Paramedic Final

Which benzo drug is often related to sexual assault cases?

1. Ketamine
2. Rohypnol
3. GHB
4. Ecstasy

2. Rohypnol

Which of the following patient’s physical appearance would be obvious by his or her past medical hx?

1. Nerosis pt
2. Quadraplegic
3. Pt with Down syndrome
4. Pt with myasthenia graves

3. Pt with Down syndrome

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

1. Has a head injury
2. Is in a state of shock
3. Has some autistic disorder
4. Has chest and abdominal injuries

3. Has some autistic disorder

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

1. Motor aphasia
2. Global aphasia
3. Sensory aphasia
4. Articulation dysphasia

1. Motor aphasia

Hyperthyroidism is managed by which medications in the hospital and home setting?

1. Iodine, Methimazole (Tapazole), Propylthiouracil (Propacil)
2. Aminoglutethimide (Cytodren), Metyrapone (Metopirone)
3. Dexamethosone (Decadron), Fludrocortisone (Forinef acetate)
4. Levathyroxine (Synthroid), Liothyronine (Cytomel), Liotrix (Euthroid)

1. Iodine, Methimazole (Tapazole), Propylthiouracil (Propacil)

Which statement reflects the physiology of ventricular tachycardia in a child?

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

2. Ventricular output is inadequate during systole, so cardiac after load is diminished

Which of the following statements best describes developmentally disabled as a condition?

1. Persons who appear cognitively impaired usually as a result of brain damage
2. A behavior that is a side effect of poor upbringing or psychological abuse/neglect
3. A pt who loses contact with reality at times to due abnormal brain activity
4. Conduct that results nan inability to cope with normal responsibilities of daily life

1. Persons who appear cognitively impaired usually as a result of brain damage

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

1. Blood pressure
2. EKG
3. Blood gas readings
4. ETCO2

2. EKG

You are attempting to assess a geriatric pt who has extreme hearing difficulties. Which of the following strategies would be best for providing psychological support for this pt?

1. Talk louder to be heard by the pt
2. Call for a sing interpreter and delay assessment
3. Write every assessment question on a pice of paper
4. Communicate empathy with your body language and perform the assessment

4. Communicate empathy with your body language and perform the assessment

During an in home delivery of a baby, the mother asks you if her baby will suffer brain damage following a brief nuchal cord event. What would be the best response that demonstrates that you are empathetic if the child is acting normal right now?

1. I don’t know, the child seems fine to me. I don’t think you ned to worry until we get more information at the hospital
2. I do not suspect there will be any complications. I can imagine that this uncertainty may be very stressful though
3. No, a nuchal cord is pretty common during deliveries and does not cause brain damage if corrected quickly
4. There is no way to tell right now, but we will have the baby tested as soon as it is possible

2. I do not suspect there will be any complications. I can imagine that this uncertainty may be very stressful though

Which of the following descriptions is true and must be remembered when treating a geriatric pt versus a younger person?

1. Geriatic pt do not tolerate being asked many questions
2. Geriatric pt brain size and weight reduces over a lifetime
3. Geriatric pt will have a higher likelihood of committing suicide
4. Geriatric pt have a higher white blood cell concentrations in their blood

2. Geriatric pt brain size and weight reduces over a lifetime

Knowing that geriatric pts commonly have decreased central blood flow secondary to progression of cardiovascular disease is critical to remember when dealing with which situation below?

1. Managing hypertension during an ascetic stroke
2. Delivering vasopressor agents during heart attack
3. Administering crystalloid fluid during shock resuscitation
4. Determining whether the pt will tolerate an orthostatic tilt test

4. Determining whether the pt will tolerate an orthostatic tilt test

During the assessment of a child who has “fallen out of a tree”, which injuries would lead you to suspect the possibility of child abuse?

1. Evidence of bilateral femur and pelvic fx
2. An open, grossly deformed ulna/radius fx
3. A closed head injury with a depressed skull fx
4. Impalement of a stick into the abdominal/chest area

1. Evidence of bilateral femur and pelvic fx

EMS providers are assessing a pt who allegedly took too much of her “heart medicine”. What signs or symptoms would lead the providers to suspect the condition may be caused by something other than an OD on heart medication?

1. Pt complains of dizziness when sitting upright in a chair
2. You witness grand mal seizure activity lasting 30 sec
3. Bradycardia with a 2nd degree heart block on the EKG monitor
4. Profound tachycardia hypotension and pale, moist skin

2. You witness grand mal seizure activity lasting 30 sec

When it is determined that a neonate has a diaphragmatic hernia, the most appropriate tx is:

1. Endotrachal intubation
2. Gastric decompression
3. BVM ventilation
4. Atropine 0.02mg/kg for bradycardia

1. Endotrachal intubation

You have a 6yo male who has an isolated fx left lower leg. which of the following times would be the most appropriate to initiate pain management medications?

1. During transport
2. After manipulating and pointing the extremity
3. Prior to manipulating and splinting the extremity
4. Pain medications are contraindicated in pediatric patients

3. Prior to manipulating and splinting the extremity

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

1. Assure the absence of obvious hemorrhage and transport
2. Draw a small amount of blood from the red colored adapter to verify potency
3. Infuse 10cc of sterile saline into the blue capped hub and assure catheter is sutured in place
4. Contact medical control for permission to aspirate 1cc of blood to confirm proper placement

1. Assure the absence of obvious hemorrhage and transport

A parent reports that his infant has had a lot of vomiting. When should an immediate EMS transport be recommended?

1. When a baby is also having more than 3 bowel movements a day
2. If there is evidence of forceful ejection of stomach contents
3. Any time a baby is unable to keep regular breast milk down
4. If the parents report that there is no odor to the baby’s emesis

2. If there is evidence of forceful ejection of stomach contents

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

1. Any ejection or forceful type of vomiting after delivery
2. Presence of clear secretions in the mouth during transport
3. Regurgitation immediately following normal breast feeding
4. Traces of blood in clear phlegm while suctioning the mouth

1. Any ejection or forceful type of vomiting after delivery

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

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

3. Hypoxia

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

1. Bradycardias
2. Bifascicular heart blocks
3. Idioventricular rhythms
4. Ventricular tachycardias

1. Bradycardias

According to national experts, which factor is most beneficial of premature infant survivability?

1. Being delivered in a cooler delivery room
2. Reversing or preventing bradycardic events
3. Extending gestation by 2-3 weeks
4. Early ALS intervention by the paramedic following delivery

3. Extending gestation by 2-3 weeks

A paramedic has opted to deliver a smaller dose of pain medication to a geriatric pt with a probably hip fx. How can he BEST defend his decision to start out conservatively with pain medication administration to the general geriatric pt if he is operating on standing orders?

1. Research shows older pt will be able to tolerate pain better than younger patients will
2 .Hip fx pts have a tendency to experience hypovolemic shock quicker than those with other injuries
3. Older pts frequently experience profound hypotensive complications following pain medication
4. Geriatric pt have a higher fat to muscle ratio which, negatively affects drug metabolism

4. Geriatric pt have a higher fat to muscle ratio which, negatively affects drug metabolism

Which treatment guideline is critical for advanced life support personnel to remember when handling a GI hemorrhage in the geriatric population?

1. To recognize an upper GI bleed, you will often find presence of melena
2. Pneumatic anti shock garments are considered a high priority of treatment
3. Vasopressor agents should be withheld if an internal hemorrhaging risk is identified
4. IV fluids should be restricted until the pt becomes hypotensive and tachycardia

3. Vasopressor agents should be withheld if an internal hemorrhaging risk is identified

EMS is transporting a pt with multiple sclerosis to the hospital for tx. of a decubitus ulcer on her hip. Which of the following treatments would benefit the pt most?

1. Take time to clean and dry the area of excessive moisture
2. Dress the wound with a moist, sterile dressing and bandage
3. Remove dressing from the affected area and allow it to dry out
4. Clean the ulcer with diluted hydrogen peroxide and saline

1. Take time to clean and dry the area of excessive moisture

Which of the following newborn conditions will most likely benefit from blow-by delivery oxygen early on?

1. Newborn with a second apgar score of three
2. Newborn with a glasgow coma scale of three
3. Newborn responding slowly to tactile stimulation
4. Newborn with a heart rate of 50 bp

3. Newborn responding slowly to tactile stimulation

A child has aspirated a foreign object into the lower airway. Which assessment finding would you most likely expect to find?

1. Fever
2. Drooling
3. Inspiratory stridor
4. Unilateral wheezing

4. Unilateral wheezing

How should an EMS provider easily recognize a common birth-related injury in a large newborn following an explosive delivery?

1. Expistaxis
2. Convulsions
3. Hemiparalysis
4. High-pitched crying

3. Hemiparalysis

A 90yo cancer pt has reportedly tried to kill himself by drinking an unknown amount of an alkaloid cleaning chemical. He denies any complaints and is stable. Which treatment is absolutely required to properly treat this pt if you are unsure about whether a toxic ingestion took place?

1. Transport the pt to the hospital
2 .Call poison control for treatment advice
3. Give 50G of activated charcoal orally
4. Draw up an anticonvulsant medication to counteract possible seizures

1. Transport the pt to the hospital

An EMS helicopter has been called to transport a critically ill neonate to a neonatal specialty hospital. Family members are unable to fly with the baby because of a sheer lack of cabin room. How should the flight crew relate this information to the family?

1. Spend extra time explaining the transfer process to make sure the family understands how to get tot eh hospital and to let them know what to expect when they arrive
2. Prepare the pt for transfer as they normally would and let the family know the situation as they are departing toward the EMS helicopter
3. As the hospital staff to handle the family’s questions and prepare to depart as soon as the pt is secured to the stretcher and ready for transport
4. Have a crew member stay behind at the sending hospital and allow a family member to fly with the pt to the receiving hospital.

1. Spend extra time explaining the transfer process to make sure the family understands how to get tot eh hospital and to let them know what to expect when they arrive

You have a 6yo pt requiring intubation. Which of the following would be the most appropriate size endotracheal tube?

1. 4 cuffed
2. 4.5 cuffed
3. 5.0 uncuffed
4. 5.5 uncuffed

4. 5.5 uncuffed

A child with special health care needs who depends on medical devices to support bodily functions will best fit which of the following terms?

1. Critically ill child
2. Chronically ill child
3. Special needs child
4. Technology assisted child

4. Technology assisted child

In the geriatric population, a pt with a femur fx will often have:

1. An open fx site
2. A hematoma formation
3. A distinct lateral foot rotation
4. A complaint of little pain when compared to other age groups

4. A complaint of little pain when compared to other age groups

Your partner is ventilating your non-intubated, 1yo pt as a rate of 60x/min. Which of the following is most likely to occur?

1. Gastric distention
2. Respiratory alkalosis
3. Appropriate ventilations
4. Hyperventilation syndrome

1. Gastric distention

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

1. Contact medical control for permission to transport to the local emergency department for further treatment
2. Offer the family the opportunity to witness the resuscitation effort and explain the procedures that are being done
3. Deliver additional medications classified as possibly helpful and not harmful, like sodium bicarbonate IVP
4. Continue resuscitation efforts until you have exhausted the prescribed medications indicated for cardiac arrest

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

You determine that a pt is non-compliant with taking her medications because she is unable to pay for them. You are aware of community resources available to help her. What is the best advice if she refuses transport?

1. While on scene, attempt to locate a clinic that serves the poor
2. Transport the pt agains her will to the ED
3. Contact medical control for a suggestion on what you should do
4. Give the pt a personal donation to help offset the costs

1. While on scene, attempt to locate a clinic that serves the poor

During transport of a bed ridden geriatric pt with pneumonia, her nurse reports that the pt has a stage three decubitus ulcer. Where do you suspect the ulcer will most likely be found during exam?

1. Back of the scapula
2. Distal end of the humerus
3. Anterior proximal tibia
4. Posterior aspect of the heel

4. Posterior aspect of the heel

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

1. The providers overdosed the child on pain medications
2. The rescuers were attempting to insert an endotracheal tube
3. The child has internal bleeding that is causing compensatory shock
4. This is a normal response to a standard IV bolus of an isotonic solution

2. The rescuers were attempting to insert an endotracheal tube

Paramedics are called to an adult foster care home to treat a quadriplegic pt who appears to be in septic shock because of a bladder infection. Which of the following accommodations will most likely be required for this type of pt if he is wearing a halo traction device?

1. The pt will have to be transported on his right side while on the EMS stretcher
2. Paramedics should anticipate using dopamine sooner to support systolic blood pressure
3. Paramedics will need to support ventilation with a BVM if the pt is positioned supine
4. The rescuers may need to consider alternative means of transportation other than their ambulance

4. The rescuers may need to consider alternative means of transportation other than their ambulance

You are called to care of confused man at the local homeless shelter. The staff says the 72yo man appears to be passing out and he was cold when they brought him in from outside. They question if he may have alzheimer’s. The pt has no complaints when questioned What action would be most appropriate for this pt?

1. Obtain a BGL and establish an IV
2. Evaluate the pt’s peripheral capillary refill time
3. Rapidly undress the pt to prevent further heat loss
4. Attempt to determine the pt’s core body temperature

4. Attempt to determine the pt’s core body temperature

Which of the following is correct regarding pediatric anatomy?

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

2. Pediatric patients have a larger surface area to volume ratio

During the assessment of a pregnant female, the pt suggests she is worried her baby may be delivered prematurely. Which of the following complications would be a reasonable concern if her baby was delivered at 36 wks?

1. Pulmonary hypertension
2. Hypothermia complications
3. Intraventricular hemorrhage
4. Atrial septal wall malformations

2. Hypothermia complications

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

1. Mother mentioning the infant has not urinated today
2. Mother indicating the child has 5-6 bowel movement per day
3. Evidence of watery, yellow, and foul smelling feces in her baby’s diaper
4. Reporting that her infant has required encouragement to breast feed in the last two days

1. Mother mentioning the infant has not urinated today

EMS is called to the home of a 78yo female complaining of severe dizziness. She is unable to stand without assistance and her daughter is very concerned for her well being. Which of the following assessment would most likely reveal significant peripheral vascular disease hx?

1. Bradycardia
2. Carotid bruits
3. Heart murmur
4. Orthostatic hypotension

2. Carotid bruits

ALS providers are assessing a geriatric female who fell and injured her hip. According to the pt, she fell and hurt her hip yesterday and was found on the floor by the mailman. Your assessment reveals an obviously deformed, shortened right leg and evidence she is incontinent of urine. Which of the following is a true statement regarding hypothermia and this particular pt?

1. The pt will most likely shiver, indicating she is losing body heat via the conduction mechanism
2. The risk of complications related to hypothermia are less likely to be seen in trauma pt her age
3. Hip fx in geriatric pt will have a transient hyperthermic event before the pt develops hypothermia
4. EMS should expect the pt is taking medications that will affect the pt’s ability to control her body temperature

4. EMS should expect the pt is taking medications that will affect the pt’s ability to control her body temperature

EMS responders are called to a nursing care enter for an 85yo female who has overdosed on her blood pressure medication. Which of the following statements best reflects the way the providers should handle this pt?

1. Quickly administering activated charcoal as the preferred tx for blood pressure medication overdoses to reverse anticipated side effects
2. Questioning staff about signs and symptoms they noticed prior to the medication administration will be the most valuable information to collect
3. Determine the risk of suicidal intentions by asking the family, staff, and pt about why the od occurred
4. Obtaining serial 12 leads is necessary to predict the side effects of the medication on this pt

3. Determine the risk of suicidal intentions by asking the family, staff, and pt about why the od occurred

Rescuers are assessing a 10yo experiencing dyspnea after ingesting “uppers” he found at a friend’s house. He is tachycardic, pale, and diaphoretic. His blood pressure is high and his EKG reveals a wide-complex ventricular tachycardia of 188. What treatment will most likely prevent this rhythm from worsening?

1. Performing vagal maneuvers
2. Administering an anti-arrhythmic
3. Placing him with his legs elevated
4. Administering high concentration of O2

4. Administering high concentration of O2

The latest sign of hypovolemia in a newborn would be:

1. Tachycardia
2. Diminished peripheral pulses
3. Oliguria
4. Cool, pale skin

3. Oliguria

You have a 4yo pt who is showing clear signs of hypoperfusion secondary to hemorrhage. Which of the following best describe the expected findings if the pt is still able to compensate?

1. A HR of 70
2. Weak central pulses
3. Blood pressure of 98 systolic
4. A capillary refill time of less than 2 seconds

3. Blood pressure of 98 systolic

Responders are called to treat a 78yo male found at the bottom of the stairs in his basement. The pt is complaining of hip and pelvic pain during movement to the prone position. Which of the following nervous system assessment findings would be considered abnormal for this scenario?

1. Decreased pain sensation
2. Slower reaction time
3. Mild memory loss
4. Difficulty speaking

4. Difficulty speaking

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

1. 4
2. 5
3. 6
4. 7

2. 5

Choose the best reason for understanding the anatomical difference between adults and children

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

1. CPR standards vary for some population groups

Which pt is most likely using an assist control ventilation setting?

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

4. A comatose adult who is completely paralyzed following a long fall one year ago

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

1. Bradycardia
2. Hypotension
3. Tachycardia
4. Arrhythmias

3. Tachycardia

With a hx of being very weak, a 30yo female pt also has drooping eyelids. She complains of difficulty swallowing and chewing, along with double vision. The pt may be suffering from :

1. Poliomyelitis
2. CP
3. Muscular dystrophy
4. Myasthenia gravis

4. Myasthenia gravis

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

1. Assure that a female attendant will be present during assessment and transport
2. Tell the pt you understand how difficult this must be and then wait for a response
3. Offer the pt an opportunity to shower or change her clothes before leaving for the ER
4. Ask the pt if she is hurting anywhere using non-clinical terminology and anatomical references

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

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

1. Peritonitis
2. Aspiration
3. Esophageal atresia
4. Bowel obstructions

2. Aspiration

Which of the following is a common lower airway issue in the pediatric patient?

1. Bronchiolitis
2. Emphysema
3. Epiglottitis
4. Croup

1. Bronchiolitis

Which condition is LEAST likely to occur in a normal progression of age in a geriatric patient?

1. Increase of acid production within the stomach
2. Decrease in saliva volume in the oral cavity
3. Increase in emptying time of the gastric tract
4. Decrease in the effectiveness of taste buds

1. Increase of acid production within the stomach

A pediatric pt is presenting with a decreased LOC and an abnormal breathing pattern. Family relays the pt has had polydipsia, polyphagia, and polyuria. Which condition most likely exists within this pt?

1. Inadequate circulation of blood glucose to the brain tissue
2. The body is breaking down alternative sources of fuel
3. The pt is developing a relative cellular alkalosis
4. Hypoperfusion of the kidneys and skin tissue

2. The body is breaking down alternative sources of fuel

Which of the following describes the correct number of attempts and time spent trying to obtain venous access before attempting intraosseous access in the critically injured pediatric patient?

1. 2 attempts and 60s
2. 2 attempts and 90s
3. 3 attempts and 60s
4. 3 attempts and 90s

4. 3 attempts and 90s

At 5lpm and 1/2″ away, blow-by O2 will yield approximately what concentration of O2

1. 33%
2. 40%
3. 50%
4. 80%

4. 80%

In the newborn with asphyxia, which of the following would be the most common cause of insufficient respiratory perfusion?

1. Hypothermia
2. Airway obstruction
3. Meconium aspiration
4. Compression of the umbilical cord

2. Airway obstruction

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

1. Call family or friends to be with her and make sure she eats right later on today
2. Consult medical control to grant you permission to obtain a refusal from her
3. Document the neighbor’s comments on our run form and follow up with her later on in the day with a home visit
4. Try to convince the pt to go with you to the hospital voluntary or transport her against her wishes if she refuses

4. Try to convince the pt to go with you to the hospital voluntary or transport her against her wishes if she refuses

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

1. BP 148/78
2. CHF
3. EKG is sinus arrhythmia
4. Lower back and joint pain

3. EKG is sinus arrhythmia

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

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

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

Which of the following treatments would benefit a neonatal pt most if he is lethargic secondary to hypoglycemia?

1. IV bolus of D50
2. IV bolus of D25
3. IV bolus of D10
4. IV bolus of D5

3. IV bolus of D10

Domestic violence is least likely related to which condition?

1. Background of past sexual abuse
2. Feelings of low self esteem
3. Hx of alcohol abuse
4. Schizophrenia diagnosis

4. Schizophrenia diagnosis

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

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

2. Perform additional ventilations and intubate the pt

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

1. Most elderly over age 65 are in skilled nursing facilities
2. The majority of those over 85 living independently are women
3. Only 10% of those over age 85 live independently
4. Most elderly in their 80s and 90s are divorced

2. The majority of those over 85 living independently are women

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

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

2. Presence of a 5cm hematoma near the injection site

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

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

2. Sudden degeneration of the cerebellum portion of the brain

A pt care advocate dials 911 to assist a 90yo female with dyspnea. According to the guardian, the pt has been short of breath all ay and was refusing help until now. The pt is conscious, severely hypoxic, and has rapid, labored breathing. The providers suspect her COPD has exacerbated the point of being critical. What is the most important intervention for this pt?

1. Administration of inhaled steroids via nebulizer
2. Delivery of a Beta2 agonist via IV push
3. Rapid emergency mode transport to an ED
4. Requesting permission to consciously sedate the pt and intubate

3. Rapid emergency mode transport to an ED

A single rescuer is managing a complete airway obstruction on a 3yo conscious pt. He suspect the pt is chocking on a partially chewed piece of food. After performing 5 abdominal thrusts the pt becomes unresponsive. The provider should next:

1. Do a blind finger sweep of the oral cavity
2. Begin chest compressions at 100/min
3. Roll the pt onto his side
4. Give 5 additional back blows

2. Begin chest compressions at 100/min

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

1. It is an implantable defibrillator and paceaker
2. The object could be an implantable injection device
3. There is a foreign object infected just beneath the skin surface
4. The object under his skin is a localized chemotherapy responder

2. The object could be an implantable injection device

You have administered Narcan IVP to a newly born infant who was exposed to narcotic pain medications given to his mother prior to delivery. Which of the following conditions would best indicate the infant’s urgent need for a second dose of Narcan?

1. Bradycardia
2. Hypotension
3. Pupil dilation
4. Petit mal seizures

1. Bradycardia

Which of the following conditions will increase the likelihood a neonate will experience hypoglycemia

1. Development of a large diaphragmatic hernia
2. Recent hx of a systemic bacterial infection
3. Maternal use of stimulants during pregnancy
4. Newborns suspected of having Down’s syndrome

2. Recent hx of a systemic bacterial infection

You are preparing to intubate a 4yo apnea pt. Which of the following uncuffed endotracheal tube sizes would be most appropriate?

1. 2.5
2. 3.5
3. 4.0
4. 5.0

4. 5.0

During a long-distance transfer of a pt with a feeding tube you suspect the G-tube is either kinked or obstructed. The feeding machine is giving an alarm of “obstruction”. How should you first confirm whether the problem is with the G tube or the machine?

1. Attempt to flush the tube with 50cc of warm water to see if it passes without resistance
2. Disconnect the pump from the feeding tube and see if the machine pumps while disconnected
3. Palpate the abdomen and visualize the presence of increased gastric contents backing up the tube
4. Instill 10cc sterile saline down the feeding tube, then aspirate back stomach contents for examination.

1. Attempt to flush the tube with 50cc of warm water to see if it passes without resistance

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

1. Prolonged labor
2. Post term gestation
3. Prolapsed cord
4. Meconium staining

2. Post term gestation

A neonate has a fever. which of the following statements is TRUE?

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

3. A newborn baby is at risk of hypoglycemia in the presence of a fever

Advance life support providers are assessing a hypoglycemic child who is mildly confused. Which option best describes this pt’s situation?

1. His capillary blood glucose level is at least 160
2. The victim will also show signs of dehydration
3. An intramuscular injection of glucagon is contraindicated
4. This pt is at risk of experiencing a grand mal seizure

4. This pt is at risk of experiencing a grand mal seizure

EMS has been called to an independent living center for an elderly female who appears to have broken her hip. According to the staff, the pt rolled over on her own in bed and they heard a crack. What do you suspect happened prior to EMS arrival

1. She really did dimply break her hip rolling over in bed
2. The staff was likely neglectful and she fell to the floor
3. The pt has a pelvic or hip cancer that has weakened her bones
4. The pt is a victim of battery and an investigation needs to occur

1. She really did dimply break her hip rolling over in bed

While assessing a 35yo female who was beaten up by her husband, you find the pt crying uncontrollably. What should the rescue team do to overcome the distraction of her crying to reduce interference during pt assessment?

1. Tell her to calm down so you can do your work correctly
2. Ask the pt to think about something else for a short time
3. Explain the difficulty in assessment given her uncontrolled crying
4. Let the pt know you understand this must be difficult, but she must be quiet

3. Explain the difficulty in assessment given her uncontrolled crying

During a newborn resuscitation, the rescuers believe the pt has lost pulses and respirations but are unsure. What additional signs/symptoms might help confirm this?

1. Peripheral cyanosis
2. Skin becoming mottled
3. Blood in the baby’s mouth
4. Delayed capillary refill time

2. Skin becoming mottled

EMS responds to a daycare center for a child with altered mental status. Caretakers describe a 9yo female “acting like she is on drugs”: There is very little to indicate a toxicological emergency. What symptom would confirm a suspicion of hypoglycemia instead of drugs?

1. Kussmaul respirations
2. Pt complaint of a headache
3. Sunken eyes and dry looking skin
4. Fruity odor on the pt breath

2. Pt complaint of a headache

You have recently delivered a newborn who is now apneic and pulseless. As you start compressions, which of the following compression rates is correct?

