Phase 1 Final Study Flashcards
Win
1
Q
The BEST legal protection for the paramedic is to:
A) always transport the patient to the hospital of the patient’s choice, regardless of the patient’s clinical condition.
B) provide a detailed patient assessment and appropriate medical care, followed by complete and accurate documentation.
C) routinely obtain more than the minimum number of continuing education credits required by the state department of health.
D) treat all patients with respect and remain aware that patients’ cultural beliefs may differ from those of the paramedic.
A
B
2
Q
Documenting a false statement that injures a person's good name or reputation constitutes: A) libel and defamation. B) assault and battery C) slander and defamation. D) gross negligence.
A
a
3
Q
Which of the following is an example of slander?
A) Asking a family member if the patient uses drugs
B) Telling the receiving facility that a patient is drunk
C) Asking a patient if he or she is under psychiatric care
D) Documenting that you noted the possible smell of alcohol
A
b
4
Q
Assault on a patient occurs when the EMS provider:
A) defames a patient’s character in his or her report.
B) touches another person without obtaining consent.
C) carries out a harmful physical act against a patient.
D) instills the fear of immediate bodily harm in a patient
A
d
5
Q
While caring for a conscious and alert 49-year-old man with a suspected myocardial infarction, you start an IV prior to
obtaining the patient’s consent. This action constitutes:
A) appropriate care.
B) assault.
C) battery.
D) gross negligence
A
c
6
Q
A paramedic who was trained and certified to perform a surgical cricothyrotomy successfully performs the procedure on a
patient in the field. However, because the EMS system’s medical director does not permit paramedics to perform a needle
cricothyrotomy, the paramedic:
A) performed outside his or her scope of practice.
B) has committed an act of gross negligence.
C) will likely be sued by the medical director.
D) did not follow the national standard of care
A
a
7
Q
Scope of practice is defined as:
A) protocols agreed upon by a consensus of emergency physicians.
B) the level of care that an EMS employer allows the paramedic to provide.
C) national patient care guidelines established by the federal government.
D) care that a paramedic is permitted to perform under the certifying state.
A
d
8
Q
A reasonable paramedic should follow the same \_\_\_\_\_\_\_\_\_\_\_\_\_\_ that another paramedic in a similar situation would. A) scope of practice B) standard of care C) wishes of the family D) medical practice act
A
b
9
Q
Osmosis is the movement of a:
A) solvent from an area of low solute concentration to one of high concentration.
B) solvent from an area of high solute concentration to one of low concentration.
C) solute from an area of high solvent concentration to one of low concentration.
D) solute from an area of low solvent concentration to one of high concentration
A
a
10
Q
Examples of steroid hormones are: A) epinephrine and prolactin. B) cortisol and testosterone. C) oxytocin and growth hormone. D) norepinephrine and antidiuretic hormone
A
b
11
Q
The hormones tetraiodothyronine and triiodothyronine are synthesized by the: A) adrenal glands. B) thyroid gland. C) pituitary gland. D) parathyroid glands
A
b
12
Q
Unlike endocrine hormones, exocrine hormones:
A) are carried to their target organs or cell groups via the blood.
B) reach their targets via a specific duct that opens into an organ.
C) diffuse through intracellular spaces to reach their target organs.
D) move through body water and act upon the cell that secreted them
A
b
13
Q
All of the following are endocrine hormones, EXCEPT: A) histamine. B) insulin. C) adrenaline. D) thyroxine
A
A
14
Q
A medication that possesses a negative chronotropic effect
will:
A) cause a decrease in the heart rate.
B) cause an increase in blood pressure.
C) decrease myocardial contractile force.
D) increase cardiac electrical conduction velocity.
A
a
15
Q
When a medication alters the velocity of the conduction of
electricity through the heart, it is said to have a(n)
_____________ effect.
A) inotropic
B) dromotropic
C) chronotropic
D) alpha agonistic
A
b
16
Q
Glucagon is used in the treatment of beta-blocker overdose
because it:
A) causes vasoconstriction and increases blood pressure.
B) produces positive inotropic and chronotropic effects.
C) activates beta-1 receptors and increases the heart rate.
D) blocks alpha-2 receptors and increases blood pressure
A
b
17
Q
A medication that possesses a positive chronotropic effect is one that:
A) decreases heart rate.
B) increases heart rate.
C) decreases cardiac contractility.
D) increases the conduction of electricity
A
b
18
Q
In order to cause a negative inotropic effect on the heart, you would have to administer a(n): A) beta-1 adrenergic antagonist. B) alpha-2 adrenergic agonist. C) beta-2 adrenergic agonist. D) alpha-1 adrenergic antagonist
A
a
19
Q
Which of the following medications possesses positive
inotropic effects, allows the cellular uptake of glucose, and is
used in the treatment of hyperkalemia?
A) Insulin
B) Osmitrol
C) Glucophage
D) Clopidogrel
A
a
20
Q
By classification, digoxin is a(n): A) inotropic agent. B) anticholinergic. C) catecholamine. D) sympathomimetic
A
a
21
Q
In order to cause a negative inotropic effect on the heart, you would have to administer a(n): A) beta-1 adrenergic antagonist. B) alpha-2 adrenergic agonist. C) beta-2 adrenergic agonist. D) alpha-1 adrenergic antagonist
A
a
22
Q
pH of 7.30 indicates: A) a neutral pH. B) a basic pH. C) alkalosis. D) acidosis
A
d
23
Q
Acidosis is characterized by a(n):
A) increase in hydrogen ions and a decrease in pH.
