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Flashcards in Exam Questions Deck (1023):
1

An inherited disease that causes excessive mucus to be produced within the lungs which then causes the patient to be prone to serious lung infections and pancreatic failure.

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Cystic Fibrosis

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2

What is the Parkland Formula and what is it used for?

 

What is the actual formula

 

How are the volumes allocated

 

What is the preferred fluid

Calculates the amount of resuscitation fluid that needs to be given to a burn patient in the first 24 hours

 

4ml * %BSA * Pt Wt (Kg)

 

50% in the first 8 hours

50% over the following 16 hours

LR

3

what is Mean Arterial Pressure?

In medicine, the mean arterial pressure is an average blood pressure in an individual during a single cardiac cycle

4

How do you calculate Mean Arterial Pressure?

[(2x diastolic) + (Systolic) / 3)

5

Why is the diastolic value in MAP multiplied by 2?

The reason that the diastolic value is multiplied by 2, is that the diastolic portion of the cardiac cycle is twice as long as the systolic

6

Wat is the Cerebral Perfusion Pressure?

defined as the difference between the Mean Arterial Pressure(MAP) and the Intracranial Pressure (ICP)

7

Wat is the formula for Cerebral Perfusion Pressure and what does it indicate?

CPP = MAP - ICP. This represents the pressure gradient driving cerebral blood flow (CBF) and hence oxygen and metabolite delivery

8

What is ICP and what is the normal range?

Intracranial pressure (ICP) is the pressure inside the skull and thus in the brain tissue and cerebrospinal fluid (CSF). ICP is measured in millimeters of mercury (mmHg) and, at rest, is normally 7–15 mmHg for a supine adult.

9

What is/are extrapyramidal syndrom / symptoms?

are serious side-effects of antipsychotic and other drugs. ... The extrapyramidal symptoms include acute dyskinesias and dystonic reactions, tardive dyskinesia, Parkinsonism, akinesia, akathisia, and neuroleptic malignant syndrome.

10

what does gestatiojnal diabtes mean for your newborn & WHY?

If you have gestational diabetes, your baby may be at increased risk of: Excessive birth weight. Extra glucose in your bloodstream crosses the placenta, which triggers your baby's pancreas to make extra insulin. This can cause your baby to grow too large (macrosomia)

11

what does "acrocyanosis" mean?

means the newborn has blue extremities and a pink core

12

What does a prolonged PR interval signify?

A prolonged PR interval indicates delayed conduction of the sinoatrial, or SA, nodal impulse to the ventricles and is called first-degree AV block

13

What is Glycogenolysis?

Glycogenolysis is the breakdown of glycogen (n) to glucose-6-phosphate and glycogen 

14

What hormones are produced by the pancreas?

The pancreas produces 2 antagonistic hormones to control blood sugar: glucagon and insulin. The alpha cells of the pancreas produce glucagon. Glucagon raises blood glucose levels by stimulating the liver to metabolize glycogen into glucose molecules and to release glucose into the blood

15

Whgere is Glucagon produced and what is its effect?

The alpha cells of the pancreas produce glucagon. Glucagon raises blood glucose levels by stimulating the liver to metabolize glycogen into glucose molecules and to release glucose into the blood

16

17

What are beta cells and what do they produce? 

Within the pancreas there are areas that are called the islets of Langerhans. The beta cells constitute the predominant type of cell in the islets. The beta cells are particularly important because they make insulin. Degeneration of the beta cells is the main cause of type I (insulin-dependent) diabetes mellitus.

18

What causes Type 1 diabetes?

The beta cells are particularly important because they make insulin. Degeneration of the beta cells is the main cause of type I (insulin-dependent) diabetes mellitus.

19

the cellular ischemic phase begins when....

right after anaerobic metabolism begins

20

You have a patient that is complaining of a headache, nausea, and vomiting. Upon assessment, you find that his blookd pressure is 220/140. Which of the following is your MOST important intervention?

Rapid transportation to the hospital.

21

Which direction does the contraction of the ventricles occur following the electrical stimulation of the "His-Purkinje" system?

From the apex of the heart up towards the aortic/pulmonic valves.

22

Which of the following vascular disorders has the greatest likelihood of becoming life threatening?

Aortic aneurysm.

23

Which of the following patient population is MOST likely to develop cardiogenic shock?

Geriatric patients with significant underlying diseases

24

You have just arrived on the scene of a patient complaining of chest pain.  The patient states the pain began approximately 30 minutes prior to your arrival and has remained unchanged after rest and nitro.  The patient denies any radiation and also denies any difficulty breathing. The pain is sharp in nature and he rates the pain as a 7 on a 1 to 10 scale. Which of these assessment findings in MOST suggestive that this patient is experiencing a cardiac event?

The pain is persistent after rest and nitroglycerin.

25

Identify the rhythm

Atrial Flutter.

26

An implanted pacemaker that fires continuously at a preset rate is referred to as:

A fixed rate pacemaker.

27

Identify the rhythm.

Normal Sinus Rhythm

28

Identify the rhythm

Sinus Bradycardia

29

You are performing CPR on a medical patient in cardiac arrest who was feeling fine 30 minutes ago. The patient then went into cardiac arrest, and you are now unable to obtain any pulses. The patient has a history of myocardial infarction and your monitor shows a sinus tachycardia at 130. Which of the following interventions would have the BEST chance to yield a positive outcome in this case?

Fluid resuscitation.

30

Which of the following signs and symptoms would most closely be associated with a patient in cardiogenic shock?

Hypotension, hypoxia, tachycardia, and pedal and/or pulmonary edema.

31

What is the time period represented on the EKG, when the ventricular cells are repolarazing and are preparing for the next impulse?

T wave

32

You are on the scene of a patient experiencing chest pressure and shortness of breath for approximately 3 hours without relief. The patient has a history of hypertension and angina pectoris. The patient complains of an upset stomach and has pale, diaphoretic skin. The assessment findings in this patient reveal which of the following?

Myocardial infarction.

33

Identify the rhythm.

Second Degree Type II Heart Block

34

You have just positioned a patient complaining of chest pain on the EMS stretcher. The patient will MOST  likely prefer which position for transport? 

Semi-fowler's.

35

Your trauma patiebt has received a chest contusion from an assault with a baseball bat. The patient is very anxious, restless and is becoming disoriented. He has moderate dyspnea and muffled heart sounds. Symptoms are unimproved with oxygen administration. What are the proper treatments to provide?

Support ventilations, rapid transport, bilateral IV and cardiac monitor.

36

You are evaluating a patient with a possible cardiac problem. How would you expect this patient to describe his pain if he was experiencing a myocardial infarction?

"I feel pressure right under my breastbone."

37

Which type of myocardial infarction affects only the innermost layer of the myocardium?

Subendocardial infarction.

38

Identify the rhythm

Second-Degree type I Heart Block

39

You are doing a wellness/blood pressure check at an adult independent living center. Which of the following findings may be an indication of an acute problem that needs transport?

68-year old male with new onset pedal edema in both lower extremities.

40

Which of the following represents the correct lidocaine maintenance regimen for a patient in the post resuscitation phase of an arrest?

1.0 to 4.0 mg/min.

41

Which of the following would you expect to see develop FIRST in the patient with peripheral artery occlusion?

Pain during exercise.

42

Which progressive event typically causes the cardiogenic shock patient to lose the ability to maintain vital organ perfusion?

Failure of preload, afterload, and contractility mechanism.

43

You are transporting a 64-year old male in respiratory distress with rales and rhonchi in all lung fields. He is coughing up copious amounts of pink, frothy sputum. Skin is cool and pale and peripheral pulses are weak. Your initial treatment plan includes high-flow oxygen, IV access, and cardiac monitoring. His pulse is 110 and weak, respiratory rate is 22 and labored, and his blod pressure is 85/50. Pulse oximetry is 93% oxygen on oxygen. Your partner reaches for some sublingual nitroglycerin.  Your response to this should be:

Dopamine will improve cardiac contractility and help treat his hypotension.

44

Which of the following is the MOST common presenting symptom of acute myocardial infarction in the adult male?

Chest pain or pressure.

45

Which of the following BEST describes angina pectoris?

Chest pain that results when the heart's demand for oxygen exceeds the blood supply available.

46

Why call for an intercept with an advanced life support (ALS) unit during the care of a cardiac patient with ACS?

ALS can provide some medications and treatments that the AEMT cannot.

47

Which of the following hypotension compensatory mechanisms will be the LEAST effective when a patient is suffering from cardiogenic shock?

Increasing contractile force.

48

Identify the rhythm

Accelerated Junctional Rhythm

49

Identify the rhythm

Torsades de Pointes

50

Why should the administration of CPAP be considered in patients with pulmonary edema?

CPAP provides ventilation pressure within the alveoli that may reduce fluid entering the alveoli.

51

You have an 81-year old patient with rales in both lower lobes and you have ruled but pneumonia as a cause. Acute pulmonary edema would BEST be described by which of the following:

Plasma in the alveoli, usually caused by left heart failure.

52

Which of the following would BEST describe why we provide morphine to a patient having a myocardial infarction?

To reduce myocardial oxygen demand.

53

The inability of the heart to meet the metabolic needs of the body would be the definition for which of the following?

Cardiogenic shock.

54

Which of these skin assessment findings would be the MOST consistent with cardiac compromise?

Mottled.

55

Your 35-year old patient has a history of oral contraceptive use and cigarette smoking. She now complains of lower leg calf area pain and distal swelling that has continued for 48 hours. The patient exhibits a positive Homan's sign. Given this history, the paramedic needs to continually assess this patient for:

Increased difficulty in breathing.

56

You are called to assess a patient with a sudden onset of unilateral limb pain while at rest. You suspect the patient is having a peripheral vascular emergency. Which of the following would BEST support your field diagnosis?

A prior history of peripheral vascular disease.

57

Which of the following would be a LATE sign of left-sided heart failure?

The presence of pink, frothy sputum.

58

Identify the rhythm.

Idioventricular Rhythm.

59

Which of the following actions by a paramedic would have the greatest impact in managing cardiac tamponade? 

Support of blood pressure.

60

What is the unit of measure for the component of a transcutaneous pacemaker regarding the amount of current delivered?

Milliamps.

61

Which of the following BEST describes a tachycardia of ventricular origin versus one of supraventricular origin?

A wide QRS and a positively deflected AVR.

62

Which of the following would be the greatest hazard associated with the usage of an artificial external pacemaker?

Failure to verify mechanical capture.

63

You are assessing a 65-year old patient who has had recurrent asthmatic attacks since the age of 12. The patient has a recent history of a right-sided MI with pedal edema. Which of the following would be an accurate description of how the asthma might have precipitated the right-sided MI?

The increase in pulmonary pressure made the right heart work harder than normal.

64

From the list below, what medical condition prevalent between the ages of 60 and 70 is seen ten times more frequently in men than in women.

Abdominal aortic aneurysm.

65

Which of the following is the initiating event responsible for an aneurysm?

Tear in the tunica intima.

66

What medication would be the most benefit to a patient with a rapidly responding atrial fibrillation?

Calcium channel blocker.

67

A patient complaining of chest pain is also having difficulty breathing. The patient states that he ate 3 hours ago, he takes aspirin and coumadin on a daily basis, and his pain started 20 minutes before 911 was called. Which of the assessment findings from the above scenario best illustrates the utilization of the OPQRST mnemonic?

The pain started 20 minutes before 911 was called.

68

Epinephrine 1:1,000 has which of the following concentrations?

1.0 mg/mL.

69

Which of the following is the BEST description of a pyrogenic reaction?

A sudden onset of fever and chills as a result of being exposed to a protein.

70

Which vessel would you have accessed when you obtain venous access in the medial aspect of the antecubital fossa?

Ulnar vein.

71

A light blue top blood tube typically contains which of the following anticoagulants?

Citrate

72

Activated charcoal is typically prepared and used in which form?

Suspension.

73

What would the correct drip rate be for administering 500ml over 60 minutes with a 15gtt administration set?

125 gtts/min.

74

You are caring for patient who has difficulty breeathing. This patient has a history of asthma and emphysema. The patient states his inhaler is not helping him. You watch the patient administer the inhaler, which he does by spraying in front of his nose. You know this is not the correct procedure. Which of the following would you recommend to the patient?

The inhaler goes in the mouth and he should hold his breath after aerosol spray.

75

Diazepam, USP, is utilizing what name form?

Generic.

76

The LEAST systemic effect occurs with which of these medication administration methods?

Intradermal.

77

The official standard for information about pharmaceuticals in the United States is the:

United States Pharmacopeia.

78

Which drug is considered a Class 1A antiarrhythmic drug?

Procainamide

79

Which of the following medications administered by EMS has the greatest potential to cause a positive outcome.

Dextrose in cases of hypoglycemia.

80

The temperature of 35 degrees Celsius would be equal to a Fahrenheit temperature of:

95.0

81

Which of the following BEST describes the benefit of learning about medications by drug classification?

When a new drug becomes available, it is easier to incorporate it into practice.

82

What has occurred if your patient develops fever, chills, backache, headache, nausea and vomiting thirty minutes after the start of an IV?

Pyrogenic reaction

83

Tinctures of Opium have been available since:

17th-18th century.

84

The response to a medication may be different for geriatric patients because of:

Decreased liver function.

85

According to the Controlled Substance Act of 1970, morphine belongs to which of the following schedules of drugs?

Schedule II.

86

Which of the following would most likely cause hemolysis while obtaining a blood sample?

Forcefully aspirating the blood into the syringe.

87

Drugs like perindopril, captopril, and enalapril that are administered to assist in the treatment of hypertension or congestive heart failure belong to which drug class?

ACE Inhibitors.

88

Elimination of drugs,or their metabolites, most often occurs in:

The urine.

89

Which of the following drugs would give you the greatest positive inotropic and chronotropic effects as well as vascular constriction?

Ephinephrine.

90

The special name given to metabolism of drugs is:

Biotransformation.

91

Why is nitroglycerin given sublingually instead of orally?

It would be deactivated by first-pass metabolism.

92

You are called to a 3-year old patient who is having difficulty breathing. The patient is beginning to show signs of cyanosis. The patient is resisting the administration of oxygen through a non-rebreather mask. Which of the following would be an appropriate solution?

Administer flavored oxygen to the child.

93

What is the principal neurotransmitter of the parasympathetic nervous system?

Acetylcholine.

94

Which medication lowers blood pressure by relaxing vascular smooth muscle and slowing AV node conduction in the heart to reduce cardiac output?

Diltiazem

95

Which of the following would be the proper drip rate of a 10 cc/kg infusion for a 4-kg neonate using a 15 gtts set over a 15-minute time frame?

40 gtts/min.

96

When a pediatric patient is suffering from dehydration, the standard fluid bolus is:

20 ml/kilogram.

97

what supplies should be used when anticipating fluid administration to a trauma patient who may also need a blood transfusion? 

A 16-gauge angiocath and a 10 gtts administration set.

98

Labetalol lowers blood pressure by what mechanisms?

Non-selective blockade of beta-receptors and limited blockade of alphal receptors.

99

In the apothecary system, what is the basic unit of fluid volume?

Minim.

100

A measuring teaspoon holds how many milliliters?

5 ml.

101

Which one of the following medications, prescribed for grand mal seizures (general tonic-clonic seizures), is classified as a barbiturate?

Phenobarbital

102

Your partner is about to administer a medication that is contraindicated.  Which of the following BEST describes how you should handle this situation?

Prevent your partner from administering the medication.

103

In the pre-hospital setting, which of the "rights of drug administration" is least likely to cause an error?

Right patient.

104

Two medications are found to be chemically equivalent for their relative therapeutic effectiveness.  This is called:

Bioequivalence.

105

What drug mechanism of action would you be attempting to achieve by administering sodium bicarbonate IV to a patient?

Chemically combining with other chemicals.

106

The correct dose when administering medications through an endotracheal tube is:

2.0 to 2.5 times the IV dose.

107

In addition to ritodrine (Yutopar), what drug is also commonly used as a tocolytic?

Terbutaline.

108

Which of the following medication routes would be subjected to first-pass metabolism?

Oral.

109

In an unusual situation, you have asked online medical control to give you permission to administer a medication. The radio communication is not very good and you are not sure what the physician said in his response to you.  Your best action at this point would be to:

Reply that communication is broken and request the order be repeated.

110

Which one of the listed medications is a selective adrenergic antagonist, which targets beta 1 receptor sites?

Esmolol

111

When an expected response occurs froma drug binding to a receptor site, the drug is a/an:

Agonist.

112

Which medication chelates cyanide forming vitamin B-12

Hydroxocabalamin.

113

Metaproterenol is the generic name for which brand name drug?

Alupent.

114

The heart would respond to which of the following adrenergic stimuli?

Beta 1.

115

A particular medication alters the binding site to prevent other medications from having their desired effect. This is an example of:

A noncompetitive antagonist.

116

Your patient has nausea and vomiting as you are preparing to transport to a tertiary medical facility. Which of the medications is indicated?

Prochlorperazine.

117

When administering medications, 0.01mg is equal to:

10 mcg.

118

When considering a drug's properties, the larger a drug's therapeutic index is, the:

Safer it is.

119

Which of the following is the MOST common reason an EMS provider obtains intravenous access?

To replace fluids.

120

What is the name for the properties of a medication when it raises the heart rate?

Positive chronotropic effects.

121

You are called to evaluate a 3-year old child that has a respiratory illness. The child is on his hands and knees in his bed. The mother says he has had a bad cough before but never like this. This cough, which sounds like inspiratory stridor to you, came on suddenly tonight. You are aware of the child's position, but also that he is drooling, not swallowing, and had circumoral cyanosis. The mother says the child has never used an inhaler and has no chronic problems. Your best action at this time is to:

Prepare the patient for transport and give oxygen.

122

Lidocaine is an example of what type of antidysrhythmic?

Sodium channel blocker.

123

Administrations of H2 receptor antagonists like cimetidine have what physiologic effect on the patient?

Decreased gastric acid secretion,

124

To calculate a drip rate, which of the following represents the correct formula?

(Volume to be administered) times (Drip factor) divided by (Time in minutes).

125

Which drug route is best suited for administration of a drug that will have effects lasting over an extended period of time?

Subcutaneous

126

Intramuscular medication is often given at the:

Dorsal gluteal.

127

Which of the following is referred to as the "fight or flight" nervous system?

Sympathetic.

128

A higher concentration of a medication in a patient's body would be caused by a/an:

Faster absorption rate.

129

Parasympathetic stimulation will result in:

Secretions by digestive glands.

130

What is the correct handling procedure when you only administer a portion of the morphine loaded into a syringe?

Take the remaining morphine into the ED and waste it in front of a nurse.

131

For any medication's mechanism of action, which of the following is the most common?

Binding to a receptor site.

132

Administration of which of the following drugs can be expected to elicit the same side effects as haloperidol?

Chlorpromazine

133

When starting an aseptic venipuncture, which of the following is correct?

Use friction with the alcohol wipe.

134

Which of the following drug orders would be appropriate and correctly written?

NTG, 0.4 mg, SL, q 5 min, up to 3 doses

135

Which of the following would be the abbreviation for the most common dose of a drug to be administered in the pre-hospital setting?

mg.

136

A patient has a blood sugar reading of 440 and you receive an order to give an IV dose of insulin.  Which of the following insulin preparations would you expect to give?

Regular insulin (Humulin R)

137

When administering medication through a gastric tube, which of the following is correct?

Tablets and pills should be crushed before being administered.

138

The correct formula for calculating the amount of medication to administer would be:

Volume to be administered = ((volume on hand) x (desired dose))/(dosage on hand).

