Quiz
FP-C 5
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Questions in this quiz (200)
1Electric alternans may be caused by?
- APulmonary embolus
- BPericardial tamponade/effusion
- CTension pneumothorax
- DDiaphragmatic rupture
2You are flying a patient via rotor craft. Your patient is suffering from an episode secondary to acute cardiovascular disease. You are flying at an altitude of 8,000 ft. The patient is most susceptible to what type of hypoxia?
- AStagnant
- BHypoxic
- CHypemic
- DHistotoxic
3Your patient was diagnosed with an AMI 3 days ago and suddenly developed dyspnea and palpitations. He is diaphoretic and anxious appearing. You hear a loud holosystolic murmur at the apex with radiation to the axilla, but do not note an S3 or S4. You auscultate crackles throughout. What do you suspect is this patient's daignosis?
- ARight ventricular failure from the AMI
- BLeft ventricular failure from the AMI
- CPulmonary embolus
- DMitral regurgitation due to papillary muscle rupture
4Your patient is complaining of a severe headache. Her BP has been ranging from 230/130 mmHg to 210/105 mmHg. She currently has nitroprusside (Nipride) infusing and being titrated. Which of the following medications would you deem most appropriate for this patient?
- ALasix to decrease her preload
- BLabetalol to decrease contractility
- CHydralazine to decrease afterload
- DNitroglycerin to decrease preload
5A 68-year-old male is diagnosed with pneumonia with resultant sepsis. His vitals are as follows: T 102.3 F, BP 108/68, HR 124, RR 28. He is exhibiting increased confusion as well. What is the initial cardiovascular response to sepsis?
- AIncreased stroke volume
- BIncreased cardiac output
- CDecreased contractility
- DIncreased ejection fraction
6What best describes over-sensing?
- AFailure to sense the patient's QRS complexes
- BVentricular failure to pacemaker firing
- CPacemaker senses the T wave or other signals and is inhibited
- DFailure of the pacemaker to respond to atrial impulse sensing with ventricular pacing
7A 62-year-old female is complaining of chest pain. She has a past medical history of HTN, hypertriglyceridemia, CAD, and DM. Current vitals are: BP 152/90 mmHg, HR 82, and RR 22. Upon auscultation, you note a split S2 on expiration and single S2 on inspiration. You obtain a 12-Lead and note a normal P wave with each QRS complex and PR interval measuring 0.2 seconds. The QRS complexes measure 0.14 seconds and are positive in leads V5 and V6 and negative in V!. What do these findings indicate?
- A2nd degree Type I AV Block
- BLBBB
- CRBBB
- DUnstable VT
8Coronary artery perfusion is dependent on?
- ASVR
- BDiastolic pressures
- CSystolic pressures
- DAfterload
9A 48-year-old man is complaining of crushing substernal chest pain. You obtain a 12-lead ECG and it shows Mobitz type I, second-degree AV block with ST segment elevation in leads II, III, and aVF. What vessel is most likely involved?
- ACircumflex
- BLAD
- CRCA
- DLeft Main Cornary Artery
10When treating a patient with a diagnosis of chronic atrial fibrillation, the flight crew knows that ____________________ medication is most important in decreasing the risk of complications associated with this arrythmia.
- AWarfarin
- BPropranolol
- CCardizem
- DDigoxin
11You respond for a transfer of a 58 year-old male with a diagnosis of anterior wall MI. While working on obtaining your initial assessment, the patient becomes tachypneic and short of breath. You listen to lung sounds and hear crackles and auscultate S3 while obtaining heart tones. Based on these findings, what would be your immediate concerns?
- APulmonary edema
- BCardiogenic shock
- CPapillary muscle rupture
- DPericarditis
12You are called to transfer a 67 year-old female patient that was admitted with a diagnosis of anteroseptal MI. On arrival, you note the patient is currently on a NTG drip at 50 mcg/min and dobutamine drip at 10 mcg/kg/min. A pulmonary artery catheter was inserted with a PCWP of 16 mmg. Current vitals are: BP 128/92, HR 106, and RR 24. No adventitious breath sounds are heard on auscultation. During your assessment, the patient becomes restless and has cool, pale skin. You decide to recheck vitals and they reveal: BP 102/68, HR 120, and RR 30 and labored. Breath sounds are still equal but crackles are audible in the bases bilaterally and you note an S3 when auscultating heart sounds. You decide to administer 40mg Lasix to the patient. You wedge the pulmonary catheter and identify a PCWP of 8 mmHg with resultant drop in BP. The most appropriate intervention at this time would be to?
- AIncrease the NTG drip rate
- BDecrease the dobutamine drip rate
- CAdminister a saline bolus
- DInitiate a neo-synephrine drip.
13Beta-blockers are contraindicated with?
- ANarcotic overdoses
- BCocaine overdoses
- CASA overdoses
- DTCA overdoses
14Which medication blocks the renin-angiotensin-aldosterone (RAA) system to help with heart failure?
- ABeta-blocker
- BCalcium-channel blockers
- CAngiotensin-converting enzyme (ACE) inhibitors
- DThiazide diuretics
15You are called to transport a patient who underwent a heart transplant approximately 8 hours ago. Upon assessment, you note he is pale, cool and clammy to the touch. He appears anxious but is alert and awake. You notice JVD and auscultate crackles throughout. Current vitals are: 96/56. HR 124, RR 28, O2 at 97% on 3L via NC. You suspect a decrease in cardiac contractility. Which of the following medications would you anticipate providing for this patient?
- AIsotonic fluid bolus
- BDobutamine
- CLasix
- DFFP
16Your patient is currently on a magnesium sulfate drip due to refractory ventricular tachycardia after suffering from an AMI. He suddenly becomes hypotensive, experiences respiratory depression, and hyporeflexia. After discontinuing the mag drip, what should you do next?
- AAdministration calcium chloride IV
- BIncrease the drip due to worsening symptoms
- CInitiate a dopamine drip
- DIntubate the patient and continue the current tx
17You are transferring a patient to a higher level ICU. You identify that the patient's PA catheter is exhibiting a large defined waveform with an obvious notch on the left side of the waveform. The distal tip is most likely located in the?
- ARA
- BRV
- CPA
- DPCWP
18CVP 0
CI 1.4
PA S/D 11/5
PCWP 4
SVR 1800- AHypovolemia
- BLeft systolic dysfunction
- CNeurogenic shock
- DSepsis
19CVP 16
CI 1.3
PA S/D 44/26
PCWP 27
SVR 2100- AHypovolemia
- BLeft systolic dysfunction
- CNeurogenic shock
- DSepsis
20CVP 0
CI 6.1
PA S/D 30/14
PCWP 6
SVR 400- AHypovolemia
- BLeft systolic dysfunction
- CNeurogenic shock
- DSepsis
21CVP 1
CI 1.6
PA S/D 12/8
PCWP 5
SVR 300- AHypovolemia
- BLeft systolic dysfunction
- CNeurogenic Shock
- DSepsis
22Your patient's PA waveform has suddenly changed to resemble a low amplitude rolling waveform. You know that this indicates?
- AWithdrawal in the RV
- BWithdrawal in to the RA
- CInadvertent advance in to wedge position
- DNormal finding
23When obtaining a PCWP on your cardiac patient, you note a large V wave on the waveform. After confirming the PA catheter is correctly placed and the balloon is not ruptured, what condition do you suspect?
