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A-Para 2 Final > Exit Exam > Flashcards

Flashcards in Exit Exam Deck (211)
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1

1. The release of glucagon into the bloodstream stimulates:
a) the liver to convert glycogen to glucose.
b) the liver to take in and store more glucose.
c) the cells to uptake sugar from the bloodstream.
d) the vessels to constrict, thus increasing blood pressure.

a) the liver to convert glycogen to glucose.

2

2) Which of the following statements regarding insulin is MOST correct?
a) Insulin stimulates the conversion of glycogen to glucose.
b) An increase in insulin levels causes an increase in blood glucose.
c) Insulin is a pancreatic hormone that performs exocrine functions.
d) Insulin is the only hormone that decreases blood glucose levels.

d) Insulin is the only hormone that decreases blood glucose levels.

3

3) Diabetes is MOST accurately defined as:
a) inadequate insulin secretion, which leads to increased circulating blood glucose levels.
b) a decrease in circulating insulin levels, which results in a drop in serum blood sugar levels.
c) a metabolic disorder in which the body’s ability to metabolize simple carbohydrates is impaired.
d) an endocrine disorder in which the liver is unable to produce and store adequate amounts of glycogen.

c) a metabolic disorder in which the body’s ability to metabolize simple carbohydrates is impaired.

4

4) A person with type 1 diabetes:

a) is often an older person whose pancreas does not produce adequate insulin.
b) can often control his or her diabetes with a proper diet and regular exercise.
c) is not as likely to experience hypoglycemia as a person with type 2 diabetes.
d) generally does not produce any insulin and requires daily insulin injections.

d) generally does not produce any insulin and requires daily insulin injections.

5

5) Diabetic patients would MOST likely present with atypical signs and symptoms of:
a) bacterial pneumonia.
b) acute coronary syndrome.
c) an acute ischemic stroke.
d) viral or fungal meningitis.

b) acute coronary syndrome

6

6) Common symptoms of type 2 diabetes include all of the following, EXCEPT:
a) thirst.
b) dysuria.
c) fatigue.
d) blurred vision.

b) dysuria.

7

7) Prior to administering 50% dextrose (D50) via IV push, it is MOST important to:

a) protect the airway with an endotracheal tube.
b) ensure that the IV line is patent and freely flowing.
c) confirm a blood glucose reading of less than 40 mg/dL.
d) draw blood for later analysis in the emergency department.

b) ensure that the IV line is patent and freely flowing

8

8) Hyperglycemia is characterized by:

a) a gradual onset and warm, dry skin.
b) shallow respirations and bradycardia.
c) a rapid onset and cool, clammy skin.
d) a blood glucose level above 110 mg/dL.

a) a gradual onset and warm, dry skin

9

9) An illness or infection would MOST likely cause:

a) diabetic ketoacidosis.
b) acute hyperglycemia.
c) blood glucose above 500 mg/dL.
d) a slow onset of hyperglycemia.

d) a slow onset of hyperglycemia

10

10) Diabetic ketoacidosis (DKA) occurs when:

a) blood glucose levels rise above 250 mg/dL.
b) the renal system begins to excrete ketones.
c) the cells metabolize fat and produce ketones.
d) insulin production exceeds glucagon production.

c) the cells metabolize fat and produce ketones.

11

11) Unlike the patient with hypoglycemia, the patient with severe hyperglycemia:

a) usually does not vomit.
b) has a normal breath odor.
c) rapidly improves with treatment.
d) is tachypneic and hyperpneic.

d) is tachypneic and hyperpneic.

12

12) Which of the following interventions would the paramedic LEAST likely perform on a patient with diabetic ketoacidosis?
a) Insulin administration
b) Endotracheal intubation
c) Sodium bicarbonate administration
d) Infusion of 1 to 2 L of normal saline

a) Insulin administration

13

13) Prehospital treatment for patients with hyperosmolar hyperglycemic nonketotic coma (HHNC) focuses on:
a) intubation and insulin administration.
b) correction of electrolyte abnormalities.
c) high-flow oxygen and IV or IM glucagon.
d) airway management and fluid rehydration.

d) airway management and fluid rehydration

14

14) Which of the following statements regarding Addison’s disease is MOST correct?
a) It most often occurs when the immune system creates antibodies that attack and destroy the adrenal cortex.
b) Addison’s disease is also known as secondary adrenal insufficiency and is most often the result of a viral infection.
c) The signs and symptoms of Addison’s disease are a direct result of the overproduction of cortisol and aldosterone.
d) Hallmark signs of Addison’s disease are hypertension and fluid retention that result from excess sodium reabsorption.

a) It most often occurs when the immune system creates antibodies that attack and destroy the adrenal cortex.

15

15) A 29-year-old man presents with bizarre behavior and profuse sweating. His wife tells you that he is a type 1 diabetic, and that he took his insulin today. During your assessment, you will MOST likely find that the patient is:

a) dehydrated.
b) tachypneic.
c) hyperglycemic.
d) breathing deeply.

b) tachypneic.

16

16) You are dispatched to the residence of a 60-year-old woman who was found unresponsive by her husband. As you are assessing the patient, her husband tells you that she is a diabetic and has recently experienced several “small strokes.” In addition to properly managing her airway, you should:

a) perform a field glucose test to rule out hypoglycemia.
b) start an IV line and give her 50 mL of 50% dextrose.
c) avoid giving her glucose because of her small strokes.
d) start an IV line and give her a 20 mL/kg fluid bolus.

a) perform a field glucose test to rule out hypoglycemia.

