Exam 6
 

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Exam 6 THIS EXAM CONTAINS 65 QUESTIONS - MUST RETAKE UNTIL YOU MISS 10 OR LESS. Some answers may be keyed wrong. Please bring this to our attention to change.   

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2. You should give oral glucose to patients who are known diabetics and:
 
A. are found unconscious.
 
B. are complaining of chest pain.
 
C. have high blood pressure.
 
D. have an altered level of consciousness.
 



 

3. Oral glucose comes in what form?
 
A. gel.
 
B. patch.
 
C. spray.
 
D. powder.
 



 

4. Oral glucose should not be given to diabetic patients who:
 
A. are found unconscious.
 
B. have low blood pressure.
 
C. are complaining of abdominal pain.
 
D. have been drinking alcoholic beverages.
 



 

5. If not given correctly, oral glucose may:
 
A. be aspirated.
 
B. cause diarrhea.
 
C. bring on chest pain.
 
D. cause the pupils to dilate.
 



 

6. You find a 19-year-old man who tells you he "just doesn't feel right." His insulin and a syringe are on a table. The patient says he thinks he took his insulin but can't remember whether he ate. He is also unable to tell you the time or what day it is. What care does he need?
 
A.  Give him oral glucose.
 
B.  Test him for a gag reflex.
 
C.  No care is required. Just encourage him to eat.
 
D.  Have the patient give himself an insulin injection.
 



 

7. A man tells you that he can't awaken his wife, who you find lying on the couch. He explains that she takes pills for diabetes. You find the patient to be unresponsive to painful stimulus. Your first action should be to:
 
A. give oral glucose.
 
B. start chest compressions.
 
C. open and maintain her airway.
 
D. assess sensory and motor function in her toes.
 



 

8. You are giving oral glucose to a patient with diabetes when the patient suddenly has a seizure. What should you do for this patient?
 
A. Maintain the airway.
 
B. Assess ability to swallow.
 
C. Place in a prone position.
 
D. Continue giving glucose to increase the blood glucose level.
 



 

9. Diabetic patients with an altered level of consciousness are in need of prompt care because:
 
A. hypertension can lead to unconsciousness.
 
B. hypoglycemia can lead to unconsciousness.
 
C. insulin overdose can lead to heat exhaustion.
 
D. cold skin temperatures can lead to hypothermia.
 


 

12. A known diabetic patient is found on the floor next to his bed. His speech is slurred, and he is unable to tell you his name. His wife states that she hasn't been able to get him to eat much for several days. What should your care include?
 
A. Give him oral glucose.
 
B. Insert an oropharyngeal airway.
 
C. Have him drink a glass of juice.
 
D. Assist him with taking his insulin.
 


 

14. Diabetic patients can have a sudden change in their level of consciousness when they:
 
A. take their insulin but skip a meal.
 
B. take their insulin but eat an extra meal.
 
C. forget to take their insulin and skip a meal.
 
D. forget to complete their daily exercise routine.


 

19. What are the classic signs and symptoms of hypoglycemia?
 
A. warm, dry skin; hunger; abdominal pain; deep, rapid respirations.
 
B. warm, dry skin; irritability; bradycardia (slow heartbeat); rapid respirations.
 
C. cold, clammy skin; bradycardia (slow heartbeat); hunger; deep, rapid respirations.
 
D. cool, clammy skin; abnormal behavior; tachycardia (rapid heartbeat); rapid respirations.
 



 

20. A change in the level of consciousness in a diabetic patient is usually due to:
 
A. dehydration.
 
B. nausea and vomiting.
 
C. a lack of glucose in the blood.
 
D. a lack of electrolytes in the blood.
 



 

21. What is a common trade name for oral glucose?
 
A. Diabenase.
 
B. Micronase.
 
C. Glucagon.
 
D. Insta-glucose.
 



 

