Paramedic Quiz Chapter 18-19
Based off chaper 18-19 of Nancy Caroline's emergency medical care in the streets
- 1.Failure of the body's compensatory mechanisms to preserve perfusion results in all of the following except
- A.
Hypotension
- B.
Low cardiac output
- C.
An increase in preload
- D.
Decreased coronary perfusion
- 2.Cardiogenic shock would most likely develop following
- A.
Localized myocardial ischemia
- B.
Any condition that causes increased preload
- C.
Decompensated congestive heart failure
- D.
Damage to more than 10% of the left ventricle
- 3.The most common cause of exogenous hypovolemic shock is
- A.
Dehydration
- B.
External bleeding
- C.
Diabetic ketoacidosis
- D.
Plasma loss from burns
- 4.Which of the following clinical signs or symptoms would you not expect to see in a patient with significant dehydration
- A.
Postural syncope when standing up
- B.
A furrowed tongue or shrunken eyes
- C.
Tenting of the skin when it is pinched
- D.
A decreased pulse rate upon standing
- 5.Hypovolemia secondary to severe sepsis is the result of
- A.
Profound vomiting and diarrhea cause by bacterium
- B.
Increased microvascular permeability and capillary leakage
- C.
Widespread vasoconstriction and preferential blood shunting
- D.
Persistent fever that results in internal loss of body fluids
- 6.A characteristic sign of neurogenic shock is
- A.
An absence of sweating
- B.
A rapid, bounding pulse rate
- C.
Cool, clammy, and pale skin
- D.
Hemiplegia or hemiparalysis
- 7.Anaphylaxis occurs when a person
- A.
Experiences urticaria and rhinorrhea after exposure to an allergen
- B.
Reacts violently to a substance to which he or she has been sensitized
- C.
Experiences a mild allergic reaction after initial exposure to an allergen
- D.
Develops a heightened reaction to a substance deemed foreign by the body
- 8.In shock, the capillaries become engorged with fluid because
- A.
The precapillary sphincters remain constricted
- B.
Oxygen cannot diffuse across the cellular membrane
- C.
The postcapillary sphincters remain constricted
- D.
Of aerobic metabolism and carbon dioxide production
- 9.An acidic condition in the blood
- A.
Inhibits hemoglobin in the red blood cells from binding with and carrying oxygen
- B.
Results in potent vasoconstriction and constriction of the postcapillary sphincters
- C.
Immediately depresses respiratory system function, resulting in severe hypoxemia
- D.
Causes a decrease in hydrogen ion production and an increase in the pH of the blood
- 10.Which of the following does not occur during multiple organ dysfunction syndrome ( MODS)
- A.
Noncardiogenic pulmonary edema
- B.
Increased lactate metabolism by the liver
- C.
Marked decrease in cardiac ejection fraction
- D.
Decreased surfactant production by the alveoli
- 11.During compensated shock
- A.
The patient's level of consciousness is a poor indicator of perfusion, because he or she is generally restless
- B.
An increase in respiratory rate and depth creates a compensatory respiratory alkalosis to offset metabolic acidosis
- C.
Chemical mediators released by the autonomic nervous system result in significant increase in blood pressure
- D.
Pulse pressure widens as the sympathetic nervous system releases catecholamines in response to poor perfusion
- 12.Which of the following signs would you most likely observe in a patient with compensated shock
- A.
Anxiety or agitation
- B.
Dilation of the pupils
- C.
Absent peripheral pulses
- D.
Response to painful stimuli
- 13.A weak radial pulse in a patient with shock indicates
- A.
A marked increase in cardiac afterload
- B.
A systolic BP that is less than 90 mm Hg
- C.
Vascular dilation and decreased blood flow
- D.
Sympathetic nervous system compensation
- 14.Your initial assessment of a shock patient begins by
- A.
Establishing a patient airway
- B.
Forming a general impression
- C.
Vascular dilation and decreased blood flow
- D.
Sympathetic nervous system compensation
- 15.The most reliable indicator that a patient is no longer able to compensate for shock is
- A.
Pale, cool, clammy skin
- B.
Sluggishly reactive pupils
- C.
An altered mental status
- D.
An increased diastolic blood pressure
- 16.Care for a patient with profound shock begins by
- A.
Applying warm blankets
- B.
Controlling major bleeding
- C.
Establishing a patent airyway
- D.
Following BSI precautions
- 17.A patient in shock with respiratory distress should be positioned
- A.
In a semi-sitting position
- B.
Supine with the legs elevated
- C.
In the trendelenburg position
- D.
On the left side with the legs elevated
- 18.When noncolloid solutions are used in the treatment of shock
- A.
They remain in the vascular compartment for up to 4 hours
- B.
You should give 2-3 times the volume of blood lost
- C.
They improve tissue perfusion by carrying oxygen to the cells
- D.
20% of the solution quickly diffuses out of the intravascular space
- 19.Which of the following statements regarding prehospital treatment of cardiogenic shock is most correct
- A.
Administer a 1000 mL crystalloid bolus if the patient's lungs are clear
- B.
Dopaine infusions greater than 10 mcg/kg/min often cause bradycardia
- C.
Norepinephrine is the vasopressor of choice for prehospital blood pressure support
- D.
Prolonged efforts to stabilize the patient in the field are not recommended
- 20.Which of the following medications impedes the further release of chemical mediators in anaphylactic shock
- A.
Diphendydramine
- B.
Epinephrine
- C.
Ipratropium
- D.
Albuterol
- 21.A patient taking________ would most likely experience a delay in the healing of a would
- A.
Antidepressants
- B.
Acetaminophen
- C.
Antihypertensives
- D.
Corticosteroids
- 22.Which of the following patients is at highest risk for a pressure injury
- A.
An obese patient
- B.
A bedridden patient
- C.
A hypertensive patient
- D.
A patient with diabetes
- 23.In general, most open wounds should be sutured or otherwise closed no longer than ___ hours
- A.
8
- B.
10
- C.
12
- D.
18
- 24.Necrosis of tissue caused by an anaerobic, toxin-producing bacterium is called
- A.
Tetanus
- B.
Gangrene
- C.
Fasciitis
- D.
Lymphedema
- 25.The swelling that occurs in conjunction with a contusion is caused by.
- A.
Inflammation of the injured blood vessels
- B.
Ruptured of large blood vessels in the dermis
- C.
Aggregation of platelets to the injured site
- D.
Leakage of fluid into spaces between the cells
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