17

17) 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:

a) 25 g of 50% dextrose.
b) in-hospital antibiotics.
c) 0.5 to 1 mg of glucagon.
d) crystalloid fluid hydration.

d) crystalloid fluid hydration.

18

18) A 68-year-old obese woman presents with a markedly decreased level of consciousness. She was found in bed by her husband. Your initial assessment reveals that her respirations are slow and shallow, her pulse is slow and weak, and her skin is cold and dry. According to the patient’s husband, she has had a recent infection, but he cannot remember what the doctor called it. You should be MOST suspicious that this patient is experiencing:

a) myxedema coma.
b) Addisonian crisis.
c) diabetic ketoacidosis.
d) acute hypothyroidism.

a) myxedema coma.

19

19) When transferring a patient between medical facilities, it is MOST important for the paramedic to:

a) ensure that all appropriate paperwork, x-rays, and lab results are delivered to the receiving facility.
b) request another paramedic if the patient's clinical condition is too unstable for one paramedic to manage effectively.
c) request that a member of the patient's family accompanies the patient in case the patient cannot speak for himself or herself.
d) ensure that a physician or nurse accompanies the patient if the patient requires care beyond the paramedic's scope of practice.

d) ensure that a physician or nurse accompanies the patient if the patient requires care beyond the paramedic's scope of practice.

20

20) Scope of practice is defined as:
A. protocols agreed upon by a consensus of emergency physicians.
B. the level of care that a paramedic's employer allows the paramedic to provide.
C. national patient care guidelines established by the federal government.
D. care that a paramedic is permitted to perform under the certifying state.

D. care that a paramedic is permitted to perform under the certifying state.

21

21) Abandonment occurs when:
a. a patient is released and did not require further medical care.
b. an emergency nurse takes a verbal report from a paramedic.
c. care of a patient was terminated without his or her consent.
d. a patient refuses care and subsequently dies of his condition.

c. care of a patient was terminated without his or her consent.

22

22) Patients with decision-making capacity:
a) cannot refuse EMS treatment and transport after they have given consent for it.
b) have the right to refuse all or part of the emergency medical care offered to them.
c) must agree to EMS transport if they give consent for emergency medical treatment.
d) cannot withdraw consent unless their conditions are deemed to be non-life-threatening.

b) have the right to refuse all or part of the emergency medical care offered to them.

23

23) If a mentally competent adult refuses emergency medical treatment, your FIRST action should be to:
a) call medical control and seek further guidance.
b) determine if his or her condition is life-threatening.
c) assume the refusal is from fear and begin treatment.
d) try to determine why he or she is refusing treatment.

d) try to determine why he or she is refusing treatment.

24

24) Which of the following statements regarding documentation is MOST correct?
a) The paramedic's personal opinion is an important part of the patient care report.
b) A thorough and accurate medical record is the paramedic's best protection in court.
c) Pertinent negatives are of minimal value and should not be part of the patient report.
d) Never quote bystanders directly regarding statements made about the patient's history.

b) A thorough and accurate medical record is the paramedic's best protection in court.

25

25) The MOST appropriate way to wash your hands following patient care involves:
a) soaking your hands in warm water and rinsing with clean water.
b) washing vigorously with antibacterial soap for at least 30 seconds.
c) using waterless hand cleaner gels or wipes instead of antibacterial soap.
d) applying isopropyl alcohol and then rinsing your hands with clean water.

b) washing vigorously with antibacterial soap for at least 30 seconds.

26

26) During an emergency call, you begin experiencing a significant amount of anxiety. The patient's family is present and the patient's condition is critical. You should:
a) request a relief paramedic and disengage from patient care at once.
b) tighten and then relax specific muscle groups to initiate relaxation.
c) try to ignore the anxiety as best you can and take care of the patient.
d) take deep breaths in through your nose and out through your mouth.

d) take deep breaths in through your nose and out through your mouth.

27

27) You are driving the ambulance to the hospital as your team is caring for a critically injured patient in the back. As you approach a car in front of you, the driver appears to panic. You should:
a) turn your siren off, turn on your public address (PA) system, and kindly ask the driver to pull over to the right and stop.
b) keep your siren on, remain at least 20 feet behind the vehicle, and then carefully pull around him on the right side.
c) turn your lights and siren off, quickly pass the vehicle on the left side, and then turn your lights and siren back on.
d) keep your lights and siren on, remain a safe distance behind the vehicle, and use your PA system to tell him to stop.

a) turn your siren off, turn on your public address (PA) system, and kindly ask the driver to pull over to the right and stop.

28

28) Dr. Eugene Nagel advanced emergency medical treatment in 1969 by:
a) training paramedics to administer certain medications directly though the chest wall and into the left ventricle.
b) developing and implementing closed-chest cardiac massage (CPR) in order to pump blood in a patient without a pulse.
c) implementing the “golden hour,” which dramatically increased survival rates of patients who experienced severe trauma.
d) developing a telemetry system that enabled fire fighters to transmit a patient's electrocardiogram to the physician at the hospital.

d) developing a telemetry system that enabled fire fighters to transmit a patient's electrocardiogram to the physician at the hospital.

29

29) The chemical sign for sodium bicarbonate is:
a) NaCl.
b) H2CO3.
c) NaHCO3.
d) KCl.

c) NaHCO3.

30

30) The net effect of osmosis is to:
a) balance the concentration of water on both sides of the cell wall.
b) equalize solute concentrations on both sides of the cell membrane.
c) utilize ATP to actively move solutes across the cell membrane.
d) maintain a higher concentration of solutes outside of the cell.

b) equalize solute concentrations on both sides of the cell membrane.