Patient Assessment and Treatment Quiz

Questions and Answers

According to the terminal drop hypothesis, what is presumed about mental function?

Mental function is presumed to decline in the 5 years preceding death. (correct)

Most late-stage adults retain high brain function until 1 month before death.

Most elderly patients experience depression after the death of a loved one.

A person's physical health begins to decline after the age of 75 years.

Age-related changes in the renal system result in:

A significant increase in filtration, which causes the excretion of large amounts of water from the body.

Dilation of the blood vessels that supply the nephrons, which allows the kidneys to maintain their function.

A decreased ability to clear wastes from the body and a decreased ability to conserve fluids when needed. (correct)

The formation of large amounts of urine secondary to an increase in kidney mass of up to 20%.

An infant or small child's airway can be occluded if it is overextended or overflexed because:

The tongue is proportionately small and can fall back into the throat.

The occiput is proportionately large and the trachea is flexible. (correct)

He or she has a long neck, which makes the trachea prone to collapse.

The back of the head is flat, which prevents a neutral position.

At what age does separation anxiety typically peak in infants and small children?

10 to 18 months Signup and view all the answers

Factors that contribute to a decline in the vital capacity of an elderly patient include all of the following, EXCEPT:

Increased surface area available for air exchange. Signup and view all the answers

In late adults, the amount of air left in the lungs after expiration of the maximum amount of air:

Increases, which hampers diffusion of gases because of the stagnant air that remains in the alveoli. Signup and view all the answers

The anterior fontanelle fuses together between the ages of:

9 and 18 months. Signup and view all the answers

The decline in cardiac function that commonly occurs in late adulthood is MOST often related to:

Atherosclerosis. Signup and view all the answers

Which of the following are noticeable characteristics of a 9-month-old infant?

Places objects in the mouth, pulls himself or herself up. Signup and view all the answers

Which of the following statements regarding an infant's vital signs is correct?

An infant's normal body temperature is typically higher than a preschooler's. Signup and view all the answers

Why does the incidence of diabetes mellitus increase with age?

Decreased physical activity, increased weight gain, and decreased insulin production. Signup and view all the answers

You are assessing a 13-month-old female who is running a fever and has been vomiting. While you are performing your physical examination on this child, you will MOST likely find that she:

Responds to her name but is fearful of your presence. Signup and view all the answers

___________ pressure is the pressure exerted by a liquid that occurs when blood moves through an artery at relatively high pressures.

Hydrostatic Signup and view all the answers

Activities such as walking, talking, and writing are regulated by the:

Somatic nervous system. Signup and view all the answers

All critical life functions are coordinated in which part of the brain?

Brain stem Signup and view all the answers

Anterior to the knee is a specialized bone called the:

Patella. Signup and view all the answers

As the bronchus divides into smaller bronchioles, the terminal ends of these smaller passages form the:

Alveoli. Signup and view all the answers

At rest, the normal adult heart rate should not exceed:

100 beats/min. Signup and view all the answers

Bile is produced by the liver and concentrated and stored in the:

Gallbladder. Signup and view all the answers

Both areas of the pons are used to:

Augment respirations during emotional or physical stress. Signup and view all the answers

Breathing occurs as the result of a(n):

Increase in carbon dioxide, which decreases the pH of the cerebrospinal fluid. Signup and view all the answers

Capillary sphincter closure during internal or external bleeding is detrimental because:

Waste products are not removed and nutrients are not delivered to the cells. Signup and view all the answers

A 75-year-old woman complains of heaviness in her chest, nausea, and sweating. After taking two prescribed nitroglycerin tablets, she still feels heaviness in her chest. What should you do?

Recall that geriatric patients often take multiple medications and that interactions can occur with potentially negative effects. Signup and view all the answers

If EMTs give naloxone (Narcan) to an unresponsive known heroin abuser, what should they recall?

Naloxone administration could cause seizures in this patient. Signup and view all the answers

A 60-year-old male presents with acute respiratory distress. What is the MOST appropriate treatment?

Oxygen via nonrebreathing mask and a focused secondary assessment. Signup and view all the answers

What are the signs and symptoms of asthma?

Wheezing on inspiration/expiration and bronchospasm. Signup and view all the answers

What are the signs and symptoms of anaphylaxis?

Flushed skin, hives, generalized edema, decreased blood pressure, laryngeal edema with dyspnea, wheezing, or stridor. Signup and view all the answers

What are signs and symptoms of bronchiolitis?

Shortness of breath, wheezing, coughing, fever, dehydration, tachypnea, and tachycardia. Signup and view all the answers

What are the signs and symptoms of bronchitis?

