NATIONAL REGISTRY PREP Flashcards by Taylor O'Connell

Which benzo drug is often related to sexual assault cases?
1. Ketamine
2. Rohypnol
3. GHB
4. Ecstasy

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Which of the following patient’s physical appearance would be obvious by his or her
past medical hx?
1. Nerosis pt
2. Quadriplegic
3. Pt with Down syndrome
4. Pt with myasthenia graves

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At the scene of a multi-vehicle collision, you area attempting to evaluate a young teen
age boy who was a belted backseat passenger. He has no obvious external injuries. The driver
of this vehicle is severely injured. As you question the boy, he does not respond to your
questions but continues to rock back and forth in his seat. He also avoids any eye contact. As
you attempt to take vital signs he pushes you away. One issue to conducer with this child is
that he:
1. Has a head injury
2. Is in a state of shock
3. Has some autistic disorder
4. Has chest and abdominal injuries

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Which of the following terms implies that the pt is unable to speak but can understand
what is being said?
1. Motor aphasia
2. Global aphasia
3. Sensory aphasia
4. Articulation dysphasia

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Hyperthyroidism is managed by which medications in the hospital and home setting?
1. Iodine, Methimazole (Tapazole), Propylthiouracil (Propacil)
2. Aminoglutethimide (Cytodren), Metyrapone (Metopirone)
3. Dexamethosone (Decadron), Fludrocortisone (Forinef acetate)
4. Levathyroxine (Synthroid), Liothyronine (Cytomel), Liotrix (Euthroid)

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Which statement reflects the physiology of ventricular tachycardia in a child?
1. Electrical conduction through the bundle branches is impaired, causing ectopy
2. Ventricular output is inadequate during systole, so cardiac after load is diminished
3. Blood supply through he coronary arteries is insufficient during systolic activity
4. The right atrium is unable to deliver adequate volume to the lungs for oxygenation

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Which of the following statements best describes developmentally disabled as a
condition?
1. Persons who appear cognitively impaired usually as a result of brain damage
2. Ab ehavior that is a die effect of poor upbringing or psychological abuse/neglect
3. A pt who loses contact with reality at times to due abnormal brain activity
4. Conduct that results nan inability to cope with normal responsibilities of daily life

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While transporting a pt 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?
1. Blood pressure
2. EKG
3. Blood gas readings
4. ETCO2

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ALS providers are treating a 3yo female who is unresponsive and breathing with atonal
type breaths. Pulse is 90 and there is no palpable blood pressure. What condition best
summarizes their finding to medical control during a radio report?
1. Respiratory dyspnea
2. Distress
3. Failure
4. Arrest

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You are attempting to assess a geriatric pt who has extreme hearing difficulties. Which of the
following strategies would be best for providing psychological support for this pt?
1. Talk louder to be heard by the pt
2. Call for a sing interpreter and delay assessment
3. Write every assessment question on a pice of paper
4. Communicate empathy with your body language and perform the assessment

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During an in home delivery of a baby, the mother asks you if her baby will suffer brain damage
following a brief nuchal cord event. What would be the best response that demonstrates that
you are empathetic if the child is acting normal right now?
1. I don’t know, the child seems fine to me. I don’t think you ned to worry until we get more
information at the hospital
2. I do not suspect there will be any complications. I can imagine that this uncertainty may be
very stressful though
3. No, a nuchal cord is pretty common during deliveries and does not cause brain damage if
corrected quickly
4. There is no way to tell right now, but we will have the baby tested as soon as it is possible

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Which of the following descriptions is true and must be remembered when treating a
geriatric pt versus a younger person?
1. Geriatic pt do not tolerate being asked many questions
2. Geriatric pt brain size and weight reduces over a lifetime
3. Geriatric pt will have a higher likelihood of committing suicide
4. Geriatric pt have a higher white blood cell concentrations in their blood

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Knowing that geriatric puts commonly have decreased central blood flow secondary to
progression of cardiovascular disease is critical to remember when dealing with which situation
below?
1. Managing hypertension during an ascetic stroke
2. Delivering vasopressor agents during heart attack
3. Administering crystalloid fluid during shock resuscitation
4. Determining whether the pt will tolerate an orthostatic tilt test

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During the assessment of a child who has “fallen out of a tree”, which injuries would lead
you to suspect the possibility of child abuse?
1. Evidence of bilateral femur and pelvic fx
2. An open, grossly deformed ulna/radius fx
3. A closed head injury with a depressed skull fx
4. Impalement of a stick into the abdominal/chest area

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When it is determined that a neonate has a diaphragmatic hernia, the most appropriate
tx is:
1. Endotracheal intubation
2. Gastric decompression
3. BVM ventilation
4. Atropine 0.02mg/kg for bradycardia

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You have a 6yo male who has an isolated fx left lower leg. which of the following times
would be the most appropriate to initiate pain management medications?
1. Duirng transport
2. After manipulating and pointing the extremity
3. Prior to manipulating and splinting the extremity
4. Pain medications are contraindicated in pediatric patients

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EMS responders are on the scene of a 3yo with a central line that they suspect is
malfunctioning. Which treatment is most prudent for this patient?
1. Assure the absence of obvious hemorrhage and transport
2. Draw a small amount of food from the red colored adapter to verify potency
3. Infuse 10cc of sterile saline into the blue capped hb and assure catheter is sutured in place
4. Contact medical control for permission to aspirate 1cc of blood to confirm proper
placement

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A parent reports that his infant has had a lot of vomiting. When should an
immediate EMS transport be recommended?
1. When a baby is also having more than 3 bowel movements a day
2. If there is evidence of forceful ejection of stomach contents
3. Any time a baby is unable to keep regular breast milk down
4. If the parents report that there is no odor to the baby’s emesis

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Which description of vomiting would be the most dangerous if found while
assessing a newly delivered infant?
1. Any ejection or forceful type of vomiting after delivery
2. Presence of clear secretions in the mouth during transport
3. Regurgitation immediately following normal breast feeding
4. Traces of blood in clear phlegm while suctioning the mouth

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6 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?
1. Hypotension
2. Hypothermia
3. Hypoxia
4. Hypercalcemia

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Which of the following EKG descriptions will you most likely find in the pediatric
population?
1. Bradycardias
2. Bifascicular heart blocks
3. Idioventricular rhythms
4. Ventricular tachycardias

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According to national experts, which factor is most beneficial of premature infant
survivability?
1. Being delivered in a cooler delivery room
2. Reversing or preventing bradycardic events
3. Extending gestation by 2-3 weeks
4. Early ALS intervention by the paramedic following delivery

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A paramedic has opted to deliver a smaller dose of pain medication to a geriatric pt with
a probably hip fx. How can he BEST defend his decision to start out conservatively with pain
medication administration to the general geriatric pt if he is operating on standing orders?
1. Research shows older pt will be able to tolerate pain better than younger patients will
2. Hip fx pts have a tendency to experience hypovolemic shock quicker than those with other
injuries
3. Older puts frequently experience profound hypotensive complications following pain
medication
4. Geriatric pt have a higher fat to muscle ratio which, negatively affects drug metabolism

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Which treatment guide line is critical for advanced life support personnel to remember
when handling a GI hemorrhage in the geriatric population?
1. To recognize an upper GI bleed, you will often find presence of melena
2. Pneumatic anti shock garments are considered a high priority of treatment
3. Vasopressor agents should be withheld if an internal hemorrhaging risk is identified
4. IV fluids should be restricted until the pt becomes hypotensive and tachycardia

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EMS is transporting a pt with multiple sclerosis to the hospital for tx. of a decubitus ulcer on her hip. Which of the following treatments would benefit the pt most? 1. Take time to clean and dry the area of excessive moisture 2. Dress the wound with a moist, sterile dressing and bandage 3. Remove dressing from the affected area and allow it to dry out 4. Clean the ulcer with diluted hydrogen peroxide and saline

Which of the following newborn conditions will most likely benefit from blow-by delivery oxygen early on? 1. Newborn with a second apgar score of three 2. Newborn with a glasgow coma scale of three 3. Newborn responding slowly to tactile stimulation 4. Newborn with a heart rate of 50 bp

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 that suggests and early one of hypoglycemia? 1. Bradycardia, hypotension, and acrocyanosis 2. Circumoral cyanosis aroudn the eyes and mouth 3. Two obese parents who are at risk of diabetes 4. Eye rolling and twitching of the patients arms

A child has aspirated a foreign object into the lower airway. Which assessment finding would you most likely expect to find? 1. Fever 2. Drooling 3. Inspiratory stridor 4. Unilateral wheezing

How should an EMS provider easily recognize a common birth-related injury in a large newborn following an explosive delivery? 1. Epistaxis 2. Convulsions 3. Hemi paralysis 4. High-pitched crying

A 90yo cancer pt has reportedly tried to kill himself by drinking an unknown amount of an alkaloid cleaning chemical. He denies any complaints and is stable. Which treatment is absolutely required to properly treat this pt if you are unsure about whether a toxic ingestion took place? 1. Transport the pt to the hospital 2. Call poison control for treatment advice 3. Give 50G of activated charcoal orally 4. Draw up an anticonvulsant medication to counteract possible seizures

AN EMS helicopter has been called to transport a critically ill neonate to a neonatal specialty hospital. Family members are unable to fly with the baby because of a sheer lack of cabin room. How should the flight crew relate this information to the family? 1. Spend extra time explaining the transfer process to make sure the family understands how to get tot eh hospital and to let them know what to expect when they arrive 2. Prepare the pt for transfer as they normally would and let the family know the situation as they are departing toward the EMS helicopter 3. As the hospital staff to handle the family’s questions and prepare to depart as soon as the pt is secured to the stretcher and ready for transport 4. Have a crew member stay behind at the sending hospital and allow a family member to fly with the pt to the receiving hospital.

You have a 6yo pt requiring intubation. Which of the following would be the most appropriate size endotracheal tube? 1. 4 cuffed 2. 4.5 cuffed 3. 5.0 uncuffed 4. 5.5 uncuffed

A child with special health care needs who depends on medical devices to support bodily functions will best fit which of the following terms? 1. Critically ill child 2. Chronically ill child 3. Special needs child 4. Technology assisted child

In the geriatric population, a pt with a femur fx will often have: 1. An open fx site 2. A hematoma formation 3. A distinct lateral foot rotation 4. A complaint of little pain when compared to other age groups

During treatment of a 6mo in a suspected SIDS case, EMS rescuers quickly recognize that the pt 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? 1. Contact medical control for permission to transport to the local emergency department for further treatment 2. Offer the family the opportunity to witness the resuscitation effort and explain the procedures that are being done 3. Deliver additional medications classified as possibly helpful and not harmful, like sodium bicarbonate IVP 4. Continue resuscitation efforts until you have exhausted the prescribed medications indicated for cardiac arrest

You determine that a pt is non-compliant with taking her medications because she is unable to pay for them. You are aware of community resources available to help her. What is the best advice if she refuses transport? 1. While on scene, attempt to locate a clinic that serves the poor. 2. Transport the pt agains her will to the ED 3. Contact medical control for a suggestion on what you should do 4. Give the pt a personal donation to help offset the costs

During transport of a bed ridden geriatric pt with pneumonia, her nurse reports that the pt has a stage three decubitus ulcer. Where do you suspect the ulcer will most likely be found during exam? 1. Back of the scapula 2. Distal end of the humerus 3. Anterior proximal tibia 4. Posterior aspect of the heel

1 During emergency treatment of a pediatric trauma pt, the pt’s heart rate begins to drop precipitously. What do you suspect has happened to cause this sudden change? 1. The providers overdosed the child on pain medications 2. The rescuers were attempting to insert an endotracheal tube 3. The child has internal bleeding that is causing compensatory shock 4. This is a normal response to a standard IV bolus of an isotonic solution

Paramedics are called to an adult foster care home to treat a quadriplegic pt who appears to be in septic shock because of a bladder infection. Which of the following accommodations will most likely be required for this type of pt if he is wearing a halo traction device? 1. The pt will have to be transported on his right side while on the EMS stretcher 2. Paramedics should anticipate using dopamine sooner to support systolic blood pressure 3. Paramedics will need to support ventilation with a BVM if the pt is positioned supine 4. The rescuers may need to consider alternative means of transportation other than their ambulance

You are called to care of confused man at the local homeless shelter. The staff says the 72yo man appears to be passing out and he was cold when they brought him in from outside. They question if he may have alzheimer’s. The pt has no complaints when questioned What action would be most appropriate for this pt? 1. Obtain a BGL and establish an IV 2. Evaluate the pt’s peripheral capillary refill time 3. Rapidly undress the pt to prevent further heat loss 4. Attempt to determine the pt’s core body temperature

Which of the following is correct regarding pediatric anatomy? 1. The smallest portion of the airway is at the larynx in the pediatric patient 2. Pediatric patients have a larger surface area to volume ratio 3. The opening to the lower airway is more posterior and inferior in a pediatric pt 4. The extremities are proportionally longer in the pediatric pt than n the adult

During the assessment of a pregnant female, the pt suggests she is worried her baby may be delivered prematurely. Which of the following complications would be a reasonable concern if her baby was delivered at 36 wks? 1. Pulmonary hypertension 2. Hypothermia complications 3. Intraventricular hemorrhage 4. Atrial septal wall malformations

Which of the following SAMPLE answers would indicate a neonate is MOST likely dehydrated related to diarrhea? 1. Mother mentioning the infant has not urinated today 2. Mother indicating the child has 5-6 bowel movement per day 3. Evidence of watery, yellow, and foul smelling feces in her baby’s diaper 4. Reporting that her infant has required encouragement to breast feed in the last two days

EMS is called to the home of a 78yo 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 assessment would most likely reveal significant peripheral vascular disease hx? 1. Bradycardia 2. Carotid bruits 3. Heart murmur 4. Orthostatic hypotension

ALS providers are assessing a geriatric female who fell and injured her hip. According to the pt, she fell and hurt her hip yesterday and was found on the floor by the mailman. Your assessment reveals an obviously deformed, shortened right leg and evidence she is incontinent of urine. Which of the following is a true statement regarding hypothermia and this particular pt? 1. The pt will most likely shiver, indicating she is losing body heat via the conduction mechanism 2. The risk of complications related to hypothermia are less likely to be seen in trauma pt her age 3. Hip fx in geriatric pt will have a transient hyperthermic event before the pt develops hypothermia 4. EMS should expect the pt is taking medications that will affect the pt’s ability to control her body temperature

EMS responders are called to a nursing care enter for an 85yo female who has overdosed on her blood pressure medication. Which for eh following statements best reflects the way the providers should handle this pt? 1. Quickly administering activated charcoal as the preferred tx for blood pressure medication overdoses to reverse anticipated side effects 2. Questioning staff about signs and symptoms they noticed prior to the medication administration will be the most valuable information to collect 3. Determine the risk of suicidal intentions by asking the family, staff, and pt about why the od occurred 4. Obtaining serial 12 leads is necessary to predict the side effects of the medication on this pt

Rescuers are assessing a 10yo experiencing dyspnea after ingesting “uppers” he found at a friend’s house. He is tachycardia, pale, and diaphoretic. His blood pressure is high and his EKG reveals a wide-complex ventricular tachycardia of 188. What treatment will most likely prevent this rhythm from worsening? (flag) 1. Performing vagal maneuvers 2. Administering an anti-arrhythmic 3. Placing him with his legs elevated 4. Administering high concentration of O2

The latest sign of hypovolemia in a newborn would be: 1. Tachycardia 2. Diminished peripheral pulses 3. Oliguria 4. Cool, pale skin

You have a 4yo pt who is showing clear signs of hypoperfusion secondary to hemorrhage. Which of the following best describe the expected findings if the pt is still able to compensate? 1. A HR of 70 2. Weak central pulses 3. Blood pressure of 98 systolic 4. A capillary refill time of less than 2 seconds

Responders are called to treat a 78yo male found at the bottom of the stairs in his basement. The pt is complaining of hip and pelvic pain during movement to the prone position. Which of the following nervous system assessment findings would be considered abnormal for this scenario? 1. Decreased pain sensation 2. Slower reaction time 3. Mild memory loss 4. Difficulty speaking

2 You have a newborn who is blue in the and 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? 1. 4 2. 5 3. 6 4. 7

Choose the best reason for understanding the anatomical difference between adults and children 1. CPR standards vary for some population groups 2. It will affect the way you obtain most of your vital signs 3. It helps us appreciate the limitations EMS has when responding to sick or injured children 4. It establishes guidelines and standards that can be used to defend rescuers in court during a civil law suit

Which pt is most likely using an assist control ventilation setting? 1. A conscious pt with late stage cystic fibrosis disease 2. An infant recovering from ARDS and RSV 3. A semi alert pt healing from a recent spontaneous tension pneumothorax 4. A comatose adult who is completely paralyzed following a long fall one year ago

Ambulance personnel are called to the woods to treat a 92yo male who is possibly confused and hypothermic, according to a neighbor. Which of the following would be the best indicator of early onset hypothermia for this normally healthy pt? 1. Bradycardia 2. Hypotension 3. Tachycardia 4. Arrhythmias