- ATricuspid valve regurgitation
- BPulmonic valve stenosis
- CAortic valve stenosis
- DMitral valve regurgitation
24The dicrotic notch on the arterial waveform is reflective of what mechanical event in the heart?
- ATricuspid valve closure
- BPulmonic valve closure
- CMitral valve closure
- DAortic valve closure
25A normal CVP/RAP reading would be?
- A6-10 mmHg
- B2-6 mmHg
- C12-16 mmHg
- D22-28 mmHg
26You note the following hemodynamic parameters: CVP 2, PCWP 12, CI 1.5, SVR 1800. What is your clinical diagnosis?
- ACardiogenic shock
- BHypovolemic shock
- CNeurogenic shock
- DSepsis
27You are transporting a patient from the ICU that is 2 days post trauma. You are packaging her for transport and the referring RN gives you her hemodynamic parameters. They are as follows: CVP 2, PCWP 8, CI 2.2, SVR 400. What is your diagnosis?
- ARight sided MI
- BHypovolemic Shock
- CNeurogenic Shock
- DCardiogenic Shock
28Which of the following hemodynamic parameters is most indicative of cardiogenic shock?
- ASystolic BP 80 mmHg, CI 1.8L/min, PCWP 30
- BSystolic BP 90 mmHg, CI 2.2L/min, PCWP 5
- CSystolic BP 120 mmHg, CI 4L/min, PCWP 12
- DSystolic BP 140 mmHg, CI 3L/min, PCWP 8 mmHg
29A patient with an extensive anterior wall myocardial infarction has a BP of 88/60 mmHg, PCWP 8 mmHg, and CI of 2L/min. Which of the following diagnoses best describes this condition?
- AVentilation perfusion disorder
- BActivity intolerance secondary to imbalance between supply and demand
- CFluid volume excess secondary to decreased CO
- DDecreased CO secondary to decreased myocardial contractility
30The central line readings obtained in the ICU prior to transport of a patient are as follows: CVP 13, CI 1.4, and a PCWP of 18. This could indicate what problem for this patient?
- AHypovolemic Shock
- BSeptic Shock
- CCardiogenic shock
- DAnaphylactic Shock
31You note the following hemodynamic parameters: CVP 2, PCWP 10, CI 1.8 and SVR 400
- ANeurogenic Shock
- BSeptic Shock
- CHypovolemic Shock
- DAnaphylactic Shock
32What is the normal SVR measurement?
- A200-400 dyne-sec/cm
- B400-1000 dyne-sec/cm
- C800-1200 dyne-sec/cm
- D1200-1800 dyne-sec/cm
33How is cardiac output determined?
- ACO = SV x HR
- BCO = MAP - HR
- CCO = BP x HR
- DNone of the above
34What is the formula for determining MAP?
- AMAP = (HR + DBP) / 2
- BMAP = [(SBP + (2 x DBP) / 3]
- CMAP = [SBP + (2xDBP) / 2]
- DNone of the above
35The _____________ measures filling pressures on the right side of the heart as the tip lies in the right atrium.
- APCWP
- BCVP
- CEnd left diastolic pressure
- DRV pressure
36The flight nurse knows that the normal SvO2 (central venous oxygen concentration)?
- A70-90%
- B50-60%
- C30-60%
- D60-80%
37What is the normal range for a PCWP?
- A4-9 mmHg
- B6-10 mmHg
- C8-12 mmHg
- D12-15 mmHg
38When attempting to wedge a PA catheter, the flight paramedic knows:
- AFill the balloon with exactly 2 mL
- BFill the balloon with up to 1.5 mL, but no more
- CFill the balloon with exactly 2.5 mL, but no more
- DFill the balloon with 1 mL, but may exceed 2mL
39Which of the following pulmonary artery pressures are within normal limits?
- APAP 34/24, PCWP 12
- BPAP 30/20, PCWP 10
- CPAP 28/18, PCWP 20
- DPAP 24/14, PCWP 12
40Which of the following hemodynamic patterns would indicate left ventricular failure in a patient with COPD?
- APAP 25/21, PCWP 13
- BPAP 48/26, PCWP 12
- CPAP 22/12, PCWP 16
- DPAP 48/26, PCWP 20
41Your patient is a 50-year old complaining of pain in her chest that is radiating to her (L) upper arm and up in to her jaw. She is alert, diaphoretic, and appears anxious. You note an audible S3 at the apex and crackles throughout the lung bases. Vitals and hemodynamic parameters are as follows: BP 80/60 mmHg, HR 118 bpm, CVP 3 mmHg, PAP 40/24 mmHg, PCWP 20 mmHg, CI 3.6 L/min, SVR 1340 dynes-sec/cm. When utilizing inotropes and vasodilators to maintain optimal PCWP, which of the following parameters would you determine optimal for this patient?
- APCWP 16, CI 2.5, BP 96/60, urine output 12 mL/Hr
- BPCWP 18, CI 2.5, BP 100/60, urine output 20 mL/Hr
- CPCWP 26, CI 1.2, BP 80/50, urine output 10 mL/Hr
- DPCWP 12, CI 1.9, BP 95/50, urine output 15 mL/Hr
42What would most likely cause dyspnea with a normal PCWP, an increase in pulmonary artery diasotlic pressure (PAD), an increase in pulmonary vascular resistance (PVR), and an increase in CVP?
- AMyocardial infarction
- BPulmonary embolism
- CCardiac tamponade
- DRight ventricular failure
43While transferring a patient out of the ICU, the flight nurse notes the patient's current hemodynamic parameters. His current CI is 1.6, CVP 17, PAP 44/22 mmHg, and PCWP 18 with a current BP of 78/60 and HR of 120. These hemodynamic parameters would suggest what diagnosis?
- ANeurogenic shock
- BRight ventricular infarction
- CSeptic shock
- DCardiogenic shock
44Normal values for the monitoring of PA pressures are:
- A2-6/8-14 mmHg
- B20-30/10-15 mmHg
- C25-35/20-30 mmHg
- D30-35/25-35 mmHg
45Your patient's peripheral A-line is showing a very sharp waveform with readings that appear exaggerated. This may be due to:
- ACatheter whip
- BOver dampening of the system pressure
- CKinking of the pressure tubing
- DCatheter embolus formation
46Central venous pressure monitors:
- AIntra-arterial pressure
- BPulmonary artery pressure
- CRight atrial pressure
- DFemoral venous pressure
47A common cause of elevated PA pressures is?
- ALeft ventricular failure
- BMitral valve stenosis
- CMitral valve regurgitation
- DAll of the above
48The central line reading obtained in the ICU prior to your arrival shows: CVP 13, CI 1.4, and PCWP 18. This could indicate what problem for the patient?
- AHypovolemia
- BHeart failure
- CAnaphylactic shock
- DNone of the above
49The patient's PA catheter is exhibiting a large, well-defined waveform with an obvious "notch" on the left side of the waveform. The distal tip is most likely located in the?
- ARA
- BPA
- CPCWP
- DRV
50Your patient has the following parameters: CVP 28, CI 1.2, PA S/D 48/29, PCWP 27 and SVR 1700: What diagnosis could you make?