139

 What is the correct volume of 10% Dextrose to administer at 1 gram/kg for a two-week old infant weighing 4 kg?

40 cc.

140

What does the letter classification represent when the Food and Drug Administration releases a newly approved drug?

Treatment potential.

141

A drug's absorption, distribution, and elimination properties are identified in the drug's profile known as the:

Pharmacokinetics.

142

Which of the following is BEST described as a liquid medication that is combined with alcohol?

Elixir.

143

You are considering the use of midazolam during a drug assisted intubation procedure.  The patient that has suffered a traumatic brain injury and is in need of airway control. When used for this purpose, what other consideration should you make prior to using the drug?

Avoid use in volume depleted or hypotensive patients

144

You are called to treat an unresponsive, apneic 27-year-old male suspected of suffering from narcotic overdose. You have adminnistered naloxone, slow IV push, as a treatment for this situation. Which of the following should you most likely anticipate?

The patient will need an additional administration of naloxone.

145

In the apothecary system, what is the basic unit of fluid volume?

Minim.

146

Which one of the listed drugs is known as a depolarizing neuromuscular blocking agent that is used in drug assisted intubations?

Succinylcholine

147

Ipratropium is effective for the treatment of asthma because of which of the following actions?

It relaxes the bronchial smooth muscle.

148

Which of the following drug orders would be appropriate and correctly written?

NTG, 0.4 mg, SL, q 5 min, up to 3 doses

149

Nalmefene is used primarily for which clinical condition?

Management of alcohol dependence.

150

Which of the following would be considered a hypotonic solution?

D5W.

151

Which of the following most accurately describes the mechanism of action for Narcan?

Blocks the opiods from occupying the receptor sites.

152

Intraosseous needle placement in a pediatric patient is preferred at the:

Medial aspect of the proximal tibia, 1-3 cm below the tuberosity.

153

When administering medication through a gastric tube, which of the following is correct?

Tablets and pills should be crushed before being administered.

154

Intramuscular medication is often given at the:

Dorsal gluteal.

155

When administering medications, 0.01mg is equal to:

10 mcg.

156

One grain in the apothecary system would equal how much in the metric system?

60 mg.

157

While gathering the medications your patient is prescribed, you learn that they are on lithium and diazepam. Which of the following disorders should you suspect?

Bipolar disorder.

158

Which choice represents the class of drugs that reduces blood pressure by reducing circulating blood volume via the kidney?

Diuretics.

159

What is the correct volume of 10% Dextrose to administer at 1 gram/kg for a two-week-old infant weighing 4 kg?

40 cc.

160

In what clinical condition should the administration of phenylephrine be avoided?

Cardiogenic shock.

161

Which one of the following antipsychotics could be expected to have the lowest chance of side effects at the therapeutic dose?

Ziprasidone.

162

A light blue top blood tupe typically contains which of the following anticoagulants?

Citrate.

163

You give a dose of methylprednisolone to your dyspneic asthma patient. Your partner correctly reminds you that the patient could exhibit which of the following serious adverse side effects?

Seizure.

164

Which is the principal reason you should wear gloves when placing a nitro tablet under a patient's tongue?

You may absorb some of the nitro through your skin.

165

Vasopressin would likely be administered to a patient suffering from which disorder?

Nocturnal Enuresis

166

If increasing the dopamine level in the brain of Parkinson's disease patients is helpful, why is dopamine administration by the paramedic an ineffective therapy in this clinical situation?

Dopamine cannot cross the blood brain barrier.

167

Dissociative anesthetics such as ketamine create dissociation between which of the following systems?

Cortical and limbic system.

168

Which one of these drugs inhibits the production of prostaglandins in order to reduce fever?

Ketorolac.

169

Amiodarone prolongs repolarization and the effective refractory period of cardiac muscle by what mechanism?

Blocking the efflux of potassium

170

Torsades des points (TdP), a polymorphic form of ventricular tachycardia that may be contributed to by interactions between certain drugs, is primarily treated by the administration of which drug?

Magnesium sulfate.

171

You have assisted a patient in taking his own Nitroglycerin during an attack of severe chest pain.  The patient's blood pressure has been normal up to this point. Now the patient complains of having a hot face and a headache. These new symptoms would lead you to believe that the patient.

Is experiencing the side effects of nitroglycerin.

172

Which of the following is considered an organophosphate nerve agent?

Sarin.

173

Nalbuphine belongs to which classification of drug?

Opiate agonist-antagonist

174

Your post-arrest patient is now receiving a procainamide loading infusion. Which of the following is an indication to stop the infusion?

You have reached the maximum loading dose of 17 mg/kg.

175

You have 30 ml of Hyperstat containing 300 mg and you are ordered to administer 60 mg. How much volume do you provide the patient?

6.0 ml.

176

Which antiarrhythmic must be given rapid IV push due to its short half-life?

Adenosine.

177

Which of the following would be an appropriate gauge and length for a subcutaneous administration needle?

24-26 gauge and 3/8" long.

178

To calculate a drip rate, which of the following represents the correct formula?

(Volume to be administered) times (Drip factor) divided by (Drip factor).

179

Mucomyst (acetylcysteine) is a specific antidote to treat an overdose from which of the following medications?

Acetaminophen.

180

Which one of the listed adverse effects of meperidine is most likely to be encountered by the paramedic after proper administration?

Respiratory depression.

181

Which of these meets the EMS provider's responsibility with regard to medication administration?

Knowing characteristics of a broad range of drugs outside of those that you provide.

182

Amyl nitrate or sodium nitrite can be utilized as an antidote for what type of poisoning?

Cyanide.

183

Which choice is a correct dosage for levalbuterol when administered for an acute asthma attack?

0.63 mg via nebulizer.

184

Which of the following would be the most appropriate to administer to a hypoglycemic neonate?

D10.

185

Which one of these drugs provides analgesia by binding to opiate receptor sites?  It also has fewer undesirable effects such as respiratory depression and addictive tendencies,

Butorphanol

186

The correct dose when administering medications through an endotrachea tube is:

2.0 to 2.5 times the IV dose.

187

Which of the following would be a contraindication or precaution for rectal medication administration?

A patient with hemorrhoids.

188

An inherited disease that causes excessive mucus to be produced within the lungs, which tehn causes the patient to be prone to serious lung infections and pancreatic failure, BEST describes which condition below?

Cystic fibrosis

189

A 15-year old male patient has been pulled from a pond and resuscitated.  Post resuscitation, the patient develops complications where his alveoli continually collapse. This patient is MOST likely suffering from a lack of:

Alveolar surfactant.

190

What condition do you suspect with the following patient? You have a young man who uses a wheelchair and has trouble breathing. Further assessment reveals coarse rhonchi in all fields with a pulse ox at 84%. He also reports a history of pale, greasy stools.

Cystic fibrosis.

191

You are treating an asthmatic who also complains of chest pain and you suspect the patient is experiencing an AMI. Which of the following medications would provide the MOST benefit in treating his asthma attack and be the LEAST likely to negatively impact his AMI?

Atrovent.

192

You are called to the scene of a 48-year-old male complaining of severe dyspnea. The patient has a history of a right-sided myocardial infarction.  He has a prescribed inhaler that contains a beta agonist as well as steroids. His inhaler has provided no relief. Which of the following would you MOST likley expect to find with this patient as a result of his long-term steroid use?

The patient may present with signs consistent with Cushing's disease.

193

The patient's chest rises and falls with ventilations.

194

You are assessing an unresponsive 32-year-old female who has a history of asthma. She tkes a steroid daily to help prevent her asthma attacks and a bronchodilator for acute care of asthma. She is breathing deeply at 26 times per minute. Her pulse is 110 and weak. Her skin is warm and dry. Which of the following assessments would be an expected finding with this patient?

An elevated blood glucose level.

195

You are caring for a patient that is in respiratory distress and you identify on the patient's medication list the drug Proventil. What is the action of this drug?

Beta-2 agonist.

196

You are called to treat a patient who fell and landed on his head. The pupils are equal and reactive, blood pressure is decreased, pulse rate in normal, and the respirations are progressively deeper and faster alternating with shallow, slow breathing. Whic of the following describes the type of brain injury?

Brain stem.

197

You are called to the scene of an 18-year old male who suddenly became short of breath and is complaining of left shoulder pain.  The symptoms began 15 minutes ago after he tried to tighten a lug nut on his car.  Lung sounds are slightly diminished in the left upper lobe, there is no JVD or tracheal deviation, and the patient is breathing at 24 times per minute. Which of the following is MOST likely the cause of the patient's dyspnea?

Spontaneous pneumothorax.

198

You are called to transfer a COPD patient who is on a Venturi mask set at 28% FI02. The patient is suffering from a situation which is causing a shift to the left of his oxygen-hemoglobin dissociation curve. Which of the following would best address this issue?

Increase the Venturi mask setting to a higher percentage.

199

You have a patient with pneumonia whom you inaccurately diagnose as having congestive heart failure. Which of the following will MOST likely occur if you follow the normal congestive heart failure treatment plan?

Lasik will make the patient more dehydrated.

200

Which of the following describes the action of an inhaler such as albuterol?

Dilates the bronchioles.

201

You have a patient with a fever and pleuritic chest pain who is coughing up green sputum and you hear adventitious lung sounds in the upper right lobe. Your patient is MOST likely suffering from:

Pneumonia.

202

A patient tells you he takes the medication Atrovent. You suspect this patient has emphysema and takes this medication for which of the following actions:

For drying of secretions.

203

The adult patient you are assessing is breathing 16 times per minute and has pale skin. Which other signs or symptoms would you expect to find if you suspected she was breathing inadequately?

Shallow breathing.

204

You are dispatched to the residente of a 42-year-old male observed sitting in a tripoid position, Which of the following would be the MOST critical sign regarding this patient?

Pulmonary edema.

205

EMS providers are stabilizing a conscious geriatric patient experiencing severe shortness of breath related to emphysema. They have applied high-flow oxygen via non-rebreather mask and confirm there is no ectopy on the cardiac monitor. What is their HIGHEST priority during transport?

Establishing a peripheral IV of an isotonic solution.

206

Rescuers are preparing to transfer a 52-year-old female with a mild pneumothorax to a larger hospital for further treatment. According to the physician arranging the transfer, he suspects her lung was punctured during a central line insertion two days ago. During the transfer the patient begins experiencing severe dyspnea and pulsus paradoxus. Which description BEST explains what the rescuers see?

Shortness of breath has increased and there is a drop in systolic blood pressure during inhalations.

207

You have a patient who has suffered a brain stem injury with increasing intracanial pressure. Which of the following types of respirations would you LEAST likely expect to see?

Kussmaul.

208

As of 2010, where does pneumonia rank in the leading causes of death in the geriatric population?

Seventh.

209

Your 24-year-old female asthmatic patient is breathing at 20 times per minute with a tidal volume of 200 ml. What is her minute volume?

4000 ml.

210

You are dispatched to the scene of a hysterical 14-year-old basketball player who says that he is unable to catch his breath. Lung sounds are equal, pulse oximetry reading is 99%, respiratory rate is 36, and the patient has no underlying medical condition. The patient is also complaining of numbness and tingling of the mouth, hands, and feet and is exhibiting spasms of the hands and feet. What should you do initially to treat this patient?

Try to calm the patient and have him slow his respirations.

211

You have a patient who takes the following medications: prednisone, Ipatropium bromide, betamethasone, and Metaproterenol. Which of the following conditions would you most likely expect this patient is suffering from?

Asthma.

212

A 25-year-old male is complaining of trouble breathing and chest tifhtness after trying to put out a car fire in an auto repair shop. What do you suspect is the MOST likely cause of his distress?

Acute swelling within the lower airways.

213

Which of the following would be your HIGHEST priority when assessing a patient complaining of difficulty breathing who also has distended neck veins?

Lung sounds.

214

You are called to the scene of a patient complaining of a rapid onset of difficulty breathing. Which of the following is your MOST critical assessment in order to properly render care to this patient?

Lung sounds.

215

You are called to the scene of a 27-year-old male who just came home from the hospital after knee surgery and suddenly became short of breath. Assessment reveals jugular venous distention and equal lung sounds.  This patient is MOST likely suffering from:

Pulmonary embolism.

216

During your assessment of a patient experiencing severe complications from cystic fibrosis (CF), you determine emergency-mode transport is necessary. What special consideration must be considered before initiating transport toward an emergency room?

What is the best destination for this particular situation?

217

After assisting a patient whith his inhaler, which of the following side effects should you expect?

Increased heart rate.

218

You are called to the residence of a 27-year-old female complaining of general illness. When you arrive, you find the patient is complaining of a headache, nausea and vomiting, confusion, agitation, loss of coordination, and chest pain. Her mother also appears to be coming down with the same symptoms.  What should your FIRST action be in this case?

Remove all people from the residence.

219

Which of the types of sputum listed below would you MOST likely expect to see in a patient with active long cancer?

Hemoptysis.

220

Which of the following would be the BEST to use for a patient experiencing respiratory distress with adequate breathing?

Non-rebreather mask.

221

You have a 47-year-old patient with high fever and a productive, purulent cough. His lungs sounds are diminished in the right upper lobe and he indicates significant pleuritic chest pain when he takes a deep inspiration. This patient is MOS likely suffering from:

Pneumonia.

222

You are called to the scene of a 27-year-old male who had a suddent onset of severe dyspnea and chest pain.  The patient has been a two-pack-a-day smoker for 12 years. He has a history of chronic bronchitis. Which of the following would lead you to determine that the cause of his problem today is a spontaneous pneumothorax versus exacerbation of his chronic bronchitis?

Unilateral hyperresonance.

223

Which of the following anatomical structures within the pulmonary system is primarily responsible for the trapped air that an asthmatic experience?

Bronchioles.

224

Which of the following would be the MOST likely position you would transport a patient experiencing breathing distress?

Fowlers.

225

You are at the scene of a drinking establishment for a patient complaining of difficulty breathing. You are unable to assess the patient's lung sounds because of the noise level. Which of the following would describe the BEST method for handling this situation?

Move the patient to the back of your ambulance.

226

Rescuers are preparing to transfer a 52-year-old female with a mild pneumothorax to a larget hospital for further treatment. According to the physician arranging the transfer, he suspects her lung was punctured during a central line insertion two days ago. During transport the patient becomes unresponsive to painful stimuli and cyanosis is observed. Rescuers rub her sternum with their knuckles and lightly brush her eyelashes with a finger tip. What do you suspect they are assessing?

Likelihood the patient has a gag reflex.

227

Which of the following would BEST describe expected results from an asthmatic in the middle of an attack?

Decreased peak flow and decreased forced expiratory volume.

228

You and your partner are resuscitating a 65-year-old COPD patient. It becomes obvious that the patient will require intubation to survive.  You decide to set up the suction machine before attempting intubation. What is the BEST reason for getting up portablesuction prior to intubation?

Inserting an endotracheal tube could trigger vomiting and aspiration.

 

 

 

Annotation: The only true statement is that you may trigger vomitinng with your effort and must be prepared.

229

Which of the following signs and/or symptoms would you MORE likely expect to observe in pneumonia than in cancer?

Fever.

230

EMS is sent to treat a 72 year-old male with trouble breathing. The family tells the providers the patient started really getting short of breath 10 minutes prior to their arrival. What finding, even if mild, will MOST likely help differentiate pneumonia from chronic bronchitis complications if the patient has a past medical history of both?

Elevated tympanic temperature.

231

You are called to the scene of a 48-year-old male complaining of severe dyspnea. The patient has a history of a right-sided myocardial infarction. He has a prescribed inhaler that contains a beta agonist as well as steroids. His inhaler has provided no relief. Which of the following assessments would you expect to find with this patient?

Diminished lung sounds.

232

When assessing a patient with a neuromuscular disorder such as spinal shock or muscular dystrophy, which of the following would be your primary concern?

Assessing tidal volume.

233

Which of the following would be the MOST expected medication provided for a patient in respiratory distress as a result of ARDS (Acute Respiratory Distress Syndrome)?

Corticosteroid.

234

What is the primary reason we administer an inhaler?

To provide immediate bronchodilation.

235

While on the scene of a stroke patient, you witness the patient become unresponsive. Presuming the patient is already on high-flow oxygen via non-rebreather mask, what is the rescuer's HIGHEST priority?

Consider the need for an advanced airway.

236

You are called to treat a 57-year-old male complaining of severe dyspnea. The patient has a history of an enlarged right heart. He has a prescribed inhaler, which contains a beta-2 agonist and a steroid. His inhaler has provided no relief, and he is now unable to communicate and there are no audible breath sounds. Which of the following should you do FIRST for this patient?

Intubate the patient and assist ventilations with a bag-valve-mask with a nebulized attachment containing Albuterol.

237

Which of the following patients would MOST likely require ventilatory assistance with a bag-valve-mask device?

A patient with multiple sclerosis.

238

You and your partner are resuscitating a 65-year-old COPD patient. It becomes obvious that the patient will require intubation to survive. Defend the BEST reason for inserting a stylet into the endotracheal tube during setup of your partner's equipment. 

It will be available if it is needed andharmless if it is not.

239

You are called to treat a patient who complained of a terrible headache prior to becoming unresponsive. The patient's pulse is 40, respirations are 8 and irregular, and his blood pressure is 200/120. Which of the following intervention will have the greatest positive impact on this patient's survival?

Transporting the patient rapidly to the hospital.

240

Which of the following BEST describes the term aphasia?

The patient cannot speak.

241

Which of these medications is often considered initially when managing the patient with an altered mental status?

Naloxone.

242

You are interviewing the family of a seizure patient. Which of the following answers to your questions should give you the greatest concern?

"He has stopped and started seizing three times in a row now."

243

What is the name of the phase of a generalized seizure right after a patient has stopped seizing?

Postictal.

244

What is the primary concern for a patient in the pstictal phase of a seizure?

Protecting the airway.

245

You are transporting a 42-yeaar-old female with a history of multiple sclerosis to the hospital after a fall in her home. Enroute to the scene you and your partner are differentiating between symptoms of the disease versus the fal. Which of these symptoms is MOST attributable to the disease rather than the fall?

Progressive muscular weakness.

246

You are treating a patient experiencing a stroke who is aphasic. He is unable to move his right arm and legs. After applying oxygen and assuring his airway is clear, which treatment will MOST likely benefit this patient?

Continue talking and reassuring the patient.

247

You have an adult patient in status epilepticus after failing to take his prescribed anticonvulsant medication. Which of the following is the appropriate treatment for this patient?

Administer Valium 5 mg IV/IO/IM.

248

Which of the following accurately reflects Cushing's reflex?

Decreased pulse and respirations and increased blood pressure and temperature.

249

Your neurological emergency patient is presenting with arms flexed, fists clenched, and legs extended. This would be an example of what type of posture and injury?

Decorticate with a lesion at or above the upper brainstem.

250

Which of the following would be a structural mechanism responsible for altering mental status?

Brain neoplasm (tumor).

251

Which of the following phases of a generalized seizure is characterized by rhythmic jerking movements of the extremities?

Clonic phase.

252

You are called to a patient complaining of a headache. The patient states there is pain on the left side of his head and he is also complaining of nasal congestion and watery eyes. These assessment findings MOST likely suggest which of the following?

Cluster headache.

253

Rank the following in order from the MOST common in occurrence to the LEAST common in occurrence.

Epilepsy, Stroke, Parkinson's.

254

Which of the following drugs is considered to be part of the management plan for a patient with a history of a neoplasm within the brain?

Anti-inflammatories.

255

Which of the following degenerative neurological disorders would present with weakness of one or more limbs, sensory loss, paresthesia, and changes in vision?

