 diabetes but refuses to take his pills. Your assessment reveals that the patient is diaphoretic, tachycardic, and tachypneic. Initial management for this patient should include: 1. 2. 3. 4. administering one to two tubes of oral glucose. applying a nonrebreathing mask at 15 L/min. assisting the patient with his diabetic medication. performing a rapid exam and obtaining vital signs. 29. When obtaining a SAMPLE history from a patient with diabetes, it would be MOST important to determine: 1. 2. 3. 4. if he or she has had any recent illnesses or excessive stress. approximately how much water the patient drank that day. if there is a family history of diabetes or related conditions. the name of the physician who prescribed his or her insulin. 30. When assessing an unconscious diabetic patient, the primary visible difference between hyperglycemia and hypoglycemia is the: 1. 2. 3. 4. patient’s mental status. rate of the patient’s pulse. presence of a medical identification tag. rate and depth of breathing. 31. You are treating a 40-year-old male with a documented blood sugar reading of 300 mg/dL. The patient is semiconscious and breathing shallowly, and is receiving assisted ventilation from your partner. You should recognize that definitive treatment for this patient includes: 1. 2. 3. 4. oxygen. glucagon. insulin. dextrose. 32. A 19-year-old male complains of “not feeling right.” His insulin and a syringe are on a nearby table. The patient says he thinks he took his insulin and cannot remember whether he ate. He is also unable to tell you the time or what day it is. The glucometer reads “error” after several attempts to assess his blood glucose level. In addition to administering oxygen, you should: 1. 2. 3. 4. contact medical control and administer oral glucose. assist him with his insulin injection and reassess him. request a paramedic ambulance to administer IV glucose. transport only with close, continuous monitoring en route. 33. Which of the following conditions is the diabetic patient at an increased risk of developing? A. blindness B. depression C. alcoholism D. hepatitis B 34. Glutose is a trade name for: A. glucotrol. B. oralglucose. C. micronase. D. glucophage. 35. To which of the following diabetic patients should you administer oral glucose? 1. 2. 3. 4. an unconscious 33-year-old male with cool, clammy skin a conscious 37-year-old female with nausea and vomiting a semiconscious 40-year-old female without a gag reflex a confused 55-year-old male with tachycardia and pallor 36. Proper procedure for administering oral glucose to a patient includes all of the following, EXCEPT: 1. 2. 3. 4. assessing the patient’s mental status. ensuring the absence of a gag reflex. checking the medication’s expiration date. requesting permission from medical control. 37. Hemoglobin is: 1. the fluid portion of the blood that transports cells throughout the body. 2. essential for the formation of clots, such as when vessel damage occurs. 3. found within the red blood cells and is responsible for carrying oxygen. D. a key component of the blood and is produced in response to an infection. 38. Which of the following statements regarding sickle cell disease is correct? 1. Sickle cell disease is an inherited blood disorder that causes the blood to clot too quickly. 2. In sickle cell disease, the red blood cells are abnormally shaped and are less able to carry oxygen. 3. The red blood cells of patients with sickle cell disease are round and contain hemoglobin A. 4. Because of their abnormal shape, red blood cells in patients with sickle cell disease are less apt to lodge in a blood vessel. 39. A 30-year-old female presents with severe acute pain to the left upper quadrant of her abdomen. During your assessment, she tells you that she has sickle cell disease. You should suspect that: 1. 2. 3. 4. her spleen is enlarged because of red blood cell engorgement. the pain in her abdomen is referred pain from an enlarged liver. she has gastrointestinal bleeding due to large blood vessel rupture. she is experiencing an aplastic crisis and needs a blood transfusion. 40. An acute accelerated drop in the hemoglobin level, which is caused by red blood cells breaking down at a faster rate than normal, occurs during a(n) __________ crisis. 1. 2. 3. 4. aplastic hemolytic vaso-occlusive splenic sequestration 41. Patients with thrombophilia are at an increased risk for: A. various cancers. B. hemorrhagicstroke. C. acutearterialrupture. D. pulmonary embolism. 42. During your assessment of a 19-year-old male, you are told that he is being treated with factor VIII. This indicates that: 1. 2. 3. 4. he has a thrombosis. hehashemophiliaB. hehashemophiliaA. his blood clots too quickly. 43. A 42-year-old male is found unresponsive on his couch by a neighbor. During your assessment, you find no signs of trauma and the patient’s blood glucose level is 75 mg/dL. His blood pressure is 168/98 mm Hg, his heart rate is 45 beats/min and bounding, and his respirations are 8 breaths/min and irregular. The patient is wearing a medical alert bracelet that states he has hemophilia. You should: A. administer oxygen via a nonrebreathing mask, apply oral glucose in between his cheek and gum, and transport. B. suspect that he has internal bleeding and is in shock, administer high-flow oxygen, and transport at once. C. administer high-flow oxygen, perform a detailed secondary assessment at the scene, and transport promptly. D. suspect that he has intracranial bleeding, assist his ventilations, and transport rapidly to an appropriate hospital. CHAPTER 20: IMMUNOLOGICAL EMERGENCIES 1. Which of the following MOST accurately defines an allergic reaction? 1. an exaggerated immune system response to any substance 2. destruction of the immune system by an external substance 3. a release of erythrocytes in response to a foreign substance 4. a direct negative effect on the body by an external substance 2. Chemicals that are responsible for the signs and symptoms of an allergic reaction to a besting include: 1. 2. 3. 4. the bee venom itself. adrenaline and histamines. leukocytes and epinephrine. histamines and leukotrienes. 3. Anaphylaxis is MOST accurately defined as a(n): 1. moderate allergic reaction that primarily affects the vasculature. 2. extreme allergic reaction that may affect multiple body systems. 3. severe allergic reaction that typically resolves without treatment. 