Chronic cough with sputum production, wheezing, cyanosis, and tachypnea. Signup and view all the answers

What are the signs and symptoms of congestive heart failure (CHF)?

Dependent edema, crackles, orthopnea, paroxysmal nocturnal dyspnea. Signup and view all the answers

What are the signs and symptoms of COVID-19?

Cough, fever, dyspnea, chest pain, and anosmia. Signup and view all the answers

What are signs and symptoms of Croup?

Fever, barking cough, and stridor. Signup and view all the answers

What are signs and symptoms of Diphtheria?

Difficulty breathing and swallowing, sore throat, thick gray buildup in throat or nose, fever. Signup and view all the answers

What are signs and symptoms of Tuberculosis (TB)?

Cough, fever, fatigue, and productive/bloody sputum. Signup and view all the answers

What are the signs and symptoms of emphysema?

Barrel chest, pursed lip breathing, dyspnea on exertion, cyanosis, and wheezing or decreased breath sounds. Signup and view all the answers

What are the signs and symptoms of Epiglottis?

Dyspnea, high fever, stridor, drooling, difficulty swallowing, severe sore throat, tripod or sniffing position. Signup and view all the answers

What are signs and symptoms of Pertussis (Whooping Cough)?

Coughing spells and a 'whooping' sound, fever. Signup and view all the answers

What are signs and symptoms of Pneumonia?

Dyspnea, chills, fever, cough, and rust-colored sputum. Signup and view all the answers

What are signs and symptoms of Pneumothorax?

Sudden chest pain with dyspnea, decreased breath sounds on the affected side, subcutaneous emphysema. Signup and view all the answers

What are signs and symptoms of Pulmonary embolus?

Dyspnea, occasionally sharp chest pain, sudden onset, tachycardia, and clear breath sounds initially. Signup and view all the answers

What are signs and symptoms of Tension Pneumothorax?

Severe shortness of breath, diminished or absent breath sounds on one side, neck vein distention, tracheal deviation, hypotension, and signs of shock. Signup and view all the answers

What are the signs and symptoms of Respiratory syncytial virus (RSV)?

Cough, wheezing, fever, and dehydration. Signup and view all the answers

What diseases will you hear wheezing with?

Asthma, COPD, CHF/Pulmonary Edema, Pneumonia, Bronchitis, Anaphylaxis. Signup and view all the answers

What diseases will you hear rhonchi with?

COPD, Pneumonia, Bronchitis. Signup and view all the answers

What diseases will you hear crackles with?

CHF/Pulmonary Edema, Pneumonia. Signup and view all the answers

What diseases will you hear stridor with?

Croup, Epiglottitis. Signup and view all the answers

What diseases will you hear decreased or absent breath sounds with?

Asthma, COPD, Pneumonia, Hemothorax, Pneumothorax, Atelectasis. Signup and view all the answers

What breath sound is indicative of a partial upper airway obstruction?

Snoring. Signup and view all the answers

What breath sound indicates constriction and/or inflammation in the bronchus?

Wheezing. Signup and view all the answers

What breath sound sounds like air trying to pass through fluid in the alveoli?

Crackles (Rales). Signup and view all the answers

What breath sound is caused by secretions or mucus in the larger airway?

Rhonchi. Signup and view all the answers

What breath sound is heard on inspiration as air tries to pass through an obstruction in the upper airway?

Stridor. Signup and view all the answers

What is a normal blood glucose level?

80-120 mg/dL. Signup and view all the answers

What is ischemia?

Decreased blood flow. Signup and view all the answers

What are the steps of the 'Scene Size-Up' portion of the Patient Assessment?

BSI/PPE, Scene Safety, # of Patients, MOI/NOI, Additional resources, C-Spine. Signup and view all the answers

What are the steps of the 'Primary Assessment' portion of the Patient Assessment?

General Impression, Life Threats, Chief Complaint, LOC/AVPU/GCS, xABCs, CUPS decision/Transport. Signup and view all the answers

What are the steps of the 'Secondary Assessment' portion of the Patient Assessment?

Vitals, Focused Assessment. Signup and view all the answers

What is xABC?

X= xanguation, A= Airway, B= Breathing, C= Circulation. Signup and view all the answers

What is CUPS?

Critical, Unstable, Potentially Unstable, Stable. Signup and view all the answers

What are question examples for AVPU/LOC?

What is your name? What city are we in? What year is it? Who is the President? Signup and view all the answers

How do you properly set up an AED?

Turn it on, put pads on patient, plug leads in, follow AED instructions. Signup and view all the answers

What is cardiac output?

Volume of blood ejected by the heart in one minute: cardiac output = heart rate x stroke volume. Signup and view all the answers

What is open pneumothorax?

