HIPAA and Pulmonary Diseases: Answers and Explanations, Exams of Nursing

Download HIPAA and Pulmonary Diseases: Answers and Explanations and more Exams Nursing in PDF only on Docsity! PARAMEDIC FINAL EXAM Questions and Answers 2024 BEST GUARANTEE A A protocol that is a written document signed by the EMS system's medical director that outlines specific directions, permissions, and sometimes prohibitions regarding patient care that is rendered prior to contacting medical control. - ANSWER Standing order If a paramedic transports a patient without the patient's consent or uses restraints in a wrongful manner - ANSWER False Imprisonment A treatment plan developed for a specific illness or injury. - ANSWER Protocol If you must deviate from your protocols because of unusual circumstances, you should FIRST: - ANSWER Notify Medical Control HIPPA mandates that: - ANSWER Patient information shall not be shared with entities or persons not involved in the care of the patient. HIPPA Defined: - ANSWER a. The first standards established to protect the confidentiality of a patient's health information. b. Medical information can be disclosed only if it is necessary for a patient's treatment or for payment. c. Special situations such as dog bites, gunshot wounds, and abuse require the release of patient information without the patient's consent. According to HIPAA, it is acceptable and permissible for hospitals to: - ANSWER share information with the EMS providers about patient outcome for purposes of quality assurance and education. Wheezing that is resolved with administration of bronchodilator medication was probably caused by? - ANSWER constriction of smooth muscles Wheezing is resolved with medications that? - ANSWER Relax the smooth muscle of the bronchiole Difficulty with exhalation is MOST characteristic of: - ANSWER obstructive lung disease COPD: Emphysema: - ANSWER Characterized by distention of the alveoli and destructive changes in the lungs. COPD: Chronic Bronchitis: - ANSWER Defined as sputum production most days of month for 3 or more months out of year for more than 2 years. Will rarely have normal oxygen saturation; (maybe less than 90%). May have another condition, including respiratory conditions A 66-year-old man with chronic bronchitis presents with severe respiratory distress. The patient's wife tells you that he takes medications for high blood pressure and bronchitis, is on home oxygen therapy, and has recently been taking an over-the-counter antitussive. She further tells you that he has not been compliant with his oxygen therapy. Auscultation of his lungs reveals diffuse rhonchi. What is the MOST likely cause of this patient's respiratory distress? - ANSWER Recent antitussive use A 76-year-old woman with emphysema presents with respiratory distress that has worsened progressively over the past 2 days. She is breathing through pursed lips and has a prolonged expiratory phase and an oxygen saturation of 76%. She is on home oxygen at 2 L/min. Your initial action should be to? - ANSWER place her in a position that facilitates breathing. Common clinical findings in patients with obstructive lung disease include all of the following, EXCEPT: - ANSWER a decreased expiratory phase Chronic obstructive pulmonary disease (COPD) is characterized by: - ANSWER changes in pulmonary structure and function that are progressive and irreversible The hypoxic drive is a phenomenon in which - ANSWER bicarbonate ions migrate into the cerebrospinal fluid of a chronically hypoventilating patient, making the brain think that acid and base are in balance Pulmonary Embolism Characteristics - ANSWER Sudden dyspnea & cyanosis, and perhaps, a sharp pain in the chest. A hallmark of pulmonary embolism is that the cyanosis does not resolve with oxygen therapy. You are dispatched to a residence for a young woman with difficulty breathing. When you arrive, you find the patient sitting in a tripod position, noticeably dyspneic and tachypneic. She tells you that she experienced a sudden sharp pain to the left side of her chest and then started having trouble breathing. She denies any past medical history and states that she only takes birth control pills. Based on this patient's clinical presentation, you should be MOST suspicious for: - ANSWER acute pulmonary embolism One of the hallmarks of a pulmonary embolism is: - ANSWER cyanosis that does not resolve with oxygen