Download ATLS POST TEST 4 LATEST VERSIONS 2023-2024 REAL EXAM 160 QUESTIONS AND CORRECT ANSWERS and more Exams Nursing in PDF only on Docsity!
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What condition is most likely to cause respiratory acidosis? - ANSWER- In larger doses narcotics induce respiratory depression and eventually respiratory arrest. AMLS Page 95 A 65 - year-old female complains of chest pain that feels like "aching" in her chest. It has become progressively worse over several days. Her temperature is 38. degrees C (100 F). Which finding will help narrow your differential diagnosis to pericarditis? - ANSWER- 12 lead ECG will demonstrate global ST-segment elevation in almost every lead. AMLS Page 128 During compensatory shock, the renin-angiotensin-aldosterone system is activated to cause a/an: - ANSWER- This selective perfusion occurs during the ischemic phase of shock. AMLS Page 146 (To stop kidneys from excreting fluid and keeping it in the vasculature, therefore increasing BP) lntrabdominal bleeds, like pancreatitis, often present with discoloration or bruising around the umbilicus. This physical exam finding is known as: - ANSWER- Cullen's sign is a blue discoloration around the umbilicus. AMLS Page 235 What clinical findings are most commonly associated with a pulmonary embolus? - ANSWER- Clear breath sounds with tachypnea. Signs and Symptoms AMLS Page 113 A 50 year old female has called 911. She complains of shortness of breath and chest. discomfort. Assessment reveals her skin is pale, moist and cool. BP is 102/68, R 24, labored with crackles, P of 130 and regular. Which type of shock is most likely occurring? - ANSWER- The patient's
respiratory rate is increased, and crackles caused by pulmonary edema can be heard on auscultation. Cardiogenic Shock Signs and Symptoms. AMLS Page 164 Patients with a history of COPD that present with an acute onset of shortness of breath are likely to have which condition? - ANSWER- Elements of patient history that suggest PE include acute onset of shortness of breath. AMLS Page 114 An elderly patient with a 1 week history of productive cough and wheezing notices an increase in difficulty in breathing when grocery shopping. Further assessment reveals pursed lip breathing, rhonchi, and minimal jugular vein distention. Which diagnosis should the healthcare provider suspect? - ANSWER- Signs and Symptoms of COPD. AMLS Page 85 A 45 year old patient is found supine on the floor. Healthcare providers note pinpoint pupils, shallow respirations and vomitus in and around the mouth. What course of action should be implemented next? - ANSWER- This is self explanatory (Suction Airway) A 20 year old female presents with a 2-day history of dyspnea, non-productive cough, chest tightness audible wheezing. Further exam reveals no fever or strider. The patient has rapid respirations with difficulty exhaling. Which diagnosis is most likely? - ANSWER- These are textbook signs of asthma Signs and Symptoms.AMLS Page 83 Anaphylaxis is most associated with which physiological event? - ANSWER- The cutaneous reaction may be observed as flushed, warm skin resulting from vasodilation and uticarea. AMLS Page 162 An elderly patient is receiving care at home while recuperating from recent knee surgery. She developed post a operative infection and has been on antibiotics for quite sometime. She is complaining of foul smelling diarrhea, and abdominal cramping and loss of appetite. Based on this presentation, the provider should suspect? - ANSWER- Signs and Symptoms Patients with this illness have diarrhea that is not bloody but has a characteristic foul odor. Abdominal pain and cramping are present in about 22% of patients. AMLS Page 319 (C-DIFF)
A caregiver for a quadriplegic patient notes an onset of difficulty in breathing and anxiousness in her patient. Further assessment shows a temperature of 101.2°F (38"C), P 128, BP 86/68, and R 24. Physical exam shows the skin is warm and urine in the Foley catheter is dark yellow and cloudy. This patient is most likely experiencing what type of shock? - ANSWER- AMLS Page 159, Table 4- 11 (Septic Shock) Respiratory Alkalosis may occur as a result of? - ANSWER- Some causes of primary respiratory alkalosis include aspirin overdose, anxiety reaction, and pulmonary embolism. See table AMLS Page 272. A 22 - year old male has recently undergone a surgical procedure to repair an injury to the thoracic vertebrae T4-T6. Assessment indicates the patient is alert and oriented, bradycardic, hypotensive and has warm dry skin which type of shock is most likely occurring? - ANSWER- In neurogenic shock the patient is often both bradycardic and hypotensive. AMLS Page 149. Warm, dry, pink skin, decreased BP, alert, normal capillary refill. AMLS Page 157 table 4- 9 An age