B) decrease in hydrogen ions and an increase in pH.
C) increase in hydrogen ions and an increase in pH.
D) decrease in hydrogen ions and a decrease in pH.
A
a
24
Q
During an acidotic state, the kidneys attempt to maintain a normal pH by: A) excreting bicarbonate. B) retaining bicarbonate. C) retaining hydrogen ions. D) secreting hydrogen ions.
A
b
25
```
Decreased efficacy or potency of a medication when taken
repeatedly by a patient is called:
A) addiction.
B) immunity.
C) tolerance.
D) habituation
```
c
26
The physical, emotional, or behavioral need for a
medication in order to maintain a certain level of “normal”
function is called:
A) withdrawal.
B) synergism.
C) dependence.
D) habituation
c
27
```
Diazepam may be indicated for patients with:
A) myasthenia gravis.
B) coma of unknown cause.
C) increased intracranial pressure.
D) acute alcohol withdrawal
```
D
28
What type of pain has its origin in a particular location but
is described by the patient as pain in a different location?
A) Somatic pain
B) Visceral pain
C) Referred pain
D) Radiating pain
c
29
Laryngospasm is defined as:
A) aspiration of foreign material.
B) spasmodic closure of the vocal cords.
C) voluntary closure of the glottic opening.
D) spontaneous collapsing of the trachea.
b
30
Surfactant is:
A) produced by the mucous cells of the left and right mainstem
bronchi.
B) quickly destroyed in patients who have a severe upper
airway obstruction.
C) a phospholipid compound that decreases surface tension on
the alveolar walls
D) a lubricating substance that increases alveolar surface
tension during breathing.
C
31
Atelectasis occurs when:
A) the alveoli are overinflated and rupture.
B) a deficiency of surfactant causes alveolar collapse.
C) deoxygenated blood diffuses across the alveoli.
D) surface tension on the alveolar walls is decreased
B
32
Atelectasis occurs when:
A) the alveoli are overinflated and rupture.
B) a deficiency of surfactant causes alveolar collapse.
C) deoxygenated blood diffuses across the alveoli.
D) surface tension on the alveolar walls is decreased
B
33
The volume of air that is moved into or out of the
respiratory tract in one breath is called:
A) tidal volume.
B) alveolar volume.
C) minute volume.
D) inspiratory reserve volume
A
34
```
Approximately ____ mL of air remains in the anatomic dead space of an adult with a tidal volume of 500 mL.
A) 100
B) 125
C) 150
D) 175
```
C
35
Tidal volume is defined as the volume of air that:
A) remains in the lungs following maximum exhalation.
B) is moved into or out of the lungs during a single breath.
C) is moved in and out of the lungs with maximal expiration.
D) is exhaled from the lungs following a forceful exhalation
B
36
Tidal volume is MOST effectively assessed by:
A) auscultating breath sounds.
B) noting the patient's respiratory rate.
C) looking for accessory muscle use.
D) observing for rise and fall of the chest.
D
37
Hypoventilation causes a(n) __________ and leads toA) increased minute volume, hypocarbia
B) decreased minute volume, hypocarbia
C) increased minute volume, hypercarbia
D) decreased minute volume, hypercarbia
D
38
Which of the following patients has the lowest minute
volume?
A) Tidal volume of 400 mL; respiratory rate of 14 breaths/min
B) Tidal volume of 350 mL; respiratory rate of 12 breaths/min
C) Tidal volume of 400 mL; respiratory rate of 24 breaths/min
D) Tidal volume of 300 mL; respiratory rate of 16 breaths/min
B
39
```
The process of moving air into and out of the lungs is called:
A) respiration.
B) oxygenation.
C) tidal volume.
D) ventilation
```
D
40
When a patient's respirations are too rapid and too shallow:
A) the majority of inhaled air lingers in areas of physiologic
dead space.
B) inhaled air may only reach the anatomic dead space before
being exhaled.
C) the increase in tidal volume will compensate for a rapid
respiratory rate.
D) minute volume increases because a larger amount of air
reaches the lungs
B
41
```
The condition in which the body's tissues and cells do not
receive enough oxygen is called:
A) anoxia.
B) hypoxia
C) asphyxia.
D) hypoxemia
```
B
42
```
Enlargement of the left ventricle due to chronically elevated blood pressure is called:
A) atrophy.
B) dysplasia.
C) hyperplasia.
D) hypertrophy
```
D
43
```
Enlargement of the left ventricle due to chronically elevated blood pressure is called:
A) atrophy.
B) dysplasia.
C) hyperplasia.
D) hypertrophy
```
D
44
When oxygen does not reach the cell, the cell reverts to:
A) anaerobic metabolism and produces lactic acid.
B) aerobic metabolism and produces carbon dioxide.
C) fat metabolism and begins producing ketoacids.
