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FP-C 5

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Quiz on FP-C 5, created by Jack Blessee on 28/08/2020.
Jack Blessee
Quiz by Jack Blessee, updated more than 1 year ago
Jack Blessee
Created by Jack Blessee almost 5 years ago
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Resource summary

Question 1

Question
Electric alternans may be caused by?
Answer
  • Pulmonary embolus
  • Pericardial tamponade/effusion
  • Tension pneumothorax
  • Diaphragmatic rupture

Question 2

Question
You 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?
Answer
  • Stagnant
  • Hypoxic
  • Hypemic
  • Histotoxic

Question 3

Question
Your 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?
Answer
  • Right ventricular failure from the AMI
  • Left ventricular failure from the AMI
  • Pulmonary embolus
  • Mitral regurgitation due to papillary muscle rupture

Question 4

Question
Your 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?
Answer
  • Lasix to decrease her preload
  • Labetalol to decrease contractility
  • Hydralazine to decrease afterload
  • Nitroglycerin to decrease preload

Question 5

Question
A 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?
Answer
  • Increased stroke volume
  • Increased cardiac output
  • Decreased contractility
  • Increased ejection fraction

Question 6

Question
What best describes over-sensing?
Answer
  • Failure to sense the patient's QRS complexes
  • Ventricular failure to pacemaker firing
  • Pacemaker senses the T wave or other signals and is inhibited
  • Failure of the pacemaker to respond to atrial impulse sensing with ventricular pacing

Question 7

Question
A 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?
Answer
  • 2nd degree Type I AV Block
  • LBBB
  • RBBB
  • Unstable VT

Question 8

Question
Coronary artery perfusion is dependent on?
Answer
  • SVR
  • Diastolic pressures
  • Systolic pressures
  • Afterload

Question 9

Question
A 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?
Answer
  • Circumflex
  • LAD
  • RCA
  • Left Main Cornary Artery

Question 10

Question
When 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.
Answer
  • Warfarin
  • Propranolol
  • Cardizem
  • Digoxin

Question 11

Question
You 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?
Answer
  • Pulmonary edema
  • Cardiogenic shock
  • Papillary muscle rupture
  • Pericarditis

Question 12

Question
You 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?
Answer
  • Increase the NTG drip rate
  • Decrease the dobutamine drip rate
  • Administer a saline bolus
  • Initiate a neo-synephrine drip.

Question 13

Question
Beta-blockers are contraindicated with?
Answer
  • Narcotic overdoses
  • Cocaine overdoses
  • ASA overdoses
  • TCA overdoses

Question 14

Question
Which medication blocks the renin-angiotensin-aldosterone (RAA) system to help with heart failure?
Answer
  • Beta-blocker
  • Calcium-channel blockers
  • Angiotensin-converting enzyme (ACE) inhibitors
  • Thiazide diuretics

Question 15

Question
You 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?
Answer
  • Isotonic fluid bolus
  • Dobutamine
  • Lasix
  • FFP

Question 16

Question
Your 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?
Answer
  • Administration calcium chloride IV
  • Increase the drip due to worsening symptoms
  • Initiate a dopamine drip
  • Intubate the patient and continue the current tx

Question 17

Question
You 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?
Answer
  • RA
  • RV
  • PA
  • PCWP

Question 18

Question
CVP 0 CI 1.4 PA S/D 11/5 PCWP 4 SVR 1800
Answer
  • Hypovolemia
  • Left systolic dysfunction
  • Neurogenic shock
  • Sepsis

Question 19

Question
CVP 16 CI 1.3 PA S/D 44/26 PCWP 27 SVR 2100
Answer
  • Hypovolemia
  • Left systolic dysfunction
  • Neurogenic shock
  • Sepsis

Question 20

Question
CVP 0 CI 6.1 PA S/D 30/14 PCWP 6 SVR 400
Answer
  • Hypovolemia
  • Left systolic dysfunction
  • Neurogenic shock
  • Sepsis

Question 21

Question
CVP 1 CI 1.6 PA S/D 12/8 PCWP 5 SVR 300
Answer
  • Hypovolemia
  • Left systolic dysfunction
  • Neurogenic Shock
  • Sepsis

Question 22

Question
Your patient's PA waveform has suddenly changed to resemble a low amplitude rolling waveform. You know that this indicates?
Answer
  • Withdrawal in the RV
  • Withdrawal in to the RA
  • Inadvertent advance in to wedge position
  • Normal finding

Question 23

Question
When 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?
Answer
  • Tricuspid valve regurgitation
  • Pulmonic valve stenosis
  • Aortic valve stenosis
  • Mitral valve regurgitation

Question 24

Question
The dicrotic notch on the arterial waveform is reflective of what mechanical event in the heart?
Answer
  • Tricuspid valve closure
  • Pulmonic valve closure
  • Mitral valve closure
  • Aortic valve closure

Question 25

Question
A normal CVP/RAP reading would be?
Answer
  • 6-10 mmHg
  • 2-6 mmHg
  • 12-16 mmHg
  • 22-28 mmHg

Question 26

Question
You note the following hemodynamic parameters: CVP 2, PCWP 12, CI 1.5, SVR 1800. What is your clinical diagnosis?
Answer
  • Cardiogenic shock
  • Hypovolemic shock
  • Neurogenic shock
  • Sepsis