related change that increases the risk of respiratory compromise is - ANSWER- Reduced lung compliance due to calcification of cartilage in the trachea and bronchioles and calcification of interstitial tissue. AMLS P. 98 A patient complaining of a 3 - day history of left, lower abdominal pain describes it as sharp in nature and, during the focused physical exam, the pain intensifies during palpation over the site. Differentials should include - ANSWER- Ectopic pregnancy or diverticulitis (Question does not state the PT is female, but pick ectopic pregnancy) Paroxysmal Nocturnal Dyspnea is most common in patients with a history of? - ANSWER- AMLS Page 60 Table 2-1 (Left-sided heart failure) The most common underlying medical conditions found in patients with acute pancreatitis is - ANSWER- The disease is thought to be caused by cholelithiasis (gall stones) or alcohol abuse in more than 90% of cases. AMLS Page 235 The patient presents with a history of fever and an upper respiratory infection. Historical Information reveals increasing water intake, orthostatic hypotension and an Increase in urination. You suspect these symptoms are caused by? - ANSWER- This is hyperglycemic DKA. Patients with DKA are dehydrated and appear ill.
They usually report polydipsia (great thirst), polyphagia (excessive hunger), and polyuria (excessive urination). Patients with severe cases will exhibit altered mental status, tachycardia, rapid breathing and orthostatic changes. AMLSPage 268 The healthcare provider is assessing a 60 year-old female patient with complaints of indigestion and mild upper abdominal discomfort. This presentation should prompt the provider to: - ANSWER- Indigestion and mild upper abdominal pain discomfort should prompt you to evaluate the patient for acute coronary syndrome. AMLS Page 225 You are dispatched to the home of a 32 year old patient with a history of Graves disease. The patient was in the ER earlier today for some "tests for my ulcers". He received contrast and was discharged. He is now complaining of not feeling well, chest pain and palpitations. You note an anxious patient with fine tremors. He is diaphoretic and has a fever if 101.5. BP 100/62, P156, R 30, Glucose 133. Which of the following are management considerations for this patient? - ANSWER- This is a thyroid storm. The goals of pharmalogic treatment in the prehospital setting are to block the peripheral adrenergic hyperactivity the thyroid hormones elicit (tachycardia, fever, anxiety, and tremors). This can be achieved by administering beta blockers. The drug of choice is propranolol. Treatment AMLS Page 261 A patient presents anxious with difficulty in breathing and chest pain. An assessment reveals hypotension, muffled heart tones and distended neck veins. There is a past medical history of pericarditis. The provider notes that there is decrease in systolic blood pressure when the patient inhales. Which diagnosis would be considered with this presentation? - ANSWER- The signs and symptoms are usually described in a triad including hypotension (low CO), distended neck veins (high right sided heart pressures), and muffled heart tones (fluid outside the heart) Signs and Symptom AMLS Page 119 (Pericardial Tamponade) Metabolic acidosis is best described by which arterial blood gas interpretation? - ANSWER- Metabolic acidosis is caused by a deficiency of bicarbonate ion (base) and and excess of hydrogen ion (acid). In the acute stage the body's physiologic response is to hyperventilate and compensate by reducing PaCo2. AMLS Page 273 If untreated, a cardiac tamponade will present with signs and symptoms of which type of shock? - ANSWER- Cardiac tamponade occurs when fluid accumulates
appropriate? - ANSWER- Psoas sign (Place PT in left lateral decubitus position and extend the right leg at the hip. Exacerbation of pain in the right lower quadrant is a positive psoas sign) AMLS Page 236 Peri-umbilical pain tends to be related to the appendix, small bowel, or cecum. AMLS Page 217 A 62 year old patient presents with a severe headache. It is described as a "thunderclap" accompanied by nausea, blurred vision and an elevated blood pressure. What neurological condition is most likely causing this patient's presentation? - ANSWER- Subarachnoid hemorrhage should be suspected in any patient who describes a sudden, severe headache that came on like a "thunderclap". AMLS Page 190 A patient complains of nausea and is passing black, tarry stools rectally. This patient is most likely suffering from - ANSWER- Dark or black blood in the stool may indicate either old bleeding or the digestion of blood from an upper GI-bleed. AMLS Page 149 A 38 year old presents with mild chest tightness and urticaria after mowing the lawn. He felt a "sting" in his left lower leg and states