therapy. Paradoxial Respiratory Movement is - ANSWER the inward movement of a segment of the chest during inhalation and a outward movement of the chest during exhalation, opposite normal chest movement and a indication of flail chest. Under normal conditions, the strength of the cardiac contraction is regulated by: - ANSWER The nervous system The circumflex branch of the left coronary artery supplies the wall of the left ventricle. - ANSWER Lateral The Left main coronary artery branches into: - ANSWER The circumflex and the left anterior descending arteries The left main coronary artery subdivides into the: - ANSWER Left anterior descending and circumflex arteries In contrast to arteries, veins: - ANSWER are more likely to distend when exposed to backpressure. How many large boxes on the ECG graph paper represent 6-seconds: - ANSWER 30 Chronotropic effect : - ANSWER Influences heart rate. For example, a drug with a positive chronotropic effect would speed up the heart rate Administering a drug that possesses a positive chronotropic effect will have direct effect on: - ANSWER The heart rate A medication that possesses a negative chronotropic effect will: - ANSWER Cause a decrease in the heart rate In contrast to the right side of the heart, the left side of the heart: - ANSWER Drives blood out of the heart against the relatively high resistance of the systemic circulation Once an advanced airway device has been inserted into a cardiac arrest patient: - ANSWER ventilations are delivered at a rate of 8 to 10 breaths/min. The appropriate dosing regimen for epinephrine in cardiac arrest is: - ANSWER 1 mg of a 1:10,000 solution every 3 to 5 minutes. You have restored spontaneous circulation in a 54-year-old man who was in ventricular fibrillation. During the arrest interval, you delivered 2 shocks, 1 mg of epinephrine, and 300 mg of amiodarone. The patient's blood pressure is 96/60 mm Hg and the cardiac monitor displays a sinus rhythm at a rate of 70 beats/min with frequent premature ventricular complexes. Appropriate post-resuscitation care for this patient : - ANSWER an infusion of amiodarone. In addition to IV fluids, treatment for a patient in neurogenic shock may include: - ANSWER amiodarone What is the approximate maximum dose of lidocaine for a 200-pound patient? - ANSWER 275 mg Following return of spontaneous circulation, you are ordered to begin a lidocaine infusion at 3 mg/min on your 50-year-old patient. You add 2 g of lidocaine to a 500 mL bag of normal saline and are using a microdrip administration set. At how many drops per minute (gtts/min) will you set the IV flow rate? - ANSWER 45 Electrical capture during transcutaneous pacing is characterized by: - ANSWER A pacemaker spike followed by a wide QRS complex The recommended first-line treatment for third-degree heart block associated with bradycardia is: - ANSWER transcutaneous pacing. Which of the following factors would present the GREATEST difficulty when distinguishing supraventricular tachycardia from ventricular tachycardia? - ANSWER Aberrant conduction Atherosclerosis is a process in which: - ANSWER plaque infiltrates the arterial wall, decreasing its elasticity and narrowing its lumen. You have just administered 0.4 mg of sublingual nitroglycerin to a 60-year- old woman with severe chest pain. The patient is receiving high-flow oxygen and has an IV line of normal saline in place. After 5 minutes, the patient states that the pain has not subsided. You should: - ANSWER Reassess her BP A 25-year-old woman presents with acute abdominal pain and vaginal bleeding. She tells you that she has soaked eight high-absorbency tampons in the past 2 hours. Approximately how much blood has she lost externally? - ANSWER 160 mL You are dispatched to a residence for a 34-year-old woman who is "sick." Upon your arrival, the patient greets you at the door. She states that she recently had her menstrual period, which was accompanied by more pain than usual. Her vital signs are stable, she is conscious and alert, and denies vaginal bleeding or fever. This patient MOST likely has? - ANSWER a ruptured ovarian cyst The Candida albicansfungus is the causative agent in: - ANSWER vaginal yeast infections In contrast to endometritis, endometriosis? - ANSWER may present without abdominal pain Which of the following would you MOST likely observe in a newborn with hemolytic disease? - ANSWER Jaundice An immature egg is called