EMT Medical Practice Test 1 — Questions and Answers

Question 1: You arrive on scene to find a patient with an altered mental status. You quickly scan the scene. Which of the following items will help to point you in the right direction in finding a cause of the altered mental status?

Unkempt house with animal fur and dirt on the floor
Medications including high blood pressure, anxiety and depression (Correct answer)
A smell of dirty clothes and cat feces
Over the counter (OCT) pain relievers

Correct answer: Medications including high blood pressure, anxiety and depression

When assessing a patient with altered mental status, identifying their current medications is crucial. Medications for conditions like high blood pressure, anxiety, and depression can have side effects, interactions, or be taken incorrectly (e.g., overdose or missed doses), all of which can directly contribute to or cause altered mental status. This information provides immediate and relevant clues to the patient's condition.

Question 2: Your patient is not responding to your loud verbal stimuli. You find the following medications: Glucophage and Lipitor. What is the likely cause of the patient’s problem?

High cholesterol
High blood pressure
Diabetic reaction (Correct answer)
Coronary Artery Disease

Correct answer: Diabetic reaction

The presence of Glucophage (metformin), a medication for Type 2 diabetes, strongly suggests the patient has a history of diabetes. An unresponsive state in a diabetic patient is most commonly caused by a severe diabetic reaction, either hypoglycemia (low blood sugar) or hyperglycemia (high blood sugar). Therefore, a diabetic reaction is the most likely primary field diagnosis.

Question 3: Your neuro assessment of an unresponsive patient reveals pin point pupils. What is your primary field diagnosis?

Beta blocker overdose
Insulin overdose
Aspirin
Narcotic (Correct answer)

Correct answer: Narcotic

Pinpoint pupils (miosis) are a classic and highly indicative sign of opioid (narcotic) overdose. Opioids stimulate the parasympathetic nervous system, causing the pupils to constrict significantly. In an unresponsive patient, this finding should immediately raise suspicion for a narcotic overdose, requiring prompt intervention.

Question 4: Your patient is a known diabetic who takes up to four insulin injections a day. Today he is found unresponsive, diaphoretic, and tachycardic. He is also only breathing 18 times a minute. What is likely the patient’s chief medical issue?

Hypoglycemia (Correct answer)
Hyperglycemia
CVA
Hypertensive crisis

Correct answer: Hypoglycemia

The patient is a known diabetic taking multiple insulin injections, and presents with unresponsiveness, diaphoresis (sweating), and tachycardia. These signs, particularly the cool, clammy skin (diaphoresis) and rapid heart rate (tachycardia), are classic compensatory responses to hypoglycemia (low blood sugar), as the body attempts to raise glucose levels. Hyperglycemia typically presents with warm, dry skin.

Question 5: You find that your diabetic patient is hypoglycemic. You have oral glucose to give to the patient. You will give 15 grams of instant glucose to the patient except if they are ___________?

Conscious with blood sugar
Semi conscious with gag reflex and the ability to swallow
Semi conscious without the ability to swallow (Correct answer)
Conscious with an altered mental status and blood sugar of 80mg/dl

Correct answer: Semi conscious without the ability to swallow

Oral glucose is administered to hypoglycemic patients who are conscious or semi-conscious and *retain a gag reflex and the ability to swallow*. If a patient is semi-conscious and lacks the ability to swallow or has no gag reflex, administering oral glucose poses a significant risk of aspiration. In such cases, alternative routes like intravenous dextrose or intramuscular glucagon are necessary.

Question 6: Which of the following is an often fatal complication of diabetes and is also the first indication of diabetes in many young patients?

Hypoglycemia
Hypertension
Cardiovascular disease
Diabetic Ketoacidosis (DKA) (Correct answer)

Correct answer: Diabetic Ketoacidosis (DKA)

Diabetic Ketoacidosis (DKA) is a severe and potentially fatal complication of diabetes, particularly Type 1, characterized by high blood glucose and ketone levels. It is often the first indication of diabetes in many young patients, as its symptoms (e.g., excessive thirst, frequent urination, abdominal pain, altered mental status) can be severe and prompt medical attention before a formal diabetes diagnosis.

Question 7: Diabetic Ketoacidosis (DKA) has the following signs and symptoms; Acetone on breath, dry skin, poor skin turgor, altered mental status, confusion, thirst, and frequent urination. What other symptoms are associated with DKA?

Normal mental status
Appearance of intoxication (Correct answer)
Tremors
Diaphoresis

Correct answer: Appearance of intoxication

Diabetic Ketoacidosis (DKA) can cause altered mental status, confusion, and a fruity (acetone) odor on the breath. These symptoms, combined with potential unsteady gait or slurred speech due to dehydration and metabolic derangement, can mimic the appearance of alcohol intoxication. This makes DKA a critical differential diagnosis for EMS when encountering individuals who appear intoxicated.

Question 8: There are two types of cerebral vascular accidents (i.e., strokes). The most common is an ischemic stroke. What is the other type?

