JBL MODULE 2 PRACTICE EXAM TEST BANK LATEST
UPDATED VERSION ACTUAL EXAM QUESTIONS AND
CORRECT VERIFIED ANSWERS LATEST UPDATE |
GUARANTEED PASS A+
A 49-year-old woman presents with a headache, nausea, and ringing in her ears. She
is conscious and alert and states that she has hypertension and type 2 diabetes. Her
BP is 202/114 mm Hg, her pulse is 60 beats/min, and her respirations are 16
breaths/min. What should you do?
A) Place her in a supine position
B) Give her one tube of oral glucose
C) Prepare for immediate transport
D) Summon an ALS unit to the scene - ANSWER: C
The patient's presentation is indicative of acute hypertensive crisis. Her blood
pressure is severely elevated and she is experiencing other symptoms one might
expect with such a high blood pressure (ie, headache, nausea, ringing in the ears).
You should place her in a position of comfort, which is usually a semisitting position;
lying her supine would likely only make her headache worse. Prompt transport to
the hospital is essential so her blood pressure can be lowered in a controlled setting.
Without knowing her blood glucose level, proceeding with oral glucose would not be
appropriate. If it does not delay transport, you could consider summoning an ALS
ambulance to the scene. It is far more important, however, to get her to a definitive
care facility
Freshly oxygenated blood returns to the heart via the:
A) aorta.
B) vena cavae.
C) pulmonary veins.
D) pulmonary arteries. - ANSWER: C
The pulmonary veins are the only veins that carries oxygen-rich blood. They carry
blood from the lungs back to the left atrium. All other veins in the human body,
including the venae cavae, carry deoxygenated blood back to the heart. The aorta is
the largest artery in the body and branches immediately from the left ventricle,
carrying freshly oxygenated blood to the rest of the body. The pulmonary arteries
carry deoxygenated blood from the right ventricle to the lungs for reoxygenation.
Your assessment of a middle-aged female with chest pressure reveals that she is
confused, is diaphoretic, and has a blood pressure of 70/50 mm Hg. In caring for this
patient, it is MOST important for you to:
A) request an ALS unit to respond to the scene.
B) assist her with her nitroglycerin if she has any.
C) reassess her vital signs at least every 5 minutes.
D) prepare for immediate transport to the hospital. - ANSWER: D
Your patient is in shock, which is most likely the result of heart failure (cardiogenic
shock). Immediate transport to the closest appropriate hospital is critical. Assess for
,and manage problems with airway, breathing, and circulation, and then get on the
road! She needs definitive care that can be provided only at the hospital. Reassess
her vital signs at least every 5 minutes, but do it en route! If you can rendezvous with
an ALS unit en route, do so. However, you should not remain at the scene to wait for
them. Nitroglycerin is clearly contraindicated for this patient; her BP is dangerously
low.
Which of the following questions would be MOST appropriate to ask when assessing
a patient with chest pain?
A) What does the pain feel like?
B) Does the pain radiate to your arm?
C) Would you describe the pain as sharp?
D) Is the pain worse when you take a deep breath? - ANSWER: A
When questioning any patient about any type of pain, you should avoid asking
leading questions that can simply be answered yes or no. To obtain the most reliable
assessment, open-ended questions should be asked to allow the patient to describe
the quality of the pain in his or her own words.
A 60-year-old woman presents with chest discomfort, confusion, and weakness. The
patient's husband tells you that she vomited once before EMS arrival. The patient's
BP is 70/40 mm Hg, her pulse is 45 beats/min and weak, and her respirations are 14
breaths/min and unlabored. Which of the following is the MOST likely cause of her
hypotension?
A) Bradycardia
B) Hypovolemia
C) Myocardial ischemia
D) Respiratory compromise - ANSWER: A
You are assessing a 70-year-old male who complains of pain in both of his legs. He is
conscious and alert, has a blood pressure of 160/90 mm Hg, a pulse rate of 110
beats/min, and respirations of 14 breaths/min and unlabored. Further assessment
reveals edema to both of his feet and legs and jugular venous distention. What
should you suspect?
