Posted on June 14th, 2010 at 7:27 PM by Bratcher



Test Handout
12/25/2008
Page 1 of 35
1. You are assessing a patient who is a brittle asthmatic.  The patient has a history of a right-sided MI.  Which of the following would be an accurate description of how the asthma might have precipitated the right-sided MI?
A: The increase in pulmonary pressure made the right heart work harder than normal.
B: The hypoxia caused by the recurrent asthma attacks made the right heart ischemic.
C: The retention in CO2 the asthmatic experienced caused acidosis, which damaged the heart tissue.
D: The repeated use of beta-2 agonists caused positive inotropic and chronotropic demands on the heart without sufficient oxygenation.
2. You are assessing an unresponsive 32-year-old female who has a history of asthma.  She takes a steroid daily to help prevent her asthma attacks and a bronchodilator for acute care of asthma.  She is breathing deeply at 26 times per minute.  Her pulse is 110 and weak.  Her skin is warm and dry.  Which of the following assessments would be an expected finding with this patient?
A: Constricted pupils.
B: An emaciated appearance.
C: An elevated blood pressure.
D: An elevated blood glucose level.
3. The innermost layer of the heart is known as which of the following?
A: Epicardium.
B: Pericardium.
C: Myocardium.
D: Endocardium.
4. The ability of cardiac cells to depolarize without any outside course is known as the property of:
A: Contractility.
B: Conductivity.
C: Automaticity.
D: Rhythmicity.
5. Which of the following ions enters the cell during depolarization?
A: Magnesium.
B: Sodium.
C: Potassium.
D: Phosphate.
6. Sinus tachycardia is MOST commonly caused by:
A: Increased sympathetic tone.
B: Increased parasympathetic tone.
C: Cocaine overdose.
D: Cardiogenic shock.
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Test Handout
12/25/2008
Page 2 of 35
7. Which of the following methods would be the BEST to use for calculating a heart rate utilizing the ECG rhythm when the ECG is irregular?
A: R-R interval.
B: Triplicate method.
C: Six second method.
D: Heart rate calculator ruler.
8. You have recently intubated a patient in respiratory arrest.   The patient now has a heart rate of 30.  There is a normal PR interval and The QRS complex measures 0.10 seconds.
Which of the following is MOST likely the cause of the dysrhythmia in this patient?
A: Hypovolemia.
B: Vagal stimulation.
C: Excessive caffeine.
D: Myocardial infarction.
9. For which of the following rhythms is transcutaneous pacing usually NOT indicated?
A: Third-degree heart block.
B: Pulseless electrical activity.
C: Asystole caused by cardioversion.
D: First-degree heart block.
10. Which of the following types of angina typically occurs at rest and may NOT respond to treatment?
A: Stable angina.
B: Prinzmetal’s angina
C: Unstable angina.
D: Vasospastic angina.
11. Which of the following traumatic events would MOST potentially lead to a myocardial infarction?
A: Tension pneumothorax.
B: Myocardial contusion.
C: Fractured clavicle.
D: Major arterial bleed.
12. Being awakened from sleep with a sudden onset of difficulty breathing is known as:
A: Pulsus paradoxus.
B: Congestive heart failure.
C: Paroxysmal nocturnal dyspnea.
D: Nocturnal dyspnea condition.
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Test Handout
12/25/2008
Page 3 of 35
13. Which of the following is NOT a laboratory assessment for determining if a patient is suffering from acute myocardial infarction?
A: CK.
B: CK-MB.
C: Troponin.
D: KCl.
14. You are called to the scene of a motor vehicle collision and find a 34-year-old female with redness to the chest and difficulty breathing.  The patient has extensive jugular venous distension, and clear bilateral lung sounds.  Pulse is 128 and thready and the blood pressure is 80/70.
These findings indicate which of the following?
A: Hemothorax.
B: Tension pneumothorax.
C: Cardiac tamponade.
D: Traumatic asphyxia.
15. Your patient is a 67-year-old male with difficulty breathing.  Assessment reveals crackles in all lobes with production of pink, frothy sputum.  Pulse is 154 and irregular and blood pressure is 78/42. The patient only responds to pain.  A 12-lead ECG shows ST elevation in leads V1 to V4.  Which of the following would be the MOST appropriate intervention?
A: Furosemide 1.0 mg/kg IV push.
B: Nitroglycerin 0.4 mg sublingual.
C: Synchronized cardioversion at 50 joules.
D: Adenosine 6.0 mg IV push.
16. A patient experiencing acute congestive heart failure with associated pulmonary edema may display all of the following adventitious lung sounds EXCEPT:
A: Crackles.
B: Stridor.
C: Wheezes.
D: Rhonchi.
17. Atropine may be given by all of the following routes except:
A: IV push.
B: Endotracheal tube.
C: Intraosseous.
D: Subcutaneous.
18. You are assisting ventilations for an unconscious adult patient with inadequate breathing.  What is the preferred method of assisting the patient’s ventilations?
A: Flow-restricted, oxygen-powered ventilatory device.
B: Pocket mask with supplemental oxygen.
C: 2-man bag-valve-mask.
D: 1-man bag-valve-mask.
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Test Handout
12/25/2008
Page 4 of 35
19. After assisting a patient with his inhaler, which of the following side effects should you expect?
A: Decreased level of consciousness.
B: Decreased blood pressure.
C: Difficulty swallowing.
D: Increased heart rate.
20. Which of the following would be a method to calm a patient with a behavioral emergency?
A: Take your time and listen to him.
B: Try to interview the patient by yourself.
C: Get close and touch the shoulder to show you care.
D: If he is having hallucinations, state you see them to.
21. Which of the following reasons explains why we modify our behavior when treating a patient with a behavioral emergency?
A: We may make a borderline patient suicidal.
B: Treating the patient in a hurry can make the situations worse.
C: You need to take time so that the hospital can prepare for the patient.
D: The underlying cause of behavioral emergencies is psychological.
22. You have a patient with carbon monoxide poisoning.  Which of the following is your MOST important treatment after removing the patient from the source?
A: Nitroglycerine.
B: Activated charcoal.
C: High-flow oxygen.
D: Epinephrine auto-injector.
23. Which of the following is a narcotic?
A: Cocaine.
B: Codeine.
C: Methamphetamine.
D: PCP (angel dust).
24. You are called to treat a male patient complaining of right upper quadrant pain and pain in his right shoulder.  This pain came on shortly after eating a piece of pizza.  Which of the following organs should you suspect?
A: Spleen.
B: Kidney.
C: Appendix.
D: Gall bladder.
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Test Handout
12/25/2008
Page 5 of 35
25. What is the name of the phase of a generalized seizure right after a patient has stopped seizing?
A: Aura.
B: Tonic.
C: Clonic.
D: Postictal.
26. What is the primary concern for a patient in the postical phase of a seizure?
A: Assessing the patient.
B: Protecting the airway.
C: Preventing further injury.
D: Loosening restrictive clothing.
27. The head of the baby has just delivered.  Which of the following should you do NEXT?
A: Clamp and cut the cord.
B: Suction the mouth, then the nose.
C: Dry the head to prevent heat loss.
D: Pull the baby’s head down to deliver the shoulders.
28. For which of the following abnormal deliveries is it appropriate for you to place your gloved hand into the birth canal?
A: Nuchal cord.