An opening through the chest that allows air into the pleural space. Signup and view all the answers

What is Hemopneumothorax?

Air and blood in the pleural space. Signup and view all the answers

What is hemothorax?

Blood in the pleural space. Signup and view all the answers

What is apnea?

The patient has stopped breathing. Signup and view all the answers

What are the 4 Aerosol-generating Procedures (AGPs)?

CPR, nebulizer treatments, endotracheal intubation, continuous positive airway pressure (CPAP). Signup and view all the answers

What is Cheyne-Stokes respiration?

A cyclical pattern of abnormal breathing that increases and then decreases in rate and depth, followed by a period of apnea. Signup and view all the answers

What is Ataxic respirations?

Irregular, ineffective respirations that may or may not have an identifiable pattern. Signup and view all the answers

How much should 2 EMTs be able to safely lift?

120-220 pounds. Signup and view all the answers

How should patients in the late stages of pregnancy be positioned?

Positioned and transported on their left side. Signup and view all the answers

What are indications of medicine?

The reasons or conditions for which a particular medication is given. Signup and view all the answers

What are contraindications of a specific medicine?

A medication is contraindicated when it would harm the patient or have no positive effect on the patient's condition. Signup and view all the answers

What are the common routes of medication administration?

Per rectum (PR), oral (PO), intravenous (IV), intraosseous (IO), subcutaneous (SC), intramuscular (IM), inhalation, sublingual (SL), transcutaneous, intranasal (IN). Signup and view all the answers

What is Tachycardia?

Rapid heart rate over 100 beats per minute. Signup and view all the answers

What is Bradycardia?

Slow heart rate less than 60 beats per minute. Signup and view all the answers

What medications may an EMT administer or assist in administering?

Aspirin, Ipratropium (Atrovent), Albuterol (Proventil, Ventolin), Epinephrine, Narcan (Naloxone), Nitroglycerin, Oral glucose, Oxygen, Acetaminophen (Tylenol), Diphenhydramine (Benadryl), Ibuprofen (Advil, Motrin, Nuprin). Signup and view all the answers

What is Aspirin (Bayer)?

An anti-inflammatory agent and anti-fever agent; prevents platelets from clumping. Signup and view all the answers

A patient presenting with a headache, fever, confusion, and red blotches on their skin should be suspected of having?

Meningitis. Signup and view all the answers

In assessment of circulation in a conscious patient, what should be involved?

Checking the radial pulse and noting skin condition. Signup and view all the answers

A sign of respiratory distress seen in the neck is:

Accessory muscle use. Signup and view all the answers

Upon arriving at the residence of a patient with a possible cardiac problem, what is most important?

Assess the scene for potential hazards. Signup and view all the answers

When documenting a patient's description of chest pain, the EMT should?

Use the patient's own words. Signup and view all the answers

Which of the following blood vessels transports oxygenated blood?

Pulmonary veins. Signup and view all the answers

Most patients are instructed to take up to how many doses of nitroglycerin before calling EMS?

Three. Signup and view all the answers

Narrowing of the coronary arteries caused by a buildup of fatty deposits is called?

Atherosclerosis. Signup and view all the answers

Prior to attaching the AED to a cardiac arrest patient, the EMT should?

Dry the chest if it is wet. Signup and view all the answers

The AED is most advantageous to the EMT because?

It delivers prompt defibrillation to patients with ventricular fibrillation. Signup and view all the answers

The electrical impulse generated by the heart originates in the:

Sinoatrial node. Signup and view all the answers

The iliac arteries immediately subdivide into the:

Femoral arteries. Signup and view all the answers

The most common reason that many people experiencing AMI do not seek immediate medical attention is because they:

Are in denial. Signup and view all the answers

The right coronary artery supplies blood to the:

Right ventricle and inferior wall of the left ventricle. Signup and view all the answers

When you arrive at the residence of a patient with a possible cardiac problem, what is most important?

Assess the scene for potential hazards. Signup and view all the answers

Study Notes

Patient Assessment and Treatment

In chest discomfort scenarios, geriatric patients often take multiple medications, leading to possible interactions.
Naloxone may induce seizures in unresponsive heroin overdose patients.
For acute respiratory distress, using oxygen via a nonrebreathing mask is preferable; focus on secondary assessment.