the symptoms came on suddenly. BP 130/82, pulse 100, respiratory rate is 20 with a normal work of breathing. The healthcare provider should - ANSWER- Initiate an IV with 0.9% Normal Saline and monitor the patient carefully (If there is no work of breathing, delay administering epi. Try to manage PT w/ least amount of interventions as possible) Healthcare providers are treating a patient that has taken an unknown amount of a prescribed pain medicine, along with an over-the-counter analgesic numerous times over the past 36 hours for chronic lumbar pain. The patient is experiencing abdominal pain, nausea and vomiting. The providers note pallor and diaphoresis blood sugar is 42 mg/dl (2.3 mmol/L). What toxin overdose is suspected? - ANSWER- Stage I/II APAP (Acetaminophen) toxicity signs and symptoms are characterized by abdominal pain and worsening nausea and vomiting. AMLS Page 363 Healthcare providers are treating a patient complaining of substernal chest pain accompanied with nausea and 1 episode of vomiting. The patient has had 2 cardiac stents placed within the last year. He has a familial history of heart disease and takes a baby aspirin daily. What information is most concerning? - ANSWER- If
the patient has having chest pain and had a stent recently placed, for example, that information is pertinent. AMLS Page 20 A firefighter has been working a fire for 4 hours on a humid, hot day. He suddenly becomes nauseated and restless. The provider observes pupil dilation and an almond odor to his breath. The vital signs are P 56, RR 22, BP 140/86. The ECG reveals sinus bradycardia with occasional PAC's. Which toxin exposure has occurred? - ANSWER- One of the most common asphyxiants is hydrogen cyanide. Notable for its bitter almond-like odor found in a solid form. Page 422. Clinical presentation includes bitter almond odor to breath. AMLS Page 366 The patient complains of sharp chest pain that worsens when supine. He is bed ridden due to complications from a recent hip surgery. The patient is tachypneic and the ECG reveals sinus tachycardia. What is the patient's working diagnosis? - ANSWER- Patients at risk of pulmonary embolism include those who have recently had surgery. The classic triad of chest pain, hemoptysis, and dyspnea is seen in fewer than 200/o of patients. Early symptoms of pulmonary embolism may be minimal, but massive pulmonary embolism evolves quickly and may rapidly become symptomatic, leading to cardiac arrest with pulseless electrical activity as the presenting rhythm. AMLS Page 92 Healthcare providers are assessing an obese 49 year old who is lethargic and not feeling well for several days. His family reports a history of extreme thirst. Vital signs are P 143, R 14, and BP 88/58. He takes medication for type 2 diabetes daily. What is the most probable working diagnosis? - ANSWER- Signs and symptoms of HHNC include fever, dehydration, vomiting, and abdominal pain, hypotension, tachycardia, rapid breathing, thirst, polyuria, or oliguria, polydipsia, focal seizures, altered LOC, focal neurological deficits. AMLS Page 270 A patient is a resident in an assisted living facility to obtain physical therapy after a knee replacement surgery. She complains of a skin rash that is red and has small bumps. She has been feeling ill for several days. What is most likely the working diagnosis? - ANSWER- A patient with MRSA may have fever, redness, localized pain, small red bumps, or deep abscesses that can affect bones, joints, heart valves, and the blood stream. AMLS Page 318
weakness the patient has been treading water for 25 minutes and now presents with tachycardia and Rapid respirations core body temperature is 93.2 which diagnosis is most likely - ANSWER- mild hypothermia a 22 year old female presents with a headache and has been that has been present for 2 days on assessing the patient you note fever diaphoresis and nausea accompanied by next if sniffed if you suspect - ANSWER- meningitis of the following statements was it which is true concerning the treatment of chest pain - ANSWER- chest bench be treated as a serious condition until proven otherwise you are called to an apartment for chest pain patient on arrival a 52 year old male states that he is now pain-free which of the following would lead you to suspect the presence of angina instead of an acute myocardial infraction - ANSWER- the pain was alleviated by rest and nitroglycerin I 56 year old man complains of abdominal pain and diarrhea for 7 days but refuses transport to a local hospital on the basis of the patient's history your best advice for the patient will be - ANSWER- accept medical treatment as diarrhea can alter electrolyte balances 46 year old male patient complains of steady dull pain in the right upper quadrant and similar pain in the right shoulder