- ARight sided MI/Right ventricular infarct
- BSeptic shock
- CCardiogenic shock
- DPulmonary embolism
51You respond for an interfacility transfer of an 18 year old male that was transported by EMS secondary to a gunshot wound to the chest. On your initial assessment you find that the patient has distant heart tones, JVD with the head elevated at 45 degrees, and associated hypotension. You suspect the patient is suffering from Beck's triad and a cardiac tamponade. The referring MD has placed a pulmonary artery catheter. along with a decreased and compromised cardiac output, what would you predict the other hemodynamic numbers would reveal?
- ADecreased CVP, Increased PCWP
- BIncreased CVP, Increased PCWP
- CDecreased CVP, Decreased PCWP
- DIncreased CVP, Decreased PCWP
52When transporting and assessing a patient with a pulmonary catheter, the flight nurse knows that if the PAP is more than 5 mmHg above the PCWP, it signals which abnormal condition is occurring?
- AHigh SVR
- BPulmonary hypertension
- CLeft ventricular failure
- DMitral valve insufficiency
53What is the primary trigger for the IABP?
- AA-line
- BPA cath
- CECG
- DEtCO2 waveform
54Which timing error is the most harmful?
- AEarly Inflation
- BLate inflation
- CLate deflation
- DAll of the Above
55During level flight you experience complete power failure of your IABP. What would your most important action be?
- ACycle the balloon manually; timing with the ECG
- BCycle the balloon manually; timing with the A-line
- CWithdrawal the IABP catheter to 10cm mark
- DManually inflate the IABP balloon every 30 minutes; regardless of timing
56The balloon has dislodged while treating your IABP patient. Which is the most common site that will be affected?
- ARight radial
- BLeft radial
- CRight femoral
- DLeft femoral
57What is the most ominous timing error that can occur while transporting a patient on an IABP?
- AEarly deflation
- BLate deflation
- CLate inflation
- DEarly inflation
58During transport you notice "rust colored flakes" in the IABP tubing. This indicates?
- AHelium tank degradation
- BIABP failure
- CHelium oxidation
- DIABP Balloon Rupture
59The secondary trigger for most IABP operations is the?
- AA-Line
- BPA catheter
- CECG waveform
- DCVP waveform
60Inadvertent migration of the IABP may cause which of the following EXCEPT:
- ALoss of renal perfusion
- BLoss of flow to the carotid vein
- CLoss of flow to the renal arteries
- DLoss of flow to the subclavian arteries
61The IABP is indicated in all of the following patients EXCEPT:
- ACardiogenic shock
- BUnstable angina
- CAortic insufficiency
- DWeaning from cardiopulmonary bypass
62You are transporting a patient on an IABP. During transport you notice that the patient's urine output has stopped. What is the problem?
- ABalloon Rupture
- BRenal artery occlusion due to balloon migration
- CSubclavian artery occlusion due to balloon migration
- DAll of the above
63While setting up your IABP, the flight paramedic knows that the standard timing ratio is?
- A1:1
- B1:2
- C1:3
- DNone of the above
64Which of the following pressures is augmented by the IABP inflation?
- AEnd systolic left ventricular pressure
- BAortic diastolic pressure
- CAortic systolic pressure
- DLeft ventricular diastolic pressure
65All IABP systems use helium as the drive gas because of which of the following characteristics?
- ALow density
- BHigh density
- CHigh molecular weight
- DAll of the above
66While monitoring the arterial line of a patient with an IABP, the balloon should show diastolic augmentation at what part of the arterial waveform?
- ADicrotic notch
- BSystolic phase
- CVentricular ejection phase
- DAnacrotic notch on RV waveform
67You are performing an assessment on your patient and you note that your patient "winces" as you are palpating their RUQ. What is the most likely cause of this patient's pain?
- ACostochondritis
- BSplenic Injury
- CGallbladder
- DStomach
68You are dispatched to a scene flight with a man who has fallen approximately 10 feet off a ladder striking his (L) lower rib region on the corner of a patio set. He is complaining of pain in the tip of his (L) shoulder. Which organ are you most concerned about?
- AStomach
- BSpleen
- CLiver
- DLung
69You are requested to transport a 32-year-old female diagnosed with DKA. She is 5'4" weighing 86kg. While in the ED, she has been breathing at a rate of 38 and you notice upon assessment that the patient appears fatigued. You make the decision to intubate the patient and request current ABGs. They are as follows: pH 7.01, PaCO2 23, PaO2 280, HCO3 17. She is currently on a NRB at 15lpm. Which of the the following plans would best suit this patient initially?
- AContinue paralysis and sedation after intubation and set vent to: VC, SIMV, rate 12, FiO2 0.6, Vt 870, PEEP 5
- BContinue paralysis and sedation after intubation and set vent to: VC, AC, rate 12, FiO2 0.7, Vt 600, PEEP 5
- CContinue sedation after intubation and set vent to: VC, AC, rate 30, FiO2 0.7, Vt 850, PEEP 5
- DContinue sedation after intubation and set vent to: VC, SIMV, rate 30, FiO2 0.6, Vt 500, PEEP 5
70You are transporting a 58 year old male diagnosed with SIADH. What is considered appropriate therapy for you to do while transporting this patient?
- AAdminister an aldosterone substitute such as fludrocortisone (Florinef)
- BAdminister furosemide
- CAdminister vasopressin
- DProvide agressive hydration and fluid resuscitation
71You are transporting a 23 year old male who has sustained traumatic injuries after being involved in a MVC. He has become hypovolemic and is demonstrating signs of shock. Which of the following would you also anticipate along with this?
- APre-renal failure
- BRenal failure
- CPost-renal failure
- DNone of the above
72You are called to transport a 26 year old patient in DKA. Which of the following assessment findings would indicate that this patient's DKA is deteriorating?
- AUrine pH less than 5.8
- BAn increase in bicarb from 22 to 25
- CDTRs decreasing from +2 to +1
- DPotassium levels decreasing from 6.3 to 5.2
73Which would be the best choice to treat someone with DI?
- AAggressive correction of acidosis using bicarbonate administration and respiratory compensation
- BAggressive glucose control with insulin
- CAggressive fluid management with DDAVP
- DAggressive diuresis using diuretics
74You are treating a patient with ARDS, exceptionally elevated WBC, elevated bands and a positive Cullen's sign. He also c/o upper abdominal pain. He has a history of alcoholism with frequent nausea and vomiting and has not routinely received any medical care. His CXR is showing infiltrates, patchy and diffuse, in the (L) lower field and elevation of the (L) side of the diaphragm. He describes his pain as constant and severe. What would his diagnosis likely be?
- AAcute GI perforation and hemorrhage
- BAcute hepatitis
- CAcute pancreatitis
- DAcute appendicitis
75A 32 year old man presents with fever, hyperglycemia and increasing confusion for the past 4 hours. HR 146, RR 32, and BP 82/48. Upon assessment you note dry mucous membranes and capillary refill of 4 seconds. Current labs are: K+ 3.0, Glucose 485, and ABGs show a pH of 7.1. Which of the following types of fluids is most appropriate initially for this patient?
- ALR
- B0.9% NS
- C0.45% NS
- D3% NS
76Which of the following laboratory findings would you expect to see in a patient with the diagnosis of SIADH?