A) Left heart failure
B) Right heart failure
C) Pulmonary edema
D) Chronic hypertension - ANSWER: B
If the right side of the heart is damaged, fluid collects in the body (edema), often
showing in the feet and legs. The collection of fluid in the part of the body that is
closest to the ground is called dependent edema. The swelling causes relatively few
symptoms other than discomfort. Another feature of right heart failure is jugular
venous distention, which is an indication of blood backing up into the systemic
circulation. Left heart failure typically presents with shortness of breath due to fluid
in the lungs (pulmonary edema), which indicates blood backing up from the left side
of the heart into the lungs. In severe pulmonary edema, the patient may cough up
pink, frothy sputum. Right heart failure and/or left heart failure are also referred to
,as congestive heart failure (CHF). Chronic hypertension cannot be established on the
basis of a single blood pressure reading.
A 62-year-old male with a history of coronary artery disease began experiencing
chest pain and nausea while on his daily jog. After sitting down and resting for 5
minutes, his pain and nausea resolve. Which of the following BEST describes this
patient's condition?
A) Musculoskeletal chest pain
B) Acute myocardial infarction
C) Unstable angina pectoris
D) Stable angina pectoris - ANSWER: D
Angina pectoris is the principle symptom of coronary artery disease (CAD). It occurs
when the heart's demand for oxygen exceeds its supply, usually during periods of
physical or emotional stress when the heart is working hard. When the increased
oxygen demand goes away, the pain typically resolves. Some patients with angina
may also experience shortness of breath, nausea, or diaphoresis. Angina is classified
as being "stable" or "unstable." Stable angina is characterized by cardiac-related
chest pain that resolves with rest and/or nitroglycerin. Unstable angina is
characterized by cardiac-related chest pain that occurs in response to progressively
less physical exertion (for example, during rest). Unstable angina is also referred to
as pre-infarction angina because it indicates a more severe degree of CAD and can
lead to acute myocardial infarction if untreated. In contrast to stable angina,
unstable angina typically does not resolve with rest and/or nitroglycerin. Given the
patient's medical history, his chest pain should not be assumed to have simply been
of a musculoskeletal origin.
At the end of ventricular relaxation, the left ventricle contains 110 mL of blood. This
is referred to as the:
A) preload.
B) afterload.
C) stroke volume.
D) cardiac output. - ANSWER: A
Preload is the amount of pressure on the ventricular wall at the end of ventricular
relaxation (diastole) and is influenced by the volume of blood in the ventricle just
before it contracts. Afterload refers to the resistance that the ventricles must
contract against. A patient with hypertension, for example, would have an increased
afterload due to systemic vasoconstriction; the smaller the arteries, the greater the
resistance the heart must contract against. Stroke volume is the volume of blood
ejected from the ventricles in a single beat. Cardiac output is the volume of blood
pumped by the heart each minute; it is calculated by multiplying the stroke volume
and heart rate.
The maximum pressure generated in the arms and legs during contraction of the left
ventricle is called:
A) afterload.
B) pulse pressure.
C) systolic blood pressure.
, D) diastolic blood pressure. - ANSWER: C
Blood pressure is the force of circulating blood against the arterial walls. Systolic
blood pressure (SBP) is the maximum pressure generated in the arms and legs during
contraction of the left ventricle, during the time period known as systole. As the left
ventricle relaxes in the stage known as diastole, the arterial pressure falls. When the
left ventricle relaxes, the aortic valve closes and blood flow between the left
ventricle and the aorta stops. The diastolic blood pressure (DBP) is the pressure
exerted against the arterial walls while the left ventricle is at rest, during the time
period known as diastole. Pulse pressure is the numeric difference between the SBP
and DBP; it represents the force generated by the heart each time it contracts. If the
patient's BP is 120/80 mm Hg, the pulse pressure would be 40 mm Hg. Afterload
refers to the amount of resistance the left ventricle must contract against.