Question 27

Question
You 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?
Answer
  • Right sided MI
  • Hypovolemic Shock
  • Neurogenic Shock
  • Cardiogenic Shock

Question 28

Question
Which of the following hemodynamic parameters is most indicative of cardiogenic shock?
Answer
  • Systolic BP 80 mmHg, CI 1.8L/min, PCWP 30
  • Systolic BP 90 mmHg, CI 2.2L/min, PCWP 5
  • Systolic BP 120 mmHg, CI 4L/min, PCWP 12
  • Systolic BP 140 mmHg, CI 3L/min, PCWP 8 mmHg

Question 29

Question
A 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?
Answer
  • Ventilation perfusion disorder
  • Activity intolerance secondary to imbalance between supply and demand
  • Fluid volume excess secondary to decreased CO
  • Decreased CO secondary to decreased myocardial contractility

Question 30

Question
The 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?
Answer
  • Hypovolemic Shock
  • Septic Shock
  • Cardiogenic shock
  • Anaphylactic Shock

Question 31

Question
You note the following hemodynamic parameters: CVP 2, PCWP 10, CI 1.8 and SVR 400
Answer
  • Neurogenic Shock
  • Septic Shock
  • Hypovolemic Shock
  • Anaphylactic Shock

Question 32

Question
What is the normal SVR measurement?
Answer
  • 200-400 dyne-sec/cm
  • 400-1000 dyne-sec/cm
  • 800-1200 dyne-sec/cm
  • 1200-1800 dyne-sec/cm

Question 33

Question
How is cardiac output determined?
Answer
  • CO = SV x HR
  • CO = MAP - HR
  • CO = BP x HR
  • None of the above

Question 34

Question
What is the formula for determining MAP?
Answer
  • MAP = (HR + DBP) / 2
  • MAP = [(SBP + (2 x DBP) / 3]
  • MAP = [SBP + (2xDBP) / 2]
  • None of the above

Question 35

Question
The _____________ measures filling pressures on the right side of the heart as the tip lies in the right atrium.
Answer
  • PCWP
  • CVP
  • End left diastolic pressure
  • RV pressure

Question 36

Question
The flight nurse knows that the normal SvO2 (central venous oxygen concentration)?
Answer
  • 70-90%
  • 50-60%
  • 30-60%
  • 60-80%

Question 37

Question
What is the normal range for a PCWP?
Answer
  • 4-9 mmHg
  • 6-10 mmHg
  • 8-12 mmHg
  • 12-15 mmHg

Question 38

Question
When attempting to wedge a PA catheter, the flight paramedic knows:
Answer
  • Fill the balloon with exactly 2 mL
  • Fill the balloon with up to 1.5 mL, but no more
  • Fill the balloon with exactly 2.5 mL, but no more
  • Fill the balloon with 1 mL, but may exceed 2mL

Question 39

Question
Which of the following pulmonary artery pressures are within normal limits?
Answer
  • PAP 34/24, PCWP 12
  • PAP 30/20, PCWP 10
  • PAP 28/18, PCWP 20
  • PAP 24/14, PCWP 12

Question 40

Question
Which of the following hemodynamic patterns would indicate left ventricular failure in a patient with COPD?
Answer
  • PAP 25/21, PCWP 13
  • PAP 48/26, PCWP 12
  • PAP 22/12, PCWP 16
  • PAP 48/26, PCWP 20

Question 41

Question
Your 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?
Answer
  • PCWP 16, CI 2.5, BP 96/60, urine output 12 mL/Hr
  • PCWP 18, CI 2.5, BP 100/60, urine output 20 mL/Hr
  • PCWP 26, CI 1.2, BP 80/50, urine output 10 mL/Hr
  • PCWP 12, CI 1.9, BP 95/50, urine output 15 mL/Hr

Question 42

Question
What 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?
Answer
  • Myocardial infarction
  • Pulmonary embolism
  • Cardiac tamponade
  • Right ventricular failure

Question 43

Question
While 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?
Answer
  • Neurogenic shock
  • Right ventricular infarction
  • Septic shock
  • Cardiogenic shock

Question 44

Question
Normal values for the monitoring of PA pressures are:
Answer
  • 2-6/8-14 mmHg
  • 20-30/10-15 mmHg
  • 25-35/20-30 mmHg
  • 30-35/25-35 mmHg

Question 45

Question
Your patient's peripheral A-line is showing a very sharp waveform with readings that appear exaggerated. This may be due to:
Answer
  • Catheter whip
  • Over dampening of the system pressure
  • Kinking of the pressure tubing
  • Catheter embolus formation

Question 46

Question
Central venous pressure monitors:
Answer
  • Intra-arterial pressure
  • Pulmonary artery pressure
  • Right atrial pressure
  • Femoral venous pressure

Question 47

Question
A common cause of elevated PA pressures is?
Answer
  • Left ventricular failure
  • Mitral valve stenosis
  • Mitral valve regurgitation
  • All of the above

Question 48

Question
The 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?
Answer
  • Hypovolemia
  • Heart failure
  • Anaphylactic shock
  • None of the above

Question 49

Question
The 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?
Answer
  • RA
  • PA
  • PCWP
  • RV

Question 50

Question
Your 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?
Answer
  • Right sided MI/Right ventricular infarct
  • Septic shock
  • Cardiogenic shock
  • Pulmonary embolism

