HealthONE EMS CCT Preassessment

Question 1 of 60

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Which of the following electrolytes flows into the cell to initiate depolarization?

Select one of the following:

  • Magnesium

  • Calcium

  • Potassium

  • Sodium

Question 2 of 60

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Metabolic acidosis occurs when the patient has a decreased _______ and a decreased _______.

Select one of the following:

  • pH; PCO2

  • HCO3–; PO2

  • pH; HCO3–

  • PCO2; HCO3–

Question 3 of 60

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Liver injuries will cause pain in the right upper quadrant along with right shoulder pain as blood accumulates around the diaphragm. The pain in the right shoulder is called:

Select one of the following:

  • Gourd's sign.

  • Kehr's sign.

  • Vagal's sign

  • Hobb's sign.

Question 4 of 60

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Given the following laboratory values, indicate which pathologic condition the patient is experiencing: pH, 7.24; PCO2, 56 mm Hg; PO2, 75 mm Hg; HCO3–, 24 mEq/L.

Select one of the following:

  • respiratory acidosis

  • respiratory alkalosis

  • metabolic acidosis

  • metabolic alkalosis

Question 5 of 60

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You are caring for a patient with a confirmed coronary thrombus (a clot). A staffed cath lab is not readily available, and the ECG indicates an evolving infarction pattern. The care team is considering ordering a thrombolytic/fibrinolytic medication to reduce the thrombus. Based on your understanding of the mechanism of action for these medications, which of the following from the patient history would indicate a contraindication to its administration?

Select one of the following:

  • The patient had a gallbladder removal (choleycystectomy) 8 months ago.

  • The patient has a history of bleeding hemorrhoids diagnosed by colonoscopy 3 months ago.

  • The patient suffered a traumatic crush injury to the right leg 2 weeks ago.

  • The patient's blood pressure is 88/54 mm Hg.

Question 6 of 60

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Can a hospital-owned helipad be utilized by EMS as a pickup point for the transport of a patient to another hospital without EMTALA being triggered?

Select one of the following:

  • Yes

  • No

  • Yes, but only with the family's permission.

  • Yes, but only with the physician's permission.

Question 7 of 60

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While caring for a patient who is mechanically ventilated and on positive end-expiratory pressure (PEEP), it is important to understand how PEEP works. Which of the following statements is TRUE regarding PEEP?

Select one of the following:

  • It occurs at the beginning of a mandatory machine breath.

  • It decreases the functional residual capacity (FRC).

  • It increases venous return.

  • It may increase intracranial pressure (ICP).

Question 8 of 60

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As ICP rises to the level of arterial pressure, the cascade of events know as Cushing's triad begins. Cushing's triad is BEST described as:

Select one of the following:

  • widened pulse pressure, bradycardia, and abnormal respiratory pattern.

  • MAP greater that 120 mm Hg, tachycardia, and abnormal respiratory pattern.

  • tachypnea, widened pulse pressure, and tachycardia.

  • apnea, bradycardia, and systolic blood pressure greater than 180 mm Hg.

Question 9 of 60

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Your patient has sustained a myocardial infarction. In addition to the 12-lead ECG showing significant ST elevations in II, III, and AVF, which of the following specifically indicates myocardial damage?

Select one of the following:

  • a troponin value of 0.02 ng/mL

  • a troponin value of 0.12 ng/mL

  • a CK-MB level of 124 ng/mL

  • a lactate dehydrogenase (LDH) level of 24 U/L

Question 10 of 60

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The formula for blood pressure (BP) is:

Select one of the following:

  • Heart rate x Stroke volume.

  • Cardiac output ÷ Mean arterial pressure.

  • Cardiac output x Systemic vascular resistance.

  • [(2 x diastolic BP) + systolic BP]/3.

Question 11 of 60

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Afterload is defined as the:

Select one of the following:

  • degree of myocardial fiber stretch induced by volume.

  • inotropic state of the heart, or force with which the heart contracts.

  • resistance the ventricles must overcome to eject blood.

  • measure of venacaval and right atrial pressures.

Question 12 of 60

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The umbilical cord contains:

Select one of the following:

  • one vein and one artery.

  • two veins and one artery.

  • one vein and two arteries.

  • two veins and two arteries.

Question 13 of 60

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You are caring for a 40-year-old male with severe gastrointestinal bleeding. He is to receive two units of packed red blood cells due to profound anemia. Based on your understanding of hemoglobin, which of the following statements is TRUE?

Select one of the following:

  • Hemoglobin is a measurement of the percentage of red blood cells in the circulating volume.

  • Hemoglobin is the protein responsible for carrying oxygen to the cells.

  • Hemoglobin levels typically elevate under periods of acute stress or sudden trauma to compensate for increased oxygenation needs.

  • A hemoglobin level of 10 g/dL is acceptable for males and females.