1. 80-100
2. 100 per minute
3. 120
4. 120-160

3. 120

Respiratory distress in the pediatric pt is best defined as which of the following?

1. The complete cessation of breathing
2. The mildest form of respiratory impairment
3. Noticeable accessory muscle use on inspiration
4. Respiratory impairment where the demands of the body for oxygen are not met

2. The mildest form of respiratory impairment

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

1. It may upset the parent and therefore the child
2. The child may become defensive and refuse treatment
3. The parent may become violent toward us or the child
4. The parent may refuse to allow us to transport the child

1. It may upset the parent and therefore the child

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

1. Ask the first responder why she thinks that device is necessary
2. Tell the first responder and pt you believe a stair chair is unneeded
3. Ask the pt what she thinks should be done to move her to the stretcher
4. Explain that the stair chair will take a few more minutes to set up and that you want to take no longer than necessary

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

What common complication should paramedics expect to encounter while treating a pt with quadriplegia?

1. Uncontrolled leg tremors
2. Ischemic EKG changes
3. Bladder incontinence
4. Diaphragmatic spasms

3. Bladder incontinence

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

1. Idioventricular
2. Ventricular fibrillation
3. Ventricular tachycardia
4. Supraventricular tachycardia

4. Supraventricular tachycardia

A new born baby is experiencing short episodes of apnea lasting less than 20 seconds. Which of the following conditions would you suspect to find following each apnea event?

1. Coughing or gagging
2. Cyanosis and bradycardia
3. Petis mal seizure activity
4. Tachycardia with EKG changes

2. Cyanosis and bradycardia

Meconium staining occurs in approximately what percentage of deliveries?

1. Less than 1%
2. 1-5%
3. 5-25%
4. 25-45%

3. 5-25%

Your pt has the following: hypertension, dizziness or lightheadedness upon standing, presence of a rash, muscle cramps, swelling of the hand, face, or eyes, cough, headache stomach up set, fatigue, and a loss of taste. He is showing side effects of which of the following?

1. Diuretics
2. Lidocaine
3. Beta blockers
4. ACE inhibitors

4. ACE inhibitors

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

1. 6yo who has not had any prescribed vaccines
2. 5yo pt with an obvious pelvic fx
3. 3yo male who has been sexually assaulted
4. 4yo female with cigar burns on her arms

1. 6yo who has not had any prescribed vaccines

Your elderly patient’s wife secretly reports that her husband always drinks excessively on Tuesdays and Thursdays after a social club meeting. She think that is why he has chest pain today. Your pt denies using any alcohol at all. What is the most critical reason for clarifying his alcohol drinking habit?

1. By law, you are compelled to recommend participating in an alcohol support group if you suspect geriatric alcohol abuse
2. This information must be documented on your EMS run form as the suspected cause/effect for his chest discomfort
3. Use of even a small amount of alcohol is considered more risky for geriatrics than younger-aged pt
4. Nitrates are contraindicated in pt who abuse alcohol on a regular basis

3. Use of even a small amount of alcohol is considered more risky for geriatrics than younger-aged pt

Rescuers are preparing to deliver a newborn they suspect will be distressed. Which of the following will be the least helpful to obtain in preparation for resuscitation of this newborn?

1. IV does of naloxone
2. 500cc self inflating BVM
3. Meconium aspirator attachment for suction
4. Assorted sizes of intraosseous infusion needles

4. Assorted sizes of intraosseous infusion needles

ALS personnel are assisting in the obstetrical delivery of a large baby. Which of the following birth injuries would be the most preventable during the expulsion process?

1. Liver rupture
2. Cranial injuries
3. Clavicle fx
4. Spinal cord injuries

4. Spinal cord injuries

In children over one year of age, what is the leading cause of accidental death?

1. Drowning
2. Motor vehicle collisions
3. Gunshot wounds
4. Burns

2. Motor vehicle collisions

According to the DOT curriculum, EMS responders should engage in which type of activity to measurably reduce childhood mortality and morbidity related to illness or injury?

1. Epidemiological research
2. Safety belt enforcement efforts
3. Confiscating illegal drugs from pt
4. Offering a blood pressure clinic at headquarters

1. Epidemiological research

Paramedics are trying to confirm an ET tube is in place immediately following an intubation attempt. If the setting is noisy and the patient is a neonate, choose the most reliable indicator the tube lies within the trachea.

1. The pt begins crying and becoming more active
2. HR increases from 115 to 160 bpm
3. There is visible mist of moisture on inner lumen of tube
4. Positive inflation results from an EDD

2. HR increases from 115 to 160 bpm

EMS providers are stabilizing a conscious geriatric patient experiencing severe shortness of breath related to emphysema. they have applied high-flow O2 via NRB and confirm there is no ectopy on the ECG. what is the HIGHEST priority during transport?

1. Positioning the PT left lateral recumbent
2. Administering racemic Epi via nebulizer
3. Establishing a peripheral IV of an isotonic solution
4. Delivery of an antipyretic medication via IV.

3. Establishing a peripheral IV of an isotonic solution

Which of these would be considered a public health program on injury and illness prevention that EMS could participate?

1. CPR training
2. First Aid training
3. Car seat installation
4. Disease outbreak monitoring

3. Car seat installation

You are called to a 3yo pt who is having difficulty breathing. The pt is beginning to show signs of cyanosis. The pt is resisting the administration of O2 through a NRB mask. Which of the following would be an appropriate solution?

1. Administer flavored O2
2. Negotiate with the child b using a reward system
3. Change the O2 administration to a nasal cannula
4. Defer the O2 administration to the arrival at the hospital

1. Administer flavored O2

You have a pt with a lower GI bleed. The cause could be:

1. Peptic ulcer
2. Duodenal ulcer
3. Ulcerative colitis
4. Esophageal varices

3. Ulcerative colitis

Which of the following would lead you to suspect that a pt is going to have an allergic or anaphylactic reaction involving swelling of the airway and blood vessel dilation?

1. Slow development of signs and symptoms after first exposure
2. Second exposure after a previous incident where the body formed antibodies
3. The first time a person is exposed he has hives, itchy eyes, and a runny nose
4. A development of diarrhea two days after eating a substance the pt was allergic to

2. Second exposure after a previous incident where the body formed antibodies

Which of the following is a branch of the RCA?

1. Anterior descending
2. Left coronary artery
3. Circumflex artery
4. Marginal artery

4. Marginal artery

You are assessing a pt with carotid bruits who is currently in a narrow complex tachycardia at a rate of 200. Which of the following would most likely occur if a carotis sinus massage was performed?

1. Embolic stroke
2. Thrombotic stroke
3. Carotid vasospasm
4. Pulmonary embolism

1. Embolic stroke

Which of the following is the terminology utilized to describe a cancer that grows quickly and can easily migrate to other sites within the body?

1. Benign
2. Malignant
3. Congenital
4. Metastases

2. Malignant

Electrokardiogram leads I, II, III are also known as the:

1. Precordial leads
2. Augmented leads
3. Unipolar leads
4. Bipolar leads

4. Bipolar leads

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

1. Administer Valium 5mg
2. Administer 5-10 midazolam
3. Insert a padded tongue blade to protect the airway
4. Restrain the pt to a backboard to protect from injury

1. Administer Valium 5mg

In the adult, which of the following organs is responsible for the production of erythropoietin?

1. Liver
2. Spleen
3. Kidneys
4. Bone marrow

3. Kidneys

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

1. Paralysis
2. Cognitive ability
3. Circulatory compromise
4. Respiratory compromise

4. Respiratory compromise

Which of the following would be a medication likely to be administered in cases of a black widow spider bite?

1. Sodium bicarb
2. Calcium chloride
3. Diazepam
4. Mag Sulfate

3. Diazepam

Which of the following would be the best educational advice you could give to a pt who has a severe food allergy?

1. Wear a medic alert bracelet
2. Recognize and avoid that food
3. Carry an epinephrine auto-injector
4. Consult a MD about desensitization

2. Recognize and avoid that food

Which of the following medications is considered useful in the treatment of a pt with a thyrotoxic crisis by reducing the level of circulating Thyroxine?

1. Glucagon
2. Naloxone
3. Propranolol
4. Dexamethasone

3. Propranolol

Which of the following is the most likely to develop as a result of a stroke or other injury to the brain or spinal cord?

1. Multiple sclerosis
2. Alzheimer’s
3. Central pain syndrome
4. ALS

3. Central pain syndrome

Which of the following occurs as a result of an increase in pulmonary pressure and hypertension by changes in blood flow at high altitude?

1. AGE
2. AMS
3. HACE
4. HAPE

4. HAPE

Which of the following drugs is typically omitted in the tx of a pt with acute congestive heart failure?

1. Nitroglycerin
2. Morphine
3. Furosemide
4. ASA

4. ASA

Upper GI bleeding is separated from lower GI bleeding by the:

1. Ileocecal valve
2. Ligament of Treitz
3. Cardiac sphincter
4. Pyloric sphincter

2. Ligament of Treitz

Your patient presents with wheezing, coughing and increased respiratory effort. This occurred following inhalation of chlorine gas. What pathophysiological process is involved?

1. Asthmatic attack caused by irritants
2. Atelectasis secondary to chlorine gas exposure
3. Pulmonary edema caused by chlorine chemical exposure
4. Acute respiratory distress secondary to lack of oxygenation

3. Pulmonary edema caused by chlorine chemical exposure

What water temperature is utilized when a frost bitten part must be rewarmed?

1. 94-96
2. 98-100
3. 102-108
4. 108-112

3. 102-108

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

1. Stroke
2. Heart attack
3. Aortic aneurysm
4. Brain hemorrhage

3. Aortic aneurysm

Which factor is primarily responsible for causing aortic aneurysms?

1. Infection
2. Congenital
3. Hypertension
4. Atherosclerosis

4. Atherosclerosis

Your assessment of a victim of an MVC reveals difficulty breathing, redness across upper chest, JVD, with clear lung sounds. Pulse is thready at 128, BP 80/60. Which assessment finding from the scenario best determines the appropriate diagnosis of cardiac tamponade?

1. JVD
2. Clear bilateral breath sounds
3. Narrowed pulse pressure
4. Pulse of 128 and thready

3. Narrowed pulse pressure

You have just contacted medical direction for permission to terminate a resuscitation attempt. Which of the following information is the physician LEAST likely to consider when deciding to terminate the resuscitation?

1. Therapy rendered
2. Medical condition of the pt
3. Quality of life evaluation performed by EMS
4. Resistance or uncertainty on behalf of the family

3. Quality of life evaluation performed by EMS

Which of the following supplies blood to the inferior wall of the left ventricle in the right coronary dominant pt?

1. RCA
2. CX
3. Anterior descending
4. LCA

1. RCA

Which of these is a peripheral thermoreceptor location?

1. Spinal cord
2. Great vessels
3. Abdominal viscera
4. Mucus membranes

4. Mucus membranes

At which of the following altitudes does high altitude illness typically begin to manifest itself?

1. 4000
2. 6000
3. 8000
4. 10000

3. 8000

You have a pt demonstrating a new complete heart block secondary to a myocardial infarction as a result of damage to the left and right bundle branches. Which of the following coronary arteries is most likely involved?

1. Left circumflex
2. Posterior descending
3. RCA
4. LAD

4. LAD

The sympathetic NS will do which of the following when stimulated?

1. Decrease HR
2. Decrease force of contractions
3. Increase stomach secretion
4. Increase HR

4. Increase HR

Which of the following GI emergencies would be the most difficult to diagnose in the prehospital setting?

1. Appendicitis
2. Crohn’s
3. Diverticulitis
4. Esophageal varices

2. Crohn’s

Which of the following stages of syphillis typically begins 5-6 weeks after the chancre has healed?

1. First stage
2. Second stage
3. Third stage
4. Fourth stage

2. Second stage

Correctly identify the pathophysiology of ingestion poisoning:

1. Poison absorption occurs mostly in the stomach
2. Poison absorption occurs mostly in the large bowel
3. In the small intestine
4. Depends on the specific medication

3. In the small intestine

For which of the following would you use sodium bicarb to eliminate the poison?

1. ASA
2. NSAID
3. Theophylline
4. Acetaminophen

1. ASA

According to the centers for disease control and prevention which ranking does drowning have in the causes of accidental death in the united states?

1. 1st
2. 3rd
3. 5th
4. 7th

3. 5th

Which of the following best describes after load?

1. The resistance against which the heart must pump
2. The volume filling the ventricles during systole
3. The volume filling the ventricles during diastole
4. The decrease in pressure in the coronary arteries

1. The resistance against which the heart must pump

You have a newborn who is breathing slowly and has a heart rate of 64. What is the FIRST step in neonatal resuscitation for this newborn?

1. Administer O2
2. Begin chest compressions
3. Assess and assure a clear airway
4. Begin BVM ventilation

3. Assess and assure a clear airway

Which of the following conditions is the most common cause of acute renal failure?

1. Renal failure
2. Pre-renal failure
3. Post-renal failure
4. Chronic renal failure

2. Pre-renal failure

Which of the following signs would be an inconsistent assessment finding for a pt with a hx of a neoplasm within the brain?

1. Double vision
2. Irregular breating
3. Behavioral changes
4. Abnormal blood sugar

4. Abnormal blood sugar

Which of the following should be your highest priority in assessing and treating a conscious pt you suspect is having an MI?

1. Administration of ASA
2. Collection of complete hx
3. Assessment of equal radial pulses
4. Identification of pt risk factors

1. Administration of ASA

Which of the following is a pre-delivery emergency?

1. Nuchal cord
2. Prolapsed cord
3. Placenta previa
4. Limb presentation

3. Placenta previa

The visible indication of a pt’s mood is termed:

1. Mood
2. Affect
3. Mental status
4. Psychosocial status

2. Affect

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

1. Position of comfort
2. Rapid fluid infusion
3. Application of PASG
4. Administration of MS

4. Administration of MS

You are treating a pt with multifocal, premature ventricular contractions. The pt is experiencing approximately 10-15 per minute. After application of O2, which of the following is MSOT appropriate?

1. Atropine
2. Epinephrine
3. Lidocaine
4. Adenosine

3. Lidocaine

What is the clinical significance for a pt with a hx of a brain abscess who now has a high temperature, severe headache, and nuchal rigidity?

1. The pt can be expected to become hypotensive
2. The abscess is affecting the occipital lobe of the cerebrum
3. The infection has migrated to the meninges of the spinal cord
4. The pt is showing signs consistent with an increase intracranial pressure1

3. The infection has migrated to the meninges of the spinal cord

Which of the following is considered the universal blood recipient?

1. A
2. B
3. AB
4. O

3. AB

Identify the bodily systems affected by influenza and its resulting symptoms.

1. Neurological system; increased confusion
2. Respiratory system; non-productive cough
3. Cardio-respiratory system; pulmonary edema
4. GI system; vomiting and diarrhea

2. Respiratory system; non-productive cough

Contraction of cardiac muscle tissue occurs after which of the following?

1. Polarization
2. Repolarization
3. Conduction
4. Depolarization

4. Depolarization

Polycythemia is defined as which of the following?

1. A decreased number of white blood cells
2. An overproduction of platelets
3. An overproduction of red blood cells
4. A decreased number of red blood cells

3. An overproduction of red blood cells

Your pt has been in bed all day following a three-day history of intractable vomiting and diarrhea. The pt just returned from a business trip to a developing country. Assessment reveals a pt that is responsive to verbal stimuli, has sunken eyeballs, warm, dry skin, a shallow respiratory rate of 22, a HR of 128 with weak peripheral pulses, and BP is 92/64. Your treatment includes:

1. High-flow O2 via face mask, IV access, and Dopamine started at 10mcg/kg/min to treat hypotension
2. Ventilatory assistance with high-flow O2, IV access, and fluid administration with D5W at 100cc/hr to treat malnutrition
3. An advanced airway and application of PEEP in order to minimize respiratory secretions
4. High-flow O2 via face mask, IV access, and volume resuscitation to replace fluid loss and to re-expand the intravascular space

4. High-flow O2 via face mask, IV access, and volume resuscitation to replace fluid loss and to re-expand the intravascular space

A specific problem that atherosclerosis can cause is:

1. Arterial rupture
2. Ventricular rupture
3. Coronary blood vessel rupture
4. Interference with dilation/constriction of arteries

4. Interference with dilation/constriction of arteries

What is the name of the tissue that covers the outside of the lungs?

1. Parietal pleura
2. Visceral pleura
3. Peri-pulmonary sac
4. Parenchymal tissue

2. Visceral pleura

Which of the following gastroenterological disease processes results from the formation of granulomas of the mucosal lining and then fibrosis and hypertrophy of the muscles underlying the submucosa?

1. Crohn’s disease
2. Diverticulitis
3. Gastroenteritis
4. Ulcerative colitis

1. Crohn’s disease

Which of the following is the functional portion of the urinary system?

1. Bowman’s capsule
2. Glomerulus
3. Nephron
4. Urethra

3. Nephron

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

1. Anabolism of glucose
2. Catabolism of glucose
3. Anabolism of fatty acids
4. Catabolism of fatty acids

4. Catabolism of fatty acids

After leaving the sinoatrial node an electrical impulse is next conducted to the:

1. Purkinje fibers
2. Bundle of HIS
3. Internodal pathways
4. AV junction

3. Internodal pathways

What is the name for the time period between exposure to a disease and seroconversion?

1. Latent period
2. Window phase
3. Disease period
4. Communicable period

2. Window phase

You are called to the scene of a 70yo female patient complaining of lower left-sided colicky pain. the pt has a low grade fever, nausea, and vomiting, and she called you because she had a bloody bowel movement. She describes the stool as bright red. This pt is most likely suffering from:

1. Appendicitis
2. Crohn’s disease
3. Diverticulitis
4. Hemorrhoids

3. Diverticulitis

You have an 81yo pt with rales in both lower lobes and you have ruled out pneumonia as a cause. Acute pulmonary edema would be best described by which of the following?

1. Plasma in the alveoli, usually caused by left heart failure
2. Blood in the alveoli, usually caused by right heart failure
3. Plasma in the alveoli, usually caused by right heart failure
4. Phlegm in the alveoli, usually caused by left heart failure

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

Which of the following is an accessory digestive organ disease?

1. Bowel obstruction
2. Kidney stones
3. Pancreatitis
4. Diverticulitis

3. Pancreatitis

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

1. Embolic stroke
2. Cluster headache
3. Thrombotic stroke
4. Hemorrhagic stroke

4. Hemorrhagic stroke

A local outbreak of influenza has struck your community. Which organization will be responsible for monitoring this outbreak and educating the public?

1. Medical control
2. Local public health
3. CDC
4. Public information systems

2. Local public health

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

1. Rotavirus
2. Enterobacteria
3. Giardia lamblia
4. Cryptosporidium parvum

2. Enterobacteria

Which of the following best describes where most neoplasms in the brain originate?

1. From a benign tumor present at birth
2. Metastasized from benign tumors located elsewhere in the body
3. Metastasized from malignant tumors located elsewhere in the body
4. From a malignant tumor formed in the brain that metastasized to other parts of the body.

3. Metastasized from malignant tumors located elsewhere in the body

Which of the following would provide the best relief of the colicky pain experienced by a pt with ulcerative colitis?

1. Oxygen
2. Antiemetics
3. Antihistamines
4. Antispasmodics

4. Antispasmodics

Your pt is taking a medication that is designed to increase blood calcium levels by increasing hormone production. Which hormone is involved?

1. Thyroxine
2. Calcitonin
3. Triiodothyronin
4. Parathyroid hormone

4. Parathyroid hormone

The best way to describe the effects of Candida that has caused an infection is to say that there is:

1. An imbalance in the normal bacteria
2. Lack of good personal hygiene
3. Lack of the proper nutrients
4. Spread of colon bacteria

1. An imbalance in the normal bacteria

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

1. An elevated bp
2. A blood loss of 30% with no signs of shock
3. A respiratory rate that is greater than her normal rate
4. A pulse rate that is 10-15 beats faster than her normal rate

2. A blood loss of 30% with no signs of shock

You are called to treat a pt complaining of a HA, facial drooping, confusion, and aphasia. The BP is 120/80, pulse ox is 98%, HR 70, RR 16. If the symptoms seem to be resolving, which of the following describes the most appropriate treatment?

1. Supine position, advanced airway, and rapid transport
2. Supine position, high-flow O2, rapid transport
3. If symptoms resolve, no tx or transport necessary
4. Left lateral position and transport

4. Left lateral position and transport

Your pt has paroxysmal nocturnal dyspnea. With which of the following is this most commonly associated?

1. Pneumonia
2. Left heart failure
3. Right heart failure
4. COPD

2. Left heart failure

Which of the following vascular disorders would most likely have a hx of recent trauma?

1. Vasculitis
2. Varicose veins
3. DVT
4. AAA

3. DVT

Which of the following signs or symptoms would best lead you to suspect you pt has pain associated with abdominal bleeding?

1. Cullen’s sign
2. Referred pain
3. Fetal position
4. Distention of the abdomen

1. Cullen’s sign

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

1. II, III, IV
2. II, IV, VI
3. III IV, V
4. III, IV, VI

4. III, IV, VI

You are called to the scene of a pt with a head injury who has a temp of 104 F. Your pt has a blood pressure of 120/80, respirations of 16, and a pulse of 70. Which of the following best describes the results of these assessment findings?

1. These would be expected findings in head injuries
2. The pt has stabilized and should not be considered critical
3. The head injury and heat illness are canceling each other’s effects on vital signs
4. The pt is probably taking a medication that is preventing the body from responding

3. The head injury and heat illness are canceling each other’s effects on vital signs

Which of the following types of artifact will make identification of the presence of a paced rhythm virtually impossible?

1. Muscle artifact
2. Patient movement
3. Wandering baseline
4. 60 cycle interference

4. 60 cycle interference

The clotting cascade is interrupted by the administration of which of the following and thus prevents clot formation?

1. Ticlid
2. ASA
3. Vitamin K
4. Coumadin

4. Coumadin

Which of the following is the MOST serious physical manifestation of anaphylaxis?

1. Urticaria
2. Wheezing
3. Pruritus
4. Hypotension

4. Hypotension

You have a pt who has just completed hemodialysis and now has profound hypotension. Why would this pt need immediate transport to the emergency department?

1. Renal diagnostics
2. Fluid replacement
3. Monitoring for seizures
4. Renal failure monitoring

2. Fluid replacement

Which of the following is a leukocyte disorder?

1. Neutropenia
2. Polycythemia
3. Multiple myeloma
4. Thrombocytopenia

1. Neutropenia

Which of the following would be responsible for humoral immunity?

1. T cell monocytes
2. B cell monocytes
3. T cell lymphocytes
4. B cell lymphocytes

4. B cell lymphocytes

You are called to treat a pt who has ingested a belladonna leaf. What would you most likely expect to see as signs and symptoms from this ingestion?

1. SLUDGE
2. CNS excitation
3. Flu-like symptoms
4. Dry skin and mucous membranes

4. Dry skin and mucous membranes

Which of the following terms is most closely associated with “systemic vascular resistance”?

1. Afterload
2. Cardiac output
3. Preload
4. Stroke volume

1. Afterload

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

1. The pt is suffering from heat stroke
2. The pt is suffering from an embolic stroke
3. The pt is suffering from a thrombotic stroke
4. The pt is suffering from a hemorrhagic stroke

4. The pt is suffering from a hemorrhagic stroke

Which of the following people described below would most likely risk suffering from exertion heat stroke?

1. 20yo diabetic on a hot day
2. 26yo shoveling snow on a cold day
3. 56yo CHF on diuretics on a hot day
4. 20yo well-hydrated football player on a warm day

2. 26yo shoveling snow on a cold day

You are assessing a pt with a heat emergency who is presenting with hot, moist skin, seizure activity, deep, rapid respirations, a rapid pulse, an increasing core temperature, and a low bp. Which of the following would best describe this pt’s condition?

1. Heat stroke where the pt has lost the ability to cool himself
2. Heat stroke where the pt still has the ability to cool himself
3. Heat exhaustion where the pt has lost the ability to cool himself
4. Heat exhaustion where the pt still has the ability to cool himself

1. Heat stroke where the pt has lost the ability to cool himself

An idiopathic inflammatory bowel disease limited in location to the rectum would be known as:

1. Proctitis
2. Pancolitis
3. Crohn’s disease
4. Ulcerative colitis

1. Proctitis

Which of the following accurately represents a normal PR interval?

1. Measured from the beginning of the P to the beginning of the Q or R, and normal is 3-5 little boxes
2. Measured from the end of the P to the beginning of the Q, and normal is 3-5 little boxes
3. Measured from the beginning of the P to the beginning of the R, and normal is 0.04 to 0.12 seconds
4. Measured from the end of the P to the beginning of the R, and normal is 0.12 – 0.20 seconds

1. Measured from the beginning of the P to the beginning of the Q or R, and normal is 3-5 little boxes

You are called to a pt with Cushing’s syndrome. Which of the following should you avoid doing if the pt is stable?

1. Adminstering O2 via nasal cannula
2. Initiating IV access
3. Evaluating blood sugar
4. Attaching cardiac monitor

2. Initiating IV access

A SCUBA tank typically contains which of the following?

1. Compressed oxygen
2. Compressed oxygen and helium
3. Compressed oxygen and nitrogen
4. Compressed oxygen and hydrogen

3. Compressed oxygen and nitrogen

This virus can exist only if the Hep B virus is present

1. Hep A
2. Hep C
3. Hep D
4. Hep E

3. Hep D

Which of the choices listed refers to intractable nausea and vomiting, which can result in dehydration that may be experienced by a female pt during her first trimester of pregnancy?