Multiple sclerosis.

256

Which of the following would be the appropriate treatment for a patient with aphagia as a result of a transient ischemic attack?

Place the patient in a left lateral recumbent position.

257

What is the MOST appropriate name for the type of cerebral vascular incident where all symptoms resolve within 24 hours of onset?

Transient ischemic attack.

258

Which of the following is the MOST common physiological cause of seizure?

Idiopathic.

259

You are preparing to transport an unresponsive stroke patient to the emergency department. Which of the following would be the BEST position to place this patient in for transport?

Recovery position.

260

What is the mortality rate for the patient populations suffering from a transient ischemic attack?

0%.

261

Which of the following degenerative neurological disorders would be the MOST difficult to distinguish from a cerebral vascular accident?

Bell's palsy.

262

Which of the following BEST describes where MOST neoplasms in the brain originate?

Metastasized from malignant tumors located elsewhere in the body.

263

Which of the following dysrhythmias is a risk factor for stroke?

Atrial fibrillation.

264

A collection of pus localized in an area of the brain would define which of the following?

Abscess.

265

Which of the following is a phase of generalized seizures?

Clonic.

266

When transporting a patient with a severe headache, what comfort measures should be provided?

Turning the lights down low in the patient area.

267

Your neurological emergency patient opens his eyes to voice command, utters incomprehensible sounds, and can localize pain. What is his Glasgow Coma Scale score?

10.

268

Which of the following is of the greatest clinical significance for patients with neurological disorders?

Respiratory compromise.

269

You are called to assess a patient with dysphasia and hemiplegia, which has occurred at least five times over the past two weeks but has resolved quickly eact time. Which of the following BEST describes the clinical significance of this situation?

The multiple episodes place this patient at risk of having a CVA.

270

Which of the following is the MOST common cause of transient ischemic attack?

Carotid artery disease.

271

You are called to assess a patient who had a sudden onset of a severe headache while exercising and, prior to losing consciousness, also complained of profuse sweating, nausea, and vomiting. Which of the following is MOST likely occurring?

The patient is suffering from a hemorrhagic stroke.

272

While at the hospital, an EMS student asks why the rescuer rechecked a stroke patient's ABCs during transport. She asks if it revealed anything new. What is the BEST defense for reassessing ABCs during the ongoing exam?

This patient's medical condition could change very quickly and compromise airway patency.

273

Why would medical direction order you to administer Dexamethasone for your patient with a brain abscess?

For its anti-inflammatory effects.

274

Your patient is a 45-year-old bus driver found unresponsive on his bus. The patient is unresponsive to pain, has snoring respirations at 8 per minute, and has flushed, warm, and diaphoretic skin. He has a pulse of 58 and a blood pressure of 186/110. Which of the following is MOST likely occurring in the above scenario?

Stroke.

275

Which of the following signs would be an inconsistent assessment finding for a patient who has a history of a neoplasm within the brain?

Abnormal blood sugar.

276

Untrained bystanders witnessing a patient having a seizure, commonly believe that the patient will:

Swallow his tongue.

277

The patient experiencing a severe headache should be re-evaluated frequently since they are prone to experience:

Vomiting.

278

If your patient is able to look in all directions with his eyes, which cranial nerves are intact?

III, IV, VI.

279

Which of the following statements is true regarding the differentiation between anaphylactic and anaphylactoid reactions?

Differentiation between anaphylactic and anaphylactoid reactions in the field is clinically unimportant.

280

Which of the following statements is true regarding the differentiation between anaphylactic and anaphylactoid reactions?

Recognize and avoid that food.

281

Which of the following statements is correct regarding the body's attempt to maintain homeostasis when hypoglycemia is present?

Gluconeogenesis produces flucose from non-sugar sources.

282

Receiving a vaccine would be classified as which type of immunity?

Induced active immunity.

283

While transporting a patient with a suspected thyroid disorder to the hospital, you are attempting to differentiate between hypothyroidism and hyperthyroidism.  What assessment would offer you the MOST insight?

Electrocardiogram.

284

Which of the following would you MOST likely expect to see in a patient with an elevated serum glucose level?

Orthostatic hypotension.

285

A 32-year old female, Type I diabetic has a blood sugar of 28 mg/dl.  This woman is MOST likely unconscious due to which of the following:

Insulin shock.

286

Which of the following would be an expected response from a histamine release?

Increased gastric motility.

287

Which of the following would be an expected response from a histamine release?

Type II diabetes.

288

During assessment of a 65-year old patient with suspected hyperthyroidism, which characteristic below should you remember specifically for older versus younger patients?

Weight loss, exhaustion, and symptoms of CHF are a classic presentation.

289

You are called to the scene of an unresponsive 45-year old male.  The patient is warm and dry, respirations are rapid and deep, and pulses are rapid and weak at the carotid and absent at the radius.  The family member who called had gone to check on the patient this morning after being concerned last night when the patient seemed to be disoriented.  The patient has a history of insulin-dependent diabetes and alcoholism and there is an empty bottle of alcohol next to the patient.  Which of the following is your MOST important intervention?

Fluid resuscitation in an attempt to restore the blood pressure.

290

You obtain a history of diabetes insipidus from a 30-year old pregnant patient during an inter-facility transport due to a delivery complication. The patient is receiving fluid therapy to reduce contractions.  Which of the following assessments would you expect to find with this patient?

Excessive urination.

291

Which of the types of response best classifies systemic lupus erythematosus?

Autoimmune.

292

Which of the following endocrine conditions will MOST likely require advance life support to transport emergency mode due to life-threatening complications associated with it?

70-year old with thyroid storm symptoms related hyperthyroidism.

293

When the blood serum insulin level falls, the patient's

Blood glucose level increases.

294

You come upon a man down at a food court in the local mall. Which finding would help you conclude the patient is MOST likely hypoglycemic?

Sudden onset of bizarre behavior.

295

Which of these would BEST be considered as the primary controlling gland for endocrine activities?

Hypothalamus.

296

Which of the following accounts for the largest number of deather per year from anaphylaxis?

Parenteral penicillin.

297

Hypogllycemia is defined as a blood supar less than which of the following?

80 mg/dl.

298

Which of the following  would you anticipate as a result of decreased insulin levels in the body?

Fat catabolism.

299

Why are cornea transplants rarely rejected?

Immune cells and antibodies are unable to reach the cornea.

300

You are called to treat an unresponsive Alzheimer's patient who has cool and clammy skin and an elevated heart rate. The blood pressure is slightly elevated, pulse oximetry is 98%, and blood sugar is 60.  Which of the following would be the appropriate intervention for this patient?

Initiate an IV and deliver 25 grams of Dextrose.

301

Which of the following is a true statement regarding Type I diabetes mellitus?

It typically has a juvenile onset.

302

Polydipsia, polyphagia, and polyuria are all symptoms of which of the following?

Hyperglycemia.

303

Which of the following abnormal assessment findings in the patient having an endocrinologic emergency would have the greatest impact motivating you to provide fluid resuscitation?

Dry skin.

304

Which of these signs or symptoms is present in diabetic ketoacidosis but is ABSENT in hyperglycemic hyperosmolar nonketotic coma?

Deep and rapid respirations.

305

Why is tuberculosis commonly seen in patients with HIV-AIDS?

They are often immuno-suppressed.

306

If the patient is hypoglycemic, which of the following physiological processes will occur in an attempt to correct this situation?

Glucagon stimulates the liver to break glycogen down through glycogenolysis.

307

Which of the following endocrine disorders is MOST commonly found in geriatric patients?

Type II diabetes.

308

Which of the following is the preferred route of delivery for epinephrine in a patient with severe anaphylactic shock?

IV.

309

Which of the following medications is considered useful in the treament of a patient with a thyrotoxis crisis by reducing the level of circulating Thyroxine (T4)?

 

Dexamethasone.

310

You are called to treat a patient with a history of hypothyroidism who has overdosed on her prescribed thyroid medication.  Which of the following assessment findings would you expect to observe?

Hyperthermia.

311

Acetone breath odor is found in which of the following?

 

Diabetic ketoacidosis.

312

Which of the following would be the last to appear in a case involving anaphylaxis?

Bradycardia.

313

Which of the following BEST explains why the patient suffering from insulin shock is often found unresponsive?

Poor brain perfusion from hypoglycemia.

314

Which of the following methods of entry of allergens into a patient will more likely result in anaphylaxis than the other methods of entry?

Injection.

315

Approximately how many deaths are there from anaphylaxis every year in the United States?

400-2,000

316

You have a patient with hypoglycemia. Which of the following signs would be the LEAST typical finding for this patient?

Flushed skin.

317

Which of the following cells of the pancreas is responsible for the production of insulin?

Beta.

318

Which of the following is the pathophysiological cause of Cushing's syndrome?

Too much adrenocorticotropic hormone.

319

When assessing a patient having an allergic reaction, which of the following should be your HIGHEST priority?

Lung sounds

320

You are treating an unresponsive patient who has dry, warm skin, rapid and shallow respiration, a rapid, weak pulse, a blood glucose level of 400, and a blood pressure of 70/40. Which of the following BEST explains the pathophysiological cause for these signs?

Too much sugar, causing hypovolemia secondary to osmotic diuresis.

321

You are called to treat a patient with a history of myxedema who has failed to take her prescribed medication for this condition. Which of the following assessment findings would you MOST likely observe?

Hypothermia.

322

How is the anterior pituitary gland stimulated to produce hormones?

By hormonal stimulation by the hypothalamus.

323

Which of the following therapies is MOST likely indicated for a patient suffering from Cushing's syndrome?

Oxygen.

324

Which of the listed conditions is used for patients who display an acute allergic reaction that has no history of previous sensitizing to the antigen?

Anaphylactoid reaction.

325

Your partner complains he is unable to sleep, his mood seems disrupted, and his physician indicates it is a hormone issue. Which of the following hormones would be involved?

Melatonin.

326

You are treating an unresponsive patient who has dry, warm skin, rapid and deep respirations, a rapid, weak pulse; a blood glucose level of 400, and a blood pressure of 70/40. Which of the following BEST explains the pathophysiological cause for these signs?

Too much sugar and not enough insulin, causing dehydration and ketoacidosis.

327

Which of the following is the responsible mechanism for the formation of ketone bodies?

Catabolism of fatty acids.

328

Which of these is a common cause of an anaphylactoid reaction?

Radiopaque contrast media.

329

Which of the following is the MOST common cause of upper grastrointestinal hemorrhage?

Peptic ulcer disease.

330

Which color will a stool sample smear change to after a couple of drops of developer are placed if there is a blood present in the sample?

Blue.

331

What is most likely the patient's condition if he is taking an H2 receptor antagonist?

Peptic ulcer.

332

You are called to treat a patient with a suspected bowel obstruction. The patient is unresponsive, tachycardic, tachypnic, hypotensive, significantly distended, hyperresonant to abdominal percussion, and vomiting feces containing emesis.  Which of the following is your MOST  important and immediate intervention?

Intubation.

333

Important information to communicate to the hospital in the radio report regarding a patient's abdominal complaint would be:

Pain quality, referred pain, other symptoms, and time of onset.

334

You are called to treat an adult patient with severe colicky pain in the left lower quadrant who has a heart rate of 104, respirations of 24, and a blood pressure of 140/80.  The patient has a low-grade fever, nausea and vomiting, and tenderness upon palpation. Which of the following would be an appropriate intervention for this patient?

Administration of antiemetics.

335

After passing through the duodenum, which of the following is the NEXT anatomical structure that food passes through?

Jejunum

336

Select the correct answer describing the transmission of Hepatitis C.

Transmission is through contact with blood.

337

You are called to treat a patient who is feverish and indicates he is suffering from anuria. He is complaining of severe abdominal pain that you would describe as positive bilateral Lloyd's sign. He has no significant medical history. Which of the following assessment findings would you expect to see in this patient?

Tall, peaked T waves.

338

Which type of pain would a patient describe as localized and intense?

Somatic/parietal.

339

Your traumatic hemorrhagic shock patient has become profoundly hypotensive and tachycardicand is showing tall, peaked T-waves on the ECG. Which of the following should you suspect?

Pre-renal acute renal failure.

340

A patient has severe abdominal pain. What is typically the most comfortable position for this patient?

Fetal position.

341

During treatment of a medical patient complaining of severe stomach pain, she asks you if she really needs to lift up her nightgown for you to assess her stomach. What is the BEST response?

Let herknow she has the right to refuse the assessment, but it is not in her best interest. Tell her you will protect her from being unnecessarily exposed.

342

Which of the statements would be applicable regarding the palpation of the abdomen of a patient with a suspected rectal foreign body obstruction?

Abodminal palpation should be performed very lightly.

343

Which of the following causes of chronic gastroenteritis would be responsive to antibiotic therapy?

Enterobacter.

344

You are transporting a 45-year-old male whose penis was reportedly injured during vigorous sex and the penis is now bent at an angle and the patient is in severe pain. Which of the following would be the appropriate way to communicate this on the radio?

State the observed assessment and request pain relief.

345

A bowel obstruction would best be indicated by which sign or symptom listed below?

Vomit containing feces.

346

You are called to treat a patient who initially complained of mild, diffuse, periumbilical pain, which is now more severe and localized to the right lower quadrant. The patient has a low-grade fever, nausea, and vomiting. Which of the following would be the MOST appropriate treatment?

Position of comfort.

347

A sharp type of pain from the abdomen that travels along neural routes is known as which of the following?

Somatic pain.

348

Which of the following signs or symptoms would you LEAST expect to find in a patient suffering from an upper grastrointestinal bleed?

Hematochezia.

349

Which of the following is the leading contributor to prerenal acute renal failure?

Hypoperfusion.

350

Your patient has severe localized pain in the right lower abdominal quadrant. What action should be avoided:

Deeep palpation of the abdomen.

351

You are called to assess a patient with an extended history of peptic ulcers. Which of the following assessment findings would you MOST likely expect to observe?

A history of pain reduction immediately following a meal.

352

Select the proper treatment for a patient with rectal bleeding from hemorrhoids.

Comfort measure, dressing for external bleeding.

353

Which of the following suggestions regarding a change in dietary habits would best prevent a healthy patient from developing diverticulitis?

Eat more foods high in fiber.

354

Periumbilical ecchymosis is known as:

Cullen's sign.

355

Swollen veins within the esophagus are referred by which of the following terms?

Varices.

356

You are called to treat a 74-year-old male with a severe bout of diarrhea and vomiting. It began this morning after the patient took his daily aspirin. He is now pale, cool, clammy, tachycardic, tachypnic, and responsive to verbal stimuli. Which of the following would be your MOST important intervention for this patient?

Initiate a fluid challenge.

357

What is the disease; almost eradicated by childhood vaccinations, which could often cause orchitis in males?

Mumps.

358

An infection at any site within the urinary tract would be called which of the following:

Urinary tract infection.

359

You are called to evaluate a 45-year-old female who is warm and dry. She has a history of diabetes. She currently has frequent painful urination, foul smelling urine, and a fever, and she moans when you percuss the left flank area. Her respirations are 26 and deep and her pulse is 120. This patient is MOST likely suffering from which of the following?

Pyelonephritis.

360

Which of the following is TRUE regarding kidney stones?

Certain stones occur in a familial pattern, suggesting heredity is a factor.

361

Your normotensive, 21-year-old female is complaining of a fever, malaise, rectal discharge, and extreme pain defecating. Which of the listed conditions would you base your treatment plan on?

Rectal abscess.

362

You are called to treat a patient with chronic renal failure who is currently hypotensive and hyperkalemic. Which of the following treatment options would BEST be utilized to correct hypotension?

Dopamine or some other vasopressor.

363

About how many Americans are affected by renal and urologic disease?

20,000,000.

364

You are called to treat a patient who is feverish and indicates he is suffering from anuria. He is complaining of severe abdominal pain that you would describe as positive bilateral Lloyd's sign. He has no significant medical history. Which of the following would be the MOST appropriate treatment option for this patient?

Oxygen.

365

"Serum hepatitis" is also identified as what type of hepatitis?

HBV.

366

Your ambulance responds to a nursing facility for a "sick person". Your assessment reveals a patient looking jaundiced and lethargic and vomiting. The patient has an intact gag reflex. She is otherwise unresponsive with tachycardia, hypotension (98/46), and a decreasing respiratory effort. Select the proper treatment.

Oxygen 15 LPM non-rebreather, IV normal saline bolus, and follow body substance isolation.

367

During an assessment, you are preparing to take a blood pressure on an emergent patient. As you move the shirtsleeve to gain access, you note the patient has a hemodialysis shunt in the arm. You have learned that is is best to take the blood pressure in:

The other arm.

368

Your patient has acute abdominal pain. While gathering the patient's history, you recall that which of the following is a risk factor for mesenteric ischemia?

Smokes 3 packs of cigarettes a day.

369

Which cells located within the pancreas produce digestive enzymes?

Acinar.

370

Which of the following signs or symptoms would BEST lead you to suspect your patient has pain associated with abdominal bleeding?

Cullen's sign.

371

Which of the following gastroenterological emergencies would be the MOST difficult to diagnose in a pre-hospital setting?

Crohn's disease.

372

The overall mortality for a patient with three of more positive signs of pancreatitis is:

95 percent.

373

During assessment of a 15-year-old male with abdominal pain, he refuses to let the rescuers check his stomach because he is in too much pain.  What is the BEST response to the situation?

Tell him how important it is that you palpate his abdomen and explain the consequences if he refuses.

374

The primary cause of esophageal varices is:

Portal hypertension.

375

Which of the following is the greatest concern regarding the pathophysiology of acute gastroenteritis?

Fluid loss.

376

Assuming the amount of bleeding is the same, which of the following patients with complaints of rectal bleeding should receive more aggresive monitoring and rapid transport?

Rectal bleeding and a history of alcoholism.

377

Which of the listed choices is a leading cause of death in renal transplant patients?

Cardiac issues.

378

A 16-year-old male contacted 911 to report he arrived home from school to find his parents unconscious in the home. While this young man was on the phone he stated that he felt sick and then he quit speaking but the dispatcher could still hear the television in the background.  What is your primary concern as you report to this scene?

Carbon monoxide poisoning.

379

You are transferring a patient from a primary hospital to a tertiary care center after he was involved in a severe trauma incident. His chart indicates that he does not take any prescription medications and does not have any known allergies. The patient begins oozing blood from venipuncture sites and from his wounds. This patient is MOST likely suffering from: 

DIC.

380

Patients overdosing on medications MOST likely risk damaging which of the following organs?

Brain and liver.

381

The MOST effective method of reducing absorption of ingested toxins is which of the following?

Administering activated charcoal.

382

You are called to treat a patient with a suspected narcotic overdose. You should be alert for which of the following:

Respiratory depression.

383

Which of the following is the antidote for an accidental overdose of atropine by injection?

Physostigmine.

384

You have been called to a patient who has had a poisonous powder cover his body.  Which of the following should you do?

Remove the clothes, brush the chemical off, and then shower him.

385

Which of the following types of white blood cells are primarily responsible for fighting infections?

Neutrophils.

386

You have an adult patient with an accidental petroleum poisoning. Which of the following is the MOST expected route for this poisoning?

Ingested.

387

Which is the appropiate pharmacological intervention for a patient with cyanide poisoning in the appropriate order?

Amyl nitrite, sodium nitrite, sodium thiosulfate.

388

What signs and/or symptoms are most commonly associated with a patient who has been exposed to a pesticide?

Diarrhea and vomiting.

389

Which of the following is a narcotic?

Codeine.

390

Which of the following is the usual adult dose of activated charcoal?