D) anaerobic metabolism and produces bicarbonate
A
45
```
When oxygen levels are low or absent, the cells revert to a process of:
A) aerobic metabolism.
B) anaerobic metabolism.
C) anaerobic anabolism.
D) aerobic catabolism
```
B
46
Which of the following statements regarding anaerobic metabolism is correct?
A) The waste products of anaerobic metabolism are carbon dioxide and water.
B) Anaerobic metabolism can be supported in most cells for only 1 to 3 minutes.
C) The lactic acid produced by anaerobic metabolism is needed to make energy.
D) Anaerobic metabolism is a normal process that occurs in the presence of oxygen
B
47
```
If you must deviate from your protocols because of unusual circumstances, you should FIRST:
A) advise the patient.
B) document the event.
C) notify medical control
D) apprise the receiving hospital
```
C
48
Health care powers of attorney are also called “durable” powers of attorney because they:
A) must be in the patient's possession at all times.
B) can only be revoked by the patient's personal physician.
C) remain in effect once a patient loses decision-making capacity.
D) do not require anyone to make decisions on the patient's behalf
C
49
```
Which of the following is a subjective finding?
A) Pale, cool, clammy skin
B) Obvious respiratory distress
C) A complaint of chest pressure
D) Blood pressure of 110/60 mm Hg
```
C
50
```
All of the following are subjective findings, EXCEPT:
A) visible blood in the ear canal.
B) a feeling of impending doom.
C) a persistent dull headache.
D) acute and severe nausea
```
A
51
Which of the following statements contains objective and subjective information?
A) “The patient's behavior was consistent with alcohol intoxication.”
B) “The patient's pulse was rapid and weak and he was diaphoretic.”
C) “The patient's wife stated that he began feeling ill a few hours ago.”
D) “The patient appeared confused and stated that he had a headache
D
52
```
Objective patient information:
A) is observed by the patient.
B) is perceived by the patient.
C) cannot be quantified.
D) is based on fact or observation
```
D
53
Other than overall patient appearance, the patient's
__________ is/are the MOST objective data for determining his or her status
A) vital signs
B) medications
C) chief complaint
D) medical history
A
54
Before asking a patient to sign a refusal form, the paramedic must:
A) ask an impartial observer to sign the refusal form first.
B) tell the patient that he or she will die without treatment.
C) ensure the patient is aware of the risks of his or her refusal.
D) ask a police officer to determine if the patient is competent
C
55
```
The most common solvent in the body, in which solutes or other substances will dissolve, is:
A) blood.
B) water.
C) plasma.
D) bile.
```
B
56
```
The sympathetic and parasympathetic nerves arise from the:
A) somatic nervous system.
B) autonomic nervous system.
C) voluntary nervous system.
D) adrenal nervous system
```
B
57
```
Stimulation of alpha receptors of the sympathetic nervous system results in:
A) tachycardia.
B) bronchodilation
C) peripheral vasodilation.
D) peripheral vasoconstriction
```
D
58
```
Which of the following substances are vital in the function of the sympathetic nervous system?
A) Epinephrine and norepinephrine
B) Aldosterone and dopamine
C) Cortisol and epinephrine
D) Aldosterone and cortisol
```
A
59
```
Excessive stimulation of the parasympathetic nervous system will result in:
A) hypertension.
B) bradycardia.
C) hyperactivity.
D) diaphoresis
```
B
60
```
Beginning with the outermost layer, the three meningeal layers of the central nervous system are the:
A) dura mater, pia mater, and arachnoid.
B) arachnoid, pia mater, and dura mater.
C) dura mater, arachnoid, and pia mater.
D) pia mater, dura mater, and arachnoid
```
C
61
Efferent nerves of the peripheral nervous system are responsible for:
A) carrying impulses from the body to the brain.
B) sensations such as pain, temperature, and pressure.
C) involuntary functions such as breathing and heart rate.
D) carrying commands from the brain to the muscles.
D
62
In response to shock or stress, sympathetic nervous system stimulation causes:
A) vasoconstriction.
B) slowing of the heart rate.
C) increased gastrointestinal function.
D) shunting of blood to the body's periphery
A
63
All of the following are functions of the parasympathetic nervous system, EXCEPT:
A) constriction of the pupils.
B) lowering of the blood pressure.
C) decreased gastrointestinal function.
D) mediating arousal in males and females
C
64
```
A loss of normal sympathetic nervous system tone causes:
A) neurogenic shock.
B) obstructive shock.
C) profound vasoconstriction.
D) a reduced absolute blood volume
```
A
65
```
Stimulation of the sympathetic nervous system causes:
A) sweating.
B) bradycardia.
C) vasodilation.
D) warm, moist skin
```
A
66
```
Insulin and glucagon are produced in specialized groups of cells in the pancreas known as the:
A) adrenal islets.
B) islets of Langerhans.
C) medullary cortex.
D) adrenal medulla
```
B
67
Which of the following statements regarding type O blood is correct?
A) It contains no surface antigens.
B) It contains type A surface antigens.
C) It contains type B surface antigens.
D) It contains both type A and B surface antigens
A
68
```
Which of the following is NOT a type of white blood cell?