1. Ketosis
2. Morning sickness
3. Emetic dehydration
4. Hyperemesis gravidarum

4. Hyperemesis gravidarum

Which of the following is the pathophysiological cause of myxedema?

1. Too little circulating thyroid hormone
2. Too much circulating thyroid hormone
3. Too little adrenocorticotropic hormone
4. Too much adrenocorticotropic hormone

1. Too little circulating thyroid hormone

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

1. Bronchodilation
2. Vasoconstriction
3. Increased gastric motility
4. Decreased capillary permeability

3. Increased gastric motility

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

1. Cecum
2. Colon
3. Ileum
4. Jejunum

4. Jejunum

During depolarization of the heart muscle, which of the following ions enters the cell?

1. Magnesium
2. Sodium
3. Potassium
4. Phosphate

2. Sodium

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

1. Iron
2. Platelets
3. White blood cells
4. Red blood cells

4. Red blood cells

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

1. Too little circulating thyroid hormone
2. Too much circulating thyroid hormone
3. Too little adrenocorticotropic hormone
4. Too much adrenocorticotropic hormone

4. Too much adrenocorticotropic hormone

Which of the following anatomical regions is the most common location for bowel obsturction?

1. Ascending colon
2. Descending colon
3. Small intestine
4. Transverse colon

3. Small intestine

Acute arterial occlusion will most commonly involve arteries in which of the following regions of the body?

1. Neck
2. Lungs
3. Abdomen
4. Extremities

4. Extremities

You are called to a football practice field on a hot afternoon. You pt is a disoriented football player with hot, clammy skin and his hx indicates dehydration. Which of the following is the most likely problem?

1. Heat cramps
2. Heat exhaustion
3. Classical heatstroke
4. Exertional heatstroke

4. Exertional heatstroke

Of the conditions listed below, which one will most likely lead to hypernatremia?

1. Addison’s
2. Cushing’s
3. Grave’s
4. Myxedema

2. Cushing’s

You have administered aspirin, nitro, and an analgesic to a pt with a previous complaint of chest pain who is now pain free and refusing transport. Which of the following would be the best argument for the pt to reconsider his decision?

1. He is within the window of opportunity for thrombolytics
2. Once he has received an analgesic, he cannot refuse treatment
3. Protocol does not allow you to discontinue care once an IV is established
4. He could go into arrest any minute and should be at the hospital if this happens

1. He is within the window of opportunity for thrombolytics

Where is the principle location of carbon dioxide in venous blood?

1. As a dissolved gas in the plasma
2. Bound to the proteins in the blood
3. In the plasma as Bicarbonate HCO3-
4. In red blood cells bound to hemoglobin

3. In the plasma as Bicarbonate HCO3-

You are called to assess a pt with a primary complaint of SOB and chest discomfort. The pt is hypotensive and you see ST elevation in leads II, III, and AVF, normal ST segments in Leads V5 and V6, and ST depression in Leads V3 and V4. Which of the following would you most likely expect to find?

1. Flat neck veins
2. Pulmonary edema
3. ST elevation in V1 and V2
4. ST elevation in R leads

4. ST elevation in R leads

You have a pt experiencing a hypertensive emergency. Which of the following reactions would you expect from the heart?

1. Increase in systemic pressure will be compensated for by Starling’s Law
2. Increase in stretching of the left ventricle will cause a decrease in cardiac output
3. The increase in systemic pressure will be compensated for by an increase in pulmonic pressure
4. The increase in systemic pressure will be compensated for by an enlargement of the left ventricle

2. Increase in stretching of the left ventricle will cause a decrease in cardiac output

Which of the following pt having an MI is at greatest risk of developing a life threatening emergency?

1. Septal wall infarct with hypotension
2. Inferior wall infarct with pedal edema
3. Lateral wall infarct with significant chest pain
4. Extensive anterior wall infarct with tachycardia

4. Extensive anterior wall infarct with tachycardia

Which of the following medications is most commonly utilized in the tx of high altitude illnesses?

1. Nifedipine
2. Furosemide
3. Acetazolamide
4. Sodium bicarb

3. Acetazolamide

Rank the following in order from the most common in occurrence to the least common in occurrence?

1. Epilepsy, stroke, parkinson’s
2. Stroke, parkinson’s epilepsy
3. Stroke, epilepsy, Parkinson’s
4. Parkinson’s, stroke epilepsy

1. Epilepsy, stroke, parkinson’s

You are called to assess and tx a 64yo male complaining of a severe headache, vomiting, visual distrubances, and left-sided paralysis. The pt’s pulse is 56 and his BP is 220/160. He is noncompliant with his “BP medication. Which of the following should you most likely suspect?

1. Chronic hypertension
2. Pulmonary hypertension
3. Thrombitoic or ebmolic CVA
4. Hypertenisve encephalopathy

4. Hypertenisve encephalopathy

Which of these substances presents a predisposing risk factor for only cold emergencies?

1. ASA
2. ETOH
3. Diuretics
4. Beta-blockers

1. ASA

Which statement most clearly describes a complete cardiac cycle?

1. The end of one contraction to the beginning of another
2. The beginning of one contraction to the end of that contraction
3. The beginning of one contraction until the end of another
4. The end of one contraction to the end of the next

4. The end of one contraction to the end of the next

You have a pt who takes the following mediations: prednisone, ipatroprium, betamethosone, and Metaproterenol. Which of the following conditions would you most likely sxpect this pt is suffering from

1. Asthma
2. Pneumonia
3. Emphysema
4. Chronic bronchitis

1. Asthma

During assessment, your pt reveals cardiac dysrhythmias and SOB. While on a NRB O2 en route to the emergency department, the pt develops worsening dyspnea and begins to exhibit bigeminal PVCs. What would these assessment findings reveal?

1. Respiratory exposure to CO
2. Respiratory exposure to Paraquat
3. Inhalation exposure to anhydrous ammonia
4. Significant dermatologic exposure to mercury

2. Respiratory exposure to Paraquat

You are called to provide tx for an unresponsive, apneic pt with a pulse who was just pulled from the water. Your initial attempt to ventilate the pt was unsuccessful. After oral suctioning and reattempting ventilation, which of the following would be the most appropriate action?

1. Place an advanced airway and suction the trachea
2. Perform chest compressions to clear the lungs of fluid
3. Decompress the stomach to alleviate the airway obstruction
4. Attempt to squeeze the BVM more slowly to break the laryngospasm

4. Attempt to squeeze the BVM more slowly to break the laryngospasm

Which of the following system would be primarily affected by the renin-angiotenin-aldosterone system

1. Cardiac
2. Gastrointestinal
3. Genitourinary
4. Respiratory

3. Genitourinary

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

1. Aleve
2. Claritin
3. Motrin
4. Xenedrine

4. Xenedrine

You are called to treat an unresponsive, apnea 27yo male suspected of suffering from a narcotic OD. You have administered naloxone, SIVP, as a tx for for this situation. Which of the following should you most likely anticipate?

1. The pt will immediately awaken
2. The pt will have a seizure or awake violently
3. The pt will need an additional administration of naloxone
4. The pt will have a reverse effect due to the slow administration

3. The pt will need an additional administration of naloxone

You are called to the residence of a 38yo male found unresponsive on the floor of his bathroom. His skin is very pale, cool, and clammy. He has complained of abdominal pain for the last month as well as black, foul-smelling feces. His respiratory rate is 28, pulse 120, bp 70/50. Which of the following field diagnoses and interventions is the most appropriate?

1. Vagal response; 0.5 – 1.0 of atropine
2. Dissecting aoritc aneurysm; PASG, fluids, and rapid transport
3. Anemia from a slow GI bleed; fluid resuscitation and rapid transport
4. Hypovolemia from a rapid GI bleed; fluid resuscitation and rapid transport

3. Anemia from a slow GI bleed; fluid resuscitation and rapid transport

Which of the following typically causes pneumonia?

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

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

You are transcutaneously pacing a pt with a 2nd degree type II block prior to your intervention.The pt remains unresponsive and apneic and you are continuing ventilations. Which of the following is your most important intervention?

1. Obtain 12 lead
2. Verifying electrical capture
3. Verifying mechanical capture
4. Setting heart rate appropriately

3. Verifying mechanical capture

Which of the following signs and symptoms occur with the Hantavirus?

1. Headache, vertigo, and vision disturbances
2. Fever, chills, earache, sore throat, and body aches
3. Body rash, abdominal pain, and difficulty breathing
4. Fever, headache, body aches, and respiratory difficulty

4. Fever, headache, body aches, and respiratory difficulty

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

1. Create an area that is sterile and free of any germs
2. Instruct her to lie on her side when she has an urge to push
3. Tell the pt to use the bathroom while you are setting up
4. Have the pt remove her pants and cover her legs with a sheet

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

Which of the following is considered a part of hemostasis?

1. Coagulation
2. Fibrinolysis
3. Platelet timing
4. Vascular dilation

1. Coagulation

Regarding underwater diving accidents, which gas law is responsible for the bends?

1. Universal gas law
2. Boyle’s law
3. Dalton’s law
4. Henry’s law

4. Henry’s law

Which of the following is the main category of pancreatitis?

1. Traumatic
2. Infectious
3. Vascular
4. Metabolic

4. Metabolic

Which of the following degenerative neurological disorders is the most likely to require an EMS call as a result of disease progression?

1. Myoclonus
2. MS
3. Alzheimer’s
4. ALS

4. ALS

Which of the following dive emergencies typically requires the least intervention from EMS personnel?

1. Nitrogen narcosis
2. Pneumomediastinum
3. Arterial gas embolism
4. Pulmonary over-pressure

1. Nitrogen narcosis

Which of the following is characterized by a progressive degeneration of nerve cells that control voluntary movement and progresses to weakness, loss of motor control, and difficulty speaking?

1. Myasthenia gravis
2. Alzheimer’s
3. Parkinson’s
4. ALS

4. ALS

You are called to transport a 24yo female G2P1 – 9 weeks gestation with no other previous medical hx. On arrival, you note that the pt has been vomiting clear emesis and appears weak and pale. Her husband tells you she has been vomiting off and on since becoming pregnant, but for several days now it has become uncontrollable and she cannot keep food or water down. You note that your pt has poor skin turgor an da cap refill of 3 sec. Your partner tells you her vitals are: BP 94/72, Pulse – 100, Resp – 22. She is alert and well oriented. With the information provided, you suspect your pt is suffering from which one of the listed disorders?

1. Dehydration
2. Morning sickness
3. Diabetes mellitus
4. Hyperemesis gravidarum

4. Hyperemesis gravidarum

You are called to a private residence to care for a pregnant pt that is bleeding vaginally. You estimate she has lost about 750cc of blood from what you see on the scene. She claims she has no pain. Based on this information, you believe the cause to be:

1. Abruptio placenta
2. Ectopic pregnancy
3. Placenta previa
4. Gestational diabetes

3. Placenta previa

You are called to treat an unresponsive Alzheimer’s pt who has cool and clammy skin and an elevated HR. The blood pressure is slightly elevated, pulse ox is 98, and BGL is 60. Which of the following would be the appropriate intervention for this pt?

1. Administer high-flow O2 and transport
2. Initiate IV and deliver 25G dextrose
3. Initiate an IV of NS and administer a fluid bolus
4. Initiage IV and administer 12.5 G Dextrose

2. Initiate IV and deliver 25G dextrose

You are called to treat a pt with a hx of myxedema who has failed to take her prescribed medication for this condition. Which of the follow assessment findings would you most likely observe?

1. Agitation
2. Tachycardia
3. Hypothermia
4. Low blood sugar

3. Hypothermia

Which of the following reasons explains why the pt with hyperglycemia is dehydrated?

1. The associated nausea and vomiting decreased fluid intake
2. The kidneys removed the excess sugar and therefore the water
3. The elevated sugar levels caused a decrease in ADH production
4. The elevated blood sugar drew water from the interstitial space

2. The kidneys removed the excess sugar and therefore the water

Which of the following accurately reflects Cushing’s reflex?

1. Increased pulse, respirations, and temperature and decreased blood pressure
2. Increased pulse and respirations and decreased blood pressure and temperature
3. Decreased pulse and respirations and increased blood pressure and temperature
4. Decreased pulse, respirations, and temperature and increased blood pressure

3. Decreased pulse and respirations and increased blood pressure and temperature

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

1. Hypoglycemia
2. Fat catabolism
3. Decreased urination
4. Pale, cool, clammy skin

2. Fat catabolism

If you have received your Hep B vaccination, what other type of Hepatitis are you protected against?

1. Hep A
2. Hep C
3. Hep D
4. Hep E

3. Hep D

You are called to treat a pt who had complained of bloody diarrhea prior to becoming unresponsive. The pt is pale, cool, clammy, tachycardic, tachypnic, and vomiting. Which of the following is your most important intervention?

1. Intubation
2. Fluid resuscitation
3. Administration of antiemetics
4. Administration of high-concentration O2

1. Intubation

Which of the following will most commonly produce sinus tach?

1. An increase in sympathetic tone
2. Decreased parasympathetic tone
3. Cocaine overdose
4. Cardiogenic shock

1. An increase in sympathetic tone

Which of the following medical conditions is caused by the formation of a blood clot within the vasculature of the brain?

1. Cerebral embolism
2. Cerebral Thrombosis
3. Intracerebral hemorrhage
4. Subarachnoid hemorrhage

2. Cerebral Thrombosis

You and your partner are dispatched to the scene of a young female pt who has been vomiting for three days. She claims the cause is from food poisoning. She is now pale, sweaty, very weak, and listless. Her pulse is 118, respirations are 28, and BP is 92/42. You believe she is hypovolemic and your partner believes she just has the flu and is “making a big deal out of nothing”. How should you proceed with the best treatment for this pt?

1. Start 2L O2
2. Prepare for rapid transport
3. Identify the source of the poisoning
4. Get the pt to start drinking some water

2. Prepare for rapid transport

What other name may be used for natural immunity?

1. Humoral
2. Acquired
3. Innate
4. Cell-mediated

3. Innate

What is the term for a white blood cell count of 16,000 per microliter

1. Normal
2. Leukopenia
3. Neutropenia
4. Leukocytosis

4. Leukocytosis

You are attempting to ventilate a near drowning/submersion pt who was just pulled from the water. Your ventilation efforts are unsuccessful. Which of the following is the most likely cause?

1. Lungs are full of fluid
2. Stomach is full of water
3. Larynx is having a spasm
4. Airway has a foreign object

3. Larynx is having a spasm

Which of the following is true regarding surface poisonings by caustic substances?

1. Alkalis cause eschars, so they burn deeper
2. Acids cause eschars, so they burn deeper
3. Acids cause eschars, so they don’t burn as deep
4. Alkalis cause eschars, so they don’t burn as deep

3. Acids cause eschars, so they don’t burn as deep

Which of the following would be a risk factor for hypothermia?

1. Adolescence
2. Hyperthyroidism
3. Use of antihistamines
4. Brief exposure to bitter cold

3. Use of antihistamines

Speech is controlled primarily by which of the following regions of the brain?

1. Occipital
2. Parietal
3. Frontal
4. Temporal

3. Frontal

When diving, which of these can occur as a result of a pulmonary over-pressure accident due to ascending too rapidly?

1. Hemothorax
2. Nitrogen narcosis
3. Arterial embolism
4. Open pneumothorax

3. Arterial embolism

You are called to assess a 67yo male with a complaint of abdominal pain and you suspect an abdominal aortic aneurysm. Which of the following signs or symptoms would you expect to find to help you confirm your field diagnosis?

1. Hypertension
2. Distended neck veins
3. Pt reports an urge to defecate
4. Unequal blood pressure in the arms

3. Pt reports an urge to defecate

Which of the following best describes why dehydration contributes to the likelihood of a heat emergency?

1. Inhibits vasodilation
2. Decreases evaporation
3. Causes electrolyte imbalances
4. Increases the base metabolic rate

1. Inhibits vasodilation

You are called to the scene of a pt with a head injury who has a temp of 104F. Other than head injury, what other condition should be a part of your field diagnosis for this pt?

1. Pyrexia
2. Heat stroke
3. Dehydration
4. Heat exhaustion

2. Heat stroke

The sympathetic NS is responsible for:

1. Bradycardia, vasodilation, and increased peristalsis
2. Tachycardia, vasoconstriction, and decreased peristalsis
3. Bradycardia, vasodilation, and decreased peristalsis
4. Tachycardia, vasoconstriction, and increased peristalsis

2. Tachycardia, vasoconstriction, and decreased peristalsis

Which of the following is the most significant pathophysiology for the insulin-dependent diabetic who is hyperglycemic due to a failure to take his insulin?

1. The inability of the brain cells to betabolize glucose
2. An increase in pH due to ketoacidosis from fat catabolism
3. Dehydration and acidosis due to diuresis and gluconeogenesis
4. Infection and cardiac abnormalities due to increased glucose levels

3. Dehydration and acidosis due to diuresis and gluconeogenesis

Which of the following would be the best description of environmental emergencies?

1. When the body is unable to maintain homeostasis
2. When the environment becomes too hot or too cold to survive
3. A situation where the surrounding area has become hazardous
4. A medical condition caused by the weather or other local factors

4. A medical condition caused by the weather or other local factors

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

1. Red
2. Pale
3. Mottled
4. Cyanotic

3. Mottled

For which causative agent of AGE is there currently an injectable vaccine?

1. Hep A
2. Escherichia coli
3. Shigella sonnei
4. Rotavirus

1. Hep A

Which of the following pt presents the greatest public health threat?

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

2. 24yo male who looks very sick and just returned from Africa

You are called to transport a 23yo female involved in a motor vehicle crash to the hospital. The pt is alert and oriented, but very frightened. During a routine rectal exam performed by the trauma surgeon, she notes that the pt has vesicular lesions of the anus and labia. The pt’s health hx is significant for genital herpes several months ago, which was treated with acyclovir. The pt begins to cry, state that she had taken all of the medications that she was instructed to and has not had sexual contact since her initial outbreak. You suspect that these new lesions are secondary to:

1. The pt recently contracted the disease again due to unsafe sex practices and that she is not being completely truthful
2. The pt had stopped taking her medication once symptoms subsided and did not complete the full course a prescribed
3. Her infection has been dormant and she is suffering from a recurrent disease process
4. She is suffering from a different communicable disease and not herpes

3. Her infection has been dormant and she is suffering from a recurrent disease process

In reference to the signs and symptoms of alcohol abuse, a black out occurs:

1. When you binge drink
2. When you pass out from drinking too much
3. When you suffer from a subdural hematoma
4. When you have a partial or total loss of memory

4. When you have a partial or total loss of memory

An inflammation of the small outpouchings in the mucosal lining of the intestinal tract is referred to as which of the following?

1. Appendicitis
2. Colitis
3. Crohn’s
4. Diverticulitis

4. Diverticulitis

You are treating a pt with Hemophilia A. Which clotting factor is deficient in this pt?

1. VII
2. VIII
3. IX
4. X

2. VIII

The first heart sound auscultated in a pt is S1. S1 is produced by which of the following?

1. Opening of the AV valves
2. Closure of the AV valves
3. Opening of the semilunar valves
4. Closure of the semilunar valves

2. Closure of the AV valves

Which of the following would be the most appropriate tx for a pt with HHNK?

1. Hyperventilation to correct acidosis
2. Insulin to correct hyperglycemia
3. Sodium bicarb to correct acidosis
4. Fluid resuscitation to correct dehydration

4. Fluid resuscitation to correct dehydration

In reviewing an ECG tracing with a supraventricular rhythm, you observe that the QRS duration is 140milliseconds. In Lead V1, you see that a horizontal line from the J point to the intersecting line of the QRS forms a triangle that is pointed upward. This would best describe which of the following?

1. Left anterior hemiblock
2. Left BBB
3. Right posterior hemiblock
4. Right BBB

4. Right BBB

Cor pulmonale is directly associated with which of the following?

1. Left ventricular failure
2. Increased pulmonary pressures
3. Increased pulmonary edema
4. Excessive mucus production

2. Increased pulmonary pressures

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

1. Heat stroke
2. Heat exhaustion
3. Heat cramps
4. Febrile illness

2. Heat exhaustion

You are assessing a pt complaining of chest pain with a left arm BP of 100/70 and a right arm B of 140/90. Which of the following would most likely be the cause of the unequal pressures?

1. Pericardial tamponade
2. Left-sided heart failure
3. High thoracic aneurysm
4. Peripheral artery disease

3. High thoracic aneurysm

You are called to treat a 48yo male complaining of CP and his 12 lead indicates he is having an extensive anterior wall MI. The pt denies any SOB, pulse ox is 96%, and he tells you he smokes two packs a day. You have administered high-concentration O2 and the pt indicates that his chest pain has increased. Which of the following is the most likely cause of the increase in pain?

1. Infarction is increasing in size
2. O2 exacerbated his COPD
3. Non-rebreather mask increased his anxiety
4. Elevated oxygen level caused a constriction in the coronary arteries

4. Elevated oxygen level caused a constriction in the coronary arteries

Where is the thalamus located anatomically?

1. Pons
2. Cerebrum
3. Diencephalon
4. Mesencephalon

3. Diencephalon

The primary cause of of esophageal varices is:

1. Acid reflux
2. Excessive vomiting
3. Portal hypertension
4. Ingestion of caustics

3. Portal hypertension

You are treating a pt experiencing a stroke who is aphasic. He is unable to move his right arm and legs. After applying O2 and assuring his airway is clear, which treatment will most likely benefit this pt?

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

2. Continue talking and reassuring the pt

Over 95% of cases of thyrotoxicosis are due to which of the following?

1. Myxedema
2. Hypothyroidism
3. Cushing’s syndrome
4. Graves’ disease

4. Graves’ disease

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

1. ASA
2. O2
3. MS
4. NTG

1. ASA

Under which of the following would it be clearly legal to transport a pt having a behavioral emergency against his will?

1. When the pt is acting strage or bizarre
2. When ordered to transport by the online physician
3. When the pt is presenting a threat to himself or to others
4. When the pt is confused and disoriented to person, place, and time

3. When the pt is presenting a threat to himself or to others

In the kidney, the area that is indented where the ureter and other tissues join the kidney is named the:

1. Hilum
2. Papilla
3. Renal pelvis
4. Bowman’s capsule

1. Hilum

You are caring for a dive emergency victim who is complaining of a sharp, tearing pain, confusion, vertigo, visual disturbances, and hemiplegia. Which of the following should you most likely suspect?

1. Nitrogen narcosis
2. Pneumomediastinum
3. Arterial gas embolism
4. Pulmonary over-pressure

3. Arterial gas embolism

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

1. Rectal bleeding 3 weeks post-partum
2. Rectal bleeding and a diet low in fiber
3. Rectal bleeding and a hx of alcoholism
4. Rectal bleeding after a difficult bowel movement

3. Rectal bleeding and a hx of alcoholism

Which of the following are true of U waves?

1. They precede T waves
2. They usually appear negatively deflected
3. They are usually associated with hyperkalemia
4. They may be associated with electrolyte imbalance

4. They may be associated with electrolyte imbalance

The increased ability to produce red blood cells is made possible by which of the following organs?

1. Liver
2. Pancreas
3. Kidneys
4. Spleen

3. Kidneys

Which of the following is caused by an increase in fluid within the brain tissue as a result of high altitude illness?

1. CVA
2. AMS
3. HAPE
4. HACE

4. HACE

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

1. Fluid resuscitation
2. Synchronized cardioversion
3. Administration of adenosine
4. Unsynchronized cardioversion

1. Fluid resuscitation

You are called to the scene of a 57yo male pt with a 5-day hx of abdominal pain, heartburn, and dark, tarry stools. Which of the following would you most likely select for a field diagnosis

1. Cardiac ischemia
2. Esophageal varices
3. H pylori caused chronic gastroenteritis
4. Salmonella caused acute gastroenteritis

4. Salmonella caused acute gastroenteritis

Which of the following respiratory conditions is most likely to lead to cor pulmonale?

1. Ards
2. Asthma
3. Pneumonia
4. Emphysema

4. Emphysema

You are called to treat a diabetic pt with warm, dry skin, hypotension, tachycardia, and normal respirations who is responsive only to painful stimuli. The pt takes an oral hypoglycemic medication. Which of the following would best apply to this situation?

1. DKA; administer fluids
2. HHNK, administer fluids
3. Hypoglycemia, administer dextrose
4. Diabetes insipidus, administer flids

2. HHNK, administer fluids

Which of the following would predispose a person to experience frostbite?

1. Taking ASA
2. Hyperthyroidism
3. Calm wind conditions
4. Wearing too much clothing

1. Taking ASA

Which of the following defines reentry?

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

2. Conduction in one branch is slowed, causing a unidirectional block in the other

Which of the following accurately reflects H1 and H2 responses?

1. H2 stimulation causes brocnchoconstriction and vasodilation
2. H1 Stimulation causes vasodilation and secretion of gastric acids
3. H1 stimulation causes bronchoconstriction and contraction of the intestines
4. H2 stimulation causes contraction of the intestines and secretion of gastric acids

4. H2 stimulation causes contraction of the intestines and secretion of gastric acids

What is the mortality rate for the pt populations suffering from a TIA?

