35) Dialysis patients who have missed an appointment may present with signs of ________,
which is a similar presentation to ________.
A) pulmonary edema; congestive heart failure
B) shortness of breath; pneumonia
C) chest pain; acute myocardial infarction
D) neurological disturbances; stroke
Objective: 24.9
36) One of the more serious diseases of the body is called renal failure. Renal failure occurs
when the:
A) adrenal glands stop working.
B) kidneys fail to function as required.
C) liver fails to function properly.
D) pancreas stops working.
Objective: 24.9
17
37) A patient with renal disease who is currently on dialysis and missed an appointment may
present with dangerously high levels of the electrolyte:
A) phosphorous.
B) potassium.
C) sodium.
D) calcium.
Objective: 24.10
38) You are attending to an end-stage renal disease (ESRD) patient who has missed dialysis.
Which of the following statements is most accurate?
A) Patients who have missed dialysis and who become unresponsive and pulseless respond very
well to the use of an AED.
B) Patients who have missed dialysis and who become unresponsive and pulseless do not
respond very well to the use of an AED.
C) Calling for ALS would not be very helpful since they cannot really do anything that an EMT
cannot do in these situations.
D) You should delay transport if necessary to wait for ALS.
Objective: 24.10
18
39) You are dispatched to an unconscious hemodialysis patient. On arrival to the dialysis clinic,
the patient is unresponsive, apneic, and pulseless. You secure the ABCs, begin ventilation, and
initiate chest compressions. However, the patient’s cardiac arrest rhythm is continuously
unresponsive to defibrillations with your AED. The best approach is to:
A) call online medical control to terminate the code. The probability of survival is too low to
continue resuscitation efforts.
B) begin transporting and contact an ALS intercept. The patient’s dysrhythmia may be related to
kidney failure.
C) run a “no-electricity” code in which compressions and ventilation are continued. No
additional defibrillations are necessary.
D) continue defibrillating as the monitor recommends. The myocardium becomes increasingly
responsive to successive defibrillations.
Objective: 24.10
40) Once you encounter uncontrolled bleeding from an AV fistula, which of the following
methods would you consider using to control bleeding in addition to direct pressure and
elevation?
A) Internal wound management
B) Tourniquet
C) Hemostatic dressings
D) Pressure points
Objective: 24.10
19
41) Why might you consider contacting medical direction before applying a tourniquet in the
case of uncontrollable bleeding from an AV fistula?
A) Damage to the fistula may occur.
B) The patient may be in danger of losing the limb.
C) Medical direction should be contacted before any use of tourniquets by the EMT.
D) Hemodialysis anticoagulants may make bleeding more severe.
Objective: 24.10
42) You are dispatched to a private residence for a sick person. When you arrive you are told by
the patient that due to the snow storm yesterday he missed his scheduled appointment at the
dialysis center and is not feeling well. Your assessment does not reveal anything remarkable
outside of the fact that he has missed his dialysis. Which of the steps below would NOT be part
of your care?
A) Assess the ABCs.
B) When you obtain vital signs, obtain a blood pressure on an arm that does not have a fistula.
C) Place the patient in a supine position.
D) Administer oxygen at 15 lpm by nonrebreather mask.
Objective: 24.10
20
43) The most frequently transplanted organ is the:
A) liver.
B) heart.
C) kidney.
D) pancreas.
Objective: 24.11
44) The medications that transplant patients need to take for the rest of their lives to prevent
organ rejection also often lead to high susceptibility of:
A) infection.
B) renal failure.
C) ulcers.
D) congestive heart failure.
Objective: 24.11
21
45) Prehospital management of all the urinary system problems of the kidney transplant patient
by the EMT can be characterized by:
A) very invasive techniques.
B) varied pharmacological interventions.
C) supportive care.
D) intensive lab testing.
Objective: 24.11
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