- AHypoglycemia
- BDilutional Hyponatremia
- CHyperkalemia
- DDilutional hypercalcemia
77A 76 year old male presents with a 4 day history of fever, cough, and (L) sided pleuritic pain. The patient's family states that he has become more lethargic and dizzy with several frequent falls. Vital signs are: WBC 17.2, HR 124, BP 72/38, T 102.0F, RR 32, O2 82% on RA. His CXR shows a LLL infiltrate. Which of the following best fits this patient?
- ASIRS
- BSepsis
- CSevere Sepsis
- DSeptic Shock
78A 76 year old woman was recently started on enteral feedings at a long-term care facility. She was transferred to the local ER due to a change in level of consciousness. You were called for a transfer flight and received report. Current labs are: Na 150, BUN 80, Glu 870, and serum osmolality of 377. What is the most likely cause of the serum osmolality being abnormal?
- AOverhydration
- BSIADH
- CDehydration
- DOver use of diuretics
79When treating the septic patient, the goal for initial fluid resuscitation is?
- A10 ml/Kg
- B15 mL/kg
- C20 mL/kg
- D30 mL/kg
80Which lab finding would be most associated with diabetes insipidus?
- AElevated capillary blood glucose
- BRelative hyperkalemia
- CRelative hypocalcemia
- DUrinary hypo-osmolality
81A key component used in both the management of DKA and HHNK is?
- AAggressive fluid resuscitation
- BRapid correction of the high glucose
- CAggressive correction of the metabolic acidosis
- DAggressive correction of the associated hyperkalemia
82Systemic inflammatory response syndrome (SIRS) can lead to multi-organ dysfunction. Which of the following organs is involved first?
- ABrain
- BLiver
- CLungs
- DHeart
83You are treating a 15 year old girl who is very lethargic and only responsive to painful stimuli. She has a history of Type I diabetes mellitus and has been sick with a virus for the past couple of days. When reviewing her lab results, what would you expect to find?
- AHyperglycemia, hypokalemia, acidosis, elevated serum osmolality
- BHyperglycemia, hyperkalemia, acidosis, elevated serum osmolality
- CHyperglycemia, hypokalemia, alkalosis, elevated serum osmolality
- DHyperglycemia, hyperkalemia, alkalosis, elevated serum osmolality
84You are transporting a 48 year old male who is complaining of severe epigastric pain that is going through his back. He has been vomiting for the past 8 hours and says that the pain is not improving any. The patient's family says that the patient drinks whiskey "constantly". You notice that his skin appears dry and his lips appear cracked. Upon palpation of his abdomen, he is very tender and it is distended. He says he cannot get comfortable and keeps turning over. Vitals are as follows: BP 92/54, HR 128, RR 24. What is the next best action for this patient?
- AAdminister antibiotics
- BGastric decompression
- CAdministration of fluid and electrolytes
- DGet patient to the OR
85Your patient had a recent craniotomy to remove a tumor. He is currently awake, alert and answering questions appropriately. He shows no signs of any neurological deficits. His vitals are currently: BP 112/76, HR 88, RR 18, O2 @ 97% on 2L, FSBG 96,. Since the craniotomy, he has been urinating approximately 50 mL/Hr. Within the last couple of hours, his urine output has increased to 350 mL/hr and has a specific gravity of 1.001. What would you suspect?
- ADevelopment of type 2 diabetes mellitus
- BDiabetes insipidus
- CSIADH
- DHypervolemia
86You are called to transfer a 31 year old male who sustained extensive electrical burns. Upon entering the room, you notice brown urine in his foley bag. Upon examining the urinalysis, you notice myoglobinuria. To prevent the development of acute tubular necrosis and further renal failure, what do you anticipate doing for this patient?
- ALR, administer HCTZ and dobutamine
- BNS, administer bicarbonate and mannitol
- CColloids, administer Lasix and dopamine
- DNS, administer Lasix and mannitol
87A 54 year old male has developed diabetes insipidus after undergoing a craniotomy for a tumor. What findings would you anticipate with this patient?
- AOliguria, high serum osmolality, hypernatremia, and low urine specific gravity
- BOliguria, low serum osmolality, hyponatremia, and high urine specific gravity
- CPolyuria, high serum osmolality, hypernatremia, and low urine specific gravity
- DPolyuria, low serum osmolality, hyponatremia and high urine specific gravity
88When treating a septic patient, the flight team knows that the target CVP for fluid resuscitation for a patient with chronic HTN is?
- A3-6
- B6-10
- C8-12
- D12-15
89The flight team knows that when treating a patient with severe sepsis, monitoring the CVP, MAP, urine ouput, and SvO2 are essential for identifying endpoints for resuscitation. What is the goal for the SvO2 in these severe sepsis patients?
- A40-50
- B55-65
- C65-70
- D75-80
90The flight crew responds to a local small facility for a 21 year old female being transferred to a Level I ICU. The patient was involved in an ATV accident with a diagnosis of acute tubular necrosis (ATN) secondary to the crush injuries she experienced when the ATV pinned her against the tree. What would be the most common explanation for the ATN development?
- AHypovolemia
- BHemorrhage
- CHyperkalemia
- DRhabdomyolysis
91Which of the following best describes multiple organ dysfunction syndrome (MODS)?
- ALoss of function of two or more components of the same organ system
- BProgressive insufficiency of two or more organ systems
- CSevere septic shock with a lactate greater than 10
- DCessation of function of two or more organ systems
92The flight crew responds to a rural ER for a 29 year old male that was brought in by local EMS for esophageal varices and upper GI bleed. The patient has an estimated blood loss of 1200 mL. On arrival, the patient informs you he has been drinking since he was 16 years old. The referring RN states they have established a vasopressin drip and the patient is now complaining of severe chest pain. What would be your first differential diagnosis?
- APneumomediastinum
- BMesenteric ischemia
- CAcute coronary syndrome
- DMallory Weiss tear
93You respond to a rural med-surg unit to transfer a 61 year old female with a diagnosis of pneumonia. The referring provider made the decision to transfer the patient due to deterioration throughout the night. The referring RN states that the patient is febrile, tachycardic, tachypneic and has increasing confusion and decreased LOC. The flight crew knows that the initial response of the cardiovascular system to sepsis is?
- AIncreased CVP
- BDecreased contractility
- CIncreased CI
- DBradycardia
94You have a 13 year old female patient with a history of insulin dependent diabetes. She is admitted to the local ICU. Her friends and family state she has had a cold over the past week and has become lethargic over the last 24 hours. Lab results are as follows: Na 150, Cl 103, Glu 504, WBC 12.3, Band 14%, Leukocytes 68%. The most likely cause of this patient's DKA is?
- AAcute infection
- BDehydration
- CNoncompliance with insulin
- DPancreatitis
95You are transporting a 50 year old male from the ICU to another facility for further evaluation. The patient has been diagnosed with an AMI. He has been complaining of increasing chest pain, SOB and weight loss. He appears very nervous and you note tremors, His ECG shows atrial fib @ 148. This patient may be experiencing?
- AAddison's disease
- BThyrotoxicosis
- CMyxedema coma
- DCushing's syndrome
96You are transporting a patient with a diagnosis of DKA. Current labs and ABGs are as follows: Na 140, CL 95, Albumin 3.5, K 2.4. ABGs: pH 6.9, PCO2 20, HCO3 15, PO2 80, Base deficit -8. Patient has not received any fluid replacement. What is the relationship between pH and K?