4. allergic reaction that causes bronchodilation and vasoconstriction. 4. The two MOST common signs of anaphylaxis are: 1. 2. 3. 4. wheezing and widespread urticaria. watery eyes and localized itching. expiratory stridor and tachycardia. hypertension and swollen hands. 5. Urticaria is the medical term for: 1. 2. 3. 4. hives. burning. swelling. a wheal. 6. The foreign substance responsible for causing an allergic reaction is called a(n): 1. 2. 3. 4. allergen. antibody. histamine. leukotriene. 7. Which of the following patients would MOST likely have a delayed onset of an allergic reaction? 1. 2. 3. 4. a 21-year-old female who inhaled pollen a 30-year-old male who was stung by a bee a 45-year-old male who ingested penicillin a 50-year-old male who was exposed to latex 8. Which of the following statements regarding fire ants is correct? 1. 2. 3. 4. Fire ants often bite a person repeatedly. Fire ant bites rarely cause anaphylaxis. Fire ant bites typically occur on the face. Most people are allergic to fire ant toxin. 9. A raised, swollen, well-defined area on the skin that is the result of an insect bite or sting is called: 1. a pustule. 2. purpura. 3. urticaria. 4. a wheal. 10. Because the stinger of a honeybee remains in the wound following a sting: A. the stinger can easily be removed with tweezers. 2. thebody’simmunesystemdeactivatesthevenom. 3. the toxicity of the venom decreases within 10 minutes. 4. it can continue to inject venom for up to 20 minutes. 11. The stinger from a honeybee should be: 1. 2. 3. 4. left in place and covered. scraped away from the skin. squeezed with tweezers and removed. irrigated with copious amounts of water. 12. Most patients who die of anaphylaxis do so within the first __________ following exposure. 1. 2. 3. 4. 5 minutes 30 minutes 60 minutes 90 minutes 13. You are assessing a young male who was stung on the leg by a scorpion. He is conscious and alert, his breathing is regular and unlabored, and his blood pressure is 122/64 mm Hg. Assessment of his leg reveals a wheal surrounded by an area of redness. He states that he had a “bad reaction” the last time he was stung by a scorpion, and carries his own epinephrine autoinjector. You should: 1. apply high-flow oxygen, apply a chemical cold pack directly to the injection site, and transport at once. 2. apply high-flow oxygen, obtain approval from medical control to assist him with his epinephrine, and transport. 3. assess his ABCs and vital signs in 15 minutes and allow him to drive himself to the hospital if he remains stable. 14. Which of the following would MOST likely provide clues regarding the source of a patient’s allergic reaction? 1. the patient’s family history 2. thepatient’sgeneralphysicalappearance 3. the environment in which the patient is found 4. the time of season in which the exposure occurred 15. A 73-year-old man presents with a generalized rash, which he thinks may have been caused by an antibiotic that he recently began taking. He has a history of coronary artery disease, hypertension, and emphysema. He is conscious and alert, his blood pressure is 144/94 mm Hg, and his pulse is 64 beats/min and regular. You auscultate his breath sounds and hear scattered wheezing, although he is not experiencing respiratory distress. In addition to administering oxygen, you should: 1. contact medical control if needed, transport the patient, and monitor him for signs of deterioration. 2. ask him if he has epinephrine and request approval from medical control to administer it to the patient. 3. avoid the use of epinephrine because of his cardiac history, even if his symptoms become severe. 4. begin transport and request to administer epinephrine if his systolic blood pressure falls below 110 mm Hg. 16. A 37-year-old male is having a severe allergic reaction to penicillin. He does not have an epinephrine autoinjector and your protocols do not allow you to carry epinephrine on the ambulance. How should you proceed with the treatment of this patient? 1. 2. 3. 4. Ask the patient if he has any diphenhydramine (Benadryl) tablets that you can administer. Administer oxygen, transport at once, and request a paramedic intercept. Remain at the scene with the patient and request a paramedic ambulance. Quickly determine if there are any bystanders who may carry epinephrine. D. apply oxygen as needed, clean the area with soap and water or a mild antiseptic, and transport him to the hospital. 17. Which of the following negative effects of anaphylaxis will be the MOST rapidly fatal if not treated immediately? 1. diffuse urticaria 2. severehypotension 3. upper airway swelling 4. systemic vasodilation 18. A 38-year-old female was bitten by fire ants while at the park with her kids. Your primary assessment reveals that she is semiconscious, has profoundly labored breathing, and has a rapid, thready pulse. She has a red rash on her entire body and her face is very swollen. You should: 1. 2. 3. 4. perform a rapid secondary assessment. assist her ventilations with 100% oxygen. administer 0.3 mg of epinephrine. place her supine with her legs elevated 6′′ to 12′′. 19. A 48-year-old male is found unconscious in the garden by his wife. When you arrive at the scene and assess the man, you find that he is unresponsive, has severely labored breathing, and has hives over his entire trunk. You should: 1. 2. 3. 4. perform a detailed secondary assessment. maintain his airway and assist his ventilations. ask his wife if he has any known allergies. apply the automated external defibrillator (AED) in the event that cardiac arrest occurs. 20. You respond to the residence of a 55-year-old female with a possible allergic reaction to peanuts that she ate approximately 30 minutes ago. The patient is conscious and alert, but has diffuse urticaria and the feeling that she has a lump in her throat. As your partner applies oxygen to the patient, you should: 1. 2. 3. 4. ask her if she has prescribed epinephrine. obtain a complete set of baseline vital signs. ascertain if she has a family history of allergies. ask her when her last allergic reaction occurred. 21. Which of the following medications blocks the release of histamines? 1. 2. 3. 4. albuterol (Ventolin) epinephrine acetaminophen (Tylenol) diphenhydramine (Benadryl) 22. Common signs and symptoms of an allergic reaction include all of the following, EXCEPT: 1. 2. 3. 