With a hx of being very weak, a 30yo female pt also has drooping eyelids. She complains of difficulty swallowing and chewing, along with double vision. The pt may be suffering from : 1. Poliomyelitis 2. CP 3. Muscular dystrophy 4. Myasthenia gravis

During tx of a female pt who has been sexually assaulted by a stranger, a male rescuer attempts to demonstrate caring sensitivity toward his pt. How best should this be done if the pt is going to be transported to an emergency room? 1. Assure that a female attendant will be present during assessment and transport 2. Tell the pt you understand how difficult this must be and then wait for a response 3. Offer the pt an opportunity to shower or change her clothes before leaving for the ER 4. Ask the pt if she is hurting anywhere using non-clinical terminology and anatomical references

According to a home health aid, your medical pt is normally paralyzed from the neck down and requires tube feeding 3-4 times per day. What situation would most commonly require EMS intervention and transport to the ED? 1. Peritonitis 2. Aspiration 3. Esophageal atresia 4. Bowel obstructions

Which of the following is a common lower airway issue in the pediatric patient? 1. Bronchiolitis 2. Emphysema 3. Epiglottitis 4. Croup

Which condition is LEAST likely to occur in a normal progression of age in a geriatric patient? 1. Increase of acid production within the stomach 1 2. Decrease in saliva volume in the oral cavity 3. Increase in emptying time of the gastric tract 4. Decrease in the effectiveness of taste buds

A pediatric pt is presenting with a decreased LOC and an abnormal breathing pattern. Family relays the pt has had polydipsia, polyphagia, and polyuria. Which condition most likely exists within this pt? 1. Inadequate circulation of blood glucose to the brain tissue 2. The body is breaking down alternative sources of fuel 3. The pt is developing a relative cellular alkalosis 4. Hypoperfusion of the kidneys and skin tissue

Which of the following describes the correct number of attempts and time spent trying to obtain venous access before attempting intraosseous access in the critically injured pediatric patient? 1. 2 attempts and 60s 2. 2 attempts and 90s 3. 3 attempts and 60s 4. 3 attempts and 90s

At 5lpm and 1/2” away, blow-by O2 will yield approximately what concentration of O2 1. 33% 2. 40% 3. 50% 4. 80%

In the newborn with asphyxia, which of the following would be the most common cause of insufficient respiratory perfusion? 1. Hypothermia 2. Airway obstruction 3. Meconium aspiration 4. Compression of the umbilical cord

After one dose of Dextrose 50%, your hypoglycemic geriatric pt is now alert and fully oriented but refusing transport. A neighbor say the pt has been very depressed for several weeks. The pt wants to stay home, promising to take better care of her diabetes. What is the best treatment plan for this pt who seems outwardly depressed? 1. Call family or friends to be with her and make sure she eats right later on today 2. Consult medical control to grant you permission to obtain a refusal from her 3. Document the neighbor’s comments on our run form and follow up with her later on in the day with a home visit 4. Try to convince the pt to go with you to the hospital voluntary or transport her against her wishes if she refuses

An ambulance crew is evaluating an 81yo 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 pt in this age group? 1. BP 148/78 2. CHF x 3. EKG is sinus arrhythmia 4. Lower back and joint pain

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? 1. A wife reporting her husband had nonconsensual sexual contact with her tonight 2. A husband failing to call 911 immediately after his wife began to experience a probably stroke 3. A court appointed legal guardian threatening a pt with physical harm after a verbal argument 4. A parent refusing to grant permission for her son to be transported by EMS with a serious leg fx

Which of the following treatments would benefit a neonatal pt most if he is lethargic secondary to hypoglycemia? 1. IV bolus of D50 2. IV bolus of D25 3. IV bolus of D10 4. IV bolus of D5

Domestic violence is least likely related to which condition? 1. Background of past sexual abuse 2. Feelings of low self esteem 3. Hx of alcohol abuse 4. Schizophrenia diagnosis

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? 1. Administer sodium bicarbonate 4.2% 1mEq/kg IV bolus 2. Perform additional ventilations and intubate the pt 3. Pace the pt with external transcutaneous pacer pads 4. Deliver 0.01 mg/kg of naloxone until the breathing rate increases

Which of the following is an accurate statement regarding the elderly and their living environments? 1. Most elderly over age 65 are in skilled nursing facilities 2. the majority of those over 85 living independently are women 3. Only 10% of those over age 85 live independently 4. Most elderly in their 80s and 90s are divorced

Nurses request you transport a pt 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? 1. New tenderness and pain near and around the injection site 2. Presence of a 5cm hematoma near the injection site 3. Evidence of a fever, poor appetite, and high white blood cell count 4. the pt describes numbness and tingling around the insertion point

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. 1. Childhood diseases like whooping cough and measles 2. Sudden degeneration of the cerebellum portion of the brain 3. Use of alcohol or illegal drugs by the mother during pregnancy 4. Excessive exposure to lead, mercury, and other toxic materials

A pt care advocate dials 911 to assist a 90yo female with dyspnea. According to the guardian, the pt has been short of breath all ay and was refusing help until now. The pt is conscious, severely hypoxic, and has rapid, labored breathing. The providers suspect her COPD has exacerbated the point of being critical. What is the most important intervention for this pt? 1. Administration of inhaled steroids via nebulizer 2. Delivery of a Beta2 agonist via IV push 3. Rapid emergency mode transport to an ED 4. Requesting permission to consciously sedate the pt and intubate

A single rescuer is managing a complete airway obstruction on a 3yo conscious pt. He suspect the pt is chocking on a partially chewed piece of food. After performing 5 abdominal thrusts the pt becomes unresponsive. The provider should next: 1. Do a blind finger sweep of the oral cavity 2. Begin chest compressions at 100/min 3. Roll the pt onto his side 4. Give 5 additional back blows

You are called to transport a sick child how has a hx of CA. 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 are. What would be the best explanation of this finding? 1. It is an implantable defibrillator and paceaker 2. The object could be an implantable injection device 3. There is a foreign object infected just beneath the skin surface 4. The object under his skin is a localized chemotherapy responder

You have administered Narcan IVP to a newly born infant who was exposed to narcotic pain medications given to housemother prior to delivery. Which of the following conditions would best indicate the infant’s urgent need for a second dose of Narcan? 1. Bradycardia 2. Hypotension 3. Pupil dilation 4. Petit mal seizures

Which of the following conditions will increase the liklihood a neonate will experience hypoglycemia 1. Development of a large diaphragmatic hernia 2. Recent hx of a systemic bacterial infection 3. Maternal use of stimulants during pregnancy 4. Newborns suspected of having Down’s syndrome

You are preparing to intubate a 4yo apnea pt. Which of the following uncured endotracheal tube sizes would be most appropriate? 1. 2.5 2. 3.5 3. 4.0 4. 5.0

During a long-distance transfer of a pt with a feeding tube you suspect the G-tube is either kinked or obstructed. The feeding machine is giving an alarm of “obstruction”. How should you first confirm whether the problem is with the G tube or the machine? 1. Attempt to flush the tube with 50cc of warm water to see if it passes without resistance 2. Disconnect the pump from the feeding tube and see if the machine pumps while disconnected 3. Palpate the abdomen and visualize the presence of increased gastric contents backing up the tube 4. Instill 10cc sterile saline down the feeding tube, then aspirate back stomach contents for examination.

Which of the following is an antepartum factor presenting potential complications in newborns? 1. Prolonged labor 2. Post term gestation 3. Prolapsed cord 4. Meconium staining

A neonate has a fever. which of the following statements is TRUE? 1. A neonate’s temperature is normal at 96.5 2. A newborn baby is unable to sweat when febrile 3. A newborn baby is at risk of hypoglycemia in the presence of a fever 4. Febrile seizures are most prevalent i the first two weeks of life

Advance life support providers are assessing a hypoglycemic child who is mildly confused. Which option best describes this pt’s situation? 1. His capillary blood glucose level is at least 160 2. The victim will also show signs of dehydration 3. An intramuscular injection of glucagon is contraindicated 4. This pt is at risk of experiencing a grand mal seizure

EMS has been called to an independent living center for an elderly female who appears to have broken her hip. According to the staff, the pt rolled over on her own in bed and they heard a crack. What do you suspect happened prior to EMS arrival 1. She really did dimply break her hip rolling over in bed 2. The staff was likely neglectful and she fell to the floor 3. The pt has a pelvic or hip cancer that has weakened her bones 4. The pt is a victim of battery and an investigation needs to occur

While assessing a 35yo female who was beaten up by her husband, you find the pt crying uncontrollably. What should the rescue team do to overcome the district of her crying to reduce interference during pt assessment? 1. Tell her to calm down so you can do your work correctly 2. Ask the pt to think about something else for a short time 3. Explain the difficulty in assessment given her uncontrolled crying 4. Let the pt know you understand this must be difficult, but she must be quiet

During a newborn resuscitation, the rescuers believe the pt has lost pulses and respirations but are unsure. What additional signs/symptoms might help confirm this? 1. Peripheral cyanosis 2. Skin becoming mottled 3. Blood in the baby’s mouth 4. Delayed capillary refill time

EMS responds to a daycare center for a child with altered mental status. Caretakers describe a 9yo female “acting like she is on drugs”: There is very little to indicate a toxicological emergency. What symptom would confirm a suspicion of hypoglycemia instead of drugs? 1. Kussmaul respirations 2. Pt complaint of a headache 3. Sunken eyes and dry looking skin 4. Fruity odor on the pt breath

You have recently delivered a newborn who is now apnea and pulseless. As you start compressions, which of the following compression rates is correct? 1. 80-100 2. 100 per minute 3. 120 4. 120-160

Respiratory distress in the pediatric pt is best defined as which of the following? 1. The complete cessation of breathing 2. The mildest form of respiratory impairment 3. Noticeable accessory muscle use on inspiration 4. Respiratory impairment where the demands of the body for oxygen are not met

Which of the following reasons best explains why we avoid confrontation with a parent at the scene when we suspect child abuse? 1. It may upset the parent and therefore the child 2. The child may become defensive and refuse treatment 3. The parent may become violent toward us or the child 4. The parent may refuse to allow us to transport the child

As of 2010, where does pneumonia rank in the leading causes of death in the geriatric population? 1. 4th 2. 5th 3. 6th 4. 7th

As you prepare to move a pt from her home bedroom, a first responder suggests that you use a stair chair. You feel that a stair chair would unnecessarily delay the pt movement. What should you do? 1. Ask the first responder why she thinks that device is necessary 2. Tell the first responder and pt you believe a stair chair is unneeded 3. Ask the pt what she thinks should be done to move her to the stretcher 4. Explain that the stair chair will take a few more minutes to set up and that you want to take no longer than necessary

What common complication should paramedics expect to encounter while treating a pt with quadriplegia? 1. Uncontrolled leg tremors 2. Ischemic EKG changes 3. Bladder incontinence 4. Diaphragmatic spasms

You are assessing a 2yo who has been healthy up until today. He is ow pale, lethargic, and difficult to arouse. Earlier he was anxious, clammy, and acting inappropriately. The pulse is now fast and thready. what do you expect to see on the cardiac monitor 1. Idioventricular 2. Ventricular fibrillation 3. Ventricular tachycardia 4. Supraventricular tachycardia

A new born baby is experiencing short episodes of apnea lasting less than 20 seconds. Which of the following conditions would you suspect to find following each apnea event? 1. Coughing or gagging 2. Cyanosis and bradycardia 3. Petit mal seizure activity 4. Tachycardia with EKG changes

Meconium staining occurs in approximately what percentage of deliveries? 1. Less than 1% 2. 1-5% 3. 5-25% 4. 25-45%

Your pt has at the following: hypertension, dizziness or lightheadedness upon standing, presence of a rash, muscle cramps, swelling of the heand, face, or eyes, cough, headache stomach up set, fatigue, and a loss of taste. He is showing side effects of which of the following? 1. Diuretics 2. Lidocaine 3. Beta blockers 4. ACE inhibitors

If an EMS provider was to report what they believed to be obvious neglect, they would most likely choose which description below? 1. 6yo who has not had any prescribed vaccines 2. 5yo pt with an obvious pelvic fx 3. 3yo male who has been sexually assaulted 4. 4yo female with cigar burns on her arms

Your elderly patient’s wife secretly reports that her husband always drinks excessively on Tuesdays and Thursdays after a social club meeting. She think that is why he has chest pain today. Your pt denies using any alcohol at all. What is the most critical reason for clarifying his alcohol drinking habit? 1. By law, you are compelled to recommend participating in an alcohol support group if you suspect geriatric alcohol abuse 2. This information must be documented on your EMS run form as the suspected cause/effect for his chest discomfort 3. Use of even a small amount of alcohol is considered more risky for geriatrics than younger-aged pt 4. Nitrates are contraindicated in pt who abuse alcohol on a regular basis

Rescuers are preparing to deliver a newborn they suspect will be distressed. Which of the following will be the least helpful to obtain in preparation for resuscitation of this newborn? 1. IV does of naloxone 2. 500cc slef inflating BVM 3. Meconium aspirator attachment for suction 4. Assorted sizes of intraosseous infusion needles

ALS personnel are assisting in the obstetrical delivery of a large baby. Which of the following birth injuries would be the most preventable during the expulsion process? 1. Liver rupture 2. Cranial injuries 3. Clavicle fx 4. Spinal cord injuries

In children over one year of age, what is the leading cause of a accidental death? 1. Drowning 2. Motor vehicle collisions 3. Gunshot wounds 4. Burns

According to the DOT curriculum, EMS responders should engage in which type of activity to measurably reduce childhood mortality and morbidity related to illness or injury? 1. Epidemiological research 2. Safety belt enforcement efforts 3. Confiscating illegal drugs from pt 4. Offering a blood pressure clinic at headquarters

Paramedics are trying to confirm an ET tube is in place immediately following an intubation attempt. If the setting is noisy and the patient is a neonate, choose the most reliable indicator the tube lies within the trachea. 1. The pt begins crying and becoming more active 2. HR increases from 115 to 160 bpm 3. There is visible mist of moisture on inner lumen of tube 4. Positive inflation results from an EDD

EMS providers are stabilizing a conscious geriatric patient experiencing severe shortness of breath related to emphysema. they have applied high-flow O2 via NRB and confirm there is no ectopy on the ECG. what is the HIGHEST priority during transport? 1. Positioning the PT left lateral recumbent 2. Administering racemic Epi via nebulizer 3. Establishing a peripheral IV of an isotonic solution. 4. Delivery of an antipyretic medication via IV.