the patient denies any recent trauma you suspect - ANSWER- the shoulder pain is referred from the spleen true regarding oxygen Administration - ANSWER- nonrebreathing face mask with reservoirs deliver a hundred percent oxygen you're right on the scene of a 21 year old female who has had a seizure and find the patient laying on the bed the patient responds to painful stimuli with a moan and exhibit snoring respiration's family members join you that and inform you that it is the only medical problem has a history of seizures that he only had one today the blood glucose levels 94 the patience to currents that is would be described as - ANSWER- postictal the patient presents with a history of headache weight loss chest discomfort night sweats and a persistent blood-tinged call for several weeks which infectious disease is most likely - ANSWER- tuberculosis
you're presented with a patient complaining of bilateral upper quadrant abdominal pain for their assessment reveals a distant adapt men Global bruising and jaundice to the sclera you would suspect which of the following - ANSWER- liver failure signs and symptoms are indicators of neurological dysfunction - ANSWER- dysarthria a 62 year old male with a history of emphysema States a sudden onset of respiratory distress accompanied by pleuritic chest pain he appears this apneic with a respiratory rate of 26 his skin is warm and non diaphoretic on osculation you not the breath sounds are diminished on the right side - ANSWER- pneumothorax an elderly female takes aspirin daily as prescribed for coronary artery disease she states the president of a gradually worsening headache over the past two weeks additionally she cites intermittent problems and walking and speaking both new to her during the history she states she fell in charge 3 weeks ago and hit her head the hospital stated that she had no injuries she exhibits an immediate life threats you would suspect which of the following - ANSWER- subdural hematoma which of the following is the most clinically significant difference between a simple pneumothorax and a tension pneumothorax - ANSWER- signs and symptoms of shock a 63 year old male with a cardiac history presents with lethargy and confusion the patient states he has chest pains and feels sweaty his vital signs are Post 40 blood pressure is 84 over palp respiratory 28 and labored auscultation of the lungs Orville's crackles in the lower lobes which of the following conditions is most likely responsible for the patients confusion - ANSWER- cardiac conditions which of the following describes the overriding goal in the formation of differential diagnosis for abdominal pain - ANSWER- differentiate acute life threats from non-life threads you suspect that a weak confused patient is suffering from undiagnosed diabetes which of the following signs and symptoms would best serve to confirm your suspicions - ANSWER- increased thirst and urination you are assisting your LS partner with a patient presenting with a diagnosed Hemorrhage of the large intestine it you are providing oxygen and IV fluids the patient presents with the following vitals Post 104 BP 106 / 62 respiratory 20
which of the following might suggest your unconscious patient is experiencing increased pressure within the brain - ANSWER- non purposeful posturing flexion or extension a patient with insulin dependent diabetes has suffered a rapid deterioration of his level of Consciousness your strongest suspicion would be - ANSWER- hypoglycemia a 54 year old male presents confused with Family reporting a one-week history of vomiting and diarrhea with little dietary or fluid and take your initial assessment reveals week rapid peripheral pulses the school the skin is cool and non diaphoretic was delayed capillary refill the post office Reed not 90% on room air you should suspect which of the following - ANSWER- hypovolemic shock which of the following signs would help confirm the suspicions of cardiogenic shock in a patient with myocardial infraction - ANSWER- crackles rales When approaching an actively seizing patient what you should do first - ANSWER- clear the air furniture and objects what is the most important question to ask when a patient complains of neurological defects - ANSWER- when did this begin your evaluating a very confused 36 year old male who has been participating in a marathon on a hot and humid day is going is hot and dry his vitals are post 126 BP 110 over 70 respiratory 40 you should suspect that the patient is suffering - ANSWER- heat stroke you are assessing a 59 year old male who is vomiting bright red blood the patient denies shortness of breath and has distended abdomen which of the following differentials would explain the patience current condition - ANSWER- increase portal pressure causing leaking esophageal varices Oregon phosphate poisoning presents with which signs and symptoms - ANSWER- salivation and incontinence of urine and stool Define us to Poria 72 year old female and obvious respiratory distress the primary survey reveals a patient Airway patent Airway labored respirations and weak poses the skin is cool and diaphoretic the calculator Rafael time is significant delayed