22. The first step in treating a patient found unconscious with a Medic Alert tag for diabetes is to:
 
A. verify that the airway is open.
 
B. give insulin.
 
C. attempt to awaken the patient.
 
D. give smelling salts.
 


 

25. As you obtain a patient history from a known diabetic, what would be another important question to ask?
 
A. Are you feeling well today?
 
B. How long have you been a diabetic?
 
C. What is your normal blood glucose level?
 
D. If you are taking insulin, did you take it today?
 



 

26. Your patient is a known diabetic who is not feeling well. You are unsure whether there is too much or too little glucose in the bloodstream. You should give the patient:
 
A. water or milk.
 
B. oxygen only and transport.
 
C. nothing without knowing for sure.
 
D. oral glucose, in case there are low levels of sugar in the bloodstream.
 



 

27. The function of insulin is to:
 
A. carry glucose to the cells.
 
B. allow glucose to enter the cells.
 
C. nourish brain cells.
 
D. allow the kidneys to pass glucose.
 


 

29. Type I diabetes:
 
A. appears more common later in life.
 
B. is identified by a complete lack of insulin production.
 
C. can frequently be controlled by diet and exercise.
 
D. requires oral medications to regulate blood glucose values.
 



 

30. Type II diabetes:
 
A. strikes children of younger ages.
 
B. requires insulin injections to control blood glucose values.
 
C. can be controlled by diet and oral medications.
 
D. patients are not able to produce insulin.
 



 

31. Classic symptoms of uncontrolled or undiagnosed diabetes include all of the following EXCEPT:
 
A. polydipsia.
 
B. polyuria.
 
C. polyphagia.
 
D. polyemesis.
 



 

32. A 28-year-old female patient, recently diagnosed with type I diabetes, is only responsive to voice on your arrival. Her roommate states she has had difficulty controlling her blood glucose levels and has gotten progressively worse the last 24 to 36 hours. Considering only the onset of her symptoms, you would suspect this patient to be:
 
A. in insulin shock.
 
B. ill for another reason.
 
C. in the normal range of blood glucose levels.
 
D. approaching diabetic coma.
 



 

33. You respond to a movie theater for an elderly patient who is confused. His wife tells you he has type II diabetes but refuses to take his pills. Your initial treatment for this patient would be to:
 
A. monitor vital signs and transport immediately.
 
B. confirm the patient can swallow without difficulty and give oral glucose.
 
C. complete a detailed exam inspecting for nonhealing wounds.
 
D. insist he take twice the dose of his oral hypoglycemic medication now.
 



 

34. Which of the following symptoms is NOT an indication of an allergic reaction?
 
A. hoarseness.
 
B. high blood pressure.
 
C. itching or burning of the skin.
 
D. swelling of the face and tongue.
 



 

35. The usual skin reactions to an allergen include itching and:
 
A. urticaria.
 
B. atrophy.
 
C. coldness.
 
D. diaphoresis.
 



 

37. A patient is experiencing itching, with tearing and swelling around the eyes after exposure to a sensitive substance. What should you do for this patient?
 
A. Give epinephrine immediately.
 
B. Tell the patient to see the family physician.
 
C. Give oxygen while completing an initial assessment.
 
D. Have a family member transport the patient to the emergency department by private car.
 



 

38. You are performing your initial assessment on a 38-year-old woman with an allergic reaction. She states that she has a mild headache, trouble breathing, and a sense of impending doom. The first treatment you should give her is:
 
A. oxygen.
 
B. aspirin.
 
C. albuterol.
 
D. activated charcoal.
 



 

39. You have just given your patient oxygen and epinephrine. How many minutes should you wait before reassessing the vital signs? (hint: think of nitro)
 
A. 1.
 
B. 2.
 
C. 5.
 
D. 10.
 



 

40. Your patient has come into contact with a substance that is causing an allergic reaction. You should NOT give epinephrine when the patient is:
 
A. wheezing.
 
B. showing signs of shock.
 
C. showing signs of respiratory distress.
 
D. showing no signs of respiratory distress.
 


 