Question 51

Question
You 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?
Answer
  • Decreased CVP, Increased PCWP
  • Increased CVP, Increased PCWP
  • Decreased CVP, Decreased PCWP
  • Increased CVP, Decreased PCWP

Question 52

Question
When 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?
Answer
  • High SVR
  • Pulmonary hypertension
  • Left ventricular failure
  • Mitral valve insufficiency

Question 53

Question
What is the primary trigger for the IABP?
Answer
  • A-line
  • PA cath
  • ECG
  • EtCO2 waveform

Question 54

Question
Which timing error is the most harmful?
Answer
  • Early Inflation
  • Late inflation
  • Late deflation
  • All of the Above

Question 55

Question
During level flight you experience complete power failure of your IABP. What would your most important action be?
Answer
  • Cycle the balloon manually; timing with the ECG
  • Cycle the balloon manually; timing with the A-line
  • Withdrawal the IABP catheter to 10cm mark
  • Manually inflate the IABP balloon every 30 minutes; regardless of timing

Question 56

Question
The balloon has dislodged while treating your IABP patient. Which is the most common site that will be affected?
Answer
  • Right radial
  • Left radial
  • Right femoral
  • Left femoral

Question 57

Question
What is the most ominous timing error that can occur while transporting a patient on an IABP?
Answer
  • Early deflation
  • Late deflation
  • Late inflation
  • Early inflation

Question 58

Question
During transport you notice "rust colored flakes" in the IABP tubing. This indicates?
Answer
  • Helium tank degradation
  • IABP failure
  • Helium oxidation
  • IABP Balloon Rupture

Question 59

Question
The secondary trigger for most IABP operations is the?
Answer
  • A-Line
  • PA catheter
  • ECG waveform
  • CVP waveform

Question 60

Question
Inadvertent migration of the IABP may cause which of the following EXCEPT:
Answer
  • Loss of renal perfusion
  • Loss of flow to the carotid vein
  • Loss of flow to the renal arteries
  • Loss of flow to the subclavian arteries

Question 61

Question
The IABP is indicated in all of the following patients EXCEPT:
Answer
  • Cardiogenic shock
  • Unstable angina
  • Aortic insufficiency
  • Weaning from cardiopulmonary bypass

Question 62

Question
You are transporting a patient on an IABP. During transport you notice that the patient's urine output has stopped. What is the problem?
Answer
  • Balloon Rupture
  • Renal artery occlusion due to balloon migration
  • Subclavian artery occlusion due to balloon migration
  • All of the above

Question 63

Question
While setting up your IABP, the flight paramedic knows that the standard timing ratio is?
Answer
  • 1:1
  • 1:2
  • 1:3
  • None of the above

Question 64

Question
Which of the following pressures is augmented by the IABP inflation?
Answer
  • End systolic left ventricular pressure
  • Aortic diastolic pressure
  • Aortic systolic pressure
  • Left ventricular diastolic pressure

Question 65

Question
All IABP systems use helium as the drive gas because of which of the following characteristics?
Answer
  • Low density
  • High density
  • High molecular weight
  • All of the above

Question 66

Question
While monitoring the arterial line of a patient with an IABP, the balloon should show diastolic augmentation at what part of the arterial waveform?
Answer
  • Dicrotic notch
  • Systolic phase
  • Ventricular ejection phase
  • Anacrotic notch on RV waveform

Question 67

Question
You 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?
Answer
  • Costochondritis
  • Splenic Injury
  • Gallbladder
  • Stomach

Question 68

Question
You 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?
Answer
  • Stomach
  • Spleen
  • Liver
  • Lung

Question 69

Question
You 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?
Answer
  • Continue paralysis and sedation after intubation and set vent to: VC, SIMV, rate 12, FiO2 0.6, Vt 870, PEEP 5
  • Continue paralysis and sedation after intubation and set vent to: VC, AC, rate 12, FiO2 0.7, Vt 600, PEEP 5
  • Continue sedation after intubation and set vent to: VC, AC, rate 30, FiO2 0.7, Vt 850, PEEP 5
  • Continue sedation after intubation and set vent to: VC, SIMV, rate 30, FiO2 0.6, Vt 500, PEEP 5

Question 70

Question
You are transporting a 58 year old male diagnosed with SIADH. What is considered appropriate therapy for you to do while transporting this patient?
Answer
  • Administer an aldosterone substitute such as fludrocortisone (Florinef)
  • Administer furosemide
  • Administer vasopressin
  • Provide agressive hydration and fluid resuscitation

Question 71

Question
You 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?
Answer
  • Pre-renal failure
  • Renal failure
  • Post-renal failure
  • None of the above

Question 72

Question
You 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?
Answer
  • Urine pH less than 5.8
  • An increase in bicarb from 22 to 25
  • DTRs decreasing from +2 to +1
  • Potassium levels decreasing from 6.3 to 5.2

Question 73

Question
Which would be the best choice to treat someone with DI?
Answer
  • Aggressive correction of acidosis using bicarbonate administration and respiratory compensation
  • Aggressive glucose control with insulin
  • Aggressive fluid management with DDAVP
  • Aggressive diuresis using diuretics

Question 74

Question
You 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?
Answer
  • Acute GI perforation and hemorrhage
  • Acute hepatitis
  • Acute pancreatitis
  • Acute appendicitis

Question 75

Question
A 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?
Answer
  • LR
  • 0.9% NS
  • 0.45% NS
  • 3% NS