Which of these would be considered a public health program on injury and illness prevention that EMS could participate? 1. CPR training 2. First Aid training 3. Car seat installation 4. Disease outbreak monitoring

You are called to a 3yo pt who is having difficulty breathing. The pt is beginning to show signs of cyanosis. The pt is resisting the administration of O2 through a NRB mask. Which of the following would be an appropriate solution? 1. Administer flavored O2 2. Negotiate with the child b using a reward system 3. Change the O2 administration to a nasal cannula 4. Defer the O2 administration to the arrival at the hospital

You have a pt with a lower GI bleed. The cause could be: 1. Peptic ulcer 2. Duodenal ulcer 3. Ulcerative colitis 4. Esophageal varices

Which of the following would lead you to suspect that a pt is going to have an allergic or anaphylactic reaction involving swelling of the airway and blood vessel dilation? 1. Slow development of signs and symptoms after first exposure 2. Second exposure after a previous incident where the body formed antibodies 3. The first time a person is exposed he has hives, itchy eyes, and a runny nose 4. A development of diarrhea two days after eating a substance the pt was allergic to

Which of the following is a branch of the RCA? 1. Anterior descending 2. Left coronary artery 3. Circumflex artery 4. Marginal artery

You are assessing a pt with carotid bruits who is currently in a narrow complex tachycardia at a rate of 200. Which of the following would most likely occur if a carotis sinus massage was performed? 1. Embolic stroke 2. Thrombotic stroke 3. Carotid vasospasm 4. Pulmonary embolism

Which of the following would be contraindicated in the pt with thyrotoxicosis? 1. Beta blockers 2. Glucocorticoids 3. Active rewarming 4. Fluid resuscitation

Which of the following would best describe expected results from an asthmatic in the middle of an attack? 1. Decreased peak flow and decreased forced expiratory volume 2. Decreased peak flow and increased forced expiratory volume 3. Increased peak flow and decreased force expiratory volume 4. Increased peak flow and increased forced expiratory volume

Which of the following is the terminology utilized to describe a cancer that grows quickly and can easily migrate to other sites within the body? 1. Benign 2. Malignant 3. Congenital 4. Metastases

Electrokardiogram leads I, II, III are also known as the: 1. Precordial leads 2. Augmented leads 3. Unipolar leads 4. Bipolar leads

What is the medical term used to refer to lung sounds auscultated in the mid axillary region? 1. Tracheal 2. Vesicular 3. Bronchial 4. Bronchovesicular

You have an adult pt in status epilepticus after failing to take his prescribed anticonvulsant medication. Which of the following is the appropriate treatment for this pt? 1. Administer Valium 5mg 2. Administer 5-10 midazolam 3. Insert a padded tongue blade to protect the airway 4. Restrain the pt to a backboard to protect from injury

In the adult, which of the following organs is responsible for the production of erythropoietin? 1. Liver 2. Spleen 3. Kidneys 4. Bone marrow

Which of the following is of the greatest clinical significance for pt with neurological disorders? 1. Paralysis 2. Cognitive ability 3. Circulatory compromise 4. Respiratory compromise

Which of the following would be a medication likely to be administered in cases of a black widow spider bite? 1. Sodium bicarb 2. Calcium chloride 3. Diazepam 4. Mag Sulfate

Which of the following would be the best educational advice you could give to a pt who has a severe food allergy? 1. Wear a medic alert bracelet 2. Recognize and avoid that food 3. Carry an epinephrine auto-injector 4. Consult a MD about desensitization

Which of the following medications is considered useful in the treatment of a pt with a thyrotoxic crisis by reducing the level of circulating Thyroxine? 1. Glucagon 2. Naloxone 3. Propranolol 4. Dexamethasone

Which of the following is the most likely to develop as a result of a stroke or other injury to the brain or spinal cord? 1. Multiple sclerosis 2. Alzheimer’s 3. Central pain syndrome 4. ALS

Which of the following occurs as a result of an increase in pulmonary pressure and hypertension by changes in blood flow at high altitude? 1. AGE 2. AMS 3. HACE 4. HAPE

Which of the following drugs is typically omitted in the tx of a pt with acute congestive heart failure? 1. Nitroglycerin 2. Morphine 3. Furosemide 4. ASA

You are called to treat a pt 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 hx. Which of the following assessment findings would you expect to see in this pt? 1. Hypotension 2. Uremic frost 3. Foul smelling urine 4. Tall, peaked T waves

A pt with a recent diagnosis of a neoplasm within the brain is now experiencing paralysis on the left side of the face. Which of the following is occurring in this situation? 1. The tumor is impacting the afferent fibers of cranial nerve V 2. The tumor is impacting the efferent fibers of cranial nerve V 3. The tumor is impacting the afferent fibers of cranial nerve VII 4. The tumor is impacting the efferent fibers of cranial nerve VII

Upper GI bleeding is separated from lower GI bleeding by the: 1. Ileocecal valve 2. Ligament of Treitz 3. Cardiac sphincter 4. Pyloric sphincter

Your patient presents with wheezing, coughing and increased respiratory effort. This occurred following inhalation of chlorine gas. What pathophysiological process is involved? 1. Asthmatic attack caused by irritants 2. Atelectasis secondary to chlorine gas exposure 3. Pulmonary edema caused by chlorine chemical exposure 4. Acute respiratory distress secondary to lack of oxygenation

What water temperature is utilized when a frost bitten part must be rewarmed? 1. 94-96 2. 98-100 3. 102-108 4. 108-112

You are dispatched to a 55yo male with a complaint of lower abdominal pain. You are surprised when you arrive on scene and find the man to be in the end stages of shock. He is wet, pale, and unresponsive with a barely palpable carotid pulse. His breathing is agonal. Yo begin CPR and quickly load for transport and ALS intercept Te wife reports that the man had severe lower abdominal pain that came on quickly. He was rolling around on the floor before he became unresponsive. As you try to put all of this together, you believe that most likely this man has suffered a/an: 1. Stroke 2. Heart attack 3. Aortic aneurysm 4. Brain hemorrhage

Which factor is primarily responsible for causing aortic aneurysms? 1. Infection 2. Congenital 3. Hypertension 4. Atherosclerosis

Your assessment of a victim of an MVC reveals difficulty breathing, redness across upper chest, JVD, with clear lung sounds. Pulse is thready at 128, BP 80/60. Which assessment finding from the scenario best determines the appropriate diagnosis of cardiac tamponade? 1. JVD 2. Clear bilateral breath sounds 3. Narrowed pulse pressure 4. Pulse of 128 and thready

You have just contacted medical direction for permission to terminate a resuscitation attempt. Which of the following information is the physician LEAST likely to consider when deciding to terminate the resuscitation? 1. Therapy rendered 2. Medical condition of the pt 3. Quality of life evaluation performed by EMS 4. Resistance or uncertainty on behalf of the family

Which of the following supplies blood to the inferior wall of the left ventricle in the right coronary dominant pt? 1. RCA 2. CX 3. Anterior descending 4. LCA

Which of these is a peripheral thermoreceptor location? 1. Spinal cord 2. Great vessels 3. Abdominal viscera 4. Mucus membranes

At which of the following altitudes does high altitude illness typically begin to manifest itself? 1. 4000 2. 6000 3. 8000 4. 10000

You have a pt demonstrating a new complete heart block secondary to a myocardial infarction as a result of damage to the left and right bundle branches. Which of the following coronary arteries is most likely involved? 1. Left circumflex 2. Posterior descending 3. RCA 4. LAD

How many Americans are affected by renal and urologic disease? 1. 250,000 2. 500,000 3. 1,000,000 4. 20,000,000

The sympathetic NS will o which of the following when stimulated? 1. Decrease HR 2. Decrease force of contractions 3. Increase stomach secretion 4. Increase HR

Which of the following GI emergencies would be the most difficult to diagnose in the prehospital setting? 1. Appendicitis 2. Crone’s 3. Diverticulitis 4. Esophageal varices

Which of the following best describes angina pectoris? 1. When chest pain is relieved with NTG or rest 2. When cerebral tissue perfusion is temporarily decreased 3. When coronary vasospasm decrease blood supply to the heart 4. Chest pain that results when the heart’s demand for O2 exceeds the blood supply available

Which of the following stages of syphillis typically begins 5-6 weeks after the chancre has healed? 1. First stage 2. Second stage 3. Third stage 4. Fourth stage

Correctly identify the pathophysiology of ingestion poisoning: 1. Poison absorption occurs mostly in the stomach 2. Poison absorption occurs mostly in the large bowel 3. In the small intestine 4. Depends on the specific medication

For which of the following would you use sodium bicarb to eliminate the poison? 1. ASA 2. NSAID 3. Theophylline 4. Acetaminophen

According to the centers for disease control and prevention which ranking does drowning have in the causes of accidental death in the united states? 1. 1st 2. 3rd 3. 5th 4. 7th

Which of the following best describes after load? 1. The resistance against which the heart must pump 2. The volume filling the ventricles during systole 3. the volume filling the ventricles during diastole 4. the decrease in pressure in the coronary arteries

You have a newborn who is breathing slowly and has a heart rate of 64. What is the FIRST step in neonatal resuscitation for this newborn? 1. Administer O2 2. Begin chest compressions 3. Assess and assure a clear airway 4. Begin BVM ventilation

Which of the following conditions is the most common cause of acute renal failure? 1. Renal failure 2. Pre-renal failure 3. Post-renal failure 4. Chronic renal failure

Which of the following is the most likely to develop as result of a stroke or other injury to the brain or spinal cord? 1. Multiple sclerosis 2. Alzheimer’s disease 3. Central pain syndrome 4. Amyotrophic lateral sclerosis

Which of the following signs would be an inconsistent assessment finding for a pt with a hx of a neoplasm within the brain? 1. Double vision 2. Irregular breating 3. Behavioral changes 4. Abnormal blood sugar

Which of the following should be your highest priority in assessing and treating a conscious pt you suspect is having an MI? 1. Administration of ASA 2. Collection of complete hx 3. Assessment of equal radial pulses 4. Identification of pt risk factors

Which of the following is a pre-delivery emergency? 1. Nuchal cord 2. Prolapsed cord 3. Placenta previa 4. Limb presentation

The visible indication of a pt’s mood is termed: 1. Mood 2. Affect 3. Mental status 4. Psychosocial status

You are called to treat a pt who initially complained of mild, diffuse, periumbilical pain, which is now more severe and localized to the right lower quadrant. The pt has a low-grade fever, nausea, and vomiting. Which of the following would be the most appropriate treatment? 1. Position of comfort 2. Rapid fluid infusion 3. Application of PASG 4. Administration of MS

You are treating a pt with multifocal, premature ventricular contractions. The pt is experiencing approximately 10-15 per minute. After application of O2, which of the following is MSOT appropriate? 1. Atroping 2. Epinephrine 3. Lidocaine 4. Adenosine

What is the clinical significance for a pt with a hx of a brain abscess who now has a high temperature, severe headache, and nuchal rigidity? 1. The pt can be expected to become hypotensive 2. The abscess is affecting the occipital lobe of the cerebrum 3. The infection has migrated to the meninges of the spinal cord 4. The pt is showing signs consistent with an increase intracranial pressure

Which of the following is considered the universal blood recipient? 1. A 2. B 3. AB 4. O

Identify the bodily systems affected by influenza and its resulting symptoms. 1. Neurological system; increased confusion 2. Respiratory system; non-productive cough 3. Cario-respiratory system; pulmonary edema 4. GI system; vomiting and diarrhea

Contraction of cardiac muscle tissue occurs after which of the following? 1. Polarization 2. Repolarization 3. Conduction 4. Depolarization

Polycythemia is defined as which of the following? 1. A decreased number of white blood cells 2. An overproduction of platelets 3. An overproduction of red blood cells 4. A decreased number of red blood cells

Your pt has been in bed all day following a three-day history of intractable vomiting and diarrhea. The pt just returned from a business trip to a developing country. Assessment reveals a pt that is responsive to verbal stimuli, has sunken eyeballs, warm, dry skin, a shallow respiratory rate of 22, a HR of 128 with weak peripheral pulses, and BP is 92/64. Your treatment includes: 1. High-flow O2 via face mask, IV access, and Dopamine started at 10mcg/kg/min to treat hypotension 2. Ventilatory assistance with high-flow O2, IV access, and fluid administration with D5W at 100cc/hr to treat malnutrition 3. An advanced airway and application of PEEP in order to minimize respiratory secretions 4. High-flow O2 via face mask, IV access, and volume resuscitation to replace fluid loss and to re-expand the intravascular space

A specific problem that atherosclerosis can cause is: 1. Arterial rupture 2. Ventricular rupture 3. Coronary blood vessel rupture 4. Interference with dilation/constriction of arteries

What is the name of the tissue that covers the outside of the lungs? 1. Parietal pleura 2. Visceral pleura 3. Peri-pulmonary sac 4. Parenchymal tissue

Which of the following gastroenterological disease processes results from the formation of granulomas of the mucosal lining and then fibrosis and hypertrophy of the muscles underlying the submucosa? 1. Crohn’s disease 2. Diverticulitis 3. Gastroenteritis 4. Ulcerative colitis

Which of the following is the functional portion of the urinary system? 1. Bowman’s capsule 2. Glomerulus 3. Nephron 4. Urethra

Which of the following is the responsible mechanism for the formation of ketone bodies? 1. Anabolism of glucose 2. Catabolism of glucose 3. Anabolism of fatty acids 4. Catabolism of fatty acids

After leaving the sinoatrial node an electrical impulse is next conducted to the: 1. Purkinje fibers 2. Bundle of HIS 3. Internodal pathways 4. AV junction

What is the name for the time period between exposure to a disease and seroconversion? 1. Latent period 2. Window phase 3. Disease period 4. Communicable period

You are called to the scene of a 70yo female patient complaining of lower left-sided colicky pain. the pt 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 pt is most likely suffering from: 1. Appendicitis 2. Crohn’s disease 3. Diverticulitis 4. Hemorrhoids

You have an 81yo pt with rales in both lower lobes and you have rules out pneumonia as a cause. Acute pulmonary edema would be best described by which of the following? 1. Plasma in the alveoli, usually caused by left heart failure 2. Blood in the alveoli, usually caused by right heart failure 3. Plasma in the alveoli, usually caused by right heart failure 4. Phlegm in the alveoli, usually caused by left heart failure

Which of the following is an accessory digestive organ disease? 1. Bowel obstruction 2. Kidney stones 3. Pancreatitis 4. Diverticulitis

At the scene of a private residence you have an elderly male pt that has collapsed into an unresponsive state. His wife says he complained of a severe headache and then immediately collapsed. This pt is most likely suffering from a/an: 1. Embolic stroke 2. Cluster headache 3. Thrombotic stroke 4. Hemorrhagic stroke

A local outbreak of influenza has struck your community. Which organization will be responsible for monitoring this outbreak and educating the public? 1. Medical control 2. Local public health 3. CDC 4. Public information systems

Which of the following causes of chronic gastroenteritis would be responsive to antibiotic therapy? 1. Rotavirus 2. Enterobacter 3. Giardia lamblia 4. Cryptosporidium parvum

Which of the following best describes where most neoplasms in the brain originate? 1. From a benign tumor present at birth 2. Metastasized from benign tumors located elsewhere in the body 3. Metastasized from malignant tumors located elsewhere in the body 4. From a malignant tumor formed in the brain that metastasized to other parts of the body

Which of the following would provide the best relief of the colicky pain experienced by a pt with ulcerative colitis? 1. Oxygen 2. Antiemetics 3. Antihistamines 4. Antispasmodics

Your pt is taking a medication that is designed to increase blood calcium levels by increasing hormone production. Which hormone is involved? 1. Thyroxine 2. Calcitonin 3. Triiodothyronin 4. Parathyroid hormone

The best way to describe the effects of Candida that has caused an infection is to say that there is: 1. An imbalance in the normal bacteria 2. Lack of good personal hygiene 3. Lack of the proper nutrients 4. Spread of colon bacteria

Which of the following would be abnormal for a pregnant female in her last trimester of pregnancy? 1. An elevated bp 2. A blood loss of 30% with no signs of shock 3. A respiratory rate that is greater than her normal rate 4. A pulse rate that is 10-15 beats faster than her normal rate

You are called to treat a pt complaining of a HA, facial drooping, confusion, and aphasia. The BP is 120/80, pulse ox is 98%, HR 70, RR 16. If the symptoms seem to be resolving, which of the following describes the most appropriate treatment? 1. Supine position, advanced airway, and rapid transport 2. Supine position, high-flow O2, rapid transport 3. If symptoms resolve, no tx or transport necessary 4. Left lateral position and transport

Your pt has paroxysmal nocturnal dyspnea. With which of the following is this most commonly associated? 1. Pneumonia 2. Left heart failure 3. Right heart failure 4. COPD

Which of the following vascular disorders would most likely have a hx of recent trauma? 1. Vasculitis 2. Varicose veins 3. DVT 4. AAA

You are dispatched to a 55yo male with a complaint of lower abdominal pain. You are surprised when you arrive o the scene and find the man to be in the end stages of shock. He is wet, play, and unresponsive with a barely palpable carotid pulse. His breathing is agonal. You being CPR and quickly load for transport and ALS intercept. The wife reports that the man had severe lower abdominal pain that came on quickly. He was rolling around on the floor before he became unresponsive. As you try to put all of this together, you believe that most likely this man has suffered a/an: 1. Stroke 2. MI 3. Aortic aneurysm 4. Brain hemorrhage

Which of the following signs or symptoms would best lead you to suspect you pt has pain associated with abdominal bleeding? 1. Cullen’s sign 2. Referred pain 3. Fetal position 4. Distention of the abdomen

If your pt is able to loo in all directions with his eyes, which cranial nerves are intact? 1. II, III, IV 2. II, IV, VI 3. III IV, V 4. III, IV, VI

Which of the following is the terminology for the cell from which other blood cells form? 1. Erythrocyte 2. Erythropoietin 3. Hematopoiesis 4. Pluripotent stem cell

You are called to the scene of a pt with a head injury who has a temp of 104 F. Your pt has a blood pressure of 120/80, respirations of 16, and a pulse of 70. Which of the following best describes the results of these assessment findings? 1. These would be expected findings in head injuries 2. The pt has stabilized and should not be considered critical 3. The head injury and heat illness are canceling each other’s effects on vital signs 4. The pt is probably taking a medication that is preventing the body from responding

Which of the following types of artifact will make identification of the presence of a paced rhythm virtually impossible? 1. Muscle artifact 2. Patient movement 3. Wandering baseline 4. 60 cycle interference

The clotting cascade is interrupted by the administration of which of the following and thus prevents clot formation? 1. Ticlid 2. ASA 3. Vitamin K 4. Coumadin

Which of the following is the MOST serious physical manifestation of anaphylaxis? 1. Urticaria 2. Wheezing 3. Pruritus 4. Hypotension

You have a pt who has just completed hemodialysis and now has profound hypotension. Why would this pt need immediate transport to the emergency department? 1. Renal diagnostics 2. Fluid replacement 3. Monitoring for seizures 4. Renal failure monitoring

Which of the following is a leukocyte disorder? 1. Neutropenia 2. Polycythemia 3. Multiple myeloma 4. Thrombocytopenia