25 - 100 grams.

391

EMS providers are assessing a patient who allegedly took too much of her "heart medicine", according to her family. What signs or symptoms would lead the providers to suspect the condition may be caused by something other than an overdose on heart medication?

You witness grand mal seizure activity lasting 30 seconds.

392

Responders are called to a ptient complaining of dizziness, nausea, and blurred vision after taking too many Digoxin pills accidentally over a 2-3 day period. Which of the following treatments is appropriate for this patient scenario?

 

Pace a symptomatic bradycardia.

393

Which of the following is the antidote given first for cases of ingested cyanide poisoning?

Amyl nitrite.

394

You are caring for a patient with a known narcotic overdose. The patient is unresponsive and apneic. Your EMS team has decided to administer naloxone. What is a major concern for you related to giving this medication?

These patients often awake violently.

395

You are treating a patient with hemophilia A. Which clotting factor is deficient in this patient?

VIII.

396

Which of the following BEST describes the purpose of the medication Coumadin?

Blocks Vitamin K activity.

397

You are assessing a patient you suspect has overdosed on cocaine. What type of pupils would you suspect to find?

Both pupils dilated.

398

You are called to a child who has just ingested his mother's sleeping pills. Which should you do FIRST?

Administer activated charcoal.

399

You are called to evaluate a 70-year-old patient with anemia who, in addition, bruises very easily.  He is very weak and febrile and has an enlarged liver and spleen. This patient is MOST likely suffering from:

Leukemia.

400

Which of the following would use activated charcoal as a binding agent?

Salicylates.

401

Correctly identify the bodily systems MOST commonly affected by marijuana.

Impairs the brain and chemicals damage the lungs and heart.

402

Which of the following is the medical terminology for the process through which plasmin dismantles a blood clot?

Fibrinolysis.

403

Indicate why a patient who has been poisoned should be transported rapidly.

Airway complications may arise.

404

Anemia is defined as a deficiency in production of which of the following?

Red blood cells.

405

Adolescents abuse drugs most commonly:

To overcome boredom and because of peer pressure.

406

Which of the following findings would be MOST important to know prior to administering an emergency medication to a geriatric patient?

A history of liver impairment.

407

Which of the following is the MOST common route of entry of toxic substances into the body?

Ingestion.

408

What is the medical terminology used for white blood cells?

Leukocytes.

409

A person with 300,000 platelets per microliter would be considered:

Normal.

410

You are called to a residence where a 27-year-old male has just been removed from the building by the fire departmet. The patient has soot about his nose and mouth. Which of the following is your MOST immediate concern?

A swelling airway.

411

Identify the signs and symptoms of a narcotic overdose.

Respiratory depression, paranoia, and hypotension.

412

What type of poisoning should you suspect when your patient presents with slow pulse, excessive salivation and sweating, nausea, vomiting, difficulty breathing and constricted pupils.

Insecticide.

413

Which of the following would represent a normal hematocrit for a male?

45.

414

Select the correct pathophysiological process of poisonous substances injected into the body.

Injected into a vein that then affects the receptor sites throughout the body.

415

Which of the following is the BEST description of the action of activated charcoal?

Prevents absorption.

416

Based on your assessment, you believe your patient has suffered an aspirin overdose. Definitive treatment of severe salicylate toxicity secondary to aspirin ingestion requires which one of the items listed?

Dialysis.

417

You are called to the scene of an unresponsive patient. The patient has snoring respirations at 4 per minute. The patient's pupils are pinpoint. Which of the following would be MOST appropriate for the above patient?

Naloxone 0.04-0.4 mg I titrated for adequate ventilation.

418

Which of the following drug overdoses will require the LEAST amount of pre-hospital intervention?

Marijuana.

419

Poisoning by intentional overdose most often occurs through:

Ingestion.

420

In the case of surface absorbed toxins, which one of the following is the most important?

Scene safety.

421

Regarding a hypoclycemic, malnourished alcoholic, which of the following represents the correct drug regimen?

25 g of D50 IV and 100 mg of thiamine IV.

422

To remember the signs and symptoms of organophosphate poisoning, the following acronym is typically used.

SLUDGE.

 

Salivation, Lacrimation, Urination, Defecation, GI cramps, and Emesis.

423

You arrive at the scene where a child has ingested a bottle of clildren's chewable vitamins. The mother says she stuck her finger down the child's throat and made him vomit. She says she could see a large number of vitamin material in the vomit. She comments that she no longer feels the child needs to go to the hospital and EMS is no longer needed. What would you advise the mom at this time?

The child should be taken to the emergency department.

424

Advanced life support providers are dispatched to a medical office for a 72-year-old male who overdosed intentionally on Atenolol (beta-blocker) to kill himself.  Which of the following treatments would be contraindicated if the patient is only responsive to deep pain, hypotensive, and bradycardic?

Propranolol hydrochloride IV infusion.

425

Which is the most important piece of information that you can collect at the scene of an acetaminophen overdose for the ED?

Time of ingestion.

426

Half of all poisonings occur in which of the following age groups?

1-5.

427

After one dose of Dextrose 50%, your hypoglycemic geriatric patient is now alert and fully oriented but refusing transport. A neighbor says the patient has been very depressed for several weeks. The patient wants to stay home, promising to take better care of her diabetes.  What is the BEST treatment plan for this patient who seems outwardly depressed?

Try to convince the patient to go with you to the hospital voluntarily or transport her against her wishes if she refuses.

428

Your 22-year-old patient has been recently infected with Haemophilus influenza type B. This patient is at risk for which of the following illnesses?

Acute epiglottitis, pneumonia, and meningitis.

429

The visible indication of a patient's mood is termed:

Affect.

430

Choose the MOST effective way to demonstrate to a patient who has been assaulted by a spouse that you care about her well-being.

Ask the patient is she wants you to call someone to be with her now.

431

Which of the following would be a method to calm a patient with a behavioral emergency?

Take your time and listen to him.

432

Which of the following BEST defines a behavioral emergency?

When a person exhibits an abnormal behavior that is unacceptable.

433

Severity of mental retardation is determined by which of the following examination techniques?

Intelligence Quotient (IQ) testing.

434

Select an anatomical system that is affected by Tetanus.

Nervous system.

435

Paramedics from a private advance life support agency are dispatched to these four potential emergency calls. Which of these descriptions would BEST match a spousal abuse situation?

A wife reporting her husband had nonconsensual sexual contact with her tonight.

436

Which of the following forms of Hepatitis are transmitted via the fecal-oral route?

Hepatitis A.

437

A very important assessment in the evaluation of a delusional psychotic patient is:

Determining if the patient is supposed to be taking medication.

438

Hypochondriasis is an example of:

Somatoform disorder.

439

Domestic violence is LEAST likely related to which condition?

Schizophrenia diagnosis.

440

Which of the following suggestions will benefit the rescuers and patient MOST during treatment of a patient with Down syndrome?

Allow extra time for obtaining past medical history from the patient.

441

Which of the following conditions would be considered a mental illness that relates to a clear loss of contact with reality because of a chemical disease of the brain?

Manic-depression.

442

During treatment of a patient suffering from a probable asthma attack, it is revealed the patient is also struggling with an emotional impairment. What special accommodation must be considered for this patient during transport?

Primary care of this patient will be focused on calming and reassurance as well as medications.

443

Which of the following is the MOST common psychiatric disorder among the elderly?

Depression.

444

A restrained patient who becomes increasingly agitated, violent and verbally abusive should be closely monitored to establish if he is suffering from which of the described conditions?

Excited delirium.

445

HIV specifically targets which of the following components of the immune system?

T lymphocytes.

446

Presented with a Herpes Simplex 1 patient, what would a correct treatment in the hospital or pre-hospital setting be?

Boosting natural immune system and Herpes outbreak medications.

447

What would lead you to suspect that a patient's behavior could erupt into violence?

Rapid speech and physical movement.

448

EMS is called to an assisted living center for a geriatric patient experiencing abdominal pain related to a possibe bowel obstruction. The patient has a history of schizophrenia, which is well controlled with prescribed medication. Which advice would you recommend for the rescuers treating this patient?

Treat the patient as you normally would treat someone without a schizophrenia history.

449

What is the name given for a relatively rapid onset of widespread disorganized thought?

Delirium.

450

What condition is most likely present when you assess the patient's posterior chest wall and find increased tactile fremitus?

Pneumonia.

451

In the case of a behavioral emergency, which of the following would be a physiological cause?

Low blood sugar.

452

The primary consideration of the paramedic when treating a victim of acute psychosis is which of the following?

Personal safety.

453

Strong links have been tied to the causes for emotional impairment and mental retardation. Choose the event or situation that is LEAST likely to cause these two conditions to develop.

Sudden degeneration of the cerebellum portion of the brain.

454

All of the following patients should eventually receive a complete secondary assessment (detailed physical exam) if time allows. With which patient would delaying the complete secondary assessment be the MOST appropriate action?

A female victim of sexual assault.

455

EMS providers find a 6-year-old girl at a homeless shelter with a fever and chills. The patient also complains of difficulty breathing and a persisten cough. Which sign or symptom would you LEAST likely expect to find if you believed the patient had pneumonia?

Subcutaneous emphysema.

456

What broad term is applied to a sudden onset, severe abnormal condition of the mind during which hallucinations, delusions, or violence may occur?

Acute psychosis.

457

You are called to care for a 16-year-old Down's syndrome patient. She is very anxious because of her difficuty breathing but she refuses transport to the hospital for treatment. What special consideerations need to be used with this patient?

The crew will need to allow for extra time to obtain a history while assessing the patient.

458

Upon arriving at the scene of a patient experiencing a seizure, you are told by the family that the adult patient has never had a seizure before. There is no evidence of hypoxia. Which of the following conditions should you most likely suspect?

Alcoholism.

459

Rescuers are reviewing infectious disease procedures within the EMS system. Lately there has been a large number of calls related to geriatric patients dying of respiratory failure. A physician suggests it is secondary to bacterial pneumonia. What do you suspect is the leading mechanism for the geriatric population dying from this disease?

Patients over 65 have impaired ability to clear germs from their airways.

460

How many rescuers is the preferred number to take down a combative patient?

5.

461

Which of the following is the MOST important consideration regarding verbal techniques useful in managing the emotionaly disturbed patient?

Ask open-ended questions and listen to the answers.

462

Nationally all EMS workers are REQUIRED by law to report in writing what information to the proper authorities every time?

Suspected child abuse and/or neglect.

463

At a homeless shelter, your diabetic, 67-year-old male has an altered level of consciousness.  He responds only to painful stimulus, has gasping respirations and cool, purpuric skin. Central pulses are weak and rapid. Peripheral pulses are unpalpable. Ill for several days with fever, headache, lethargy, and a stiff neck, you suspect:

Menigococcal Meningitis.

464

Which of the following statements is true regarding the assessment and eventual treatment of acute psychosis patient?

Many treatable medical conditions may result in acute psychosis.

465

Which of the following would be the most consistent with signs and symptoms of Hepatitis C?

Dark urine, abdominal pain, jaundice, and fatigue.

466

Which of the following typically causes pneumonia?

A weakness in host defenses, the presence of a particularly virulent organism, or the introduction of a large amount of an invading organism.

467

A person with delusions of paranoia would be classified as having:

Scizophrenia.

468

During treatment of an infant experiencing a high fever related to sepsis, rescuers must be alert for which common complication during transport?

Hypoglycemic reaction.

469

Which of the following would suggest to you that a patient is at an increased risk of suicide?

Sudden improvement from depression.

470

A 48-year-old male patient appears alert, but is disoriented to person, place, time and events. You observe moist skin and tremors without shivering. He asks if you can see the spiders on his skin. Which of the following should you suspect is the MOST likely cause of his signs and symptoms?

Alcoholic delirium or withdrawl.

471

You are treating a behavioral emergent patient who is taking lithium. Which of the following disorders would you suspect this patient suffers from?

Bipolar.

472

Your 21-year-old male patient reports his suspicion that he may have Chlamydia. This is based on the fact that he had unprotected sexual relations one week ago with a partner who is known to have the disease. What assessment finding might you discover upon further history and physical examination?

Fever, malaise, painful urination, and testicular swelling.

473

Which of the following would MOST likely be seen in the earlier stages of Lyme disease?

Painless, flat, red lesions.

474

During treatment of a female patient who has been sexually assaulted by a stranger, a male rescuer attempts to demonstrate caring sensitivity toward his patient.  How BEST should this be done if the patient is going to be transported to an emergency room?

Assure that a female attendant will be present during assessment and transport.

475

Which of the following would be proper for a patient you suspect has a communicable disease?

Isolate the patient and protect the rescuer immediately, then continue questioning.

476

Why is assessment repeated so frequently on patients with signs and symptoms of a behavioral problem?

Patients can quickly change from one behavior to another.

477

When communicating information to other healthcare providers about a patient with a gynecologic complaint it is important to remain professional by:

Using proper medical terms.

478

Which of the following SAMPLE answers would indicate a neonate is MOST likely dehydrated related to diarrhea?

Mother mentioning the infant has not urinated today.

479

What should you do FIRST if the amniotic sac is still intact as the head is delivered?

Use your fingers to puncture the sac.

480

You are caring for a pregnant patient that states she is about to deliver. She reports that she has had prenatal care and a history of gestational diabetes.  This history leads you to suspect:

The newborn will be larger than normal.

481

Intercostal muscle retraction after suctioning and drying.

482

When is it appropriate to place a gloved hand into the birth canal during an abnormal delivery?

Prolapsed cord.

483

Your neighbor calls you at home to ask a question about her newborn baby who is less than 5 days old and she, as a new parent, is worried her baby is sick.  Which of the following conditions would be abnormal if the child has been healthy up to now?

Before, during, and after feeding, the baby seems to vomit up traces of blood.

484

ALS providers are reassessing a newborn patient after 20 seconds of bag-valve-mask ventilations.  A crew member suggests that BVM ventilations should be stopped. What do you sspect he has witnessed to suggest ventilations can be discontinued?

The newborn begins screaming and crying vigorously.

485

Which of the following conditions is most likely to present with pelvic pain, fever and chills?

Pelvic inflammatory disease.

486

Which of the following time frames BEST defines the neonate?

Birth to 1 month of age.

487

When caring for a newborn, the infant begins to have excessive salivation and chewing motions. This movement is most consistent with:

Subtle seizures.

488

A common cause of vaginal discomfort, odorous discharge and vaginal itching is:

Bacterial vaginosis.

489

During transport of a newborn, the patient's heart rate slows to 56 per minute. Capillary refill is delayed and the patient is increasingly lethargic. Which one of the following should you do FIRST?

Begin assisting ventilations.

490

You and your partnet are preparing to deliver a baby. The patient tells you this is her first pregnancy and she is frightened. Choose the BEST reason for asking the patient if she wants you to contact a relative or friend to be with her.

Calling a friend or relative could comfort the patient.

491

You are dispatched to a college dormitory for a 20-year-old female who has been the vistim of sexual assault.  The scene is safe and police are on their way. The patient says that she has changed her clothing and wants to take a shower before she is transported to the hospital.  What would your MOST appropriate recommendation be?

Discourage her from taking a shower and place her removed clothing in a paper bag.

492

Which description of vomiting would be the MOST dangerous if found while assessing a newly delivered infant.

Any ejection or forceful type of vomiting after delivery.

493

What is the name of the stage of delivery when the baby is delivered?

Expulsion.

494

Bradycardia in the neonate is MOST often a sign of which of the following?

Hypoxia.

495

You have assisted in a home delivery. You are waiting for the placenta to deliver before transport. The mother is bleeding but uterine contraction has yet to occur. What is the next action?

Massage the uterus until you feel the uterus contract.

496

A full-term infant is unresponsive, limp, and barely breathing. His condition is unimproved despite one minute of BVM ventilations and oxygen. Which of the following treatments would be the MOST appropriate if the rescuers suspect long-term maternal narcotic intoxication and observe symptomatic bradycardia?

Perform additional ventilations and intubate the patient.

497

In the pregnant female, what is the name of the organ that holds the fetus?

Uterus.

498

You have just placed a female who is 9-months-pregnant on a back board. The patient was stable prior to this and was complaining of back pain. She is now unresponsive, iss breathing rapidly, and has a weak, rapid pulse. Which of the following is your MOST immediate priority?

Tilt the board onto the patient's left side.

499

Which of the following would be abnormal for a pregnant female in her last trimester of pregnancy?

An elevated blood pressure.

500

Which of the following patients is stable and may be transported to the hospital non-emergency?

23-year-old female experiencing severe labor pains.

501

Your patient reports that she had a miscarriage two days ago. She now has a condition that is charaacterized by bloody, foul-smelling vaginal discharge, moderate abdominal pain, and fever that started two hours ago.  What is most likely the problem?

Endometritis.

502

which of the following time frames best defines the newborn?

1 day to 1 month old.

503

While caring for a newborn, the infant begins to have excessive salivation and chewing motions. This movement is most consistent with:

Subtle seizures.

504

A common cause of vaginal discomfort, odorous discharge and vaginal itching is:

Bacterial vaginosis

505

During transport of a newborn, the patient's heart slows to 56 per minute. Capillary refill is delayed and the patient is increasingly lethargic. Which of the following should you do first?

Begin assisting ventilations.

506

Which of the following organs of a neonate is MOST seriously affected by sudden drops in glucose levels in the blood stream?

Brain

507

The BEST explanation of a bloody show during pregnancy is:

A small mixture of blood and mucous that precedes delivery.

508

The female urinary system includes which organ?

The urethra.

509

You are called to transport a 24-year-old female G2P1 9 weeks gestation with no other previous medical history. On arrival, you note that the patient has been vomiting clear emesis and appears weak and pale. Her husband tell you she has been vomiting off and on since becoming pregnant, but uncontrolably for several days and cannot keep food or water down. You note that your patient has poor skin turgor and capillary refill of 3 seconds. Your partner tells you her vitals are: Blood pressure 94/72, Pulse 100, Respiration 22/min. She is alert and well oriented. Which of the listed treatment plans would you put into action?

Oxygen, IVLactated Ringer's solution, Cardiac monitor, BGL, and transport.

510

Rescuers are deciding whether chest compressions should be continued or stopped during resuscitation of a newborn. Which finding would BEST suggest chest compressions should be continued if the baby remains unresponsive?

The newborn has a pulse less than 60.

511

You are caring for a one-week-old infant. The mother states the child choked on formula.  You provided oropharyngeal suction and now must complete an assessment. What is the most appropriate action during the assessment of this infant?

Ask the parents if they would like to hold their baby during the examination.

512

A newborn infant has hadd a fever for three hours prior to your arrival at the home. What is your plan of action during transport?

Ensuring adequate airway patency.

513

the term gravidity referes to which of the following?

The number of times a woman has been pregnant.

514

You are assessing a pregnant female who is about to give birth and you observe a prolapsed cord. Which of the following is the correct procedure for this situation?

Place your gloved hand into the vagina and lift the head up until the cord begins pulsating.

515

Paramedics are transporting a mother nd newly born baby following a anormal delivery. According to the baby's doctor, the newborn is at risk of a physical abnormality that will cause unexpected vomiting. What is the BEST treatment for this patient if the transport will last 10-15 minutes and the neonate is alert?

Position the newborn on his side and prepare for additional suctioning.

516

Which of the following indicated an immediate need for chest compressions in a newborn?

Heart rate less than 60.

517

You are working to resuscitate a newborn infant. You have already intubated the airway and are delivering 100% oxygen. There is no response to the first IV bolus dose of epinephrine. What is the most likely cause of the infant remaining lethargic and bradycardic?