A) Eosinophil
B) Neutrophil
C) Granulocyte
D) Histamine
```
D
69
```
In the presence of infection, white blood cells release endogenous chemicals called _________, which produce fever.
A) pyrogens
B) histamines
C) leukotrienes
D) catecholamines
```
A
70
```
The chief white blood cell of the immune response is the:
A) lymphocyte.
B) neutrophil.
C) monocyte.
D) eosinophil.
```
A
71
_____________ are the MOST abundant white blood cells, are largely responsible for protecting the body against infection,
and are key components of the first response to foreign body invasion.
A) Neutrophils
B) Eosinophils
C) B lymphocytes
D) Basophils
A
72
```
What type of valves are the aortic and pulmonic valves?
A) Papillary
B) Chordis
C) Semilunar
D) Atrioventricular
```
C
73
```
The second heart sound (S2) represents:
A) opening of the pulmonic valve.
B) closure of the atrioventricular valves.
C) opening of the aortic valve.
D) closure of the semilunar valves
```
D
74
```
Dysfunction of the mitral valve may cause backflow of blood into the:
A) right ventricle.
B) right atrium.
C) left atrium.
D) left ventricle
```
C
75
```
The atrioventricular valves of the heart include the:
A) tricuspid and mitral.
B) mitral and aortic.
C) bicuspid and aortic.
D) tricuspid and pulmonic
```
A
76
The semilunar valves of the heart function by:
A) preventing backflow of blood into the atria.
B) minimizing the forward flow of blood.
C) attaching to the papillary muscles.
D) preventing backflow of blood into the ventricles
D
77
```
Closure of the tricuspid and mitral valves occur during:
A) ventricular relaxation.
B) ventricular contraction.
C) the diastolic phase.
D) atrial contraction
```
B
78
Generally, the only physical finding in a patient with a prolapsed mitral valve is:
A) a chronically irregular heart rate.
B) sharp chest pain following strenuous exertion.
C) dyspnea and palpitations while in a sitting position.
D) a clicking sound heard during cardiac auscultation
D
79
S1, the first heart sound, represents:
A) closure of the mitral and tricuspid valves.
B) the sound heard at the end of diastole.
C) closure of the aortic and pulmonic valves.
D) the sound heard at the end of systole.
A
80
```
Cardiac muscle comprises the heart. This muscle is:
A) smooth and involuntary.
B) smooth and voluntary.
C) nonstriated and involuntary.
D) striated and voluntary
```
C
81
```
Unlike skeletal muscle, cardiac muscle is:
A) striated voluntary.
B) nonstriated voluntary.
C) nonstriated involuntary.
D) striated involuntary
```
D
82
```
The myocardium is the only muscle that can generate its own electrical impulses. This process is called:
A) automaticity.
B) excitability.
C) conductivity.
D) dromotropy
```
A
83
```
Excessive stimulation of the parasympathetic nervous system will result in:
A) hypertension.
B) bradycardia.
C) hyperactivity.
D) diaphoresis
```
B
84
```
Ventricular muscle contraction and the pumping of blood throughout the body occur during:
A) systole.
B) diastole.
C) asystole.
D) the cardiac cycle
```
A
85
```
The residual pressure in the circulatory system while the left
ventricle is relaxing is called the:
A) pulse pressure.
B) diastolic pressure.
C) systolic pressure.
D) mean arterial pressure
```
B
86
```
The MOST common type of exogenous hypovolemic shock is:
A) severe diarrhea.
B) internal hemorrhage
C) excess plasma loss.
D) external bleeding
```
D
87
If an adult patient is in hypovolemic shock, you should
attempt to insert a(n) ______ over-the-needle catheter into the
_______.
A) 14-gauge, antecubital vein
B) 16-gauge, metacarpal vein
C) 14-gauge, metacarpal vein
D) 18-gauge, external jugular vein
A
88
```
Prior to administering dopamine to a patient, the paramedic
must ensure that the patient is:
A) awake and alert.
B) not bradycardic.
C) tracheally intubated.
D) not hypovolemic
```
D
89
In hypovolemic shock, lactated Ringer's solution should
be:
A) mixed with normal saline solution.
B) titrated to the patient's physiologic response.
C) given until a systolic BP of 110 mm Hg is achieved.
D) avoided if the patient's shock is caused by blood loss
B
90
Typically, ETCO2 is approximately:
A) 2 to 5 mm Hg higher than the arterial PaCO2.
B) 2 to 5 mm Hg lower than the arterial PaCO2.
C) 5 to 10 mm Hg higher than the arterial PaCO2.
D) 5 to 10 mm Hg lower than the arterial PaCO2.
B
91
On a capnographic waveform, point ___ is the maximal
ETCO2 and is the best reflection of the alveolar CO2 level.
A) B
B) C
C) D
D) E
C
92
```
Relative to the wrist, the elbow is:
A) anterior.
B) posterior.
C) proximal.
D) distal.
```
C
93
```
Which of the following organs occupy all four abdominal quadrants?
A) Liver and spleen
B) Stomach and pancreas
C) Colon and pancreas
D) Small intestine and colon
```
D
94
```
Beginning with the outermost layer, the three meningeal layers of the central nervous system are the:
A) dura mater, pia mater, and arachnoid.