B: Prolapsed cord.
C: Limb presentation.
D: Transverse presentation.
29. You have a patient with hives, itching, watery eyes, and a runny nose.  He is not complaining of difficulty breathing and his vital signs are normal.  Which of the following BEST describes this patient’s condition?
A: Inhalation poisoning.
B: Mild allergic reaction.
C: Anaphylactic reaction.
D: Severe allergic reaction.
30. A series of two or more seizures without an intervening period of consciousness defines which of the following?
A: A petit mal seizure.
B: Status epilepticus.
C: Hypertonic seizure activity.
D: Focal motor seizure.
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Test Handout
12/25/2008
Page 6 of 35
31. An exaggerated response by cellular immunity of the immune system to a foreign substance is known as which of the following?
A: Anaphylaxis.
B: Allergic reaction.
C: Antibody activation.
D: Humoral immunity.
32. Careful handling of the hypothermic patient is necessary to prevent which of the following?
A: Acute stroke.
B: Myocardial infarction.
C: Ventricular fibrillation.
D: Lactic acidosis.
33. During transport of a mother and her recent newborn to the hospital, the mother complains of a sudden onset of difficulty breathing and excruciatingly sharp chest pain.  She becomes unresponsive, has noted jugular venous distension, and is hypotensive.  Which of the following is MOST likely the cause?
A: Postpartum hemorrhage.
B: Meconium staining.
C: Pulmonary embolism.
D: Myocardial infarction.
34. Following exposure to an allergen, which of the following antibodies is released and then attaches to the membranes of mast cells and basophils?
A: IgA.
B: IgD.
C: IgB.
D: IgE.
35. Neoplasms affect approximately how many Americans per year?
A: 400.
B: 4,000.
C: 40,000.
D: 400,000
36. The increased ability to produce red blood cells is made possible by which of the following organs?
A: The liver.
B: The pancreas.
C: The kidneys.
D: The spleen.
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Test Handout
12/25/2008
Page 7 of 35
37. The most fundamental pathophysiology of diabetic ketoacidosis is which of the following?
A: Too little insulin.
B: Too much insulin.
C: Too much sugar.
D: Too little sugar.
38. Where does the pain associated with appendicitis typically begin?
A: Right lower quadrant.
B: Periumbilical.
C: Left lower quadrant.
D: Around the epigastrum.
39. Which of the following components of neurological anatomy is directly responsible for thermoregulation?
A: Medulla oblongata.
B: Cerebellum.
C: Thalamus.
D: Hypothalamus.
40. Which of the following are the MOST appropriate body substance isolation precautions in preparation for childbirth?
A: Gloves only.
B: Gloves and booties.
C: Gloves, gowns, and booties.
D: Gloves, gown, and goggles.
41. Which of the following is NOT a function of the vagina?
A: Reception of the penis during copulation.
B: An outlet for menstrual blood and debris.
C: A passageway during childbirth.
D: Protection for the pelvic structures.
42. Which of the following is produced by the posterior pituitary?
A: Prolactin.
B: Oxytocin.
C: Calcitonin.
D: Testosterone.
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Test Handout
12/25/2008
Page 8 of 35
43. Which of the following is the MOST common cause of non-traumatic abdominal pain in the female?
A: Mittelschmerz.
B: Pelvic inflammatory disease.
C: Endometriosis.
D: Ectopic pregnancy.
44. Which of the following is the MOST common cause of seizures?
A: Head injury.
B: Idiopathic epilepsy.
C: Hypoglycemia.
D: Eclampsia.
45. Which of the following is the MOST common cause of transient ischemic attack?
A: Hypotension.
B: Carotid artery disease.
C: Beta blocker medications.
D: Cerebrovascular spasm.
46. Which of the following is the MOST common route of entry of toxic substances into the body?
A: Inhalation.
B: Ingestion.
C: Injection.
D: Absorption.
47. Which of the following would be MOST appropriate for fluid management for heat cramps?
A: Two IVs running wide open.
B: An electrolyte fluid orally.
C: A 20 ml/kg fluid bolus.
D: 2-4 sodium tablets.
48. You are called to a child who has just ingested his mother’s sleeping pills.  Which should you do FIRST?
A: Administer 1 mEq/kg of sodium bicarbonate.
B: Administer Syrup of Ipecac.
C: Have the child drink milk.
D: Administer activated charcoal.
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Test Handout
12/25/2008
Page 9 of 35
49. You are transporting a patient with heat stroke. In what condition would you suspect to find the skin of this patient?
A: Hot and moist.
B: Pale and diaphoretic.
C: Moist and warm.
D: Hot and dry.
50. While working at a concert during a hot summer day, you are dispatched to a patient complaining of dizziness and nausea.  You suspect he has been overcome by heat.  Which of the following symptoms would you suspect to find if the patient is suffering from heat stroke?
A: Constricted pupils.
B: Slurred speech.
C: Hot, dry skin.
D: Bradycardia.
51. A 72-year-old female complains of chest pain and trouble breathing.  She suddenly vomits and her heart stops beating.  What is your FIRST priority?
A: Begin rescue ventilations.
B: Clear her airway with rigid suction.
C: Roll the patient onto her stomach.
D: Insert a double lumen airway.
52. You are assessing an 18-year-old female complaining of abdominal pain.  All of the following questions would be appropriate EXCEPT:
A: Do you take oral contraceptives?
B: Are you, or could you be, pregnant?
C: When was your last menstrual period?
D: When did you last have sexual intercourse?
53. Kleptomania is an example of a/an:
A: Mood disorder.
B: Impulse disorder.
C: Personality disorder.
D: Somatoform disorder.
54. Which of the following can be treated with antibiotics?
A: Fungi.
B: Viruses.
C: Bacteria.
D: Parasites.
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Test Handout
12/25/2008
Page 10 of 35
55. If a person who is scuba diving ascends too quickly to the surface after being at sufficient depths, he will MOST likely develop:
A: Barotrauma.
B: Altitude illness.
C: Nitrogen narcosis.
D: Decompression illness.
56. Which of the following BEST describes why dehydration contributes to the likelihood of a heat emergency?
A: Inhibits vasodilation.
B: Decreases evaporation.
C: Causes electrolyte imbalances.
D: Increases the base metabolic rate.
57. You are transferring a patient to a tertiary care center following a trauma event and a blood transfusion to stabilize the patient.  En route to the center, the patient experiences a severe anaphylactic reaction to the transfusion with bronchospasms and severe hypotension.  Which of the following should you administer?
A: Benadryl 25-50 mg IV.
B: Epi 1:10,000 0.3 mg IV.
C: Albuterol 2.5 mg nebulized.
D: Dopamine 10-20 mcg/kg/min.
58. A person with 3.2 million red blood cells per cubic millimeter would be considered:
A: Normal.
B: Anemic.
C: Leukopenic.
D: Polycythemic.
59. Where does erythropoietin come from?
A: Liver.
B: Spleen.
C: Kidneys.
D: Bone marrow.
60. Approximately how long does the average red blood cell survive?
A: 4-5 days.
B: 6-12 days.
C: 100-140 days.
D: 180-360 days.
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Test Handout
12/25/2008
Page 11 of 35
61. Which of the following is a characteristic of the inflammatory response?
A: Vasoconstriction.
B: Decreased chemotaxis.