4. abdominal cramps. drying of the eyes. flushing of the skin. persistent dry cough. 23. Which of the following sounds indicates swelling of the upper airway? A. rales B. stridor C. rhonchi D. wheezing 24. While auscultating breath sounds of a patient who was stung multiple times by a yellow jacket, you hear bilateral wheezing over all lung fields. This indicates: 1. 2. 3. 4. rapid swelling of the upper airway tissues. a significant amount of fluid in the alveoli. narrowing of the bronchioles in the lungs. enlargement of the bronchioles in the lungs. 25. Which of the following physiologic actions does epinephrine produce when given for an allergic reaction? 1. 2. 3. 4. bronchodilation and vasodilation vasoconstriction and bronchodilation bronchoconstriction and vasoconstriction blocking of further histamine release 26. Epinephrine is indicated for patients with an allergic reaction when: A. wheezing and hypotension are present. 2. thepatientisanxiousandtachycardic. 3. aparamedicispresentatthescene. 4. the reaction produces severe urticaria. 27. The adult epinephrine auto-injector delivers ______ mg of epinephrine, and the pediatric auto-injector delivers ______ mg. 1. 2. 3. 4. 0.1, 0.01 0.01, 0.1 0.03, 0.3 0.3, 0.15 28. When using an auto-injector to give epinephrine, the primary injection site is the: 1. 2. 3. 4. medial part of the buttocks. lateral portion of the arm. lateral portion of the thigh. medial portion of the thigh. 29. When administering epinephrine via auto-injector, you should hold the injector in place for: 1. 2. 3. 4. 5 seconds. 10 seconds. 15 seconds. 20 seconds. 30. Immediately after giving an epinephrine injection, you should: 1. 2. 3. 4. properly dispose of the syringe. record the time and dose given. reassessthepatient’svitalsigns. notify medical control of your action. 31. A 50-year-old male was stung by a honeybee approximately 15 minutes ago. He presents with respiratory distress, facial swelling, and hypotension. After placing him on oxygen and administering his epinephrine via auto-injector, you note that his breathing has improved. Additionally, his facial swelling is resolving and his blood pressure is stable. Your next action should be to: 1. 2. 3. 4. reassess his breathing and blood pressure in 15 minutes. visualize his airway to assess for oropharyngeal swelling. notify medical control of the patient’s response to your treatment. record the time and dose of the injection, and transport promptly. 32. You have administered one dose of epinephrine to a 40-year-old female to treat an allergic reaction that she developed after being stung by a scorpion. Your reassessment reveals that she is still having difficulty breathing, has a decreasing mental status, and has a blood pressure of 80/50 mm Hg. You should: 1. 2. 3. 4. monitor her en route to the hospital and call medical control if she worsens. crush up an antihistamine tablet and place it in between her cheek and gum. request permission from medical control to give another dose of epinephrine. administer a nebulized bronchodilator to improve the status of her breathing. 33. The effects of epinephrine are typically observed within _________ following administration. 1. 2. 3. 4. 30 seconds 1 minute 30 minutes 1 hour 34. Common side effects of epinephrine include all of the following, EXCEPT: A. drowsiness. 2. tachycardia. 3. headache. 4. dizziness. 35. A 19-year-old female was stung multiple times on the legs by fire ants. She states that she is allergic to fire ants, but does not carry her own epinephrine. The patient is conscious and alert and complains of pain to the area of the bites. Her blood pressure is 122/70 mm Hg, her pulse is 100 beats/min and strong, and her respirations are 18 breaths/min and unlabored. You should: 1. 2. 3. 4. position her legs well above the level of her heart. administer oxygen and transport her to the hospital. request a paramedic unit to administer epinephrine. advise her to see her physician as soon as possible. 36. After administering 0.3 mg of epinephrine via auto-injector to a 22-year-old female with an allergic reaction, you note improvement in her breathing and dissipation of her hives. However, she is still anxious and tachycardic. You should: 1. contact medical control and obtain authorization to administer another 0.3 mg of epinephrine. 2. transport her rapidly, as it is obvious that she is having a severe reaction to the epinephrine. 3. monitor her closely but recall that anxiety and tachycardia are side effects of epinephrine. 4. consider administering 0.15 mg of epinephrine to completely resolve her allergic reaction. 1. CHAPTER 21: TOXICOLOGY 1. Substance abuse is MOST accurately defined as: 1. 2. 3. 4. knowingly selling illicit drugs in order to buy more drugs. willfully using a therapeutic drug to treat a medical illness. unwillingly and unknowingly consuming drugs or alcohol. knowingly misusing a substance to produce a desired effect. 2. The EMT’s primary responsibility to the patient who has been poisoned is to: 1. 2. 3. 4. administer the appropriate antidote. recognize that a poisoning occurred. administer 25 g of activated charcoal. contact poison control immediately. 3. Heroin is an example of a(n): 1. 2. 3. 4. opioid. hypnotic. cholinergic. sympathomimetic. 4. Hypotension, hypoventilation, and pinpoint pupils would be expected following an overdose of: A. ecstasy. B. oxycodone(Percocet). C. amphetaminesulfate(Benzedrine). D. crack cocaine. 5. Signs and symptoms of a sympathomimetic drug overdose include: 1. 2. 3. 4. sedation. tachycardia. hypotension. slurred speech. 6. Which of the following drugs is NOT a sedative-hypnotic? 1. 2. 3. 4. secobarbital (Seconal) diazepam (V alium) cocaine flunitrazepam (Rohypnol) 7. Your paramedic partner administers atropine to a 49-year-old male with bradycardia. Which of the following side effects would you expect the patient to experience? 1. 2. 3. 4. pupillary constriction excessivelacrimation a fall in blood pressure dry mucous membranes 8. Which of the following questions would be of LEAST pertinence during the initial questioning of a patient who ingested a substance? 1. 2. 3. 4. How much of the substance was taken? How long ago was it taken? What type of substance was taken? Why was the substance ingested? 9. A poison that enters the body by __________ is the MOST difficult to treat. 