- AAn increase in pH of 0.15 causes an increase in K of 0.6
- BAn increase in pH of 0.10 causes a decrease in K of 0.6
- CAn increase in pH of 0.08 causes an increase in K by 0.20
- DAn increase in pH of 0.10 causes an increase in K by 0.08
97Which of the following ABGs would you suspect to see in a patient that is diagnosed with DKA?
- ApH 7.40, PaO2 80, PaCO2 30, HCO3 22
- BpH 7.40, PaO2 70, PaCO2 22, HCO3 33
- CpH 7.27, PaO2 90, PaCO2 50, HCO3 20
- DpH 7.20, PaO2 88, PaCO2 23, HCO3 16
98Black and blue bleeding around the umbilicus is called?
- AKehr's sign
- BCullen's sign
- CMcBurney's point
- DGrey-Turner's sign
99The drug of choice for treating a GI bleed is?
- ANormal saline
- BNipride
- CSandostatin
- DPepcid
100When treating a patient with suspected DKA, what values would you use to differentiate the diagnosis of DKA from hyperosmolar hyperglycemic nonketoic (HHNK) condition?
- AA serum glucose of 550
- BA serum potassium of 3.5
- CPositive serum ketone
- DA serum osmolality of 320
101Beck's Triad includes all of the following EXCEPT?
- AJVD
- BMuffled Heart Tones
- CLeft Shoulder Pain
- DNarrowing Pulse Pressure
102Newton's 3rd Law states?
- AFor every action there is an equal and opposite reaction
- BAn object in motion stays in motion, an object at rest stays at rest
- CF=MA
- DNone of the Above
103You are transporting a patient that has been involved in a T-Bone type accident. The patient was a restrained driver that was struck on the driver's side. The patient had a brief LOC and is now conversing with you with a GCS of 15. The patient is c/o left shoulder pain. This is described as?
- AChvostek's Sign
- BKehr's Sign
- CMcBurney's Point
- DCullen's Sign
104The consensus formula calculates hourly fluid replacement for burn patients. What equation would you use?
- A2mL x kg x % BSA
- B4mL x kg x %BSA
- C6mL x kg x % BSA
- D1-3mL x kg x % BSA
105Minimum urine output for the adult burn patient with non-suspected rhabdomyolysis would be?
- A1-5mL/hr
- B10-20mL/hr
- C30-50mL/hr
- D60-80mL/hr
106You have a 70kg female patient involved in an MVC that caught fire. She has received 1st degree burns to her abdomen and lower back and second and third degree burns to her face, head, hands and both arms. What would you calculate her BSA burns as?
- A27%
- B32%
- C39%
- D63%
107You are caring for a male burn patient weighing 120kg with 45% BSA of second and third degree burns. Using the modified formula, what would your fluid resuscitation amount be for the first 8hrs?
- A6300-12,600 mL
- B12,500-25,000 mL
- C5,400-10,800 mL
- D4,800-9,600 mL
108Which of the following is not a treatment strategy when dealing with rhabdomyolysis and myoglobinuria?
- AMannitol
- BNaHCO3- treatment
- CFluid resuscitation
- DVasopressin administration
109You are managing a burn patient who weighs 90kg with 65% BSA of 2nd and 3rd degree burns. How much fluid should this patient receive in the first 8 hours when using the Parkland formula?
- A23,400
- B11,700
- C8,500
- D5,850
110You are called on a rotor flight to Ohio to pick up a 70kg burn patient that has 45% 2nd and 3rd degree burns. The patient was burned approximately 26 hours ago. The physician reports that the patient has had a total of six liters of fluid in a 24-hr period because he does not want the patient to get cerebral edema. Using the Parkland Formula, how much fluid should this patient have received in the first 24-hours of burn care?
- A6300 mL
- B9450 mL
- C12600 mL
- D12000 mL
111During transport of a burn patient, you notice an absent P wave and an increased QRS interval on the ECG. Initial ECG showed ST in the 160s with peaked T wave. What electrolyte abnormality do you suspect?
- AHypomagnesemia
- BHyperkalemia
- CHypercalcemia
- DHypokalemia
112You are transporting a 72kg male presenting with 2nd and 3rd degree burns to his entire face, anterior torso and complete left arm. How much fluid should the patient get in the first 8 hours using the Parkland formula?
- A4536 mL
- B9200 mL
- C2300 mL
- D3066 mL
113You are toned for a scene flight for an MVC involving a semi-truck versus a car. On arrival, you find an 18 year old male patient in the front seat with agonal respirations. Prior to extrication, the patient becomes pulseless and apneic. The most common cause of mortality with this type of accident is an aortic tear. An aortic tear is commonly associated with which of the following?
- ABlunt force injury to the chest wall
- BPenetration injury to the chest wall
- CAcceleration/deceleration injury
- DCardiac contusion
114Sudden cardiac death associated with high-speed projectile objects are described as commotio cordis. This is a result of which of the following?
- ACardiac tamponade
- BCardiac contusion
- CFatal dysrhythmia
- DAortic arch tear
115A 24 year old male presents to his local ER via EMS after an MVC. He is cool, clammy, and pale with obvious abdominal distension and pain with palpation, which he rates as a 10/10. His current BP is 78/52 and HR 140. He complains of LUQ pain and associated left shoulder pain. He also complains of increased pain with inspiration. The flight nurse notes Cullen's sign upon inspection. What is the most likely cause of his shoulder pain?
- ACholelithiasis
- BAortic arch tear
- CRuptured spleen
- DPulmonary contusion
116Recommended urinary output when caring for an adult patient trauma or medical patient should be?
- A100 mL/hr
- B30-50 mL/hr
- C1-2 mL/hr
- D> 250 mL/hr
117You are transporting a patient with a history of seizure activity just PTA. The patient has been outside fishing in mid-July. Her husband drove her to the closest ER for treatment. Labs reveal: CK 28,000, BUN 68, CR 2.0, Coags normal and urine is very dark with an output of 20 mL over the past 2 hours. She is unresponsive with a BP 100/40, HR 140, RR 28 and SaO2 94%. Your diagnosis is:
- ATCA overdose
- BCushings syndrome
- CThyroid storm
- DRhabdomyolysis
118When treating rhabdomyolysis, the flight crewmember knows that giving large amounts of fluid and administering _____________ will help by alkalinizing the urine.
- ALasix
- BK+
- CNaCl-
- DNaHCO3-
119The hallmark indicator that rhabdomyolysis is occurring in a hyperthermic patient is?
- AAltered mental status
- BIncreased BUN
- CHyperthermia
- DElevated (CK)
120A 27 year old multiple trauma patient from the emergency department undergoes fluid resuscitation with 3L of NSS and 5 units of unwarmed PRBCs. He remains unconscious, intubated, and ventilated with 100% oxygen. He has received sedation and remains immobilized on a backboard. The flight nurse should remain concerned about?
- ADecreased clotting times due to the banked PRBCs
- BAlkalosis due to the blood administration
- CHypothermia due to the unwarmed blood
- DHypokalemia due to blood administration
121You are on the scene of a 21 year old male gunshot wound to the left chest. The left chest has been decompressed with a needle. The patient is intubated and continues to desaturate and you note an increase in SQ air. How will you manage this patient?