43. Which of the following signs indicates a possible upper airway involvement?
 
A. stridor.
 
B. urticaria.
 
C. watery eyes.
 
D. uneven pupils.
 



 

44. An allergic reaction that happens soon after exposure to a substance is most likely caused by:
 
A. mutations of white blood cells.
 
B. abnormal red blood cell production.
 
C. the body having an immune response to that substance.
 
D. an under-reaction of the immune system.
 



 

45. Which of the following is the main chemical released into the body during an allergic reaction?
 
A. histamine.
 
B. epinephrine.
 
C. beta-carotene.
 
D. antihistamine.
 



 

46. Which of the following words is defined as "an extreme allergic reaction"?
 
A. protein.
 
B. antigen.
 
C. antibodies.
 
D. anaphylaxis.
 



 

47. Which of the following actions does epinephrine cause when given for an allergic reaction?
 
A. dilates blood vessels and dilates bronchi.
 
B. dilates blood vessels and constricts bronchi.
 
C. constricts blood vessels and dilates bronchi.
 
D. constricts blood vessels and constricts bronchi.
 


 

50. Which of the following is the normal adult dosage of epinephrine in milligrams?
 
A. 0.1.
 
B. 0.15.
 
C. 0.2.
 
D. 0.3.
 


 

52. Your patient is a 25-year-old man who is having a severe allergic reaction. He has a prescribed inhaler and EpiPen but is unable to inform you of his usual dose. You should:
 
A. contact medical control for instructions.
 
B. contact your supervisor for further instructions.
 
C. give oxygen and call for a paramedic unit.
 
D. give the prescribed drugs at the maximum dose.
 



 

53. A patient who has been stung by a bee has a bee sting kit in his car. The patient has never used the kit and asks for your help. You should first:
 
A. inject 0.3 mg of 1/1,000 epinephrine IM.
 
B. inject 1.0 mg of 1/1,000 epinephrine SC.
 
C. give him two antihistamine tablets.
 
D. place a constricting band below the site of the sting.
 



 

54. A young woman who has been stung by a bee states that she is allergic to bee stings. The patient is given an epinephrine injection. En route to the hospital, you should administer a second dose if:
 
A. she becomes drowsy.
 
B. breathing does not improve.
 
C. swelling is not reduced.
 
D. urticaria persists.
 



 

55. You are listening to the breath sounds of a patient who has complained of shortness of breath. You hear a wheezing sound over both sides at the midaxillary areas of the chest. These sounds might be caused by:
 
A. a complete airway obstruction by the tongue.
 
B. normal air movement through the patient's nose.
 
C. narrowing of the lower air passages of the lungs.
 
D. enlargement of the lower air passages of the lungs.
 



 

56. Stridor is a sound produced by:
 
A. an enlargement of the tongue and gums.
 
B. air movement through the small nasal passages.
 
C. a narrowing or constriction of the lower airway caused by swelling or a foreign object.
 
D. a narrowing or constriction of the upper airway caused by swelling or a foreign object.
 



 

57. Which of the following is NOT a symptom of anaphylaxis (allergic reaction)?
 
A. hives.
 
B. hypertension.
 
C. burning, itching skin.
 
D. swelling of the lips and tongue..
 



 

58. Which of the following is NOT a sign or symptom of a pit viper snakebite?
 
A. paralysis.
 
B. burning pain.
 
C. one or two puncture wounds.
 
D. swelling and bluish discoloration.
 



 

59. Which of the following is NOT a sign or symptom of a coral snake bite?
 
A. blurred vision.
 
B. slurred speech.
 
C. bluish discoloration and burning pain.
 
D. small bite pattern with scratch like wounds.
 


 

61. Which of the following snake or insect bites is NOT cyotoxic (poisonous to local tissues)?
 
A. black widow spider.
 
B. brown recluse spider.
 
C. copperhead snake.
 
D. cottonmouth water moccasin snake.
 


 