Hypothermia.

518

Your young female patient suggests she might be pregnant.  She complains of severe abdominal pain under the left diaphragm.Your most approriate action is to:

Administering high-concentration oxygen.

519

Preceding the intubation attempt of a newly born baby, the basic EMT reports that ventilation have become less effective. They suggest ventilations are no longer causing chest rise because a relief valve is popping off. What is the BEST advice for the paramedic to follow?

Disable the pop-off valve on the bag-valve-mask.

520

You are dispatched to the residence of a 20-year-old female who appears very ill. She indicates that she has had a fever and foul-smelling vaginal discharge, and she reports severe pain upon palpitation of the lower abdomen. Her history indicates that she has been diagnosed with gonorrhea and chlamydia. Which of the following is MOST likely the cause of the abdominal discomfort?

Pelvic inflamatory disease.

521

The head of the baby has just delivered. Which of the following should you do NEXT?

Suction the mouth and nose, if secretions are present.

522

In regards to the assessment of the female genitalia, what statement is true?

The mucosa becomes thin, pale and dry in the elderly female.

523

Which of the following is your greatest concern regarding a newborn who was born prematurely?

Keeping the infant warm.

524

During delivery of a premature baby, you observe significant meconium staining. Identify the BEST reason for assertive suctioning of the trachea before stimulating the newborn.

Reduces the potential of atelectasis and pneumothorax.

525

Which of the following factors has been shown to produce low birth weight newborns?

Maternal narcotic use.

526

Which statement is most TRUE regarding cardiac arrest in the newborn population?

The most common cause of cardiac arrest in this population is hypoxia, not an arrhythmia.

527

When should you cut the umbilical cord?

After pulsations have stopped and after you have clamped the cord.

528

Your 15-day-old infant patiebt is now hypotensive following chronic diarrhea. Which of the following treatments would be contraindicated?

IV administration of a vasopressor medication.

529

You have a conscious female patient who has been sexually assaulted. Which of the following is MOST correct regarding the assessment and management of this patient?

Place bloody articles in paper bags.

530

Which of the following is CONTRAINDICATED in the management of an ectopic pregnancy case?

Packing the vagina with sterile gauze.

531

If needed, when should a newborn first be suctioned?

As soon as the newborn's head delivers.

532

ALS responders are transporting a newborn who experienced a lengthy delivery due to her large body size. Which of the following treatments will benefit this neonate the MOST  if there is evidence of a preceding hypoxic event and the infant presents as depressed?

Intubation.

533

You have already placed oxygen by non-rebreather on your pregnant patient that is at the end of her second trimester. During transport she begins tonic-clonic seizures. Which of the following should you do NEXT?

Administer 2.0-4.0 grams magnesium sulfate IV push.

534

Which of the following would properly represent a female who has been pregnant three times, gve birth twice, and had one spontaneous abortion?

G3, P2, AB1.

535

Which of the following is your biggest concern regarding the delivery of twins?

You should pay special attention to keeping the infants warm.

536

What is the name for severe discomfort during the menstrual period?

Dysmenorrhea.

537

When applying suction with a meconium aspirator, the setting for the suction should always be at or less than which of the following?

100 cm/H20.

538

While assessing the female genitalia, you assess a white, curd-like discharge with no odor. Which of the following should you MOST likely suspect?

Candidiasis.

539

Which of the following is an antepartum factor presenting potential complications in newborns?

Post-term gestation.

540

Which of the following is the MOST common cause of non-traumatic abdominal pain in the female?

Pelvic inflammatory disease.

541

A mother has recently delivered an infant who is breathing with increased effort and a weak crying. The rescuer's assessment reveals cyanosis of the trunk and limbs. What is the MOST common and MOST immediate complication following unresolved central cyanosis?

Cardiac arrest.

542

Which of the following is/are the FIRST step/steps in resuscitation of the newborn?

Drying, warming, and tactile stimulation.

543

As you are examining an expectant patient, you discover that the infant's legs and buttocks are already delivered. What is the name for this type of presentation?

Breech.

544

What actions should you take to prepare for an imminent delivery? This pregnant female is full term and this is her third child.

Have the patient remove her pants and cover her legs with a sheet.

545

You have a newborn who is blue in the hand but pink centrally, pulse is 80, respirations are 10, movement is weak, and he has a slight facial grimace when you flick the feet. What would the APGAR score be for this newborn?

5.

546

EMS has just delivered a newborn baby in the back of a minivan that ran off a slippery road. The baby remains unresponsive, cold after drying and stimulating, and showing signs of cyanosis. Which of the following conditions is the MOST likely to cause the child to remain apneic if uncorrected?

Hypothermia.

547

Which of the following neonatal patient conditions should be considered "at risk" for experiencing apnea?

Being premature.

548

You are called to transport a 24-year-old female G2P1 - 9 weeks gestation with no other previous medical history. On arrival, you note that the patient has been vomiting off and on since becoming pregnant, but for several days now it has become uncontrollable and she cannot keep food or water down. You note that your patient has poor skin turgor and a capillary refill of 3 seconds.Your partner tells you her vitals are: Blood pressure - 94/72, Pulse - 100, Respirations - 22.  With the information provided, you suspect your patiet is suffering from which one of the listed disorders?

Dehydration.

549

You have been called to assist with a delivery. Upon your arrival, you discover the first responders have just delivered a newborn. Which of the following should be your highest priority regarding the management of this newborn?

Clear the airway, if necessary.

550

You are called to the scene of a trauma involving  a female who is 9 months pregnant and in labor.  She was cut in her radial artery and you have controlled the bleeding. Her pulse is 98, respirations are 26 and shallow, blood pressure is 100/70, her skin is slightly pale, and she is anxious. Which of the following is your primary concern?

Providing her with high-concentration oxygen.

551

Meconium staining occurs in approximate what percentage of deliveries?

5-25%

552

During assessment of a neonate who is acting "strangely" according to the parents, your partner suggests checking a blood glucose level as soon as possible. What do you suspect your partner found thart suggests an early onset of hypoglycemia?

Eye rolling and twitching of the patient's arms.

553

A mother has just delivered a healthy, very active baby girl on a city bus prior to EMS arrival. Upon evaluation of the baby and mom, it appears the baby has stopped breathing and has no pulse.  What situation likely cause the cardiac arrest to occur?

Airway obstruction.

554

A baby has been born at a safe house for battered women. You arrive to find the infant seizing. Which condition is most likely responsible for the seizure?

Hypoxia.

555

You are treating a five-year-old female who is very dehydrated. The patient's mother tells you the girl has been sick for several days and is now unable to be awakened. Which of the following findings would indicate the patient is suffering from poor perfusion?

Delayed capillary refill time.

556

Which of the following situations would be a reportable offense by law if found by providers when treating a child?

Cigarette burns to the forearms.

557

When should an EMS provider consider a patient at highest risk for fractures related to osteoporosis complications?

Age 72.

558

EMS providers are having difficulty visualizing the vocal cords of a five-year-old female during intubation. Which of the following techniques would improve intubation success?

Performing posterior/superior pressure on the larynx/cricoid membrane.

559

Which of the following is a CONTRAINDICATION for an open cricothyrotomy but is allowable for needle cricothyrotomy? 

Patients under the age of 12.

560

EMS personnel are treating a 5-year-old with epiglottitis complications. The child is having difficuty breathing, is easily agitated, and is starting to drool. His pulse oximetry reading is normal. What advice would you offer during trnsport if you were in charge?

Secure child in car seat and transport with mother along in the back.

561

ALS providers are resuscitating a 2-year-old female found in cardiac arrent by her babysitter. The patient's original EKG was a narrow-complex rhythm described as PEA. Which of the following facts would help determine the cause for this arrhythmia?

The parents report the child has been sick for several days.

562

EMS providers respond to a child experiencing trouble breathing and difficulty swallowing. According to the parents, the patient went to sleep without complain and woke up with severe dyspnea. Which finding would suggest a higher risk of epiglottitis?

563

Parents of a 5-year-old tell rescuers they witnessed a grand mal seizure lasting a minute or so prior to the rescuer's arrival. What statement is MOST correct regarding this event?

It will be important to identify possible historical reasons for the seizure activity.

564

Incontinence is the medical term describing the:

Inability to retain urine or feces.

565

Respiratory distress in the pedriatric patient is BEST  defined as which of the following?

The mildest form of respiratory impairment.

566

Which of the following pulse ranges would you expect to find in a newborn?

120-160.

567

Rescuers are transporting a 1 1/2-year-old child whose parents described as suddently becoming short of breath after crawling around the kitchen floor. The child seems to have labored breathing and presents with stridor on inspiration. What is the FIRST suspicion the rescuers should have?

Foreing body airway obstruction.

568

EMS providers are assessing a 12-year-old male with a wide-complex tachycardia on the EKG monitor. Which of the following signs or symptoms would reveal to the rescuers that the patient is clearly unstableand requires immediate cardioversion?

An impaired level of consciousness.

569

Confronted with a pediatric patient with pertussis, how would  you protect your partner and yourself?

N-95 respiratory mask for rescuers and a surgical mask for the patient along with supplemental oxygen.

570

EMS reports to Paramedic providers that their pediatric patient has been sick for a day or two, and they suspect she has complications from croup. During the assessment of the child, what would be an expected sign?

Low-grade fever.

571

Approximately how many children in the United States are killed every year from trauma?

25,000.

572

Which of the following treatments is often omitted when properly treating a geriatric patient with a history of severe osteoarthritis?

Long backboard.

573

A single rescuer is managing a complete airway obstruction on a 3-year-old conscious patient. He suspects the patient is choking on a partially chewed piece of food. After performing 5 abdominal thrusts the patient becomes unresponsive. The provider should NEXT:

Begin chest compressions at 100/min.

574

Which of the following population age groups is at the highest risk of developing decubitus ulcers?

75-85-year-olds.

575

Which of the following EKG descriptions will you MOST likely find in the pediatric population?

Bradycardias.

576

EMS is dispatched to a child struck by a car while riding a bicycle in the roadway. The child has a possible head injury and a deformed right arm. During immobilization, the patient's parents arrive on scene. Rescuers should expect which of the following as a normal reaction?

Anxiety about whether their child is getting the best treatment possible.

577

The skin of an elderly female is prone to tears and bruises due to a lack of which of the following in the tissue.

Collagen.

578

Identify a common finding in geriatric patients who are struggling with an alcohol addiction.

Hostility when questioned about alcohol consumption.

579

Which of the following statements is TRUE regarding drug and alxohol use in the geriatric population?

Use of even small amounts of alcohol is more likely to cause interference with drug therapy than for younger adults.

580

During the first minutes of pediatric resuscitation, there should be no debating which treatment standard below?

Accurate, basic life support skills are essential to the positive responses to ALS.

581

You are transporting a 3-year-old female weighing approximately 45 pounds who was recently struck by a vehicle. The patient is compensating, but she needs fluid replacement. Which of the following is the MOST correct  in terms of managing this patient?

400 ml.

582

During emergency treatment of a pedriatric trauma patient, the patient´s heart rate begins to drop precipitously. What do you suspect has happened to cause this sudden change?

The rescuers were attempting to insert an endotracheal tube.

583

You are describing how a new EMS provider should deal with subtle differences between the young patient and the old. Identify the statement that is MOST accurate regarding patient assessment of these two categories of patients.

Geriatric patients require you to differentiate chronic problems from acute concerns.

 

584

While transporting a 5-year-old with a partial foreign airway obstruction, he begins coughing forcefully and ends up with a complete airway obstruction. What has MOST likely occurred if the patient suddenly turns blue?

The foreign body has shifted downward to a narrowing.

585

At 0200 hrs, ALS is dispatcched to assist a basic life support ambulance for a "sick child". Upon arrival, they find a 5-year-old child who has complications that need assessment of resolution. Which of the following is beyond the scope of reasonable EMS care?

Determining the patency of a ventricular shunt device.

586

A babysitter explains she witnessed a child seizing and called 911 a minute after it started. What is the MOST common cause for a child to have a convulsion?

High temperature.

587

ALS providers are preparing to transport a postictal 9-year-old following a grand mal seizure. What transport recommendation would you suggest the crew follow to properly care for this child?

Allow the patient's mother to ride in the back compartment with the child.

588

You are called to treat an unresponsive pediatric patient who has been stung by a bee and how has tachycardia, tachypnea, wheezing, hives, edema, and hypotension. Which of the following is your MOST important intervention regarding the treatment of this patient?

Administration of epinephrine.

589

Which of the following BEST defines fibrosis?

The formation of fiberlike connective tissue in an organ.

590

Which situation or finding would trigger you to suspect abuse of a child?

Patient tells you she has unexplained bleeding from her genitals.

591

During a social discussion at work regarding a new independent living center opening in your agency's response area, a paramedic references 4 points regarding the geriatric community. What statement is TRUE?

In the coming years, more than 65 percent of EMS calls will be for geriatric patients.

592

You are treating a 5-year-old patient in cardiac arrest. The monitor shows ventricular fibrillation. Which of the following would be the appropriate energy setting for the SECOND shock if the patient weighs 20 kg?

80 joules.

593

You are called to the scene of a young child with a surgical shunt.. The child is very lethargic and listless. Which of the following is MOST likely occurring?

The shunt has most likely failed.

594

You are caring for a 5-year-old male with lethargy and a fever of 103 degrees Fahrenheit. Lungs sounds are clear, but the child complained of a very sore throat prior to going to bed.  During transport, you observe copious secretions. Which of the following do you suspect?

Epiglottitis.

595

Which of the following statements is TRUE regarding the anatomy of a pediatric patient?

The anterior fontanel could remain open until 18 months old.

596

What is the most appropriate medication for a 4-year-old child with severe bradycardia and hypotension?

Epinephrine 0.01 mg/kg.

597

EMS rescuers are transporting a pediatric patient who has been resuscitated after a brief period of cardiac arrest. 

Excessive acid accumulation the the blood stream.

598

For which of the following reasons is shock a more unusual occurrence in pediatric versus adult patients?

The pediatric peripheral blood vessels constrict more efficiently.

599

Which of the following is true regarding changes in body systems related to aging?

Decrease in stroke volume.

600

During a long-distance transfer of a 10-year-old patient struggling  to breathe, you find him becoming quieter and acting tired. He seems like he is beginning to go to sleep. What should the provided think of this behavior?

His condition is worsening and this could be a grave sign.

601

Following your assessment of a very sick infant you need to determine if the provlem is respiratory failure or hypoperfusion. With hypoperfusion, the infant will most likely have a:

Lack of tears when crying.

602

An ambulance crew is evaluating an 81-year old male who, according to relatives, seems depressed, lazy, and very confused over the last couple of weeks. Which description MOST likely suggests an acute endocrine problem and is an abnormal finding for a patient in this age group?

Congestive heart failure.

603

In the pediatric population , which of the following is a common cause of shock?

Vomiting and diarrhea.

604

Which of the following is an accurate statement regarding the elderly and their living environments?

The majority of those over 85 living independently are women.

605

Modes of disease transmission for German measles (Rubella) include:

Respiratory droplets from coughing.

606

Which of the following is a common physiological change associated with aging.

Diminished immune response leading to increased infection.

607

Regarding falls, which of the following anatomical regions is most ofter injured in pediatric patients?

Head.

608

Which of the following is a true statement regarding the differences between the adult and pediatric airway?

The child's trachea is softer and more flexible than an adult's.

609

While treating a 1-year-old for severe respiratory failure, you find him semi-responsive with snoring-type breathing at 14 breaths per minute. What is your highest priority after you have repositioned the patient's head?

Bag-valve-mask assistance.

610

Which patient is at a higher risk for choking from a foreign body airway obstruction?

Three-year-old.

611

You have a 2-month-old who weighs 4 kg and is bradycardic. Which of the following is the correct dose and type of medication?

0.04 mg of epinephrine.

612

Which of the following alternative advanced airways can be used in pediatric patient?

Laryngeal mask airway.

613

You have just completed the transport and delivery of a 6-year-old patient you suspect sustained the injuries as a result of child abuse. Your partner disagrees with your assessment. What sould you do?

Notify local law enforcement or child protective services of your suspicions.

614

You are called to the home of a six-month male infant with an irregular breathing pattern and poor feeding for the past couple of days. Upon your arrival, you find the small patient in his mother's arms. The mother is attempting to feed the child from a bottle. Primary (Initial) assessment reveals lethargy, hyperpnea, and pallor. Mother reports a two-day history of poor feeding, vomiting, and diarrhea. How might this child have contracted the illness you have identified based upon the history and physical examination?

The child's daycare staff having poor food handling, diaper dhandling or toy cleaning practices.

615

EMS responders are on the scene of a 3-year-old with a central line that they suspect is malfunctioning. Which treatment is MOST prudent for this patient?

Assure the absence of obvious hemorrhage and transport.

616

Which of the following is MOST likely to occur if you place an oropharyngeal airway that is too small in a pediatric patient? 

It can obstruct the airway.

617

A Glasgow coma scale of 10 for a pediatric patient would repreent which of the following?

Moderate head injury.

618

Which unresponsive patient(s) will MOST likely benefit from a nasogastric tube being inserted by EMS?

Children being ventilated with abdominal distention.

619

After you have confirmed a conscious 6-year-old child has choked on a toy, you assess that the airway is still partially obstructed.  What is the BEST plan if the child is able to cry?

Encourage the patient to cough forcefully.

620

Which past medical history or information about your pediatric patient would help you differentiate and select the child has croup rather than an allergic reaction if the dispatch time was 0200 hrs for trouble breathing and difficulty swallowing?

Onset occurred during the fall or early winter months.

621

Which of the following would be the MOST appropriate size angiocath for a 2-year-old weighing 10 kg and in need of fluid resuscitation?

22 gauge.

622

Which of the following is a typical finding which challenges the physical or emotional well-being of the elderly?

A chroic decline in effective function of body systems.

623

During treatment of a 6-month-old in a suspected SIDS case, EMS rescuers quickly recognize the patient outcome will be death. The infant shows signs of lividity and remains in cardiac arrest after two rounds of emergency resuscitation medication. Which action would you implement NEXT if you were in charge of this call?

Offer the family the opportunity to witness the resuscitation effort and explain the procedures that are being done.

624

Correctly identify the signs and symptoms connected to childhoo mumps.

Increased temperature (over 103 fahrenheit), headache, decreased appetite, and swollen parotid glands.

625

You are dispatched to a child in cardiac arrest and you and your partner decide to initiate CPR. Which of the following is the appropriate compression to ventilation ratio?

15:2.

626

Which of these signs would you expect to see in a pediatric patient who is in compensated shock but would be unexpected in a pediatric patient in decompensated shock?

Normal systolic pressure.

627

You are assessing an 82-year-old female patient with a minor complaint. Which of the following is appropriate?

Use additional physical contact to make up for any hearing and/or vision deficiencies present.

628

Which of the following age groups has a normal respiratory rate of 22 to 34.

3 to 5 years of age.

629

You are assessing a 6-year-old choking victim and determine he is apneic. Your partner has completed 5 abdominal thrusts, the child has become unresponsive, and your partner is unclear on what to do next.  What would you suggest?

Begin compressions and remember to look in the mouth before ventilating.

630

You are assessing a patient experiencing severe chest pain. A blood pressure assessment reveals a difference of greater than 20 mmHg in systolic readings between the left and right arm. Which of the following best explains this difference?

A possible tearing aortic aneurysm.

631

You are treating a patient who has a central venous line in place. Choose the statement that is TRUE regarding this type of catheter.

These catheters are inserted with a sterile technique in a controlled setting.

632

In comparison to nursing home treatment, which statement is true of in-home healthcare?