vital signs are post 138 blood pressure 60 over palp respiratory 32 with bilateral crackles the patient is suffering from what type of shot - ANSWER- cardiogenic an age-related change that increase the risk of respiratory compromise is - ANSWER- decrease in lung compliance after the primary survey what assessment component should follow the unresponsive medical patient - ANSWER- Baseline vitals female patient is an anaphylactic shock the patient has audible upper Airway noises wheezing in sinuses with a decreasing level of Consciousness the appropriate immediate course of action is - ANSWER- prepare to assist with animations you're responding to a call for knowledge and vomiting which of the following is true - ANSWER- vomiting is an indication of an underlying optimality a cool clammy patient complains of burning epigastric pain that summly becomes a knife like in his rapidly worsening which of the following conditions is most likely the cause - ANSWER- perforated ulcer anaphylaxis is most associated with which physiological vent - ANSWER- vasodilation while ministering ventilations with a bag valve mask to a patient breathing 6 times a minute which of the following would help to minimize gastric distention - ANSWER- measuring ventilation is just until the chest Rises a patient complains of nausea and is passing black stools rectally this patient is most likely suffering from - ANSWER- upper GI bleed you respond for a report of an impetus phetamine overdose your patient is most likely to present with - ANSWER- rapid pulse the most common underlying medical conditions found in patients with acute pancreatitis is - ANSWER- gallstones and heavy alcohol use a female patient complaining of three day history of left lower abdominal pain describes it as sharp during the focus physical exam the pain intensifies during
a. Anxiety/panic attack b. Narcotic overdose c. Methanol ingestion d. Diabetic ketoacidosis - ANSWER- b. Narcotic overdose
- A 55-year-old complains of an 'aching' chest discomfort that persists over several days. The patient has a temperature of 101F (38.3C). Which finding will help narrow the diagnosis to pericarditis? a. Pain is relieved when supine b. Pulsus alternans is present c. S3 gallop is auscultated d. ST-segment elevation in all leads - ANSWER- d. ST-segment elevation in all leads
- Anaphylaxis is most associated with which physiological event? a. Hemorrhage b. Vasodilation c. Bradycardia d. Hypertension - ANSWER- b. Vasodilation
- Acute Respiratory Distress Syndrome (ARDS) is characterized by what pathological change? a. Excessive mucous production b. Inflammation of the visceral pleura c. Breakdown of the alveolar-capillary membrane d. Accumulation of fluid between the pleural layers - ANSWER- c. Breakdown of the alveolar-capillary membrane
- Continuous positive airway pressure would be most beneficial in treating which patient? a. A 43yo with a decreased LOC with respiratory difficulty b. A 22yo with severe asthma who is not responding to nebulizer treatments c. A 38yo with carpal pedal spasms, clear lung sounds, and respirations of 40/min d. A 55yo with jugular vein distension and a BP of 90/60 - ANSWER- b. A 22yo with severe asthma who is not responding to nebulizer treatments
- What is the initial treatment for a patient experiencing hyperosmolar hyperglycemic nonketotic coma (HHNC)? a. Crystalloid IV fluid administration b. Administration of dextrose c. Administration of insulin d. Fluid bolus of 5% dextrose in water (D5W) - ANSWER- a. Crystalloid IV fluid administration
- Your patient has had a seizure secondary to a nerve agent exposure. What medication would be best to diminish the seizure? a. Atropine b. Diphenhydramine c. Midazolam d. Pralidoxime - ANSWER- c. Midazolam
- Respiratory alkalosis may occur as a result of: a. Fever and anxiety b. Renal failure and dehydration c. Airway obstruction and chest wall pain d. Prolonged vomiting - ANSWER- a. Fever and anxiety
- An age-related change that increases the risk of respiratory compromise is: a. Increase of mucus production b. Increase in intrathoracic volume c. Decrease in lung compliance d. Decrease in dead space ventilation - ANSWER- c. Decrease in lung compliance
- Paroxysmal nocturnal dyspnea is most common in patients with a history of: a. Left-sided heart failure b. Pneumonia c. Asthma d. Multiple sclerosis - ANSWER- a. Left-sided heart failure (?)