C: Decreased phagocyte activity.
D: Increased capillary permeability.
62. Regarding a hypoglycemic, malnourished alcoholic, which of the following represents the correct drug regimen?
A: 25 g of D50 IV and 100 mg of thiamine IV.
B: 50 g of D50 IV and 100 mg of thiamine IV.
C: 25 g of D50 IV and 50 mg of thiamine IM.
D: 50 g of D50 IV and 50 mg of thiamine IM.
63. Which of the following uses heat or hot water as a part of the management?
A: Spider bites.
B: Scorpion bites.
C: Coral snake bites.
D: Marine animal bites.
64. Which of the following would use activated charcoal as a binding agent?
A: Iron.
B: Lead.
C: Lithium.
D: Salicylates.
65. What is the MOST important aspect to consider when dealing with inhaled poisons?
A: Identifying the source.
B: Providing for rescuer safety.
C: Wearing protective clothing.
D: Providing high-concentration oxygen.
66. Which of the following is the MOST common route of toxic exposure?
A: Injection.
B: Ingestion.
C: Inhalation.
D: Absorption.
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Test Handout
12/25/2008
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67. Which age group is the MOST likely to have an accidental poisoning?
A: Children under 6.
B: Adults over the age of 65.
C: Children between 6 and 18.
D: Adolescents between the ages of 13 and 20.
68. What is the average glomerular filtration rate of the kidneys per day?
A: 6 liters.
B: 8 liters.
C: 140 liters.
D: 180 liters.
69. The notched part of the kidney where the ureter and other structures join kidney tissue is called the:
A: Hilium.
B: Papilla.
C: Renal pelvis.
D: Bowman’s capsule.
70. Your patient is complaining of an achy or colicky pain that is poorly localized and felt deep within the body.  Which of the following BEST describes this pain?
A: Somatic pain located in solid structures.
B: Referred pain located in solid structures.
C: Visceral pain located in hollow structures.
D: Somatic pain located in hollow structures.
71. Your traumatic hemorrhagic shock patient has become profoundly hypotensive, tachycardic, and showing tall peaked T-waves on the ECG.
Which of the following treatment options would be your highest priority of care for this patient to correct the renal dysfunction?
A: Fluid resuscitation.
B: Oxygen administration.
C: Apply and inflate PASG.
D: Lasix to reduce potassium.
72. Which of the following terms BEST describes the process of removing impurities such as urea and creatinine from the blood as well as sodium, potassium, and hydrogen ions?
A: Hemodialysis.
B: Renal dialysis.
C: Peritoneal lavage.
D: Peritoneal dialysis.
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Test Handout
12/25/2008
Page 13 of 35
73. Which of the following would be the BEST definition of renal calculi?
A: A hardening of the renal tissue.
B: Blockages occurring in the urethra.
C: Infection of the nephrons and surrounding tissue.
D: Crystal aggregation in the kidney’s collection system.
74. Which of the following describes the appropriate management of a patient with renal calculi?
A: Avoid analgesics.
B: Position the patient supine.
C: Administer large amounts of fluid.
D: Percuss the flank to loosen the stone.
75. Which of the following is an upper urinary tract infection?
A: Cystitis.
B: Urethritis.
C: Prostatitis.
D: Pyelonephritis.
76. You are called to treat an otherwise healthy patient complaining of severe abdominal pain that you would describe as being positive bilateral Lloyd’s sign.  The patient is feverish and indicates they are suffering from anuria.
Which of the findings in the patient described above BEST suggests that this is a urological versus some other abdominal issue?
A: Fever.
B: Lloyd’s sign.
C: Severe abdominal pain.
D: Anuria with sufficient hydration.
77. Which cells located within the pancreas produce digestive enzymes?
A: Acini.
B: Alpha.
C: Beta.
D: Delta.
78. The common site of pain for appendicitis, located 1 ½ to 2 inches above the anterior iliac crest, is referred to as:
A: Cullen’s point.
B: Murphy’s point.
C: McBurney’s point.
D: Grey-Turner’s point.
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Test Handout
12/25/2008
Page 14 of 35
79. Peptic ulcers MOST commonly occur in the:
A: Duodenum.
B: Esophagus.
C: Jejunum.
D: Stomach.
80. Which of the following is the MOST common cause of upper gastrointestinal hemorrhage?
A: Peptic ulcer disease.
B: Varix rupture.
C: Esophagitis.
D: Gastritis.
81. Which of the following would be an expected response from a histamine release?
A: Bronchodilation.
B: Vasoconstriction.
C: Increased gastric motility.
D: Decreased capillary permeability.
82. A cluster headache would be classified as which of the following types of headache?
A: Tension headache.
B: Organic headache.
C: Migraine headache.
D: Vascular headache.
83. Which of the following represents the correct pharmacological intervention for the adult patient experiencing status epilepticus?
A: 1-2 mg of diazepam.
B: 5-10 mg of diazepam.
C: 10-20 mg of midazolam.
D: 50-100 grams of 50% dextrose.
84. What is the correct terminology for the seizure phase where the patient experiences continuous muscle tension?
A: Tonic.
B: Clonic.
C: Dystonic.
D: Postictal.
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Test Handout
12/25/2008
Page 15 of 35
85. Which of the following accurately reflects Cushing’s reflex?
A: Increased pulse, respirations, and temperature and decreased blood pressure.
B: Increased pulse and respirations and decreased blood pressure and temperature.
C: Decreased pulse and respirations and increased blood pressure and temperature.
D: Decreased pulse, respirations, and temperature and increased blood pressure.
86. If your patient is able to look in all directions with his eyes, which cranial nerves are intact?
A: II, III, IV.
B: II, IV, VI.
C: III, IV, V.
D: III, IV, VI.
87. Where is the thalamus located anatomically?
A: Pons.
B: Cerebrum.
C: Diencephalon.
D: Mesencephalon.
88. Rank the following in order from the MOST common in occurrence to the LEAST common in occurrence.
A: Epilepsy, Stroke, Parkinson’s.
B: Stroke, Parkinson’s, Epilepsy.
C: Stroke, Epilepsy, Parkinson’s.
D: Parkinson’s, Stroke, Epilepsy.
89. You are dispatched to the residence of a 76-year-old female who is having a possible cerebrovascular accident.  You arrive to find the patient alert and sitting in a chair with obvious left-sided paralysis and the inability to speak or swallow.  She is breathing at 20 times per minute, shallow, and her pulse ox is 94%.  Which of the following would be an appropriate treatment for this patient?
A: Transport her on her left side and assist ventilations.
B: Nasally intubate her and transport her in a supine position.
C: Transport her on her right side and give 4 lpm nasal cannula.
D: Transport her sitting up and administer 12-15 lpm non-rebreather.
90. You are called to the scene of a 27-year-old male who just came home from the hospital after knee surgery and suddenly became short of breath.  Assessment reveals jugular venous distention and equal lung sounds.  This patient is MOST likely suffering from:
A: Pneumonia.
B: Pulmonary embolism.
C: Right-sided heart failure.
D: Spontaneous pneumothorax.
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Test Handout
12/25/2008
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91. You have a patient with a fever and pleuritic chest pain who is coughing up green sputum and you hear adventitious lung sounds in the upper right lobe.  Your patient is MOST likely suffering from:
A: Asthma.
B: Pneumonia.