Question 76

Question
Which of the following laboratory findings would you expect to see in a patient with the diagnosis of SIADH?
Answer
  • Hypoglycemia
  • Dilutional Hyponatremia
  • Hyperkalemia
  • Dilutional hypercalcemia

Question 77

Question
A 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?
Answer
  • SIRS
  • Sepsis
  • Severe Sepsis
  • Septic Shock

Question 78

Question
A 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?
Answer
  • Overhydration
  • SIADH
  • Dehydration
  • Over use of diuretics

Question 79

Question
When treating the septic patient, the goal for initial fluid resuscitation is?
Answer
  • 10 ml/Kg
  • 15 mL/kg
  • 20 mL/kg
  • 30 mL/kg

Question 80

Question
Which lab finding would be most associated with diabetes insipidus?
Answer
  • Elevated capillary blood glucose
  • Relative hyperkalemia
  • Relative hypocalcemia
  • Urinary hypo-osmolality

Question 81

Question
A key component used in both the management of DKA and HHNK is?
Answer
  • Aggressive fluid resuscitation
  • Rapid correction of the high glucose
  • Aggressive correction of the metabolic acidosis
  • Aggressive correction of the associated hyperkalemia

Question 82

Question
Systemic inflammatory response syndrome (SIRS) can lead to multi-organ dysfunction. Which of the following organs is involved first?
Answer
  • Brain
  • Liver
  • Lungs
  • Heart

Question 83

Question
You 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?
Answer
  • Hyperglycemia, hypokalemia, acidosis, elevated serum osmolality
  • Hyperglycemia, hyperkalemia, acidosis, elevated serum osmolality
  • Hyperglycemia, hypokalemia, alkalosis, elevated serum osmolality
  • Hyperglycemia, hyperkalemia, alkalosis, elevated serum osmolality

Question 84

Question
You 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?
Answer
  • Administer antibiotics
  • Gastric decompression
  • Administration of fluid and electrolytes
  • Get patient to the OR

Question 85

Question
Your 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?
Answer
  • Development of type 2 diabetes mellitus
  • Diabetes insipidus
  • SIADH
  • Hypervolemia

Question 86

Question
You 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?
Answer
  • LR, administer HCTZ and dobutamine
  • NS, administer bicarbonate and mannitol
  • Colloids, administer Lasix and dopamine
  • NS, administer Lasix and mannitol

Question 87

Question
A 54 year old male has developed diabetes insipidus after undergoing a craniotomy for a tumor. What findings would you anticipate with this patient?
Answer
  • Oliguria, high serum osmolality, hypernatremia, and low urine specific gravity
  • Oliguria, low serum osmolality, hyponatremia, and high urine specific gravity
  • Polyuria, high serum osmolality, hypernatremia, and low urine specific gravity
  • Polyuria, low serum osmolality, hyponatremia and high urine specific gravity

Question 88

Question
When treating a septic patient, the flight team knows that the target CVP for fluid resuscitation for a patient with chronic HTN is?
Answer
  • 3-6
  • 6-10
  • 8-12
  • 12-15

Question 89

Question
The 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?
Answer
  • 40-50
  • 55-65
  • 65-70
  • 75-80

Question 90

Question
The 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?
Answer
  • Hypovolemia
  • Hemorrhage
  • Hyperkalemia
  • Rhabdomyolysis

Question 91

Question
Which of the following best describes multiple organ dysfunction syndrome (MODS)?
Answer
  • Loss of function of two or more components of the same organ system
  • Progressive insufficiency of two or more organ systems
  • Severe septic shock with a lactate greater than 10
  • Cessation of function of two or more organ systems

Question 92

Question
The 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?
Answer
  • Pneumomediastinum
  • Mesenteric ischemia
  • Acute coronary syndrome
  • Mallory Weiss tear

Question 93

Question
You 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?
Answer
  • Increased CVP
  • Decreased contractility
  • Increased CI
  • Bradycardia

Question 94

Question
You 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?
Answer
  • Acute infection
  • Dehydration
  • Noncompliance with insulin
  • Pancreatitis

Question 95

Question
You 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?
Answer
  • Addison's disease
  • Thyrotoxicosis
  • Myxedema coma
  • Cushing's syndrome

Question 96

Question
You 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?
Answer
  • An increase in pH of 0.15 causes an increase in K of 0.6
  • An increase in pH of 0.10 causes a decrease in K of 0.6
  • An increase in pH of 0.08 causes an increase in K by 0.20
  • An increase in pH of 0.10 causes an increase in K by 0.08

Question 97

Question
Which of the following ABGs would you suspect to see in a patient that is diagnosed with DKA?
Answer
  • pH 7.40, PaO2 80, PaCO2 30, HCO3 22
  • pH 7.40, PaO2 70, PaCO2 22, HCO3 33
  • pH 7.27, PaO2 90, PaCO2 50, HCO3 20
  • pH 7.20, PaO2 88, PaCO2 23, HCO3 16

Question 98

Question
Black and blue bleeding around the umbilicus is called?
Answer
  • Kehr's sign
  • Cullen's sign
  • McBurney's point
  • Grey-Turner's sign

Question 99

Question
The drug of choice for treating a GI bleed is?
Answer
  • Normal saline
  • Nipride
  • Sandostatin
  • Pepcid