Which of the following would you anticipate as a result of decreased insulin levels in the body? 1. Hypoglycemia 2. Fat catabolism 3. Decreased urination 4. Pale, cool, clammy skin

Which of the following would be responsible for humoral immunity? 1. T cell monocytes 2. B cell monocytes 3. T cell lymphocytes 4. B cell lymphocytes

You are called to treat a pt who has ingested a belladonna leaf. What would you most likely expect to see as signs and symptoms from this ingestion? 1. SLUDGE 2. CNS excitation 3. Flu-like symptoms 4. Dry skin and mucous membranes

Which of the following terms is most closely associated with “systemic vascular resistance”? 1. Afterload 2. Cardiac output 3. Preload 4. Stroke volume

You are called to assess a pt who had a sudden onset of 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? 1. The pt is suffering from heat stroke 2. The pt is suffering from an embolic stroke 3. The pt is suffering from a thrombotic stroke 4. The pt is suffering from a hemorrhagic stroke

Which of the following people described below would most likely risk suffering from exertion heat stroke? 1. 20yo diabetic on a hot day 2. 26yo shoveling snow on a cold day 3. 56yo CHF on diuretics on a hot day 4. 20yo well-hydrated football player on a warm day

You are assessing a pt with a heat emergency who is presenting with hot, moist skin, seizure activity, deep, rapid respirations, a rapid pulse, an increasing core temperature, and a low bp. Which of the following would best describe this pt’s condition? 1. Heat stroke where the pt has lost the ability to cool himself 2. Heat stroke where the pt still has the ability to cool himself 3. Heat exhaustion where the pt has lost the ability to cool himself 4. Heat exhaustion where the pt still has the ability to cool himself

An idiopathic inflammatory bowel disease limited in location to the rectum would be known as: 1. Proctitis 2. Pancolitis 3. Crohn’s disease 4. Ulcerative colitis

You are called to assess a 40yo male who had crushing chest pain while he was working out. After rest, the pain has diminished, but it is still present. The pt informs you he has a hx of angina and takes one nitro to have relief. Your 3-lead ECG shows sinus tachycardia of 110, ST elevation in Lead I, and ST depression in Leads II and III. After two nitro and O2 the ST segments are normal and the pt is pain free. Which of the following would be the most appropriate field impression and tx? 1. Stable angina; no intervention necessary 2. MI; O2, ASA, NTG, and transport 3. MI; O2, ASA, MS, and transport 4. Unstable angina, MI; O2, ASA, and transport

Which of the following represents the appropriate maintenance regimen for amiodarone in a post resuscitation phase? 1. 0.5mg/min 2. 150mg/min 3. 1-4mg/min 4. 2-10mg/min

Which of the following is the most common cause of non-traumatic abdominal pain in the female? 1. Mittelschmerz 2. PID 3. Endometriosis 4. Ectopic pregnancy

Which of the following accurately represents a normal PR interval? 1. Measured from the beginning of the P to the beginning of the Q or R, and normal is 3-5 little boxes 2. Measured from the end of the P to the beginning of the Q, and normal is 3-5 little boxes 3. Measured from the beginning of the P to the beginning of the R, and normal is 0.04 to 0.12 seconds 4. Measured from the end of the P to the beginning of the R, and normal is 0.12 - 0.20 seconds

A cluster headache would be classified as which of the following types of headache? 1. Tension 2. Organic 3. Migraine 4. Vascular

You are called to a pt with Cushing’s syndrome. Which of the following should you avoid doing if the pt is stable? 1. Adminstering O2 via nasal cannula 2. Initiating IV access 3. Evaluating blood sugar 4. Attaching cardiac monitor

A SCUBA tank typically contains which of the following? 1. Compressed oxygen 2. Compressed oxygen and helium 3. Compressed oxygen and nitrogen 4. Compressed oxygen and hydrogen

This virus can exist only if the Hep B virus is present 1. Hep A 2. Hep C 3. Hep D 4. Hep E

Which of the choices listed refers to intractable nausea and vomiting, which can result in dehydration that may be experienced by a female pt during her first trimester of pregnancy? 1. Ketosis 2. Morning sickness 3. Emetic dehydration 4. Hyperemesis gravidarum

Which of the following is the pathophysiological cause of myxedema? 1. Too little circulating thyroid hormone 2. Too much circulating thyroid hormone 3. Too little adrenocorticotropic hormone 4. Too much adrenocorticotropic hormone

Which of the following would be an expected response from a histamine release? (Flag) 1. Bronchodilation 2. Vasoconstriction 3. Increased gastric motility 4. Decreased capillary permeability

After passing through the duodenum which of the following is the next anatomical structure that food passes through? 1. Cecum 2. Colon 3. Ileum 4. Jejunum

During depolarization of the heart muscle, which of the following ions enters the cell? 1. Magnesium 2. Sodium 3. Potassium 4. Phosphate

Anemia is defined as a deficiency in production of which of the following? 1. Iron 2. Platelets 3. White blood cells 4. Red blood cells

Which of the following is the pathophysiological cause of Cushing’s syndrome? 1. Too little circulating thyroid hormone 2. Too much circulating thyroid hormone 3. Too little adrenocorticotropic hormone 4. Too much adrenocorticotropic hormone

Which of the following anatomical regions is the most common location for bowel obsturction? 1. Ascending colon 2. Descending colon 3. Small intestine 4. Transverse colon

Which of the following is the responsible mechanism for the formation of ketone bodies? 1. Anabolism of glucose 2. Catabolism of glucose 3. Anabolism of fatty acids 4. Catabolism of fatty acids

Acute arterial occlusion will most commonly involve arteries in which of the following regions of the body? 1. Neck 2. Lungs 3. Abdomen 4. Extremities

You are called to a football practice field on a hot afternoon. You pt is a disoriented football player with hot, clammy skin and his hx indicates dehydration. Which of the following is the most likely problem? 1. Heat cramps 2. Heat exhaustion 3. Classical heatstroke 4. Exertional heatstroke

Of the conditions listed below, which one will most likely lead to hypernatremia? 1. Addison’s 2. Cushing’s 3. Grave’s 4. Myxedema

You are called to the scene of a 27yo male who had a sudden onset of severe dyspnea and CP. The pt has been a 2pk/day smoker for 12 yrs. He has a hx of chronic bronchitis. Which of the following would lead you to determine that the cause of his problem today is a spontaneous pneumothorax vs exacerbation of his chronic bronchitis 1. Hemoptysis 2. Unequal lung sounds 3. JVD 4. Unilateral hyperresonance

You are assessing ventilation for an unconscious adult pt with inadequate breathing. What is the preferred method of assisting the pt’s ventilations? 1. Flow-restricted, O2-powered ventilatory device 2. Pocket mask with supplemental O2 3. 2 person BVM 4. 1 person BVM

Pulmonary edema may develop during hypertensive emergency. This is because the high systemic pressure: 1. Increases pulmonic pressures 2. Causes a left ventricular failure 3. Forces fluid out of the lung’s parenchymal tissue 4. Forces blood out of the pulmonary capillaries into the alveoli

Which of the following hypotension compensatory mechanisms will be the least effective when a pt is suffering from cardiogenic shock? 1. Improving preload 2. Increasing contractile force 3. Improving respiratory efficiency 4. Increasing peripheral vascular resistance

You have administered aspirin, nitro, and an analgesic to a pt with a previous complaint of chest pain who is now pain free and refusing transport. Which of the following would be the best argument for the pt to reconsider his decision? 1. He is within the window of opportunity for thrombolytics 2. Once he has received an analgesic, he cannot refuse treatment 3. Protocol does not allow you to discontinue care once an IV is established 4. He could go into arrest any minute and should be at the hospital if this happens

Where is the principle location of carbon dioxide in venous blood? 1. As a dissolved gas in the plasma 2. Bound to the proteins in the blood 3. In the plasma as Bicarbonate HCO3- 4. In red blood cells bound to hemoglobin

You are called to assess a pt with a primary complaint of SOB and chest discomfort. The pt is hypotensive and you see ST elevation in leads II, III, and AVF, normal ST segments in Leads V5 and V6, and ST depression in Leads V3 and V4. Which of the following would you most likely expect to find? 1. Flat neck veins 2. Pulmonary edema 3. ST elevation in V1 and V2 4. ST elevation in R leads

You have a pt experiencing a hypertensive emergency. Which of the following reactions would you expect from the heart? 1. Increase in systemic pressure will be compensated for by Starling’s Law 2. Increase in stretching of the left ventricle will cause a decrease in cardiac output 3. The increase in systemic pressure will be compensated for by an increase in pulmonic pressure 4. The increase in systemic pressure will be compensated for by an enlargement of the left ventricle

Which of the following pt having an MI is at greatest risk of developing a life threatening emergency? 1. Septal wall infarct with hypotension 2. Inferior wall infarct with pedal edema 3. Lateral wall infarct with significant chest pain 4. Extensive anterior wall infarct with tachycardia

Which of the following medications is most commonly utilized in the tx of high altitude illnesses? 1. Nifedipine 2. Furosemide 3. Acetazolamide 4. Sodium bicarb

Rank the following in order from the most common in occurrence to the least common in occurrence? 1. Epilepsy, stroke, parkinson’s 2. Stroke, parkinson’s epilepsy 3. Stroke, epilepsy, Parkinson’s 4. Parkinson’s, stroke epilepsy

Which of the following drugs is typically omitted in the tx of a pt with acute congestive heart failure? 1. Nitroglycerin 2. Morphine 3. Furosemide 4. ASA

The sympathetic NS is responsible for: 1. Bradycardia, vasodilation, and increased peristalsis 2. Tachycardia, vasoconstriction, and decreased peristalsis 3. Bradycardia, vasodilation, and decreased peristalsis 4. Tachycardia, vasoconstriction, and increased peristalsis

for which of the following pt would a 3 lead ECG analysis be the most useful? 1. Unresponsive trauma pt 2. Pt complaining of chest pain 3. Pt complaining of a racing heart 4. Unresponsive pt with rigor mortis

You are called to assess and tx a 64yo male complaining of a severe headache, vomiting, visual distrubances, and left-sided paralysis. The pt’s pulse is 56 and his BP is 220/160. He is noncompliant with his “BP medication. Which of the following should you most likely suspect? 1. Chronic hypertension 2. Pulmonary hypertension 3. Thrombotic or embolic CVA 4. Hypertensive encephalopathy

You are performing CPR on a medical pt in a cardiac arrest who was feeling fine 30 minutes ago. The pt then went into cardiac arrest, and you are now unable to obtain any pulses. The pt has a hx of MI and your monitor shows a sinus tach at 130. The pt has just gone into asystole despite all your efforts and you have ruled out and treated all possible causes. Which of the following would be the most appropriate intervention? 1. Terminate the code 2. Administer Epi 3. Administer sodium bicarb 4. Establish TCP

Which of these substances presents a predisposing risk factor for only cold emergencies? 1. ASA 2. ETOH 3. Diuretics 4. Beta-blockers

Which statement most clearly describes a complete cardiac cycle? 1. The end of one contraction to the beginning of another 2. The beginning of one contraction to the end of that contraction 3. The beginning of one contraction until the end of another 4. The end of one contraction to the end of the next

You have a pt who takes the following mediations: prednisone, ipatroprium, betamethosone, and Metaproterenol. Which of the following conditions would you most likely sxpect this pt is suffering from 1. Asthma 2. Pneumonia 3. Emphysema 4. Chronic bronchitis

During assessment, your pt reveals cardiac dysrhythmias and SOB. While on a NRB O2 en route to the emergency department, the pt develops worsening dyspnea and begins to exhibit bigeminal PVCs. What would these assessment findings reveal? 1. Respiratory exposure to CO 2. Respiratory exposure to Paraquat 3. Inhalation exposure to anhydrous ammonia 4. Significant dermatologic exposure to mercury

You are called to provide tx for an unresponsive, apnea pt with a pulse who was just pulled from the water. Your initial attempt to ventilate the pt was unsuccessful. After oral suctioning and reattempting ventilation, which of the following would be the most appropriate action? 1. Place an advanced airway and suction the trachea 2. Perform chest compressions to clear the lungs of fluid 3. Decompress the stomach to alleviate the airway obstruction 4. Attempt to squeeze the BVM more slowly to break the laryngospasm

You are dispatched to the residence of a 42yo male observed sitting in a tripod posiiton. Which of the following would be the most critical sign regarding this pt? 1. Peripheral edema 2. Pulmonary edema 3. Elevated HR 4. Peripheral cyanosis

Which of the following system would be primarily affected by the renin-angiotenin-aldosterone system 1. Cardiac 2. Gastrointestinal 3. Genitourinary 4. Respiratory

You are assessing a male pt in his mid-50s who is having a severe headache. Although he is conscious and oriented, his BP is 204/128, the HR is 108/min, and rest are 18/min. he has a hx of well controlled hypertension and Type II diabetes. The only change made recently to his meds was the addition of a new OTC medication he just started last week. Of the listed OTC. which is likely to contribute to his elevated BP 1. Aleve 2. Claritin 3. Motrin 4. Xenedrine

You are called to treat an unresponsive, apnea 27yo male suspected of suffering from a narcotic OD. You have administered naloxone, SIVP, as a tx for for this situation. Which of the following should you most likely anticipate? 1. The pt will immediately awaken 2. The pt will have a seizure or awake violently 3. The pt will need an additional administration of naloxone 4. The pt will have a reverse effect due to the slow administration

You are called to the residence of a 38yo male found unresponsive on the floor of his bathroom. His skin is very pale, cool, and clammy. He has complained of abdominal pain for the last month as well as black, foul-smelling feces. His respiratory rate is 28, pulse 120, bp 70/50. Which of the following field diagnoses and interventions is the most appropriate? 1. Vagal response; 0.5 - 1.0 of atropine 2. Dissecting aoritc aneurysm; PASG, fluids, and rapid transport 3. Anemia from a slow GI bleed; fluid resuscitation and rapid transport 4. Hypovolemia from a rapid GI bleed; fluid resuscitation and rapid transport

Which of the following typically causes pneumonia? 1. Stimulation of type II pneumocytes resulting in the breakdown of cilia 2. Increased pulmonary capillary permeability resulting in protein-rich fluid filling the air spaces 3. Resistance to antimicrobials or the use of broad-spectrum antibiotics for a viral infection 4. A weakness in host defenses, the presence of a particularly virulent organism, or the introduction of a large amount of an invading organism

You are transcutaneously pacing a pt with a 2nd degree type II block prior to your intervention.The pt remains unresponsive and apnea and you are continuing ventilations. Which of the following is your most important intervention? 1. Obtain 12 lead 2. Verifying electrical capture 3. Verifying mechanical capture 4. Setting heart rate appropriately

Which of the following signs and symptoms occur with the Hantavirus? 1. Headache, vertigo, and vision disturbances 2. Fever, chills, earache, sore throat, and body aches 3. Body rash, abdominal pain, and difficulty breathing 4. Fever, headache, body aches, and respiratory difficulty

What actions should you take to prepare for an imminent delivery? This pregnant female is full term and this is her third child. 1. Create an area that is sterile and free of any germs 2. Instruct her to lie on her side when she has an urge to push 3. Tell the pt to use the bathroom while you are setting up 4. Have the pt remove her pants and cover her legs with a sheet

Which of the following would cause disruptions in perfusion, while diffusion would be normal? 1. Emphysema 2. Pulmonary edema 3. Inhalation injuries 4. Pulmonary embolism

Which of the following ECG abnormalities would be most indicative of a myocardial ischemia? 1. Pathological Q waves 2. Physiological Q waves 3. An elevated ST segment 4. A depressed ST segment

Which of the following is considered a part of hemostasis? 1. Coagulation 2. Fibrinolysis 3. Platelet timing 4. Vascular dilation

Regarding underwater diving accidents, which gas law is responsible for the bends? 1. Universal gas law 2. Boyle’s law 3. Dalton’s law 4. Henry’s law

Which of the following is the main category of pancreatitis? 1. Traumatic 2. Infectious 3. Vascular 4. Metabolic

Which of the following dive emergencies typically requires the least intervention from EMS personnel? 1. Nitrogen narcosis 2. Pneumomediastinum 3. Arterial gas embolism 4. Pulmonary over-pressure

Which of the following is characterized by a progressive degeneration of nerve cells that control voluntary movement and progresses to weakness, loss of motor control, and difficulty speaking? 1. Myasthenia gravis 2. Alzheimer’s 3. Parkinson’s 4. ALS

You are called to transport a 24yo female G2P1 - 9 weeks gestation with no other previous medical hx. On arrival, you note that the pt has been vomiting clear emesis and appears weak and pale. Her husband tells you she 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 pt has poor skin turgor an da cap refill of 3 sec. Your partner tells you her vitals are: BP 94/72, Pulse - 100, Resp - 22. She is alert and well oriented. With the information provided, you suspect your pt is suffering from which one of the listed disorders? 1. Dehydration 2. Morning sickness 3. Diabetes mellitus 4. Hyperemesis gravidarum