C: Emphysema.
D: Chronic bronchitis.
92. Which of the following would be the MOST expected medication provided for a patient in respiratory distress as a result of ARDS (Adult Respiratory Distress Syndrome)?
A: Nitro.
B: Lasix.
C: Albuterol.
D: Corticosteroid.
93. What is the medical term used to refer to lung sounds auscultated in the mid-axillary region?
A: Tracheal.
B: Vesicular.
C: Bronchial.
D: Bronchovesicular.
94. Which of the following respiratory patterns would you expect to see in a patient with increased intracranial pressure?
A: Ataxic.
B: Eupnistic.
C: Kussmaul.
D: Apneustic.
95. The anatomical region of the pharynx that is a combination of the two pharyngeal areas is called the:
A: Oropharynx.
B: Nasopharynx.
C: Tracheopharynx.
D: Laryngopharynx.
96. On an EMS run, your partner asks you to explain why you called for the police for the “crazy” woman on Liberty Street who was just suicidal.  What is the BEST reason for calling the police on a psychiatric problem?
A: You needed them to secure a knife on the scene.
B: You anticipated the patient could be violent or dangerous.
C: To serve as a witness in case the patient accuses you of wrongdoing.
D: To protect the patient’s civil rights in the event you had to restrain her.
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Test Handout
12/25/2008
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97. Which of the following should be your highest priority in assessing and treating a conscious patient you suspect is having a myocardial infarction?
A: The administration of aspirin.
B: The collection of a complete history.
C: The assessment of equal radial pulses.
D: The identification of patient risk factors.
98. You and your partner are preparing to deliver a baby.  The patient tells you this is her first pregnancy and she is frightened.  Choose the BEST reason for asking the patient if she wants you to contact a relative or friend to be with her.
A: It will protect the rescuers from civil liability later.
B: Relatives can serve as legal witneseses for the EMS run form.
C: If needed, relatives or friends could assist with the delivery.
D: Calling a friend or relative could comfort the patient.
99. What is the medical terminology for the voluntary nervous system?
A: Somatic.
B: Peripheral.
C: Autonomic.
D: Sympathetic.
100. Under which of the following circumstances would it be appropriate to remove relatives from the scene when assessing a patient having a behavioral emergency?
A: When the relatives’ presence agitates the patient.
B: Always in order to maintain patient confidentiality.
C: Try to avoid removing relatives as they can calm the patient.
D: When you are going to question the relatives about the patient.
101. Which of the following situations poses the greatest risk factor for suicide?
A: Divorce.
B: Depression.
C: Living alone.
D: Alcohol or drug abuse.
102. Which of the following is the MOST important consideration regarding verbal techniques useful in managing the emotionally disturbed patient?
A: Repeat and paraphrase what they say.
B: Ask them if they are having suicidal thoughts.
C: Ask open-ended questions and listen to the answers.
D: Tell them you also see whatever it is they are seeing.
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Test Handout
12/25/2008
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103. Which of the following BEST describes the physiological function of hormones?
A: To determine gender.
B: To regulate glucose levels.
C: To chemically maintain homeostasis.
D: To stimulate the autonomic nervous system.
104. How does the endocrine system regulate body function?
A: By direct stimulation.
B: By releasing hormones.
C: By regulating metabolism.
D: By stimulating the autonomic nervous system.
105. Which of the following is the primary composition of blood?
A: Plasma.
B: Platelets.
C: Red blood cells.
D: White blood cells.
106. Which of the following is correct regarding the cardiac cycle?
A: The first phase is diastole.
B: It is represented by the PQRST.
C: It ends with ventricular contraction.
D: It begins with the closure of the mitral valve.
107. Which of the following BEST describes pulmonary circulation as blood leaves the heart?
A: Blood travels through the pulmonary artery, under low pressure, to receive oxygen.
B: Blood travels through the pulmonary artery, under high pressure, to deliver oxygen.
C: Blood travels through the pulmonary vein, under low pressure, to receive oxygen.
D: Blood travels through the pulmonary vein, under high pressure, to deliver oxygen.
108. Which of the following anatomical structures within the pulmonary system is primarily responsible for the trapped air that an asthmatic experiences?
A: Alveoli.
B: Bronchi.
C: Bronchioles.
D: Trachea.
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Test Handout
12/25/2008
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109. Where is the principle location of carbon dioxide in venous blood?
A: As a dissolved gas in the plasma.
B: Bound to the proteins in the blood.
C: In the plasma as sodium bicarbonate.
D: In red blood cells bound to hemoglobin.
110. Which of the following environmental emergencies related to the cold is MOST common?
A: Frost nip.
B: Frost bite.
C: Trench foot.
D: Hypothermia.
111. In which of the following situations would you expect chronic hypothermia to develop?
A: A person shoveling snow.
B: A trapped mountain climber.
C: A person with hypothyroidism.
D: A person just pulled from icy waters.
112. Which of the following signs, symptoms, or sequelae would you expect to develop in a dry near drowning?
A: Laryngospasm.
B: Pulmonary edema.
C: Swelling skin tissue.
D: Unequal lung sounds.
113. Which of the following federal agencies is responsible for tracking the morbidity and mortality of infectious diseases?
A: OSHA.
B: FCC.
C: NFPA.
D: CDC.
114. During a focused history of a patient having a cardiovascular incident, the patient informs you that he takes Dyazide.  This medication falls under which of the following classifications?
A: Diuretic.
B: Beta blocker.
C: Antidysrhythmic.
D: Antihypertensive.
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115. Which of the following accurately represents a normal PR interval?
A: Measured from the beginning of the P to the beginning of the Q, and normal is 3 to 5 little boxes.
B: Measured from the end of the P to the beginning of the Q, and normal is 3 to 5 little boxes.
C: Measured from the beginning of the P to the beginning of the R, and normal is 0.12 to 0.20 seconds.
D: Measured from the end of the P to the beginning of the R, and normal is 0.12 to 0.20 seconds.
116. In which of the following situations would the act of performing an ECG analysis be of the LEAST benefit?
A: Chest pain.
B: Cardiac arrest.
C: Difficulty breathing.
D: Multi-system trauma.
117. What is the unit of measure for the component of a transcutaneous pacemaker regarding the amount of current delivered?
A: Volts.
B: Amps.
C: Joules.
D: Milliamps.
118. After applying electrode pads and pacing pads, which of the following should occur NEXT for transcutaneous pacing?
A: Set the desired rate.
B: Increase the current.
C: Check for electrical capture.
D: Check for mechanical capture.
119. You are managing a 67-year-old female diabetic who is complaining of shortness of breath.  Her lung sounds are clear, neck veins are distended, pulse is 70, respirations are 24, blood sugar is 90, and the blood pressure is 72/50.  A 12-Lead reveals elevation in Leads II, III, AVF, and V4R.  After oxygen, which of the following should be your initial treatment option in this situation?
A: 1 liter of NS.
B: 25 grams of D50.
C: 0.3 to 0.4 mg of Nitro.
D: 2-20 mcg/kg/min of Dopamine.
120. You are assessing a patient with pedal and sacral edema.  Which of the following would BEST pertain to the clinical significance of these findings?
A: Left-heart failure.
B: Right-heart failure.
C: Systemic hypertension.
D: Peripheral vascular disease.