63. People die of bee stings because of:
 
A. aneurysm.
 
B. thrombosis.
 
C. hypovolemia.
 
D. hypersensitivity.
 



 

64. A patient experiencing an allergic reaction has multiple small raised areas of skin that itch. This is called:
 
A. urticaria.
 
B. wheals.
 
C. allergens.
 
D. ecchymosis.
 



 

65. Which of the following insects is unable to sting multiple times?
 
A. wasps.
 
B. yellow jackets.
 
C. honey bees.
 
D. hornets.
 



 

66. When documenting signs and symptoms related to bites and stings, a single, well-defined, white elevation of the skin is properly called a:
 
A. hive.
 
B. wheal.
 
C. urticaria.
 
D. rash.
 



 

67. Immediately after giving an epinephrine injection you should:
 
A. record the time and dose given.
 
B. place the syringe in a sharps container.
 
C. obtain repeat vital signs.
 
D. advise medical control the medication was given.


 

69. Prior to administering an epinephrine auto-injector, it is important to do all of the following EXCEPT:
 
A. remove the safety cap.
 
B. obtain an order from medical control.
 
C. verify the medication has not expired.
 
D. contact ALS.
 



 

70. The onset of action for epinephrine is:
 
A. within 1 minute.
 
B. 10 minutes.
 
C. 30 minutes.
 
D. within 1 hour.
 



 

71. A 10-year-old patient was bitten by an insect and is now experiencing dizziness, nausea, vomiting, and a rash. You suspect she was bitten by a:
 
A. brown recluse spider.
 
B. hobo spider.
 
C. black widow spider.
 
D. fire ant.
 



 

72. An 84-year-old woman was recently cleaning a closet when a bug bit her. Several hours later she describes a swollen, tender area on her hand that appears pale. You suspect she was bitten by a:
 
A. brown recluse spider.
 
B. black widow spider.
 
C. red ant.
 
D. yellow jacket.
 



 

73. A 6-year-old child was bitten by a black widow spider. Priority care should focus on:
 
A. monitoring vital signs.
 
B. relieving muscle cramps.
 
C. evaluating for breathing difficulty.
 
D. immobilization of the affected extremity.
 


 

75. You should give activated charcoal if your patient has a history of ingesting a poison and:
 
A. has chest pain and coughing.
 
B. has an altered level of consciousness.
 
C. the ingested substance is a strong acid.
 
D. medical control has directed administration.
 



 

76. The usual adult dose for activated charcoal is how many grams?
 
A. 12 1/2 to 25.
 
B. 25 to 50.
 
C. 50 to 100.
 
D. 100 to 125.
 



 

77. The usual pediatric dose for activated charcoal is how many grams?
 
A. 12 1/2 to 25.
 
B. 25 to 50.
 
C. 50 to 100.
 
D. 100 to 125.
 



 

78. A 4-year-old patient is unconscious and limp as the mother hands the child to you at the door. She explains that she found him next to an empty bottle of toilet bowl cleaner, and she thinks he drank it. You should first:
 
A. contact medical control and monitor the child for breathing difficulties.
 
B. get the mother to help you get the patient to drink a glass of milk.
 
C. give water continuously to the patient en route to the hospital.
 
D. give 12 1/2 to 25 g of activated charcoal and then give oxygen.
 



 

79. A woman who has been given one dose of activated charcoal vomits as you are preparing her for transport. You should:
 
A. encourage her to drink a glass of milk to coat her stomach.
 
B. encourage her to drink a glass of water to dilute the remaining poison.
 
C. remove and flush off any clothing that became contaminated by the vomit.
 
D. give her a second dose of activated charcoal after getting approval from medical control.
 



 

80. A woman who had an alkaline chemical splashed in her eye states her eye feels as though it is burning. You also note excessive tearing from the injured eye. Your care should include:
 