Question 14 of 60

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The Circle of Willis is a complex system of arterial flow at:

Select one of the following:

  • the base of the skull.

  • the cerebellar junction.

  • the brain stem.

  • the cerebral intersection.

Question 15 of 60

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The Allen test is used to assess:

Select one of the following:

  • upper extremity perfusion.

  • cerebral circulation.

  • heart rate.

  • capillary refill time.

Question 16 of 60

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When assessing your patient's airway prior to intubation, you use the Mallampati classification. Your physical assessment reveals that the posterior pharynx is partially exposed. Based on your knowledge of this classification, you know that this is a Mallampati grade class of:

Select one of the following:

  • I

  • II

  • III

  • IV

Question 17 of 60

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Stagnant hypoxia results from:

Select one of the following:

  • the cells' inability to utilize oxygen.

  • a lack of available hemoglobin molecules.

  • a failure to transport oxygenated blood.

  • a lack of adequate ventilation.

Question 18 of 60

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Patients with acute myocardial infarction, cerebrovascular accident, severe traumatic brain injury, and abdominal aneurysm are all examples of patients who:

Select one of the following:

  • will not tolerate the altitude changes associated with air medical transport.

  • will require a respiratory therapist during transport.

  • are good candidates for rotor-wing transport

  • are too critical to transport.

Question 19 of 60

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Given the following laboratory values, indicate which pathologic condition the patient is experiencing: pH, 7.56; PCO2, 42 mm Hg; PO2, 82 mm Hg; HCO3–, 36 mEq/L.

Select one of the following:

  • respiratory acidosis

  • respiratory alkalosis

  • metabolic acidosis

  • metabolic alkalosis

Question 20 of 60

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You are caring for a patient who is being mechanically ventilated. The current ventilator settings are as follows: tidal volume of 600 mL, respiratory rate of 12 breaths/min, FIO2 of 40%. While considering normal respiratory parameters, you recall that the minute ventilation is measured by:

Select one of the following:

  • the respiratory rate x the SaO2.

  • the tidal volume x the AA gradient.

  • the PaO2 x the respiratory rate.

  • the respiratory rate x the tidal volume.

Question 21 of 60

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The mitral and tricuspid valves open during what phase of the cardiac cycle?

Select one of the following:

  • atrial systole

  • isovolumetric contraction

  • ventricular ejection

  • ventricular filling

Question 22 of 60

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Preeclampsia is defined as the presence of:

Select one of the following:

  • hypertension, decreased deep tendon reflexes, and proteinuria.

  • hypertension, edema, and an elevated glucose tolerance test.

  • hypertension, edema, and proteinuria.

  • hypertension, seizures, and ketonuria.

Question 23 of 60

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The clinical presentation of diffuse axonal injury (DAI) usually begins with:

Select one of the following:

  • confusion.

  • pupillary changes.

  • amnesia.

  • immediate unconsciousness

Question 24 of 60

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The two pairs of arteries that supply oxygenated blood to the brain are the:

Select one of the following:

  • cerebellar and cerebral arteries.

  • external and internal carotid arteries.

  • vertebral and internal carotid arteries.

  • vertebral and cerebral arteries.

Question 25 of 60

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Nitrogen gas bubbles in the joints or the folds of the intestinal tract are called the:

Select one of the following:

  • Chokes

  • Bends

  • Staggers

  • Creeps

Question 26 of 60

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You are preparing to transport a critical patient who is being mechanically ventilated. As part of your patient assessment, you note that the most recent arterial blood gas (ABG) results were: pH, 7.44; PaO2, 78 mm Hg; PaCO2, 43 mm Hg; and SaO2, 98 mm Hg. Which of the following is an indicator of the effectiveness of ventilation?

Select one of the following:

  • pH

  • PaO2

  • PaCO2

  • SaO2

Question 27 of 60

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During an abdominal assessment, you palpate deeply into the right upper quadrant. The patient immediately responds with severe pain during the palpation. The patient actually catches her breath for a moment. This is a positive _______ sign.

Select one of the following:

  • Cullen's

  • Chadwick's

  • Murphy's

  • Levine's

Question 28 of 60

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During uterine life, which of the following statements is MOST accurate regarding fetal circulation?

Select one of the following:

  • The left ventricle pumps blood to the lungs

  • Blood returns from the lungs into the left atrium.

  • The right ventricle pumps blood to the lungs.

  • The right atrium receives blood from the lungs.

Question 29 of 60

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A minimum of _______ of blood in the thoracic cavity is considered a massive hemothorax.

Select one of the following:

  • 750 ml

  • 1000 ml

  • 1300 ml

  • 1500 ml

Question 30 of 60

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All of the following decrease cardiac contractility EXCEPT:

Select one of the following:

  • milrinone.

  • hypocalcemia.