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121. Which of the following clinical conditions would be your greatest concern for your patient having a hypertensive emergency?
A: Pedal edema, basilar rales, and slight headache.
B: Restlessness, confusion, blurred vision, and nausea.
C: Severe headache, stiff neck, photophobia, and nausea.
D: Severe headache, vomiting, blindness, seizure, and paralysis.
122. Which progressive event typically causes the cardiogenic shock patient to lose the ability to maintain vital organ perfusion?
A: Myocardial death.
B: Failure of Starling’s law mechanism.
C: Failure of preload, afterload, and contractility mechanism.
D: Failure of respiration secondary to massive pulmonary edema.
123. Which of the following patient populations is MOST likely to develop cardiogenic shock?
A: Patients with significant anterior chest trauma.
B: Patients with a history of right ventricular infarct.
C: Patients with a history of myocarditis or pericarditis.
D: Geriatric patients with significant underlying diseases.
124. You have a patient in cardiogenic shock who also has acute pulmonary edema.  Which of the following medications will have the LEAST negative impact on this patient’s compensatory mechanisms?
A: Oxygen.
B: Morphine.
C: Furosemide.
D: Nitroglycerin.
125. Your patient has a history of SVT and left-sided myocardial infarction.  The patient now has a narrow complex tachycardia at a rate of 180, pulmonary edema, a blood pressure of 70/40, and is unresponsive.  Which of the following should be your initial treatment?
A: Lasix.
B: Dopamine.
C: Dobutamine.
D: Synchronized cardioversion.
126. Which of the following is considered a non-cardiac cause of cardiac arrest?
A: Hypertension.
B: Hyperkalemia.
C: Hypercholesterolemia.
D: Carbohydrate intolerance.
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127. 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?
A: Therapy rendered.
B: Medical condition of the patient.
C: Quality-of-life evaluation by EMS.
D: Resistance or uncertainty on behalf of the family.
128. Which of the following degenerative vascular diseases MOST commonly occurs as a result of hypertension?
A: Atherosclerosis.
B: Infectious aneurysm.
C: Congenital aneurysm.
D: Cystic medial necrosis.
129. Which of the following would BEST describe the medical term “claudication”?
A: Venous occlusion as a result of a thrombosis.
B: Arterial occlusion as a result of a thrombosis.
C: Pulmonary artery occlusion as a result of an embolism.
D: Severe pain in the calf muscle due to inadequate blood supply.
130. Acute arterial occlusion will MOST commonly involve arteries in which of the following regions of the body?
A: Lungs and brain.
B: Lungs and heart.
C: Abdomen and brain.
D: Abdomen and extremities.
131. You have an adult patient in status epilepticus after failing to take his prescribed anticonvulsant medication.  Which of the following is the appropriate treatment for this patient?
A: Initiate an IV of normal saline.
B: Administer 5-10 mg of midazolam IV push.
C: Insert a padded tongue blade to protect the airway.
D: Restrain the patient to a backboard to protect from injury.
132. Which of the following medications is NOT normally considered initially when managing the patient with an altered mental status?
A: Dextrose.
B: Naloxone.
C: Vitamin B1.
D: Sodium bicarbonate.
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133. Which of the following assessment findings for a patient complaining of a headache would lead you to suspect meningitis?
A: Nuchal rigidity.
B: Nausea and vomiting.
C: Dizziness and weakness.
D: Blurred vision and watery eyes.
134. What is the clinical significance for a patient with a history of a brain abscess who now has a high temperature, severe headache, and nuchal rigidity?
A: The patient can be expected to become hypotensive.
B: The abscess is affecting the occipital lobe of the cerebrum.
C: The infection has migrated to the meninges of the spinal cord.
D: The patient is showing signs consistent with an increase in intracranial pressure.
135. Which of the following oxygen or ventilation therapy choices would be appropriate for a patient suffering from a transient ischemic attack with an isolated complaint of dysphasia?
A: Intubation.
B: Nasal cannula.
C: Assisted ventilations.
D: Non-rebreather mask.
136. Which of the following degenerative neurological disorders is the MOST likely to require an EMS call as a result of disease progression?
A: Myoclonus.
B: Multiple sclerosis.
C: Alzheimer’s disease.
D: Amyotrophic Lateral Sclerosis.
137. You are called to treat an unresponsive Alzheimer’s patient who has cool and clammy skin and an elevated heart rate.  The blood pressure is slightly elevated, pulse oximetry is 98%, and blood sugar is 60.  Which of the following would be the appropriate intervention for this patient?
A: Administer high-flow oxygen and transport.
B: Initiate an IV and deliver 25 grams of Dextrose.
C: Initiate an IV of NS and administer a fluid bolus.
D: Initiate an IV and administer 12.5 grams of Dextrose.
138. How does obesity affect the development of adult onset diabetes?
A: A decrease in the pancreatic production of insulin.
B: An increase in the pancreatic production of glucagon.
C: Damage to the pancreas as a result of hyperglycemia.
D: A relative deficiency in the number of insulin receptors per cell.
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139. Which of the following would you MOST likely expect to see in a patient with an elevated serum glucose level?
A: Bradycardia.
B: Tall, peaked T waves.
C: Pale, cool, clammy skin.
D: Orthostatic hypotension.
140. If a patient is hypoglycemic, which of the following physiological processes will occur in an attempt to correct this situation?
A: Glycogen breaks glucose down through glycogenolysis.
B: Glucagon breaks glycogen down through glycogenolysis.
C: Glycogen breaks glucose down through gluconeogenesis.
D: Glucagon breaks glycogen down through gluconeogenesis.
141. Which of the following statements is correct regarding the body’s attempt to maintain homeostasis when hypoglycemia is present?
A: Glycogenolysis breaks glucagon down into glucose.
B: Glucagon is released by the beta cells of the pancreas.
C: Glycogen is released by the alpha cells of the pancreas.
D: Gluconeogenesis produces glucose from non-sugar sources.
142. Which of the following is the pathophysiological cause of Cushing’s syndrome?
A: Too little circulating thyroid hormone.
B: Too much circulating thyroid hormone.
C: Too little adrenocorticotropic hormone.
D: Too much adrenocorticotropic hormone.
143. You have a patient with a history of Addison’s disease who has a decreased level of consciousness.  Which of the following would be an appropriate intervention to increase the level of consciousness?
A: Administer narcan.
B: Administer dextrose.
C: Administer prednisone.
D: Administer a beta blocker.
144. You have a patient with a history of Addison’s disease who has tall, peaked T waves, tachycardia, and hypotension.  Which of the following pathological causes would be primarily responsible for this situation?
A: Increased gluconeogenesis and potassium retention.
B: Increased sodium excretion and potassium retention.
C: Decreased gluconeogenesis and potassium excretion.
D: Decreased sodium retention and potassium excretion.
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145. You are dispatched to a homeless shelter for a diabetic, 67-year-old male with an altered level of consciousness.  The patient presents to you unconscious amd responsive only to painful stimulus with gasping respirations and cool, purpuric skin.  Carotid and femoral pulses are weak and rapid.  Peripheral pulses are not palpable.  Reports from staff at the shelter reveal that this patient had been ill for several days with fever, headache, lethargy, and a stiff neck.  Priority pre-hospital treatment interventions should include:
A: Oxygen per facemask, nebulized bronchodilator therapy, and Dopamine infusion.