1. 0%
2. 5%
3. 15%
4. 33%

1. 0%

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

1. Hypovolemia
2. Pulmonary embolism
3. Ventricular aneurysm
4. Pericardial tamponade

3. Ventricular aneurysm

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

1. Improving preload
2. Increasing contractile force
3. Improving respiratory efficiency
4. Increasing peripheral vascular resistance

2. Increasing contractile force

Your pt is suffering from a dysrhythmia, which is resulting in hypotension, diminished loc, tach greater than 180, and decreased pulse ox readings. You suspect the cause might be an MI. Which of the following is the MOST important intervention?

1. Administer ASA
2. Administer O2
3. Identify the rhythm
4. Decrease the HR

4. Decrease the HR

Which of the following is considered to be a risk factor for experiencing an environmental emergency?

1. A pt with a hx of regularly exercising
2. Renal failure pt are at greater risk
3. The elderly only
4. A hx of overall good general health offers no protection

2. Renal failure pt are at greater risk

Your pt assessment reveals colicky abdominal pain in lower quadrants, accompanied by a hx of bloody diarrhea, nausea, and vomiting. What would your field dx be in this case?

1. Diverticulitis
2. Gastroenteritis
3. Hemorrhoids
4. Ulcerative colitis

1. Diverticulitis

The Helicobacter pylori bacillus is usually the cause of:

1. Acute gastritis
2. Chronic hepatitis
3. Acute gastroenteritis
4. Chronic gastroenteritis

4. Chronic gastroenteritis

Which of the following is the MOST common complication of acute myocardial infarction?

1. Dysrhythmias
2. Chest pain
3. Vomiting
4. Dyspnea

1. Dysrhythmias

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

1. Thins the blood
2. Blocks vitamin K activity
3. Decreases platelet aggregation
4. Interferes with thrombin activation

2. Blocks vitamin K activity

You are assessing a 62yo female with a complaint of CP. 12 lead indicates an extensive anterior wall MI. Which of the following is the most likely life threatening problem that will develop?

1. Pulmonary edema from LHF
2. Bradycardia from a complete heart block
3. Ventricular aneurysm from infarcted tissue
4. Supraventricular tachycardia from cardiac irritation

1. Pulmonary edema from LHF

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

1. Discomfort to the pt
2. Damage to the myocardium
3. Failure to verify mechanical capture
4. The presence of a runaway pacemaker

3. Failure to verify mechanical capture

During the diastolic phase of the cardiac cycle, which of the following valves remains open?

1. Semilunar
2. Aortic
3. Tricuspid
4. Pulmonary

3. Tricuspid

Approximately how many americans are diagnosed with hypertension?

1. 1M
2. 10M
3. 25M
4. 50M

4. 50M

Which of the following ions is MOST responsible for ensuring cardiac muscle contraction?

1. Magnesium
2. Chloride
3. Calcium
4. Sodium

3. Calcium

Which of the following best describes a hypertensive emergency?

1. An acute elevation of blood pressure requiring intervention within one hour
2. A blood pressure that increases by 50 mmHg within 4 hrs
3. Uncontrollable blood pressure for at least 72 hrs
4. A blood pressure of 180/100 for 2 hrs or more

1. An acute elevation of blood pressure requiring intervention within one hour

While caring for a pt with a cardiac emergency you view the presentation of a pt with cardiogenic shock, which is best described as:

1. A pump failure issue that is usually a result of a myocardial contusion
2. A type of shock that usually occurs as a result of a cardiac tamponade
3. A shock that remains after dysrhythmias, hypovolemia, or poor vascular tone have been addressed
4. A shock that occurs after a pt has had a myocardial infarction involving the right ventricle

3. A shock that remains after dysrhythmias, hypovolemia, or poor vascular tone have been addressed

Which of the following is a lab test typically used to determine if a pt is suffering from AMI?

1. Hematocrit
2. KCI
3. PTT
4. CK-MB

4. CK-MB

You have a pt in cardiogenic shock who also has acute pulmonary edema.Which of the following medications will have the least negative impact on this pt’s compensatory mechanisms?

1. Oxygen
2. Morphine
3. Furosemide
4. Nitroglycerin

1. Oxygen

Which of these is regarded as a typical cause of PEA?

1. Short QT syndrome
2. Ischemic stroke
3. Hyperkalemia
4. Hypertension

3. Hyperkalemia

Which of the following is the leading cause of death among all persons in the united states?

1. Cerebrovascular accident
2. Lung cancer
3. Myocardial infarction
4. Traffic accidents

3. Myocardial infarction

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

1. 72
2. 84
3. 100
4. 144

3. 100

While caring for a pt in left heart failure the pt’s spouse asks you what is the most common cause of this condition. Which of the following would be the most accurate answer?

1. COPD
2. MI
3. Congenital defects
4. Obesity

2. MI

Which of the following reflects the intrinsic firing rate of the SA node:

1. 15-40
2. 40-60
3. 60-80
4. 60-100

4. 60-100

From the list below which factor would be the most influential in causing right heart failure?

1. Cor pulmonale
2. Left heart failure
3. Pulmonary edema
4. Tricuspid valve disorders

2. Left heart failure

You suspect that your pt has developed cardiac tamponade. You attach an ECG monitor. Which of the following would you expect to see that would support your suspicion?

1. Bradycardia
2. Inverted P waves
3. Electrical alternans
4. PR segment depression

3. Electrical alternans

In the average adult, an increased diastolic pressure is a reflection of an increase in:

1. Preload
2. Left ventricular pumping
3. Pulmonary artery pressure
4. Systemic vascular resistance

4. Systemic vascular resistance

Which of the following interventions would be the most appropriate selection to increase the blood pressure of a hypotensive, bradycardia (55) pt with a hx of pheochromocytoma, who has ST elevation in Leads V1 and V2 and CP so as to receive NTG and/or MS?

1. Atropine
2. Dopamine drip
3. Fluid challenge
4. Epinephrine drip

2. Dopamine drip

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

1. Volts
2. Amps
3. Joules
4. Milliamps

4. Milliamps

Which of the following is the limiting factor of cardiac anatomy that determines intrapericardiac pressure?

1. The tough, fibrous nature of the pericardium
2. The increase in pressure reduces atrial output
3. The increase in pressure reduces electrical conduction
4. The tamponade of bleeding from an increase in pressure

1. The tough, fibrous nature of the pericardium

Which of the choices below best represents the reason we give aspirin to patients we suspect of having a heart attack?

1. Platelet aggregation inhibitor
2. Thrombolytic agent
3. Blood thinner
4. Analgesic

1. Platelet aggregation inhibitor

Which of the following ECG abnormalities would be most indicative of myocardial ischemia?

1. Pathological Q waves
2. Physiological Q waves
3. Elevated ST segment
4. Depressed ST segment

4. Depressed ST segment

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

1. 2+ pitting edema in the sacral area
2. The presence of pink, frothy sputum
3. The presence of JVD
4. HR of 120

2. The presence of pink, frothy sputum

Angina most often occurs due to which of the following?

1. Arterial spasm
2. Carotis artery obstruction
3. Coronary artery disease
4. Pulmonary emoblus

3. Coronary artery disease

You have been called to treat a pt who had previously suffered a massive left-sided MI and is now complaining of difficulty breathing. The pt has been non-compliant with this prescribed medication. Which of the following assessment findings would suggest that the pt is now suffering from right heart failure as well?

1. Sacral edema
2. Pulmonary edema
3. BP of 74/50
4. Decreased LOC

1. Sacral edema

Acute arterial occlusion will most likely occur as a result of which of the following medical conditions?

1. Emboli
2. Claudication
3. Atherosclerosis
4. Arteriosclerosis

1. Emboli

You are managing a 57yo male diabetic who is complaining of shortness of breath. His lung sounds are clear, neck veins are distended, pulse is 70, respirations are 24, BGL 90, and BP is 72/50. A 12 Lead reveals elevation in Leads II, III, AVF, and V4R. After oxygen and aspirin, which of the following should be your initial treatment option in this situation?

1. 1L NS
2. 25G D50
3. 0.3-0.4 NTG
4. 2-20 mcg/kg/min Dopamine

1. 1L NS

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

1. Tachycardia, warm skin, and altered level of consciousness
2. Hypotension, cyanosis, bradycardia, strong bounding pulse
3. Hypertnesion, alterled LOC, CP, JVD
4. Hypotension, hypoxia, tachycardia, and pedal and/or pulmonary edema

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

Which of the following BEST describes angina pectoris?

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

4. Chest pain that results when the heart’s demand for O2 exceeds the blood supply available

Your pt is a 67yo male with difficulty breathing. Assessment reveals crackles in all lobes with production of pink, frothy sputum. Pulse is 154 and irregular and bp is 78/42. The pt only 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?

1. Furosemide 1mg/kg IV push
2. NTG 0.4mg
3. Synchronized cardioversion at 120-200 joules
4. Adenosine 6mg RIVP followed by 12mg if needed

3. Synchronized cardioversion at 120-200 joules

You are performing CPR on a medical pt in cardiac arrest who was feeling fine 30 minutes ago. The pt then went into cardiac arrest and you are unable to obtain a pulse. The pt has a hx of MI and your monitor shows sinus tach at 130. The pt has just gone into asystole despite all your efforts what do you do?

1. Terminate code
2. Administer epi
3. administer sodium bicarb
4. Establish TCP

1. Terminate code

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

1. Atropine
2. Dopamine drip
3. Epinephrine
4. Transcutaneous pacing

4. Transcutaneous pacing

Which of the following assessment tools would best be used to properly identify cardiac tamponade?

1. EKG revealing elevated ST segments
2. Tracheal deviation with extreme dyspnea
3. EKG showing PVCs
4. Manual blood pressure cuff with resulting pulses paradoxus

4. Manual blood pressure cuff with resulting pulses paradoxus

You are assessing a pt who is exhibiting signs of angina. Which of the following is your most important consideration?

1. Ruling out unstable angina or infarct
2. Determining where the pain radiates
3. Ascertaining whether the pain started at rest
4. Identifying whether the pt has taken his nitro

1. Ruling out unstable angina or infarct

Which of the following has the greatest risk of increasing the chance of a person developing a cardiovascular disease?

1. Gaining weight
2. Exercising less
3. Continuing smoking
4. Increasing stress levels

3. Continuing smoking

Your trauma pt has received a chest contusion from an assault with a baseball bat. The pt is very anxious, restless and is becoming disoriented. He has moderate dyspnea and muffled heart tones. Symptoms are unimproved with O2 admin. What are the proper treatments to provide?

1. Bilateral IV with bolus, cardiac monitor, and pleural decompression
2. Support ventilations, rapid transport, bilateral IV and cardiac monitor
3. IV TKO, cardiac monitor, spinal immobilization, O2 by NRB
4. Bilateral IV TKO, cardiac monitor, rapid transport, pleural decompression

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

Of the adult population, which pts are at risk for developing a hypertensive emergency?

1. Pregnant women
2. Hemorrhagic stroke pt
3. Those with a hx of hypertension
4. Those with hypertensive encephalopathy

3. Those with a hx of hypertension

You have decided to induce hypothermia in your hypotensive, post-cardiac arrest, adult pt. Which of the following is the correct method?

1. 1-2L NS at 4 degrees C
2. 1-2L NS at 68 degrees F
3. 5ml/kg NS at 4 degrees C
4. 20ml/kg NS at 68 degrees F

1. 1-2L NS at 4 degrees C

When you arrive on the scene where CPR is being performed on a cardiac arrest victim, you find the person who is performing ventilations is doing so at about 30 per minute. What is the best method for correcting this situation?

1. Suggest to the rescuer his rate is too fast
2. Offer to take over ventilations from this rescuer
3. Order all CPR to stop and state a new crew is taking over CPR
4. Explain to rescuers that rapid ventilation does not allow the heart to fill

1. Suggest to the rescuer his rate is too fast

You are called to the scene of an elderly male pt with chest pain and palpitations. Your assessment reveals a hr of 210 per minute. Your goal should be which of the following?

1. Decrease inotropy
2. Increase chronotropy
3. Increase inotropy
4. Decrease chronotropy

4. Decrease chronotropy

Which of the following is considered to be a criteria for termination of resuscitation?

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

1. Victims of blunt trauma who have presented with and remain in asystole

You have just decided to terminate resuscitation at the residence of a pt. Your new basic EMT partner asks why there was no transport tot he emergency department where additional measures would be available. Which of the following would be your best response?

1. A code is less effective when run in an ambulance
2. Transport would have been more costly for the family
3. Transport would have raised false hopes for the family
4. Our care is better than the hospital’s for this type of call

3. Transport would have raised false hopes for the family

If a pt had a decrease in cardiac output secondary to myocardial damage, how would the body initially attempt to compensate to maintain an adequate blood pressure?

1. Decrease heart rate
2. Increase fluid retention
3. Decrease stroke volume
4. Increase vascular resistance

4. Increase vascular resistance

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

1. Hepatic failure
2. Acute renal failure
3. Left ventricular failure
4. Right ventricular failure

4. Right ventricular failure

Which of the following would be an atypical finding in a pt experiencing cardiac tamponade?

1. Narrow pulse pressure
2. JVD
3. Muffled heart tones
4. Absent lung sounds

4. Absent lung sounds

You are assessing a pt you suspect is suffering from cariogenic shock. Which of the following would best help you differentiate this as a left-sided issue?

1. Pedal edema
2. Pulmonary edema
3. ST elevation in II, III, AVF and V4R
4. A positive response to a fluid challenge

2. Pulmonary edema

You are presented with an unstable bradycardia pt. Which of the following is the initial hr setting for TCP of this pt according to the AHA?

1. 40 per minute
2. 60 per minute
3. 80 per minute
4. 100 per minute

3. 80 per minute

While auscultating a pt’s heart sounds, you hear an extra beat prior to SI or the normal lub sound of the heart. This is known as which of the following?

1. S2
2. S3
3. S4
4. S5

3. S4

Acute arterial occlusion will most common involve arteries in which of the following regions of the body?

1. Neck
2. Lungs
3. Abdomen
4. Extremities

4. Extremities

In the case of an idioventricular rhythm, which of the following would be the most consistent?

1. The pacemaker site is at the AV node
2. The P waves are inverted and attached to the QRS
3. The heart rate is less than 60 complexes per minute
4. The QRS duration is greater than 0.12 and the axis is indeterminate

4. The QRS duration is greater than 0.12 and the axis is indeterminate

Your assessment reveals an 80yo female with a decreased LOC, hypotension pulmonary edema, and tachycardia. Select the correct answer regarding her condition and proper treatment.

1. Cardiogenic shock; nitro, lasix, asa, o2, iv, monitor
2. Renal failure; Dope, epi, beta-blockers, monitor, iv, o2
3. Myocardial infarction; epi, asa, nitro, morphine, O2, monitor
4. Cardiogenic shock; dobutamine or dopamine, O2, monitor, bilateral IV

4. Cardiogenic shock; dobutamine or dopamine, O2, monitor, bilateral IV

When attaching the leads of an ECG monitor, a lead II tracing requires the positive electrode to be placed on the:

1. Left arm
2. Left leg
3. Right arm
4. Right leg

2. Left leg

You are called to assess a 57yo pt with a primary complaint of chest pain. The pain began while the pt was climbing two flights of stairs and he informs you that he is now pain free, but it took three nitro tablets instead of the usual two for him to have relief. His 12 lead shows no abnormalities now. Which of the following is the MOST appropriate field impression an recommendation for this pt?

1. Angina, no intervention
2. Unstable angina, transport for further evaluation
3. Myocardial ischemia, O2, ASA, transport
4. Myocardial infarction, O2, ASA, NTG, MS, and transport

2. Unstable angina, transport for further evaluation

Which of the following interventions would be the MOST appropriate selection to treat a 57yo male pt with ST elevation in Leads V1-V6, pulmonary edema, blood pressure 90/50, Hr 60, and chest pain?

1. Furosemide
2. Nitroglycerine
3. Epinephrine drip
4. Dobutamine drip

4. Dobutamine drip

Which of the following would best describe why we provide oxygen to a pt having an MI?

1. To reduce myocardial oxygen demand
2. To vasodilate cardiac blood vessels
3. To provide additional oxygen to the brain
4. To oxygenate the collateral cardiac circulation

1. To reduce myocardial oxygen demand

You observe ST depression in leads I and II. Which of the following most accurately reflects this?

1. Non-diagnostic
2. This is normal in these leads
3. The pt is suffering from infarct
4. The pt is having ischemic event

1. Non-diagnostic

You have a pt with a normal heart rate and rhythm who is having a hypertensive emergency. Which of the following medications would address the hypertension at the same time having little or no effect on the heart?

1. Beta blocker
2. ACE inhibitor
3. Calcium channel blocker
4. Combined alpha/beta agonist

2. ACE inhibitor

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

1. Reaction to pain
2. Lack of blood flow
3. An allergic reaction
4. An additional problem

4. An additional problem

Which of the following represents the appropriate maintenance regimen for amiodarone in a post resuscitation phase?

1. 0.5mg/min
2. 150mg/min
3. 1-4mg/min
4. 2-10mg/min

1. 0.5mg/min

Which of the following pt populations is most likely to develop cardiogenic shock?

1. Pt with significant anterior chest trauma
2. Pt with hx of right ventricular infarct
3. Pt with hx of myocarditis or pericarditis
4. Geriatric pt with significant underlying diseases

2. Pt with hx of right ventricular infarct

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

1. 0.5mg/min
2. 0.5 to 0.75 mg/kg
3. 1-4 mg/min
4. 2-4 mg/min

3. 1-4 mg/min

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

1. Cyanosis
2. Pain at rest
3. Paresthesia
4. Pain during exercise

4. Pain during exercise

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

1. Beta agonist
2. Sodium channel blocker
3. Calcium channel blocker
4. Potassium channel blocker

3. Calcium channel blocker

Which of the following would best describe why we provide morphine to a pt having an MI?

1. To reduce myocardial oxygen demand
2. To vasodilate cardiac blood vessels
3. To provide additional oxygen to the brain
4. To oxygenate the collateral cardiac circulation

2. To vasodilate cardiac blood vessels

You are monitoring a pt ECG in diagnostic mode and observe a narrow QRS, ST elevation in Leads V1 and V2, and a heart rate of 50. Which of the following would MOST accurately represent these findings?

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

1. The pt is having a septal wall MI, which is delaying AV node condution

You have ROSC in a cardiac arrest victim. Which of the following describes the highest level of responsiveness the pt can demonstrate to be considered a candidate for induced hypothermia?

1. Alert
2. Responds to verbal stimuli
3. Responds to painful stimuli
4. Unresponsive

3. Responds to painful stimuli

Which of these best explains why we push hard, push fast, and minimize interruptions when performing chest compressions?

1. To circulate oxygen
2. To circulate the blood
3. To stop the heart from fibrillating
4. To maintain an adequate blood pressure

2. To circulate the blood

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

1. Blocking the eflux of calcium
2. Blocking the efflux of potassium
3. Blocking the influx of Mag
4. Blocking Beta 1 receptors which are attached to the calcium channels

2. Blocking the efflux of potassium

You witness an adult pt collapse in front of you while you are covering a sporting event. His wife indicates he has an implanted pacemaker and a quick assessment of leads reveals asystole. Which of the following would be most appropriate action?

1. Immediate CPR for 2 min then reassess
2. Begin CPR while preparing immediate D-fib
3. Begin CPR, establish IV and administer epi.
4. Begin CPR while preparing for immediate external pacing

3. Begin CPR, establish IV and administer epi

Which progressive event typically causes the cariogenic shock pt to lost the ability to maintain vital organ perfusion?

1. Myocardial death
2. Failure of Starling’s law mechanism
3. Failure of preload, afterload, and contractility mechanism
4. Failure of respiration secondary to massive pulmonary edema

3. Failure of preload, afterload, and contractility mechanism

Which choice reflects the general cardiac action of Dilantin?

1. Beta blocker
2. Calcium channel blocker
3. Potassium channel blocker
4. Sodium channel blocker

4. Sodium channel blocker

Which of the following is the most typical finding in right-sided myocardial infarction?

1. Hypertension
2. Hypotension
3. Flushed skin
4. Tachycardia

2. Hypotension

Which of the following is considered a major risk factor for cardiovascular disease?

1. Liver disease
2. Overall mental health
3. Individual response to stress
4. Diabetes mellitus

4. Diabetes mellitus

During a temper tantrum, a 5yo child attempts to hold his breath to upset his parents and make a point. After a short period of time, the child passes out and falls to the ground. How do you suspect a medically-trained person would describe the respiratory pattern immediately following the syncopal episode?

1. Slow, then fast, the slow again
2. Shallow and rapid for about 10 minutes
3. Apneic for a minute or so, then normal
4. Tachypneic for a short time, then regular

4. Tachypneic for a short time, then regular

Which of the following best describes peak expiratory flow testing?

1. The pt exhales normally after a normal inhalation
2. The pt exhales forcefully after a normal inhalation
3. The pt exhales normally after a maximal inhalation
4. The pt exhales forcefully after a maximal inhalation

4. The pt exhales forcefully after a maximal inhalation

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

1. Finding an oil-based lubricant on the valve of the oxygen regulator
2. Mopping the ambulance floor with cleaning chemicals that don’t’ kill germs
3. Discovering dried emesis between the cushions of the bench seat in the ambulance
4. Noticing a sharps container half full of needles and used syringes mounted properly in the unit

2. Mopping the ambulance floor with cleaning chemicals that don’t’ kill germs

Identify the most dangerous result of an unrecognized esophageal placement of an endotracheal tube.

1. Flatulance
2. Aspiration
3. Stomach rupture
4. Air empolism

3. Stomach rupture

You are assisting in the care of a cardiac arrest pt. Your partner is ventilating the pt with a bvm. Other rescuers arrive and take over chest compressions and possible defibrillation. You can see there is no chest rise when your partner ventilates the pt. Which of the following should you choose next to improve the situation?

1. Attach O2 flow to the BVM
2. Evaluate the pt for a pneumothorax
3. Evaluate the pt for an airway obstruction
4. Assist your partner to maintain a seal in the BVM

4. Assist your partner to maintain a seal in the BVM

Which unresponsive pt will most likely benefit from a nasogastric tube being inserted by EMS?

1. A victim you believe is bleeding internally
2. Pt you suspect OD on ASA
3. Any pt who has ingested a caustic chemical
4. Children being ventilated with abdominal distention

4. Children being ventilated with abdominal distention

While ventilating a pt with a flow-restricted oxygen-powered ventilation device, you should:

1. Listen for the alarm indicating the relief valve is activating
2. Avoid tipping the head back, even in non-traumatic patients
3. Never use it on a pt who has a suspected abdominal injury
4. Determine if the pt has ever had cardiac bypass surgery

3. Never use it on a pt who has a suspected abdominal injury

Which of the following tanks would least likely be used as a portable oxygen bottle carried into scene by rescuers?

1. D cylinder
2. E cylinder
3. M cylinder
4. Super D cylinder

3. M cylinder

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

1. Biot’s
2. Kussmaul
3. Cheyne-Stokes
4. Central neurogenic hyperventilation

2. Kussmaul

During resuscitation, rescuers perform a cricoid pressure maneuver during ventilations. Which of the following statement is most true regarding this procedure?

1. It will likely cause more air to enter the esophagus instead of the trachea
2. This procedure should not be performed on infants or children less than 8y of age
3. The skill of cricoid pressure may only be performed by advanced life support personnel
4. Complications of this procedure include esophageal rupture and possibly laryngeal trauma

4. Complications of this procedure include esophageal rupture and possibly laryngeal trauma

Which of the following describes the proper technique when performing the jaw-thrust maneuver?

1. Position yourself at the side of the pt’s head
2. Retract the lower lip with your thumb to keep the mouth open
3. The pt’s head, neck, and spine should be moderately extended
4. Stabilize the head with you forearms and forcibly shift the jaw posteriorly

2. Retract the lower lip with your thumb to keep the mouth open

Rescuers are preparing to transfer a 52yo female with a mild pneumothorax to a larger hospital for further tx. According to the physician arranging the transfer, he suspects her lung was punctured during a central line insertion two days ago. During transport the pt becomes unresponsive to painful stimuli and cyanosis is observed. Rescuers rub her stern with their knuckles an slightly brush he eyelashes with a finger tip. What do you suspect they are assessing?

1. Central nervous system level of function
2. Likelihood pt has a gag reflex
3. Whether the pt will tolerate an IV
4. Peripheral nerve integrity

2. Likelihood pt has a gag reflex

Which of the following methods would be the most effective to ventilate an unresponsive pt who is suffering from adult respiratory distress syndrome where you were unable to secure the airway with an ET tube?

1. Mouth to mask with supplemental O2
2. 2-person BVM with adjustable peep setting
3. 1-person BVM with administration of a loop diuretic
4. Insertion of an esophageal-tracheal dual lumen airway and positive pressure ventilation

4. Insertion of an esophageal-tracheal dual lumen airway and positive pressure ventilation

You have just inserted an ET tube into a 2yo child. Which of the following techniques would be the most reliable way to confirm proper tube placement if the child is in cardiac arrest?

1. Ausculation of lung sounds
2. Colorimetric End tidal CO2 detector
3. Use of an esophageal detector device
4. Seeing equal chest rise and fall during ventilation

4. Seeing equal chest rise and fall during ventilation

You are transferring a 27yo male with a known C-6 fx with cord involvement. Which of the following findings would be most consistent with this injury?

1. Decrease in tidal volume, normal respiratory rate
2. Increase in tidal volume, normal respiratory rate
3. Decrease in tidal volume, increase in respiratory rate
4. Increase in tidal volume, decrease in respiratory rate

1. Decrease in tidal volume, normal respiratory rate

Which of these is negatively affected when you properly provide BVM ventilation?