B) arachnoid, pia mater, and dura mater.
C) dura mater, arachnoid, and pia mater.
D) pia mater, dura mater, and arachnoid
```
C
95
```
As an electrical impulse travels down the electrical conduction system, it transiently slows at the:
A) AV node.
B) bundle of His.
C) sinoatrial node.
D) interatrial septum.
```
A
96
```
An organ is composed of:
A) a group of cells.
B) multiple organisms.
C) identical cells and tissues.
D) various types of tissues
```
D
97
Fibrinolytic agents dissolve blood clots by:
A) converting plasminogen to plasmin, which digests the fibrin
strands of the clot.
B) reducing the overall number of circulating platelets, which
thins the blood.
C) blocking certain clotting factors in the liver necessary to
hold the clot together.
D) converting plasmin to fibrin, which digests the plasminogen
matrix of the clot.
A
98
Streptokinase (Streptase) can stop an evolving acute
myocardial infarction by:
A) inhibiting platelet aggregation near a vascular occlusion.
B) blocking certain clotting factors, which thins the blood.
C) dilating the occluded vessel and improving blood flow.
D) converting plasminogen to plasmin, which degrades fibrin
D
99
```
When activated, fibrinogen is converted to:
A) fibrin.
B) plasmin.
C) thrombin.
D) thromboplastin
```
A
100
__________ is the protein that bonds to form the fibrous component of a blood clot
C
101
The induction phase of the immune response begins when:
A) part of the immune system recognizes an antigen.
B) the body is initially exposed to a foreign substance.
C) an antibody binds to a specific antigen and destroys it.
D) biologic mediators release histamine and other chemicals.
A
102
```
Red bone marrow is essential for the formation of:
A) calcium.
B) interstitial fluid.
C) mature blood cells.
D) granular leukocytes
```
C
103
How does the body respond to hypoperfusion?
A) Decreased preload, stroke volume, and heart rate
B) Catecholamine release and increased systemic vascular resistance
C) Splenic retention of red blood cells secondary to systemic hypoxia
D) A compensatory decrease in cardiac output and cardiac oxygen demand
B
104
Patients with type 1 diabetes mellitus:
A) need exogenous insulin to survive.
B) are less likely to develop ketoacidosis.
C) experience excessive cellular uptake of glucose.
D) control their disease with dietary modification
A
105
```
Common components of a medication profile include all of
the following, EXCEPT:
A) pregnancy risk factors.
B) the weight of the drug.
C) potential incompatibility.
D) mechanism of action
```
B
106
```
Unlike Schedule I drugs, Schedule II drugs have:
A) accepted medical uses.
B) a higher abuse potential.
C) limited dependence potential.
D) no accepted medical application
```
A
107
Compared to Schedule III drugs, Schedule IV drugs:
A) include medications such as Vicodin and have a high
potential for psychological dependence.
B) have a moderate potential for physical dependence and
include cough syrups that contain codeine.
C) may lead to severe addiction and include short-acting
barbiturates, amphetamines, and opiates.
D) have a lower abuse potential and include medications such
as diazepam (Valium) and lorazepam (Ativan).
D
108
```
All of the following are Schedule II substances, EXCEPT:
A) Ritalin.
B) fentanyl.
C) cocaine.
D) heroin
```
D
109
```
Phenobarbital is classified as a:
A) Schedule II narcotic.
B) Schedule III benzodiazepine.
C) Schedule V sedative-hypnotic.
D) Schedule IV barbiturate
```
D
110
```
Promethazine hydrochloride (Phenergan) can be classified
as all of the following, EXCEPT as a(n):
A) antiemetic.
B) phenothiazine.
C) alpha agonist.
D) antihistamine
```
C
111
```
The catecholamine epinephrine (adrenaline) has an affinity for:
A) alpha and beta receptors.
B) alpha-1 receptors only.
C) beta-1 receptors only.
D) alpha-1 and beta-2 receptors
```
A
112
```
Stimulation of alpha-1 receptors results in:
A) insulin secretion.
B) vasoconstriction.
C) arterial dilation.
D) glucagon secretion
```
B
113
```
In order to cause a negative inotropic effect on the heart,
you would have to administer a(n):
A) beta-1 adrenergic antagonist.
B) alpha-2 adrenergic agonist.
C) beta-2 adrenergic agonist.
D) alpha-1 adrenergic antagonist.
```
A
114
```
Which adrenergic receptor, when stimulated, inhibits
norepinephrine release?
A) Beta-1
B) Alpha-1
C) Alpha-2
D) Beta-2
```
C
115
In order to relieve the bronchospasm associated with an
acute asthma attack, the paramedic would give a(n):
A) alpha-1 agonist.
B) beta-2 agonist.
C) beta-1 agonist.
D) alpha-2 agonist
B
116
```
In general, alpha-adrenergic receptor antagonists:
A) decrease the heart rate
B) lower the blood pressure.
C) are used for hypotension.
D) increase vascular resistance
```
B
117
Stimulation of alpha-2 receptors:
A) constricts the vascular smooth muscle.
B) suppresses the release of norepinephrine.
C) causes profound systemic hypertension.