B: Endotracheal intubation with cervical spine precautions, intravenous access, and spinal immobilization.
C: Oxygen by facemask, blood glucose determination, 50% Dextrose administration, intravenous access, and fluid resuscitation.
D: Airway and ventilatory assistance utilizing appropriate PPE, observing for and management of seizures, and IV access with fluid resuscitation.
146. Possible pathogens that may lead to bacterial meningitis include all of the following EXCEPT:
A: Cryptococcus.
B: Neisseria meningitides.
C: Listeria monocytogenes.
D: Streptococcus pneumoniae.
147. Describe the correct course of treatment for an eight-year-old female with a diagnosis of Varicella Disease.
A: Acyclovir 120 mg four times for five days; oatmeal baths.
B: Amoxicillin 500 mg twice daily; Aspirin every four hours; contained to residence.
C: Immediate Varicella vaccination; children’s Acetaminophen; broad spectrum antibiotic.
D: Tylenol every four hours; updated Varicella vaccination; Aczone topical cream three times.
148. Correctly identify the signs and symptoms connected to childhood mumps.
A: Decreased appetite and associated nausea, blisters, and lymphitis.
B: Increased swelling of thyroid membrane, blurred vision, and headache.
C: Increased temperature (over 105 Fahrenheit), stiffened neck muscles, and vertigo.
D: Increased temperature (over 103 Fahrenheit), headache, decreased appetite, and swollen parotid glands.
149. Which of the following signs would you MOST likely expect to see as you assess a patient with a slow lower gastrointestinal bleed?
A: Melena.
B: Hematuria.
C: Hematemesis.
D: Hematochezia.
150. Which of the following signs and symptoms occur with the Hantavirus?
A: Headache, vertigo, and vision disturbances.
B: Fever, chills, earache, sore throat, and body aches.
C: Body rash, abdominal pain, and difficulty breathing.
D: Fever, headache, body aches, and respiratory difficulty.
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151. Which of the following are some of the illnesses that children are typically immunized against?
A: Hepatitis A, Hepatitis B, and Polio.
B: Diphtheria, Tetanus, and HIV.
C: Hantavirus, Rhinovirus, and MMR.
D: Hepatitis E, Hepatitis C, and Varicella.
152. Identify the bodily system affected by influenza and its resulting symptoms.
A: Neurological system; increased confusion.
B: Respiratory system; non-productive cough.
C: Cardio-respiratory system; pulmonary edema.
D: Gastrointestinal system; vomiting and diarrhea.
153. Which of the following would be an abnormal sign associated with a heat emergency?
A: Seizures.
B: Weak pulse.
C: Slow respirations.
D: Elevated blood pressure.
154. Which of the following would be the most effective measure to reduce the likelihood of becoming frostbitten?
A: Dress warmly.
B: Eat appropriately.
C: Get plenty of rest.
D: Eat at regular intervals.
155. At which of the following altitudes does high altitude illness typically begin to manifest itself?
A: 4,000 feet.
B: 6,000 feet.
C: 8,000 feet.
D: 10,000 feet.
156. Which of the following would be considered an early sign or symptom of high altitude illness?
A: Ataxia.
B: Vomiting.
C: Lightheadedness.
D: Decreased urinary output.
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157. Using a pharmacological substance for purposes other than medically defined reasons would be the definition of which of the following?
A: Abuse.
B: Addiction.
C: Overdose.
D: Alcoholism.
158. Which of the following vascular conditions will MOST likely result in chronic hypertension?
A: Vasculitis.
B: Claudication.
C: Arteriosclerosis.
D: Arterial occlusion.
159. You are called to treat a patient who initially presented with sharp, tearing pain, confusion, vertigo, and hemiplegia about 2 minutes after ascending from a dive.  The patient is now unresponsive with a weak, rapid pulse.  Which of the following is your MOST important intervention?
A: Decompressing the mediastinum.
B: Transporting to a recompression chamber.
C: Placing the patient in a Fowler’s position.
D: Decompressing the developing pneumothorax.
160. The pathophysiology that ensues from vomiting and diarrhea secondary to Acute Gastroenteritis (AGE) affects every body system.  Respiratory symptoms typically include an increase in tidal volume and respiratory rate.  This change in respiratory system mechanics is a result of:
A: Respiratory compensation of metabolic acidosis.
B: A decrease in tissue perfusion requiring more oxygen.
C: Osmotic fluid shifts from the gastrointestinal tract to the pulmonary vasculature.
D: The body’s compensatory response to decreased circulating blood volume by increasing intrathoracic pressure in order to shunt blood to vital organs.
161. Select the correct pathophysiological process of poisonous substances injected into the body.
A: Effects are felt dependant on the vein’s distance from the heart.
B: IV administration through an artery that is routed throughout the body.
C: IV administration through a vein that then affects the receptor sites of the brain and cardiovascular system.
D: IV administration through a vein that is first delivered to the liver for filtering, then adverse affects are experienced.
162. Your patient has the following assessment findings: Slurred speech, drowsy appearance and droopy eyelids, blood pressure 118/54, pulse 56, and respirations 8 and regular. The patient has vomited copiously. What is your field impression and probable initial treatment?
A: Possible narcotic overdose; oxygen, IV Narcan 2 mg.
B: Possible amphetamine overdose; oxygen, IM Narcan 4 mg.
C: Possible narcotic overdose; oxygen, IV, and Romazicon 2 mg.
D: Possible amphetamine overdose; IV, Thiamin 100 mg, Narcan 2 mg, and Dextrose 25 grams.
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163. Your 21-year-old male patient reports his suspicion that he may have Chlamydia.  This is based on the fact that he had unprotected sexual relations one week ago with a partner who is known to have the disease.  What assessment findings might you discover upon further history and physical examination?
A: Pleuritic chest pain and shortness of breath.
B: Nausea, vomiting, and a positive Cullen’s sign.
C: Fever, malaise, painful urination, and testicular swelling.
D: Back pain, tea-colored urine, and a vesicular rash around the external genitalia.
164. You are en route to the local emergency department with a 38-year-old female with genital herpes.  The patient asks you what type of antibiotics the physician may prescribe.  She appears somewhat anxious as she tells you she has a Penicillin allergy.  The MOST appropriate answer to her question would be:
A: “The physician will probably prescribe Amoxicillin, as it provides good coverage for most sexually-transmitted diseases.”
B: “Since you are allergic to Penicillin, the physician will probably stay away from antibiotics all together.”
C: “Since you are allergic to Penicillin, the physician will probably prescribe Gentamicin.”
D: “Your infection is caused by a virus and it is not generally treated with antibiotics.”
165. After transporting a patient with scabies, protective measures to minimize the spread of it include:
A: No action is required, as scabies can not live away from its human host.
B: Wear gloves, bag linen separately, and spray the patient compartment with an effective insecticide.
C: Take the ambulance out of service until the ambulance can be cleared by the local health department.
D: Take the ambulance out of service until the ambulance can be cleared by the local medical direction authority.
166. You are called to transport a 23-year-old female involved in a motor vehicle crash to the regional trauma center secondary to a positive abdominal ultrasound. The patient is alert and oriented although very frightened.  During routine rectal exam performed by the trauma surgeon, she notes that the patient has vesicular lesions of the anus and labia.  The patient’s health history is significant for genital herpes several months ago which was treated with acyclovir.  She begins to cry stating that she had taken all of the medications that she was instructed to and has not had sexual contact since her initial outbreak.