1. Alveolar pressure
2. Carbon dioxide removal
3. Cerebral perffusion pressures
4. Venous blood return

4. Venous blood return

You and your partner are providing ventilations using a BVM device to a pt who has a broken nose. The pt has a gag reflex and there is no cervical spine considerations needed. Which of the following will provide the greatest opening of the airway.

1. Head-tilt chin-lift
2. Head-tilt neck-lift
3. Head-tilt jaw thrust/lift and proper head/neck/chest relationship
4. Head neutral jaw-lift with manual cervical spine control and moderate cricoid pressure

1. Head-tilt chin-lift

EMS providers are having difficulty visualizing the vocal cords of a 5yo female during intubation. Which of the following techniques would improve intubation success?

1. Placing a towel roll underneath the occipital lobe of her head
2. Performing posterior/superior pressure on the larynx/cricoid membrane
3. Inserting a steril french catheter into he pt’s so to trigger a gag refles
4. Tipping the pt’s head an chin downward toward the chest during visualization

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

Your pt is complaining of neck pain after being involved in a side impact accident. He is able to feel pain in his left index finger but is unable to feel touch, he is able to feel touch in his right index finger but feels no pain. Which of the following do you most likely suspect?

1. Ascending tract injury at c7 on left
2. Ascending tract injury at c7 on right
3. Partial lobe injury of the cerebrum on left
4. Parietal lobe injury of the cerebrum on the right

1. Ascending tract injury at c7 on left

Which of the following causes an increase in heart rate in compensated shock?

1. Cellular ischemia due to hypoxia
2. A decrease in pressure sensed by baroreceptors
3. An increase in parasympathetic tone
4. The release of epi due to decreased kidney perfusion

2. A decrease in pressure sensed by baroreceptors

Adult pt with closed bilateral femur tx. How much blood do you estimate the pt to lose?

1. 0.5L
2. 1L
3. 2L
4. 3L

4. 3L

Which of the following anatomical structures are initially damaged in a strain?

1. muscles and tendons
2. cartilage and muscles
3. muscles and ligament
4. cartilage and ligaments

1. muscles and tendons

Where should you place your hands to manually stabilize a c spine

1. on the neck
2. head and shoulders
3. cranium and facila bones
4. facial bones and mandible

4. facial bones and mandible

You are dispatched to man collapsed in a freshly dug ditch. the FD assures you it is safe to enter. they advise you the victim hit an energized power line and collapse. What would you do first?

1. Assess for entrance and exit wounds
2. manually immobile the head
3. look for external bleeding
4. apply high flow o2

2. manually immobile the head

What is the MAP of a pt who has a bp of 140/80

1. 140
2. 100
3. 80
4. 60

2. 100

Which of the following is most likely occurring in a pt who has worsening stroke-like symptoms following a blow to the head?

1. Epidural hematoma
2. Moderate concussion
3. Intracerebral hemorrhage
4. Severe diffuse axonal injury

3. Intracerebral hemorrhage

You are called to the scene of an adult pt who was the unrestrained driver in a single car MVC. Pt is pale, cold, clammy, pulse 60, resp 12, pupils equal, dilated, sluggish weak central pulses and absent peripheral pulses. Your rapid trauma sure reveals a scalp laceration, unequal lung sounds, flattened jugular veins, absent distal pulse, motor and sensory function, and a flail segment to right chest. Which best describes pt’s situation?

1. neurogenic shock from spinal injury
2. Closed head injury with ICP
3. Stage 4 hemorrhage with profound hypotension and decompensated shock
4. Respiratory and obstructive shock fro a developing tension pneuma

4. Respiratory and obstructive shock fro a developing tension pneuma

Which of the following is the most immediate concern for a pt with a large body surface area burn?

1. infection
2. hypothermia
3. hypovolemia
4. organ failure

2. hypothermia

Which of the following would be your greatest pathophysiological concern regarding a closed femur fx?

1. Infection
2. Muscle spasm
3. Massive hemorrhage
4. Compartment syndrome

4. Compartment syndrome

After blood has passed through the capillary system, which of the following is least responsible for returning blood to the heart?

1. venous valves
2. muscle contraction
3. Systolic pressure

3. Systolic pressure

You are called to treat a pt who has been exposed to radiation and complained of a burning sensation within minutes of exposure, he is also complaining of nausea and vomiting. Based on the above symptoms, which of the following whole body exposure doses would you predict the pt experienced?

1. 75-125
2. 125-200
3. 200-600
4. 600-1000

3. 200-600

Which of the following organs, if fx and the integrity of the visceral peritoneum lost, will cause the greatest collateral damage to the body?

1. Liver
2. spleen
3. kidney
4. pancreas

2. spleen

You have a 26yo pt with a chest injury resulting in absent lung sounds on the left and hyper resonance on the left. Trachea is midline and neck veins normal. The pt hs complaining of severe chest pain and i having difficulty breathing with a respiratory rate of 24. Which of the following should you do immediately for this pt?

1. Decompress left chest
2. Decompress right chest
3. Intubate and provide pain relief
4. Administer high-flow supplemental o2

4. Administer high-flow supplemental o2

You are called to treat a pt who has been exposed to radiation and complained of a burning sensation within minutes of exposure. He is also complaining of nausea and vomiting. Which of the following best explains the pathophysiology behind the symptoms the pt is experiencing?

1. Radiation has damaged the nerve fibers within the GI tract
2. Radiation has cause paralysis of the muscles of peristalsis
3. Radiation at this level disrupts cells, causing a cellular hypovolemia
4. Radiation negatively impacts the fast-reproducing cells of the GI tract

4. Radiation negatively impacts the fast-reproducing cells of the GI tract

The hollow organ most susceptible to injury from penetrating abdominal trauma is:

1. Stomach
2. Large bowel
3. Small bowel
4. Urinary bladder

3. Small bowel

You are treating a crush syndrome pt with an entrapped arm and you have been unable to medicate the pt or administer fluids. Which of the following would be your most appropriate action?

1. Amputate the limb to avoid the release of toxins
2. Initiate medicaitons and fluids after relieving entrapment
3. Apply a tourniquet to the limb prior to relieving entrapment
4. Apply a tourniquet to the limb after relieving entrapment

3. Apply a tourniquet to the limb prior to relieving entrapment

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

1. Lefort I
2. Lefort II
3. Lefort III
4. Lefort IV

3. Lefort III

With a complete laceration of the calcanea tendon, which of the following movements would a pt be incapable of performing?

1. Dorsiflexion
2. Plantar flexion
3. Ankle eversion
4. Ankle inversion

2. Plantar flexion

Which of the following would you expect to find with a pt experiencing neurogenic shock as a result of a spinal cord injury at c7?

1. Tachycardia
2. Hypertension
3. Pale, cool, clammy skin,
4. Diaphragmatic breathing

4. Diaphragmatic breathing

What type of brain injury results in an actual bruising of the brain?

1. Ecchymosis
2. Concussion
3. Hematoma
4. Contusion

4. Contusion

An isolated laceration of the calcanea tendon would most likely be treated by:

1. Providing a pressure dressing, splinting in the position found, and apply heat to the wound
2. Providing a pressure dressing, splint in a position of function, and apply local cooling
3. Providing a gentle circumferential dressing, splint in the position of function, and apply local cooling
4. Providing gentle circumferential dressing, splint in the position found, and apply heat to the wound

3. Providing a gentle circumferential dressing, splint in the position of function, and apply local cooling

You are treating a pt you suspect has a developing epidural hematoma. Which of the following is your most important intervention?

1. Intubation and hyperventilation
2. Rapid transport for immediate surgery
3. Administration of Mannitol to reduce ICP
4. Elevation of the head of the cot by 30 degrees

2. Rapid transport for immediate surgery

You have a pt who was the passenger of a motor vehicle involved in a front end collision. The pat was searing his lap restraint too high and has a red mark at the level of the umbilicus. He has JVD, diminished lung sounds on the left, hyporesonance to percussion on the left, hypotension, and a hollow-appearing abdomen. Which of the following is your most critical intervention?

1. Fluid resuscitation
2. Pleural decompression
3. Applying and inflating PASG
4. Rapid transport to trauma center

4. Rapid transport to trauma center

On the torso, what is the name of the portion of the sternum immediately above the angle of Louis?

1. Manubrium
2. Sternal notch
3. Xiphoid process
4. Body of the sternum

1. Manubrium

Why do we apply a cervical collar to a pt with a suspected spinal injury?

1. To fully immobilize the cervical spine
2. To remind the pt and us not to move the pt’s head and neck
3. To secure the head and neck in a neutral position to maximize the airway
4. To place the pt in slightly hyper-extended position for airway management

2. To remind the pt and us not to move the pt’s head and neck

A pt has been stabbed on the right anterior portion of the chest along the anterior midclavicular line at the 8th intercostal space. Which of the following organs has most likely been damaged?

1. Lung
2. Liver
3. Spleen
4. Stomach

2. Liver

How much blood may be lost from the vasculature into the abdominal cavity before the abdomen shows signs of distention in the adult pt?

1. 0.5L
2. 1 L
3. 1.5 L
4. 2 L

3. 1.5 L

Identify the tissue structure that lies between the muscle and dermal layer of skin

1. Bones
2. Cartilage
3. Epidermis
4. Fatty tissue

4. Fatty tissue

The appropriate management of a tib/fib fx would include:

1. Immobilization from the distal femur the foot
2. Immobilization from the proximal tib/fib to the foot
3. Immobilization from the distal femur to the distal tib/fib
4. Immobilization from the proximal tib/fib to the distal tib/fib

1. Immobilization from the distal femur the foot

You are assessing a pediatric pt who has received a chemical splash second degree burn to his anterior chest. What is the percentage of BSA of this burn?

1. 4.5
2. 9
3. 13.5
4. 18

2. 9

Which of the following is true regarding the pathophysiology of blast injuries?

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

2. Lung tissue will become less compliant to ventilation

What is the name for visible red streaks extending from the margins of a wound up the affected extremity proximally?

1. Lymphangitis
2. Ecchymosis
3. Erythema
4. Abscess

1. Lymphangitis

Which of the following assessments would allow you to best differentiate a pneumothorax from a hemothorax?

1. Lung sounds
2. Blood pressure
3. Chest percussion
4. Breathing difficulty

3. Chest percussion

Which of the following would be the best indication for the inflation of PASG?

1. profoundly hypotensive pt with pulmonary edema
2. Pt with a myocardial contusion in cardiogenic shock
3. Hypotensive pt with a pelvic and closed femur fx
4. profoundly hypotensive pt with penetrating chest injury

3. Hypotensive pt with a pelvic and closed femur fx

What is the purpose of checking vital signs every 5 min in the head injured pt?

1. To follow standard protocol
2. To decide what type of head injury
3. To determine whether any scarring will be present
4. To evaluate any signs of increasing ICP

4. To evaluate any signs of increasing ICP

Which type of skull fx is the least likely to have associated damage to the underlying meninges, cerebral and cerebellar tissue?

1. Linear
2. Basilar
3. Depressed
4. Comminuted

1. Linear

You are dispatched to an assault call where a 25yo male was struck in the face by a blunt object. The pt is supine and unresponsive and ays go to maintain c-spine, you notice that the zygomatic bones depress when you place pressure on them. As you open the airway with a jaw-thrust, you note instability of the entire facial region up to the eyebrows. What is your highest priority with this trauma pt?

1. Suction and attempt to ventilate with a BVM
2. Orally intubate the pt and attempt to ventilate
3. Place a NPA and attempt to ventilate
4. Perform abdominal thrusts and look in the airway for obstructions

2. Orally intubate the pt and attempt to ventilate

Responders are called to the scene of an industrial accident. Victim has accidentally amputated his hand. Which treatment below would best describe the care the responders should provide?

1. Wrap amputated part in sterile dressing and then a plastic bag and keep cool
2. Wrap amputated part in a plastic bag and keep the hand warm, at or near body temperature
3. Apply a constriction band or tourniquet to the amputated limb to slow the bleeding and rapidly transport
4. Control the bleeding on the injured extremity and transfer the amputated part in a red biohazard bag for disposal

1. Wrap amputated part in sterile dressing and then a plastic bag and keep cool

Which of the following is the preferred fluid to replace lost fluid in situations involving hemorrhagic shock?

1. D5W
2. D10W
3. NS
4. LR

3. NS

Which of the following describes the appropriate tx of a pt whose skin has been contaminated with sodium?

1. Flush with water for at least 5 min
2. Flush with water for at least 20 min
3. Brush sodium off, cover with oil
4. Brush sodium off, flush with water

3. Brush sodium off, cover with oil

What is occurring during the capillary stagnation phase of hemorrhagic shock?

1. Arteriole constriction causes the pre-sphincter muscles to close
2. The pre-capillary sphincters open and red blood cells clump together
3. The post-capillary sphincters open and clumps of red blood cells circulate through the body
4. The pre-and post-capillary sphincter muscles are closed, increasing hydrostatic pressure

2. The pre-capillary sphincters open and red blood cells clump together

What percentage of pts who suffer multi-system trauma will also experience significant musculoskeletal injury?

1. 30
2. 50
3. 80
4. 90

3. 80

You have a pt with bilateral arm fx as a result of a head on motor vehicle collision The pt was wearing his seatbelt and the air bag did deploy. Your assessment of the abdomen revealed some redness on the abdomen at th umbilicus from the belt, but the pt was negative for bruising or distention so you elected to splint both arms on scene prior to transport. Which of the following is the most accurate regarding this scenario?

1. A red mark on the abdomen is often the only clue to a critical abdominal injury
2. Delaying transport to address the arm injuries prevented further injury from occurring
3. The bilateral arm fx are a critical injury and require a rapid extrication and transport
4. An assessment of abdominal sounds should have been performed to rule out abdominal injuries

1. A red mark on the abdomen is often the only clue to a critical abdominal injury

You are assessing a pt who has fallen from a ladder and is now complaining of a severe, tearing pain in the chest, which is radiating to the back. Assessment reveals a harsh systolic murmur. Which of the following assessment findings would you also expect to be present?

1. Unequal lung sounds
2. Distended jugular veins
3. Rapid, irregular heart rate
4. Unequal upper extremity pulses

4. Unequal upper extremity pulses

Which of the following terms applies to the condition where a pt has blood in the anterior chamber of the eye in front of the iris?

1. Hyphema
2. Retinal detachment
3. Acute retinal artery occlusion
4. Sub-conjunctival hemorrhage

1. Hyphema

Approximately how many people are killed in the united states every year as a result of lightning strikes?

1. 50-100
2. 150-300
3. 350-500
4. 550-1000

1. 50-100

You are assessing a pediatric pt who has received a chemical splash second degree burn to his anterior chest. What is the severity of this burn?

1. Minor
2. Moderate
3. Severe
4. Critical

2. Moderate

You are treating a 27yo adult pt who has just been removed from a burning industrial building. The pt had severe dyspnea, complained of CP, and a seizure and is now unresponsive. Which of the following is the most likely cause of this pt’s condition?

1. Cyanide poisoning
2. MI
3. Carbon monoxide poisoning
4. Concurrent episode of epilepsy

1. Cyanide poisoning

Which of the following is a strong corrosive that reacts with water to produce heat and chemical burns

1. Phenol
2. Alkalis
3. Dry lime
4. Sodium

3. Dry lime

Which of the following are the most frequent and life threatening injuries associated with an explosion?

1. Burns
2. lung injuries
3. bowel injuries
4. penetrating wounds

2. lung injuries

A pt has received a neck injury resulting in damage to the glossopharyngeal nerve. Which of the following would you most likely expect this pt to experience?

1. A loss of sensation to the arms and shoulders
2. An inability to raise the arms at the shoulders
3. A loss of control with the muscles of the neck
4. An inability to monitor pressure in the carotid sinus

4. An inability to monitor pressure in the carotid sinus

Which of the following would best demonstrate an appropriate empathic response for the burn-injured pt?

1. Providing prompt and safe transportation
2. Actively listening to the pt’s concerns
3. Administering medication for pain management
4. Explaining the burn center capabilities to the pt

3. Administering medication for pain management

Which of the following describes the law of inertia?

1. Doubling the force when you double the mass
2. The faster you decelerate, the more likely the injury
3. Quadrupling the energy when you double the velocity
4. Continuing strait when you hit a slick patch on a curve

4. Continuing strait when you hit a slick patch on a curve

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

1. Beck’s triad
2. Tachycardia
3. Hypotension
4. Unequal pupils

3. Hypotension

Which of the following occurs or is most commonly associated with traumatic spinal injury vs. non-traumatic spinal injury?

1. Osteomyelitis
2. Central cord syndrome
3. Vertebral spondylolysis
4. Vertebral disk herniation

2. Central cord syndrome

Which of the following can be used to minimize an increase in intracranial pressure when preparing to intubate?

1. Lidocaine
2. Morphine
3. Succ
4. Thiamine

1. Lidocaine

You have a 27yo stable trauma pt with a closed mid-shaft radius/ulna fx. The pt is in a significant amount of pain. Assuming no contraindications, when would be the most appropriate time to initiate the administration of pain medication to this pt?

1. At the scene, after immobilization
2. In the hospital ED by the physician
3. In the ambulance, prior to transport
4. At the scene, prior to immobilization

4. At the scene, prior to immobilization

Which of the following will have the greatest positive impact on a thermal burn pt who has received second and third degree burns on the front of both lower extremities?

1. Administering an analgesic
2. Providing significant fluid bolus
3. Applying wet sheets to pt’s legs
4. Removing gross contamination from the area

2. Providing significant fluid bolus

A metacarpal joint would be an example of which type of joint?

1. Triaxial
2. Diathroses
3. Synathroses
4. Amphiarthroses

2. Diathroses

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

1. Minor
2. Moderate
3. Severe
4. Critical

2. Moderate

Which of the following best explains why a thorough scene survey and evaluation of MOI is so important in cases of abdominal trauma?

1. abdominal injuries are often slow to produce obvious signs
2. An evaluation of MOI will allow you to determine severity
3. Scene assessment and mechanism are part of the initial assessment
4. An evaluation of the scene will allow you to identify the injured organ

1. abdominal injuries are often slow to produce obvious signs

Which of these situations would most likely be a medical cause of back pain in which spinal immobilization would be unnecessary?

1. A pt with a hx of osteoporosis
2. A pt with a gradual onset of low back pain
3. A pt with a hx of vertebral spondylolysis
4. A pt who felt sudden cervical neck pain when lifting

2. A pt with a gradual onset of low back pain

You have an adult pt with an estimated blood loss of 1000ml. Which of the following assessment findings would you expect?

1. Decreasing pulse strength
2. Decreasing blood pressure
3. Decreasing respiratory volume
4. Decreasing peripheral vasoconstriction

1. Decreasing pulse strength

Which of the following would be the most appropriate for a circumferential pressure dressing of a limb?

1. Gauze bandage
2. Elastic bandage
3. Adhesive bandage
4. Self-adherent roller bandage

4. Self-adherent roller bandage

How much blood can be lost from closed bilateral femur fx and lower leg fx?

1. 1L
2. 2L
3. 3L
4. 4L

3. 3L

What is most likely occurring in the trauma pt that has increasing bp, decreasing hr, and irregular respirations?

1. neurogenic shock
2. hemorrhagic shock
3. decompensated shock
4. Increased ICP

4. Increased ICP

You are called to assess and treat a pt who has suffered a deep, penetrating wound to the central chest and is complaining of difficult and painful swallowing, pleuritic chest pain, and pain radiating to the mid back. What other assessment finding should you expect to see with this pt?

1. Unequal lung sounds
2. Unequal pulses in the upper extremities
3. Subcutaneous emphysema around the lower neck
4. JVD, muffled heart tones, hypotension

3. Subcutaneous emphysema around the lower neck

Which of the following best explains the pathophysiological reason for a low systolic bp in a pt with a tension pneumothorax?

1. The increase in intrathoracic pressure decreases the blood return to the heart
2. The loss of blood from pulmonary tissue and vessel damage leads to hypovolemia
3. The decrease in ventilation cases systemic hypercarbia leading to vessel dilation
4. The increase in intrathoracic pressure decreases the heart’s ability to pump blood out

1. The increase in intrathoracic pressure decreases the blood return to the heart

During compensated shock, which of the following accurately describe the capillary sphincter muscles of non-essential tissues?

1. Pre and post muscles open
2. Pre and post muscles closed
3. pre open post closed
4. post open pre closed

2. Pre and post muscles closed

Which of the following would be an expected finding in a pt with an injury to a vascular structure within the abdomen?

1. Tachycardia
2. Shoulder pain
3. Warm, dry skin
4. Distended neck veins

2. Shoulder pain

A decreasing pulse pressure in hemorrhagic shock is due to which of the following?

1. capillary washout lowers systolic pressure
2. decreased preload causes increased cardiac force
3. arteriole constriction raises diastolic pressure
4. decreased kidney perfusion causes renal hypertension

3. arteriole constriction raises diastolic pressure

Approx. what percentage of pts presenting to ED with soft tissue injuries develop infection?

1. 2
2. 6
3. 10
4. 12

2. 6

Which of the following phases of the body’s response to a burn injury places the greatest demand on the body for nutrients?

1. Emergent phase
2. Fluid shift phase
3. Resolution phase
4. Hypermetabolic phase

4. Hypermetabolic phase

In the pre-hospital setting, the pt with a basilar skull fracture will most likely present with

1. Retroauricular ecchymosis
2. CSF drainage from the ear
3. CSF drainage from the nose
4. Bilateral periorbital ecchymosis

2. CSF drainage from the ear

You have an anxious trauma pt with pale, cool, clammy skin and a stable blood pressure of 120/80. Pulse and respirations are rapid. Which of the following best classifies this pt?

1. Compensated shock with aerobic metabolism
2. Compensated shock with anaerobic metabolism
3. Decompensated shock with aerobic metabolism
4. Decompensated shock with anaerobic metabolism

2. Compensated shock with anaerobic metabolism

Assuming that all are fired from the same distance, which of the following type of weapon causes the greatest damage?

1. Shotgun
2. Handgun
3. Domestic hunting rifle
4. Assault rifle with full metal jacket

2. Handgun

Which set of terms most accurately describes the components of a modern day trauma system?

1. Analysis, education, re-analysis
2. Matriculation, organization, structure
3. Leadership, education, data management, research
4. Data management, incident command, quality control

3. Leadership, education, data management, research

Which of the following is a condition that would be expected regarding a radiation exposure?

1. Delayed cancer
2. Soft tissue burns
3. Respiratory arrest
4. Cardiac dysrhythmias

1. Delayed cancer

Which of the following lung injuries is typically the slowest to develop?

1. Hemothorax
2. Hemopneumothorax
3. Pulmonary contusion
4. Simple pneumothorax

3. Pulmonary contusion

Your pt has received a stab wound to the anterior upper abdomen, resulting in a laceration of the inferior vena cava. The pt has shallow respirations of 24, bp of 80/60, pulse of 50. Which of the following would be appropriate scene management if your transport time to a trauma facility is 10 minutes?

1. Apply and inflate PASG
2. Initiate two large bore IVs
3. Administer a dipamine drip
4. Assist ventilations with a BVM

4. Assist ventilations with a BVM

What is the actual chemical process that damages the body tissue in a burn situation?

1. Evaporation and denaturing
2. Combustion and evaporation
3. Combustion and denaturing
4. Combustion only

1. Evaporation and denaturing

Which of the following is the principle life threat from esophageal rupture secondary to trauma?

1. Aspiration pneumonia
2. Tension pneumothorax
3. Tension hemophemothorax
4. Damage to mediastinal organs

4. Damage to mediastinal organs

Which of the following is the most likely cause of an injury involving the abdominal vasculature?

1. Explosion
2. Blunt trauma
3. Rapid deceleration
4. Penetrating trauma

4. Penetrating trauma

In the pt with a head and spinal injures, what is true regarding airway management

1. A head injury can cause a pt to lose his gag reflex
2. A c spine injury can cause the pt to lose his gag reflex
3. A c spine injury can cause a pt to lose the ability to breathe with his diaphragm and only be able to breathe with his intercostals
4. All of the above

4. All of the above

Mr. Doe attempted to get out of bed during the night and is unable to move because of severe pain in his back. Identify which of the following conditions is most likely to have cause an injury that is producing this pain:

1. Fibromyalgia
2. Osteoarthritis
3. MS
4. Muscular dystrophy

2. Osteoarthritis

The difference between a Level 1 trauma center and a Level II trauma center is that a Level II center must be able to:

1. Manage most traumatic injuries
2. Provide some surgical capabilities
3. At least stabilize some traumatic injuries
4. Arrange for the transfer of pts to a higher-level center

1. Manage most traumatic injuries

You work in a factory where you are called to help with a worker that has amputated his lower arm in a machine. The torn distal portion is spurting blood. You have no gloves or first-aid kit with you. Your best action at this time is to:

1. Wait until EMS arrives to help
2. Grab a plastic bag to use to provide direct pressure
3. Do not touch the site until someone can bring you gloves
4. Check your hands for open wounds before applying direct pressure to the victim

2. Grab a plastic bag to use to provide direct pressure

When does the cellular ischemia phase of hemorrhagic shock begin?

1. When irreversible shock begins
2. When decompensated shock begins
3. Right after anaerobic metabolism begins
4. Prior to the beginning of anaerobic metabolism

3. Right after anaerobic metabolism begins

What percentage of burn injuries are considered life threatening?