Home healthcare reduces the cost of rehabilitation and can reduce recovery time.

633

Which of the following patients would most likely require a treatment requiring supplemental sugar?

Unresponsve with a blood sugar of 60.

634

You are called to transport a sick child who has a history of cancer. During secondary assessment you discover a small raised area near the left clavicle about the size of a watch battery. There is no obvious swelling or discoloration to the area. Whata would be the best explanation of this finding?

The object could be an implantable injection device.

635

Nurses request you transport a patient with a vascular access port that is malfunctioning. They suggest the catheter needs to be repaired. Which of the following situations would confirm the staff was most likely correct?

Presence of a 5-centimeter hematoma near the injection site.

636

Which of the following patients is MOST likely to be under assessed?

The system abuser.

637

Which of the following is the MOST common form of cerebral palsy?

Spastic paralysis.

638

In general, a person's ability to cope with his own death is based on many factors. Which of the following is considered an asset for accepting a terminal illness?

Strong spiritual beliefs.

639

A home health care nurse calls EMS to transfer a patient from his home to a long-term care facility across town for admission. The patient is chronically ill; however, he is resistant to leaving his home for a more extensive treatment of diabetes. Which of the following statements MOST accurately describes the situation above?

This is normal; the patient likely has a fear of losing independence or privacy.

640

Regarding hospice-type care, which of the following is true?

Care meets the family's and the patient's needs simultaneously.

641

During transfer of a cancer patient,you identify the patient has a central line for chemotherapy. Which of the following statements is MOST accurate regarding this catheter?

It is typically placed into the subclavian vein near the clavicle.

642

You are assessing the blood sugar of a conscious, adult male patient who has just finished a meal. Which of the following would you expect to find for his glucometer reading given that the patient has no history of diabetes?

130.

643

In the geriatric population, visual impairment can be caused by which of the following?

Long-term hypertension.

644

While working in the high school health clinic, a student questions you regarding what causes people to become obese. Which of the following statements is correct?

Most obese people eat more calories than they use in a day

645

You are called to care for a patient who just returned home following an outpatient procedure. The patient has a central line in place and uses home oxygen. She now has trouble breathing and chest discomfort. What finding would most likely suggest that the patient was overloaded with fluid via the central line?

Distended neck veins and rales throughout lung fields.

646

Whicxh of the following reasons BEST explains why we avoid confrontation with a parent at the scene when we suspect child abuse?

It may upset the parent and therefore the child.

647

Which of the following is the primary reason for continuous 4-Lead ECG monitoring?

To quickly identify negative changes in the patient's rhythm.

648

Which of the following terms indicates a progressive hearing loss that occurs with aging?

Presbycusis.

649

Using measurement of distal pulses and blood pressure, you have watched a patient's pulse fall and his blood pressure rie. Without any other additional information, what key condition are these changes most indicative of in a trauma patient?

Head injury.

650

What is the best defense for the insertion of a central line? The patient is a 75-year-old male who is scheduled to receive aggressive chemotherapy.

by inserting the central line, other complications can be avoided later on.

651

Which of the following indicated a positive tilt test result?

Heart rate increase of 22 bpm and BP decrease of 30 mmHg.

652

When low birth weight infants have an ongoing need for mechanical ventilation, it is most likely due to:

Bronchopulmonary dysplasia.

653

In the home healthcare setting, which is a key component that makes palliative care unique?

The patient has as terminal illness or injury.

654

You are called to a sidewalk where a patient appears to have passed out secondary to excessive alcohol consumption. Which of the following would be the BEST method to determine the actual level of consciousness?

Perform a sternal rub.

655

If an EMS provider was to report what they believed to be obvious neglect, they would MOST likely choose which description below?

A 6-year-old who has not had any prescribed vaccines.

656

Studies have shown which of the following statements is TRUE regarding home health care?

For rehabilitation, home health care is far less expensive than a nursing home.

657

You are monitoring capnometry and it is providing a waveform and a number. Which of these best repreent what you are actually measuring?

The amount of carbon dioxide in the exhaled air.

658

Mr. Jones is a 75-year-old male with cancer that has metastasized from his liver to his bones and lungs.  He is bed-confined and on oxygen 24 hours a day.  EMS is dispatched to his home to assist with suctioning of his tracheostomy.  Which statement MOST likely describes this patient's current situation?

Mr. Jones has likely been determined to have a terminal illness.

659

In which setting is private, for-profit home healthcare service most prevalent?

Urban areas.

660

EMS providers are called to a home for a middle-aged male who has fallen and needs assistance getting up. During examination, you discover the patient has stomach cancer that is terminal. Which of the following statements is TRUE regarding his choice to refuse hospice support if he is alert and oriented to time, place, and date?

The choice to accept or deny treatment is up to him if he is competent.

661

Which of the following terms implies that the patient is unable to speak but can understand what is being said?

Motor aphasia.

662

Which of the following describes the BEST method for treating an uncooperative patient?

Treat the patient as you would want your loved ones treated.

663

When utilizing Lead II of an ECG which electrode is looking where?

The electrode on the left leg is looking up at the right arm.

664

A 75-year-old female is complaining of severe abdominal pain in the lower quadrants. She has a Foley catheter in place and is recovering from his surgery. Urinary output has been diminished for the past 12 hours. What statement is TRUE regarding flushing a Foley catheter to assure patency?

This procedure is relatively harmless and may give relief to your patient.

665

You are called to check on a geriatric patient who has been unseen for several days by the neighbors. You find him in his home disaoriented and mildly hypothermic. Ambient air temperature in the homeis 62 degrees Fahrenheit. Further assessment reveals medication tablets cut in half or thirds. What do you suspect?

The patient has some financial difficulties.

666

Which of these would cause an inaccurate elevated capnometry reading?

A patient who just had a carbonated beverage.

667

How much does a patient's actual weight have to exceed his ideal weight to be considered obese?

20-30%

668

EMS responders often observe conflicts between home health care professionals and the EMS provider. Which of these would represent the largest issue bertween there groups?

Difficulty merging protocols with home health care standards.

669

Identify the situation in which a patient will benefit from acute care in a nursing home rather than home health care.

An obese patient recovering from recent reconstructive hip surgery.

670

Which of the following is an inappropriate term used to describe a patient who often calls EMS for no apparent medical reason?

Frequent flyer.

671

Family has asked you assist them in transferring a patient from a hospital-type bed to a commode. During the transfer, they ask you to clean and redress an open wound on the patient's leg.  You are concerned that your treatment protocol requires transport to the hospital after such care. What suggestion is most practical for this type of request?

Consult medical control for permission to clean and redress the wound as recommended.

672

Which of the following correctly describes why you would obtain a blood pressure by palpation?

The surrounding environment is too loud to hear through your stethoscope.

673

Which of the following descriptions matches a vascular access device found in the home health care setting?

Broviac.

674

You are called to a drinking establishment for a patient who was found unresponsive in the bathroom. The patient smells of alcohol, is breathing rapidly, and is tachycardic and moist. Which of the following should be last on your rule-out diagnosis list?

Alcohol overdose.

675

Which of the following BEST describes the diastolic pressure in a blood pressure reading?

The pressure in the arteries when the heart is at rest.

676

As you prepare to move a patient from her home bedroom, a first responder suggests that you use a stair chair. You feel that the stair chair would unnecessarily delay the patient movement. What should you do?

Ask the first responder why she thinks that device is necessary.

677

With a history of being very weak, a 30-year-old-female patient also has drooping eyelids. She complains of difficulty swallowing and chewing, along with double vision. The patient may be suffering from:

Myasthenia gravis.

678

You are transporting a 48-year-old terminally ill patient with AIDS to a facility that specializes in hospice care. Which of the following treatments or comfort measures may be reasonable accommodated for a patient request during inter-facility transport?

Discontinuing feeding or hydration by machine and/or feeding tube.

679

What does a glucometer measure?

The number of mg/dL of glucose in the blood.

680

You make contact with the first patient, the driver involved in a hed-on MVC. You determine that the patient has a carotid pulse, but no radial pulse and is unresponsive.  The method that should be used to move this patient is a/an:

Rapid extrication procedure.

681

After running an EMS call, the rescuers should restock equipment as soon as possible. What is the BEST reason for doing so?

You may be sent to another call right away.

682

Which of the following two factors are typically taken into account when making ambulance deployment decisions?

Past community responses and projected demographic changes.

683

At the scene of a four-car-mother-vehicle crash, you find one driver in each vehicle. None of the vitims appear to be pinned, so minimal rescue work is needed. As your partner and other EMS personnel begin assessment on these victims, what other action must occur early in this scene management?

360-degree walk around.

684

As the first arriving unit to a crash involving a school bus full of students, you have reported to dispatch what resources are needed. One of the next important responsiblities for the EMT or Paramedic will be to set up:

Incident command.

685

During vehicle decontamination, which solution should you use to clean blood from the ambulance railing?

Bleach and water.

686

During the normal operation of an emergency vehicle on ice or snow roadways, what changes must be made in driving habits?

Increase distance between the vehicles and have your hands on wheel at 9 and 3 o'clock.

687

What driver habit or behavior will have the MOST dangerous side effects while emergency driving?

Use of street drugs or alcohol.

688

You are parking an ambulance a safe distance from the scene of a motor vehicle accident. To avoid carbon monoxide you must be mindful of how close the vehicle exhaust is to the scene, but you must also consider:

Wind direction.

689

Identify which statute will MOST likely seem vague to ems vehicle drivers while in emergency mode.

Speed limits.

690

When inspecting your unit at the beginning of your shift, which piece of equipment should be checked right away?

Oxygen delivery system.

691

Which of the following would BEST protect you in the patient compartment if your vehicle was involved in a motor vehicle colllision?

Using your safety restraint.

692

You are on the scene of a hazardous materials spill when a bystander that has wet clothing and an odd odor approaches you. The patient is having some dizziness and nausea. What shold be your first course of action?

Make him report to the decontamination line for decontamination.

693

Which is the BEST reason the driver of an ambulance starts his vehicle at the beginning of his shift?

To assure the vehicle will be able to go if dispatched to a call.

694

Where, when, and under what conditions do most accidents involving ambulances occur?

At intersections, during the day, and with good road conditions.

695

In the EMS service, what are the risks associated with scheduling  personnel for 24 hour shifts?

Fatigue can interfere with performance and safety.

696

Which of the following would BEST describe gross negligence on the part of the provider?

Failing to check laryngoscope function prior to taking the vehicle out, but marking that you did on the checklist.

697

One method that helps with safely driving an emergency vehicle is to:

Delegate other operational duties.

698

During routine maintenance of your ambulance, you are assuring all of your equipment is in safe working order. Which of the following actions or findings would you consider MOST dangerous?

Finding an oil-based lubricant on the valve of the oxygen regulator.

699

Your vehicle is the first to arrive at an accident scene where fluid appears to be leaking from one of the automobiles. Where should you park your vehicle?

100 feet between the wreckage and uncoming traffic.

700

Which resource is MOST likely sterile and disposable?

Soft suction catherers.

701

In order for an ambulance to use the privileges of emergency mode driving the operator MUST be able to defend which component of the response?

There was true emergency declared.

702

Driving an emergency vehicle at speeds over the posted speed limit will:

Save only a few minutes of travel time.

703

Rescuers are performing a pre-shift inspection of the ambulance and determine the on-board oxygen tank must be changed. After removing the regulator off the old tank and confirming the full tank is oxygen, which of the following steps should be completed next?

Clear any foreign matter from the high pressure valve on top of the tank by quickly opening and closing it.

704

During an EMS run, it is necessary for you to report "on the scene" to the Emergency Medical Dispatcher (EMD). Identify the MOST important reason for doing this.

This information confirms to the EMD that you have arrived at a request for help.

705

The greatest risk of causing a serious crash while driving an emergency vehicle is:

Excessive speed.

706

For safety purposes during a two-person lift or carry, it is vital that you:

Communicate with your partner during the lift.

707

What is the BEST reason an ambulance should request a police escort?

To prevent you from becoming lost.

708

While responding to an emergency call, the driver of an ambulance will encounter the following situations. Select the condition that is MOST predictable and should be planned for ahead of time.

Train traffic that obstructs roadways.

709

The standard that determines how an emergency driver will be critiqued as either "right"  or "wrong" after a crash is BEST known as:

Due regard.

710

During a two-person lift of a patient on a backboard, it is important to:

Lift your legs.

711

What maneuver should be tried before attempting to lift any heavy object?

Push.

712

Steps that need to be taken to prepare a patient for air transport by helicopter are:

Strap down all sheets and blankets and do not use IV poles.

713

Which of the following is the terminology used to describe the highest volume of calls at a given time?

Peak load.

714

What move is used to remove a MVC patient that is stable and primarily seated, but at risk to spinal cord injury?

Short backboard device.

715

Which of the following are the specifications that address ambulance design and safety features?

DOT KKK 1822 Specs.

716

Which of the following statements is TRUE about the equipment that should be brought to the patient's side in cases of life-threatening conditions?

A suction devide is needed.

717

Which of the following basic ambulance designs looks like a standard van?

718

Which of the following ethical principles applies during mass casualty incidents?

Doing the greatest good for the greatest number.

719

As a result of an entrapment, you are only able to see your patient's head and rifht arm. He is showing signs of hypoperfusion, when would your treatment begin?

Immediately after determining scene safety.

720

Under the standard METTAG triage system, a patient with a delayed status would receive which of the following colored tags and numbered priority?

Yellow, priority 2.

721

What is the most dangerous aspect of a radiological dispersion device?

Radioactive airborne particulate.

722

Which of the following would be an excellent indication that you may be entering a scene involving terrorism and/or weapons of mass destruction?

Confirmation of a secondary device.

723

From the patients listed below, which one best meets the criteria for air medical activation?

A patient with a head injury and a Glasgow Coma scale of 8.

724

During a rescue operation, which scenario will most likely deal with augers?

Machinery entrapment.

725

You have responded to a motor vehicle collision involving damage to the front end of the vehicle.  The driver-side airbag has not deployed. Which of the following is one of the preferred steps in dealing with the SRS system to prevent deployment during a rescue?

Disconnect the battery cables and maintain a safe distance from SRS for 3-5 minutes.

726

You are working at an accident scene, which had a prolonged extrication for the one critical victim. A helicopter is en route to transport the patient. As you hear the helicopter in the distance you note there are multiple pieces of plastic and medical trash blowing around the accident scene. What action must be taken before the helicopter is allowed to land?

Landing zone cleared of trash.

727

During extrication of a truck driver trapped in his cab, you see the rescue squad is assembling the extrication tools. What precaution should the EMS provider exercise given this scenario?

Cover the patient with a blanket.

728

Which of the following BEST describes the purpose of having an incident command system suring times of a mass casualty incident?

To control, direct, and coordinate emergency response resources.

729

The National Medical System (NDMS) is:

A section of the U.S. Department of Health and Human Services and is responsible for managing the federal medical response to an emergency or disaster.

730

When working with an aerial apparatus in high-angle rescue, which of the following statements are correct?

A litter belay should be used when transferring to a bucket.

731

Which of the following is the most likely trained and experienced in incident command and would be the best individual to be in command at a multi-jurisdictional mass casualty incident?

Senior fire personnel.

732

Which of the following would be of LEAST concern regarding the assessment of the safety of a confined space prior to entering?

Adequate lighting.

733

You are called to a local warehouse for workiers there that are "feeling sick". There is no one outside to greet you so you decide to use the front entrance. As you are about to exit your unit, you notice a few dead birds in the parking lot. As you mention this to your partner, you see more dead birds. How does this affect your normal emergency response?

Stay in your unit and retreat from the scene until rescue providers arrive.

734

The most appropriate method to remove an unresponsive patient from a vehicle crash were fire is imminent would be to:

Remove the patient as quickly as possible with attention given to c-spine.

735

You approach a motor-vehicle-crash and observe two passengers in the front seat that appear unresponsive. The vehicle hit a guardrail at a high rate of speed. You are able to open the doors to begin assessment on these patients. What action should be taken to assure you are working in a safe environment?

Check for any un-deployed safety devices.

736

You are assisting with the extrication of an unconscious trauma victim trapped under a tractor. What is the EMS provider's biggest responsibility during the extrication phase?

Serving as an advocate for safety.

737

The EMS definition of rescue is:

The act of delivering from danger or imprisonment.

738

Which of the following BEST reflects the primary reason low head dams are considered dangerous.

Recirculating currents.

739

What is one of the major advantages of using rotary wing transport verses fixed wing transport in EMS? Compared to fixed wing transport, rotary wing medical transport?

Is able to respond to emergency scenes.

740

Which of the following type of vehicle stabilization equipment is made from 2x6's of hardwood cut to varying lengths and secured together?

Step chocks.

741

A rapid extrication procedure from a vehicle should be performed on which of the following patients:

An unresponsive patient who smells of alcohol and has a bump on his head.

742

You respond to a MVC where the vehicle is on its roof down in a ditch of a highway median. From the list below, what equipment would be the most useful to stabilize the vehicle?

4x4 wood or other cribbing materials.

743

Disaster Medical Assistance Teams (DMATs) are made up of what types of personnel?

Civiliann medical personnel along with logistical and administrative staff.

744

Which of the following describes the proper method of approaching a helicopter?

Downhill side from the back.

745

Which is true concerning bystanders and victims of a terrorist attack?

They should be guided and protected.

746

You are called to the scene of a single vehicle collision in a residential area. What is your greatest concern for rescuer safety when approaching the vehicle which has struck a utility box?

Electrocution from the electrical feed box.

747

You are involved in a very unusual multiple casualty incident where a plane crash has left 80 victims scattered over a one mile area.  This area involves a housing subdivision with small business locations. During this rescue, you are responsible to comb the area for victims, triage, treat, and transport. You have been at this task for six hours and have found 22 victims with 20 of those being deceased. What important action should you be provided with, if needed?

Stress relief.

748

During rescue situations, which type of glove should be worn by rescue personnel?

Leather.

749

You are involved with a low-angle, hazardous-terrain rescue. What is the preferred packaging device?

Stokes basket stretcher.

750

Which of the following describes the essential elements of scene size-up in order from the highest to the lowest?

Life safety, incident stavilization, property conservation.

751

Which of the following is responsible for obtaining the necessary equipment and supplies to handle a disaster?

Logistics.

752

When an Incident Command System is activated, which position is responsible for communicating with the press?

Public information officer.

753

Which of the following exercises will have the BEST ability to test the preparedness of the entire system without placing any actual patients at risk?

Table top exercise.

754

What purpose does a windshield assessment serve for a crew pulling onto the scene of a mass casualty incident?

Helps the crew form an impression of what is happening from the relative safety of the truck.

755

For the first couple of days following a mass shoothing at a mall you experience nightmares, intrusive thoughts, and increased startle reflex.  These symptoms would:

Be considered normal.

756

You are called to the scene of a car bombing along a parade route during a 4th of July parade. Your first priority is life safety. What is your next priority and what two items are included in that priority?

Incident stabilization: Establishing command and notifying authorities.

757

Which of the following is the greatest common problem facing EMS systems regarding disaster management?

Communication issues.

758

When there are multiple agencies involved in commanding a disaster scene, this type of command is referred to as:

Unified command.

759

Which of the following would be the MOST appropriate to include in a radio report to the hospital when you are involved with a mass casualty incident?

Priority, destination hospital, ETA, transport unit, principal injury.

760

Which of the following is a class of agents that are useful when aerosolized but useless when they hit the ground?

Vomiting agents.

761

Which of the following would BEST prepare an emergency provider to be prepared for multiple casualty incidents and disasters?