A. patching the injured eye with a dry, sterile dressing.
 
B. irrigating the eye with water for at least 5 minutes.
 
C. irrigating the eye with water for at least 20 minutes.
 
D. irrigating the eye with a neutralizing agent to decrease the burn.
 


 

83. A patient who has taken a CNS depressant and has an altered level of consciousness should be continuously reassessed because you must:
 
A. maintain the airway due to the possibility of vomiting.
 
B. give activated charcoal once the patient is completely unresponsive.
 
C. ask about the exact substance taken once the patient regains consciousness.
 
D. turn the patient over to law enforcement once the patient regains consciousness.
 



 

84. A worker at the community swimming pool is complaining of being dizzy and states, "I can't catch my breath." Coworkers tell you that they found him in the chemical supply room. On the basis of this history, you suspect:
 
A. toxic inhalation.
 
B. toxic absorption.
 
C. toxic overdose by ingestion.
 
D. poisoning by ingestion.
 



 

85. Signs and symptoms of a suspected ingested poison include nausea, vomiting, and burns:
 
A. on the extremities.
 
B. around the mouth.
 
C. across the abdomen.
 
D. involving one or both of the eyes.
 


 

87. You are called to an industrial warehouse. The patient is a worker whose arms are covered from the elbows down with a powdery substance that he says is a potent pesticide. He tells you that his arms became red and extremely painful even after he brushed off most of the pesticide. Your next action should be to:
 
A. brush off the remaining powder and irrigate both of his arms.
 
B. brush off the remaining powder and apply a dry, sterile dressing.
 
C. apply ice packs to the affected areas and prepare for transport.
 
D. apply a neutralizing agent and splint his arms in a position of comfort.
 



 

88. Before giving activated charcoal, you should:
 
A. shake the container thoroughly.
 
B. have the patient drink a glass of milk.
 
C. mix it with an equal amount of water.
 
D. make sure the patient is unresponsive.
 



 

89. Approximately three fourths of all poisonings are by:
 
A. mouth.
 
B. inhalation.
 
C. injection.
 
D. surface contact.
 



 

90. You are obtaining a history from an adult who has possibly taken orally an unknown substance. Which of the following is NOT relevant to your history or the patient's condition?
 
A. How much was taken?
 
B. How long ago was it taken?
 
C. What type of substance was taken?
 
D. Has the patient ever taken this before?
 


 

92. When removing a contact poison from the eyes it is important to do all of the following EXCEPT:
 
A. irrigate from the bridge of the nose out.
 
B. gently open the eyelids to flush the surface of the eyes.
 
C. administer a neutralizing agent.
 
D. flood the affected area for a minimum of 20 minutes.
 



 

93. A person who routinely misuses a substance and requires more to achieve the same result best describes:
 
A. addiction.
 
B. tolerance.
 
C. withdrawal.
 
D. substance abuse.
 



 

94. The most commonly abused drug in the United States is:
 
A. alcohol.
 
B. opioids.
 
C. anticholinergic agents.
 
D. marijuana.
 



 

95. Delirium tremens is a syndrome related to withdrawal from:
 
A. alcohol.
 
B. opioids.
 
C. sedatives.
 
D. hypnotics.
 



 

96. You are called to a hotel room for an unresponsive patient found fully clothed in a bathtub of cold water. The patient is in respiratory arrest with pinpoint pupils. Based on these findings you suspect the patient has overdosed on:
 
A. heroin.
 
B. alcohol.
 
C. diazepam.
 
D. jimson weed.
 



 

97. Abused inhalants are likely to produce what unique complication when compared to most other sedatives?
 
A. respiratory compromise.
 
B. drooling.
 
C. cardiac arrest.
 
D. seizures.
 



 

98. The production of dangerous ketones is caused by:
 
A. acidosis when glucose levels are critically low.
 
B. insulin allowing too much glucose into the cell too quickly.
 
C. metabolizing fats when glucose is unavailable.
 
D. low blood glucose levels releasing acids into the blood.
 



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