1. 1-3
2. 3-5
3. 5-7
4. 7-10

2. 3-5

The pt was wearing his seatbelt in the front end collision but it was positioned too high. He now has erythema across his abdomen. He is pale, cool and clammy and you find abdominal distention. He remains responsive to painful stimuli. Which of the following would have the greatest impact on controlling the internal bleeding in the pt described above/

1. O2
2. Immobilization on a backboard
3. Initiation of a massive fluid bolus
4. Application and inflation of PASG

4. Application and inflation of PASG

Which of the following organs if injured would be the most likely to cause chemical peritonitis?

1. Liver
2. Spleen
3. Kidney
4. Pancreas

4. Pancreas

Which of the following assessment findings would be more consistent with a fx than with a sprain or dislocation?

1. Pain
2. Swelling
3. Crepitus
4. Deformity

3. Crepitus

A pt with a closed head injury who had an increased blood pressure, an increased pulse is now showing bradycardia and hypotension Which of the following best explains the reason these vital signs are changing?

1. Using a outlet to release the pressure from swelling
2. Adjusting to the head injury as the body returns to homeostasis
3. Increasing ICP is placing too much pressure on vital control areas
4. Tolerating the decreased oxygen to the tissues in the injured areas

3. Increasing ICP is placing too much pressure on vital control areas

You are treating a victim of a blast injury who is responsive to painful stimuli and has signs of hemoptysis. Lung sounds are diminished and you hear crackles in all fields. Which of the following treatments would be most appropriate?

1. Administering a diuretic to reduce pulmonary edema
2. Assist ventilations carefully and supplement with oxygen
3. Intubate and overcome poor compliance with forceful ventilations
4. Perform bilateral pleural decompressions to relieve pneumothorax

2. Assist ventilations carefully and supplement with oxygen

In rhabdomyolysis, which of the following released byproducts presents the greatest risk of damage to the kidneys?

1. Lactic acid
2. Myoglobin
3. Phosphate
4. Potassium

2. Myoglobin

Which of the following is correct regarding the treatment of liquid chemical burns?

1. Contact lenses should not be removed
2. Neutralizing agents should be used when available
3. Transport should be delayed while eyes are irrigated
4. A garden hose can be used for irrigating large chemical burn areas

4. A garden hose can be used for irrigating large chemical burn areas

Which of the following is the first-line drug for a pt with signs and symptoms of increased intracranial pressure?

1. Oxygen
2. Atropine
3. Mannitol
4. Furosemide

1. Oxygen

In most cases where significant trauma has caused injury to a pt in a motor vehicle crash, the type of packaging that is provided for transport would be:

1. Position of comfort
2. In-line spinal immobilization
3. Cervical spine immobilization
4. In a slight trendelenburg position

2. In-line spinal immobilization

How much fluid typically needs to fill the pericardial sac before significant signs and symptoms of a pericardial tamponade develop?

1. 10-20cc
2. 50-100cc
3. 100-300cc
4. 500-1000cc

3. 100-300cc

Swelling and pooling of blood within the fascia of a muscle such as the rectus femurs will most likely lead to:

1. Muscle strain
2. Muscle cramping
3. Muscle contusion
4. Compartment syndrome

4. Compartment syndrome

A pt has a 40% partial thickness burn and weighs 100kg. How much of an initial fluid bolus should you administer to the pt while applying the parkland formula?

1. 500cc
2. 2000cc
3. 5000cc
4. 8000cc

4. 8000cc

Fluid or blood loss in small children is especially signifiant because:
1. Children are smaller than adults
2. Children generally have limited blood reserves
3. A child’s heart cannot pump as hard as an adult’s
4. The child’s blood vessels cannot change size rapidly
2. Children generally have limited blood reserves

Blood vessel size is directly and indirectly controlled by the:

1. Somatic nervous system
2. Voluntary nervous system
3. Sympathetic nervous system
4. Parasympathetic nervous system

3. Sympathetic nervous system

You are called at 10am to the scene of an MVC that most likely occurred during the night. You find an unresponsive pt that has a slow, weak, thready carotid pulse. The skin is cold and mottled with no peripheral pulses. you find minimal respirations and the blood pressure is unobtainable. Your first impression is that of:

1. Compensating shock
2. Decompensated shock
3. Irreversible shock
4. Obstructive shock

3. Irreversible shock

Which of the following wold be the appropriate fluid management for a pt with uncontrolled internal hemorrhage?

1. KVO
2. 20ml/kg of NS
3. Maintaining a blood pressure of 88
4. Maintaining a blood pressure of 100

3. Maintaining a blood pressure of 88

Which of the following is secreted by the adrenal cortex in response to a decrease in circulating volume to cause an increase in water and sodium retention in the kidneys?

1. Angiotenin
2. Aldosterone
3. Glucocorticoids
4. ADH

2. Aldosterone

Which of the following assessment findings would you expect to see in a pt in compensated shock?

1. Absent radial pulses
2. Slowing respiratory rate
3. Decreasing pulse pressure
4. Decreasing LOC

3. Decreasing pulse pressure

Which of the following medications would be the least likely to increase the chances of acquiring an infection?

1. Aspirin
2. Cortisone
3. Ibuprofen
4. Prednisone

1. Aspirin

You are assessing a pt with a significant epistaxis following a traumatic blow to the head. Which of the following is most likely correct regarding this injury?

1. The injury involved the septum
2. This is likely an anterior hemorrhage
3. The Kiesselback’s plexus is likely damaged
4. The nasal cavity’s posterior wall may be compromised

4. The nasal cavity’s posterior wall may be compromised

Which of the following nasal injuries is the most likely to cause the airway to become compromised?

1. Basilar skull fx
2. Nasal bone fx
3. Vomer bone fx
4. Kisselback’s plexus damage

2. Nasal bone fx

A pt received a blow to the head, which caused him to bite off the end of his tongue. He is alert and denying any pain to his tongue. Which cranial nerve may have been damaged as a result of the head injury?

1. Facial
2. Trigeminal
3. Hypoglossal
4. Glossopharyngeal

1. Facial

You are assessing a spinal trauma pt who is unable to extend his arms or feel anything below the clavicles. Which of the following assessment findings would you expect?

1. unequal grip
2. Diminished lung sounds
3. Normal BP
4. Pale, cool, clammy skin

2. Diminished lung sounds

Which of the following the best way to stop the paradoxical movement of a flail segment on an unresponsive pt?

1. Ventilate the pt
2. Place sand bags on the flail
3. Tape a bulky dressing over the flail
4. Place the pt onto the flail segment

1. Ventilate the pt

You are called to treat a pt with bilateral femur and lower leg fx with no bones protruding. Which of the following would be the BEST method of immobilizing these fx?

1. Bilateral traction splint
2. Two padded board splints
3. Pneumatic anti-shock garment
4. Padding and tying the two legs together

3. Pneumatic anti-shock garment

Which of the following joint dislocations has the greatest potential for causing a reduction in distal circulation?

1. Hip dislocation
2. Knee dislocation
3. Patellar dislocation
4. Shoulder dislocation

2. Knee dislocation

You are trying to determine how deep a burn is on a pt’s foot that was exposed to fire when he stumbled into a fire. There is no light other than that from the campfire. You are trying to determine the extent of third degree burns. what method?

1. Move the pt closer to the fire so that you can examine the foot
2. Wrap the foot loosely in a sterile dressing skip extent assessment and transport
3. Move the pt away from the fire and explore the injury site with your gloved hand looking for areas that are pain free
4. Move the pt away from the fire using the reduced light as best you can while looking for black areas and asking about the location of pain

2. Wrap the foot loosely in a sterile dressing skip extent assessment and transport

You are assessing a pt who suddenly complains of neck pain and numbness after turning his head. Which of the following medical condition is most likely present?

1. Osteoporosis
2. Herniated disk
3. Vertebral spondylolysis
4. degenerative disk disease

3. Vertebral spondylolysis

You have a 30yo female who was the driver of a vehicle that was hit in the driver’s side door. She is unresponsive and her trachea is midline, neck veins are flat, lung sounds are absent on the left side and percussion reveals hyporesonance, and she has a rapid carotid pulse and absent radial pulses. She is not demonstrating any paradoxical breathing, though she appears to have some broken ribs on the left side. Her abdomen is flat and non-tender. Which of the following treatments would be most appropriate for the pt described above?

1. 1 large-bore IV at TKO
2. Decompression of the left chest
3. Decompression of the right chest
4. Two large-bore IV wide open

4. Two large-bore IV wide open

Which of the following types of injuries accounts for the largest percentage of motor vehicle fatalities?

1. Head
2. Extremity fx
3. Chest/abdomen/pelvis
4. Spinal and chest fx

1. Head

An example of uncontrollable hemorrhage would be:

1. Lacerated brachia artery
2. Lacerated femoral vein
3. Lacerated jugular vein
4. Lacerated portal vein

4. Lacerated portal vein

In a burn injury, where would you expect the greatest damage to occur to localized tissue?

1. Zone of stasis
2. Zone of hyperemia
3. Zone of coagulation
4. Zone of denaturation

3. Zone of coagulation

You are assessing a pt who received a penetrating injury to the neck. The pt is tachy, and complaining of severe GI discomfort. Which of the following structures of the neck was most likely damaged?

1. Vagus nerve
2. Carotid sinus
3. Thyroid gland
4. Glossopharyngeal nerve

1. Vagus nerve

Which of the following plays the primary processing role within the spinal cord with regard to the reflex system?

1. Gray matter
2. White matter
3. Ascending tracts
4. Descending tracts

1. Gray matter

What is the most appropriate action for this trauma pt who received a chest injury from a blunt object? He now has dyspnea, diminished breath sounds on the right, hemoptysis, crackles in the right chest, and a respiratory rate of 30. Oxygen sat is 86%, jugular veins are normal, pulse is 110 and weak.

1. Fluid resuscitation
2. Administration of furosemide
3. Rapid transport to a trauma center
4. Pleural decompression of the right chest

3. Rapid transport to a trauma center

During your assessment of a thoracic trauma pt, you failed to adequately assess lung sounds. Which of the following differential field diagnoses would be most negatively impacted by this action?

1. Tension pneumothorax vs a hemothorax
2. Myocardial contusion vs an aortic aneurysm
3. Myocardial contution vs a pulmonary contusion
4. Tension pneumothorax vs a pericardial tamponade

4. Tension pneumothorax vs a pericardial tamponade

You rapidly removed a pt from the scene prior to performing an adequate scene survey to determine mechanism of injury. Which of the following conditions would you most likely misdiagnose as a result of this action?

1. Hemothorax
2. Pneumothorax
3. Myocardial contusion
4. Pericardial tamponade

3. Myocardial contusion

A pt has fallen a significant distance and landed on his feet causing his heel bones to fx. Which other injury is most likely a result of this fall?

1. Pelvic fx
2. Lumbar fx
3. Bilateral femur fx
4. Bilateral tibia/fibula fx

2. Lumbar fx

You are called to assess and tx a pt who has suffered a deep, penetrating wound to the central chest and is complaining of difficult and painful swallowing, pleuritic chest pain, and pain radiating to the mid back. Which of the following tx options would be contraindicated for this pt?

1. Intubation
2. Combitube
3. Fluid resuscitation
4. Positive pressure ventilation

2. Combitube

You have a pt with a weak carotid pulse and an absent femoral and radial pulse. Which organ/organs can you suspect is/are still being perfused?

1. Brain
2. Heart
3. Heart and brain
4. Heart, brain, and kidneys

4. Heart, brain, and kidneys

During pre hospital care of a pt with hemorrhagic shock, the goal of the treatment and transport should be to:

1. Return circulating blood volume levels as soon as possible
2. Replace lost fluid with intravenous crystalloids
3. Maintain circulating oxygen
4. Prevent hypothermia

1. Return circulating blood volume levels as soon as possible

Which of the following would you expect to see in a pt in decompensated shock?

1. Mild anxiety
2. Weak central pulses
3. Decreasing heart rate
4. Increasing respirations

2. Weak central pulses

You are called to an industrial site where a worker has been trapped by a stamping machine for 10 min. His left thigh is grossly enlarged and very painful and he has a laceration on his right forearm. His right leg is trapped in the machine and his right foot has been amputated. He is alert and oriented and the mechanics are preparing to release the pt from the machine. Which of the following is your highest priority in treating this pt once he is freed?

1. Controlling bleeding in the right leg
2. Immovilizing the left leg and applying ice packs to the thigh
3. Initiating two large bore IVs and administering fluid and sodium bicarb
4. Placing the right foot in a sealed bag and placing he bag in ice water

1. Controlling bleeding in the right leg

Upon your arrival at an industrial site, a pt climbs into the back of your ambulance. Then pt states he accidentally got a chemical sprayed in his eye. This type of chemical requires a minimum of 10 for rinsing. Which of the following actions should you take?

1. Take the pt into the work site where there is an eyewash station
2. Lay the pt on the affected eye side and pour sterile water over the eye
3. Place the pt on the stretcher and cover both eyes before transport
4. Lay the pt on the unaffected eye side and pour sterile water over the eye

1. Take the pt into the work site where there is an eyewash station

Which of the following most accurately reflects the mortality from a gunshot wound that penetrates the cranium

1. 70-79
2. 80-89
3. 90-95
4. 96-100

3. 90-95

Which type of breathing would you expect to see in a pt with a moderate elevation in ICP?

1. Ataxic
2. Agonal
3. Cheyne-Stokes
4. Central nervous system hyperventilation

4. Central nervous system hyperventilation

You are transporting a trauma pt to the hospital. The pt was involved in a head on MVC when the pt’s car was hit by a large heavy truck. The pt was thought to be unresponsive due to a head injury. His BP has gone from 128/88 to 96/42 and the pulse is slowing. You are concerned that this pt may also have:

1. Chest injury
2. Pelvic fx
3. Abdominal injury
4. Spinal cord injury

4. Spinal cord injury

Pericardial tamponade would most likely occur from which of the following mechanisms of injury?

1. High energy penetrating injury
2. Low-energy penetrating injury
3. Shotgun type 1
4. Blast trauma

2. Low-energy penetrating injury

What is the term used to describe a decrease in JVD upon inspiration for a pt suffering from a pericardial tamponade?

1. Beck’s triad
2. Kussmaul’s sign
3. Pulsus paradoxus
4. Electrical alternans

2. Kussmaul’s sign

You have a conscious pt who has received a penetrating injury resulting in the laceration of the inferior vena cava. Which of the following S/Sx would you most likely expect to see

1. Gray’s turner
2. Abdominal distension
3. Bilateral shoulder pain
4. Periumbilical ecchymosis

3. Bilateral shoulder pain

You have a pt with a developing hemothorax, possible spinal fx., and bilateral femur fx. Which of the following would be the best splinting device to use of the legs

1. bilateral traction splint
2. Securing the legs to the backboard and pad
3. Immobilizing the femurs with four padded board splines
4. PASG

2. Securing the legs to the backboard and pad

Which of the following would be the most expected assessment finding with a dislocated joint?

1. Swelling
2. Crepitus
3. Fixed in place
4. Absent distal pulses

3. Fixed in place

Which of the following would be a more common finding in a dislocation that in a closed mid shaft, long bone fx

1. pain
2. swelling
3. deformity
4. absence of distal pulses

4. absence of distal pulses

Your pt has received an injury to the posterior ankle resulting in a laceration of the calcanea tendon. Which of the following assessment findings would be expected?

1. Abnormal eversion of the foot
2. Abnormal inversion of the foot
3. Abnormal dorsiflexion of the foot
4. Abnormal plantar flexion of the foot

3. Abnormal dorsiflexion of the foot

Which of the following assessment findings would you most likely expect to observe in a pt with a ruptured urinary bladder

1. Urinary incontinence
2. Firm distended abdomen
3. Rigid, board-like abdomen
4. Blood in the urethra

4. Blood in the urethra

Which of the following signs would you most likely see with this pt? The pt has had an external bleeding rate of 300ml/min for 5min.

1. Decreased bp
2. Decreasing respiratory rate
3. Decreasing vasoconstriction
4. Increasing respiratory volume

1. Decreased bp

You are called to the scene of a pt who was thrown from a vehicle and on approach you see he has a severely lacerated left arm with moderate venous bleeding. Which of the following is your greatest consideration regarding this situation?

1. Controlling the bleeding to prevent hemorrhagic shock
2. Performing an immediate assessment to identify any life threats
3. Obtaining a medical hx to determine if hemophilia will be an issue
4. Assessing the arm distal to the injury for pulse, motor, and sensory function

2. Performing an immediate assessment to identify any life threats

Which of the following describes the appropriate care for a dislodged tooth?

1. Wrap the tooth in a dry, sterile dressing
2. Rinse the tooth and wrap in a sterile, saline soaked gauze
3. Place the tooth in the sharps container, as they cannot be reattached
4. Wrap the tooth in a dry, sterile dressing, seal in a bag, and place in ice water

2. Rinse the tooth and wrap in a sterile, saline soaked gauze

Lifelong care of a victim of permanent spinal cord injury may exceed:

1. $100K
2. $500K
3. $1M
4. $100m

3. $1M

During assessment of a trauma pt, you find a stab wound just left of the sternum. The wound is not bubbling, lung sounds are clear and equal, neck veins are distended, and trachea is midline. For the pt described, which of the following should you do first?

1. Decompress the left chest
2. Initiate two large bore IVs
3. Administer high-concentration O2
4. Seal the chest injury with an occlusive dressing

3. Administer high-concentration O2

Which of the following organs or structures, when struck with a high velocity penetrating object is the least likely to suffer extensive damage?

1. Lungs
2. solid organs
3. Hollow organs
4. Pelvis

3. Hollow organs

You are assessing spinal trauma pt who is unable to extend his arms or feel anything below the clavicles. Where would you anticipate his spinal cord injury is located?

1. C3
2. C5
3. T2
4. T4

1. C3

The serous layer of tissue that surrounds the abdominal organs is known as the:

1. Parietal layer
2. Pleural layer
3. Periosteal layer
4. Peritoneal layer

4. Peritoneal layer

You have a pt who was struck on the left side of the abdomen. He is complaining of abdominal pain and left shoulder pain and is showing signs of hypoperfusion. Which of the following has most likely been injured?

1. Liver
2. Spleen
3. Small intestine
4. Descending colon

2. Spleen

You have a 27yo female pt who was struck in the abdomen earlier in the day and is now complaining of hematuria and significant abdominal pain. Which of the following organs has most likely been damage?

1. Ovary
2. Uterus
3. Kidney
4. Gall bladder

3. Kidney

Which of the following may affect your ability to accurately evaluate a spinal cord injury? Your pt has:

1. Just eaten a meal
2. Long bone injuries
3. Recently ingested aspirin
4. Frequent motor vehicle crashes

2. Long bone injuries

For which of the following would the application of PASG have the greatest potential benefit with the least risk of complication from the PASG?

1. Septic shock
2. Ruptured AAA
3. Bilateral femur fx
4. Hypotension due to pelvic fx

3. Bilateral femur fx

Metaproterenol is the generic name for which brand name drug?

1. Alupent
2. Breathine
3. Proventil
4. Ventolin

1. Alupent

Which of the following is currently accepted as the maximum life span for a human being?

1. 90yrs
2. 100yrs
3. 110yrs
4. 120yrs

4. 120yrs

The body is experiencing an inflammatory response. What part of the plasma protein system is responsible for the production of a substance that works with prostaglandins to cause pain?

1. Antibodies
2. The kinin system
3. The coagulation system
4. The complement system

4. The complement system

Which of the following would be considered a hypotonic solution?

1. 0.9 NaCL
2. Colloids
3. D5W
4. LR

3. D5W

Which of the following would be the primary determining factor as to the degree to which stress will cause or affect the pt’s response to an illness?

1. The type of stressor
2. The severity of the stressor
3. The duration of the stressor
4. The pt’s perception of the stressor

4. The pt’s perception of the stressor

Which of the following is the principle motivation for systems to formulate a plan to take some pts to freestanding outpatient center or clinics vs. to the emergency department of hospitals?

1. To improve transport times for EMS providers
2. To allow for specialized treatment of these patients
3. To reduce the cost of services provided to the community
4. To improve reimbursement for EMS providers by insurance companies

3. To reduce the cost of services provided to the community

Labetalol lowers blood pressure by what mechanisms?

1. Slowing HR by blocking beta 1 receptors
2. Lowering peripheral resistance by stimulating alpha 1 receptors
3. Non-selective blockade of beta receptors and limited blockade of alpha 2 receptors
4. Selective blockade of beta 2 receptors and nonselective stimulation of alpha receptors

1. Slowing HR by blocking beta 1 receptors

Regarding illness and injury prevention programs, which of the following best describes how our focus on our own personal safety benefits the entire community?

1. An injured EMS provider is nearly always a preventable injury
2. If exposed to a communicable illness, the provider could become a carrier
3. Injury and illness of EMS providers negatively impacts recruitment and retention
4. If one of our own becomes injured at the scene, pt car is negatively impacted

2. If exposed to a communicable illness, the provider could become a carrier

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

1. Pharmacology knowledge is limited to drugs within the local protocol
2. Knowing characteristics of a broad range of drugs outside of those that you provide
3. Pharmacology knowledge should be very extensive for any drugs available in the local healthcare system
4. Knowing contraindications and precautions only for the drugs that you carry and provide within your EMS system

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

Which of the following represent the principle source of hydration intake for the body?

1. Food
2. Water
3. Cellular metabolism
4. Water vapor from breathing

2. Water

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

1. Cardiogenic shock
2. Neurogenic
3. Septic shock
4. Spinal shock

1. Cardiogenic shock

Which of the following would demonstrate an appropriate professional behavior upon entering the home of a traditional japans family?

1. Taking your shoes off
2. Using the pt’s first name
3. Maintaining a confident and arrogant stance
4. Shaking the pt’s left hand with you left hand

1. Taking your shoes off

Which of the following describes the Moro reflex?

1. Throwing the arms wide and spreading the fingers when startled
2. The response by an infant when its cheek is touched
3. An infant turning his head in response to food
4. Palm grasping when a finger is placed there

1. Throwing the arms wide and spreading the fingers when startled

Multiple organ dysfunction syndrome is most often caused by :

1. Septic shock
2. Acute pancreatitis
3. Hypovolemic shock
4. Malnutrition and diabetes

1. Septic shock

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

1. Oral
2. Rectal
3. Buccal
4. Subcutaneous

1. Oral

In the extracellular fluid, the principle cation is:

1. Sodium
2. Calcium
3. Potassium
4. magnesium

1. Sodium

Which of the following is the most appropriate position to interview a pt under normal circumstances

1. Remaining at eye level 4ft away arms closed
2. Remaining at eye level about 1.5 ft away, with arms open
3. Dropping below eye level, about 12 ft away
4. Standing above eye level about 1.5ft

2. Remaining at eye level about 1.5 ft away, with arms open

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

1. 15gtts
2. 40gtts
3. 56gtts
4. 80gtts

2. 40gtts

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

1. Dextrose in cases of hypoglycemia
2. Epi in cases of cardiac arrest
3. Amiodarone
4. Dopamine in cases of cariogenic shock

1. Dextrose in cases of hypoglycemia

Which of the following plans will reduce the chances of serious injury of an employee?

1. Install video survelliance equipment
2. Implement a driver’s safety program
3. Establish stricter discipline procedures
4. Train all employees in first aid techniques

2. Implement a driver’s safety program

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

1. Adenosine
2. Atropine
3. Dobutamine
4. Epinephrine

4. Epinephrine

Which of the following factors that persecutees disease in the human body deal with the relative number of hydrogen ions?

1. Hypoxia
2. Hydration
3. Acid base balance
4. Electrolye imbalance

3. Acid base balance

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

1. Elixer
2. Syrup
3. Emulsion
4. Suspension

1. Elixer

Which of the following primary sources of law in the US is also referred to as case law

1. Common law
2. Legislative law
3. Constitutional law
4. Administrative law

1. Common law

What is the proper application of Betadine, in order for it to work?

1. Should be allowed to dry
2. Should be applied with vigor
3. Should be removed with alcohol
4. Should be applied after alcohol

1. Should be allowed to dry

Which anti arrhythmic must be given rapid IV push due to short half life?

1. Adenosine
2. Amiodarone
3. Phenytoin
4. Procainamide

1. Adenosine

Which phase of research involves the testing of a medication on a limited population of pt who have the disease it is intended to treat in order to find therapeutic drug levels and watch for toxic and side effects?

1. Phase 1
2. Phase 2
3. Phase 3
4. Phase 4

2. Phase 2

Which of the following would be the best description of homeostasis

1. The ability of the body to adapt to varying environments
2. The ability of the body to maintain a normal blood pressure
3. The tendency of the body to maintain a net constant composition
4. A decrease in bodily function due to a loss of circulating blood volume

3. The tendency of the body to maintain a net constant composition

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

1. Ulnar
2. Dorsal
3. Radial
4. Dorsal venous arch

1. Ulnar

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

1. Safer it is
2. Better it works
3. More dangerous it is
4. Larger the dose needed to make it work

1. Safer it is

The rules or standards that govern the conduct of members of a particular profession is the definition of:

1. Ethics
2. Morals
3. Duty to Act
4. Standard of Care

1. Ethics

Which of the following are primarily responsible for the activation of the inflammatory response?

1. Mast cells
2. Leukocytes
3. Lymphocytes
4. Thrombocytes

1. Mast cells

Why is nitro given sublingually instead of orally?

1. The acid in the stomach deactivates the drug
2. It would be deactivated by first-pass metabolism
3. It can cause significant stomach an intestinal discomfort
4. It is not absorbed through GI tissue and would be excreted

2. It would be deactivated by first-pass metabolism

During your initial assessment, you discover your pt is bleeding from an obvious stab wound. which of the following statement is true regarding proper care?