Conditions such as hypertension cause an increase in afterload; as the arteries
narrow, the left ventricle must work harder to overcome the increases resistance to
forward blood flow.
A 65-year-old man has generalized weakness and chest pressure. He has a bottle of
prescribed nitroglycerin, but states that he has not taken any of his medication. The
EMT should:
A) apply the AED and prepare the patient for immediate transport.
B) administer up to 325 mg of aspirin if the patient is not allergic to it.
C) assist the patient with his nitroglycerin with medical control approval.
D) perform a secondary assessment and obtain baseline vital signs. - ANSWER: B
Aspirin has clearly been shown to reduce mortality and morbidity associated with
acute coronary syndrome (ACS) and should be given as early as possible; the dose is
160 to 325 mg. Even though this patient has chest pain and prescribed nitroglycerin,
you must first complete a secondary assessment and obtain baseline vital signs.
Medical control will need this information--specifically, the patient's blood pressure--
to determine whether you should assist the patient with his nitroglycerin. The AED is
not indicated for this patient because he is not in cardiac arrest.
A patient who is experiencing an acute myocardial infarction:
A) most often describes his or her chest pain as being sharp or tearing.
B) has chest pain or discomfort that does not change with each breath.
C) often experiences relief of his or her chest pain after taking nitroglycerin.
D) often complains of a different type of pain than a patient with angina. - ANSWER:
B
The type of chest pain or discomfort associated with acute myocardial infarction
(AMI) is the same that is experienced by patients with angina pectoris (eg, dull,
crushing, pressure, heaviness); thus, you cannot distinguish AMI from angina
pectoris based solely on the type or quality of pain. Furthermore, the pain associated
with AMI, like that of angina, often radiates to the arm, jaw, back, or epigastrium.
Relative to other causes of chest pain or discomfort (eg, pleurisy, pneumothorax),
the pain associated with AMI and angina does not worsen or improve when the
patient takes a breath. Rest and nitroglycerin often relieve the pain associated with
stable angina, but are less likely to relieve the pain associated with unstable angina
or AMI.
UPDATED VERSION ACTUAL EXAM QUESTIONS AND
CORRECT VERIFIED ANSWERS LATEST UPDATE |
GUARANTEED PASS A+
A 49-year-old woman presents with a headache, nausea, and ringing in her ears. She
is conscious and alert and states that she has hypertension and type 2 diabetes. Her
BP is 202/114 mm Hg, her pulse is 60 beats/min, and her respirations are 16
breaths/min. What should you do?
A) Place her in a supine position
B) Give her one tube of oral glucose
C) Prepare for immediate transport
D) Summon an ALS unit to the scene - ANSWER: C
The patient's presentation is indicative of acute hypertensive crisis. Her blood
pressure is severely elevated and she is experiencing other symptoms one might
expect with such a high blood pressure (ie, headache, nausea, ringing in the ears).
You should place her in a position of comfort, which is usually a semisitting position;
lying her supine would likely only make her headache worse. Prompt transport to
the hospital is essential so her blood pressure can be lowered in a controlled setting.
Without knowing her blood glucose level, proceeding with oral glucose would not be
appropriate. If it does not delay transport, you could consider summoning an ALS
ambulance to the scene. It is far more important, however, to get her to a definitive
care facility
Freshly oxygenated blood returns to the heart via the:
A) aorta.
B) vena cavae.
C) pulmonary veins.
D) pulmonary arteries. - ANSWER: C
The pulmonary veins are the only veins that carries oxygen-rich blood. They carry
blood from the lungs back to the left atrium. All other veins in the human body,
including the venae cavae, carry deoxygenated blood back to the heart. The aorta is
the largest artery in the body and branches immediately from the left ventricle,
carrying freshly oxygenated blood to the rest of the body. The pulmonary arteries
carry deoxygenated blood from the right ventricle to the lungs for reoxygenation.
Your assessment of a middle-aged female with chest pressure reveals that she is
confused, is diaphoretic, and has a blood pressure of 70/50 mm Hg. In caring for this
patient, it is MOST important for you to:
A) request an ALS unit to respond to the scene.