D) increases the release of norepinephrine
B
118
Medication routes, from slowest to fastest rates of
absorption, are:
A) subcutaneous, intramuscular, sublingual, inhalation,
intravenous.
B) intramuscular, sublingual, subcutaneous, intravenous,
inhalation.
C) intravenous, inhalation, sublingual, subcutaneous,
intramuscular.
D) subcutaneous, sublingual, inhalation, intramuscular,
intravenous.
A
119
```
Medications administered by the ___________ route, by
definition, have 100% bioavailability.
A) sublingual
B) intramuscular
C) endotracheal
D) intravenous
```
D
120
Which of the following statements regarding the sublingual
administration of nitroglycerin is correct?
A) Large doses of IV nitroglycerin are required to achieve the
same effect as a single sublingual nitroglycerin dose
B) Sublingual nitroglycerin administration involves placing a
tablet in between the patient's cheek and gum
C) Sublingual nitroglycerin has a delayed onset of action, but
nearly a 100% bioavailability
D) Nitroglycerin given by the sublingual route has a rapid onset
of action, but a low bioavailability
D
121
When administering a medication via the intramuscular
route, you should:
A) pinch the skin over the injection site and insert the needle at
a 45° angle.
B) stretch the skin over the injection site and insert the needle at
a 90° angle.
C) use a 24- to 26-gauge ½ʺ to 1ʺ needle to inject medication
into the muscle.
D) use a 21-gauge needle to inject medication into the fatty
tissue of the arm.
B
122
After inserting the needle during an intramuscular or
subcutaneous injection, but before delivering the medication,
you should:
A) ensure that you stretch the skin taut
B) inquire about any medication allergies.
C) look in the barrel of the syringe for blood.
D) pull back on the plunger to aspirate for blood
D
123
Neither subcutaneous nor intramuscular injections should
be given to patients:
A) with inadequate peripheral perfusion.
B) who are morbidly obese or very thin.
C) who require less than 5 mL of a drug.
D) with a systolic BP greater than 140 mm Hg.
A
124
Which of the following is NOT always considered a
mandatory action after administering a medication via the
enteral or parenteral route?
A) Contacting on-line medical control
B) Monitoring the patient's condition
C) Immediately disposing of any sharps
D) Documenting the time of administration
A
125
Compared with enterally administered medications,
parenterally administered medications:
A) require the presence of a peripheral IV line.
B) must pass through the gastrointestinal tract to be effective.
C) are absorbed into the central circulation at a more
predictable rate.
D) achieve their therapeutic effects much more slowly and are
less predictable.
C
126
The ________ route of medication administration refers to
any route in which medication is absorbed through some portion
of the gastrointestinal tract.
A) oral
B) enteral
C) rectal
D) gastric tube
B
127
Gathering a patient's medical history and performing a
secondary assessment should occur:
A) immediately after you form your visual general impression
of the patient.
B) shortly after making patient contact and determining his or
her complaint.
C) after initial treatment has been rendered and you are en route
to the hospital.
D) after life threats have been identified and corrected in the
primary assessment.
D
128
You will MOST likely develop your field impression of a
patient based on the:
A) medications the patient is taking.
B) chief complaint and patient history.
C) results of your secondary assessment.
D) patient's perception of his or her problem
B
129
Other than overall patient appearance, the patient's
__________ is/are the MOST objective data for determining his
or her status.
A) vital signs
B) medications
C) chief complaint
D) medical history
A
130
Serial vital signs:
A) are of no value unless they are repeated every 5 minutes.
B) provide definitive information about the patient's problem.
C) provide comparative data regarding the patient's condition.
D) establish a baseline to which further vital signs are
compared.
C
131
Which of the following reassessment findings is MOST
significant in a patient with penetrating chest trauma?
A) Loud heart tones to auscultation
B) Blood pressure of 90/76 mm Hg
C) Symmetrical chest rise and fall
D) Heart rate of 78 beats per minute
B
132
Which of the following statements includes a pertinent negative?
A) “The patient complains of nausea but denies vomiting.”
B) “The patient rates his pain as an 8 on a scale of 0 to 10.”
C) “The possible smell of ETOH was noted on the patient.”
D) “The rapid head-to-toe exam revealed abrasions to the chest.”
A
133
Which of the following is an example of a pertinent
negative?
A) A family member states that the patient has hypertension.
B) A patient tells you that he has developed a plan for suicide.
C) A patient with chest discomfort denies shortness of breath.
D) An agitated patient tells you that he did not request your
help.
C
134
Which of the following statements regarding the rapid
exam of a trauma patient is correct?
A) The rapid exam is used to identify injuries that must be
managed before and during packaging and loading the patient
for transport.
B) Any trauma patient should receive a rapid head-to-toe exam,
even if his or her injury is minor and the mechanism of injury is
not significant.
C) The rapid exam is the first assessment you will perform on a
trauma patient and is designed to find and treat immediate
threats to life.
D) The rapid exam is a detailed exam that should take between
1 and 2 minutes and should primarily focus on the patient's chief
complaint.
A
135
The rapid exam of a patient is usually performed:
A) as soon as your general impression of the patient suggests
that he or she is critically injured
B) immediately after determining that the patient has
experienced a significant mechanism of injury.
