Which of the following electrolytes flows into the cell to initiate depolarization?
Metabolic acidosis occurs when the patient has a decreased _______ and a decreased _______.
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:
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.
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?
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.
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?
Yes, but only with the family's permission.
Yes, but only with the physician's permission.
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?
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).
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:
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.
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?
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
The formula for blood pressure (BP) is:
Heart rate x Stroke volume.
Cardiac output ÷ Mean arterial pressure.
Cardiac output x Systemic vascular resistance.
[(2 x diastolic BP) + systolic BP]/3.
Afterload is defined as the:
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.
The umbilical cord contains:
one vein and one artery.
two veins and one artery.
one vein and two arteries.
two veins and two arteries.
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?
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.
The Circle of Willis is a complex system of arterial flow at:
the base of the skull.
the cerebellar junction.
the brain stem.
the cerebral intersection.
The Allen test is used to assess:
upper extremity perfusion.
capillary refill time.
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:
Stagnant hypoxia results from:
the cells' inability to utilize oxygen.
a lack of available hemoglobin molecules.
a failure to transport oxygenated blood.
a lack of adequate ventilation.
Patients with acute myocardial infarction, cerebrovascular accident, severe traumatic brain injury, and abdominal aneurysm are all examples of patients who:
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.
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.
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:
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.
The mitral and tricuspid valves open during what phase of the cardiac cycle?
Preeclampsia is defined as the presence of:
hypertension, decreased deep tendon reflexes, and proteinuria.
hypertension, edema, and an elevated glucose tolerance test.
hypertension, edema, and proteinuria.
hypertension, seizures, and ketonuria.
The clinical presentation of diffuse axonal injury (DAI) usually begins with:
The two pairs of arteries that supply oxygenated blood to the brain are the:
cerebellar and cerebral arteries.
external and internal carotid arteries.
vertebral and internal carotid arteries.
vertebral and cerebral arteries.
Nitrogen gas bubbles in the joints or the folds of the intestinal tract are called the:
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?
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.
During uterine life, which of the following statements is MOST accurate regarding fetal circulation?
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.
A minimum of _______ of blood in the thoracic cavity is considered a massive hemothorax.
All of the following decrease cardiac contractility EXCEPT:
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
Disconnect the ventilator from the patient and begin manual ventilation.
Increase the airway pressure setting.
Increase the FIO2.
Increase the tidal volume setting.
Shock, sepsis, and multiorgan dysfunction syndrome (MODS) share which of the following common denominators?
dilation of great vessels
inability of oxygen supply to meet demand
a carbon dioxide deficit
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?
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.
Any substance that can alternately bind or release H+ depending on outside conditions is called a(n):
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?
insufficient isotonic fluid resuscitation
50% dextrose administration
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:
improper lead placement
a global MI
The MOST common anesthetic trigger for malignant hyperthermia is
In young children, the narrowest part of the trachea is the:
The normal cardiac output for an average adult is:
2 to 3 L/min.
5 to 6 L/min.
6 to 8 L/min
8 to 10 L/min.
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?
In a potential neonatal resuscitation situation, the initial evaluation begins with the evaluation of:
airway, neurologic status, and perfusion.
neurologic status, perfusion, and circulation to the skin.
breathing, perfusion, and skin color.
breathing, color, and pulse rate.
Glycolysis, the citric acid cycle, and the electron transport chain are the three essential components of which of the following processes?
adenosine triphosphate (ATP) breakdown
semipermeable membrane respiration
Which of the following is a TRUE statement with regard to carbon dioxide monitoring?
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.
A "sterile cockpit" refers to a:
method of decontaminating the aircraft.
communication technique during critical phases of flight.
pilot's absolute control over radio communications.
None of the above.
Renal dysfunction that results from the mobilization of muscle proteins that impair filtration is a condition known as
While auscultating the fetal heart, the heart rate is noted to be 155 beats/min. This rate is:
Which of the following is an example of a depolarizing neuromuscular blocking agent?
While a patient is receiving IV magnesium sulfate, appropriate assessments for toxicity include checking for:
changes in level of consciousness.
increased patellar reflexes.
decreased patellar reflexes.
The IABP is used to :
Reduce afterload by inflating during systole
Reduce afterload by inflating during diastole
Increase contractility by delating during diastole
Increase preload by inflating during systole
In the symptomatic hyperkalemia patient, all of the following medications are a part of the accepted treatment EXCEPT:
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:
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.
In the normal, healthy adult, which of the following provides the stimulus for breathing?
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
Classic clinical signs and symptoms of a pericardial tamponade are called Beck's triad. Beck's triad is best described as:
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.
The buretrol is an intravenous (IV) device that is sometimes used in pediatrics. Its purpose is to:
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.
The Monroe-Kellie doctrine describes the contents of the cranial vault as:
brain, neurons, and blood.
brain, blood, and cerebrospinal fluid.
cerebrospinal fluid, air, and blood.
brain, blood, and air.
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:
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.
Each alveoli is in contact with the pulmonary capillary. This is referred to as:
the alveolar–arterial gradient.
the pulmonary capillary membrane.
the alveolar capillary membrane.
the alveolar bed.
In aerobic metabolism, the ultimate acceptor of electrons is:
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?
During RSI procedures, chemical paralytic agents are used. What neurotransmitter is affected by these agents?