You are called to a private residence to care for a pregnant pt that is bleeding vaginally. You estimate she has lost about 750cc of blood from what you see on the scene. She claims she has no pain. Based on this information, you believe the cause to be: 1. Abruptio placenta 2. Ectopic pregnancy 3. Placenta previa 4. Gestational diabetes

You are called to treat an unresponsive Alzheimer’s pt who has cool and clammy skin and an elevated HR. The blood pressure is slightly elevated, pulse ox is 98, and BGL is 60. Which of the following would be the appropriate intervention for this pt? 1. Administer high-flow O2 and transport 2. Initiate IV and deliver 25G dextrose 3. Initiate an IV of NS and administer a fluid bolus 4. Initiage IV and administer 12.5 G Dextrose

You are called to treat a pt with a hx of myxedema who has failed to take her prescribed medication for this condition. Which of the follow assessment findings would you most likely observe? 1. Agitation 2. Tachycardia 3. Hypothermia 4. Low blood sugar

Which of the following reasons explains why the pt with hyperglycemia is dehydrated? 1. The associated nausea and vomiting decreased fluid intake 2. The kidneys removed the excess sugar and therefore the water 3. The elevated sugar levels caused a decrease in ADH production 4. The elevated blood sugar drew water from the interstitial space

Which of the following accurately reflects Cushing’s reflex? 1. Increased pulse, respirations, and temperature and decreased blood pressure 2. Increased pulse and respirations and decreased blood pressure and temperature 3. Decreased pulse and respirations and increased blood pressure and temperature 4. Decreased pulse, respirations, and temperature and increased blood pressure

Which of the following would you anticipate as a result of decreased insulin levels in the body? 1. Hypoglycemia 2. Fat catabolism 3. Decreased urination 4. Pale, cool, clammy skin

If you have received your Hep B vaccination, what other type of Hepatitis are you protected against? 1. Hep A 2. Hep C 3. Hep D 4. Hep E

You are called to treat a pt who had complained of bloody diarrhea prior to becoming unresponsive. The pt is pale, cool, clammy, tachycardic, tachypnic, and vomiting. Which of the following is your most important intervention? 1. Intubation 2. Fluid resuscitation 3. Administration of antiemetics 4. Administration of high-concentration O2

Which of the following will most commonly produce sinus tach? 1. An increase in sympathetic tone 2. Decreased parasympathetic tone 3. Cocaine overdose 4. Cardiogenic shock

Which of the following medical conditions is caused by the formation of a blood clot within the vasculature of the brain? 1. Cerebral embolism 2. Cerebral Thrombosis 3. Intracerebral hemorrhage 4. Subarachnoid hemorrhage

You and your partner are dispatched to the scene of a young female pt who has been vomiting for three days. She claims the cause is from food poisoning. She is now pale, sweaty, very weak, and listless. Her pulse is 118, respirations are 28, and BP is 92/42. You believe she is hypovolemic and your partner believes she just has the flu and is “making a big deal out of nothing”. How should you proceed with the best treatment for this pt? 1. Start 2L O2 2. Prepare for rapid transport 3. Identify the source of the poisoning 4. Get the pt to start drinking some water

What other name may be used for natural immunity? 1. Humoral 2. Acquired 3. Innate 4. Cell-mediated

What is the term for a white blood cell count of 16,000 per microliter 1. Normal 2. Leukopenia 3. Neutropenia 4. Leukocytosis

You are attempting to ventilate a near drowning/submersion pt who was just pulled from the water. Your ventilation efforts are unsuccessful. Which of the following is the most likely cause? 1. Lungs are full of fluid 2. Stomach is full of water 3. Larynx is having a spasm 4. Airway has a foreign object

Which of the following is true regarding surface poisonings by caustic substances? 1. Alkalis cause eschars, so they burn deeper 2. Acids cause eschars, so they burn deeper 3. Acids cause eschars, so they don’t burn as deep 4. Alkalis cause eschars, so they don’t burn as deep

Which of the following would be a risk factor for hypothermia? 1. Adolescence 2. Hyperthyroidism 3. Use of antihistamines 4. Brief exposure to bitter cold

Speech is controlled primarily by which of the following regions of the brain? 1. Occipital 2. Parietal 3. Frontal 4. Temporal

When diving, which of these can occur as a result of a pulmonary over-pressure accident due to ascending too rapidly? 1. Hemothorax 2. Nitrogen narcosis 3. Arterial embolism 4. Open pneumothorax

You are called to assess a 67yo male with a complaint of abdominal pain and you suspect an abdominal aortic aneurysm. Which of the following signs or symptoms would you expect to find to help you confirm your field diagnosis? 1. Hypertension 2. Distended neck veins 3. Pt reports an urge to defecate 4. Unequal blood pressure in the arms

Nitroglycerine accomplishes which of the following in the setting of congestive heart failure? 1. Causes coronary vasodilation 2. Increases preload 3. Decreases venous return 4. Promotes diuresis

Which of the following best describes why dehydration contributes to the likelihood of a heat emergency? 1. Inhibits vasodilation 2. Decreases evaporation 3. Causes electrolyte imbalances 4. Increases the base metabolic rate

You are called to the scene of a pt with a head injury who has a temp of 104F. Other than head injury, what other condition should be a part of your field diagnosis for this pt? 1. Pyrexia 2. Heat stroke 3. Dehydration 4. Heat exhaustion

Which of the following is the most significant pathophysiology for the insulin-dependent diabetic who is hyperglycemic due to a failure to take his insulin? 1. The inability of the brain cells to betabolize glucose 2. An increase in pH due to ketoacidosis from fat catabolism 3. Dehydration and acidosis due to diuresis and gluconeogenesis 4. Infection and cardiac abnormalities due to increased glucose levels

Which of the following would be the best description of environmental emergencies? 1. When the body is unable to maintain homeostasis 2. When the environment becomes too hot or too cold to survive 3. A situation where the surrounding area has become hazardous 4. A medical condition caused by the weather or other local factors

Which of these skin assessment findings would be the most consistent with cardiac compromise? 1. Red 2. Pale 3. Mottled 4. Cyanotic

For which causative agent of AGE is there currently an injectable vaccine? 1. Hep A 2. Escherichia coli 3. Shigella sonnei 4. Rotavirus

Increased core body temperature as a result of inadequate thermolysis would be the definition of which of the following? 1. Pyrexia 2. Heat stroke 3. Heat illness 4. Heat exhaustion

Which of the following pt presents the greatest public health threat? 1. 6yo male with an active case of varicella zoster virus 2. 24yo male who looks very sick and just returned from Africa 3. 70yo male in a nursing home whose cough produces blood-tinged sputum 4. 22yo female who is HIV positive and sexually active with multiple partners

You are called to transport a 23yo female involved in a motor vehicle crash to the hosptial. the pt is alert and oriented, but very frightened. During a routine rectal exam performed by the trauma surgeon, she notes that the pt has vesicular lesions of the anus and labia. The pt’s health hx is significant for genital herpes several months ago, which was treated with acyclovir. The pt begins to cry, state 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: 1. The pt recently contracted the disease again due to unsafe sex practices and that she is not being completely truthful 2. The pt had stopped taking her medication once symptoms subsided and did not complete the full course a prescribed 3. Her infection has been dormant and she is suffering from a recurrent disease process 4. She is suffering from a differet communicable disease and not herpes

In reference to the signs and symptoms of alcohol abuse, a black out occurs: 1. When you binge drink 2. When you pass out from drinking too much 3. When you suffer from a subdural hematoma 4. When you have a partial or total loss of memory

An inflammation of the small outpouchings in the mucosal lining of the intestinal tract is referred to as which of the following? 1. Appendicitis 2. Colitis 3. Crohn’s 4. Diverticulitis

You are treating a pt with Hemophilia A. Which clotting factor is deficient in this pt? 1. VII 2. VIII 3. IX 4. X

The first heart sound auscultated in a pt is S1. S1 is produced by which of the following? 1. Opening of the AV valves 2. Closure of the AV valves 3. Opening of the semilunar valves 4. Closure of the semilunar valves

Which of the following would be the most appropriate tx for a pt with HHNK? 1. Hyperventilation to correct acidosis 2. Insulin to correct hyperglycemia 3. Sodium bicarb to correct acidosis 4. Fluid resuscitation to correct dehydration

In reviewing an ECG tracing with a supra ventricular rhythm, you observe that the QRS duration is 140milliseconds. In Lead V1, you see that a horizontal line from the J point to the intersecting line of the QRS forms a triangle that is pointed upward. This would best describe which of the following? 1. Left anterior hemiblock 2. Left BBB 3. Right posterior hemiblock 4. Right BBB

Cor pulmonale is directly associated with which of the following? 1. Left ventricular failure 2. Increased pulmonary pressures 3. Increased pulmonary edema 4. Excessive mucus production

You are called to a local factory for a pt who has passed out. The pt was in an overheated room and your assessment findings reveal a 28yo male with cool, diaphoretic skin. The pt has a pulse of 124 and a bp of 88/40. Which of the following would you suspect based on the above assessment findings? 1. Heat stroke 2. Heat exhaustion 3. Heat cramps 4. Febrile illness

You are assessing a pt complaining of chest pain with a left arm BP of 100/70 and a right arm B of 140/90. Which oft eh following would most likely be the cause of the unequal pressures? 1. Pericardial tamponade 2. Left-sided heart failure 3. High thoracic aneurysm 4. Peripheral artery disease

You are called to evaluate a 45yo female who is warm and dry. She has a hx of diabetes. She currently has frequent painful urniation, foul smelling uring, fever, moan when you percuss the left flank area. her respiration are 26 and deep an her pulse is 120. Pt is most likely suffering from which o the following? 1. Renal calculi 2. Pyelonephritis 3. DKA 4. Lower urinary tract infection

You are called to treat a 48yo male complaining of CP and his 12 lead indicates he is having an extensive anterior wall MI. The pt denies any SOB, pulse ox is 96%, and he tells you he smokes two packs a day. You have administered high-concentration O2 and the pt indicates that his chest pain has increased. Which of the following is the most likely cause of the increase in pain? 1. Infarction is increasing in size 2. O2 exacerbated his COPD 3. Non-rebreather mask increased his anxiety 4. Elevated oxygen level caused a constriction in the coronary arteries

Where is the thalamus located anatomically? 1. Pons 2. Cerebrum 3. Diencephalon 4. Mesencephalon

The primary cause of of esophageal varices is: 1. Acid reflux 2. Excessive vomiting 3. Portal hypertension 4. Ingestion of caustics

You are treating a pt experiencing a stroke who is aphasic. He is unable to move his right arm and legs. After applying O2 and assuring his airway is clear, which treatment will most likely benefit this pt? 1. Have him sit straight to improve circulation to the head 2. Continue talking and reassuring the pt 3. Move the pt to a couch or recliner 4. Check his pulse ox reading

Over 95% of cases of thyrotoxicosis are due to which of the following? 1. Myxedema 2. Hypothyroidism 3. Cushing’s syndrome 4. Graves’ disease

You are called to the scene of a pt with ST elevation consistent with a lateral wall infarct who is also complaining of substernal chest pain. Which of the following treatments should you perform FIRST if the pt denies SOB or any allergies? 1. ASA 2. O2 3. MS 4. NTG

Which of the following respiratory patterns would you expect to see in a pt with increased intracranial pressure? 1. Ataxic 2. Eupnistic 3. Kussmaul 4. Apneustic

Under which of the following would it be clearly legal to transport a pt having a behavioral emergency against his will? 1. When the pt is acting strage or bizarre 2. When ordered to transport by the online physician 3. When the pt is presenting a threat to himself or to others 4. When the pt is confused and disoriented to person, place, and time

In the kidney, the area that is indented where the ureter and other tissues join the kidney is named the: 1. Hilum 2. Papilla 3. Renal pelvis 4. Bowman’s capsule

You are caring for a dive emergency victim who is complaining of a sharp, tearing pain, confusion, vertigo, visual disturbances, and hemiplegia. Which of the following should you most likely suspect? 1. Nitrogen narcosis 2. Pneumomediastinum 3. Arterial gas embolism 4. Pulmonary over-pressure

Assuming the amount of bleeding is the same, which of the following puts with complaints of rectal bleeding should receive more aggressive monitoring and rapid transport? 1. Rectal bleeding 3 weeks post-partum 2. Rectal bleeding and a diet low in fiber 3. Rectal bleeding and a hx of alcoholism 4. Rectal bleeding after a difficult bowel movement

Which factor is primarily responsible for causing aortic aneurysms? 1. Infection 2. Congenital 3. Hypertension 4. Atherosclerosis

Which of the following are true of U waves? 1. they precede T waves 2. They usually appear negatively deflected 3. They are usually associated with hyperkalemia 4. They may be associated with electrolyte imbalance

The increased ability to produce red blood cells is made possible by which of the following organs? 1. Liver 2. Pancreas 3. Kidneys 4. Spleen

Which of the following is caused by an increase in fluid within the brain tissue as a result of high altitude illness? 1. CVA 2. AMS 3. HAPE 4. HACE

You are performing CPR on a medical pt in cardiac arrest who was feeling fine 30 minutes ago. The pt then went into cardiac arrest, and you are now unable to obtain any pulses. The pt has a hx of MI and our monitor shows a sinus tach at 130. Which of the following interventions would have the BEST chance to yield a positive outcome in this case? 1. Fluid resuscitation 2. Synchronized cardioversion 3. Administration of adenosine 4. Unsynchronized cardioversion

You are called to the scene of a 57yo male pt with a 5-day hx of abdominal pain, heartburn, and dark, tarry stools. Which of the following would you most likely select for a field diagnosis 1. Cardiac ischemia 2. Esophageal varices 3. H pylori caused chronic gastroenteritis 4. Salmonella caused acute gastroenteritis

Which of the following respiratory conditions is most likely to lead to cor pulmonale? 1. Ards 2. Asthma 3. Pneumonia 4. Emphysema

You are called to treat a diabetic pt with warm, dry skin, hypotension, tachycardia, and normal respirations who is responsive only to painful stimuli. The pt takes an oral hypoglycemic medication. Which of the following would best apply to this situation? 1. DKA; administer fluids 2. HHNK, administer fluids 3. Hypoglycemia, administer dextrose 4. Diabetes insipidus, administer flids

Which of the following would predispose a person to experience frostbite? 1. Taking ASA 2. Hyperthyroidism 3. Calm wind conditions 4. Wearing too much clothing

Which of the following defines reentry? 1. Multiple cardiac cells other than pacemaker cells depolarize simultaneously 2. Conduction in one branch is slowed, causing a unidirectional block in the other 3. A decreased cardiac output causes greater than normal after load 4. There is a longer than normal refractory period, allowing for faster depolarization

Which of the following accurately reflects H1 and H2 responses? 1. H2 stimulation causes brocnchoconstriction and vasodilation 2. H1 Stimulation causes vasodilation and secretion of gastric acids 3. H1 stimulation causes bronchoconstriction and contraction of the intestines 4. H2 stimulation causes contraction of the intestines and secretion of gastric acids

Which of the following ECG findings would be the most expected in a pt experiencing angina? 1. A normal 12 lead 2. ST segment elevation 3. ST segment depression 4. Widened QRS complexes

What is the mortality rate for the pt populations suffering from a TIA? 1. 0% 2. 5% 3. 15% 4. 33%

You are performing CPR on a medical pt in cardiac arrest who was feeling fine 30 minutes ago. The pt then went into cardiac arrest, and you are now unable to obtain any pulses. The pt has a hx of MI and your monitor shows a sinus tach at 130. Which of the following would best fit this situation? 1. Hypovolemia 2. Pulmonary embolism 3. Ventricular aneurysm 4. Pericardial tamponade

Your pt is suffering from a dysrhythmia, which is resulting in hypotension, diminished loc, tach greater than 180, and decreased pulse ox readings. You suspect the cause might be an MI. Which of the following is the MOST important intervention? 1. Adminsiter ASA 2. Administer O2 3. Identify the rhythm 4. Decrease the HR

You are called to treat a pt with a hx of Crohn’s disease who is unresponsive, tachycardia, pale, cool, clammy, and normotensive. The pt had diarrhea, vomiting, and abdominal pain. Which of the following is most likely to positively affect the unresponsiveness? 1. Fluid resuscitation 2. Oxygen administration 3. Dextrose administration 4. Antispasmodic administration

Which of the following is considered to be a risk factor for experiencing an environmental emergency? 1. A pt with a hx of regularly exercising 2. Renal failure pt are at greater risk 3. The elderly only 4. A hx of overall good general health offers no protection

Your pt assessment reveals colicky abdominal pain in lower quadrants, accompanied by a hx of bloody diarrhea, nausea, and vomiting. What would your field dx be in this case? 1. Diverticulitis 2. Gastroenteritis 3. Hemorrhoids 4. Ulcerative colitis

The Helicobacter pylori bacillus is usually the cause of: 1. Acute gastritis 2. Chronic hepatitis 3. Acute gastroenteritis 4. Chronic gastroenteritis