- ARe-needle the left chest
- BAdvance the ETT below the level of injury
- CInsert a chest tube
- DDecrease respiratory rate down to 10 per minute
122Myoglobinuria, if left untreated, will result in what critical condition?
- AHyperkalemic crisis
- BAcute tubular necrosis
- CCardiomyopathy
- DPolycystic kidney disease
123When adminstering PRBCs, the Flight Paramedic can expect a rise in hemoglobin and hematocrit of ________________ for each unit of blood?
- A1 gm/dL increase in the hemoglobin and 3% increase in the hematocrit
- B2 gm/dL increase in the hemoglobin and a 3% increase in the hematocrit
- C1 gm/dL increase in the hemoglobin and a 5% increase in the hematocrit
- D2 gm/dL increase in the hemoglobin and a 5% increase in the hematocrit
124You are dispatched to an intra-facility transfer to a Level I trauma center for a 16 year old female with massive head, chest and abdominal trauma from an MVC. She has received 5 units of PRBCs prior to your arrival. She continues to bleed profusely from all of her wounds despite direct pressure to control bleeding and a hypovolemic state. You suspect DIC. What treatment do you expect to administer?
- ADobutamine
- BPRBCs
- CRapid fluid volume replacement
- DPlatelets, cryoprecipitate, and FFP
125You respond to a rural facility to transporta 12 YOM patient with head, chest and thoracic spine trauma. Upon viewing the X-ray, you note a widened mediastinum, obliteration of the aortic knob and the presence of a pleural cap. You suspect what injury?
- ATension pneumothorax
- BEsophageal disruption
- CAortic disruption
- DTracheal bronchial disrutpion
126A massive hemothorax in an adult is defined as a rapid accumulation of more than?
- A500cc of blood
- B1500cc of blood
- C2000cc of blood
- D750cc of blood
127When transferring a patient with multiple or massive transfusion, the flight nurse knows administering multiple units of blood may result in citrate toxicity. What electrolyte is indicated to counteract citrate toxicity?
- ASodium
- BPotassium
- CMagnesium
- DCalcium
128Fractures of the 1st-3rd ribs should indicate a high index of suspicion for which injury?
- AEsophageal Rupture
- BAortic Dissection
- CPulmonary contusion
- DLiver Laceration
129When inserting a chest tube, the correct insertion site recommended is?
- A3rd ICS mid-clavicular
- B4-5th ICS mid-axillary
- C5th ICS mid-axillary
- D4th ICS anterior axillary
130You arrive on the scene to manage a fall victim. She presents with a BP of 70/P, HR 60, RR 28, SaO2 96%. EMS reports the patient had a brief LOC, but now has a GCS of 14. You note a deformity to the right femur and she is complaining of neck pain. Your diagnosis of this patient is?
- AEpidural bleed
- BHypovolemic shock
- CNeurogenic shock
- DSubdural bleed
131A patient presenting with Beck's triad is most likely experiencing?
- ALiver laceration
- BTension pneumothorax
- CIncreased ICP
- DCardiac tamponade
132Long-term complications associated with musculoskeletal injuries include all of the following EXCEPT?
- AInfection
- BThrombophlebitis
- CDelayed Bone Healing
- DARDS
133Injury patterns associated with rear impact collisions are?
- AT12/L1 and C-Spine fractures
- BClavicle, ribs, femur, tib/fib injuries and abdominal injuries
- CC-spine fractures, clavicle and pelvic fractures
- DFractured ribs, skull fractures, patella, femur, acetabular fractures and dislocated hip
134After a multisystem trauma occurs, death within minutes is usually a result of?
- AMultisystem organ failure
- BBlood loss secondary to pelvic fracture
- CGreat vessel laceration
- DHead Injury
135A 23 YOM sustained numerous injuries after falling from a roof. You received a report from the transferring RN and are told that the patient has a right tension pneumothorax. Upon assessment, you expect to find?
- ATracheal deviation toward the right and diminished or absent breath sounds on the right
- BTracheal deviation toward the right and diminished or absent breath sounds on the left
- CTracheal deviation to the left and diminished or absent breath sounds on the left
- DTracheal deviation to the left and diminished or absent breath sounds on the right
136Of the following, what is the most common cause of myocardial contusion?
- AHit to the chest from a high-speed projectile
- BGetting kicked in the chest by a horse
- CInjuries after a motor vehicle collision
- DPerforming CPR
137A 21 YOF was involved in a domestic disturbance and has severely fractured ribs on the (L) side and multiple abrasions and bruising noted on the back and abdomen. She has started to complain of sharp pain in her (L) shoulder. What do you suspect?
- ARotator cuff injury
- BRuptured spleen
- CPulmonary contusion
- DThoracic spine injury
138You are transporting a 32 YOF who was involved in an MVC with chest trauma. You notice Beck's triad and suspect cardiac tamponade. What is included in Beck's triad?
- ATachycardia, flat neck veins, muffled heart sounds
- BHypertension, distended neck veins, pulsus paradoxus
- CHypotension, distended neck veins, muffled heart sounds
- DHypotnesion, flat neck veins, decreased right atrial pressure
139You are called to transfer a 23 YOM patient that was involved in a head-on accident with a semi-truck. The patient is showing s/s of hypoxia with a NRB @ 15/L min being administered. Currently the patient has a GCS of 10 and breathing shallow and rapid @ 28/min. Current labs and VS: BP 100/70, P 139, RR 28, Skin pale/dry/warm. H&H -7 & 19. The patient has a current urine output of 0.5mL/kg/hr for the past 3 hours. What type of shock is the patient suffering from?
- AHypoxic hypoxia
- BStagnant hypoxia
- CHypemic hypoxia
- DHistotoxic hypoxia
140You respond to an interfacility transfer for a 21 YOF that is being transferred for respiratory distress. The patient sustained a pulmonary contusion in an MVC. She has no medical history or pulmonary disease. Over the past few hours she has been complaining of worsening dyspnea, with her respiratory rate increasing and her SaO2 decreasing. Breath sounds reveal fine crackles bilaterally. Her ABGs reveal a respiratory alkalosis with an associated hypoxiemia. The chest x-ray shows patchy infiltrates. She is diagnosed with ARDS. Because of her hypoxia, high flow oxygen is applied and ABGs are trended. Considering the high concentration of oxygen that this patient is requiring to maintain an adequate SaO2, close assessment for clinical indication of oxygen toxicity is important. Which of the following will manifest first with this condition?
- AMoist, productive cough
- BSubsternal chest pain
- CDyspnea
- DCyanosis
141You are called to transfer a 21 YO patient from a small regional hospital to a level 1 trauma center. Prior to your arrival, the referring MD has placed a PA catheter to monitor the patient's hemodynamic status. During report you note that the patient has had significant changes in the past 6 hours. He is febrle with a temp of 101.4 F, skin is warm and dry and the patient seems restless and agitated. His current hemodynamic parameters are: BP 84/38, HR 134, CO 10.1, CI 5.2, CVP 4.2, PCWP 4, SVR 452, SvO2 90%. What does the high SvO2 reading indicate?