an: - ANSWER oocyte The uterine fundus is measure: - ANSWER vertically from the top of the pubic bone to the top of the fundus. A spontaneous abortion: - ANSWER occurs naturally and may or may not have an identifiable cause. . If a woman is gravida 3 and para 2: - ANSWER she has delivered two babies, but was pregnant 3 times A woman has been pregnant three times, has had two spontaneous abortions, and has carried one baby to term. You should document her obstetric history as: - ANSWER G3A2P1 During the second stage of labor: - ANSWER contractions become more intense and more frequent. You are dispatched to the parking lot of a shopping mall for a pregnant woman with severe vomiting. When you arrive and assess the patient, she tells you that she is 26 weeks pregnant and that this is her first child. She further tells you that her normal morning sickness nausea became worse 3 days ago and that she has vomited numerous times since then; she also noticed small amounts of blood in her vomitus. Her blood pressure is 94/60 mm Hg, pulse rate is 124 beats/min and weak, and respirations are 22 breaths/min and regular. After loading the woman in the ambulance and placing her on her left side, you should: suspect hyperemesis gravidarum, administer high-flow oxygen, start a large-bore IV and give a 250-mL normal saline bolus, assess her blood sugar and cardiac rhythm, consider administering diphenhydramine if protocols allow, and transport promptly. - ANSWER suspect hyperemesis gravidarum, administer high- flow oxygen, start a large-bore IV and give a 250-mL normal saline bolus, assess her blood sugar and cardiac rhythm, consider administering diphenhydramine if protocols allow, and transport promptly. A woman is in the second stage of labor when: - ANSWER she feels a strong urge to move her bowels. Women who experience hyperemesis gravidarum: - ANSWER have persistent nausea and vomiting throughout pregnancy that often causes dehydration and malnutrition. In pregnancy, magnesium sulfate is used principally for? - ANSWER eclamptic seizures What is the corpus luteum? - ANSWER Remnants of the follicle after the egg has been released What is the primary source of heat production for the newborn? - ANSWER Nonshivering thermogenesis. fever, but then began experiencing a high-pitched cough. His skin is warm and dry, his heart rate is 120 beats/min, and his oxygen saturation is 99% on room air. There are no signs of increased work of breathing. You should: - ANSWER allow the child to assume a position of comfort, avoid agitating him, and transport him to the hospital. . Which of the following statements regarding croup is correct? - ANSWER Croup is a viral upper airway infection that may cause stridor You should be MOST suspicious for child abuse when caring for an injured 4-year-old child if: - ANSWER there was an unusual delay in calling 9-1-1. Which of the following injury patterns is MOST suggestive of child abuse? - ANSWER Bruises on the abdomen Which of the following behaviors or actions should make you the MOST suspicious that a caregiver has abused his or her child? - ANSWER Offering unsolicited explanations for abnormal physical exam findings EMS providers can be MOST effective in helping reduce the incidence of suicide, domestic violence, and child abuse by? - ANSWER noting risk factors at the scene and reporting data A child in anaphylactic shock: - ANSWER May require a low dose of a epinephrine infusion A typical finding for a foreign body aspiration is: - ANSWER an afebrile child with a sudden onset of coughing or gagging while playing. A foreign-body airway obstruction should be suspected in a child who presents with: - ANSWER acute respiratory distress without fever. Which of the following represents the correct drug, dose, and delivery route for an 18-kg child experiencing severe respiratory distress due to bronchospasm? - ANSWER Ipratropium, 0.5 mg nebulized Initial drug for bradycardia in child is? - ANSWER Epinephrine is indicated during newborn resuscitation if: the heart rate remains below 60 beats/min after 30 seconds of effective ventilation and an additional 30 seconds of chest compressions When evaluating a child's oxygen saturation level with a pulse oximeter: - ANSWER it should be evaluated in the context of the pediatric assessment triangle and remainder of the primary assessment. A child's vocal cords can be difficult to visualize during