Being familiar with the incident command system in his area.

762

Which of the following is true regarding the glass on a vehicle?

Tempered glass is found in the side windows and is most easily broken with a window punch.

763

The safest assumption to make on the scene of a detonated explosive devise is:

There is a secondary device.

764

Which of the following individuals has the greatest likelihood of transferring the disaster scene to the hospital if he fails to do his job properly?

Transportation officer. 

765

You have an incident where you have very limited access to the patient trapped in a vehicle. Which of the following assessments should occur regardless of how trapped the patient is:

Primary assessment.

766

During a Multiple Casualty Incident, which position is emotionally the most difficult for the EMS provider?

Triage officer.

767

When should secondary triage occur during a mass casualty incident?

After moving the patients to the treatment area. 

768

What should you do to assure the safety of bystanders and non-protected workers at the scene of a suspected chlorine gas leak?

Have them move to an area officially identified as the cold zone.

769

What effect would a rainstorm have on a deployed chemical weapon scene?

Disperse the chemical over a larger area.

770

When comparing G agents and VX agents, which agent is more toxic and by how much?

VX is 100-150 times more toxic than G.

771

Which of the following is responsible for obtaining the necessary equipment and supplies to handle a disaster?

Logistics.

772

For the first couple of days following a mass shooting at a mall you experience nightmares, intrusive thoughts,d and increased startle reflex.  These symptoms would:

Be considered normal.

773

The qualification of HAZMAT Operations Level prepares the responder to enter what zone?

Warm zone.

774

Which two chemical agents can cause pulmonary edema?

Blood agents and choking agents.

775

Which emitted radiation particles pose the least amount of hazard to you?

Alpha particles.

776

What purpose does a windshield assessment serve for a crew pulling onto the scene of a mass casualty incident?

Helps the crew form an impression of what is happening from the relative safety of the truck.

777

What should you do to assure the safety of bystanders and non-protected workers at the scene of a suspected chlorine gas leak?

Have them move to an area officially identified as the cold zone.

778

What effect would a rainstorm have on a deployed chemical weapon scene?

Disperse the chemical over a larger area.

779

When comparing G agents and VX agents, which agent is more toxic and by how much?

VX is 100-150 times more toxic than G.

780

A terrorist event has exposed many victims to radiation, You are responsible to triage about 20 people in one of the train cars where a dirty bomb exploded that was underneath the train car. There is minimal damage to the train car.  What would you expect to find with these victims?

Many may have no injuries now but have effects later.

781

The Center for Disease (CDC) categorizes bioterrorism agents according to their.

Ease of being transmitted.

782

A patient has been exposed to a substance that has caused his heart to slow. You have provided the patient with atropine to increase the heart rate. After administering atropine, the patient immediately goes into respiratory arrest. Which of the following terms BEST describes this situation?

Synergistic effect.

783

You are arriving on the scene of a motor vehice collision that involves a chemical truck. Right away you see that there are many non-critical, ambulatory victims. Where should these victims be sent and by what means should they get there?

They should be directed to walk, upwind, upstream or uphill from the scene

784

Which source would provide you the LEAST amount of useful information at the scene of an overturned tanker truck that is leaking some type of clear fluid?

Shipping papers in the cab of the truck.

785

Which of the following best describes a situation that is unstable and at risk of causing additional injuries?

Open incident.

786

You have a chemical leaking at a hazardous materials incident that has a high flash point, high ignition temperature, and extremely low vapor density  The chemical has high water solubility and a low lethal concentration. Which of the following is at the greatest risk?

The unresponsive worker on top of the tank.

787

The most common route of hazardous materials exposure is:

Respiratory inhalation.

788

While working in a "warm zone", which level of PPE should be worn by the rescuer, if the technicians working in the "hot zone" are using level A protection?

Level B protection.

789

Which of these would be the LEAST useful in initially recognizing that a hazardous materials situation exists?

Shipping papers.

790

Nerve agents were originally developed as a/an:

Pesticide.

791

EMS is typically responsible for which of the following at a hazardous materials incident?

Use the placard system to identify the chemical.

792

Which of the following agents will typically cause nausea and vomiting?

Sarin gas.

793

Your patient was immersed in a chemical that is mildly corrosive. A hazardous material specialist has begun washing the victim. From the list below, which statement is most accurate?

The decontamination process has probably been underway for several minutes.

794

Which of the following should be used to decontaminate a patient that has been exposes to a material that is mildly acidic?

Dilution.

795

You are driving your unit to a scene where there has been a chemical exposure. As you arrive many victims approach the ambulance expecting treatment. You know that the fire department and HazMat team will arrive in just a few minutes. To prevent exposure to your partner and yourself, it would be best to communicate with your PA system and:

Stay in your vehicle.

796

When a substance settles to the lowest point on the ground or rises when released in the air, it can best be described as its:

Vapor density.

797

A hazardous substance is transferred from a contaminated person to a non-contaminated person. The non-contaminated person is said to have received a:

Secondary contamination.

798

A patient who has just been brought to the cold zone from a hazardous material incident is having severe difficulty breathing as a result of the exposure. Which of these is the appropriate classification of this situation?

Acute.

799

You are deciding whether to use the fast-break decontamination process or the eight-step decontamination process. What factor affects your decision regarding the choice?

Self-rescued patients.

800

In terms of radiation exposure cases, which of the following types of radiation is a ray, instead of a particle?

Gamma and X-ray radiation.

801

You are involved in a prolonged response to a multiple casualty incident during a winter storm. Which of the following is a measure you should use to keep yourself healthy?

Increase fluid intake for hydration.

802

The maximum concentration of a substance in the air that a person can be exposed to for eight hours a day, forty hours a week, without any adverse effects has been identified. Which statement best describes this finding?

Threshold limit value/time-weighted average.

803

Which of the following is an action you should avoid when treating a chemical agent victim?

Shelter in place to prevent further contamination.

804

Biological agents come in categories A, B,and C. Which category is the most dangerous and which category does Ricin fit in?

Category A/Category B.

805

Which of the following is the MOST important care that can be provided to a patient  with a significant abdominal injury to increase the likelihood of survival?

Rapid transportation to a trauma center.

806

During examination of a geriatric patient who has fallen out of bed to the floor at a nursing home, you collect the following information. Select the finding that would MOST likely suggest elder abuse rather than a legitimate fall?

The caregiver does nto attempt to explain what may have happened.

807

A phobia is an example of a/an:

Anxiety disorder.

808

Which of the choices listed refers to intractable nausea and vomiting, which can result in dehydration that may be experienced by a female patient during her first trimester of pregnancy?

Hyperemesis gravidarum

809

Which of these treatments are unique and a proper recommendation when treating your pediatric patients versus most older pediatric, adult, and geriatric patients?

Placing padding underneath the patient's shoulder blades during spinal immobilization.

810

Along the jogging trail in town, a woman is found sitting on the trail holding her foot. EMS is called to evaluate the patient. The healthy 45-year-old female complains of burning and pain on the bottom or her foot. She has had this pain about four weeks and it is worse in the morning. Today while she was walking, it became so bad she could not put weight on it. Her pain is most likely caused from:

Non-traumatic inflammation.

811

Which of the following newborn conditions will MOST likely benefit from blow-by delivery oxygen early on?

Newborn responding slowly to tactile stimulation.

812

Which of the following sounds is corrected with a head-tilt chin-lift?

Snoring.

813

You arrive at the scene where a child has ingested a bottle of children's chewable vitamins. The mother says she stuck her finder down the child's throat and made him vomit. She says she could see a large number of vitamin material in the vomit. She comments that she no longer feels the child needs to go to the hospital and EMS is no longer needed. What would you advise the mom at this time?

The child should be taken to the emergency department.

814

You are called to treat an inresponsive Alzheimer's patient who has cool and clammy skin and an elevated heart rate.  The blood pressure is slightly elevated, pulse oximetry is 98%, and blood sugar is 60. Which of the following would be the appropriate intervention for this patient?

Initiate an IV and deliver 25 grams of Dextrose.

815

A patient with a pelvic ring fracture and a bilateral closed femur fracture should be predicted to have lost how much blood?

3 liters.

816

Narcan is usefull for reversing the effects of which of the following medication?

Morphine.

817

Which of the following cardiac conduction abnormalities occurs frequently and can be detected with a single-lead monitoring?

AB blocks.

818

Your neurological emergency patient is presenting with arms flexed, fists clenched, and legs extended. This would be an example of what type of posture and injury?

Decorticate with a lesion at or above the upper brainstem.

819

What is the medical name for the area where the pancretic duct and bile duct empty into the duodenum?

Ampulla of Vater.

820

You are attempting to ventilate a potential near-drowning/submersion incident patient who was just removed from the river. You observe lung compliance is poor; however, lung sounds are clear. Which of the following is MOST likely the cause of poor compliance?

Fluid in the tissue of the lungs.

821

A "moon-faced" appearance is associated with which of the following?

Cushing's syndrome.

822

Which of the following answers would correctly identify the signs and symptoms seen with a significant anhydrous ammonia exposure?

Bronchial spasm and laryngeal and pulmonary edema.

823

A person with 3.2 million red blood cells per cubic millimeter would be considered:

Anemic.

824

You have a patient with an impaled object in the cheek, an angulated tibia-fibula, an abdominal evisceration, and an open pneumothorax. Which of the following injuries should you treat FIRST with this patient?

Open pneumothorax.

825

Which of the following causes a decrease in blood pressure in decompensated shock?

A decrease in the return of blood to the heart.

826

A young, adult male has been found to have a foreign object inserted into his penis.. The assessment and treatment of this patient must be handled the same as a:

Sexual assault victim.

827

You are called to treat a diabetic patient with warm, dry skin, hypotension, tachycardia, and normal respirations who is responsive only to painful stimulation. The patient takes an oral hypoglycemic medication, Which of the following would BEST apply to this situation?

HHNK, administer fluids.

828

You are at a high school assessing a female patient who has been splashed in the face and neck with a powerful acid. Which of the following would MOST likely be the patient's primary concern regarding this injury?

Disfigurement.

829

Nurses request you transport a patient with a vascular access port that is malfunctioning. They suggest the catheter needs to be repaired. Which of the following situations would confirm the staff was most likely correct?

Presence of a 5-centimeter hematoma near the injection site.

830

Which of the following would be the BEST to use for a patient experiencing respiratory distress with adequate breathing?

Non-rebreather mask.

831

Identify the rhythm.

Ventricular Tachycardia

832

A patient complaining that the walls are moving in and out would be an example of a disruption in the patient's:

Perception.

833

In the event you are on a roadside rendering care to a trauma victim, which of the following would offer you the greatest protection from other drivers?

Orange or lime green vest.

834

You have assisted a patient in taking his own Nitroglycerin during an attack of severe chest pain. The patient's blood pressure has been normal up to this point. Now the patient complains of having a hot face and a headache. These new symptoms would lead you to believe that the patient:

Is experiencing the side effects of nitroglycerin.

835

Which past medical history or information about your pediatric patient would help you differentiate and select the child has croup rather than an allergic reaction if the dispatch time was 0200 hrs for trouble breathing and difficulty swallowing?

Onset occurred during the fall or early winter months.

836

Visceral pain usually starts in which of the following?

The walls of hollow organs.

837

Which of the following is the MOST common route of entry of toxic substances into the body?

Ingestion.

838

You are assessing a patient who has amputated his right foot in an industrial accident. He asks you how he is doing and you answer, "The people at the hospitl will be able to reattach this." Which of the following would be the MOST appropriate assessment of your statement?

You have provided the patient with a false assurance.

839

Please use this rhythm to answer the followin question. Identify the rhythm shown.

Torsades de Pointes.

840

In which of the following scenarios would you MOST likely expect a patient to have a spinal injury?

A patient with an anterior depressed skull fracture from a strike to the head.

841

You are assessing a patient who received an electrical entrance burn to the right hand and an exit would to the left ankle. You note that the skin is black and charred. What is the depth of this injury?

Full thickness.

842

What medication would be of the most benefit to a patient with a rapidly responding atrial fibrillation?

Calcium channel blocker.

843

You are hunting with a friend in a remote location. Your friend becomes injured and you have no medical equipment with you. Which piece of equipment will be the most difficult to improvise?

Basic airways adjunct.

844

You are called to treat a 56-year-old male with a history of peptic ulcers. The patient is unresponsive, pale, cool, clammy, tachycardic, tachypnic, hypotensive, and vomiting copious amounts of blood. Which of the following is your MOST important immediate intervention?

Airway protection.

845

EMS is called to a park for a middle-aged male acting strangely. Witnesses suspect alcohol ingestion because he is acting socially unacceptably. The patient is hugging strangers and laughing at inappropriate times. All of his actions seem uncoordinated and at times non-purposeful. Which of the following description would BEST explain his behavior, if there was no evidence of alcohol or drug use today?

History of being developmentally disabled.

846

Identify a common complaint from a family member of an EMS worker who works in a rural community.

"He is never home with the family around the holidays".

847

Which of the following is the MOST appropriate intervention for a patient with diabetic ketoacidosis?

Initiate fluid resuscitation.

848

Which of the following injuries would you LEAST likely expect to see with blunt abdominal trauma?

Evisceration.

849

You are called to the scene of an unresponsive 3-year-old. You explain the situation fully to the parents and ask them if you may transport the patient to the nearest hospital. The hospital has no pediatric specialists, but you believe this course of action is in the patient's best interest. Which type of consent have you requested?

Informed consent.

850

You are called to the residence of a 36-year-old female who is alert, is oriented to person only,and whose speech is slurred. Which of the following should be the FIRST on your list for a differential diagnosis?

Hypoglycemia.

851

You are called to assess a 40-year-old male who had crushing chest pain while he was working out. After rest, the pain has diminished, but it is still present.  The patient informs you he has a history of angina and takes one nitro to have relief. Your 3-lead ECG shows sinus tachycardia of 110, ST elevation in Lead, and ST depression in Leads II and III. After two nitro and oxygen the ST segments are normal and the patient is pain free. Which of the following would be the MOST appropriate field impression and treatment?

Unstable angina, myocardial ischemia or infarction; oxygen, aspirin, and transport.

852

An EMS provider failed to recognize a misplaced endotracheal tube, which resulted in a negative outcome for the patient. A new device has just arrived on the market that claims to reduce the likelihood of this occurrence in the future. Which of the following is the MOST important consideration prior to allowing the implementation of this new product??

There must be ample scientific research to support the claim.

853

Which of the following best explains why we avoid rubbing a frostbitten extremity?

Ice crystals within the tissue may cause further injury.

854

Which statement regarding the use of rocuronium is true?

Rocuronium has a more rapid onset than vecuronium.

855

A  patient has been exposed to a substance that has caused his heart to slow. You have provided the patient with atropine to increase the heart rate. After administering atropine, the patient immediately goes into respiratory arrest. Which of the following terms BEST describes this situation?

Synergistic effect.

856

You hare a 26-year-old male who has a chief complain of pain in the lower posterior lateral back that radiates to his genitals. He indicates he has had this pain before. Which of the following would be the BEST way to assess his current condition?

Asking him to compare this pain to the last time he had it.

857

Which of the following BEST explains the pathophysiological reason for a low systolic blood pressure in a patient with a tension pneumothorax?

The increase in intrathoracic pressure decreases the blood return to the heart.

858

What is the name for mid-cycle abdominal pain as a result of ovulation?

Mittelschmerz.

859

The greatest impact a paramedic can make in preventing death from a myocardial event is:

Educating patients on the symptoms of a heart attack.

860

Which type of fracture would you predict to be present if a patient was struck in the femur by a high-velocity projectile?

Comminuted.

861

Which of the following repreents Cushing's reflex?

Increasing blood pressure, decreasing pulse, and irregular respirations.

862

You are present at the scene involving a hazardous materials field. Which of the following describes the greatest limitation?

Complete decontamination is not probable.

863

You are called to intercept an incoming intermediate service, which is transporting a burn patient who has received a superficial burn to the anterior chest and a partial thickness burn to the anterior neck and face from a broken steam pipe. The initial responding crew was able to initiate fluid resuscitation but was unable to place a supraglottic airway as the patient still had a gag reflex. They report ventilations have become increasingly difficult to provide. Which of the following is your greatest concern?

Increased pulmonary edema from the fluid resuscitation.

864

You have a patient who is breathing at 10 times per minute, is unable to walk, has an open airway, and has a delayed capillary refill time. This patient would fit what category of the START Triage System?

Red.

865

You are called to the scene of a 70-year-old female patient complaining of lower left-sided colicky pain. The patient has a low grade fever, nausea, and vomiting, and she called you because she had a bloody bowel movement. She describes the stool as bright red. This patient is MOST likely suffering from:

Diverticulitis.

866

You have one care provided hold the thorax while you flex the elbow, gradually apply traction along the axis of the humerus, and gently rotate the arm externally. This maneuver describes reduction of which of the following shoulder dislocations?

Inferior dislocation.

867

Which of the following represents the correct lidocaine maintenance regimen for a patient in the post resuscitation phase of an arrest?

1.0 to 4.0 mg/min.

868

Pain upon percussion just below the lowest rib by the lumbar spine is called a positive:

Lloyd's sign.

869

As you perform CPR in a home, it becomes obvious that the resuscitation is futile. What advice is critical to remember when preparing the family for the outcome?

Family members may become angry and begin yelling.

870

If needed, when should a newborn first be suctioned?

As soon as the newborn's head delivers.

871

With a dpatient in hemorrhagic shock, the goal of fluid resuscitation is to:

Maintain preload.

872

Rescuers are treating a patient who is having a severe allergic reaction. You are unable to ventilate effectively with a bag-valve-mask. Which of the following techniques would be the MOST effective?

Switching ventilations to a pocket mask with supplemental oxygen.

873

During examination of a male patient with back and jaw pain, you discover the new onset of an irregular heart beat. Select the statement that BEST describes your findings?

The patient is at risk of going into cardiac arrest and he may require CPR.

874

You have a patient with a helmet and shoulder pads on. Which of the following is true regarding the management of this patient?

You should hold the skull and do not let the head drop if removing the helmet.

875

During your assessment of a patient, you find a shunt in his lower arm. The patient states he had the shunt placed last week and only had dialysis once. His complaint today is that he doesn't feel well. He had a fever and nausea with redness and soreness around the shunt. Based on this information, you believe the problem to be:

Infection.

876

Which of the following patients would benefit the MOST from an advanced airway?

An unresponsive adult with no gag reflex.

877

What broad term is applied to a suddent onset, severe abnormal condition of the mind during which hallucinations, delusions, or violence may occur?

Acute psychosis.

878

You are at the scene of a medical emergency. You discover this patient has a very serious communicable disease and you want to inform the hospital staff in the most secure way you can. Which of the following would best meet that need?

Over a standard telephone landline.

879

Which of the following would describe an attibute for increasing effectiveness and efficiency in verbal communication?

Being genuine, sincere, and honest.

880

Using the HELP self-rescue method involves which of the following?

Floating with your head out of water and your body in a fetal tuck.

881

You are assessing a pregnant female who is about to give birth and you observe a prolapsed cord. Which of the following is the correct procedure for this situation?

Place your gloved hand into the vagina and lift the head up until the cord begins pulsating.

882

You are called to treat a patient who has been exposed to radiation and complained of a burning sensation within minutes of exposure. He is also complaining of nausea and vomiting. Which of the following is your MOST important treatment consideration after the patient has been decontaminated?

Prompt transport for medical attention.

883

EMS is called to the home of a 78-year-old female complaining of severe dizziness. She is unable to stand without assistance and her daughter is very concerned for her well-being. Which of the following assessments would MOST likely reveal significant peripheral vascular disease history?