- Observing a patient's body positioning can be an early indicator that the patient is: a. Sick or not sick b. Does not speak the same language as the provider c. Has family who can provide historical information d. Diagnosed with multiple underlying medical conditions - ANSWER- a. Sick or not sick
- Which assessment finding is crucial to obtain from a patient suspected of a stroke? a. Last oral intake b. Medication allergies c. Onset of symptoms d. Risk factors - ANSWER- c. Onset of symptoms
- A 62yo patient presents with a severe headache. It is described as a "thunderclap" accompanied with nausea, blurred vision, and an elevated blood pressure. What neurologic condition is most likely the cause of this patient's presentation? a. Brain abscess b. Ischemic stroke c. Epidural hematoma d. Subarachnoid hemorrhage - ANSWER- d. Subarachnoid hemorrhage
- A 38yo presents with mild chest tightness and urticaria after mowing the lawn. He felt a "sting" in his left lower leg and states the symptoms came on suddenly. BP 130/82, P 100, R 20 with a normal work of breathing and clear lung sounds. The healthcare provider should: a. Immediately transport to the receiving facility b. Initiate an IV with 0.9% NS and monitor the patient carefully c. Initiate an IV with 0.9% NS and administer 0.5mg of epinephrine d. Obtain a blood glucose level - ANSWER- b. Initiate an IV with 0.09% NS and monitor the patient carefully
- Healthcare providers are treating a patient complaining of substernal chest pain accompanied with nausea and one episode of vomiting. The patient has had two
cardiac stents placed within the last year. He has a familial history of heart disease and takes a baby aspirin daily. What information is most concerning? a. Familial history of heart disease b. Recent stent placement c. Nausea and vomiting d. Daily use of aspirin - ANSWER- b. Recent stent placement
- The patient complains of sharp chest pain that worsens when supine. He is bed ridden due to complications from a recent hip surgery. The patient is tachypneic and the ECG reveals sinus tachycardia. What is the patient's working diagnosis? a. Cardiac tamponade b. Gastroenteritis c. Pneumothorax d. Pulmonary embolism - ANSWER- d. Pulmonary embolism
- A patient is a resident in an assisted living facility to obtain physical therapy after a knee replacement surgery. She complains of a rash that is red and has small bumps. She has been feeling ill for several days. What is the most likely working diagnosis? a. Escherichia coli b. Shigellosis c. Methicillin-resistant Staphylococcus aureus d. Clostridum difficile - ANSWER- c. Methicillin-resistant Staphylococcus aureus
- A foreign exchange university student is found by his roommate and EMS is dispatched. The patient presents with an unusual flat red rash on his chest and arms. He has been ill with fever, nausea, and vomiting. Physical exam reveals stiffness of the neck. The healthcare provider will anticipate which diagnosis? a. Chicken pox (varicella) b. Meningitis c. Encephalitis d. H5, N1 (avian) influenza - ANSWER- b. Meningitis
- Healthcare providers are treating a 49yo male complaining of diffuse abdominal cramping. He has been ill with vomiting for 3 days. What working diagnosis is most probable?