Which of the following is the MOST common complication of acute myocardial infarction? 1. Dysrhythmias 2. Chest pain 3. Vomiting 4. Dyspnea

Which of the following best describes the purpose of the medication Coumadin? 1. Thins the blood 2. Blocks vitamin K activity 3. Decreases platelet aggregation 4. Interferes with thrombin activation

Which of the following signs or symptoms would best lead you to suspect your pt has pain associated with abdominal bleeding? 1. Cullen’s sign 2. Referred pain 3. Fetal positioning 4. Distention of the abdomen

You are assessing a 62yo female with a complaint of CP. 12 lead indicates an extensive anterior wall MI. Which of the following is the most likely life threatening problem that will develop? 1. Pulmonary edema from LHF 2. Bradycardia from a complete heart block 3. Ventricular aneurysm from infarcted tissue 4. Supraventricular tachycardia from cardiac irritation

Which of the following best describes afterload? 1. The resistance against which the heart must pump 2. The volume filling the ventricles during systole 3. The volume filling the ventricles during diastole 4. The decrease in pressure in the coronary arteries

Which of the following would be the greatest hazard associated with the usage of an artificial external pacemaker? 1. Discomfort to the pt 2. Damage to the myocardium 3. Failure to verify mechanical capture 4. The presence of a runaway pacemaker

During the diastolic phase of the cardiac cycle, which of the following valves remains open? 1. Semilunar 2. Aortic 3. Tricuspid 4. Pulmonary

Approximately how many americans are diagnosed with hypertension? 1. 1M 2. 10M 3. 25M 4. 50M

Which of the following ions is MOST responsible for ensuring cardiac muscle contraction? 1. Magnesium 2. Chloride 3. Calcium 4. Sodium

Which of the following best describes a hypertensive emergency? 1. An acute elevation of blood pressure requiring intervention within one hour 2. A blood pressure that increases by 50 mmHg within 4 hrs 3. Uncontrollable blood pressure for at least 72 hrs 4. A blood pressure of 180/100 for 2 hrs or more

A specific problem that artherosclerosis can cause is: 1. Atrial rupture 2. Ventricular rupture 3. Coronary blood vessel rupture 4. Interference with dilation/constriction of arteries

Contraction of cardiac muscle tissue occurs after which of the following? 1. Polarization 2. Repolarization 3. Conduction 4. Depolarization

While caring for a pt with a cardiac emergency you view the presentation of a pt with cariogenic shock, which is best described as: 1. A pump failure issue that is usually a result of a myocardial contusion 2. A type of shock that usually occurs as a result of a cardiac tamponade 3. A shock that remains after dysrhythmias, hypovolemia, or poor vascular tone have been addressed 4. A shock that occurs after a pt has had a myocardial infarction involving the right ventricle

You are treating a pt 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 pt? 1. Have him sit straight to improve circulation to the head 2. Continue talking and reassuring the pt 3. Move the pt to a couch or recliner 4. Check his pulse oximetry reading

Which of the following is a lab test typically used to determine if a pt is suffering from AMI? 1. Hematocrit 2. KCI 3. PTT 4. CK-MB

You have a pt in cardiogenic shock who also has acute pulmonary edema.Which of the following medications will have the least negative impact on this pt’s compensatory mechanisms? 1. Oxygen 2. Morphine 3. Furosemide 4. Nitroglycerin

Which of these is regarded as a typical cause of PEA? 1. Short QT syndrome 2. Ischemic stroke 3. Hyperkalemia 4. Hypertension

Which of the following is the leading cause of death among all persons in the unites states? 1. Cerebrovascular accident 2. Lung cancer 3. Myocardial infarction 4. Traffic accidents

You are utilizing the R-R interval method to calculate a heart are on an ECG and you have counted 15 small boxes between two consecutive R waves. What is the heart rate of this ECG? 1. 72 2. 84 3. 100 4. 144

While caring for a pt in left heart failure the pt’s spouse asks you what is the most common cause of this condition. Which of the following would be the most accurate answer? 1. COPD 2. MI 3. Congenital defects 4. Obesity

Which of the following reflects the intrinsic firing rate of the SA node: 1. 15-40 2. 40-60 3. 60-80 4. 60-100

From the list below which factor would be the most influential in causing right heart failure? 1. Cor pulmonale 2. Left heart failure 3. Pulmonary edema 4. Tricuspid valve disorders

You suspect that your pt has developed cardiac tamponade. You attach an ECG monitor. Which of the following would you expect to see that would support your suspicion? 1. Bradycardia 2. Inverted P waves 3. Electrical alternans 4. PR segment depression

In the average adult, an increased diastolic pressure is a reflection of an increase in: 1. Preload 2. Left ventricular pumping 3. Pulmonary artery pressure 4. Systemic vascular resistance

Which of the following interventions would be the most appropriate selection to increase the blood pressure of a hypotensive, bradycardia (55) pt with a hx of pheochromocytoma, who has ST elevation in Leads V1 and V2 and CP so as to receive NTG and/or MS? 1. Atropine 2. Dopamine drip 3. Fluid challenge 4. Epinephrine drip

What is the unit of measure for the component of a transcutaneous pacemaker regarding the amount of current delivered? 1. Volts 2. Amps 3. Joules 4. Milliamps

Which of the following is the limiting factor of cardiac anatomy that determines intrapericardiac pressure? 1. The tough, fibrous nature of the pericardium 2. The increase in pressure reduces atrial output 3. The increase in pressure reduces electrical conduction 4. The tamponade of bleeding from an increase in pressure

Which of the choices below best represents the reason we give aspirin to patients we suspect of having a heart attack? 1. Platelet aggregation inhibitor 2. Thrombolytic agent 3. Blood thinner 4. Analgesic

Which of the following ECG abnormalities would be most indicative of myocardial ischemia? 1. Pathological Q waves 2. Physiological Q waves 3. Elevated ST segment 4. Depressed ST segment

Which of the following would be a late sign of left-sided heart failure? 1. 2+ pitting edema in the sacral area 2. The presence of pink, frothy sputum 3. The presence of JVD 4. HR of 120

Angina most often occurs due to which of the following? 1. Arterial spasm 2. Carotis artery obstruction 3. Coronary artery disease 4. Pulmonary emoblus

You have been called to treat a pt who had previously suffered a massive left-sided MI and is now complaining of difficulty breathing. The pt has been non-compliant with this prescribed medication. Which of the following assessment findings would suggest that the pt is now suffering from right heart failure as well? 1. Sacral edema 2. Pulmonary edema 3. BP of 74/50 4. Decreased LOC

Acute arterial occlusion will most likely occur as a result of which of the following medical conditions? 1. Emboli 5. Claudication 6. Atherosclerosis 7. Arteriosclerosis

you are managing a 57yo male diabetic who is complaining of shortness of breath. His lung sounds are clear, neck veins are distended, pulse is 70, respirations are 24, BGL 90, and BP is 72/50. 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. 1L NS 2. 25G D50 3. 0.3-0.4 NTG 4. 2-20 mcg/kg/min Dopamine

Which of the following drugs is typically omitted in the treatment of a pt with acute congestive heart failure? 1. NTG 2. MS 3. Furosemide 4. ASA

You are assessing a pt with carotid bruits who is currently in a narrow complex tachycardia at a rate of 200. Which of the following would most likely occur if a carrots sinus massage was performed? 1. Embolic stroke 2. Thrombotic stroke 3. Carotis vasospasm 4. Pulmonary embolism

Which of the following signs and symptoms would most closely be associated with a pt in cardiogenic shock? 1. Tachycardia, warm skin, and altered level of consciousness 2. Hypotension, cyanosis, bradycardia, strong bounding pulse 3. Hypertnesion, alterled LOC, CP, JVD 4. Hypotension, hypoxia, tachycardia, and pedal and/or pulmonary edema

Which of the following BEST describes angina pectoris? 1. When chest pain is relieved with NTG or rest 2. When cerebral tissue perfusion is temporarily decreased 3. When coronary vasospasm decrease blood supply to the heart 4. Chest pain that results when the heart’s demand for O2 exceeds the blood supply available

Your pt is a 67yo male with difficulty breathing. Assessment reveals crackles in all lobes with production of pink, frothy sputum. Pulse is 154 and irregular and bp is 78/42. The pt only response to pain. A 12 lead ECG shows ST elevation in leads V1 to V4. Which of the following would be the most appropriate intervention? 1. Furosemide 1mg/kg IV push 2. NTG 0.4mg 3. Synchronized cardioversion at 120-200 joules 4. Adenosine 6mg RIVP followed by 12mg if needed

You are performing CPR on a medical pt in cardiac arrest who was feeling fine 30 minutes ago. The pt then went into cardiac arrest and you are unable to obtain a pulse. The pt has a hx of MI and your monitor shows sinus tach at 130. The pt has just gone into asystole despite all your efforts what do you do? 1. Terminate code 2. Administer epi 3. administer sodium bicarb 4. Establish TCP

Nitroglycerine accomplishes which of the following in the setting of congestive heart failure? 1. Causes coronary vasodilation 2. Increases preload 3. Decreases venous return 4. Promotes diuresis

You have a pt who is unresponsive, has spontaneous respirations, has a carotid pulse of 40, and absent radial and femoral pulses. Your ECG analysis is of a second degree Type 2, and the 12 lead shows ST elevation in leads V1 and V2. Which of the following is your most appropriate intervention? 1. Atropine 2. Dopamine drip 3. Epinephrine 4. Transcutaneous pacing

Which of the following assessment tools would best be used to properly identify cardiac tamponade? 1. EKG revealing elevated ST segments 2. Tracheal deviation with extreme dyspnea 3. EKG showing PVCs 4. Manual blood pressure cuff with resulting pulses paradoxus

You are assessing a pt who is exhibiting signs of angina. Which of the following is your most important consideration? 1. Ruling out unstable angina or infarct 2. Determining where the pain radiates 3. Ascertaining whether the pain started at rest 4. Identifying whether the pt has taken his nitro

Which of the following has the greatest risk of increasing the chance of a person developing a cardiovascular disease? 1. Gaining weight 2. Exercising less 3. Continuing smoking 4. Increasing stress levels

Your trauma pt has received a chest contusion from an assault with a baseball bat. The pt is very anxious, restless and is becoming disoriented. He has moderate dyspnea and muffled heart tones. Symptoms are unimproved with O2 admin. What are the proper treatments to provide? 1. Bilateral IV with bolus, cardiac monitor, and pleural decompression 2. Support ventilations, rapid transport, bilateral IV and cardiac monitor 3. IV TKO, cardiac monitor, spinal immobilization, O2 by NRB 4. Bilateral IV TKO, cardiac monitor, rapid transport, pleural decompression

Of the adult population, which pts are at risk for developing a hypertensive emergency? 1. Pregnant women 2. Hemorrhagic stroke pt 3. Those with a hx of hypertension 4. Those with hypertensive encephalopathy

Which of the following supplies blood to the inferior wall of the left ventricle in the right coronary dominant pt? 1. RCA 2. CX 3. Anterior descending 4. LCA

Which of the following is the most common cause of death for the pt suffering from cardiogenic shock? 1. End-organ failure 2. Fatal dysrhythmias 3. Massive MI 4. Septic shock secondary to infection

You are performing CPR on a medical pt in cardiac arrest who was feeling fine 30 minutes ago. The pt then went into cardiac arrest, and you are now unable to obtain any pulses. The pt has a hx of MI and your monitor shows a sinus tach at 130. Which of the following would best fit this situation? 1. Hypovolemia 2. Pulmonary embolism 3. Ventricular aneurysm 4. Pericardial tamponade

You have decided to induce hypothermia in your hypotensive, post-cardiac arrest, adult pt. Which of the following is the correct method? 1. 1-2L NS at 4 degrees C 2. 1-2L NS at 68 degrees F 3. 5ml/kg NS at 4 degrees C 4. 20ml/kg NS at 68 degrees F

You are called to assess a 40yo male who had crushing chest pain while he was working out. After rest, the pain has diminished, but is still present. The pt informs you that he has a hx of angina and takes one nitro to have relief. Your 3 lead ECG shows sinus tach at 110, ST elevation in Lead I, and ST depression in leads II, and III. After 2 nitro and O2 the ST segments are normal and the pt is pain free.Which of the following would be the MOST appropriate field impression and treatment? 1. Stable angina, no intervention necessary 2. Myocardial ischemia, O2, ASA, NTG, transport 3. Myocardial infarction, O2, ASA, MS, transport 4. Unstable angina, myocardial ischemia, or infarction, O2, ASA, transport

When you arrive on the scene where CPR is being performed on a cardiac arrest victim, you find the person who is performing ventilations is doing so at about 30 per minute. What is the best method for correcting this situation? 1. Suggest to the rescuer his rate is too fast 2. Offer to take over ventilations from this rescuer 3. Order all CPR to stop and state a new crew is taking over CPR 4. Explain to rescuers that rapid ventilation does not allow the heart to fill

You are called to the scene of an elderly male pt with chest pain and palpitations. Your assessment reveals a hr of 210 per minute. Your goal should be which of the following? 1. Decrease inotropy 2. Increase chronotropy 3. Increase inotropy 4. Decrease chronotropy

Which of the following is considered to be a criteria for termination or resuscitation? 1. Victims of blunt trauma who have presented with and remain in asystole 2. Elderly pt who show no signs of improvement through out the arrest 3. ALS on scene efforts have been sustained for at least 10 minutes 4. The pt is 8yo of age or older

After leaving the SA node, and electrical impulse is next conducted to the: 1. Purkinje fibers 2. Bundle of His 3. Internodal pathways 4. Atrioventricular junction

You have just decided to terminate resuscitation at the residence of a pt. Your new basic EMT partner asks why there was no transport tot he emergency department where additional measures would be available. Which of the following would be your best response? 1. A code is less effective when run in an ambulance 2. Transport would have been more costly for the family 3. Transport would have raised false hopes for the family 4. Our care is better than the hospital’s for this type of call

Which of the following should be your highest priority in assessing and treating a conscious pt you suspect of having an MI? 1. Administration of ASA 2. Collection of a complete hx 3. Assessment of equal radial pulses 4. Identification of pt risk factors

If a pt had a decrease in cardiac output secondary to myocardial damage, how would the body initially attempt to compensate to maintain an adequate blood pressure? 1. Decrease heart rate 2. Increase fluid retention 3. Decrease stroke volume 4. Increase vascular resistance

During depolarization of the heart muscle, which of the following ions enters the cell? 1. Magnesium 2. Sodium 3. Potassium 4. Phosphate

You have a pt demonstrating a new complete heart block secondary to a myocardial infarction as a result of damage to the left and right bundle branches. Which of the following coronary arteries is Most likely involved? 1. Left circumflex 2. Posterior descending 3. Right coronary artery 4. Left anterior descending

You are on scene with a 72yo female with a chief complaint of nausea and generalized weakness. The pt’s hx is significant for cardiac disease and kidney stones. The pt currently take Flolan by continuous infusion for a diagnosis of primary pulmonary hypertension. Current assessment finds reveal 3+ pitting edema in the lower extremities, JVD, and clear lung sounds. the 12 lead EKG shows P wave enlargement in Leads II, III, AVF. Based upon assessment findings and hx, your initial field impression of this pt should be: 1. Hepatic failure 2. Acute renal failure 3. Left ventricular failure 4. Right ventricular failure

You are called to treat a 48yo male complaining of CP and his 12-lead indicates he is having an extensive anterior wall MI. The pt denies any SoB, pulse ox is 96, and he tells you he smoke two packs of cigarettes a day. You have administered high-concentration oxygen and the pt indicates that his chest pain has increased. Which of the following is the most likely cause of the increase in pain? 1. The infarction is increasing in size 2. The oxygen exacerbated his COPD 3. The non-rebreather mask increased his anxiety 4. The elevated oxygen level caused a constriction in the coronary arteries

Which of the following would be an atypical finding in a pt experiencing cardiac tamponade? 1. Narrow pulse pressure 2. JVD 3. Muffled heart tones 4. Absent lung sounds

You are assessing a pt you suspect is suffering from cariogenic shock. Which of the following would best help you differentiate this as a left-sided issue? 1. Pedal edema 2. Pulmonary edema 3. ST elevation in II, III, AVF and V4R 4. A positive response to a fluid challenge

Which factor is primarily responsible for causing aortic aneurysms? 1. Infection 2. Congenital 3. Hypertension 4. Atherosclerosis

Which of the following is the leading cause of death among all persons in the united States? 1. CVA 2. Lung cancer 3. MI 4. Traffic accidents

You are presented with an unstable bradycardia pt. Which of the following is the initial hr setting for TCP of this pt according to the AHA? 1. 40 per minute 2. 60 per minute 3. 80 per minute 4. 100 per minute

While auscultating a pt’s heart sounds, you hear an extra beat prior to SI or the normal lub sound of the heart. This is known as which of the following? 1. S2 2. S3 3. S4 4. S5

Acute arterial occlusion will most common involve arteries in which of the following regions of the body? 1. Neck 2. Lungs 3. Abdomen 4. Extremities

Which of the following accurately represents a normal PR interval? 1. Measure from the beginning of the P to the beginning of the Q or R, and normally is 3-5 little boxes. 2. Measured from the end of the P to the beginning of the Q, and normally is 3-5 little boxes. 3. Measured from the beginning of the P to the beginning of the R, and normal is 0.04 to 0.12 seconds 4. Measured from the end of the P to the beginning of the R and normal is 0.12-0.20 seconds.