1. You should apply an airtight dressing to all wounds that result from stabbing
2. Dressings should be used to cover sterile bandages when attempting to control bleeding
3. Bleeding control techniques should be started during the scene size up while you form a general impression
4. OSHA recommends you take strict body substance isolation precision when dressing an open wound

4. OSHA recommends you take strict body substance isolation precision when dressing an open wound

If a pt is breathing rapidly and deeply, this is most likely an attempt to correct which of the following?

1. Metabolic acidosis
2. Metabolic alkalosis
3. Respiratory acidosis
4. Respiratory alkalosis

1. Metabolic acidosis

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

1. Inhalation
2. Intravenous
3. Intramuscular
4. Subcutaneous

4. Subcutaneous

Which of the following is true regarding the primary negative effects of aging on the immune response?

1. B-cell function decreases due to a decrease in bone mass
2. B-cell function decreases due to a decrease in thymus size
3. T-cell function decreases due to a decrease in bone size
4. T-cell function decreases due to a decrease in thymus size

4. T-cell function decreases due to a decrease in thymus size

Steroid metabolism and drug detoxification occurs in what part of the cell?

1. Cytoplasm
2. Nucleolus
3. Mitochondria
4. Smooth ER

1. Cytoplasm

Which of the following is an appropriate initial dose of succinylcholine for a 168lb pt undergoing a drug facilitated intubation procedure?

1. 115mcg
2. 168mcg
3. 115mg
4. 168mg

3. 115mg

What will the renal response be to a metabolic acidosis?

1. Retention of bicarbonate
2. Retention of carbonic acid
3. Elimination of bicarbonate
4. Elimination of carbonic acid

1. Retention of bicarbonate

There are epidemiological factor and clinical factors, when discussing disease risk factors. An epidemiological factor would be:

1. Host
2. Agent
3. Prevalence
4. Environment

3. Prevalence

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

1. Dopamine cannot cross the blood brain barrier
2. It must be administered as a controlled IV drip
3. Lowering the acetylcholine level is the only effective treatment
4. Use of dopamine by the Advanced EMT may cause bradycardia or hypotension

1. Dopamine cannot cross the blood brain barrier

Acute extrapyramidal symptoms from cholinergic blockade in the basal ganglia of the cerebral hemispheres, is a common side effect of haloperidol. This is typically treated with which of the following drugs?

1. Atropine
2. Diphenhydramine
3. Dopamine
4. Seratonin

2. Diphenhydramine

Which of the following ages would exceed the expected age for a toddler to complete toilet training?

1. 12 mos
2. 24 mos
3. 30 mos
4. 36 mos

4. 36 mos

What is the medical term used to represent fluid that is located outside of the blood vessels and also outside of the cells?

1. Interstitial fluid
2. Intracellular fluid
3. Extracellular fluid
4. Intravascular fluid

1. Interstitial fluid

Phenobarbital Sodium IVP 200 mg/ml is most commonly used to treat which one of the following disorders?

1. Anxiety
2. Status epilepticus
3. Pediatric absence seizures
4. Prophylaxis in epilepsy patients

2. Status epilepticus

Pralidoxime is administered to a victim for what type of poisoning?

1. Chlorine
2. Cyanide gas
3. Mustard gas
4. Sarin

4. Sarin

Which type of research focuses on the current state of affairs in a particular area rather than trying to change anything or discover new interventions?

1. Cohort studies
2. Descriptive studies
3. Intervention studies
4. Case-controlled studies

2. Descriptive studies

Diazepam, USP is utilizing what name form?

1. Brand name
2. Chemical name
3. Generic name
4. Official name

4. Official name

What type of shock would profound hypoglycemia cause?

1. Hypovolemic
2. Neurogenic
3. Obstructive
4. Psychogenic

2. Neurogenic

A partner with more experience suggests that your knowledge of prehospital therapy is weak because of a lack of experience. Choose the process you should follow if you believe his statement to be accurate:

1. Ask your manager to evaluate your abilities an map out ideas for improvement
2. Ask for a leave of absence so that you may return for additional initial education
3. Begin working more shift per pay period to increase your real-life experience
4. Schedule yourself immediately for continuing education sessions in the area

4. Schedule yourself immediately for continuing education sessions in the area

A suicidal overdose pt is threatening to take additional medication if given the chance. The pt vital signs are stable an there is no obvious injury on exam. What should you as a rescuer do next?

1. Have the pt arrested for attempting suicide
2. Quietly ask your partner to prepare the restraint devices
3. Ask the pt to stop saying she is going to overdose on more medication
4. Contact the pt psychologist and ask for additional hx on the pt

2. Quietly ask your partner to prepare the restraint devices

Which antidepressant drug would you expect to have the lowest occurrence of severe side effects?

1. SSRI
2. MAOI
3. TCA
4. PTZ

1. SSRI

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

1. Dram
2. Minim
3. Ounce
4. Teaspoon

2. Minim

Select the statement that most accurately describes the registration process for EMS providers.

1. Registration is a process that grants licenses to providers to work within a state
2. Registration is the activity of entering one’s name into an official book of record
3. Registration is the path a provider follows to be granted permission to practice nationally
4. Registration permits the federal government to track continuing education credits for professionals

2. Registration is the activity of entering one’s name into an official book of record

Which of the following is a systemic aspect of the acute inflammatory response?

1. Exudation
2. Leukocytosis
3. Toxin dilution
4. Vascular changes

2. Leukocytosis

An infection can develop when a fetus or newborn has low levels of immunoglobulin. When is this state most likely to occur?

1. In the last trimester in utero
2. From birth to three months
3. From five months to six months
4. From eight months to twelve months

3. From five months to six months

Responsibilities of an EMS rescuer are most likely to include which of the following?

1. Performing regular vehicle maintenance
2. Assisting with disaster management planning
3. Delivering a medication to an elderly shut-in
4. Fundraising for local political events for candidates

2. Assisting with disaster management planning

You have just completed the transport and delivery of a 6yo pt you suspect sustained the injuries as a result of child abuse. Your partner disagrees with your assessment. What should you do?

1. Notify the hospital staff of your suspicions and have them investigate further
2. Notify local law enforcement of child protective services of your suspicions
3. Since you and your partner disagree, inform a superior and have him or her decide
4. Document your suspicious on the pt care report and explain that you r partner disagreed

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

A written or verbal prescription from a physician is required for a pharmacist to provide a medication. This mandate comes from which Federal legislation?

1. The Pure Food and Drug Act of 1906]
2. The Harrison Narcotic Act of 1914
3. The Durham-Humphrey Amendments of 1951
4. The Federal Food, Drug, and cosmetic Act of 1938

3. The Durham-Humphrey Amendments of 1951

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

1. Altering a normal metabolic pathway
2. Having the drug bind to a receptor site
3. Changing the physical properties of cells
4. Chemically combining with other chemicals

4. Chemically combining with other chemicals

Which of the following would be an appropriate type of response to a pt’s statement that he “placed his hand in the auger”?

1. Advice
2. Silence
3. Avoidance
4. Asking why

2. Silence

he mechanism of action for vecuronium differs from succinylchoine in which principal way?

1. Vecuronium binds to the nicotinic receptor and causes depolarization
2. Vecuronium binds to the muscarinic receptor and causes depolarization
3. Vecuronium binds to the nicotinic receptor without causing depolarization
4. Vecuronium binds to the muscarinic recpetor without causing depolarization

3. Vecuronium binds to the nicotinic receptor without causing depolarization

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

1. Diltiazem
2. Esmolol
3. Magnesium Sulfate
4. Propanolol

2. Esmolol

Vasopressin would like be administered to a pt suffering from which disorder?

1. Cushing’s disease
2. Diabetes mellitus
3. Hyperthyroidism
4. Nocturnal enuresis

4. Nocturnal enuresis

The most practical way to prevent cross contamination of pt would be to:

1. Use disposable equipment whenever possible
2. Never transport patients you suspect are contagious
3. Assure that linen is thrown away when soiled with blood
4. Wear gloves whenever you make any pt contact

1. Use disposable equipment whenever possible

During an inflammatory response, which of the following is first in the sequence of events of the cellular components?

1. Diapedesis
2. Vascular dilation
3. Increased permeability
4. Exudation of white cells

2. Vascular dilation

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

1. A new combination
2. Treatment potential
3. Chemical classification
4. A new molecular drug

2. Treatment potential

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

1. An antagonist
2. AN agonist-antagonist
3. A competitive antagonist
4. A noncompetitive antagonist

4. A noncompetitive antagonist

A victim of a motorcycle accident is found thrown 30ft from the site of the impact. The pt is unresponsive with a pulse of 42, systolic pressure of 84, and respirations of 12. What type of shock is this pt most likely experiencing?

1. Hypovolemic
2. Neurogenic
3. Obstructive
4. Septic

2. Neurogenic

During which age classification does peer pressure begin to shape the child’s belief structure?

1. Adolescent
2. Preschool
3. School age
4. Infant

2. Preschool

Nalmefene is used primarily for which clinical disorder?

1. Chronic pain control
2. Arthritic inflammtion
3. Treatment of opiate OD
4. Management of alcohol dependence

4. Management of alcohol dependence

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

1. Lowered BGL
2. Stridor
3. Tinnitus
4. Seizures

4. Seizures

Which drug may be administered by a paramedic to a victim of a known tricyclic antidepressant OD?

1. Atropine
2. Diphenhydramine HCL
3. Naloxone
4. Sodium Bicarb

4. Sodium Bicarb

An acetaminophen overdose can result in which of the described conditions?

1. Neuralgia
2. Anaphylaxis
3. Hepatic necrosis
4. Respiratory depression

3. Hepatic necrosis

Which one of the listed drugs would be most accurately classified as a synthetic sympathetic agonist?

1. Atropine
2. Dobutamine
3. Furosemide
4. Levophed

2. Dobutamine

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

1. The pt starts complaining of a yellow halo ring around bright lights
2. The systolic bp is 102/60 with a hr of 102/min
3. You have reached the maximum loading dose of 17mg/kg
4. The QRS width is now 0.08 seconds, and it was 0.16 seconds

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

From the statements below, what are the primary factors that influence the heat stress on the hazardous material team member?

1. Exertion and dehydration
2. Temperature and humidity
3. Type of suit and hazardous material
4. Physical fitness and scene terrain

2. Temperature and humidity

The qualification of hazmat Operations Level prepares the responder to enter what zone?

1. Hot zone
2. Warm zone
3. Cool zone
4. Cold zone

2. Warm zone

You have a chemical leaking at a hazardous materials incident that has a high flash point, high ignition temperature, and extremely low vapor density. The chemical has high water solubility and low lethal concentration. Which of the following is at the greatest risk?

1. The unresponsive worker on top of the tank
2. The unresponsive worker in a ditch near the tank
3. The unprotected EMS worker upwind from the incident
4. The fully protected fire fighter spraying the tank down with water

1. The unresponsive worker on top of the tank

A pt is moved up or down an incline in a low angle rescue situation by:

1. Using a litter belay device to lift the litter up the incline
2. Securing the team to a harness and having the team carry the litter
3. Sliding the litter up or down the incline using a simple hauling system
4. Rigging a simple hauling system to assist the litter team in moving the litter

4. Rigging a simple hauling system to assist the litter team in moving the litter

You have an unresponsive pt who is trapped in a vehicle on an incline. There is a significant risk of the vehicle tipping over or sliding further down the incline. How should you proceed?

1. Have the vehicle secured with a rope or a come-along
2. Have a jack placed on the downhill side of the vehicle
3. Have a winch attached to the vehicle and pull it up
4. Have the vehicle stabilized with step chocks

1. Have the vehicle secured with a rope or a come-along

You have an adult pt who is fully immersed in water that is 35 degrees Fahrenheit. What time period of submersion will most likely result in death?

1. 5-10 min
2. 10-15 min
3. 15-20 min
4. 20-30 min

3. 15-20 min

Which of the following methods would be most appropriate to utilize when assessing an emotionally disturbed pt?

1. Contact and cover
2. Assess and retreat
3. Cover and conceal
4. Distract and evade

1. Contact and cover

Your pt was immersed in a chemical that is mildly corrosive. A hazardous material specialist has begun washing the victim. From the list below, which statement is most accurate?

1. Decontamination process has probably been underway for several minutes
2. The decontamination phases just now begun and will likely take several hours
3. There is no risk of the pt becoming critically ill during the rest of the process
4. EMS plays a significant role during this phase of decontamination in most response systems

1. Decontamination process has probably been underway for several minutes

Which of the following should be used to decontaminate a pt that has been exposed to a material that is mildly acidic

1. Dilution
2. Absorption
3. Vegetable oil
4. Neutralization

1. Dilution

Your non-critically injured pt is located at the scene of a hazardous materials incident. Other than the treatment of decontamination, where does assessment and stabilization treatment typically begin?

1. Hot zone
2. Warm zone
3. Cool zone
4. Cold zone

4. Cold zone

You are present at the scene involving a hazardous materials field decontamination. Which of the following describes the greatest limitation

1. Risk of injury to the rescuer
2. Complete decontamination is not probable
3. Choosing the proper method of decontamination
4. Embarrassment of the pt to being undressed

2. Complete decontamination is not probable

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

1. Turn the ignition switch to accessory
2. Cut the cable to the car battery
3. Disconnect the battery cable and maintain a safe distance for 3-5 minutes
4. Cut the batter cables, raise the steering wheel, and move the seat back

3. Disconnect the battery cable and maintain a safe distance for 3-5 minutes

Which of the following would best fit the definition of disaster management?

1. Management of incidents involving a large number of pt
2. Management of incidents that overwhelm resources and damage system infrastructure
3. Management of incidents where there are more patients than responding vehicles available
4. Management of incidents involving natural issues such as tornadoes, hurricanes, and floods

2. Management of incidents that overwhelm resources and damage system infrastructure

You have an incident where you have very limited access to the pt trapped in a vehicle. Which of the following assessments should occur regardless of how trapped the pt is?

1. Rapid trauma survey
2. Primary assessment
3. Detailed exam
4. Focused exam

2. Primary assessment

While attempting to identify a hazardous material at a fixed facility, which of the following is most likely to be used?

1. Placards
2. Shipping papers
3. NFPA 704
4. Emergency response guidebook

3. NFPA 704

You prepare to decontaminate a pt that is covered with a dry sodium powder. After brushing the powder off, which of the following would you choose next?

1. Water
2. Vegetable oil
3. Isopropyl alcohol
4. Tincture of green soap

2. Vegetable oil

A terrorist event has exposed many victims to radiation. You are responsible to triage about 20 ppl in one of the train cars where a dirty bomb exploded that was underneath the train car. There is minimal damage to the train car. What would you expect to find with these victims?

1. Burn and soft tissue injuries
2. Most will have inhalation injuries
3. Most will have injuries like any bomb blast
4. Many may have no injuries now but have effects later

4. Many may have no injuries now but have effects later

The statements “go on” and “I’m listening” are used when gathering a hx from a pt. These statements utilize which of the following communications techniques?

1. Clarificatin
2. Empathy
3. Facilitation
4. Reflection

3. Facilitation

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

1. Syphilis
2. Gonorrhea
3. Candidiasis
4. Gardenella

3. Candidiasis

You would perform a modified secondary assessment (focused exam) over a rapid secondary assessment (rapid trauma exam) on a pt because:

1. Your general impression is poor and there is a significant mechanism
2. Your general impression is stable, but there is a significant mechanism
3. Your general impression is poor, but there is no significant mechanism
4. Your general impression is stable and there is no significant mechanism

4. Your general impression is stable and there is no significant mechanism

Which of the following assessment findings of the nose is most closely associated with cocaine abuse?

1. Erosion
2. Rhinitis
3. Epistaxis
4. Obstruction

1. Erosion

Rescuers are assessing a gunshot victim and the suspect has multiple wounds. He is shouting, “my leg, my leg is killing me” as they are checking his head, neck, and chest. What is the best response the rescuers should offer?

1. “We need to check you from your head to your toes so we do not miss anything”
2. “We are worried you could have a more critical injury than your leg”
3. “Please hold still and stop yelling, we have to check you out this way”
4. They should ignore his yelling and continue their assessment

2. “We are worried you could have a more critical injury than your leg”

Which of the following is the principle purpose of performing a physical exam in the out-of-hospital setting?

1. To gain confidence from the pt
2. To investigate areas you suspect are involved
3. To perform a complete and thorough assessment
4. To be able to document for reporting requirements

2. To investigate areas you suspect are involved

A basilar skull fx might be indicated by:

1. Periorbital ecchymosis
2. An indentation in the occipital skull
3. Sluggish pupils
4. Asymmetrical smile

1. Periorbital ecchymosis

Which of the following is the latest sign of hypoperfusion to become apparent?

1. Diaphoresis
2. Rapid pulse
3. Altered mental status
4. Decreased blood pressure

3. Altered mental status

While auscultating the abdomen, you hear borborygmi. Which of the following best explains this assessment finding?

1. Peritonitis
2. Paralytic ileus
3. Hyperperistalsis
4. Peritoneal inflammation

3. Hyperperistalsis

In a pt with Parkinson’s disease, there is an increase in muscle tone and muscle resistance during movement. This is known as:

1. Spasticity
2. Flaccidity
3. Rigidity
4. Paratonia

3. Rigidity

The presence of JVD is found by easily observed jugular veins when the pt is:

1. In a supine position
2. Sitting straight upright
3. Sitting at a 45-degree angle
4. In a slight head-down, legs elevated position

3. Sitting at a 45-degree angle

During the medical exam of a pt complaining of dizziness and nausea, the rescuer may modify his assessment slightly. Which of the following will MOST likely be omitted during this particular pt assessment?

1. Circulatory assessment
2. Palpation of the skull
3. Pupil response to light
4. Auscultation of lung sounds

2. Palpation of the skull

Which of the following age groups has a normal respiratory rate of 22-34?

1. Less than 1 yr.
2. 1-2 yrs.
3. 3-5yrs
4. 6-12 yrs.

3. 3-5yrs

An EMS provider is documenting details of a cardiac arrest on a computer charting system. What data will most likely be added as a supplement beyond the computer-generated report?

1. Use of popular illegal street drugs
2. Details of suspected neglect of a child
3. Specific vital signs and interpretation of ECGs
4. Information found during a physical examination

2. Details of suspected neglect of a child

You are called to the scene of an elderly female complaining of nausea and vomiting for the past two hours. Her vital signs are within normal limits and her only medication is insulin. When applying the critical thinking process, which of the following should you suspect?

1. She is becoming dehydrated
2. She has a GI flu
3. She is having an MI
4. Her BGL is not within normal limits

3. She is having an MI

Which of the following pt would best be classified as having a potentially life-threatening injury vs. the other two pt acuity classifications?

1. An unresponsive, multi-system trauma pt
2. A pt with an isolated closed femur fx
3. A pt with a diabetic hx having chest pain
4. A pt with a puncture would of the foot caused by a nail

3. A pt with a diabetic hx having chest pain

Where should you place your hands when assessing the posterior chest for equal expansion?

1. Parallel to the fifth rib
2. Parallel to the seventh rib
3. Parallel to the tenth rib
4. Parallel to the twelfth rib

3. Parallel to the tenth rib

Which of the following techniques should be used to assess the heart’s point of maximal impulse when it is unpalpable?

1. Percussion
2. Observation
3. Auscultation
4. ECG monitoring

3. Auscultation

Which of the following is the most important reason to demonstrate empathy when obtaining a medical history?

1. It shows professionalism
2. It demonstrates the standard of care
3. It encourages the pt to share more
4. It reflects a caring and compassionate approach

3. It encourages the pt to share more

Which of the following should be performed immediately after your scene size-up?

1. An initial pt assessment
2. A focused pt assessment
3. Identifying the location of all pts.
4. Determinating the mechanism of injury

1. An initial pt assessment

Upon assessment of the abdomen, you observe the presence of ascites. Which of the following would best explain this assessment finding?

1. Abdominal bleeding
2. Peritoneal inflammation
3. Right heart failure
4. Abdominal aortic aneurysm

3. Right heart failure

An ophthalmoscope is used to determine which of the following?

1. Visual acuity
2. Hypopyon
3. Glaucoma
4. Diplopia

2. Hypopyon

which of the following is the most important aspect of obtaining a primary assessment of your patient?

1. it directs your treatment plan
2. It allows you to identify all life threats
3. It provides direction for the remainder of your assessment
4. It contains baseline vital signs that determine the acuity of the patients

3. It provides direction for the remainder of your assessment

What is the primary goal of using the trauma pt assessment with every trauma pt?

1. Have a system you do not deviate from
2. Identify all injuries quickly and accurately
3. Determine breathing status immediately
4. Investigate the most serious injury first

1. Have a system you do not deviate from

At a trauma scene, which of the following would give you the most information about a patient that you believe may be developing a tension pneumothorax?

1. rising pulse rate
2. Tracheal tugging
3. Change in skin color
4. Dropping blood pressure

4. Dropping blood pressure

What is a major concern with the pt who has sustained a traumatic head or facial injury?

1. Usually has a spinal cord injury and thus is treated as such
2. Removes the possibility of evaluation of a spinal cord injury
3. Rarely has a spinal cord injury but it should always be suspected
4. Has a critical injury that is a higher priority than a spinal cord injury

3. Rarely has a spinal cord injury but it should always be suspected

You are attempting to interview a patient who is blatantly hostile toward you. Which of the following would be the most appropriate course of action given the situation?

1. threaten the patient
2. Restring the patient immediately
3. Have an appropriate show force
4. Leave the patient alone until he calms down

3. Have an appropriate show force

EMS is dispatched to “man down” at a bar. Witnesses report an intoxicated patron had a seizure and then became uncooperative. As the rescuers begin assessing the patient, he begins yelling profanity and kicking his legs. Despite efforts to calm the patient, he continues to resist treatment. Which option protects the rescuers from being successfully sued for negligence?

1. offering the patient the opportunity to sign a refusal of treatment form.
2. Calling the police and having the patient placed a protective custody
3. Telling what this is unseen to call you back when he comes down and leaving
4. Preparing to transport the victim to the hospital with implied consent in mind

4. Preparing to transport the victim to the hospital with implied consent in mind

Which of the following is the first neuroendocrine response to a psychological stressor?

1. cortisol
2. Catecholamines
3. Corticotropin releasing factor
4. Adrenocorticotropic hormone

3. Corticotropin releasing factor

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

1. Tablets and pills should be crushed before being administered
2. Enteric coated tablets can be administered to a gastric tube
3. The medication is delivered in a 30 mL syringe of cold normal saline
4. Once the medication is delivered it should be followed with a 10 mL flash

1. Tablets and pills should be crushed before being administered

Which of the following would be an appropriate method of conveying empathy when obtaining a patient’s medical history?

1. Repeat the pt’s words
2. Ask him how it makes him feel
3. Use phrases such as, “go on” or “I’m listening”
4. Use phrases such as, “I understand” or “I can’t imagine”

4. Use phrases such as, “I understand” or “I can’t imagine”

you have a patient with a medical emergency that caused it traumatic injury. If you were to follow the protocol for either of these emergencies, you would place the patient at significant risk. Which of the following would be your most appropriate response to the situation?

1. synthesize an appropriate response on your own
2. Follow the protocol that would do the least harm
3. Follow both protocols to stay within the standards
4. Do not intervene and transport without intervention

1. synthesize an appropriate response on your own

where should you place your hands when assessing the posterior chest for equal expansion?

1. parallel to the fifth rib
2. Parallel to the seventh rib
3. Parallel to the 10th rib
4. Parallel to the 12th rib

3. Parallel to the 10th rib

Which of the following disorders of the nose would be the most likely to progress to meningitis?

1. sinusitis
2. Anterior epistaxis
3. Posterior epistaxis
4. Nasal foreign body

1. sinusitis

The appropriate fluid resuscitation for a patient in decompensating shock, with a BP of 90/60, would be:

1. Administer 20 ml/kg of normal saline
2. Administer 10 ml/kg of lactated ringers
3. Administer a 500 ml fluid challenge of normal saline
4. Administer normal saline at a rate to maintain the blood pressure

4. Administer normal saline at a rate to maintain the blood pressure

During assessment of a trauma pt, you find a stab wound just left of the sternum. The wound is not bubbling, lung sounds are clear and equal, neck veins are distended, and trachea is midline. This patient is most likely suffering from a:

1. Hemothorax
2. Open pneumothorax
3. Percardial tamponade
4. Tension pneumothorax

3. Percardial tamponade

You have a pt with a hx of Addison’s disease who has a decreased LOC. Which of the following would be an appropriate intervention to increase the LOC?

1. Administer narcan
2. Administer dextrose
3. Administer prednisone
4. Administer a beta blocker

2. Administer dextrose

You have one care provider hold the thorax while you flex the elbow, gradually apply traction along the axis of the humerus, and gently rotate the arm externally, this maneuver describes reduction of which of the following shoulder dislocations?

1. Anterior
2. Inferior
3. Superior
4. Posterior

2. Inferior

About how many American’s are affected by renal and urologic disease?

1. 250K
2. 500K
3. 1M
4. 20M

4. 20M

What is the most appropriate intervention for a pt with new onset atrial fibrillation? The pt has exophthalmos, pulse of 130, and a high fever of 106F .

1. Rapid cooling
2. Cardioversion
3. Fluid resuscitation
4. Dextrose administration

3. Fluid resuscitation

Which of the following would you expect to find in a pt with a cerebral abscess that is less likely in a pt with a benign brain tumor?

1. Fever
2. Seizures
3. Nausea and vomiting
4. Headache and lethargy

1. Fever

What is the most common cause of transient ischemic attack?