  • acidosis.

  • hyperkalemia.

Question 31 of 60

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During transport of a mechanically ventilated patient, the low-pressure alarm has continued to sound. After performing a quick troubleshooting attempt, the cause of the alarm cannot be found, and it continues to signal a low-pressure alert status. Which of the following is the most appropriate next action to be taken

Select one of the following:

  • Disconnect the ventilator from the patient and begin manual ventilation.

  • Increase the airway pressure setting.

  • Increase the FIO2.

  • Increase the tidal volume setting.

Question 32 of 60

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Shock, sepsis, and multiorgan dysfunction syndrome (MODS) share which of the following common denominators?

Select one of the following:

  • dilation of great vessels

  • inability of oxygen supply to meet demand

  • cellular function

  • a carbon dioxide deficit

Question 33 of 60

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You are onboard a VFR-rated rotor-wing aircraft at night en route to a scene where an unresponsive child requires transport to a specialty care facility. Approximately 5 minutes from the scene coordinates, you encounter increasingly bad weather, with visibility falling below FAA specified minimums. Which of the following is your best option?

Select one of the following:

  • Decrease airspeed and continue to the scene because it is so close.

  • Decrease altitude to try to get below the bad weather and continue to the scene.

  • Abort the response or secure an alternate landing zone in an area with acceptable weather.

  • Abort the response and begin calling all other flight programs in the area to see if they are able to complete the mission.

Question 34 of 60

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Any substance that can alternately bind or release H+ depending on outside conditions is called a(n):

Select one of the following:

  • ion.

  • base.

  • buffer.

  • acid.

Question 35 of 60

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Your patient is being treated for diabetic ketoacidosis. The most recent chemistry panel for this patient reveals a serum potassium of 2.5 mEq/L. Based on your understanding of this potassium abnormality, which of the following is the most likely cause for this value?

Select one of the following:

  • insufficient isotonic fluid resuscitation

  • 50% dextrose administration

  • metabolic alkalosis

  • insulin administration

Question 36 of 60

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Your patient is short of breath and complaining of chest pain. He is seated in a tripod position, which he says improves his condition. When analyzing his 12-lead ECG, you note that all complexes are low-voltage, with ST segment elevation and T-wave inversion in all leads. You suspect:

Select one of the following:

  • improper lead placement

  • a global MI

  • pericarditis

  • WPW syndrome

Question 37 of 60

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The MOST common anesthetic trigger for malignant hyperthermia is

Select one of the following:

  • succinylcholine (Anectine).

  • propofol (Diprivan).

  • pancuronium (Pavulon).

  • vecuronium (Norcuron).

Question 38 of 60

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In young children, the narrowest part of the trachea is the:

Select one of the following:

  • vallecula.

  • cricoid ring.

  • epiglottis.

  • hyoid.

Question 39 of 60

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The normal cardiac output for an average adult is:

Select one of the following:

  • 2 to 3 L/min.

  • 5 to 6 L/min.

  • 6 to 8 L/min

  • 8 to 10 L/min.

Question 40 of 60

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You are transporting a patient being treated for diabetic ketoacidosis. The patient is on the ventilator, and the most recent arterial blood gas (ABG) panel from the sending facility was pH, 7.34; PaO2, 96 mm Hg; PCO2, 43 mm Hg. Your patient is receiving an intravenous potassium drip at 10 mEq/hour and an insulin drip/continuous infusion at 6 units/hour. What lab value must be frequently reassessed during the care and transport of this patient?

Select one of the following:

  • glucose

  • potassium

  • calcium

  • lactate

Question 41 of 60

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In a potential neonatal resuscitation situation, the initial evaluation begins with the evaluation of:

Select one of the following:

  • airway, neurologic status, and perfusion.

  • neurologic status, perfusion, and circulation to the skin.

  • breathing, perfusion, and skin color.

  • breathing, color, and pulse rate.

Question 42 of 60

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Glycolysis, the citric acid cycle, and the electron transport chain are the three essential components of which of the following processes?

Select one of the following:

  • oxidative respiration

  • adenosine triphosphate (ATP) breakdown

  • semipermeable membrane respiration

  • cellular respiration

Question 43 of 60

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Which of the following is a TRUE statement with regard to carbon dioxide monitoring?

Select one of the following:

  • Capnography monitoring will yield a numeric value only.

  • Capnometry monitoring will yield a graphical waveform only.

  • Both capnography and capnometry provide data reflecting tissue perfusion.

  • Both capnography and capnometry provide data on the patency of the airway and the adequacy of ventilation.

Question 44 of 60

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A "sterile cockpit" refers to a:

Select one of the following:

  • method of decontaminating the aircraft.

  • communication technique during critical phases of flight.

  • pilot's absolute control over radio communications.

  • None of the above.