Medical Conditions and Symptoms

Asthma: Symptoms include wheezing during inspiration and expiration due to bronchospasm.
Anaphylaxis: Characterized by flushed skin, hives, generalized edema, hypotension, and respiratory distress.
Bronchiolitis: Symptoms are shortness of breath, wheezing, coughing, fever, dehydration, tachypnea, and tachycardia.
CHF Symptoms: Features include lower extremity edema, crackles from pulmonary edema, orthopnea, and paroxysmal nocturnal dyspnea.
COVID-19: Symptoms encompass cough, fever, dyspnea, chest pain, and anosmia.
Pneumothorax: Indicates sudden chest pain and dyspnea with decreased breath sounds on the affected side.

Specific Breath Sounds and Associated Diseases

Wheezing: Common in asthma, COPD, CHF, pneumonia, bronchitis, and anaphylaxis.
Rhonchi: Indicates conditions like COPD, pneumonia, and bronchitis due to mucus in large airways.
Crackles: Found in CHF and pneumonia, indicating fluid in alveoli.
Stridor: Indicates upper airway obstruction seen in croup and epiglottitis.

Vital Signs and Parameters

Normal blood glucose levels range from 80-120 mg/dL.
Cardiac output is calculated as the volume of blood pumped by the heart per minute—determined by heart rate and stroke volume.
The heart's electrical impulse originates in the sinoatrial node.

Medication Administration

EMTs may administer aspirin, epinephrine, narcan (naloxone), and nitroglycerin among others, for various conditions like chest pain and suspected cardiac issues.
When administering nitroglycerin, patients may typically take up to three doses before calling for EMS.

Atypical Symptoms and Conditions

Symptoms indicating meningitis include headache, fever, confusion, and red blotches on the skin.
Dissecting Aortic Aneurysm: Involves separation of aorta's inner layers.

Pediatric Considerations

In infants or small children, airway obstruction can occur if the head is overextended or overflexed, due to proportionately large occiputs making tracheas flexible.

Cardiac Conditions and Risks

Angina pectoris results from myocardial oxygen demand exceeding supply.
Cardiogenic shock from acute myocardial infarction is caused by decreased heart pumping force.

Scene Safety and Patient Access

Scene assessment for safety is critical on arrival at emergency situations, ensuring EMT safety before patient intervention.

Assessment Techniques

AVPU/LOC Questions: Include determining patient awareness and orientation.
Secondary assessment involves vital checks and focused evaluations.

Renal System Changes

Age-related changes in the renal system lead to decreased waste clearance and increased difficulty conserving fluids.

Patient Transport

Positions for late-stage pregnant patients should favor the left side to optimize blood flow and reduce pressure on the vena cava.### Separation Anxiety
Peaks typically between 10 to 18 months in infants and small children.

Vital Capacity in Elderly

Vital capacity declines due to factors such as loss of respiratory muscle mass, increased stiffness of the thoracic cage, but not due to increased surface area for air exchange.

Lung Function in Late Adulthood

After maximum expiration, the amount of air remaining in the lungs increases, which hampers gas diffusion because of stagnant air in the alveoli.

Anterior Fontanelle Fusion

The anterior fontanelle typically fuses between 9 to 18 months.

Cardiac Function Decline

Commonly related to atherosclerosis in late adulthood.

Characteristics of a 9-Month-Old Infant

Notable behaviors include placing objects in the mouth and pulling themselves up to stand.

Infant Vital Signs

An infant’s normal body temperature is usually higher than that of a preschooler.

Diabetes Mellitus and Aging

Increased incidence is associated with decreased physical activity, weight gain, and decreased insulin production.

Assessing a 13-Month-Old Child

During assessment, the child will likely respond to their name but may be fearful of unfamiliar presence.

Hydrostatic Pressure

Refers to the pressure exerted by a liquid when blood moves through an artery at high pressures.

Somatic Nervous System Functions

Regulates voluntary activities such as walking, talking, and writing.

Brain Function Coordination

All critical life functions are coordinated in the brain stem.

Specialized Bone in Front of the Knee

The patella is the specialized bone located anterior to the knee.

Alveoli Formation

Terminal ends of bronchioles form the alveoli during the division of the bronchus.

Normal Adult Heart Rate

At rest, a normal adult heart rate should not exceed 100 beats per minute.

Bile Production and Storage

Bile is produced by the liver and concentrated and stored in the gallbladder.

Pons Functionality

Both areas of the pons augment respirations during emotional or physical stress.

Mechanism of Breathing

Breathing is triggered by an increase in carbon dioxide, which lowers the pH of cerebrospinal fluid.

Consequences of Capillary Sphincter Closure

Closure during internal or external bleeding prevents the removal of waste products and delivery of nutrients to cells.

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Description

Test your knowledge on assessing and treating various medical conditions, particularly in geriatric patients. This quiz covers topics such as medication interactions in chest discomfort, symptoms of asthma, anaphylaxis, and more. Enhance your understanding of critical patient care scenarios.