- AIntra-cardiac shunt
- BIncreased oxygen delivery
- CSevere hypoxia
- DDecreased oxygen saturation
142Your patient has the following hemodynamic parameters: BP 170/80, HR 60, RR 22 & irregular, ICP 23, CVP 20, PA 32/14, PCWP 15. What's your patient's CPP?
- A46
- B52
- C87
- D81
143Brown-Sequard Syndrome is a rare spinal cord injury that involves?
- AAnterior cord lesions
- BPosterior cord lesions
- CCentral cord lesions
- DIpsilateral cord lesions
144You're dispatched to a scene flight at night for a possible man that has fallen off a bridge. On arrival you find that your patient was involved from a fall of 20'. EMS states that he had a brief loss of consciousness and a period of lucidness, but now is fading in and out of consciousness. This presentation most often presents with what type of head trauma?
- AEpidural bleed
- BIntraventricular bleed
- CSubdural bleed
- DDiffuse axonal injury
145Cushing's Triad consists of?
- AWidening pulse pressures, tachycardia and normal respirations
- BHypertension, bradycardia and respiratory changes (Cheyne-Stokes)
- CHypotension, widening pulse pressures, bradycardia
- DHypertension, tachycardia, narrowing pulse pressures
146Diffuse axonal injury will most likely represent how on a CT scan?
- ANormal and unidentifiable
- BGranulated or salt and pepper appearance
- CIdentified by cervical spine subluxation
- DAll of the above
147Your patient has an ICP of 28. The current BP is 100/60. His cerebral perfusion pressure is approximately?
- A45
- B60
- C70-90
- D100
148A 60 year old female patient with a history of extensive emphysema became unresponsive while watching TV with her husband. Local EMS transported the patent to the local ED where you are called to transport the patient to a level I stroke center. On your primary assessment, you note paralysis of her left extremities, aphasia, and decreased LOC with a current GCS of 12. Which of the following would be a contraindication to fibrinolytics?
- ASeizure
- BSluggish, dilated pupils
- CCholecystectomy 6 months ago
- DAbdominal aortic aneurysm
149Normal adult CPP is at least?
- A40
- B60
- C70
- D50
150You respond to a rural facility to pick up a patient with a diagnosis of a skull fracture. Upon arrival, the x-ray shows multiple fractures that radiate from a compressed area. What type of skull fracture does this patient have?
- ABasilar fracture
- BLinear stellate fracture
- CDiastatic fracture
- DDepressed skull fracture
151Calculate the following cerebral perfusion pressure?
BP 150/75 HR 140 RR 28 SaO2 100% CVP 2 ICP 25- A98
- B65
- C75
- D125
152When evaluating the CT of a patient believed to have a diffuse axonal injury you expect to see?
- AA contact lense shaped collection of blood
- BAn unremarkable CT scan
- CA large collection of blood covering a single hemisphere
- DHigh density region surrounded by zones of low density
153The classic description of a patient suffering from an epidural hematoma is?
- ARapid onset of unconsciousness, posturing and seizure
- BUnconsciousness, followed by a brief period of lucidity, and a period of rapid decrease in the level of consciousness
- CSlow loss of consciousness, pupillary changes and seizures
- DSlow loss of consciousness, ipsilateral posturing, and contralateral pupillary changes
154A basilar skull fracture is associated with all of the following EXCEPT?
- ACSF rhinorrhea
- BCSF otorrhea
- CSeventh cranial nerve palsy
- DEleventh cranial nerve paralysis
155When monitoring invasive intracranial pressure lines, the transducer should be leveled at the?
- AForamen of Kellie
- BForamen of Ovale
- CForamen of Monro
- DForamen of Magnum
156The patient suffering from Brown-Sequard Syndrome presents with which of the following S/S?
- AComplete flaccidity below the level of injury
- BIpsilateral motor loss, contralateral pain loss
- CGreater weakness in upper extremities than in lower extremities
- DComplete motor pain and temperature loss below the level of the injury
157You are flying a 56 year old female secondary to a severe headache that came on suddenly. She states that she's been out of her blood pressure medication for three weeks and cannot afford to buy more. Her blood pressure ranges from 250/138 to 210/126. The referring MD has started Nitroprusside and oxygen by NRB. Which of the following describes appropriate drug therapy and goals for this patient presentation?
- ABeta blockers to decrease contactility
- BArterial vasodilators to decrease afterload
- CDiuretics to decrease preload
- DVenous vasodilators to decrease preload
158The flight team is dispatched for a transfer at the local ER for a patient that's suffering from a subarachnoid hemorrhage. What is the goal for systolic blood pressure for this patient during transport?
- A120 systolic
- B130 systolic
- C140 systolic
- D160 systolic
159You are transporting a patient who consumed a significant overdose of Elavil (amitriptyline). Upon your assessment, you would expect to find what patient presentation?
- ABradycardia and Hypotension
- BHyperventilation and Hyporeflexia
- CFever and agitation
- DSevere bradycardia and salivation
160You arrive at a facility to transport a patient who says they took an entire bottle of acetaminophen (Tylenol). They are currently complaining of RUQ pain. Based on this presentation, when did this patient most likely ingest this drug?
- ALess than one hour ago
- BWithin the last 1-4 hours
- CWithin the last 6-12 hours
- DWithin the last 24-72 hours
161You are treating an 86 year old male with digitalis toxicity due to an accidental overdose. What electrolyte would be evaluated first with this known diagnosis?
- ACalcium
- BPotassium
- CSodium
- DChloride
162Your patient was exposed to cyanide. What antidote management would best suit this patient?
- APhysostigmine
- BOxygen
- CAtropine and 2-PAM
- DAmyl nitrate and sodium thiosulfate
163In an aspirin overdose, the primary acid base disturbance would be ___________ followed by _______________?
- ARespiratory alkalosis, metabolic acidosis
- BRespiratory acidosis, metabolic acidosis
- CRespiratory alkalosis, metabolic alkalosis
- DRespiratory acidosis, metabolic alkalosis
164Which medication could potentially prevent the early symptoms of hypoglycemia?
- AValium
- BVerapamil
- CMetoprolol
- DLisinopril
165A 37 year old male patient is being transferred to a higher level ICU secondary to an overdose from an unknown drug. During your primary assessment, you note the patient is very thin. Upon obtaining an EKG, you note a prolonged QT segment. Based on your understanding of pathophysiology, you would anticipate a reduction in a certain electrolyte that may be causing these problems. Which electrolyte is least likely to be the cause of the prolonged QT?
- AMagnesium
- BCalcium
- CPotassium
- DSodium
166You are transporting a patient who overdosed on her prescription medication. Within minutes of your transport, you notice torsades de pointes on the cardiac monitor. Based upon this rhythm disturbance, what medication do you suspect the patient ingested?
- AFluoxetine
- BMetoprolol
- CHydrocodone
- DAmitriptyline
167Your patient has a diagnosis of salicylate toxicity. What acid-base imbalances would you anticipate?
- ARespiratory alkalosis and metabolic acidosis
- BRespiratory alkalosis and metabolic alkalosis
- CRespiratory acidosis and metabolic acidosis
- DRespiratory acidosis and metabolic alkalosis
168The term effacement refers to?
- ACervical dilation
- BPosition of fetal head
- CThickness of cervix and represented as a %
- DThe lie of the baby
169Your patient is presenting active delivery and you have a breech presentation. Delivery is halted upon delivery of the head. What would be the next best action?