Question 100

Question
When treating a patient with suspected DKA, what values would you use to differentiate the diagnosis of DKA from hyperosmolar hyperglycemic nonketoic (HHNK) condition?
Answer
  • A serum glucose of 550
  • A serum potassium of 3.5
  • Positive serum ketone
  • A serum osmolality of 320

Question 101

Question
Beck's Triad includes all of the following EXCEPT?
Answer
  • JVD
  • Muffled Heart Tones
  • Left Shoulder Pain
  • Narrowing Pulse Pressure

Question 102

Question
Newton's 3rd Law states?
Answer
  • For every action there is an equal and opposite reaction
  • An object in motion stays in motion, an object at rest stays at rest
  • F=MA
  • None of the Above

Question 103

Question
You 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?
Answer
  • Chvostek's Sign
  • Kehr's Sign
  • McBurney's Point
  • Cullen's Sign

Question 104

Question
The consensus formula calculates hourly fluid replacement for burn patients. What equation would you use?
Answer
  • 2mL x kg x % BSA
  • 4mL x kg x %BSA
  • 6mL x kg x % BSA
  • 1-3mL x kg x % BSA

Question 105

Question
Minimum urine output for the adult burn patient with non-suspected rhabdomyolysis would be?
Answer
  • 1-5mL/hr
  • 10-20mL/hr
  • 30-50mL/hr
  • 60-80mL/hr

Question 106

Question
You 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?
Answer
  • 27%
  • 32%
  • 39%
  • 63%

Question 107

Question
You 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?
Answer
  • 6300-12,600 mL
  • 12,500-25,000 mL
  • 5,400-10,800 mL
  • 4,800-9,600 mL

Question 108

Question
Which of the following is not a treatment strategy when dealing with rhabdomyolysis and myoglobinuria?
Answer
  • Mannitol
  • NaHCO3- treatment
  • Fluid resuscitation
  • Vasopressin administration

Question 109

Question
You 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?
Answer
  • 23,400
  • 11,700
  • 8,500
  • 5,850

Question 110

Question
You 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?
Answer
  • 6300 mL
  • 9450 mL
  • 12600 mL
  • 12000 mL

Question 111

Question
During 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?
Answer
  • Hypomagnesemia
  • Hyperkalemia
  • Hypercalcemia
  • Hypokalemia

Question 112

Question
You 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?
Answer
  • 4536 mL
  • 9200 mL
  • 2300 mL
  • 3066 mL

Question 113

Question
You 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?
Answer
  • Blunt force injury to the chest wall
  • Penetration injury to the chest wall
  • Acceleration/deceleration injury
  • Cardiac contusion

Question 114

Question
Sudden cardiac death associated with high-speed projectile objects are described as commotio cordis. This is a result of which of the following?
Answer
  • Cardiac tamponade
  • Cardiac contusion
  • Fatal dysrhythmia
  • Aortic arch tear

Question 115

Question
A 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?
Answer
  • Cholelithiasis
  • Aortic arch tear
  • Ruptured spleen
  • Pulmonary contusion

Question 116

Question
Recommended urinary output when caring for an adult patient trauma or medical patient should be?
Answer
  • 100 mL/hr
  • 30-50 mL/hr
  • 1-2 mL/hr
  • > 250 mL/hr

Question 117

Question
You 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:
Answer
  • TCA overdose
  • Cushings syndrome
  • Thyroid storm
  • Rhabdomyolysis

Question 118

Question
When treating rhabdomyolysis, the flight crewmember knows that giving large amounts of fluid and administering _____________ will help by alkalinizing the urine.
Answer
  • Lasix
  • K+
  • NaCl-
  • NaHCO3-

Question 119

Question
The hallmark indicator that rhabdomyolysis is occurring in a hyperthermic patient is?
Answer
  • Altered mental status
  • Increased BUN
  • Hyperthermia
  • Elevated (CK)

Question 120

Question
A 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?
Answer
  • Decreased clotting times due to the banked PRBCs
  • Alkalosis due to the blood administration
  • Hypothermia due to the unwarmed blood
  • Hypokalemia due to blood administration

Question 121

Question
You 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?
Answer
  • Re-needle the left chest
  • Advance the ETT below the level of injury
  • Insert a chest tube
  • Decrease respiratory rate down to 10 per minute

Question 122

Question
Myoglobinuria, if left untreated, will result in what critical condition?
Answer
  • Hyperkalemic crisis
  • Acute tubular necrosis
  • Cardiomyopathy
  • Polycystic kidney disease

Question 123

Question
When adminstering PRBCs, the Flight Paramedic can expect a rise in hemoglobin and hematocrit of ________________ for each unit of blood?
Answer
  • 1 gm/dL increase in the hemoglobin and 3% increase in the hematocrit
  • 2 gm/dL increase in the hemoglobin and a 3% increase in the hematocrit
  • 1 gm/dL increase in the hemoglobin and a 5% increase in the hematocrit
  • 2 gm/dL increase in the hemoglobin and a 5% increase in the hematocrit

Question 124

Question
You 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?
Answer
  • Dobutamine
  • PRBCs
  • Rapid fluid volume replacement
  • Platelets, cryoprecipitate, and FFP

Question 125

Question
You 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?
Answer
  • Tension pneumothorax
  • Esophageal disruption
  • Aortic disruption
  • Tracheal bronchial disrutpion

