Medical Tests Medical Tests Certifications NREMT Questions & Answers

• Question 71:

  You are assessing a 53-year-old female who neighbors discovered acting funny. The patient appears to be fatigued and confused and exhibiting slurred speech. She is breathing and has a pulse and skin that is cool and mottled. Vital signs are pulse 68 beats per minute, respirations 14 per minute, blood pressure 108/60 mmHg, and temperature 92.7 degrees Fahrenheit. There are no signs of trauma to the patient. Patient prescriptions of Verapamil, Digoxin, Synthroid, and nitroglycerin are found in the bedroom. Allergies are unknown. The temperature in her apartment is 55 degrees Fahrenheit. Based on the assessment findings, which of the following conditions is most likely a contributing factor to the patient's condition?

  A. Hypothyroidism

  B. Hypertension

  C. Atrial fibrillation

  D. Seizure

  Correct Answer: A

  The paramedic must recognize that the patient is hypothermic, based on the body temperature as well as the temperature in the apartment. Furthermore, the paramedic must recognize that the patient suffers from hypothyroidism, as evidenced by her use of Synthroid. Hypothyroidism describes a thyroid that is slow and can only generate minimal cellular metabolism. Since heat generation is a product of cellular metabolism, the patient s body temperature drops accordingly. Neither atrial fibrillation, hypertension, nor seizure would cause the patient to become hypothermic.

• Question 72:

  "You are planning a continuing education seminar with your service's medical director. After you both decide that behavioral emergencies need to be addressed, he asks you to define normal behavior. You would reply: "

  A. Behavior that the person believes is normal

  B. A person's observable conduct or activity

  C. Behavior that society views as acceptable

  D. Behavior that does not hurt anyone

  Correct Answer: C

  Although a universal definition is difficult to establish, normal behavior is generally defined as behavior that is readily accepted within a society. Behavior that a person thinks is normal for him or herself may not be accepted by society and therefore is not considered normal. An example would be a person who thinks that clothing is optional to wear in a public setting. Just because a particular behavior does not hurt anyone does not make it normal. Again, not wearing clothes in public does not hurt anyone, but is typically frowned upon in modern society. A person s observable conduct or activity describes behavior in a general sense and does not distinguish between normal and abnormal.

• Question 73:

  Which of the following substances is the most common cause of anaphylaxis?

  A. Bee stings

  B. Penicillin

  C. Aspirin

  D. Fungi and molds

  Correct Answer: B

  Penicillin and other antibiotics are the most common causal agents for anaphylaxis. Authorities estimate penicillin to produce an allergic or anaphylactic reaction 1 out of every 10,000 times it is used and cause an estimated 500 deaths per year. By contrast, bee stings are responsible for less than 100 deaths annually. Anaphylactic reactions to aspiring and fungi and molds are infrequent and therefore not common causal agents.

• Question 74:

  You are assessing a 32-year-old male complaining of abdominal pain and weakness. The patient informs you that he has Addison's disease as a result of steroid use as a teenager. No life-threatening conditions are noted to the airway, breathing, or circulation. Vital signs are pulse 110 beats per minute, respirations 16 per minute, blood pressure 110/72 mmHg, and SpO2 98% on room air. Given the patient's past medical history, you would:

  A. Administer Activated Charcol.

  B. Administer Oral Glucose.

  C. Contact ALS.

  D. Check the blood glucose level.

  Correct Answer: D

  Always check the blood glucose level of any patient with adrenal insufficiency.

• Question 75:

  When assessing a patient complaining of depression, which of the following would be most suggestive that the patient is at risk for suicide?

  A. Previous attempt that was unsuccessful

  B. Packing away of cherished possessions

  C. Hostility toward concerned family members

  D. Recent diagnosis of hypertension

  Correct Answer: A

  A previous attempt at suicide is highly suggestive of a patient's risk for suicide. This is compounded by the depression, which can exacerbate suicidal feelings and willingness to carry out the act to finality. Persons contemplating suicide typically give possessions away and do not store them. Hostility towards family members in and of itself is not an indication of the potential for suicide. While a diagnosis of medical condition can predispose one to consider suicide, these conditions are generally terminal (e.g., cancer, HIV infection). Hypertension is generally treatable with lifestyle modification and medications.

• Question 76:

  A medical condition where the patient some times suffers convulsions or seizure activity?

  A. Postictal state

  B. Tonic-clonic

  C. Focal motor

  D. Epilepsy

  Correct Answer: D

  Epilepsy is medical conditon where the patient often suffers seizures. Tonic-clonic and focal motor are types of seizure activity and a postictal state is the period of time after a seizure where the patient is slow to respond and is possibly unresponsive where the brain is resetting and resting.

• Question 77:

  Statements from patients are used as assessment tools, which of the following statements about stroke symptoms should cause the clinician to use a higher index of suspicion?

  A. This is the worst head ache I have ever had.

  B. This head ache is behind my right eye.

  C. My head is throbbing.

  D. Bright light causes my head to hurt worse.

  Correct Answer: A

  "This is the worst head ache I have ever had." this statement should not be ignored or considered to the dramatic, it should cause the clinician to modify their assessment to include a hemorrhagic stroke in their differential. All of the other statements do classify the intensity of their head ach and it may not rule out a stroke, however the statement of the worst head ach should alert you to the possibility of a more acute findings.

• Question 78:

  The clinician's best role in the assessment and treatment of a Stroke patient is rapid recognition and transport to a stroke center. What is window of opportunity from the onset of symptoms and treatment?

  A. any time before symptoms resolve

  B. three hours

  C. in the first 24 hours

  D. once you have a stroke there is no chance to fix it

  Correct Answer: B

  Anytime there is a blockage not allowing blood flow the quicker blood flow is returned the better the results. It is well established if tPa is infused within three hours of onset of symptoms there is a greater chance that all deficits will resolve without lasting effects.

• Question 79:

  Stroke symptoms often the same as other medical problems to prevent miss treatment for the signs and symptoms working through the differentials is a must. One of the most common other medical problems which is often mistaken for a CVA is hypoglycemia. How can a clinician rule in or out this differential?

  A. Check pupils

  B. Check blood sugar

  C. Check grips

  D. Check arm drift

  Correct Answer: B

  One of the easiest and most often over looked diagnosis tools is the glucometer check the blood sugar. The other screening info in this question are not ruling in or out hypoglycemia.

• Question 80:

  To assess a patient with a stroke there are two major assessment tools the Cincinnati Stroke Scale and the Los Angeles Prehospital Stroke Screen. Which one of these two tools uses arm drift as a diagnostic tool?

  A. Neither

  B. Cincinnati Stroke Scale

  C. Los Angeles Prehospital Stroke Screen

  D. Both

  Correct Answer: B

  The Cincinnati stroke scale uses arm drift as a diagnostic tool. Ask the patient to lift both arms up in front of them, close their eyes and watch for an arm to drift downward. If there is a drift downward on one arm then assess for a CVA on that side.