C) after all life-threatening conditions have been identified and
addressed in the primary assessment.
D) following at least one complete set of vital signs, including
assessment of the pupils and blood glucose
C
136
```
The upper airway of an adult consists of all the structures
above the:
A) carina.
B) bronchus.
C) vocal cords.
D) cricoid ring
```
C
137
```
The function of the lower airway is to:
A) warm, filter, and humidify air.
B) protect the lungs from aspiration.
C) deliver oxygenated blood to the cells.
D) exchange oxygen and carbon dioxide
```
D
138
```
Changes in the rate and depth of breathing are regulated
primarily by the:
A) pH of venous blood.
B) pH of the CSF.
C) saturation of oxygen and hemoglobin.
D) amount of oxygen in the blood plasma
```
B
139
```
The hypoxic drive stimulates breathing in patients with:
A) chronically decreased PaO2 levels.
B) emphysema or chronic bronchitis.
C) chronically decreased PaCO2 levels.
D) mild bronchospasm caused by asthma
```
A
140
```
The hypoxic drive, a backup system to control breathing, is stimulated when:
A) arterial PaO2 levels decrease.
B) arterial PaCO2 levels increase.
C) arterial PaO2 levels increase.
D) arterial PaCO2 levels decrease
```
A
141
Using the DOPE mnemonic, which of the following
interventions would you MOST likely have to perform if you
suspect “O” as the cause of acute deterioration in the intubated
child?
A) Tracheobronchial suctioning
B) Immediate extubation of the child
C) Needle decompression of the chest
D) Checking the bag-mask device for defects
A
142
You are attempting to intubate a 5-year-old girl when you
note that her heart rate has fallen from 120 beats/min to 80
beats/min. A patent IV line has been established. The MOST
appropriate action is to:
A) administer 0.02 mg/kg of atropine to increase her heart rate
B) abort the intubation attempt and begin chest compressions at
100/min.
C) give a 20 mL/kg normal saline bolus and continue your
intubation attempt.
D) abort the attempt and ventilate with a bag-mask device and
100% oxygen
D
143
Endotracheal intubation is MOST accurately defined as:
A) inserting an ET tube through the vocal cords via the patient's
mouth.
B) passing an ET tube through an opening in the cricothyroid
membrane.
C) inserting an ET tube through the glottic opening via the
patient's nose.
D) passing an ET tube through the glottic opening and sealing
off the trachea.
D
144
```
All of the following are complications associated with
orotracheal intubation, EXCEPT:
A) laryngeal swelling.
B) damage to the vocal cords.
C) necrosis of the nasal mucosa.
D) barotrauma from forceful ventilation
```
C
145
The major advantage of ET intubation is that it:
A) facilitates tracheal suctioning
B) protects the airway from aspiration.
C) is an easy skill to learn and perform.
D) provides a route for certain medications
B
146
Several cycles of basic life support maneuvers have failed
to relieve a severe airway obstruction in an unresponsive 44-
year-old woman. You should:
A) intubate the patient and attempt to push the foreign body into
one of the mainstem bronchi.
B) continue basic life support maneuvers and transport the
patient to the hospital immediately.
C) perform direct laryngoscopy and attempt to remove the
obstruction with Magill forceps.
D) place the patient's head in a neutral position and perform an
emergency cricothyrotomy
C
147
```
In the average female, the menstrual cycle lasts ___ days.
A) 21
B) 24
C) 28
D) 35
```
C
148
During normal menstruation, approximately ____ to ____
mL of blood is discharged from the vagina.
A) 25, 65
B) 50, 75
C) 65, 80
D) 75, 100
A
149
Which of the following statements regarding endometritis is
correct?
A) Untreated endometritis may result in septic shock.
B) Endometritis is defined as an enlargement of the uterus.
C) Endometritis is most commonly caused by an intrauterine
device.
D) Endometritis results when endometrial tissue grows outside
the uterus.
A
150
In contrast to endometritis, endometriosis:
A) may present without abdominal pain.
B) is an inflammation of the uterine lining.
C) generally causes light menstrual periods.
D) is often the result of gynecologic surgery
A
151
```
Which of the following is a potential complication of pelvic
inflammatory disease?
A) Uterine rupture
B) Ectopic pregnancy
C) Respiratory failure
D) Urinary tract infection
```
B
152
Which of the following statements regarding ectopic
pregnancy is MOST correct?
A) Ectopic pregnancy occurs when a fertilized egg implants in a
fallopian tube.
B) Most ectopic pregnancies present with symptoms during the
second trimester.
C) Use of an intrauterine device is the most common cause of
an ectopic pregnancy.
D) In ectopic pregnancy, a fertilized egg implants somewhere
other than the uterus
D
153
You are delivering a baby who was in a breech presentation.
The baby's body has delivered, and you are attempting to deliver
its head by lifting its body upward. After about 3 minutes, the
baby's head has not delivered. You should:
A) elevate the mother's hips with pillows, administer high-flow
oxygen, and transport immediately.
B) support the baby's body, carefully turn the mother on her left
side, and transport expeditiously.
C) place your gloved hand in the vagina and gently lift the
baby's face away from the vaginal wall.