Question 126

Question
A massive hemothorax in an adult is defined as a rapid accumulation of more than?
Answer
  • 500cc of blood
  • 1500cc of blood
  • 2000cc of blood
  • 750cc of blood

Question 127

Question
When 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?
Answer
  • Sodium
  • Potassium
  • Magnesium
  • Calcium

Question 128

Question
Fractures of the 1st-3rd ribs should indicate a high index of suspicion for which injury?
Answer
  • Esophageal Rupture
  • Aortic Dissection
  • Pulmonary contusion
  • Liver Laceration

Question 129

Question
When inserting a chest tube, the correct insertion site recommended is?
Answer
  • 3rd ICS mid-clavicular
  • 4-5th ICS mid-axillary
  • 5th ICS mid-axillary
  • 4th ICS anterior axillary

Question 130

Question
You 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?
Answer
  • Epidural bleed
  • Hypovolemic shock
  • Neurogenic shock
  • Subdural bleed

Question 131

Question
A patient presenting with Beck's triad is most likely experiencing?
Answer
  • Liver laceration
  • Tension pneumothorax
  • Increased ICP
  • Cardiac tamponade

Question 132

Question
Long-term complications associated with musculoskeletal injuries include all of the following EXCEPT?
Answer
  • Infection
  • Thrombophlebitis
  • Delayed Bone Healing
  • ARDS

Question 133

Question
Injury patterns associated with rear impact collisions are?
Answer
  • T12/L1 and C-Spine fractures
  • Clavicle, ribs, femur, tib/fib injuries and abdominal injuries
  • C-spine fractures, clavicle and pelvic fractures
  • Fractured ribs, skull fractures, patella, femur, acetabular fractures and dislocated hip

Question 134

Question
After a multisystem trauma occurs, death within minutes is usually a result of?
Answer
  • Multisystem organ failure
  • Blood loss secondary to pelvic fracture
  • Great vessel laceration
  • Head Injury

Question 135

Question
A 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?
Answer
  • Tracheal deviation toward the right and diminished or absent breath sounds on the right
  • Tracheal deviation toward the right and diminished or absent breath sounds on the left
  • Tracheal deviation to the left and diminished or absent breath sounds on the left
  • Tracheal deviation to the left and diminished or absent breath sounds on the right

Question 136

Question
Of the following, what is the most common cause of myocardial contusion?
Answer
  • Hit to the chest from a high-speed projectile
  • Getting kicked in the chest by a horse
  • Injuries after a motor vehicle collision
  • Performing CPR

Question 137

Question
A 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?
Answer
  • Rotator cuff injury
  • Ruptured spleen
  • Pulmonary contusion
  • Thoracic spine injury

Question 138

Question
You 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?
Answer
  • Tachycardia, flat neck veins, muffled heart sounds
  • Hypertension, distended neck veins, pulsus paradoxus
  • Hypotension, distended neck veins, muffled heart sounds
  • Hypotnesion, flat neck veins, decreased right atrial pressure

Question 139

Question
You 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?
Answer
  • Hypoxic hypoxia
  • Stagnant hypoxia
  • Hypemic hypoxia
  • Histotoxic hypoxia

Question 140

Question
You 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?
Answer
  • Moist, productive cough
  • Substernal chest pain
  • Dyspnea
  • Cyanosis

Question 141

Question
You 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?
Answer
  • Intra-cardiac shunt
  • Increased oxygen delivery
  • Severe hypoxia
  • Decreased oxygen saturation

Question 142

Question
Your 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?
Answer
  • 46
  • 52
  • 87
  • 81

Question 143

Question
Brown-Sequard Syndrome is a rare spinal cord injury that involves?
Answer
  • Anterior cord lesions
  • Posterior cord lesions
  • Central cord lesions
  • Ipsilateral cord lesions

Question 144

Question
You'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?
Answer
  • Epidural bleed
  • Intraventricular bleed
  • Subdural bleed
  • Diffuse axonal injury

Question 145

Question
Cushing's Triad consists of?
Answer
  • Widening pulse pressures, tachycardia and normal respirations
  • Hypertension, bradycardia and respiratory changes (Cheyne-Stokes)
  • Hypotension, widening pulse pressures, bradycardia
  • Hypertension, tachycardia, narrowing pulse pressures

Question 146

Question
Diffuse axonal injury will most likely represent how on a CT scan?
Answer
  • Normal and unidentifiable
  • Granulated or salt and pepper appearance
  • Identified by cervical spine subluxation
  • All of the above

Question 147

Question
Your patient has an ICP of 28. The current BP is 100/60. His cerebral perfusion pressure is approximately?
Answer
  • 45
  • 60
  • 70-90
  • 100

Question 148

Question
A 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?
Answer
  • Seizure
  • Sluggish, dilated pupils
  • Cholecystectomy 6 months ago
  • Abdominal aortic aneurysm

Question 149

Question
Normal adult CPP is at least?
Answer
  • 40
  • 60
  • 70
  • 50

Question 150

Question
You 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?
Answer
  • Basilar fracture
  • Linear stellate fracture
  • Diastatic fracture
  • Depressed skull fracture

Question 151

Question
Calculate the following cerebral perfusion pressure? BP 150/75 HR 140 RR 28 SaO2 100% CVP 2 ICP 25
Answer
  • 98
  • 65
  • 75
  • 125