You suspect that these new lesions are secondary to:
A: The patient recently contracted the disease again due to unsafe sex practices and that she is not being completely truthful with the healthcare team.
B: The patient had stopped taking her medication once symptoms subsided and did not complete the full course as prescribed.
C: Her infection has been dormant and she is suffering from a recurrent disease process.
D: She is suffering from a different communicable disease and not herpes.
167. Which of the following would normally be included within a local protocol regarding the documentation and reporting of an infectious disease exposure?
A: Informing your co-workers of your exposure.
B: Indicating your exposure on the patient billing sheet.
C: Notifying your company’s infectious control contact person.
D: Including the specific details of your exposure on the patient run form.
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168. You are called to the residence of a 38-year-old 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 is 120, and blood pressure is 70/50.  Which of the following field diagnoses and interventions is the MOST appropriate?
A: Vagal response; 0.5 to 1.0 mg of atropine.
B: Dissecting aortic aneurysm; PASG, fluids, and rapid transport.
C: Anemia from a slow GI bleed; fluid resuscitation and rapid transport.
D: Hypovolemia from a rapid GI bleed; fluid resuscitation and rapid transport.
169. Which of the following causes of food poisoning is more likely to present with respiratory effects rather than gastrointestinal complaints?
A: E. coli.
B: Shigella.
C: Salmonella.
D: Clostridium botulinum.
170. What is the pathophysiology behind the cause of the SLUDGE process?
A: Accumulation of ACh leads to parasympathetic activity of smooth muscle in the lungs, GI tract, heart, eyes, bladder, and secretory glands.
B: Accumulation of ACh leads to sympathetic activity of smooth muscle in the lungs, GI tract, heart, eyes, bladder, and secretory glands.
C: Decrease of ACh leads to parasympathetic activity of smooth muscle in the lungs, GI tract, heart, eyes, bladder, and secretory glands.
D: Decrease of Ach leads to sympathetic activity of smooth muscle in the lungs, GI tract, heart, eyes, bladder, and secretory glands.
171. During assessment, your patient reveals cardiac dysrhythmias and shortness of breath. En route to the emergency department, the patient develops worsening dyspnea and begins to exhibit bigeminal PVCs while on non-rebreather oxygen. What would the assessment findings reveal?
A: Respiratory exposure to CO.
B: Respiratory exposure to Paraquat.
C: Inhalation exposure to anhydrous ammonia.
D: Significant dermatological exposure to mercury.
172. Your ambulance is requested for abdominal pain. Your patient has a history of cholecystitis. He is experiencing diffuse upper epigastric pain, nausea, and emesis. Select the correct treatment.
A: IV normal saline, cardiac monitor, oxygen 2 LPM cannula.
B: Oxygen 2 LPM cannula, saline lock, cardiac monitor, and morphine 2 to 4 milligrams.
C: IV normal saline, Demerol 50 milligrams, cardiac monitor, and oxygen 2 LPM cannula.
D: Oxygen 15 LPM non-rebreather, IV normal saline bolus, cardiac monitor, and Dilaudid 10 milligrams.
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173. Acute hepatitis would be correctly described as which of the following?
A: Acute onset of the hepatitis bacteria.
B: Inflammation of the liver from the hepatitis virus.
C: Acute onset and rapid recovery from the hepatitis bacteria.
D: Acute inflammation of the gall bladder from the Hepatitis A virus.
174. Your ambulance responds to a nursing facility for a “sick person”. Your assessment reveals a patient looking jaundiced and lethargic and vomiting. The patient is unresponsive with tachycardia, hypotension (98/46), and a decreased respiratory effort. Select the proper treatment.
A: Oxygen 15 LPM non-rebreather, IV normal saline TKO, cardiac monitor.
B: Oxygen per BVM, endotracheal intubation, IV normal saline TKO, cardiac monitor.
C: Oxygen 6 LPM cannula, IV normal saline TKO, cardiac monitor, facemask on the patient.
D: Oxygen 15 LPM non-rebreather, IV normal saline bolus, cardiac monitor, body substance isolation.
175. You are called to provide treatment for a 57-year-old male complaining of severe chest pain that he rates as a 10 on a 1 to 10, his skin is jaundiced, and he has scleral icterus.  Which of the following medications would be the LEAST effective?
A: Aspirin.
B: Morphine.
C: Beta-blocker.
D: Nitroglycerin.
176. You are called to a patient complaining of bloody diarrhea.  Upon assessment you identify colicky pain in the lower quadrants, nausea, and vomiting.  Which of the following would be your MOST likely field diagnosis?
A: Diverticulitis.
B: Gastroenteritis.
C: Hemorrhoids.
D: Ulcerative colitis.
177. You are called to the scene of a 57-year-old male patient with a 5-day history of abdominal pain, heartburn, and dark, tarry stools.  Which of the following would you MOST likely select for a field diagnosis?
A: Cardiac ischemia.
B: Esophageal varices.
C: H-pylori-caused chronic gastroenteritis.
D: Salmonella-caused acute gastroenteritis.
178. You are called to assess a patient with an extended history of peptic ulcers.  Which of the following assessment findings would you MOST likely expect to observe?
A: Dysphagia.
B: Significant hematochezia.
C: Bradycardia secondary to vagal stimulation.
D: A history of pain reduction immediately following a meal.
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179. Which of the following BEST describes the desired effect of Zantac for a patient with a history of peptic ulcers?
A: Acts as an antacid.
B: Coats the stomach.
C: Stimulates coagulation.
D: Decreases acid production.
180. You are called to treat a patient with a suspected bowel obstruction.  The patient is unresponsive, tachycardic, tachypnic, hypotensive, significantly distended, hyperresonant to abdominal percussion, and vomiting feces containing emesis.  Which of the following is your MOST important and immediate intervention?
A: Intubation.
B: Fluid resuscitation.
C: Abdominal decompression.
D: Oxygen administration with a non-rebreather.
181. Which of the following vascular disorders has the greatest likelihood of becoming life threatening?
A: Vasculitis.
B: Aortic aneurysm.
C: Deep vein thrombosis.
D: Peripheral artery occlusion.
182. You are called to assess and treat a 57-year-old male with chief complaint of a severe headache, vomiting, visual disturbances, and left-sided paralysis.  The patient’s pulse is 56 and his blood pressure is 220/160.  They are supposed to take “blood pressure” medication but did not care for the side effects.
Which of the following is your MOST important intervention for this patient?
A: Administration of nifedipine.
B: Administration of antiemetics.
C: Hyperventilation with supplemental oxygen.
D: Rapid transportation to an emergency department.
183. You are transcutaneously pacing a patient who had a complete heart block prior to your intervention.  The patient remains unresponsive and apneic and you are continuing ventilations.  Which of the following is your MOST important intervention?
A: Obtaining a 12-Lead ECG.
B: Verifying electrical capture.
C: Verifying mechanical capture.
D: Setting the heart rate appropriately.
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184. You have a patient who is responsive to painful stimuli, is breathing at 24 times per minute, has a carotid pulse of 40 and absent radial and femoral pulses, pale, cool, clammy and you are unable to obtain a blood pressure.  Your ECG analysis is of a Second Degree Type II and the 12-Lead shows ST elevation in Leads V1 and V2.