B) assist her with her nitroglycerin if she has any.
C) reassess her vital signs at least every 5 minutes.
D) prepare for immediate transport to the hospital. - ANSWER: D
Your patient is in shock, which is most likely the result of heart failure (cardiogenic
shock). Immediate transport to the closest appropriate hospital is critical. Assess for
,and manage problems with airway, breathing, and circulation, and then get on the
road! She needs definitive care that can be provided only at the hospital. Reassess
her vital signs at least every 5 minutes, but do it en route! If you can rendezvous with
an ALS unit en route, do so. However, you should not remain at the scene to wait for
them. Nitroglycerin is clearly contraindicated for this patient; her BP is dangerously
low.
Which of the following questions would be MOST appropriate to ask when assessing
a patient with chest pain?
A) What does the pain feel like?
B) Does the pain radiate to your arm?
C) Would you describe the pain as sharp?
D) Is the pain worse when you take a deep breath? - ANSWER: A
When questioning any patient about any type of pain, you should avoid asking
leading questions that can simply be answered yes or no. To obtain the most reliable
assessment, open-ended questions should be asked to allow the patient to describe
the quality of the pain in his or her own words.
A 60-year-old woman presents with chest discomfort, confusion, and weakness. The
patient's husband tells you that she vomited once before EMS arrival. The patient's
BP is 70/40 mm Hg, her pulse is 45 beats/min and weak, and her respirations are 14
breaths/min and unlabored. Which of the following is the MOST likely cause of her
hypotension?
A) Bradycardia
B) Hypovolemia
C) Myocardial ischemia
D) Respiratory compromise - ANSWER: A
You are assessing a 70-year-old male who complains of pain in both of his legs. He is
conscious and alert, has a blood pressure of 160/90 mm Hg, a pulse rate of 110
beats/min, and respirations of 14 breaths/min and unlabored. Further assessment
reveals edema to both of his feet and legs and jugular venous distention. What
should you suspect?
A) Left heart failure
B) Right heart failure
C) Pulmonary edema
D) Chronic hypertension - ANSWER: B
If the right side of the heart is damaged, fluid collects in the body (edema), often
showing in the feet and legs. The collection of fluid in the part of the body that is
closest to the ground is called dependent edema. The swelling causes relatively few
symptoms other than discomfort. Another feature of right heart failure is jugular
venous distention, which is an indication of blood backing up into the systemic
circulation. Left heart failure typically presents with shortness of breath due to fluid
in the lungs (pulmonary edema), which indicates blood backing up from the left side
of the heart into the lungs. In severe pulmonary edema, the patient may cough up
pink, frothy sputum. Right heart failure and/or left heart failure are also referred to
,as congestive heart failure (CHF). Chronic hypertension cannot be established on the
basis of a single blood pressure reading.
A 62-year-old male with a history of coronary artery disease began experiencing
chest pain and nausea while on his daily jog. After sitting down and resting for 5
minutes, his pain and nausea resolve. Which of the following BEST describes this
patient's condition?
A) Musculoskeletal chest pain
B) Acute myocardial infarction
C) Unstable angina pectoris
D) Stable angina pectoris - ANSWER: D
Angina pectoris is the principle symptom of coronary artery disease (CAD). It occurs
when the heart's demand for oxygen exceeds its supply, usually during periods of
physical or emotional stress when the heart is working hard. When the increased
oxygen demand goes away, the pain typically resolves. Some patients with angina
may also experience shortness of breath, nausea, or diaphoresis. Angina is classified
as being "stable" or "unstable." Stable angina is characterized by cardiac-related
chest pain that resolves with rest and/or nitroglycerin. Unstable angina is
characterized by cardiac-related chest pain that occurs in response to progressively
less physical exertion (for example, during rest). Unstable angina is also referred to
as pre-infarction angina because it indicates a more severe degree of CAD and can
lead to acute myocardial infarction if untreated. In contrast to stable angina,
unstable angina typically does not resolve with rest and/or nitroglycerin. Given the
patient's medical history, his chest pain should not be assumed to have simply been
of a musculoskeletal origin.