Question 152

Question
When evaluating the CT of a patient believed to have a diffuse axonal injury you expect to see?
Answer
  • A contact lense shaped collection of blood
  • An unremarkable CT scan
  • A large collection of blood covering a single hemisphere
  • High density region surrounded by zones of low density

Question 153

Question
The classic description of a patient suffering from an epidural hematoma is?
Answer
  • Rapid onset of unconsciousness, posturing and seizure
  • Unconsciousness, followed by a brief period of lucidity, and a period of rapid decrease in the level of consciousness
  • Slow loss of consciousness, pupillary changes and seizures
  • Slow loss of consciousness, ipsilateral posturing, and contralateral pupillary changes

Question 154

Question
A basilar skull fracture is associated with all of the following EXCEPT?
Answer
  • CSF rhinorrhea
  • CSF otorrhea
  • Seventh cranial nerve palsy
  • Eleventh cranial nerve paralysis

Question 155

Question
When monitoring invasive intracranial pressure lines, the transducer should be leveled at the?
Answer
  • Foramen of Kellie
  • Foramen of Ovale
  • Foramen of Monro
  • Foramen of Magnum

Question 156

Question
The patient suffering from Brown-Sequard Syndrome presents with which of the following S/S?
Answer
  • Complete flaccidity below the level of injury
  • Ipsilateral motor loss, contralateral pain loss
  • Greater weakness in upper extremities than in lower extremities
  • Complete motor pain and temperature loss below the level of the injury

Question 157

Question
You 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?
Answer
  • Beta blockers to decrease contactility
  • Arterial vasodilators to decrease afterload
  • Diuretics to decrease preload
  • Venous vasodilators to decrease preload

Question 158

Question
The 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?
Answer
  • 120 systolic
  • 130 systolic
  • 140 systolic
  • 160 systolic

Question 159

Question
You are transporting a patient who consumed a significant overdose of Elavil (amitriptyline). Upon your assessment, you would expect to find what patient presentation?
Answer
  • Bradycardia and Hypotension
  • Hyperventilation and Hyporeflexia
  • Fever and agitation
  • Severe bradycardia and salivation

Question 160

Question
You 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?
Answer
  • Less than one hour ago
  • Within the last 1-4 hours
  • Within the last 6-12 hours
  • Within the last 24-72 hours

Question 161

Question
You 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?
Answer
  • Calcium
  • Potassium
  • Sodium
  • Chloride

Question 162

Question
Your patient was exposed to cyanide. What antidote management would best suit this patient?
Answer
  • Physostigmine
  • Oxygen
  • Atropine and 2-PAM
  • Amyl nitrate and sodium thiosulfate

Question 163

Question
In an aspirin overdose, the primary acid base disturbance would be ___________ followed by _______________?
Answer
  • Respiratory alkalosis, metabolic acidosis
  • Respiratory acidosis, metabolic acidosis
  • Respiratory alkalosis, metabolic alkalosis
  • Respiratory acidosis, metabolic alkalosis

Question 164

Question
Which medication could potentially prevent the early symptoms of hypoglycemia?
Answer
  • Valium
  • Verapamil
  • Metoprolol
  • Lisinopril

Question 165

Question
A 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?
Answer
  • Magnesium
  • Calcium
  • Potassium
  • Sodium

Question 166

Question
You 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?
Answer
  • Fluoxetine
  • Metoprolol
  • Hydrocodone
  • Amitriptyline

Question 167

Question
Your patient has a diagnosis of salicylate toxicity. What acid-base imbalances would you anticipate?
Answer
  • Respiratory alkalosis and metabolic acidosis
  • Respiratory alkalosis and metabolic alkalosis
  • Respiratory acidosis and metabolic acidosis
  • Respiratory acidosis and metabolic alkalosis

Question 168

Question
The term effacement refers to?
Answer
  • Cervical dilation
  • Position of fetal head
  • Thickness of cervix and represented as a %
  • The lie of the baby

Question 169

Question
Your 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?
Answer
  • Administer Brethine 0.25mg SQ
  • Administer MgSO4 4g IV bolus
  • Perform Mauriceu's Maneuver
  • Place patient in the knee-chest position

Question 170

Question
Poor variability is caused by all of the following EXCEPT?
Answer
  • Fetal hypoxia
  • Extreme prematurity
  • Smoking by mother
  • Nuchal cord

Question 171

Question
The most accepted initial treatment for PIH related to hypertension may include all of the following EXCEPT?
Answer
  • Labetalol 10-20 mg IVP
  • Brethine 0.25mg SQ
  • MgSO4 4-6g slow IVP
  • Hydralazine 2mg IVP

Question 172

Question
The second stage of labor ends with?
Answer
  • Start of contractions
  • Delivery of the fetus
  • Full effacement
  • Crowning

Question 173

Question
You 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?
Answer
  • Brethine 0.25mg SQ
  • CaCl 1g/10mL
  • Lasix
  • NaHCO2 50mEq IVP

Question 174

Question
You 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?
Answer
  • Liver laceration
  • Abruptio placenta
  • Uterine rupture
  • Placenta previa

Question 175

Question
The patient is a breech presentation and delivery appears to be halted upon delivery of the head. The appropriate action would be to?
Answer
  • Initiate rapid transport, placing mother in a knee-chest position
  • Administer tocolytic agents
  • Perform Trousseau's maneuver
  • Perform Mariceau's maneuver