Question 45 of 60

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Renal dysfunction that results from the mobilization of muscle proteins that impair filtration is a condition known as

Select one of the following:

  • myoglobinuria.

  • methylglobinuria.

  • rhabdomyoglobin.

  • rhabdomyolsis

Question 46 of 60

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While auscultating the fetal heart, the heart rate is noted to be 155 beats/min. This rate is:

Select one of the following:

  • bradycardic.

  • normal.

  • tachycardic.

  • abnormal.

Question 47 of 60

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Which of the following is an example of a depolarizing neuromuscular blocking agent?

Select one of the following:

  • vecuronium (Norcuron)

  • rocuronium (Zemuron)

  • succinylcholine (Anectine)

  • atracurium (Tricium)

Question 48 of 60

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While a patient is receiving IV magnesium sulfate, appropriate assessments for toxicity include checking for:

Select one of the following:

  • changes in level of consciousness.

  • increased patellar reflexes.

  • decreased patellar reflexes.

  • visual changes

Question 49 of 60

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The IABP is used to :

Select one of the following:

  • Reduce afterload by inflating during systole

  • Reduce afterload by inflating during diastole

  • Increase contractility by delating during diastole

  • Increase preload by inflating during systole

Question 50 of 60

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In the symptomatic hyperkalemia patient, all of the following medications are a part of the accepted treatment EXCEPT:

Select one of the following:

  • bicarbonate.

  • insulin.

  • calcium

  • glucose.

Question 51 of 60

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Dobutamine (Dobutrex) is a frequently used sympathomimetic in critical care transport. It stimulates beta-1 receptors to increase myocardial contractility. Dobutamine is different than dopamine in that it:

Select one of the following:

  • has a positive inotropic effect.

  • has less chronotropic effect.

  • is useful to support cardiac output in acute myocardial infarction.

  • is less likely to precipitate cardiac arrhythmias.

Question 52 of 60

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In the normal, healthy adult, which of the following provides the stimulus for breathing?

Select one of the following:

  • the need to eliminate carbon dioxide from the blood

  • the need to increase oxygenation of the blood

  • the need to maintain a normal SaO2 level

  • the need to maintain a normal V/Q ratio

Question 53 of 60

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Classic clinical signs and symptoms of a pericardial tamponade are called Beck's triad. Beck's triad is best described as:

Select one of the following:

  • muffled heart tones, JVD, and wide pulse pressure.

  • muffled heart tones, JVD, and narrowed pulse pressure.

  • S3 heart sound, JVD, and narrowed pulse pressure.

  • S4 gallop, JVD, and widened pulse pressure.

Question 54 of 60

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The buretrol is an intravenous (IV) device that is sometimes used in pediatrics. Its purpose is to:

Select one of the following:

  • provide a backup IV fluid source if the IV bag runs dry.

  • prevent fluid overload if the IV pump malfunctions.

  • prevent an air embolus in the bloodstream.

  • provide a chamber to add an incompatible drug.

Question 55 of 60

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The Monroe-Kellie doctrine describes the contents of the cranial vault as:

Select one of the following:

  • brain, neurons, and blood.

  • brain, blood, and cerebrospinal fluid.

  • cerebrospinal fluid, air, and blood.

  • brain, blood, and air.

Question 56 of 60

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A patient is being transferred on a medication that is not carried by your transport service and that is not covered under your protocols. You should:

Select one of the following:

  • ensure that orders for use of the medication is in the transfer orders.

  • discontinue the medication for transport.

  • request a different service to respond to transport the patient.

  • discuss medication options with your patient.

Question 57 of 60

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Each alveoli is in contact with the pulmonary capillary. This is referred to as:

Select one of the following:

  • the alveolar–arterial gradient.

  • the pulmonary capillary membrane.

  • the alveolar capillary membrane.

  • the alveolar bed.

Question 58 of 60

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In aerobic metabolism, the ultimate acceptor of electrons is:

Select one of the following:

  • carbon dioxide.

  • glucose.

  • chloride.

  • oxygen.

Question 59 of 60

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You are transporting a trauma patient to a tertiary care facility for definitive care. Prior to transport, this patient underwent a prolonged resuscitation effort at the sending hospital. Based on the prolonged resuscitation, which of the following would be the most specific test to reflect organ perfusion?

Select one of the following:

  • bicarbonate

  • serum pH

  • alkaline phosphatase

  • lactate

Question 60 of 60

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During RSI procedures, chemical paralytic agents are used. What neurotransmitter is affected by these agents?

Select one of the following:

  • acetylcholinesterase

  • dopamine

  • midazalom

  • acetylcholine

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HealthONE EMS CCT Preassessment

mark.betterton
Quiz by , created almost 2 years ago

Certificate Critical Care Transport Quiz on HealthONE EMS CCT Preassessment, created by mark.betterton on 28/01/2015.

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