At the end of ventricular relaxation, the left ventricle contains 110 mL of blood. This
is referred to as the:
A) preload.
B) afterload.
C) stroke volume.
D) cardiac output. - ANSWER: A
Preload is the amount of pressure on the ventricular wall at the end of ventricular
relaxation (diastole) and is influenced by the volume of blood in the ventricle just
before it contracts. Afterload refers to the resistance that the ventricles must
contract against. A patient with hypertension, for example, would have an increased
afterload due to systemic vasoconstriction; the smaller the arteries, the greater the
resistance the heart must contract against. Stroke volume is the volume of blood
ejected from the ventricles in a single beat. Cardiac output is the volume of blood
pumped by the heart each minute; it is calculated by multiplying the stroke volume
and heart rate.
The maximum pressure generated in the arms and legs during contraction of the left
ventricle is called:
A) afterload.
B) pulse pressure.
C) systolic blood pressure.
, D) diastolic blood pressure. - ANSWER: C
Blood pressure is the force of circulating blood against the arterial walls. Systolic
blood pressure (SBP) is the maximum pressure generated in the arms and legs during
contraction of the left ventricle, during the time period known as systole. As the left
ventricle relaxes in the stage known as diastole, the arterial pressure falls. When the
left ventricle relaxes, the aortic valve closes and blood flow between the left
ventricle and the aorta stops. The diastolic blood pressure (DBP) is the pressure
exerted against the arterial walls while the left ventricle is at rest, during the time
period known as diastole. Pulse pressure is the numeric difference between the SBP
and DBP; it represents the force generated by the heart each time it contracts. If the
patient's BP is 120/80 mm Hg, the pulse pressure would be 40 mm Hg. Afterload
refers to the amount of resistance the left ventricle must contract against.
Conditions such as hypertension cause an increase in afterload; as the arteries
narrow, the left ventricle must work harder to overcome the increases resistance to
forward blood flow.
A 65-year-old man has generalized weakness and chest pressure. He has a bottle of
prescribed nitroglycerin, but states that he has not taken any of his medication. The
EMT should:
A) apply the AED and prepare the patient for immediate transport.
B) administer up to 325 mg of aspirin if the patient is not allergic to it.
C) assist the patient with his nitroglycerin with medical control approval.
D) perform a secondary assessment and obtain baseline vital signs. - ANSWER: B
Aspirin has clearly been shown to reduce mortality and morbidity associated with
acute coronary syndrome (ACS) and should be given as early as possible; the dose is
160 to 325 mg. Even though this patient has chest pain and prescribed nitroglycerin,
you must first complete a secondary assessment and obtain baseline vital signs.
Medical control will need this information--specifically, the patient's blood pressure--
to determine whether you should assist the patient with his nitroglycerin. The AED is
not indicated for this patient because he is not in cardiac arrest.
A patient who is experiencing an acute myocardial infarction:
A) most often describes his or her chest pain as being sharp or tearing.
B) has chest pain or discomfort that does not change with each breath.
C) often experiences relief of his or her chest pain after taking nitroglycerin.
D) often complains of a different type of pain than a patient with angina. - ANSWER:
B
The type of chest pain or discomfort associated with acute myocardial infarction
(AMI) is the same that is experienced by patients with angina pectoris (eg, dull,
crushing, pressure, heaviness); thus, you cannot distinguish AMI from angina
pectoris based solely on the type or quality of pain. Furthermore, the pain associated
with AMI, like that of angina, often radiates to the arm, jaw, back, or epigastrium.
Relative to other causes of chest pain or discomfort (eg, pleurisy, pneumothorax),
the pain associated with AMI and angina does not worsen or improve when the
patient takes a breath. Rest and nitroglycerin often relieve the pain associated with
stable angina, but are less likely to relieve the pain associated with unstable angina
or AMI.