Carotid bruits.

884

In a burn injury, where would you expect the greatest damage to occur to localized tissue?

Zone of coagulation.

885

From the statements below, what are the primary factors that influence the heat stress on the hazardous material team member?

Temperature and humidity.

886

In rhabdomyolysis, which of the following released byproducts presents the greatest risk of damage to the kidneys?

Myoglobin.

887

You are called to treat a patient with a suspected narcotic overdose. You should be alert for which of the following?

Respiratory depression.

888

Which of the following situations poses the greatest risk factor for suicide?

Depression.

889

In which of the following situations would you LEAST likely initiate resuscitative measures?

An 18-year-old patient found unresponsive with dependent lividity.

890

You are called to treat a patient who has been exposed to radiation and complained of a burning sensation within minutes of exposure. He is also complaining of nausea and vomiting. Based on the above symptoms, which of the following whole body exposure doses would you predict the patient experienced?

600-1,000 RAD.

891

Which of these skin assessment findings would be the MOST consistent with cardiac compromise?

Mottled.

892

Which of the following would BEST prepare an emergency provider to be prepared for multiple casualty incidents and disasters.

Being familiar with the incident command system in his area.

893

Which of the following thoracic injuries is associated with paradoxical movement?

Flail chest.

894

Which of the following best describes "Scope of Practice"? You are allowed to provide any treatment you are:

Licensed, authorized, and trained to do.

895

You are evaluating a patient who lives in a nursing home and is acting abnormally. She has a history of diabetes and you are unclear whether the patient's sugar is low or high. What is the MOST appropriate reason for giving instant glucose?

The benefits of giving sugar outweigh the consequences of it.

896

The most fundamental pathophysiology of diabetic ketoacidosis is which of the following?

Too little insulin.

897

Which of the following is the correct medical terminology for one sided weakness?

Hemiparesis.

898

A suicidal overdose patient is threatening to take additional medication if given the chance. The patient's vital signs are stable and there is no obvious injury on exam. What should you as a rescuer do NEXT?

Quietly ask your partner to prepare the restraint devices.

899

You have a conscious patient who has received a penetrating injury to the lumbar region. Which of the following signs or symptoms would you MOST likely expect to see?

 

Grey-Turner's sign.

900

Your patient is breathing at 22 times per minute, his pulse is 120, BP is 80/60 and he is in a tremendous amount of pain from a fractured femur. You have minimal access as the patient is trapped in the vehicle. Which of the following would be the preferred method of addressing this patient's pain?

Distract the patient by talking.

901

During a quality assurance review of EMS run forms, there is evidence that personnel failed to folow the standard of care properly. Which statement is TRUE regarding the standard of care and this scenario?

Employees should use protocols to help identify local standards of care for their community.

902

During a call you are spit on by the patient, who is acting intoxicated. The patient is uncooperative and using profanity while yelling at you. There is no risk of harm to you or the team. What should you do when the police arrive on the scene?

Have everyone apply face protection and continue patient treatment.

903

When should you cut the umbilical cord?

After pulsations have stopped and after you have clamped the cord.

904

Which of the following would MOST likely be seen in the earlier stages of Lyme disease?

Painless, flat, red lesions.

905

You have already placed oxygen by non-rebreather on your pregnant patient that is at the end of her second trimester.  During transport she begins tonic-clonic seizures. Referring to the above scenario, what would you expect the patient's blood pressure to be?

180/120.

906

How large does a hole have to be in the chest for it to develop into a sucking chest wound?

Two-thirds of the diameter of the trachea.

907

There is an EMS provider who can do assessment, bleeding control, CPR, give oxygen, and use an AED but is usually untrained i the use of a long backboard. Which of the following levels of certification/licensure is being described?

EMR.

908

Which of the following signs, symptoms, or sequelae would you expect to develop in a dry near drowning/submersion incident?

Laryngospasm.

909

You have an anxious trauma patient with pale, cool, clammy skin and a stable blood pressure of 120/80. His pulse and respirations are rapid. Which of the following BEST classifies this patient?

Compensated shock with anaerobic metabolism.

910

Which of the following poisonous creatures can usually be found anywhere in the United States?

Black widow spiders.

911

Which of the following MOST accurately reflects the mortality from a gunshot wound that penetrates the cranium?

90-95%.

912

While completing a reassessment (ongoing exam), your patient can't understand why you need to check his vitals again. Choose why you should suggest the patient reconsider allowing you to continue your assessment.

It will help you decide if a different treatment is necessary.

913

A patient has a 40% partial thickness burn and weighs 100 kg. How much of an initial fluid bolus should you administer to the patient while applying the Parkland formula?

8,000 ml.

914

If a patient is hypoglycemic, which of the following physiological processes will occur in an attempt to correct this situation?

Glucagon stimulates the liver to break glycogen down through glycogenlysis.

915

You are called to an industrial site where a worker has been trapped by a stamping machine for ten minutes. His left thigh is grossly enlarged and very painful and he has a laceration on his right forearm. His right leg is trapped in the machine and his right foot has been amputated.  He is alert and oriented and the mechanics are preparing to release the patient from the machine. Which of the following do you anticipate will occur when they release the patient?

The patient will rapidly lose blood from the right leg.

916

The Centers for Disease Control (CDC) categorizes bioterrorism agents according to their:

Ease of being transmitted.

917

Which type of breathing would you expect to see in a patient with  a moderate elevation in intracranial pressure?

Central nervous system hyperventilation.

918

Which of the following would provide the greatest negative prognosis of a patient exposed to radiation?

Signs of nausea, vomiting, and diarrhea within an hour of exposure.

919

You are evaluating a patient whose hand was exposed to the cold and it was initially red, but it is now blanched. The patient is also complaining of diminished sensation in that hand. Which of the following do you suspect?

 

Superficial frostbite involving the epidermis.

920

You are on the scene of a patient experiencing chest pressure and shortness of breath for approximately 3 hours without relief. The patient has a history of hypertension and angina pectoris. The patient complains of an upset stomach and has pale, diaphoretic skin. The assessment findings in this patient reveal which of the following?

Myocardial infarction.

921

Which of the following airway devices is contraindicated if the patient has recently eaten?

Laryngeal mask airway, LMA.

922

When a patient has a history of developing hives following a bee sting, there is a concern with a new sting incident that:

Each reaction is worse than the last and could develop into anaphylaxis.

923

Advanced life support providers are called to a residence to assist a basic life support ambulance with a 72-year-old male patient who has a severe lower back pain with numbness in both legs. The EMTs advise that the patient has weak pedal pulses in both feet and the discomfort is described as a tearing-like sensation through his back and abdomen. What intervention will benefit this patient MOST?

Emergency transport to the emergency department in a position of comfort.

924

You arrive to find a 25-year-old male lying in bed, pulseless, and apneic. Which category of moves should you utilize?

Emergency.

925

You are called to assess a patient with dysphasia and hemiplegia, which has occurred at least five times over the past two weeks but has resolved quickly each time. Which of the following BEST describes the clinical significance of this situation?

The multiple episodes place this patient at risk of having a CVA.

926

You are called to transport a 23-year-old female involved in a motor vehicle crash to the hospital. The patient is alert and oriented, but very frightened. During a routine rectal exam performed by the trauma surgeon, she notes that the patient has vesicular lesions of the anus and labia.  The patient's health history is significant for genital herpes several months ago, which was treated with acyclovir.  The patient begins to cry, stating that she had taken all of the medications that she was instructed to and has not had sexual contact since her initial outbreak. You suspect that these new lesions are secondary to:

Her infection has been dormant and she is suffering from a recurrent disease process.

927

Which of the following stages of grief would exist if a family member promised to be quiet if you would just try to resuscitate her child?

Bargaining.

928

Based on your assessment, you believe your patient has suffered an aspirin overdose. Definitive treatment of severe salicylate toxicity secondary to aspirin ingestion requires which one of the items listed?

Dialysis.

929

During assessment of a patient with an altered mental status, which treatment or assessment must be your HIGHEST priority?

Maintaining an open, patent airway.

930

You are assessing an unresponsive 32-year-old female who has a history of asthma. She takes a steroid daily to help prevent her asthma attacks and a bronchodilator for acute care of asthma. She is breathing deeply at 26 times per minute. Her pulse is 110 and weak. Her skin is warm and dry. Which of the following assessments would be an expected finding with this patient?

An elevated blood glucose level.

931

How would an EMS rescuer demonstrate appropriate professional conduct during the assessment of an 8-year-old male with a gunshot wound to the groin area?

Exhibit empathy that the child may be embarrassed and think he did something wrong to cause this event to occur.

932

Which of the following would BEST describe gross negligence on the part of the provider?

Failing to check laryngoscope function prior to taking the vehicle out, but marking that you did on the checklist.

933

The term gravidity refers to which of the following?

The number of times a woman has been pregnant.

934

You have just removed a potential adult drowning victim from a pool and you assess the patient to be pulseless, apneic, and unresponsive. Which of the following should you do NEXT?

Begin CPR at a 30:2 ratio and dry the chest.

935

Which patient is MOST likely confined to a bed or electric wheelchair related to their injury or illness?

32-year-old with quadriplegia.

936

You are treating a patient with epistaxis who also requires back boarding. Which of the following is your greatest concern?

Airway management.

937

Which of the following stages of syphilis typically begins 5-6 weeks after the chancre has healed?

Second stage.

938

While assessing a 72-year-old male who had blurred vision, he suddenly becomes more confused. You find the following vital signs: pulse 178 and irregular, respirations 36 and shallow, and blood pressure 172/86 while sitting up on his own. Select the treatment that should be withheld during emergency transport to the emergency room

Lowering blood pressure.

939

During delivery of a premature baby, you observe significant meconium staining. Identify the BEST reason for assertive suctioning of the trachea before stimulating the newborn.

Reduces the potential of atelectasis and pneumothorax.

940

One group of EMS providers is suggesting one method of treating patients. There is another group suggesting a different method. Medical control will most likely choose the method based on:

The medical director's review of current research.

941

Using measurement of distal pulses and blood pressure, you have watched a patient's pulse fall and his blood pressure rise. Without any other additional information, what key condition are these changes most indicative of in a trauma patient?

Head injury.

942

Your patient presents with wheezing, coughing and increased respiratory effort. This occurred following inhalation of chlorine gas. What pathophysiological process is involved?

Pulmonary edema caused by chlorine chemical exposure.

943

When a chest wound is found to be sucking air, the dressing applied must be:

Occlusive.

944

You are assessing a 62-year-old female with a complaint of chest pain. Her 12-lead indicates she is having an extensive anterior wall myocardial infarction. Which of the following is the MOST likely life-threatening problem that will develop?

Pulmonary edema from left heart failure.

945

You are monitoring a patient's ECG in diagnostic mode and observe a narrow QRS, ST elevation in Leads V1 and V2, and a heart rate of 50. Which of the following would MOST accurately represent these findings?

The patient is having a septal wall MI, which is delaying AV node conduction.

946

EMS is assessing an 85-year-old male following a fall from a standing position. The crew suggests to the patient's wife that her husband is more likely to have a closed head injury when compared to other age groups. Which of the following would be TRUE regarding head injuries in the geriatric population versus younger patients?

The brain of a geriatric patient fits more loosely within the cranial vault, increasing the risk of shearing-type forces during a fall.

947

You are called to the scene of a 47-year-old male with a current chief complaint of chest pain. The patient informs you he has never been sick a day in his life prior to this. Which of the following will provide you the greatest information?

OPQRST.

948

Nalmefene is used primarily for which clinical condition?

Management of alcohol dependence.

949

When should a patient be directed to apply heat following a musculoskeletal injury?

After 48 hours.

950

Rescuers have arrived on-scene of a 25-year-old male complaining of ankle pain. The patient advises he fell after twisting his ankle in a sinkhole. He heard a crack and it is obviously angulated. Which of the following treatments would be appropriate for this patient complaint and history?

Use of an air splint on the lower leg and stretcher transport.

951

Which of the following is the principal benefit of EMS providers educating the community on injury and illness prevention?

Reduces death and disability.

952

You have recently attached an ECG monitor to a cardiac patient. The rhythm reveals a normal QRS complex, normal P waves, and a PR interval of 0.28 seconds. Which of the following AV junction dysrhythmias is characterized by the findings in the above scenario?

First-degree heart block.

953

Which of the following signs would you expect to see in a patient in decompensated shock?

Weak central pulses.

954

Which of the following organs, if fractured and the integrity of the visceral peritoneum lost, will cause the greatest collatral damage to the body?

Pancreas.

955

Which of the following statements is correct regarding the body's attempt to maintain homeostasis when hypoglycemia is present?

Gluconeogenesis produces glucose from non-sugar sources.

956

Under which of the following circumstances would asking close-minded questions be appropriate when gathering a patient's history?

When the patient is short of breath.

957

When does the cellular ischemic phase of hemorrhagic shock begin?

Right after anaerobic metabolism begins.

958

You have a patient who is unresponsive, has spontaneous respirations, has as carotid pulse of 40, and absent radial and femoral pulses. Your ECG analysis is of a Second Degree Type II, and the 12-Lead shows ST elevation in Leads V1 and V2. You have decided to pace this patient and as a result, he wakes up and is in a tremendous amount of pain from the pacemakrer. He also indicates that he is allergic to all of the pain relieving medications you have on board. What would be your MOST appropriate course of aaction based on this information?

Explain the situation to the patient and recommend continued pacing.

959

In the newborn with asphyxia, which of the following would be the MOST common cause of insufficient respiratory perfusion?

Airway obstruction.

960

You have applied a pressure dressing and bandage to an extremity too tightly. You should expect which of the following complications?

Diminished distal perfusion.

961

Immobilizaztion of a sprained ankle would be best accomplished with which of the following options?

Pillow splint.

962

Which one of the listed adverse effects of meperidine is most likely to be encountered by the paramedic after proper administration?

Respiratory depression.

963

Which of the following is MOST likely to occur if you place an oropharyngeal airway that is too small in a pediatric patient?

It can obstruct the airway.

964

You are performing ventilations with a basic airway adjunct. Which part of a bag-valve-mask could be missing and still allow rescue ventilations to be performed?

02 reservoir.

965

Emergency transport to the hospital is most likely to occur for which of the following nose disorders?

Epistaxis.

966

You are assessing a patient who has fallen from a ladder and is now complaining of a severe, tearing pain in the chest, which is radiating to the back.  Assessment reveals a harsh systolic murmur. The patient has a blood pressure of 80/60 and a pulse of 110. Aside from oxygen and transport, which of the following treatments would be the MOST appropriate?

Venous access.

967

A SCUBA (self-contained underwater breathing apparatus) tank typically contains which of the following?

Compressed oxygen and nitrogen.

968

Which of the following would be unexpected as a complication of external pacing?

Hypertension.

969

You are called to the residence of a patient who was discharged from the hospital three days ago for the treatment of a brain tumor. His wife informs you the patient had the tumor surgically removed and received chemotherapy and radiation therapy. The patient complained of a headache earlier in the day and is now running a fever of 102 degrees Fahrenheit, is disoriented, and is complaining of nausea and vomiting. Which of the following shoud you MOST likely suspect?

The patient has developed a brain abscess.

970

You have given a dose of methylprednisolone to your dyspneic asthma patient. Your partner correctly reminds you that the patient could exhibit which of the following serious adverse side effects?

Seizure.

971

If your patient has cold and clammy skin, which of the following should you MOST likely suspect?

Hypoperfusion or shock.

972

Select the correct answer describing the transmission of Hepatitis C.

Transmission is through contact with blood.

973

While caring for a newborn, the infant begins to have excessive saslivation and chewing motions. This movement is most consistent with:

Subtle seizures.

974

You are called to the residence of an elderly patient who tripped on a throw rug, fell, and broke her lower leg. Which of the following would be the MOST appropriate injury prevention strategy the EMS provider could perform?

Refer the case to an agency that specializes in making homes safe.

975

Identify the rhythm.

Second-Degree Type I Heart Block.

976

Which of the following patients would be the best candidate for thrombolytic therapy?

A 48-year-old male suffering from a lateral wall infarction diagnosed within the last 2 hours.

977

Your 35-year-patient has a history of oral contraceptive use and cigarette smoking. She now complains of lower leg calf area pain and distal swelling that has continued for 48 hours.The patient exhibits a positive Homan's sign. Given this history, the paramedic needs to continually assess this patient for:

Increased difficulty in breathing.

978

In which of the following situations would the act of performing an ECG analysis be of the LEAST benefit?

Multi-system trauma.

979

Identify the rhythm.

Paroxysmal Supraventricular Tachycardia.

980

You are managing a 57-year-old male diabetic who is complaining of shortness of breath. His lung sounds are clear, neck veins are distended, pulse is 70, respirations are 24, blood sugar is 90 and the blood pressure is 75/50. A 12-Lead reveals elevation in Leads II, III, AVF,  and V4R. After oxygen and aspirin, which of the following should be your initial treatment option in this situation?

1 liter of NS.

981

Which of the following would be a LATE sign of left-sided heart failure?

The presence of pink, frothy sputum.

982

You have a patient experiencing a hypertensive emergency. Which of the following reactions would you expect from the heart?

The increase in stretching of the left ventricle will cause a decrease in cardiac output.

983

Which of the following best represents the rhythm shown?

Torsades de Pointes.

984

Which coronary artery is most likely involved?

Posterior descending.

985

Identify the rhythm

Normal Sinus Rhythm.

986

Identify the 12-Lead.

Inferior Wall MI

987

Which of the following is a lab test typically used to determine if a patient is suffering from acute myocardial infarction?

CK-MB.

988

In patients 65 and over, the leading cause of hospitalization from the following list is:

Congestive heart failure.

989

Which of the following methods would be the BEST to use for calculating a heart rate utilizing the ECG rhythm when the ECG is irregular?

Counting R waves in six seconds

990

You are called to treat a 48-year-old male complaining of chest pain and his 12-lead indicates he is having an extensive anterior wall MI. The patient denies any shortness of breath, his pulse oximeter reading is 96%, and he tells you he smokes tow packs of cigarettes a day. You have administered high-concentration oxygen and the patient indicates that his chest pain has increased. Which of the following is the MOST likely cause of the increase in pain?

The elevated oxygen level caused a constriction in the coronary arteries.

991

Which of the following vascular disorders has the greatest likelihood of becoming life threatening?

Aortic aneurysm.

992

During a cardiac arrest call you administered epinephrine, sodium bicarbonate, and amiodarone. The patient now has spontaneous respirations and pulse. Which of the following is MOST likely to be ordered by medical control as a maintenance medication?

Amiodarone.

993

Which of the following is the initiating event responsible for an aneurysm?

Tear in the tunica intima.

994

Identify the rhythm

Second-Degree Type I Heart Block.

995

You suspect that your patient has developed cardiac tamponade. You attach an ECG monitor. Which of the following would you expect to see that would support your suspicion?

 

Electrical alternans.

996

Which of the following defines reentry?

Conduction in one branch is slowed, causing a unidirectional block in the other.

997

For which of the following is transcutaneous pacing usually CONTRADINDICATED?

Pulseless electrical activity.

998

Identify the rhythm.

Ventricular Tachycardia

999

You have recently intubated a patient in respiratory arrest. The patient now has a hear rate of 30 and a corresponding carotid pulse. The radial pulse is absent.. There is a normal PR interval and the QRS complex leasures 0.10 seconds. Which of the following is MOST likely the cause of the dysrhythmia in this patient?

Vagal stimulation.

1000

Which of the following would lead you to suspect electrical alternans?