1. injection 2. ingestion 3. inhalation 4. absorption 10. The poison control center will be able to provide you with the most information regarding the appropriate treatment for a patient with a drug overdose if the center: 1. 2. 3. 4. knows the location of the closest hospital. is aware of the patient’s age and gender. is aware of the substance that is involved. knows why the patient overdosed on the drug. 11. Which of the following statements regarding inhaled poisons is correct? A. Lung damage may progress after the patient is removed from the environment. 2. Carbon monoxide is very irritating to the upper airway and may cause swelling. 3. Burns around the eyes are the most common indication of an inhalation poisoning. 4. Chlorine is a colorless and odorless gas that causes hypoxia and pulmonary edema. 12. Your priority in caring for a patient with a surface contact poisoning is to: 1. 2. 3. 4. move the patient to a safe area. avoid contaminating yourself. decontaminatethepatient’sskin. obtain and maintain a patent airway. 13. Phosphorus or elemental sodium should be brushed off of the skin instead of irrigated with water because: 1. 2. 3. 4. water makes these chemicals impossible to remove. severe swelling will occur when mixed with water. this will eliminate the chances of you being exposed. these chemicals may ignite upon contact with water. 14. Most poisonings occur via the __________ route. A. ingestion 2. injection 3. inhalation 4. absorption 15. Syrup of ipecac is no longer recommended to treat patients who have ingested a poisonous substance because it: 1. has been linked to hypotension. 2. does not effectively induce vomiting. 3. may result in aspiration of vomitus. 4. has toxic effects on the myocardium. 16. Activated charcoal is given to patients who have ingested certain substances because it: 1. 2. 3. 4. induces vomiting and empties the stomach. binds to the substance and prevents absorption. decreases absorption of poisons into the lungs. is a direct antidote for many toxic substances. 17. In general, injected poisons are impossible to dilute or remove because they: 1. 2. 3. 4. are usually absorbed quickly into the body. are usually fatal within 30 minutes of exposure. absorb slowly into the body, despite their potency. react with the blood, which increases their toxicity. 18. As you enter the residence of a patient who has possibly overdosed, you should: 1. 2. 3. 4. be alert for personal hazards. look for drug paraphernalia. observe the scene for drug bottles. quickly gain access to the patient. 19. Your unit is dispatched to the county jail for an intoxicated inmate. Upon arrival, you find the patient, a 33- year-old male, lying supine in a jail cell. He is responsive to painful stimuli only and has slow, shallow respirations. You should be MOST concerned that this patient: 1. might become violent. 2. may vomit and aspirate. C. may experience a seizure. D. is severely hypoglycemic. 20. You receive a call to a residence where a man found his wife unconscious on the couch. The patient is unresponsive, her respiratory rate is 8 breaths/min, her breathing is shallow, her heart rate is 40 beats/min, and her pulse is weak. The husband hands you an empty bottle of hydrocodone (Vicodin), which was refilled the day before. You should: 1. 2. 3. 4. initiate ventilatory assistance. contact the poison control center. perform a rapid head-to-toe exam. apply oxygen via a nonrebreathing mask. 21. It is MOST important to determine a patient’s weight when asking questions pertaining to a toxic ingestion because: 1. 2. 3. 4. additional help may be needed at the scene to lift the patient. this will allow you to predict if the exposure is lethal. this will determine whether or not to give syrup of ipecac. activated charcoal is given based on a patient’s weight. 22. Airborne substances are diluted with: 1. 2. 3. 4. oxygen. syrup of ipecac. activated charcoal. an alkaline antidote. 23. Activated charcoal administration is contraindicated in patients who have ingested: 1. 2. 3. 4. ibuprofen. acetaminophen (Tylenol). acids or alkalis. steroid drugs. 24. Common names for activated charcoal include all of the following, EXCEPT: A. Fructose. 2. Actidose. 3. LiquiChar. 4. InstaChar. 25. The usual dose for activated charcoal is up to ______ for a pediatric patient and up to ______ for an adult patient. 1. 2. 3. 4. 5 g, 10 g 10 g, 20 g 12.5 g, 25 g 25 g, 50 g 26. A 4-year-old male ingested an unknown quantity of acetaminophen (Tylenol). The child’s mother states that the ingestion occurred approximately 20 minutes ago. The child is conscious and alert and in no apparent distress. After contacting medical control, you should: 1. induce vomiting with syrup of ipecac. 2. transport the child for definitive care. 3. administer up to 25 g of activated charcoal. 4. give the child cold milk to absorb the Tylenol. 27. Before giving activated charcoal, you should: 1. 2. 3. 4. obtain approval from medical control. have the patient drink a glass of milk. mix it with an equal amount of water. mix the suspension by stirring the bottle. 28. The major side effect associated with ingestion of activated charcoal is: 1. 2. 3. 4. headache. black stools. abdominalpain. ringing in the ears. 29. After administering activated charcoal to a patient, it is MOST important to: 1. 2. 3. 4. call medical control. be alert for vomiting. reassess the patient’s blood pressure. document the intervention. 30. A person who routinely misuses a substance and requires increasing amounts to achieve the same effect is experiencing a(n): 1. 2. 3. 4. addiction. dependence. withdrawal. tolerance. 31. The MOST commonly abused drug in the United States is: A. cocaine. B. alcohol. C. codeine. D. marijuana. 32. A hypnotic drug is one that: A. induces sleep. 2. preventsamnesia. 3. increasesthepulse. 4. increases the senses. 33. When caring for a known alcoholic patient with severe trauma to the chest and abdomen, you should be concerned that: 1. delirium tremens (DTs) are commonly induced by physical trauma and can lead to lifethreatening seizures. 2. internal bleeding may be profuse because prolonged alcohol use may impair the blood’s ability to clot. 3. long bone fractures are likely because chronic alcohol consumption weakens the structure of the bones. 4. signs and symptoms of shock may be masked by the stimulant effects produced by alcohol. 34. DTs is a syndrome associated with withdrawal from: 1. cocaine. 2. opioids. C. alcohol. D. sedatives. 