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NREMT Practice Test Bank - Multiple Choice – Questions and Answers
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NREMT Practice Test Bank - MultipleChoice Exam
Hypoglycemia and acute ischemic stroke can present similarly because:
• A:both oxygen and glucose are needed for brain function.
• B:the majority of stroke patients have a history of diabetes.
• C:the most common cause of a stroke is hypoglycemia.
• D:they are both caused by low levels of glucose in the blood. - -• A:both
oxygen and glucose are needed for brain function.
Reason: Although stroke and hypoglycemia are two distinctly different
conditions, their signs and symptoms are often similar. This is because the
brain requires both oxygen and glucose to function normally. An acute
ischemic stroke is caused by a lack of oxygen to a part of the brain due to a
blocked cerebral artery, whereas hypoglycemia (low blood glucose level)
deprives the entire brain of glucose. In either case, the patient presents with
signs of impaired brain function (ie, slurred speech, weakness, altered
mental status). Both conditions may lead to permanent brain damage or
death if not treated promptly.
-When dealing with an emotionally disturbed patient, you should be MOST
concerned with:
• A:gathering all of the patient's medications.
• B:safely transporting to the hospital.
• C:whether the patient could harm you.
• D:obtaining a complete medical history. - -You selected C; This is correct!
Reason: When managing any patient with an emotional or psychiatric crisis,
your primary concern is your own safety. Safely transporting the patient to
the hospital is your ultimate goal. If possible, you should attempt to obtain a
medical history and should take any of the patient's prescribed medications
to the hospital. However, this should not supercede your own safety or
interfere with safely transporting the patient.
-You are at the scene where a man panicked while swimming in a small lake.
Your initial attempt to rescue him should include:
• A:rowing a small raft to the victim.
• B:reaching for the victim with a long stick.
• C:throwing a rope to the victim.
• D:swimming to the victim to rescue him. - -You selected B; This is correct!
Reason: General rules to follow when attempting to rescue a patient from the
water include "reach, throw, row, and then go." In this case, you should
,attempt to reach the victim by having him grab hold of a large stick or
similar object. If this is unsuccessful, throw the victim a rope or flotation
device (if available). If these are not available, row to the patient in a small
raft (if available). Going into the water to retrieve the victim is a last resort.
The rescuer must be a strong swimmer because patients who are in danger
of drowning are in a state of blind panic and will make every attempt to keep
themselves afloat, even if it means forcing the rescuer underwater.
-How should you classify a patient's nature of illness if he or she has a low
blood glucose level, bizarre behavior, and shallow breathing?
• A:Behavioral emergency
• B:Altered mental status
• C:Respiratory emergency
• D:Cardiac compromise - -The correct answer is B;
Reason: The nature of illness (NOI) is the medical equivalent to mechanism
of injury (MOI). Altered mental status should be the suspected NOI in any
patient with any fluctuation in level of consciousness, which can range from
bizarre behavior to complete unresponsiveness. Causes of an altered mental
status include hypo- or hyperglycemia, head trauma, stroke, behavioral
crises, drug overdose, and shock, among others.
-A young female is unresponsive after overdosing on an unknown type of
drug. Her respirations are slow and shallow and her pulse is slow and weak.
Which of the following drugs is the LEAST likely cause of her condition?
• A:Seconal
• B:Heroin
• C:Cocaine
• D:Valium - -The correct answer is C;
Reason: Of the drugs listed, cocaine would be the least likely cause of the
patient's condition. Cocaine is a central nervous system (CNS) stimulant; you
would expect her to be hypertensive, tachycardic, tachypneic, and perhaps
even violent. Heroin, Valium, and Seconal are all CNS depressants and could
explain her condition. Heroin is an illegal narcotic (opiate), Valium is a
benzodiazepine sedative-hypnotic drug, and Seconal is a barbiturate.
Narcotics, benzodiazepines, and barbiturates are all CNS depressants. When
taken in excess, they cause a decreased level of consciousness, respiratory
depression, bradycardia, and hypotension.
-Activated charcoal is contraindicated for a patient who is:
• A:conscious and alert and has ingested a large amount of Motrin.
• B:emotionally upset and has ingested two bottles of aspirin.
• C:agitated and claims to have ingested a bottle of Tylenol.
• D:awake and alert and has swallowed a commercial drain cleaner. - -You
selected D; This is correct!