Transient ischemic attack
Hemorrhagic (Correct answer)
Thrombotic
Embolic

Correct answer: Hemorrhagic

Strokes, or cerebrovascular accidents, are broadly categorized into two main types. The most common is an ischemic stroke, which occurs when a blood clot blocks blood flow to the brain. The other type is a hemorrhagic stroke, which occurs when a blood vessel in the brain ruptures and bleeds into the surrounding brain tissue, causing damage.

Question 9: For a condition to be diagnosed as a transient ischemic attack (TIA), the symptoms must be resolved in 24 hours ______________?

With some minor deficits
With some major long lasting effects
With out any memory effects
With out any permanent effects (Correct answer)

Correct answer: With out any permanent effects

A Transient Ischemic Attack (TIA) is characterized by temporary stroke-like symptoms that result from a brief interruption of blood flow to the brain. For a condition to be diagnosed as a TIA, all neurological symptoms must fully resolve within 24 hours without any evidence of permanent brain damage or lasting neurological deficits. This complete resolution distinguishes a TIA from an ischemic stroke.

Question 10: To assess a patient with a stroke, there are two major assessment tools: the Cincinnati Stroke Scale and the Los Angeles Prehospital Stroke Screen. Which one of these two tools uses arm drift as a diagnostic tool?

Neither
Cincinnati Stroke Scale (Correct answer)
Los Angeles Prehospital Stroke Screen
Both

Correct answer: Cincinnati Stroke Scale

The Cincinnati Prehospital Stroke Scale is a rapid assessment tool used by EMS to identify potential stroke patients. It evaluates three key signs: facial droop, arm drift, and abnormal speech. Arm drift specifically involves asking the patient to hold both arms out with palms up and observing if one arm drifts downward, indicating unilateral weakness.

Question 11: Stroke symptoms often present the same as other medical problems. To prevent improper treatment for the signs and symptoms, working through the differentials is a must. Hypoglycemia is often mistaken for a CVA. How can a clinician rule in or out this differential?

Check pupils
Check blood sugar (Correct answer)
Check grips
Check arm drift

Correct answer: Check blood sugar

Hypoglycemia (low blood sugar) can present with neurological symptoms such as altered mental status, weakness, and slurred speech, which closely mimic those of a stroke. Therefore, checking the patient's blood glucose level is a crucial and rapid diagnostic step to rule out or confirm hypoglycemia as the cause of the symptoms. Correcting hypoglycemia can quickly resolve these symptoms, preventing unnecessary stroke treatment.

Question 12: The clinician's best role in the assessment and treatment of a stroke patient is rapid recognition and transport to a stroke center. What is the window of opportunity from the onset of symptoms until treatment?

any time before symptoms resolve
three hours (Correct answer)
in the first 24 hours
once you have a stroke there is no chance to fix it

Correct answer: three hours

For ischemic stroke patients, there is a critical 'window of opportunity' for administering thrombolytic medications (clot-busters) like tPA. This window is generally considered to be within three hours from the onset of symptoms for optimal effectiveness and to minimize risks. Rapid recognition and transport to a stroke center are paramount to ensure patients can receive this time-sensitive treatment.

Question 13: Statements from patients are used as assessment tools. Which of the following statements about stroke symptoms should cause the clinician to use a higher index of suspicion?

This is the worst headache I have ever had. (Correct answer)
This headache is behind my right eye.
My head is throbbing.
Bright light causes my head to hurt worse.

Correct answer: This is the worst headache I have ever had.

A sudden, severe headache described as 'the worst headache of my life' is a classic symptom highly suggestive of a subarachnoid hemorrhage, a type of hemorrhagic stroke. This specific description indicates a sudden onset of intense pain, often due to irritation of the meninges by blood, and warrants immediate medical attention and a high index of suspicion for a serious intracranial event.

Question 14: A medical condition where the patient sometimes suffers convulsions or seizure activity is known as?

Postictal state
Tonic-clonic
Focal motor
Epilepsy (Correct answer)

Correct answer: Epilepsy

Epilepsy is a chronic neurological disorder characterized by recurrent, unprovoked seizures. Seizures are episodes of abnormal electrical activity in the brain that can manifest as convulsions, altered consciousness, or other neurological symptoms. While other conditions can cause single seizures, epilepsy refers to the predisposition to having repeated seizures.

Question 15: When assessing a patient complaining of depression, which of the following would be most suggestive that the patient is at risk for suicide?

Previous attempt that was unsuccessful (Correct answer)
Packing away of cherished possessions
Hostility toward concerned family members
Recent diagnosis of hypertension

Correct answer: Previous attempt that was unsuccessful

A previous suicide attempt is the single most significant predictor of future suicide attempts and completed suicide. Individuals who have attempted suicide before are at a much higher risk, even if the previous attempt was unsuccessful. This history indicates a higher lethality of intent and a demonstrated capacity to act on suicidal thoughts.

EMT Medical Practice Test 1

You arrive on scene to find a patient with an altered mental status.
You quickly scan the scene.
Which of the following items will help to point you in the right direction in finding a cause of the altered mental status?