35. A 49-year-old male presents with confusion, sweating, and visual hallucinations. The patient’s wife tells you that he is a heavy drinker and she thinks he had a seizure shortly before your arrival. This patient is MOST likely experiencing: 1. 2. 3. 4. acute hypovolemia. alcoholintoxication. acuteschizophrenia. DTs. 36. During your assessment of a 50-year-old male who was found unconscious in an alley, you note that he has slow, shallow respirations; significant bradycardia; facial cyanosis; and pinpoint pupils. As your partner begins assisting the patient’s ventilations, he directs your attention to the patient’s arms, which have multiple needle tracks on them. This patient’s clinical presentation is MOST consistent with: 1. 2. 3. 4. a heroin overdose. alcoholintoxication. a closed head injury. an overdose of diazepam (Valium). 37. You and your paramedic partner are caring for a patient who ingested codeine, acetaminophen (Tylenol), and propoxyphene (Darvon). The patient is unresponsive, his breathing is slow and shallow, and his pulse is slow and weak. Treatment for this patient will include: 1. 2. 3. 4. assisted ventilation, naloxone (Narcan), and rapid transport. oxygen via a nonrebreathing mask and rapid transport. assisted ventilation, flumazenil (Romazicon), and rapid transport. oxygen via a nasal cannula, atropine, and rapid transport. 38. You respond to a local motel for a young female who was sexually assaulted. The patient is conscious but confused. She tells you that the last thing she remembers was drinking beer at a club with her friends the night before. When she awoke, she was in the bed of the motel room. You should be MOST suspicious that this patient: 1. 2. 3. 4. is a heroin abuser. is acutely intoxicated. was given flunitrazepam (Rohypnol). is abusing marijuana. 39. You respond to a college campus for a young male who is acting strangely. After law enforcement has secured the scene, you enter the patient’s dorm room and find him sitting on the edge of the bed; he appears agitated. As you approach him, you note that he has dried blood around both nostrils. He is breathing adequately, his pulse is rapid and irregular, and his blood pressure is 200/110 mm Hg. Treatment for this patient includes: 1. 2. 3. 4. requesting a paramedic to administer naloxone (Narcan). assisting his ventilations with a bag-mask device. asking law enforcement to place handcuffs on the patient. attempting to calm him and giving him oxygen if tolerated. 40. In an apparent suicide attempt, a 19-year-old female ingested a full bottle of amitriptyline (Elavil). At present, she is conscious and alert and states that she swallowed the pills approximately 30 minutes earlier. Her blood pressure is 90/50 mm Hg, her pulse is 140 beats/min and irregular, and her respirations are 22 breaths/min with adequate depth. When transporting this patient, you should be MOST alert for: 1. 2. 3. 4. acute respiratory depression. a sudden outburst of violence. an increase in her blood pressure. seizures and cardiac arrhythmias. 41. You are dispatched to a local nursery for a 39-year-old female who is sick. When you arrive, you find the patient lying on the floor. She is semiconscious, has copious amounts of saliva coming from her mouth, and is incontinent of urine. You quickly feel her pulse and note that it is very slow. Initial management for this patient should include: 1. 2. 3. 4. thoroughly suctioning her oropharynx. assisted ventilation with a bag-mask device. performing a rapid secondary assessment. requesting a paramedic to give her atropine. 42. Atropine sulfate and pralidoxime chloride are antidotes for: 1. lysergic acid diethylamide (LSD). 2. diphenhydramine(Benadryl). C. nervegasagents. D. anticholinergic drugs. 43. A patient who presents with rapid breathing, nausea and vomiting, ringing in the ears, and a high fever should be suspected of ingesting a significant quantity of: 1. 2. 3. 4. cocaine. aspirin. Tylenol. ibuprofen. 44. An overdose on acetaminophen, the active ingredient in Tylenol, will MOST likely cause: 1. 2. 3. 4. liver failure. gastriculcers. kidney failure. central nervous system (CNS) depression. 45. Which of the following statements regarding the Salmonella bacterium is correct? 1. 2. 3. 4. Refrigeration of food will prevent salmonellosis. Symptoms of salmonellosis appear within 12 hours. The Salmonella bacterium produces toxins that cause food poisoning. The Salmonella bacterium itself causes food poisoning. 46. A 3-year-old female ingested several leaves from a plant in the living room. The child’s mother is not sure what type of plant it is, stating that she bought it simply because it was pretty. After completing your initial assessment of the child, you should: 1. 2. 3. 4. administer 25 g of activated charcoal. induce vomiting with syrup of ipecac. contact the regional poison control center. immediately transport the child to the hospital. 1. CHAPTER 22: PSYCHIATRIC EMERGENCIES 1. ____________ is what you can see of a person’s response to the environment. 1. 2. 3. 4. Affect Behavior Neurosis Psychosis 2. The term “behavioral crisis” is MOST accurately defined as: 1. a sudden, violent outburst of an otherwise mentally stable person toward a family member. 2. any reaction that interferes with activities of daily living or is deemed unacceptable by others. 3. a situation in which a patient demonstrates bizarre behavior and becomes a risk to other people. 4. a period of severe depression that lasts longer than 2 weeks and cannot be controlled with medications. 3. From a mental health standpoint, an abnormal or disturbing pattern of behavior is a matter of concern if it lasts for at least: 1. 2. 3. 4. 1 week. 2 weeks. 3 weeks. 1 month. 4. In contrast to a behavioral crisis, a psychiatric emergency occurs when a person: 1. 2. 3. 4. demonstrates agitation or violence or becomes a threat to himself or herself, or to others. experiences feelings of sadness and despair for longer than a month. exhibits impaired functioning due to a chemical or genetic disturbance. experiences a sudden attack of panic secondary to a stressful situation. 5. When assessing a patient who is displaying bizarre behavior, the EMT should: 1. 2. 3. 4. consider that an acute medical illness may be causing the patient’s behavior. avoid asking questions about suicide because this may give the patient ideas. check his or her blood glucose level only if he or she has a history of diabetes. carefully document his or her perception of what is causing the patient’s behavior. 