In the case of an idioventricular rhythm, which of the following would be the most consistent? 1. The pacemaker site is at the AV node 2. The P waves are inverted and attached to the QRS 3. The heart rate is less than 60 complexes per minute 4. The QRS duration is greater than 0.12 and the axis is indeterminate

You are performing CPR on a medical pt in cardiac arrest who was feeling fine 30 minutes ago. The pt then went into cardiac arrest, and you are now unable to obtain any pulses. The pt has a hx of MI and our monitor shows a sinus tach at 130. Which of the following interventions would have the BEST chance to yield a positive outcome in this case? 1. Fluid resuscitation 2. Synchronized cardioversion Administration of adenosine Unsynchronized cardioversion

Your assessment reveals an 80yo female with a decreased LOC, hypotension pulmonary edema, and tachycardia. Select the correct answer regarding her condition and proper treatment. 1. Cardiogenic shock; nitro, lasix, asa, o2, iv, monitor 2. Renal failure; Dope, epi, beta-blockers, monitor, iv, o2 3. Myocardial infarction; epi, asa, nitro, morphine, O2, monitor 4. Cardiogenic shock; dobutamine or dopamine, O2, monitor, bilateral IV

When attaching the leads of an ECG monitor, a lead II tracing requires the positive electrode to be placed on the: 1. Left arm 2. Left leg 3. Right arm 4. Right leg

Your pt has paroxysmal nocturnal dyspnea. With which of the following is this most commonly associated? 1. Pneumonia 2. Left-heart failure 3. Right-heart failure 4. COPD

You are called to assess a 57yo pt with a primary complaint of chest pain. The pain began while the pt was climbing two flights of stairs and he informs you that he is now pain free, but it took three nitro tablets instead of the usual two for him to have relief. His 12 lead shows no abnormalities now. Which of the following is the MOST appropriate field impression an recommendation for this pt? 1. Angina, no intervention 2. Unstable angina, transport for further evaluation 3. Myocardial ischemia, O2, ASA, transport 4. Myocardial infarction, O2, ASA, NTG, MS, and transport

Which of the following interventions would be the MOST appropriate selection to treat a 57yo male pt with ST elevation in Leads V1-V6, pulmonary edema, blood pressure 90/50, Hr 60, and chest pain? 1. Furosemide 2. Nitroglycerine 3. Epinephrine drip 4. Dobutamine drip

Which of the following would best describe why we provide oxygen to a pt having an MI? 1. To reduce myocardial oxygen demand 2. to vasodilate cardiac blood vessels 3. To provide additional oxygen to the brain 4. To oxygenate the collateral cardiac circulation

You observe ST depression in leads I and II. Which of the following most accurately reflects this? 1. Non-diagnostic 2. This is normal in these leads 3. The pt is suffering from infarct 4. The pt is having ischemic event

You have a pt with a normal heart rate and rhythm who is having a hypertensive emergency. Which of the following medications would address the hypertension at the same time having little or no effect on the heart? 1. Beta blocker 2. ACE inhibitor 3. Calcium channel blocker 4. Combined alpha/beta agonist

You are assisting the lead paramedic to care for a pt that is possibly having a heart attack. The pt had chest pain for 15 minutes that goes up his neck and out to his left arm. His color is quite flushed, his pulse is rapid, and he says he is short of breath. You have been taught that most of the heart attack pt have pale or gray colored skin. This patients red face is most likely due to: 1. Reaction to pain 2. Lack of blood flow 3. An allergic reaction 4. An additional problem

Which of the following represents the appropriate maintenance regimen for amiodarone in a post resuscitation phase? 1. 0.5 mg/min 2. 150 mg/min 3. 1-4 mg/min 4. 2-10 mg/min

You are assessing a pt complaining of chest pain with a left arm blood pressure of 100/70 and a right arm blood pressure of 140/90. Which of the following would most likely be the cause of the unequal pressures? 1. Pericardial tamponade 2. Left-sided heart failure 3. High thoracic aneurysm 4. Peripheral artery disease

Which of the following pt populations os most likely to develop cardiogenic shock? 1. Pt with significant anterior chest trauma 2. Pt with hx of right ventricular infarct Pt with hx of myocarditis or pericarditis Geriatric pt with significant underlying diseases

A pt has CP, nausea, and general weakness. BP is 80/50, HR 58, ou observe a first-degree heart block on your ECG, and your 12 lead indicates ST elevation in V1 and V2 with development of Q waves. Which of the following best describes the clinical significance of these findings? 1. The pt is likely to go into a complete heart block 2. The left CX is the probably location of the blockage 3. The pt should next progress into a second degree type 1 4. Atropine would be a safe drug to administer to increase the heart rate

Which of the following represents the correct lidocaine maintenance regimen for a pt in the post resuscitation phase of an arrest? 1. 0.5mg/min 2. 0.5 to 0.75 mg/kg 3. 1-4 mg/min 4. 2-4 mg/min

Which of the following would you expect to see develop FIRST in the pt with peripheral artery occlusion? 1. Cyanosis 2. Pain at rest 3. Paresthesia 4. Pain during exercise

You are assessing a 65yo pt who has recurrent asthmatic attackes since the age of 12. Pt has hx of right sided MI with pedal edema. Which of the following would be an accurate description of how asthma precipitated the right sided MI? 1. The increase in pulmonary pressure made the right heart work harder than normal 2. the hypoxia caused by the recurrent asthma attacks made the right heart ischemic 3. The retention in CO2 the asthmatic experienced over the years caused and acidosis damaging the heart tissue 4. The repeated use of beta 2 agonists caused positive inotropic and chronotropic demands on the heart without sufficient oxygenation

You have an 81yo pt with rales in both lower lobes and you have rules out pneumonia as a cause. Acute pulmonary edema would best be described by which of the following? 1. Plasma in the alveoli, usually caused by left heart failure 2. Blood in the alveoli, usually caused by right heart failure 3. Plasema in the alveoli, usually caused by right heart failure 4. Phlegm in the alveoli, usually caused by an immune response

What medication would be of the most benefit to a pt with a rapidly responding atrial fibrillation? 1. Beta agonist 2. Sodium channel blocker 3. Calcium channel blocker 4. Potassium channel blocker

Which of the following would best describe why we provide morphone to a pt having an MI? 1. To reduce myocardial oxygen demand 2. To vasodilate cardiac blood vessels 3. To provide additional oxygen to the brain 4. To oxygenate the collateral cardiac circulation

You are monitoring a pt 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? 1. The pt is having a septal wall MI, which is delaying AV node condution 2. The pt is having a myocardial ischemic event and bradycardia is due to hypoxia 3. The pt is having a bradycardia event secondary to parasympathetic stimulation 4. The pt is having a massive right-sided MI, which is resulting in a decrease in SA node impulses

You have ROSC in a cardiac arrest victim. Whihc of the following describes the highest level of responsiveness the pt can demonstrate to be considered a candidate for induced hypothermia? 1. Alert 2. Responds to verbal stimuli 3. Responds to painful stimuli 4. Unresponsive

Knowing that geriatric patients commonly have decreased cerebral blood flow secondary to progression of cardiovascular disease is critical to remember when dealing with which situation below? 1. Managing hypertension during an ischemic stroke 2. Delivering vasopressor agents during a heart attack 3. Administering crystalloid fluids during shock resuscitation 4. Determining whether the pt will tolerate an orthostatic tilt test

Which of these best explains why we push hard, push fast, and minimize interruptions when performing chest compressions? 1. To circulate oxygen 2. To circulate the blood 3. To stop the heart from fibrillating 4. To maintain an adequate blood pressure

Amiodarone prolongs repolarization and the affective refractory period of cardiac muscle by what mechanism 1. Blocking the eflux of calcium 2. Blocking the efflux of potassium 3. Blocking the influx of Mag 4. Blocking Beta 1 receptors which are attached to the calcium channels

You witness an adult pt collapse in front of you while you are covering a sporting event. His wife indicates he has an implanted pacemaker and a quick assessment of leads reveals asystole. Which of the following would be most appropriate action? 1. Immediate CPR for 2 min then reassess 2. Begin CPR while preparing immediate D-fib 3. Begin CPR, establish IV and administer epi. 4. Begin CPR while preparing for immediate external pacing

Which progressive event typically causes the cariogenic shock pt to lost the ability to maintain vital organ perfusion? 1. Myocardial death 2. Failure of Starling’s law mechanism 3. Failure of preload, afterload, and contractility mechanism 4. Failure of respiration secondary to massive pulmonary edema

Which choice reflects the general cardiac action of dilantin? 1. Beta blocker 2. Calcium channel blocker 3. Potassium channel blocker 4. Sodium channel blocker

Which of the following is the most typical finding in right-sided myocardial infarction? 1. Hypertension 2. Hypotension 3. Flushed skin 4. Tachycardia

Which of the following will most commonly produce sinus tach? 1. Increase in sympathetic tone 2. Decreased parasympathetic tone 3. Cocaine od 4. Cardiogenic shock

Which of the following is considered a major risk factor for cardiovascular disease? 1. Liver disease 2. Overall mental health 3. Individual response to stress 4. Diabetes mellitus

During a temper tantrum, a 5yo child attempts to hold his breath to upset his parents and make a point. After a short period of time, the child passes out and falls to the ground. How do you suspect a medically-trained person would describe the respiratory pattern immediately following the syncopal episode? 1. Slow, then fast, the slow again 2. Shallow and rapid for about 10 minutes 3. Apneic for a minute or so, then normal 4. Tachypneic for a short time, then regular

Which of the following is correct regarding the technique for performing an open chricothyrotomy? 1. Insert a needle into the membrane caudally 2. Attach a large-bore IV needle to a 10cc syringe 3. Make a 1-2cm vertical incision over the membrane 4. Make a 1-2 cm vertical incision through the membrane

Which of the following best describes peak expiratory flow testing? 1. The pt exhales normally after a normal inhalation 2. The pt exhales forcefully after a normal inhalation 3. The pt exhales normally after a maximal inhalation 4. The pt exhales forcefully after a maximal inhalation

During routine maintenance of your ambulance, you are assuring all of your equipment is in safe working order. Which of the actions or findings would you consider most dangerous? 1. Finding an oil-based lubricant on the valve of the oxygen regulator 2. Mopping the ambulance floor with cleaning chemicals that dont’ kill germs 3. Discovering dried emesis between the cushions of the bench seat in the ambulance 4. Noticing a sharps container half full of needles and used syringes mounted properly in the unit

Identify the most dangerous result of an unrecognized esophageal placement of an endotracheal tube. 1. Flatulance 2. Aspiration 3. Stomach rupture 4. Air empolism

You are assisting in the care of a cardiac arrest pt. Your partner is ventilating the pt with a bvm. Other rescuers arrive and take over chest compressions and possible defibrillation. You can see there is no chest rise when your partner ventilates the pt. Which of the following should you choose next to improve the situation? 1. Attach O2 flow to the BVM 2. Evaluate the pt for a pneumothorax 3. Evaluate the pt for an airway obstruction 4. Assist your partner to maintain a seal in the BVM

Which statement is true regarding normal atmospheric air? 1. The majority of atmospheric air molecules are hydrodgen 2. Approximately 30% of atmospheric air volume is O2 3. Carbon dioxide makes up about 11% of atmospheric air 4. At sea level, atmospheric air pressure is approximately 760 mmHg

Which of the following is a common term used to describe a soft suction catheter? 1. Yankauer 2. Flexible 3. Oral 4. German

Which unresponsive pt will most likely benefit from a nasogastric tube being inserted by EMS? 1. A victim you believe is bleeding internally 2. Pt you suspect OD on ASA 3. Any pt who has ingested a caustic chemical 4. Children being ventilated with abdominal distention

You are treating a pt with a cervical spine fx allowing ventilation to occur only through the use of two thirds of the diaphragm. The pt is spontaneously breathing at a rate of 12. Which of the following would be the most appropriate tx for this pt? 1. Sedate the pt, intubate, and place on a portable ventilator 2. Assist ventilations with a BVM and attempt to maintain a capnometry reading of 40 3. Administer high concentration O2 though NRB to obtain a pulse ox of 98 4. Hyperventilate the pt using a BVM to achieve a capnometry reading of 30 and a pulse ox of 98

While ventilating a pt with a flow-restricted oxygen-powered ventilation device, you should: 1. Listen for the alarm indicating the relief valve is activating 2. Avoid tipping the head back, even in non-traumatic patients 3. Never use it on a pt who has a suspected abdominal injury 4. Determine if the pt has ever had cardiac bypass surgery

Which of the following tanks would least likely be used as a portable oxygen bottle carried into scene by rescuers? 1. D cylinder 2. E cylinder 3. M cylinder 4. Super D cylinder

You have a pt who has suffered a brain stem injury with increasing intracranial pressure. Which of the following types of respirations would you least likely expect to see? 1. Biot’s 2. Kussmaul 3. Cheyne-Stokes 4. Central neurogenic hyperventilation

In general, which of the following is the preferred method for gastric decompression when gastric distention is present and the pt is unresponsive? 1. Orogastric tube placement 2. Nasogatric tube placement 3. Esophageal tracheal tube placement 4. Placing the pt in the recovery position and pressing on the abdomen

During resuscitation, rescuers performa cricoid pressur maneuver during ventilations. Which of the following statement is most true regarding this procedure? 1. It will likely cause more air to enter the esophagus instead of the trachea 2. This procedure should not be performed on infants or children less than 8y of age 3. The skill of cricoid pressure may only be performed by advanced life support personnel 4. Complications fo this procedure include esophageal rupture and possibly laryngeal trauma

Which of the following describes the proper technique when performing the jaw-thrust maneuver? 1. Position yourself at the side of the pt’s head 2. Retract the lower lip with your thumb to keep the mouth open 3. The pt’s head, neck, and spine should be moderately extended 4. Stabilize the head with you forearms and forcibly shift the jaw posteriorly

Rescuers are preparing to transfer a 52yo femalie with a mild pneumothorax to a larger hospital for further tx. According to the physician arranging the transfer, he suspects her lung was punctured during a central line insertion two days ago. During transport the pt becomes unresponsive to painful stimuli and cyanosis is oberverd. Resuers rub her stern with their knuckles an slightly brush he eyelashes with a finger tip. What do you suspect they are assessing? 1. Central nervous system level of function 2. Likelihood pt has a gag reflex 3. Whether the pt will tolerate an IV 4. Peripheral nerve integrity

Which of the following methods would be the most effective to ventilate an unresponsive pt who is suffering from adult respiratory distress syndrome where you were unable to secure the airway with an ET tube? 1. Mouth to mask with supplemental O2 2. 2-person BVM with adjustable peep setting 3. 1-person BVM with administration of a loop diuretic 4. Insertion of an esophageal-tracheal dual lumen airway and positive pressure ventilation

You have just inserted an ET tube into a 2yo child. Which of the following techniques would be th most reliable way to confirm proper tue placement if the child is in cardiac arrest? 1. Ausculation of lung sounds 2. Colorimetric End tidal CO2 detector 3. Use of an esophageal detector device 4. Seeing equal chest rise and fall during ventilation

You are transferring a 27yo male with a known C-6 fx with cord involvement. Which of the following findings would be most consistent with this injury? 1. Decrease in tidal volume, normal respiratory rate 2. Increase in tidal volume, normal respiratory rate 3. Decrease in tidal volume, increase in respiratory rate 4. Increase in tidal volume, decrease in respiratory rate

During the resuscitation of a traumatic cardiac arrest pt, the pt is being ventilated with a ATV. You are aware the the pt;s color has not improved at all during CPR and no carotid pulses are felt. Most likely there is no change in this pt because the ventilation is causing: 1. A pheumothorax 2. Further lung damage 3. Reduced blood return to the heart 4. An interference with the chest compressions

Which of these is negatively affected when you properly provide BVM ventilation? 1. Alveolar pressure 2. Carbon dioxide removal 3. Cerebral perfusion pressures 4. Venous blood return

You and your partner are providing ventilations using a BVM device to a pt who has a broken nose. The pt has a gag reflex and there is no cervical spine considerations needed. Which of the following will provide the greatest opening of the airway. 1. Head-tilt chin-lift 2. Head-tilt neck=lift 3. Head-tilt jaw thrust/lift and proper head/neck/chest relationship 4. Head neutral jaw-lift with manual cervical spine control and moderate cricoid pressure