D) elevate the mother's hips and apply gentle traction to the
baby's body until the head has delivered
C
154
In contrast to an abruptio placenta, a placenta previa:
A) typically presents with tearing abdominal pain.
B) is usually caused by maternal abdominal trauma.
C) is associated with an absence of fetal heart tones.
D) usually presents with painless vaginal bleeding
D
155
You are assessing a 36-year-old woman who is in the 33rd
week of her pregnancy. The patient complains of bright red
vaginal bleeding, but denies abdominal pain or cramping. She
tells you that she last felt her baby move about 5 or 10 minutes
ago. Fetal heart tones are audible at a rate of 130 beats/min.
Gentle palpation of her abdomen reveals that it is soft and
nontender. Which of your assessment findings is MOST
suggestive of placenta previa?
A) The age of the patient
B) Bright red vaginal bleeding
C) Absence of abdominal pain
D) Audible fetal heart tones
C
156
Abruptio placenta is MOST accurately defined as:
A) separation of the placenta secondary to blunt maternal
abdominal trauma.
B) premature separation of a normally implanted placenta from
the uterine wall.
C) a condition in which the placenta progressively detaches
from the uterine wall.
D) a placenta that implants low in the uterus and partially or
fully covers the cervix.
B
157
```
In pregnancy, magnesium sulfate is used principally for:
A) eclamptic seizures
B) tocolytic therapy.
C) ventricular dysrhythmias.
D) hyperemesis gravidarum
```
A
158
When caring for a prolapsed umbilical cord, you should:
A) position the mother in a left lateral recumbent position with
her knees flexed into her abdomen.
B) keep the presenting part of the baby off the umbilical cord
during rapid transport to the hospital.
C) have your partner cover the exposed portion of the umbilical
cord with dry, sterile dressings.
D) instruct the mother to push during each contraction to
facilitate passage of the baby past the cord
B
159
Appropriate care for postpartum bleeding in the prehospital
setting includes all of the following, EXCEPT:
A) infusing oxytocin at a rate of 0.2–0.3 units/min.
B) massaging the uterus in a clockwise fashion.
C) administering IV fluids to maintain perfusion.
D) carefully placing sanitary pads in the vagina
D
160
If your EMS system protocols permit you to administer
oxytocin to the mother following birth to control severe
postpartum bleeding, it is MOST important to:
A) administer a 500-mL normal saline bolus.
B) first massage the uterus for at least 5 minutes
C) ensure that she is not delivering a second baby.
D) obtain at least two blood pressure readings first
C
161
Prior to administering ipratropium (Atrovent), the
paramedic should routinely ask the patient if he or she is allergic
to:
A) wheat.
B) peanuts.
C) aspirin.
D) opiates
B
162
In general, the paramedic can administer up to ___ mg of
naloxone (Narcan) before contacting medical control.
A) 4
B) 10
C) 15
D) 20
B
163
```
The onset of action of naloxone (Narcan) is:
A) less than 2 minutes.
B) 2 to 5 minutes
C) 5 to 8 minutes.
D) greater than 10 minutes
```
A
164
```
The minimum single dose that is recommended for naloxone (Narcan) is
A) 0.4 mg.
B) 0.8 mg.
C) 2 mg.
D) 4 mg.
```
C
165
Naloxone (Narcan) reverses the central nervous system
depressant effects of drugs such as morphine and fentanyl by:
A) stimulating narcotic receptor sites.
B) facilitating excretion by the renal system.
C) agonizing opiate receptor sites.
D) competitively inhibiting opiate receptor sites
D
166
```
Succinylcholine (Anectine) is contraindicated for patients
with:
A) head trauma.
B) major burns.
C) tachycardia.
D) blunt force trauma
```
B
167
```
Succinylcholine (Anectine) is preferred by many
paramedics because it:
A) has a short duration of action.
B) is a nondepolarizing paralytic.
C) does not cause fasciculations.
D) has a slow onset of action
```
A
168
```
Succinylcholine should not be used in patients with:
A) a closed head injury.
B) known hyperkalemia.
C) a rapid heart rate.
D) suspected hypokalemia
```
B
169
Which of the following statements regarding
succinylcholine is correct?
A) It has a rapid onset of action and long duration of action.
B) It causes tachycardia, especially in small children.
C) It has a rapid onset of action and short duration of action.
D) It may induce or exacerbate existing hypokalemia
C
170
Colloid solutions:
A) contain proteins that are too large to pass out of the capillary
membranes, so the solutions remain in the vascular
compartment.
B) include solutions such as lactated Ringer's and normal saline
and rapidly expand the intravascular compartment.
C) are safe to use in the prehospital setting because they rapidly
and effectively expand the intravascular compartment.
D) do not contain large molecules and are therefore ineffective
in expanding the intravascular compartment.
A
171
```
All of the following are examples of colloid solutions,
EXCEPT:
A) dextran.
B) hetastarch.
C) Plasmanate.
D) lactated Ringer's
```
D
172
```
In the prehospital setting, the MOST commonly used IV
solutions are:
A) colloid solutions.
B) hypotonic crystalloids.
C) hetastarch and saline.
D) isotonic crystalloids
```
D