6. Organic brain syndrome is MOST accurately defined as: 1. 2. 3. 4. bizarre behavior secondary to a chemical imbalance or disturbance in the brain. a dysfunction of the brain caused by abnormal physical or physiological function. a disorder that cannot be traced to the abnormal structure or function of an organ. a change in behavior or mental status secondary to inadequate cerebral blood flow. 7. A 78-year-old female presents with an acute change in her behavior. The patient’s son tells you that his mother has type 2 diabetes and was diagnosed with Alzheimer’s disease 6 months ago. The patient’s speech is slurred and she is not alert to her surroundings. You should: 1. 2. 3. 4. transport the patient to a psychiatric facility. inquire about the possibility of head trauma. conclude that the patient’s blood sugar is high. allow the patient to refuse transport if she wishes. 8. Which of the following conditions or factors would be the LEAST likely to result in a change in behavior? 1. 2. 3. 4. low blood glucose levels antihypertensivemedications exposure to excess heat or cold inadequate blood flow to the brain 9. Which of the following is an example of a functional behavioral disorder? 1. 2. 3. 4. head trauma drug addiction schizophrenia Alzheimer’s disease 10. The first step in assessing a patient with a behavioral emergency is to: 1. 2. 3. 4. take vital signs. restrain the patient. ensure your safety. obtain proper consent. 11. You respond to a call for an unknown emergency. When you arrive at the scene, the patient’s husband meets you at the door and states that his wife has been depressed and has locked herself in an upstairs bedroom. He further tells you that he keeps his handgun in the bedroom. You should: 1. 2. 3. 4. ask the husband to attempt to reason with his wife. remain in a safe place and request law enforcement. get in your ambulance and leave the scene immediately. go upstairs with caution and attempt to talk to the patient. 12. General guidelines for managing a patient with a behavioral emergency include: 1. firmly identifying yourself as an EMS provider. 2. placing the patient between yourself and an exit. 3. allowing the patient to be alone if he or she wishes. 4. being prepared to spend extra time with the patient. 13. A 40-year-old male intentionally cut his wrist out of anger after losing his job. Law enforcement has secured the scene prior to your arrival. As you enter the residence and visualize the patient, you can see that he has a towel around his wrist and a moderate amount of blood has soaked through it. You should: 1. 2. 3. 4. approach the patient with caution. quickly tend to the bleeding wound. tell the patient that you want to help. calmly identify yourself to the patient. 14. When assessing a patient with a behavioral crisis, you should: 1. 2. 3. 4. be direct and clearly state your intentions. frisk the patient for the presence of weapons. spend as little time with the patient as possible. ask the police to handcuff the patient for safety. 15. A 22-year-old male with a history of clinical depression called 9-1-1 and stated that he has attempted to kill himself. Your unit and law enforcement officers arrive at the scene simultaneously. You find the patient lying supine on the living room floor. He is unconscious and cyanotic. An empty bottle of hydromorphone (Dilaudid) is found on an adjacent table. You should: 1. 2. 3. 4. open the patient’s airway and assess his respirations. ask the police to handcuff the patient for safety purposes. provide care after determining what Dilaudid is used for. wait for the police to examine him before providing care. 16. A 66-year-old male presents with bizarre behavior. His daughter states that he did not seem to recognize her and was very rude to her. The patient is conscious, and has a patent airway and adequate breathing. You should: 1. 2. 3. 4. conclude that the patient has Alzheimer’s disease. ask the daughter how her father normally behaves. carefully restrain the patient and transport at once. advise the patient that his behavior is unacceptable. 17. A technique used to gain insight into a patient’s thinking, which involves repeating in question form what the patient has said, is called: 1. 2. 3. 4. active listening. passivelistening. intuitivelistening. reflective listening. 18. Which of the following statements regarding the physical examination of a patient with a behavioral problem is correct? A. It is only appropriate to perform a physical examination on a patient with a behavioral problem if he or she is unconscious or is being physically restrained. C. The physical examination of a patient with a behavioral problem often yields crucial information and should always be performed, even if the patient is violent. D. Performing a physical examination on a patient with a behavioral problem will likely cause him or her to become violent and should be avoided in the field. 19. You are assessing a conscious 55-year-old male with a sudden change in behavior. Which of the following clinical findings would be MOST suggestive of dysfunction of this patient’s central nervous system? 1. 2. 3. 4. an irregular pulse rapid eye movement excessive tearing or crying consistent eye contact 20. Assessing the blood pressure and oxygen saturation of a patient with a behavioral crisis should be performed: 1. 2. 3. 4. within the first few minutes after making patient contact. at least every 5 minutes in order to detect signs of shock. only if you will be transporting the patient to the hospital. if doing so will not worsen his or her emotional distress. 21. In addition to ensuring his or her own safety, the EMT’s responsibility when caring for a patient with a behavioral emergency is to: 1. 2. 3. 4. diffuse and control the situation and safely transport the patient. diagnose the patient’s problem and provide definitive treatment. transport the patient directly to a specialized psychiatric facility. determine the underlying cause of the problem and offer advice. 22. Common causes of acute psychotic behavior include all of the following, EXCEPT: 1. intense stress. 2. schizophrenia. C. Alzheimer’sdisease. D. mind-altering substance use. 23. The single most significant factor that contributes to suicide is: 1. 2. 3. 