You have decided to pace this patient and as a result, he wakes up and is in a tremendous amount of pain from the pacemaker.  He also indicates that he is allergic to all of the pain relieving medications you have on board.  What would be your MOST appropriate course of action based on this information?
A: Discontinue the pacemaker.
B: Administer an analgesic and epi sub-Q.
C: Start an epi drip and then once you see it is working, DC the pacer.
D: Explain the situation to the patient and recommend continued pacing.
185. Patients with acute pancreatitis experience which of the following?
A: Nausea, vomiting, and flank pain radiating to the groin.
B: Fever, nausea, vomiting, flank tenderness, and hypertension.
C: Nausea, vomiting, epigastric pain, and elevated amylase levels.
D: Fever, nausea, vomiting, right upper quadrant pain, and hypertension.
186. Select the correct management of acute pancreatitis.
A: IV bolus, cardiac monitor, pain management.
B: Oxygen, cardiac monitor, pain management IM.
C: Oxygen, saline lock, cardiac monitor, position of comfort.
D: Oxygen, IV fluids, cardiac monitor, and pain management.
187. Select which answer would BEST describe the patient with hemorrhaging from the mouth, extreme dyspnea and cyanosis, anxiousness, pallor, and a history of liver cirrhosis.
A: Crohn’s disease.
B: Laryngeal cancer.
C: Esophageal varices.
D: Lower GI hemorrhage.
188. Your patient is a 70-year-old female with rectal bleeding. She reveals she had a difficult bowel movement. After straining for fifteen minutes, she noticed blood in her toilet tissue. Initial assessment is unremarkable. Identify the correct field impression.
A: Hemorrhoids.
B: Diverticulitis.
C: Protruding bowel.
D: Upper GI hemorrhage.
189. Select the proper treatment for a patient with rectal bleeding from hemorrhoids.
A: Saline lock, cardiac monitor, pain medications.
B: Comfort measures, dressing for external bleeding.
C: Trauma dressings, cardiac monitor, nasal cannula.
D: Nasal cannula 2-4 LPM, IV titrated to blood pressure, cardiac monitor.
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190. You respond to the home of a 7-year-old male with a severe arm laceration.  His mother states that he was running in the house, tripped, and fell through a window.  Upon arrival, the child is in his mother’s arms, crying, and his arm is bleeding profusely.  You don disposable gloves and protective eyewear and apply direct pressure to the child’s wound with a dressing.  After the call, your partner asks why you took the time to don gloves and goggles when the child was “bleeding to death in front of us”.  Your response to this should be:
A: “You are right.  I should have known better.”
B: “If you have to ask that question, maybe you should go back to EMT school.”
C: “Taking precautions against potentially infectious body fluids takes minimal time, is good practice, and is part of being a professional healthcare provider.”
D: “The application of universal precautions is now an expectation of the public, so by donning this equipment, I was putting the mother and child at ease by increasing confidence.”
191. When should you as a professional pre-hospital care provider consider the use of body substance isolation (BSI) precautions?
A: Only when you know the patient has an infectious disease.
B: If you are willing to incur the risk, you need not worry about BSI.
C: As an experienced EMS professional, your judgment will dictate the situation in which to use BSI.
D: EMS personnel should take BSI precautions with every patient, regardless of whether he or she has an infection or not.
192. Which of the following would clearly indicate that a myocardial infarction is occurring?
A: Chest pain radiating to the jaw.
B: ST elevation in 2 contiguous leads.
C: ST depression in 2 contiguous leads.
D: A decrease in cardiac enzymes levels.
193. Which of the following would BEST describe why we provide oxygen to a patient having a myocardial infarction?
A: To reduce myocardial oxygen demand.
B: To vasodilate cardiac blood vessels.
C: To provide additional oxygen to the brain.
D: To oxygenate the collateral cardiac circulation.
194. Which of the following would BEST describe why we provide morphine to a patient having a myocardial infarction?
A: To reduce myocardial oxygen demand.
B: To vasodilate cardiac blood vessels.
C: To provide additional oxygen to the brain.
D: To oxygenate the collateral cardiac circulation.
Last Edited On:12/25/2008 7:19:17 PM Platinum Education (c) 2008


Test Handout
12/25/2008
Page 34 of 35
195. You are called to treat a patient complaining of chest pain and his 12-lead indicates he is having an extensive anterior wall MI.  The patient denies any shortness of breath and his pulse oximeter reading is 98%.  Which of the following is true regarding oxygen administration?
A: Oxygen is not necessary as the patient denies shortness of breath.
B: Oxygen should be administered at 12-15 liters per minute to increase the pulse oximeter to 100%.
C: Oxygen should be provided at 2-4 liters per minute to avoid constricting the coronary arteries.
D: Oxygen should be provided at 6 liters per minute via nasal cannula to decrease anxiety yet increase the pulse oximeter reading.
196. Which of the following assessment tools would BEST be used to properly identify cardiac tamponade?
A: EKG revealing elevated ST segments.
B: Tracheal deviation with extreme dyspnea.
C: EKG showing premature ventricular contractions.
D: Manual blood pressure cuff with resulting pulsus paradoxus.
197. You are assessing a 32-year-old female who was involved in a head-on motor vehicle collision at moderate speeds. Examination of the vehicle reveals a deformed steering wheel and shoulder and lap restraints were not used. Windshield starring is also evident. The patient complains of moderate dyspnea. Assessment also reveals sternal bruising, jugular vein distention, and muffled heart sounds. What would be the correct field impression?
A: Cardiac tamponade.
B: Ruptured pericardium.
C: Hemothorax/pneumothorax.
D: Sternal fracture with lacerated liver.
198. Your assessment of an assault victim reveals a bruise across the chest consistent with a baseball bat. There is moderate dyspnea and there are muffled heart sounds on auscultation. There is jugular vein distention and the patient is very anxious and is becoming disoriented. Oxygen alone by first responders has been very inadequate in improving the dyspnea. What would be the proper treatments to incorporate?
A: Bi-lateral IV with bolus, cardiac monitor, and pleural decompression.
B: Bi-lateral IV, cardiac monitor, support ventilations, and rapid transport.
C: IV TKO, cardiac monitor, spinal immobilization, and oxygen by non-rebreather.
D: Bi-lateral IV TKO, cardiac monitor, rapid transport, and pleural decompression.
199. Which of the following represents the correct lidocaine maintenance regimen for a patient in the post resuscitation phase of an arrest?
A: 0.5 mg/min.
B: 0.5 to 0.75 mg/kg.
C: 1.0 to 4.0 mg/min.
D: 2.0 to 4.0 mg/kg.
Last Edited On:12/25/2008 7:19:17 PM Platinum Education (c) 2008


Test Handout
Paramedic 12/25/2008
Cagle Page 35 of 35
200. You have just defibrillated a patient from ventricular fibrillation into what appears to be a rhythm which should produce a pulse.  In cases where the arrest was not witnessed, which of the following BEST describes why we continue to provide chest compression?
A: The patient is typically in a PEA.
B: The toxins need to be removed with CPR.
C: The bolus medications still need to be circulated.
D: The rhythm will become ventricular tachycardia without compressions.
Last Edited On:12/25/2008 7:19:17 PM Platinum Education (c) 2008

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