A pt with a spinal cord injury at C7 will hyperventilate because: 1. No innervation of the cardiac plexus 2. No innervation of the intercostal muscles 3. No innervation of the diaphragmatic muscle 4. NO transmission from the medulla oblongata

Which of the following describes agonal breathing? 1. Deep and rapid respirations 2. Shallow and slow or infrequent breathing 3. Deep and slow or rapid and gasping respirations 4. Irregular pattern of rate and depth with sudden periods of apnea

You have extended the next and placed you index fingers on the angle of the jaw an moved it in an anterior fashion. Which of the following best describes the procedure performed? 1. Head-tilt chin-lift 2. Head-tilt jaw-thrust 3. Modified jaw thrust 4. Triple airway maneuver

You are managing a pt in cardiac arrest. Which of the following airway management devices will provide for the greatest protection of the airway, minimize gastric distention, go in the fastest, provide for PEEP, and provide the least interruption of chest compressions? 1. King 2. LMA 3. ET 4. OPA

Which of the following is appropriate regarding suctioning through an ET tube? 1. The suction catheter should go down to the carina 2. Suctioning should never last longer than 20 seconds 3. The pt must always be pre-oxygenated prior to suctioning 4. The larger the number of French units the smaller the diameter of the suction catheter

Rescuers have placed an OPA into your adult pt but selected a size larger than you would have preferred. You are now unable to ventilate the pt. Which of the following most likely occurred? 1. Longer OPA caused a bronchospasm 2. Longer OPA protruded into the glottic opening 3. Longer OPA pushed the tongue over the glottic opening 4. Longer OPA pushed the epiglottis over the glottic opening

EMS providers are having difficulty visualizing the vocal cords of a 5yo female during intubation. Which of the following techniques would improve intubation success? 1. Placing a towel roll underneath the occipital lobe of her head 2. Performing posterior/superior pressure on the larynx/cricoid membrane 3. INserting a steril french catheter into he pt’s so to trigger a gag refles 4. Tipping the pt’s head an chin downward toward the chest during visualization

Your pt is complaining of neck pain after being involved in a side impact accident. He is able to feel pain in his left index finger but is unable to feel touch, he is able to fetlock in his right index finger but feels no pain. Which of the following do you most likely suspect? 1. Ascending tract injury at c7 on left 2. Ascending tract injury at c7 on right 3. Partial lobe injury of the cerebrum on left 4. Parietal lobe injury of the cerebrum on the right

Which of the following causes an increase in heart rate in compensated shock? 1. Cellular ischemia due to hypoxia 2. A decrease in pressure sensed by baroreceptors 3. An increase in parasympathetic tone 4. The ease of epic due to decreased kidney perfusion

Adult pt with closed bilateral femur tx. How much blood do you estimate the pt to lose? 1. 0.5L 2. 1L 3. 2L 4. 3L

Which of the following anatomical structures are initially damaged in a strain? 1. muscles and tendons 2. cartilage and muscles 3. muscles and ligament 4. cartilage and ligaments

Where should you place your hands to manually stabilize a c spine 1. on the neck 2. head and shoulders 3. cranium and facila bones 4. facial bones and mandible

You are dispatched to man collapsed in a freshly dug ditch. the fd assures you it is safe to enter. they advise you the victim hit an energized power line and collapse. What would you do first? 1. Assess for entrance and exit wounds 2. manually immobile the head 3. look for external bleeding 4. apply high flow o2

What is the MAP of a pt who has a bp of 140/80 1. 140 2. 100 3. 80 4. 60

Which of the following is most likely occurring in a pt who has worsening stroke-like symptoms following a blow to the head? 1. Epidural hematoma 2. Moderate concussion 3. Intracerebral hemorrhage 4. Severe diffuse axonal injury

You are called to the scene of an adult pt who was the unrestrained driver in a single car MVC. Pt is pale, cold, clammy, pulse 60, resp 12, pupils equal, dilated, sluggish weak central pulses and absent peripheral pulses. Your rapid trauma sure reveals a scalp laceration, unequal lung sounds, flattened jugular veins, absent distal pulse, motor and sensory function, and a flail segment to right chest. Which best describes pt’s situation? 1. neurogenic shock from spinal injury 2. Closed head injury with ICP 3. Stage 4 hemorrhage with profound hypotension and decompensated shock 4. Respiratory and obstructive shock for a developing tension pneuma

Which of the following is the most immediate concern for a pt with a large body surface area burn? 1. infection 2. hypothermia 3. hypovolemia 4. organ failure

Which of the following would be your greatest pathophysiological concern regarding a closed femur fx? 1. Ifection 2. Muscle spasm 3. Hemorrhage 4. Compartment syndrome

You are called to treat a pt 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 pt experienced? 1. 75-125 2. 125-200 3. 200-600 4. 600-1000

You have a 26yo pt with a chest injury resulting in absent lung sounds on the left and hyper resonance on the left. Trachea is midline and neck veins normal. The pt hs complaining of severe chest pain and i having difficulty breathing with a respiratory rate of 24. Which of the following should you do immediately for this pt? 1. Decompress left chest 2. Decompress right chest 3. Intubate and provide pain relief 4. Administer high-flow supplemental o2

You are called to treat a pt 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 best explains the pathophysiology behind the symptoms the pt is experiencing? 1. Radiation has damaged the nerve fibers within the GI tract 2. Radiation has cause paralysis of the muscles of peristalsis 3. Radiation at this level disrupts cells, causing a cellular hypovolemia 4. Radiation negatively impacts the fast-reproducing cells of the GI tract

The hollow organ most susceptible to injury from penetrating abdominal trauma is: 1. Stomach 2. Large bowel 3. Small bowel 4. Urinary bladder

You are treating a crush syndrome pt with an entrapped arm and you have been unable to medicate the pt or administer fluids. Which of the following would be your most appropriate action? 1. Amputate the limb to avoid the release of toxins 2. Initiate medicaitons and fluids after relieving entrapment 3. Apply a tourniquet to the limb prior to relieving entrapment 4. Apply a tourniquet to the limb after relieving entrapment

You are dispatched to an assault call where a 25yo male was struck in the face by a blunt object. The pt is supine and unresponsive and ays go to maintain c-spine, you notice that the zygomatic bones depress when you place pressure on them. As you open the airway with a jaw-thrust, you note instability of the entire facial region up to the eyebrows. Which of the following would best describe this pt’s injuries? 1. Lefort I 2. Lefort II 3. Lefort III 4. Lefort IV

With a complete laceration of the calcanea tendon, which of the following movements would a pt be incapable of performing? 1. Dorsiflexion 2. Plantar flexion 3. Ankle eversion 4. Ankle inversion

Which of the following would you expect to find with a pt experiencing neurogenic shock as a result of a spinal cord injury at c7? 1. Tachycardia 2. Hypertension 3. Pale, cool, clammy skin, 4. Diaphragmatic breathing

What type of brain injury results in an actual bruising of the brain? 1. Ecchymosis 2. Concussion 3. Hematoma 4. Contusion

An isolated laceration of the calcanea tendon would most likely be treated by: 1. Providiing a pressure dressing, splinting in the position found, and apply heat to the wound 2. Providing a pressure dressing, splint in a position of function, and apply local cooling 3. Providing a gentle circumferential dressing, splint in the position of function, and apply local cooling 4. Providing gentle circumferential dressing, splint in the position found, and apply heat to the wound

You are treating a pt you suspect has a developing epidural hematoma. Which of the following is your most important intervention? 1. Intubation and hyperventilation 2. Rapid transport for immediate surgery 3. Administration of Mannitol to reduce ICP 4. Elevation of the head of the cot by 30 degrees

You have a pt who was the passenger of a motor vehicle involved in a front end collision. The pat was searing his lap restraint too high and has a red mark at the level of the umbilicus. He has JVD, diminished lung sounds on the left, hyporesonance to percussion on the left, hypotension, and a hollow-appearing abdomen. Which of the following is your most critical intervention? 1. Fluid resuscitation 2. Pleural decompression 3. Applying and inflating PASG 4. Rapid transport to trauma center

On the torso, what is the name of the portion of the sternum immediately above the angle of Louis? 1. Manubrium 2. Sternal notch 3. Xiphoid process 4. Body of the sternum

Why do we apply a cervical collar to a pt with a suspected spinal injury? 1. To fully immobilize the cervical spine 2. To remind the pt and us not to move the pt’s head and neck 3. To secure the head and neck in a neutral position to maximize the airway 4. To place the pt in slightly hyper-extended position for airway management

A pt has been stabbed on the right anterior portion of the chest along the anterior midclavicular line at the 8th intercostal space. Which of the following organs has most likely been damaged? 1. Lung 2. Liver 3. Spleen 4. Stomach

How much blood may be lost from the vasculature into the abdominal cavity before the abdomen shows signs of distention in the adult pt? 1. 0.5L 2. 1 L 3. 1.5 L 4. 2 L

Identify the tissue structure that lies between the muscle and dermal layer of skin 1. Bones 2. Cartilage 3. Epidermis 4. Fatty tissue

The appropriate management of a tib/fib fx would include: 1. Immobilization from the distal femur the foot 2. Immobilization from the proximal tib/fib to the foot Immobilization from the distal femur to the distal tib/fib Immobilization from the proximal tib/fib to the distal tib/fib

You are assessing a pediatric pt who has received a chemical splash second degree burn to his anterior chest. What is the percentage of BSA of this burn? 1. 4,5 2. 9 3. 13.5 4. 18

Which of the following is true regarding the pathophysiology of blast injuries? 1. Most penetrating wounds will be deep 2. Lung tissue will become less compliant to ventilation 3. It will restrict O2, as nitrogen is more readily dissolved in the blood stream 4. Ruptured abdominal contents will lead to immediate and severe infection and irritation

What is the name for visible red streaks extending from the margins of a wound up the affected extremity proximally? 1. Lymphangitis 2. Ecchymosis 3. Erythema 4. Abscess

Which of the following assessments would allow you to best differentiate a pneumothorax from a hemothorax? 1. Lung sounds 2. Blood pressure 3. Chest percussion 4. Breathing difficulty

Which of the following would be the best indication for the inflation of PASG? 1. profoundly hypotensive pt with pulmonary edema 2. Pt with a myocardial contusion in cardiogenic shock 3. hypotensive pt with a pelvic and closed femur fx 4. profoundly hypotensive pt with penetrating chest injury

What is the purpose of checking vital signs every 5 min in the head injured pt? 1. To follow standard protocol 2. To decide what type of head injury 3. To determine whether any scarring will be present 4. To evaluate any signs of increasing ICP

Which type of skull fx is the least likely to have associated damage to the underlying meninges, cerebral and cerebellar tissue? 1. Linear 2. Basilar 3. Depressed 4. Comminuted

You are dispatched to an assault call where a 25yo male was struck in the face by a blunt object. The pt is supine and unresponsive and ays go to maintain c-spine, you notice that the zygomatic bones depress when you place pressure on them. As you open the airway with a jaw-thrust, you note instability of the entire facial region up to the eyebrows. What is your highest priority with this trauma pt? 1. Suction and attempt to ventilate with a BVM 2. Orally iintubate the pt and attempt to ventilate 3. Place a NPA and attempt to ventilate 4. Perform abdominal thrusts and look in the airway for obstructions

Responders are called to the scene of an industrial accident. Victim has accidentally amputated his hand. Which treatment below would bet describe the care the responders should provide? 1. Wrap amputated part in sterile dressing and then a plastic bag and keep cool 2. Wrap amputated part in a plastic bag and keep the hand warm, at or near body temperature 3. Apply a constriction band or tourniquet to the amputated limb to slow the bleeding and rapidly transport 4. Control the bleeding on the injured extremity and transfer the amputated part in a red biohazard bag for disposal

Which of the following is the preferred fluid to replace lost fluid in situations involving hemorrhagic shock? 1. D5W 2. D10W 3. NS 4. LR

Which of the following describes the appropriate tx of a pt whose skin has been contaminated with sodium? 1. Flush with water for at least 5 min 2. Flush with water for at least 20 min 3. Brush sodium off, cover with oil 4. Brush sodium off, flush with water

0 What is occurring during the capillary stagnation phase of hemorrhagic shock? 1. Arteriole constriction causes the pre-sphincter muscles to close 2. The pre-capillary sphincters open and red blood cells clump together 3. The post-capillary sphincters open and clumps of red blood cells circulate through the body 4. The pre-and post-capillary sphincter muscles are closed, increasing hydrostatic pressure

What percentage of pts who suffer multi-system trauma will also experience significant musculoskeletal injury? 1. 30 2. 50 3. 80 4. 90

You have a pt with bilateral arm fx as a result of a head on motor vehicle collision The pt was wearing his seatbelt and the air bag did deploy. Your assessment of the abdomen revealed some redness on the abdomen at th umbilicus from the belt, but the pt was negative for bruising or distention so you elected to splint both arms on scene prior to transport. Which of the following is the most accurate regarding this scenario? 1. A red mark on the abdomen is often the only clue to a critical abdominal injury 2. Delaying gtransport to address the arm injuries prevented further injury from occurring 3. THe bilateral arm fx are a critical injury and require a rapid extrication and transport 4. An assessment of abdominal sounds should have been performed to rule out abdominal injuries

You are assessing a pt 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. Which of the following assessment findings would you also expect to be present? 1. Unequal lung sounds 2. Distended jugular veins 3. Rapid, irregular heart rate 4. Unequal upper extremity pulses

Which of the following terms applies to the condition where a pt has blood in the anterior chamber of the eye in front of the iris? 1. Hyphema 2. Retinal detachment 3. Acute retinal artery occlusion 4. Sub-conjunctival hemorrhage

Approximately how many people are killed in the united states every year as a result of lightening strikes? 1. 50-100 2. 150-300 3. 350-500 4. 550-1000

You are assessing a pediatric pt who has received a chemical splash second degree burn to his anterior chest. What is the severity of this burn? 1. Minor 2. Moderate 3. Severe 4. Critical

You are treating a 27yo adult pt who has just been removed from a burning industrial building. The pt had severe dyspnea, complained of CP, and a seizure and is now unresponsive. Which of the following is the most likely cause of this pt’s condition? 1. Cyanide poisoning 2. MI 3. Carbon monoxide poisoning 4. Concurrent episode of epilepsy

Which of the following is a strong corrosive that reacts with water to produce heat and chemical burns 1. Phenol 2. Alkalis 3. Dry lime 4. Sodium

Which of the following are the most frequent and life threatening injuries associated with an explosion? 1. Burns 2. lung injuries 3. bowel injuries 4. penetrating wounds

A pt has received a neck injury resulting in damage to the glossopharyngeal nerve. Which of the following would you most likely expect this pt to experience? 1. A loss of sensation to the arms and shoulders 2. An inability to raise the arms at the shoulders 3. A loss of control with the muscles of the neck 4. An inability to monitor pressure in the carotid sinus

which of the following would best demonstrate an appropriate empathic response for the burn-injured pt? 1. Providing prompt and safe transportation 2. Actively listening to the pt’s concerns 3. Administering medication for pain management 4. Explaining the burn center capabilities to the pt

Which of the following describes the law of inertia? 1. Doubling the force when you double the mass 2. The father you decelerate, the more likely the injury 3. Quadrupling the energy when you double the velocity 4. Continuing strait when you hit a slick patch on a curve

You are treating an unresponsive cervical spine injury pt who is breathing very slowly at 16x per minute. There is no muscle tone from the shoulders down and the skin is pink, warm, and dry. Which of the following assessment findings would you also expect to see with this pt? 1. Beck’s triad 2. Tachycardia 3. Hypotension 4. Unequal pupils

Which of the following occurs or is most commonly associated with traumatic spinal injury vs. non-traumatic spinal injury? 1. Osteomyelitis 2. Central cord syndrome 3. Vertebral spondylolysis 4. Vertebral disk herniation

Which of the following can be used to minimize an increase in intracranial pressure when preparing to intubate? 1. Lidocaine 2. Morphine 3. Succ 4. Thiamine

You have a 27yo stable trauma pt with a closed mid-shaft radius/ulna fx. The pt is in a significant amount of pain. Assuming no contraindications, when would be the most appropriate time to initiate the administration of pain medication to this pt? 1. At the scene, after immobilization 2. In the hospital ED by the physician 3. IN the ambulance, prior to transport 4. At the scene, prior to immobilization

Which of the following will have the greatest positive impact on a thermal burn pt who has received second and third degree burns on the front of both lower extremities? 1. Administering an analgesic 2. Providing significant fluid bolus 3. Applying wet sheets to pt’s legs 4. Removing gross contamination from the area

A metacarpal joint would be an example of which type of joint? 1. Triaxial 2. Diathroses 3. Synathroses 4. Amphiarthroses

8 You have a 4yo pt with a first degree sunburn involving 40% of his body surface area. Assuming no other complications, what would the severity rating for this burn injury be? 1. Minor 2. Moderate 3. Severe 4. Critical

NATIONAL REGISTRY PREP Flashcards

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