4. depression. drug abuse. advanced age. a chronic illness. B. A physical examination for a behavioral problem may be difficult to perform but may provide clues to the patient’s state of mind and thought processes. 24. You are assessing a 45-year-old female who is severely depressed. She states that it seems as though her entire world is crashing down around her. She further states that she has had frequent thoughts of suicide, but is not sure if she can actually go through with it. How should you manage this situation? 1. 2. 3. 4. Ask the patient if she has developed a suicidal plan. Leave the scene and have a neighbor check in on her. Have law enforcement place her in protective custody. Encourage the patient to remain quiet during transport. 25. People at risk for suicide include all of the following, EXCEPT: 1. 2. 3. 4. married males older than 30 years. those with a recent diagnosis of a serious illness. children with parents addicted to alcohol. substance abusers. 26. It is MOST important for the EMT to remember that suicidal patients may: 1. inject illicit drugs. 2. beself-destructive. C. behomicidalaswell. D. have a definitive plan. 27. Signs of agitated delirium include: 1. 2. 3. 4. pallor, hypotension, and constricted pupils. diaphoresis, tachycardia, and hallucinations. slurred speech, bradycardia, and a high fever. subdued behavior, crying, and suicidal thoughts. 28. Law enforcement personnel request your assistance for a 30-year-old man who they pulled over for erratic driving. The patient became acutely violent while he was being questioned, which required one of the officers to subdue him with a Taser. When you arrive and assess the patient, you find that he is very agitated and is experiencing apparent hallucinations. His skin is flushed and diaphoretic. You should: 1. quickly rule out any life-threatening conditions and then perform a detailed secondary assessment as he is being restrained. 2. suspect that he is acutely hypoglycemic, consider giving him one tube of oral glucose, and transport with lights and siren. D. recognize that he is experiencing a complex psychiatric crisis, quickly load him into the ambulance, and transport without delay. 29. A 38-year-old male with a history of schizophrenia is reported by neighbors to be screaming and throwing things in his house. You are familiar with the patient and have cared for him in the past for unrelated problems. Law enforcement officers escort you into the residence when you arrive. The patient tells you that he sees vampires and is attempting to ward them off by screaming and throwing things at them. He has several large lacerations to his forearms that are actively bleeding. The MOST appropriate way to manage this situation is to: 1. 2. 3. 4. try to gain the patient’s trust by telling him that you see the vampires too. request that the police officers arrest him and take him to the hospital. restrain the patient with appropriate force in order to treat his injuries. approach the patient and calm him by placing your hand on his shoulder. 30. You receive a call for a domestic dispute. When you arrive at the scene, you find a young male standing on the front porch of his house. You notice that an adjacent window is broken. The patient has a large body, is C. limit physical contact with the patient as much as possible and avoid interrupting him if he is attempting to communicate with you. clenching his fists, and is yelling obscenities at you. Which of the following findings is LEAST predictive of this patient’s potential for violence? 1. his clenched fists 2. the broken window 3. his shouting of obscenities 4. his large body 1. CHAPTER 23: OBGYN EMERGENCIES 1. Each ovary produces an ovum in alternating months and releases it into the: 1. 2. 3. 4. vagina. uterus. cervix. fallopian tube. 2. In anticipation of receiving a fertilized ovum, the lining of the uterine wall: 1. 2. 3. 4. thins and begins to separate. becomes engorged with blood. diverts blood flow to the vagina. sheds and is expelled externally. 3. The onset of menstruation is called menarche and usually occurs in women who are: 1. 2. 3. 4. between 12 and 14 years of age. between 11 and 16 years of age. between 25 and 35 years of age. between 45 and 50 years of age. 4. When a female has reached menarche: 1. 2. 3. 4. she is capable of becoming pregnant. she can no longer produce an ovum. she usually requires hormone therapy. menstrual periods become less frequent. 5. It is not uncommon for young females who experience their first menstrual period to: 1. 2. 3. 4. have a falsely positive home pregnancy test result. lose up to 500 mL of blood within the first 24 hours. experience abdominal cramping, which may be misinterpreted. become so emotionally distraught that they contemplate suicide. 6. Which of the following statements regarding pelvic inflammatory disease (PID) is correct? 1. 2. 3. 4. The most severe cases of PID occur in women who are not sexually active. PID can scar the fallopian tubes, which increases the risk of an ectopic pregnancy. PID most commonly affects women who have had an ectopic pregnancy in the past. The most common presenting symptom of PID is generalized upper abdominal pain. 7. PID typically does NOT affect the: 1. 2. 3. 4. uterus. ovaries. urinary bladder. fallopian tubes. 8. Potentially life-threatening consequences of PID include: 1. 2. 3. 4. ovarian cysts and gonorrhea. bacterial vaginosis and chlamydia. uterine rupture with severe bleeding. ovarian abscess and ectopic pregnancy. 9. Which of the following clinical presentations is MOST consistent with PID? 1. 2. 3. 4. left lower quadrant pain, referred pain to the left shoulder, and fever pain around the umbilicus, low-grade fever, and generalized weakness upper abdominal cramping, severe headache, and heavy vaginal bleeding lower abdominal pain, fever, general malaise, and foul-smelling vaginal discharge 10. Which of the following conditions does NOT typically present with vaginal discharge? A. chlamydia B. gonorrhea C. genitalherpes D. PID 11. As a woman approaches menopause: 1. 2. 3. 4. her menstrual periods may become irregular and vary in severity. she cannot become pregnant because of fluctuating hormone levels. she usually experiences abdominal cramping without vaginal bleeding. her risk of developing PID lowers significantly. 12. Which of the following conditions would MOST likely lead to PID if left untreated? 