Question 176

Question
Which of the following fetal heart tone tracings is an ominous sign?
Answer
  • Sinusoidal
  • Early decelerations
  • Variable decelerations
  • Accelerations

Question 177

Question
When 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?
Answer
  • Elevated BP
  • Elevated RR
  • Elevated HR
  • Absent DTRs

Question 178

Question
HELLP syndrome is characterized by?
Answer
  • Hypertension, elevated liver enzymes and low platelets
  • Hypertension, elevated lipase and low protein
  • Hemolysis, elevated liver enzymes and low platelets
  • Hemolysis, elevated lipase and low protein

Question 179

Question
Postpartum 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?
Answer
  • Administration of PRBCs
  • Continued vigorous fundal massage
  • Methergine 0.2mg IV or IM
  • Pitocin 20-40 units in 1000cc of LR

Question 180

Question
Late decelerations may indicate?
Answer
  • Cord compression
  • Uterine placental insufficiency
  • Acidosis
  • Inadequate uterine contractions

Question 181

Question
What are the three classic s/s of pregnancy induced hypertension (PIH)?
Answer
  • Headache, hyperreflexia and HELLP
  • Hypertension, edema, and proteinuria
  • Hypertension, headache, and proteinuria
  • Hypertension, headache and hyper-reflexia

Question 182

Question
Which of the following maneuvers may be used to help deliver an infant with shoulder dystocia?
Answer
  • Erb's maneuver
  • Forceps technique maneuver
  • Leopold's maneuver
  • McRobert's maneuver

Question 183

Question
A 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?
Answer
  • Administer 0,25mg Brethine SQ
  • Maintain an IV of D5W throughout transport
  • Verify adequate urine output secondary to your fluid bolus
  • Administer MgSO4 4g bolus over 20-30 minutes

Question 184

Question
In evaluating fetal heart characteristics, which is the most important in determining neurological maturity?
Answer
  • Accelerations
  • Variability
  • Flat or decreased beat-to-beat variability
  • Transient accelerations and decelerations from the baseline FHR

Question 185

Question
The flight team recognizes that DIC is a common complication of?
Answer
  • Abruptio placenta
  • Ovarian rutpure
  • Ectopic pregnancy
  • Placenta previa

Question 186

Question
Your patient is reported to have transposition of the great vessels. It is essential to the survival of the neonate to maintain?
Answer
  • Oxygen
  • PDA patency
  • Indomethacin
  • Oxytocin

Question 187

Question
The equation for determination of ETT size in a neonate or child is?
Answer
  • (12+4)/4
  • (16 X 2)/2
  • (16+age)/4
  • (16+age)(4)

Question 188

Question
When giving a neonate PGE1 for PDA patency, the flight crewmember knows that a primary complication to administration is?
Answer
  • Closure of the PDA
  • Apnea
  • Pulmonary HTN
  • Metabolic Acidosis

Question 189

Question
With 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.
Answer
  • 10%
  • 30%
  • 25%
  • 40%

Question 190

Question
A common injury pattern seen in pediatrics struck by a vehicle is called?
Answer
  • Beck's triad
  • Cushing's triad
  • Waddell's triad
  • Kehr's sign

Question 191

Question
Your 10kg neonate starts presenting with a repetitive mouth & tongue movement, bicycling motion, eye deviation and rapid blinking. What type of seizure would this represent?
Answer
  • Clonic
  • Tonic
  • Myoclonic
  • Subtle

Question 192

Question
A neonate who is experiencing repetitive motion of a bicycling type action with lip smacking is presenting with what type of seizure?
Answer
  • Subtle
  • Tonic
  • Clonic
  • Myoclonic

Question 193

Question
The high vascular resistance in the fetal lung is due to the following physiologic mechanisms?
Answer
  • Changes in O2 tension
  • Changes in pH and CO2 tension
  • Pulmonary arterial vasoconstriction
  • Increase in systemic vascular resistance

Question 194

Question
During transport of a neonate, which of the following findings would indicate that the neonate is in stress?
Answer
  • Sucking
  • Fist clenched
  • Hiccoughing or sneezing
  • Quiet and alert

Question 195

Question
Increased irritability, increased HR and BP, eye fluttering and decreased SaO2 may be subtle signs of?
Answer
  • Seizures
  • Congenital heart defect
  • Hydrocephalus
  • Neurologic abnormality

Question 196

Question
You are transporting a 32 week preamture neonate with respiratory distress. Which drug may be administered in preparation for transport?
Answer
  • Antibotics
  • Surfactant
  • D10
  • Prostaglandin

Question 197

Question
Your patient is PDA dependent. This would indicate that your patient would likely require the administration of which of the following drugs?
Answer
  • Indomethacin
  • Progesterone
  • Prostaglandin
  • Synthetic surfactant

Question 198

Question
Which of the following is one of the most common side effects complicating the transport of a neonate receiving prostaglandin therapy?
Answer
  • Hypertension
  • Hypothermia
  • Apnea
  • Tachypnea

Question 199

Question
You 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?
Answer
  • PGE-1 administration
  • High flow oxygen
  • Cath and dilate the PA and patch the VSD
  • Indomethacin for PDA closure

Question 200

Question
Which of the following congenital disorders results in a right to left shunt?
Answer
  • PDA
  • Isolated VSD
  • Tetralogy of fallot
  • ASD
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