- AAdminister Brethine 0.25mg SQ
- BAdminister MgSO4 4g IV bolus
- CPerform Mauriceu's Maneuver
- DPlace patient in the knee-chest position
170Poor variability is caused by all of the following EXCEPT?
- AFetal hypoxia
- BExtreme prematurity
- CSmoking by mother
- DNuchal cord
171The most accepted initial treatment for PIH related to hypertension may include all of the following EXCEPT?
- ALabetalol 10-20 mg IVP
- BBrethine 0.25mg SQ
- CMgSO4 4-6g slow IVP
- DHydralazine 2mg IVP
172The second stage of labor ends with?
- AStart of contractions
- BDelivery of the fetus
- CFull effacement
- DCrowning
173You are transferring a 32-week gestation female to a higher level OB unit. The patient has received a 4g bolus of MgSO4 and is currently on an infusion drip of 5g/hr. You assess your patient's DTRs and note they are absent. You discontinue the infusion and recheck the the DTRs after 5 minutes. You suspect acute MgSO4 toxicity. What would be your treatment?
- ABrethine 0.25mg SQ
- BCaCl 1g/10mL
- CLasix
- DNaHCO2 50mEq IVP
174You arrive on the scene of a 21 year old female involved in a motor vehicle collision single vehicle rollover. She is 28 weeks pregnant. The patient is gravida 2 para 1. Your assessment reveals palpation of fetal parts over the abdomen. What is your diagnosis?
- ALiver laceration
- BAbruptio placenta
- CUterine rupture
- DPlacenta previa
175The patient is a breech presentation and delivery appears to be halted upon delivery of the head. The appropriate action would be to?
- AInitiate rapid transport, placing mother in a knee-chest position
- BAdminister tocolytic agents
- CPerform Trousseau's maneuver
- DPerform Mariceau's maneuver
176Which of the following fetal heart tone tracings is an ominous sign?
- ASinusoidal
- BEarly decelerations
- CVariable decelerations
- DAccelerations
177When administering MgSO4 to prevent seizures in the OB patient, therapeutic levels range from 4-8 mEq/L. What assessment finding indicates toxic levels for the OB patient?
- AElevated BP
- BElevated RR
- CElevated HR
- DAbsent DTRs
178HELLP syndrome is characterized by?
- AHypertension, elevated liver enzymes and low platelets
- BHypertension, elevated lipase and low protein
- CHemolysis, elevated liver enzymes and low platelets
- DHemolysis, elevated lipase and low protein
179Postpartum hemorrhage is defined as blood loss of 500cc or greater following delivery. You have attempted vigorous fundal massage without any improvement in bleeding. You should next be considering what?
- AAdministration of PRBCs
- BContinued vigorous fundal massage
- CMethergine 0.2mg IV or IM
- DPitocin 20-40 units in 1000cc of LR
180Late decelerations may indicate?
- ACord compression
- BUterine placental insufficiency
- CAcidosis
- DInadequate uterine contractions
181What are the three classic s/s of pregnancy induced hypertension (PIH)?
- AHeadache, hyperreflexia and HELLP
- BHypertension, edema, and proteinuria
- CHypertension, headache, and proteinuria
- DHypertension, headache and hyper-reflexia
182Which of the following maneuvers may be used to help deliver an infant with shoulder dystocia?
- AErb's maneuver
- BForceps technique maneuver
- CLeopold's maneuver
- DMcRobert's maneuver
183A 32 year old female who has IDDM and is 30 weeks gestation is going to be transferred to a high risk OB facility. The patient has had contractions every 5 minutes for the last hour and has received one liter of NS. You should prepare to?
- AAdminister 0,25mg Brethine SQ
- BMaintain an IV of D5W throughout transport
- CVerify adequate urine output secondary to your fluid bolus
- DAdminister MgSO4 4g bolus over 20-30 minutes
184In evaluating fetal heart characteristics, which is the most important in determining neurological maturity?
- AAccelerations
- BVariability
- CFlat or decreased beat-to-beat variability
- DTransient accelerations and decelerations from the baseline FHR
185The flight team recognizes that DIC is a common complication of?
- AAbruptio placenta
- BOvarian rutpure
- CEctopic pregnancy
- DPlacenta previa
186Your patient is reported to have transposition of the great vessels. It is essential to the survival of the neonate to maintain?
- AOxygen
- BPDA patency
- CIndomethacin
- DOxytocin
187The equation for determination of ETT size in a neonate or child is?
- A(12+4)/4
- B(16 X 2)/2
- C(16+age)/4
- D(16+age)(4)
188When giving a neonate PGE1 for PDA patency, the flight crewmember knows that a primary complication to administration is?
- AClosure of the PDA
- BApnea
- CPulmonary HTN
- DMetabolic Acidosis
189With regards to volume loss due to hemorrhage, the flight crewmember knows that the pediatric patient will not demonstrate hypotension until approximately ___________ loss of blood volume.
- A10%
- B30%
- C25%
- D40%
190A common injury pattern seen in pediatrics struck by a vehicle is called?
- ABeck's triad
- BCushing's triad
- CWaddell's triad
- DKehr's sign
191Your 10kg neonate starts presenting with a repetitive mouth & tongue movement, bicycling motion, eye deviation and rapid blinking. What type of seizure would this represent?
- AClonic
- BTonic
- CMyoclonic
- DSubtle
192A neonate who is experiencing repetitive motion of a bicycling type action with lip smacking is presenting with what type of seizure?
- ASubtle
- BTonic
- CClonic
- DMyoclonic
193The high vascular resistance in the fetal lung is due to the following physiologic mechanisms?
- AChanges in O2 tension
- BChanges in pH and CO2 tension
- CPulmonary arterial vasoconstriction
- DIncrease in systemic vascular resistance
194During transport of a neonate, which of the following findings would indicate that the neonate is in stress?
- ASucking
- BFist clenched
- CHiccoughing or sneezing
- DQuiet and alert
195Increased irritability, increased HR and BP, eye fluttering and decreased SaO2 may be subtle signs of?
- ASeizures
- BCongenital heart defect
- CHydrocephalus
- DNeurologic abnormality
196You are transporting a 32 week preamture neonate with respiratory distress. Which drug may be administered in preparation for transport?
- AAntibotics
- BSurfactant
- CD10
- DProstaglandin
197Your patient is PDA dependent. This would indicate that your patient would likely require the administration of which of the following drugs?
- AIndomethacin
- BProgesterone
- CProstaglandin
- DSynthetic surfactant
198Which of the following is one of the most common side effects complicating the transport of a neonate receiving prostaglandin therapy?
- AHypertension
- BHypothermia
- CApnea
- DTachypnea
199You are called to transport a 5 day old neonate. On arrival, your reports that the baby is suffering from tetralogy of fallot. You know that this disease process causes severe hypoxia. What is the long-term treatment to correct the heart defect?
- APGE-1 administration
- BHigh flow oxygen
- CCath and dilate the PA and patch the VSD
- DIndomethacin for PDA closure
200Which of the following congenital disorders results in a right to left shunt?
- APDA
- BIsolated VSD
- CTetralogy of fallot
- DASD
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- Quiz on FP-C 5, created by Jack Blessee on 28/08/2020.
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- Jack Blessee
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- English
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