1. chlamydia 2. ovarian cysts 3. genitalherpes 4. ectopic pregnancy 13. Bacterial vaginosis is a condition that occurs when: 1. 2. 3. 4. harmful bacteria infect and cause damage to the uterus, cervix, and fallopian tubes. normal bacteria in the vagina are replaced by an overgrowth of other bacterial forms. numerous bacteria enter the uterus through the cervix and cause severe tissue damage. abnormal bacteria enter the vagina and cause damage without causing any symptoms. 14. Which of the following statements regarding gonorrhea is correct? 1. 2. 3. 4. Most men who are infected with gonorrhea do not experience symptoms. Painful urination is a common symptom of gonorrhea in men and women. Symptoms of gonorrhea usually appear within 3 months after being infected. Mild infections with gonorrhea cause abdominal pain, vomiting, and fever. 15. In contrast to bleeding caused by external trauma to the vagina, bleeding caused by conditions such as polyps or cancer: 1. 2. 3. 4. may be relatively painless. is typically not as severe. can be controlled in the field. often presents with acute pain. 16. Whenever possible, a female sexual assault victim should be: A. given the option of being treated by a female EMT. B. encouraged to take a shower and change her clothes. C. thoroughly assessed, even if no signs of injury exist. D. asked to provide a brief description of the perpetrator. 17. When a woman presents with abdominal pain or other vague symptoms, the EMT is often unable to determine the nature of the problem until he or she: 1. 2. 3. 4. has gathered patient history information. has obtained a complete set of vital signs. ascertains if the patient was ever pregnant. has formed a general impression of the patient. 18. During your assessment of a young female with nontraumatic vaginal bleeding, you note that her level of consciousness is decreased, her respirations are rapid and shallow, her skin is cool and moist, and her pulse is rapid and weak. You should: 1. 2. 3. 4. perform a rapid secondary assessment. assist her ventilations with a bag-mask device. assess her blood pressure and elevate her legs. perform a visual assessment of her vaginal area. 19. If a woman with vaginal bleeding reports syncope, the EMT must assume that she: 1. 2. 3. 4. is pregnant. is in shock. has an infection. has an ectopic pregnancy. 20. When caring for a woman who is experiencing a gynecologic emergency, the EMT’s main focus should be to: 1. 2. 3. 4. determine the underlying cause of her problem. ask questions related to her gynecologic history. maintain her ABCs and transport without delay. keep assessment and treatment to a minimum. 21. A 26-year-old female presents with heavy vaginal bleeding. She is conscious, but restless. Her blood pressure is 84/54 mm Hg, her pulse is 120 beats/min and weak, and her respirations are 22 breaths/min with adequate depth. She tells you that she inserted a tampon about 2 hours ago. You should: 1. administer high-flow oxygen, ask her to remove the tampon, perform a detailed secondary assessment, and transport promptly. 2. administer high-flow oxygen, perform a detailed assessment of her vaginal area for signs of trauma, place her on her side, and transport. D. assist her ventilations with a bag-mask device, place one sterile dressing into her vagina, perform a rapid secondary assessment, and transport. 22. General treatment for a woman with vaginal bleeding and shock following sexual assault includes all of the following, EXCEPT: 1. 2. 3. 4. supplemental oxygen and lower extremity elevation. refraining from placing any dressings into the vagina. carefully removing any foreign bodies from the vagina. treating external lacerations with moist, sterile compresses. C. administer high-flow oxygen, place a sterile pad over her vagina, keep her warm, elevate her lower extremities, and transport without delay. 23. You are dispatched to a residence for a 40-year-old female who complains of lower abdominal pain, fever and chills, and a foul-smelling vaginal discharge. Which of the following additional assessment findings would increase your index of suspicion for PID? 1. 2. 3. 4. a shuffling gait when walking bright red blood in the urine a history of ectopic pregnancy vaginal passage of blood clots 24. Which of the following statements regarding rape is correct? 1. 2. 3. 4. The EMT should try to determine if rape occurred. Rape is a legal diagnosis, not a medical diagnosis. Rape causes more physical harm than emotional harm. Only a licensed physician can make a diagnosis of rape. 25. When caring for a female patient who has been sexually assaulted, you should: 1. 2. 3. 4. ask the patient for a concise, detailed report of what happened to her. allow law enforcement to take her statement before you begin treatment. advise her that she will not be allowed to shower or change her clothes. place any bloodstained clothing or other articles in separate paper bags. 26. Law enforcement personnel request your assistance to assess a 31-year-old female who was sexually assaulted. When you arrive at the scene, you find the patient sitting on a curb outside her apartment. She is conscious, alert, and crying. When you ask her what happened, she tells you that she does not want to be treated or transported to the hospital. She further tells you that all she wants to do is clean up. You should: 1. 2. 3. 4. provide emotional support and visually assess her for obvious trauma. advise her that she cannot clean herself up because this will destroy evidence. ask her if there is anyone you can contact, such as a friend or relative. perform a limited hands-on assessment to detect life-threatening injuries. 27. The physical examination of a sexual assault victim should be: 1. 2. 3. 4. limited to a brief survey for life-threatening injuries. performed in the presence of at least two police officers. as detailed as possible so all injuries can be documented. deferred until the patient can be evaluated by a physician. 28. When documenting a call in which a female was sexually assaulted, you should: 1. 2. 3. 4. only use quotation marks when recording any statements made by witnesses. translate the patient’s words or statements using proper medical terminology. record your opinion only if you have reasonable proof to justify the statement. keep the report concise and record only what the patient stated in her own words.