intubation because: - ANSWER Epiglottis is floppy and U shaped First-degree heart block in children: - ANSWER is typically asymptomatic and does not require special treatment When an infant or child is in respiratory failure: - ANSWER he or she can no longer compensate, which causes hypoxia and hypercarbia. A sick or injured child's general appearance is MOST reflective of: - ANSWER his or her central nervous system function Distributive shock in children is MOST often the result of: - ANSWER sepsis Early distributive shock in children is characterized by: - ANSWER warm, flushed skin The pediatric assessment triangle was designed to: - ANSWER help EMS providers form a hands-off general impression of an ill child. In contrast to a child with pulmonary edema secondary to congestive heart failure, the respirations of a hypercarbic child without pulmonary edema would MOST likely be: - ANSWER tachypneic and without retractions Triage and emergency medical treatment should be performed: - ANSWER in the cold zone. What level of personal protective equipment is typically worn by the hazardous materials decontamination team in the warm zone? - ANSWER Level B When a base substance is placed on a burn caused by an acid: - ANSWER Heat is generated as a by-product of the reaction Signs and symptoms of nerve agent exposure include all of the following, EXCEPT: - ANSWER tachycardia The seizures associated with nerve agent exposure: - ANSWER will continue until a MARK 1 antidote is administered You are dispatched to a residence for a 50-year-old woman with respiratory distress. While you are assessing the patient, she tells you that she began experiencing flulike symptoms 4 days ago, shortly after delivering mail on the rural mail route for which she is responsible. Due to her illness, she has been unable to return to work. Her blood pressure is 90/50 mm Hg, pulse rate is 120 beats/min, and respirations are 26 breaths/min and labored. Auscultation of her breath sounds reveals the presence of coarse crackles. This patient has MOST likely been exposed to: - ANSWER anthrax Anthrax is a bacterium that: - ANSWER lies dormant in a space and is released when exposed to the optimal temp and moisture Although anthrax is the most deadly, anthrax is the only that is communicable. - ANSWER pulmonary, cutaneous What type of injuries will MOST likely occur if a passenger is wearing his or her lap belt above the pelvic bone during a frontal impact? - ANSWER Abdominal and lumbar spine You receive a call to a residence for a patient who is "sick." Upon arriving at the scene, you find the patient, a 39-year-old woman, lying on the couch with a wet washcloth on her forehead. She is conscious and alert, and tells you that she has had several episodes of diarrhea and noticed bright red blood in her stool. Her pulse rate is rapid and weak, her skin is cool and clammy, and her blood pressure is 98/58 mm Hg. Her medical history is significant for hemophilia, for which she is receiving factor VIII therapy. As you pull out a nonrebreathing mask, she tells you that her husband will be home in a few hours and that he will take her to the hospital. You should: - ANSWER advise her that her condition dictates immediate transport to the hospital and that delaying transport could result in death. A young woman attempted to commit suicide by cutting her wrist. Bright red blood is spurting from the injury site. Despite direct pressure and a pressure dressing, the wound continues to bleed heavily. You should: - ANSWER apply a tourniquet between her elbow and wrist. According to the rule of nines, an adult man with partial- and full-thickness burns to his head, face, and anterior chest has burns to % of his total body surface area. - ANSWER 18 The MOST important prehospital treatment intervention for a patient with carbon monoxide poisoning is: - ANSWER High flow oxygen The LEAST common sign or symptom of carbon monoxide toxicity is: - ANSWER Cherry red skin color binds to red blood cells and prevents them from transporting oxygen to all parts of the body. - ANSWER Carbon monoxide The application of ice to partial-thickness burns: - ANSWER Can exacerbate tissue injury and should be avoided Patients suspected of having burns to the upper airway will benefit MOST from: - ANSWER cool, humidified oxygen. If a knife is impaled in the neck: - ANSWER a cricothyrotomy may be required to establish a patent airway.