,Reason:Activated charcoal adsorbs (sticks to) many ingested substances,
preventing them from being absorbed into the body by the stomach or
intestines. In some cases, you may give activated charcoal to patients who
have ingested certain substances, if approved by medical control or local
protocol. Activated charcoal is contraindicated for patients who have
ingested an acid or alkali (ie, drain cleaner) or a petroleum product (ie,
gasoline), who have a decreased level of consciousness and cannot protect
their own airway, or who are unable to swallow.
-The MOST obvious way to reduce heat loss from radiation and convection is
to:
• A:move away from a cold object.
• B:increase metabolism by shivering.
• C:wear a thick wind-proof jacket.
• D:move to a warmer environment. - -you selected D; This is correct!
Reason:In a cold environment, the body has two ways of staying warm:
generating heat (thermogenesis) and reducing heat loss. Radiation is the
transfer of heat by radiant energy. The body can lose heat by radiation, such
as when a person stands in a cold room. Convection occurs when heat is
transferred to circulating air, as when cool air moves across the body's
surface. A person standing in windy cold weather, wearing lightweight
clothing, is losing heat to the environment mostly by convection. The
quickest and most obvious way to decrease heat loss from radiation and
convection is to move out of the cold environment and seek shelter from
wind. Shivering increases the body's metabolism and is a mechanism for
generating heat, not reducing heat loss. Layers of clothing trap air and
provide excellent insulation; thus, layered clothing decreases heat loss
better than a single, thick jacket. Conduction is the direct transfer of heat
from a part of the body to a colder object by direct contact, as when a warm
hand touches cold metal or ice. The most obvious way to decrease heat loss
by conduction is to remove your hand from the cold object.
-A near-drowning is MOST accurately defined as:
• A:complications within 24 hours following submersion in water.
• B:immediate death due to prolonged submersion in water.
• C:survival for at least 24 hours following submersion in water.
• D:death greater than 24 hours following submersion in water. - -You
selected C; This is correct!
Reason:Collectively, drowning and near-drowning are referred to as
submersion injuries. Drowning is defined as death after submersion in a
liquid medium, usually water. In a drowning, death is either immediate or
occurs within 24 hours following submersion. Near-drowning is defined as
survival, at least temporarily (24 hours), after submersion. It should be
, noted, however, that complications such as pneumonia and pulmonary
edema can cause death greater than 24 hours following submersion. For this
reason, all patients with a submersion injury should be transported to the
hospital, even if they appear fine at the scene.
-A young woman reports significant weight loss over the last month,
persistent fever, and night sweats. When you assess her, you note the
presence of dark purple lesions covering her trunk and upper extremities.
You should suspect:
• A:end-stage cancer.
• B:HIV/AIDS.
• C:tuberculosis.
• D:rheumatic fever. - -You selected B; This is correct!
Reason:Weight loss, fever, and night sweats could indicate tuberculosis or
HIV/AIDS; however, the dark purple lesions on the skin, which are called
Kaposi's sarcoma, are malignant skin tumors and are a classic finding in
patients in the later stages of AIDS.
-A 48-year-old male became acutely hypoxic, experienced a seizure, and is
now postictal. The MOST effective way to prevent another seizure is to:
• A:dim the lights in the back of the ambulance.
• B:place him in the recovery position.
• C:administer high-flow supplemental oxygen.
• D:give him oral glucose if he can swallow. - -You selected C; This is
correct!
Reason:You should administer high-flow oxygen to all patients who are
actively seizing and to patients who experienced a seizure and are postictal.
This is especially true if the seizure was caused by hypoxia. Increasing the
oxygen content of the blood, which minimizes hypoxia, may prevent another
seizure. The recovery position is appropriate for uninjured patients with a
decreased level of consciousness and adequate breathing; it will help
maintain the airway and facilitate drainage of secretions from the mouth, but
will not prevent another seizure. Oral glucose may prevent another seizure if
hypoglycemia was the cause of the seizure. You should dim the lights in the
back of the ambulance to help prevent any seizure, not just those that are
caused by hypoxia.
-Which of the following conditions would be the LEAST likely to be present in
a patient who was submerged in water?
• A:Spinal injury
• B:Gastric distention
• C:Hyperglycemia
• D:Laryngospasm - -You selected C; This is correct!
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