FISDAP MEDICAL EXAM 2 LATEST VERSIONS A & B 2023 -
2024 ACTUAL EXAM 220 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (100% CORRECT AND VERIFIED ANSWERS) |ALREADY GRADED A+||NEWEST VERSIONS FISDAP MEDICAL VERSION A A 32 -year-old man who was stung by a bee has diffuse hives, facial swelling, and difficulty breathing. When he breathes, you hear audible stridor. What does this indicate? A) Swelling of the upper airway structures B) Swelling of the lower airway structures C) Narrowing of the two mainstem bronchi D) Narrowing of the bronchioles in the lungs - ANSWER - A) Swelling of the upper airway structures Rationale: This patient is experiencing a severe allergic reaction (anaphylaxis). Strid or, which is a high -pitched sound heard on inhalation, indicates swelling of the structures and tissues of the upper airway. If not promptly treated, the patient's airway may clos e completely, resulting in respiratory arrest. Narrowing of the bronchioles in the lungs causes wheezing, a whistling sound that may be heard during inhalation, exhalation, or both. Which of the following drugs can cause or worsen excited delirium? A) Her oin B) Cocaine C) Ketamine D) Marijuana - ANSWER - B) Cocaine Rationale: Excited delirium, also referred to as agitated delirium, is a condition caused by a severe increase in the metabolic rate, combined with impairment of cognitive function. The symptoms of excited delirium include hyperactive irrational behavior with possible vivid hallucinations, which can create the potential for violence. Common physical manifestations include hypertension, tachycardia, diaphoresis, hyperthermia, and dilated pupils. Drugs that i ncrease metabolism, such as cocaine or methamphetamine (sympathomimetics), can cause or worsen excited delirium. The condition can lead to sudden death, usually from metabolic acidosis. Heroin, an opioid, depresses metabolism; therefore, it would not cause or worsen excited delirium. Ketamine, a sedativehypnotic, is commonly used to treat patients with excited delirium. Marijuana can cause changes in reality perception; however, the more potent sympathomimetics are far more common in inducing or worsening e xcited delirium. A 55 -year-old woman with a history of diabetes is found unresponsive with rapid, shallow respirations. The patient's husband tells you that he does not know when his wife last took her insulin. Management of this patient should include: A) assisted ventilations and oral glucose. B) assisted ventilations nd rapid transport. C) oral glucose and oxygen via nonrebreathing mask. D) subcutaneous injection of insulin and 100% oxygen. - ANSWER - B) assisted ventilations nd rapid transport. Rationale: Without knowing if and when the patient last took her insulin, it is difficult to determine if she is experiencing diabetic coma or insulin shock. Nonetheless, her rapid, shallow respirations --which are likely not producing adequate tidal volume --should be treate d with ventilation assistance. Because she is unresponsive and obviously unable to swallow, oral glucose is contraindicated. Assess the patient's blood glucose level and pass this information along to the hospital; if possible, arrange for a paramedic inte rcept so she can receive intravenous dextrose. If the patient is experiencing diabetic coma, insulin is what she truly needs; however, insulin is rarely, if ever, administered in the prehospital setting, even by paramedics. After ensuring adequate oxygenat ion and ventilation, transport the patient without delay. A 39 -year-old man asks you to take him to the hospital because has had a fever, headache, and diarrhea for the past 2 days. His blood pressure is 120/60 mm Hg, his pulse is 110 beats/min, and his respirations are 16 breaths/min. You should: A) ask him if h e has a history of HIV infection or hepatitis. B) transport him to the hospital in a position of comfort. C) request an ALS ambulance to the scene to start an IV line. D) advise him that he can drive himself to his family physician. - ANSWER - B) transport him to the hospital in a position of comfort. Rationale: Although the patient is likely experiencing the flu, there are other diseases, some of which are communicable, that can cause similar symptoms. The patient is requesting EMS transport; failure to comply consti tutes abandonment. Although he is tachycardic, the remainder of his vital signs are stable; therefore, requesting an ALS ambulance to the scene to start an IV is not necessary. Simply transport him in a position of comfort and monitor him en route. If the patient is infected with HIV or hepatitis, he may choose to voluntarily disclose that information. However, to inquire about infection with such diseases is unethical. When assessing a patient with an apparent behavioral crisis, the MOST important initial observation the EMT should make is whether or not: A) the patient is oriented to person, place, and time. B) the patient's residence is well kept or in disarray. C) there is any drug paraphernalia near the patient. D) the patient seems aggressive or verba lly abusive. - ANSWER - D) the patient seems aggressive or verbally abusive. Rationale: All of the options in this question are important to assess. However, the safety of you and your crew supersedes everything! If ANY patient is aggressive or verbally abusive, that is a direct threat to your safety, and you should request law enforcement personnel. It is common (and wise) for law enforcement to be dispatched to the scene automatically for patients with behavioral crises. If they are not, however, you should request them as soon as possible. Once it is safe for you and your team to do your job, you should gather information specific to the patient's chief complaint or presentation. Which of the following signs is LEAST suggestive of a diabetic emergency?