1. Hypotension
2. Carotid artery disease
3. Beta blocker medications
4. Cerebrovasclar spasm

2. Carotid artery disease

Which of the following is the period of time when a host is unable to transmit an infectious disease?

1. Incubation
2. Window
3. Disease
4. Latent

4. Latent

You have just delivered a newly born, non-asphyxiated female. Which of the following is your preferred target for her temperature?

1. 32.5 – 36.5C
2. 36.5 – 37C
3. 37.5 – 39.5C
4. 39.5 – 41.5C

2. 36.5 – 37C

Rescuers with basic life support ambulance have requested that paramedics meet them along the highway to assist with the treatment of a 2 wk old status seizure patient. Which of the following medication orders will online medical direction likely suggest to suspend the seizure activity?

1. 2mg Narcan slow IVP
2. 0.5-1 g/kg of 10% dextrose in water IVP
3. 3-5 mcg/kg Midazolam rectally
4. 0.01 – 0.03 mg/kg of ativan via rectal mucosa

2. 0.5-1 g/kg of 10% dextrose in water IVP

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

1. Peak load
2. Reserve capacity
3. System status management
4. Primary area of responsibility

1. Peak load

Which of the following is true regarding the mammalian diving reflex?

1. It is stronger in adults than in children
2. It shunts blood to the brain and the heart
3. It stimulates the sympathetic nervous system
4. The water needs to be less than body temperature

2. It shunts blood to the brain and the heart

What you are protected from view but unprotected from bullets or other projectiles you are said to be:’

1. Covered
2. Contacted
3. Distracted
4. Concealed

4. Concealed

Which anti arrhythmic must be given rapid IV push due to short half life?

1. Adenosine
2. Amiodarone
3. Phenytoin
4. Procainamide

1. Adenosine

When an EMS provider attempts to preserve evidence at a scene, it is best placed:

1. Inside a plastic bag
2. Inside a brown paper bag
3. Inside a powder-free latex glove
4. Wrapped in sterile aluminum foil

2. Inside a brown paper bag

How large does a hole have to be in the chest for it to develop into a sucking chest wound?

1. Any size wound to the chest
2. Equal to the diameter of the trachea
3. One-third the diameter of the trachea
4. Two-thirds of the diameter of the trachea

1. Any size wound to the chest

You have responded to the scene of a motor vehicle collision where a 27yo male driver has been pinned by the steering wheel. The pt is unresponsive, breathing at 30x minute and very shallow, has petechiae of the skin from the shoulders on up. The remaining rapid trauma assessment reveals no other injuries. What other signs would you most likely expect to observe with this pt?

1. Bradycardia
2. Flat neck veins
3. Bloodshot eyes
4. Unequal lung sounds

3. Bloodshot eyes

With a pt in hemorrhagic shock, the goal of fluid resuscitation is to:

1. Maintain preload
2. Maintain blood volume
3. Obtain a normal blood pressure
4. Pull fluid into the vascular space

2. Maintain blood volume

The greatest percentage of total body water is located in the body within the:

1. interstitial fluid
2. Intracellular fluid
3. Extracellular fluid
4. Intravascular fluid

2. Intracellular fluid

Which of the following age groups is most likely able to speak but may be unable to understand what is being said?

1. 1-3yo
2. 3-5yo
3. 5-8yo
4. 8-10yo

1. 1-3yo

During transport, rescuers determine a secondary assessment should not be done on a trauma patient. What is the best reason for the rescuers to have delayed completing the secondary assessment until now?

1. the patient was considered potentially unstable while on scene
2. Protocol requires that detailed assessment be done during transport
3. The patient likely refuse treatment and assessment until transport
4. The rescuers suspect the patient’s airway and breathing is becoming compromised

1. the patient was considered potentially unstable while on scene

Which of the following would be the most appropriate strategy for developing the ability to think better under pressure?

1. Attend classes to increase your knowledge level
2. Raise your technical skills to the instinctive level
3. Perform relaxation exercises during stressful calls
4. Ask your physician to prescribe anti-anxiety medication

2. Raise your technical skills to the instinctive level

You are assessing a pt with an 8-day old wound. The wound site has a foul smell and there is subcutaneous emphysema around the wound. Which of the following is true about the appropriate care for this pt?

1. Dress the wound and encourage the pt to receive a tetanus booster
2. Dress the wound and transport to a facility that has hyperbaric capabilities
3. Leave the wound open to allow for drainage and to allow air to destroy the bacteria
4. Dress the wound and encourage the pt to see his family physician for antibiotics

2. Dress the wound and transport to a facility that has hyperbaric capabilities

A pt may have a spinal column injury without trauma to the cord. Your assessment would reveal this by evidence of:

1. Absence of pain
2. Presence of shock
3. Absence of any neurological deficit
4. Severity of the mechanism of injury

3. Absence of any neurological deficit

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

1. Pts over 65 have impaired ability to clear germs from their airways
2. These pts are likely exposed to younger patients in the community
3. Older patients take medications that weaken their immune responses
4. Geriatric patients have genetic predisposition for this type of pneumonia

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

You are called to a medical emergency at a local machine shop. Near the entrance of the building you find two victims who appear to have collapsed. What is your next action at this point?

1. Contact CHEMTREC for additional support
2. Proceed into the scene with caution
3. Immediately move downwind
4. Withdraw from the scene

4. Withdraw from the scene

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

1. Local burns to the skin
2. Respiratory tract burns
3. Diarrhea and vomiting
4. Decreased LOC and hypoxia

3. Diarrhea and vomiting

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

1. amiodarone
2. Lidocaine
3. Magnesium sulfate
4. Procainamide

3. Magnesium sulfate

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

1. assessing tidal volume
2. Assessing blood pressure
3. Assessing ventilatory rate
4. Assessing ability to move extremities

1. assessing tidal volume

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

1. Tear in the tunica intima
2. Weakening of the tunica media
3. Rupture of the tunica adventitia
4. Laceration through the arterial wall

1. Tear in the tunica intima

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

1. Head-on, at night, and with good road conditions
2. Head-on, during the day, and with bad road conditions
3. At intersections, at night, and with bad road conditions
4. At intersections, during the day, and with good road conditions

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

Which of the following closed fracture site will most likely result in the largest amount of blood loss?

1. Iliac crest fx
2. Pelvic ring fx
3. Single femur fx
4. Bilateral humerus fx

2. Pelvic ring fx

Which of the following injuries has the highest risk of air embolism involving the heart or lungs?

1. Lacerated jugular vein
2. Lacerated carotid artery
3. Lacerated popliteal vein
4. Lacerated femoral artery

1. Lacerated jugular vein

You are providing treatment for a pt with a partially avulsed upper eyelid. Which of the following would be the most appropriate treatment plan?

1. Cover both eyes with dry, sterile dressing
2. Apply direct pressure to the eyelid to control bleeding
3. Cover the injured eye with a cup or other protective material
4. Cover the injured eye with a protective rigid shield and the other eye with a soft dressing

4. Cover the injured eye with a protective rigid shield and the other eye with a soft dressing

The point of maximum impulse is located over which of the following?

1. the apex of the left ventricle
2. The superior portion of the right ventricle
3. The tricuspid valve
4. The aortic arch

1. the apex of the left ventricle

You have a 26-year-old male who has a chief complaint of pain in the lower posterior lateral back that radiates to his genitals. He indicates he has had this pain before. Which of the following would be the best way to assess his current condition?

1. performing a rapid medical assessment
2. Doing a DCAP-BTOS assessment of the affected area
3. Asking him about his current medications and allergies
4. Asking him to compare this pain to the last time he had it

4. Asking him to compare this pain to the last time he had it

You are transporting a trauma patient that was injured during a football tackle. He complains of severe right shoulder and arm pain. The athletic trainer removed his helmet and padding. Which device may help you to evaluate the distal circulation in the injured arm?

1. Glucometer
2. Stethescope
3. Pulse oximetry
4. Sphygmomanometer

3. Pulse oximetry

How do you calculate mean arterial pressure (MAP)?
[ (2 x diastolic) + systolic ] divided by 3

Which of the following is a phase of the clotting process?

1. Pre-clotting phase
2. Fibrinolytic phase
3. Anti-coagulation phase
4. Vascular phase

4. Vascular phase

What is the medical term used to refer to lung sounds auscultated in the mid-axillary region?

1. Tracheal
2. Vesicular
3. Bronchial
4. Bronchvesicular

2. Vesicular

You have just delivered a full-term newborn. Which of the following is the most accurate method of determining the newborn’s heart rate?

1. A 3 lead ECG
2. Using a pulse oximeter
3. By checking the apical pulse
4. By checking the umbilical pulse

4. By checking the umbilical pulse

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

1. Use vinyl gloves and eye protection
2. Cover the pt with a blanket
3. Have the victim lie flat and close his eyes
4. Have the pt slide from the doors if possible

1. Use vinyl gloves and eye protection

The most practical way to prevent cross-contamination of patients would be to:

1. use disposable equipment whenever possible
2. Never transport patients you suspect you’re contagious
3. Assure that linen is thrown away when soiled with blood
4. Wear gloves when ever you make patient contact

1. use disposable equipment whenever possible

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

1. Cortical and limbic
2. Cerebral and cortical
3. Synaptic and dendrite
4. Medullar and CNS

1. Cortical and limbic

Which choice properly identifies how racemic epinephrine is prepared?

1. Bovine epinephrine prepared for veterinary use
2. A mixture of 50% each of dextro-rotary and levo-rotary epinephrine
3. Epinephrine which has been specially prepared for administration by injection
4. Stabilized form of epinephrine that performs as a synthetic agonist without the palpitations, tremulousness and anxiety side effects

2. A mixture of 50% each of dextro-rotary and levo-rotary epinephrine

You respond to a structure fire at a residence and begin to care for a 32-year-old victim of severe smoke inhalation. Which medication would be most appropriate to reduce the effects of cyanide on the victim?

1. Amyl nitrate
2. Pralidoxime
3. Sodium Nitrite
4. Sodium Thiosulfate

1. Amyl nitrate

Which of the following adult pt would require ventilatory assistance?

1. Tidal volume 300cc, resp. rate 14
2. Tidal volume 325cc, resp. rate of 26
3. Tidal volume 500cc, resp. rate of 12
4. Tidal volume 700cc, resp rate of 10

1. Tidal volume 300cc, resp. rate 14

You were called to the scene of an elderly female complaining of nausea and vomiting for the past two hours. Her vital signs are within normal limits and her only medication is insulin. When applying to critical thinking process, which of the following should you suspect?

1. she is becoming dehydrated
2. She has a gastrointestinal flu
3. She is having a myocardial infarction
4. Her blood sugar levels are not within normal limits

3. She is having a myocardial infarction

which of the following is the principal purpose of performing a physical exam in the out of hospital setting?

1. to gain confidence from the patient.
2. To investigate areas he suspects are involved
3. To perform a complete and thorough assessment
4. To be able to document for reporting purposes

2. To investigate areas he suspects are involved

You are called to intercept with an incoming intermediate service, which is transporting a burn pt who has received a superficial burn to the anterior chest and a partial thickness burn to the anterior neck and face from a broken steam pipe. The initial responding crew was able to initiate fluid resuscitation but was unable to place a supraglottic airway as the pt still had a gag reflex. They report ventilation have become increasingly difficult to provide. Which of the following is your greatest concern?

1. Hypovolemia from third spacing
2. Eschar development involving the burned surface area
3. Increased pulmonary edema from the fluid resuscitation
4. The inability to form a good seal with the BVM due to facial trauma

2. Eschar development involving the burned surface area

Your pt has received an injury to the neck resulting in disruption of the thyroid gland. Which of the following would you eventually expect to occur with this type of injury?

1. An increase in blood pressure
2. An increase in cellular metabolism
3. An increase in blood calcium levels
4. An increase in white blood cell production

3. An increase in blood calcium levels

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

1. Diarrhea
2. Absent bowel sounds
3. Vomit containing feces
4. Painful, distended abdomen

3. Vomit containing feces

Where does the pain associated with appendicitis typically begin?

1. Right lower quadrant
2. Periumbilical
3. Left lower quadrant
4. Around the epigastrium

2. Periumbilical

During assessment of a neonate who is acting “strangely” according to the parents, your partner suggests checking a blood glucose level as soon as possible. What do you suspect your partner found that suggests and early one of hypoglycemia?

1. Bradycardia, hypotension, and acrocyanosis
2. Circumoral cyanosis around the eyes and mouth
3. Two obese parents who are at risk of diabetes
4. Eye rolling and twitching of the patients arms

3. Two obese parents who are at risk of diabetes

ALS providers are treating a 3yo female who is unresponsive and breathing with agonal type breaths. Pulse is 90 and there is no palpable blood pressure. What condition best summarizes their finding to medical control during a radio report?

1. Respiratory dyspnea
2. Distress
3. Failure
4. Arrest

4. Arrest

Which of the following would be the most appropriate method of managing a scene in a pt’s residence with too many responders?

1. Tell them to go outside
2. Ask some of them to go outside
3. Ignore them for now an ideal with it after the call
4. Ask them to go out and set up your vehicle for transport

2. Ask some of them to go outside

Which of the following would most likely cause the greatest environmental distraction for an accurate and complete assessment?

1. High noise levels
2. Cold temperature
3. Too many responders
4. Concerned family members

3. Too many responders

Regarding the general approach to the emergency patient, during which phase are potentially life-threatening injuries identified?

1. Primary assessment
2. Ongoing assessment
3. All phases of the call
4. Focused hx and physical

3. All phases of the call

You are at the scene of a roadside emergency. What is the safest method to approach the vehicle?

1. Both EMS providers should approach from opposite sides
2. Walk between the lights of your ambulance and the vehicle
3. Notify dispatch of the make, model, and plate after completely assessing the vehicle
4. Have the EMS driver remain with the ambulance as the other provider approaches from the passenger side

4. Have the EMS driver remain with the ambulance as the other provider approaches from the passenger side

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

1. Automobile accidents
2. Heavy commuter traffic
3. Inclement weather
4. Train traffic that obscures roadways

4. Train traffic that obscures roadways

A written EMS document must have which component to effectively and legally communicate information to other health professionals?

1. Be signed by the author
2. Describe the author’s intentions
3. Have been written in pen on paper
4. Include medical and technical terminology

3. Have been written in pen on paper

A pt has received a whole body dosage of radiation of 3 normal radiation units (RAD). What is the severity of this exposure?

1. Normal
2. Minor
3. Moderate
4. Critical

1. Normal

You are called to treat a significantly kyphotic 85yo female with a diagnosed cervical spine fx secondary to a cervical spine tumor. The pt has no neurological deficit. The pt also has pulmonary edema secondary to left heart failure. Which of the following would be the best way to manage this pt?

1. Sit the pt up with a c-collar for cervical protection
2. Immobilize the pt in a seated position using a short board
3. Fully immobilize the pt on a long board with appropriate padding
4. Spinal precautions are not necessary, as this pt has a non-traumatic spinal issue

1. Sit the pt up with a c-collar for cervical protection

Which of the following signs, symptoms, or sequelae would you expect to develop in a dry near drowning/submersion incident?

1. Laryngospasm
2. Pulmonary edema
3. Swelling skin tissue
4. Unequal lung sounds

1. Laryngospasm

Which of the following would be unanticipated as an acute cause for alteration in a patient’s behavior?

1. Physical factors
2. Chemical factors
3. Reaction to stress
4. Mental retardation

4. Mental retardation

Which of the following signs or symptoms is more consistent with a neoplasm of the brain than other neurological disorders?

1. Headache
2. Nausea/vomiting
3. Weakness or paralysis on one side of the body
4. New onset of seizures with normal blood sugar levels

4. New onset of seizures with normal blood sugar levels

Which of the following ECG findings would be the most expected in a pt experiencing angina?

1. Normal 12-lead
2. ST segment elevation
3. ST segment depression
4. Widened QRS complexes

3. ST segment depression

Which of the following is the most common cause of death for the pt suffering from cardiogenic shock?

1. End-organ failure
2. Fatal dysrhythmias
3. Massive MI
4. Septic shock secondary to infection

1. End-organ failure

You are assessing a pt who was involved in a diving emergency who has severe substernal chest pain, an irregular pusle, abnormal heart sounds, a reduced blood pressure, and a narrow pulse pressure. Which of the following is most likely occurring in this situation?

1. The pt has an arterial gas embolism reducing blood flow to the heart
2. The pt has a tension pneumothorax caused by pulmonary over-pressure
3. The pt has a pneumomediastinum, causing a reduction in returned blood
4. The pt is having an MI caused by the stress of the dive

3. The pt has a pneumomediastinum, causing a reduction in returned blood

What is the name for the yellowing of the eyes seen in severe cases of hepatitis?

1. Bilirubin
2. Jaundice
3. Scleral icterus
4. McBurney’s signs

3. Scleral icterus

Which of the following is the most influential in determining stroke volume?

1. Venous return
2. Afterload
3. Arterial pressure
4. Myocardial size

1. Venous return

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

1. 4mcg/min dopamine
2. 0.04 mg of epi
3. 0.4 mg adenosine
4. 0.08 mg atropine

2. 0.04 mg of epi

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

1. disable the pop off valve on the bag valve mask
2. Attempt a needle decompression of the chest wall
3. Instructs the basic to turn the mask on the ventilation device upside down
4. Have the basic position towels or blankets under the patient’s head and neck area

1. disable the pop off valve on the bag valve mask

You’re the senior EMS provider at an accident scene in a rural location. You have one critical patient, two seriously injured, and one minor trauma patient. There is only one transporting unit at the scene and another will arrive in about 20 minutes. How would you base your decision regarding calling for a helicopter transport?

1. Determine which pt can afford the helicopter
2. It is difficult for two units to transport four patients
3. It will save more than 20 minutes for the critical pt
4. Seeing if the air medical service your agency has a contact is available

3. It will save more than 20 minutes for the critical pt

During an MCI, a destination log typically contains which of the following?

1. Triage tag number
2. Patient vital signs
3. Patient name
4. Medical hx

1. Triage tag number

You arrive at the scene of a motor-vehicle-crash to find the pt is pinned under collapsed steering column. You have called for a rescue unit to assist. You walk around the scene to make sure it is clear of hazards and determine there is no easy access to the locked vehicle. The pt becomes unresponsive at this time so your best action would e to:

1. Wait for rescue personnel to arrive
2. Break a window and unlock the door
3. Attempt access through the trunk of the vehicle
4. Take an ax to the door-locking pin away from the pt

2. Break a window and unlock the door

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

1. Green priority 2
2. Green priority 3
3. Yellow, priority 2
4. Yellow, priority 3

3. Yellow, priority 2

During the eight-step process of gross decontamination, at which step do decon personnel shower and scrub all victims and rescuers?

1. Step 1
2. Step 2
3. Step 3
4. Step 4

3. Step 3

You are called to the scene of a 25yo female who is unconscious. Her husband suspects she may have overdosed on an unknown drug. He is visibly upset and may have been crying. How should you handle the husband upon arrival?

1. Ask him to step out of the room so you can treat the pt
2. Immediately question him about allergies and medical hx
3. Reassure him that you are going to take good care of his wife
4. Tell him you are going to have to call the police department

3. Reassure him that you are going to take good care of his wife

An immune response can be triggered by which of the following?

1. Hapten
2. Antigen
3. Immunogen
4. HLA antigen

3. Immunogen

Which of the following airway devices is contra indicated if the patient has recently eaten?

1. oropharyngeal airway, OPA
2. Laryngeal mask airway, LMA
3. Laryngeal tracheal airway, king LT
4. Esophageal tracheal, dual-lumen airway, Combitube

2. Laryngeal mask airway, LMA

You are called to the scene of a 27yo trauma pt who is supine, unresponsive to verbal stimuli, and having agonal breathing. The pt has blood coming from his mouth secondary to a lacerated tongue. He is currently pinned under his car from the legs down. Assessment reveals the pt has an intact gag reflex. Which of the following would be the best method to secure his airway?

1. Performing a nasotracheal intubation
2. Performing a modified jaw thrust and suctioning
3. Performing a modified jaw thrust and inserting an OPA
4. Providing the pt with succinylcholine and placing an ETDLA

1. Performing a nasotracheal intubation

Which of these airway devices has a negative impact on positive end expiratory pressure (PEEP)?

1. ET tubes
2. Combitube
3. King LT
4. OPA

1. ET tubes

You have intubated a pt and are determining correct placement. Which of the following would be the most reliable indicator?

1. Pulse oximetry readings
2. Absent eqigastric sounds
3. Clear and equal lung sounds
4. Continuous waveform capnography

4. Continuous waveform capnography

You are dispatched to the residence of a 76yo female who is having a possible CVA. You arrive to find the pt alert and sitting in a chair with obvious left-sided paralysis and the inability to speak or swallow. She is breathing at 20x per minute, shallow, and her pulse ox is 94%. Which of the following would be an appropriate treatment for this pt?

1. Transport her on her left side and assist ventilations
2. Nasally intubate her and transport her in a supine position
3. Transport her on her right side and give 4lpm nasal cannula
4. Transport her sitting up and administer 12-15 lpm NRB

1. Transport her on her left side and assist ventilations

Which of the following is most likely performed after a rapid extrication?

1. Stablizing the head
2. Splinting fx femur
3. Performing a rapid trauma assessment
4. Placing a cervical collar on pt

2. Splinting fx femur

You are evaluating a 42yo who is on room air and appears to be in no respiratory distress. He has a pulse ox of 99% and a normal minute volume. How many liters per minute of oxygen is he inspiring?

1. 1-2 Lpm
2. 2-4 lpm
3. 4-6 lpm
4. 6-12 lpm

3. 4-6 lpm

A pt with a spinal cord injury at C7 will hyperventilate because:

1. No innervation of the cardiac plexus
2. No innervation of the intercostal muscles
3. No innervation of the diaphragmatic muscle
4. No transmission from the medulla oblongata

2. No innervation of the intercostal muscles

You are called to treat a pt with a hx of Amyotrophic Sclerosis who has difficulty breathing, an ineffective cough, absent lung sounds in the right upper lobe and a temperature of 102F. Which of the following would best describe the clinical significance of the assessment findings?

1. The pt has developed a hemothorax
2. This is a normal progression for this disease
3. The pt has developed a simple pneumothorax
4. The disease processes affecting the CNS

3. The pt has developed a simple pneumothorax

You are called to the residence of a pt who is paralyzed secondary to a cervical spine fx at C7. The pt is warm to the touch and has adventitious lung sounds in the right lower lobe. All other lung fields are clear. Which of the following would best explain the pt’s current condition?

1. The pt has aspirated a foreign body into his right lung, causing a lower airway obstruction
2. The pt is having an expected side effect of dopamine administration, which is common on paralyzed patients.
3. Hypoventilation secondary to the spinal injury caused the pt to develop pneumonia in the right lower lobe
4. The pt is warm secondary to an inability to regulate temperature and the adventitious lung sounds are secondary to right-sided paralysis

3. Hypoventilation secondary to the spinal injury caused the pt to develop pneumonia in the right lower lobe

Kussmaul respirations would be most easily confused with:

1. Biot’s respirations
2. Agonal respirations
3. Cheyne-Stokes respirations
4. Central neurogenic hyperventilation

4. Central neurogenic hyperventilation

You are assisting ventilations for an unconscious adult pt with inadequate breathing. What is the preferred method of assisting the pt’s ventilations?

1. Flow-restricted, oxygen-powered ventilatory device
2. Pocket mask with supplemental oxygen
3. 2-rescuer BVM
4. 1 rescuer BVM

1. Flow-restricted, oxygen-powered ventilatory device

Which of the following respiratory patterns would you expect to see in a pt with increased intracranial pressure?

1. Ataxic
2. Eupnistic
3. Kussmaul
4. Apneustic

1. Ataxic

Which of the following are you checking when you assess the upper airway during the primary assessment?

1. Sounds of snoring
2. Sounds of wheezing
3. Equal chest rise and fall
4. Breathing rate and effort

1. Sounds of snoring

Your lethargic 57yo pt has warm, dry skin, respirations of 24 and of normal depth, pulse of 120, BP 110/70, a BGL of 500, and hx of Type 2 diabetes. What is the most appropriate intervention?

1. Hyperventilation
2. Fluid resuscitation
3. Sodium bicarb
4. Administration of insulin

2. Fluid resuscitation

An absence seizure is also known by which of the following?

1. Simple partial seizure
2. Complex partial seizure
3. Grand mal seizure
4. Petit mal seizure

4. Petit mal seizure

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

1. Inhalation
2. Ingestion
3. Injection
4. Absorption

1. Inhalation

Regarding endocrinology, which of the following is a true statement?

1. ADH decreases blood volume
2. Insulin decreases blood sugar levels
3. Glucagon decreases blood sugar levels
4. Hyperglycemic patients have Kussmaul respirations

2. Insulin decreases blood sugar levels

Which of the following is your most critical intervention for a 57yo unresponsive female with the following signs? She has a blood sugar of 600, Kussmaul’s respirations, warm, dry skin, and a BP of 90/50?

1. Glucagon
2. Hyperventilation
3. Fluid resuscitation
4. Sodium bicarb

3. Fluid resuscitation

A young adult male has been found to have a foreign object inserted into his penis. The assessment and treatment of this pt must be handled the same as a:

1. Standard call
2. Potential suicide
3. Psychiatric case
4. Sexual assault victim

4. Sexual assault victim

Which of the following is the most toxic causative agent involving food poisoning?

1. E Coli
2. Shigella
3. Salmonella
4. Clostridium botulinum

1. E Coli

The signs and symptoms of a pt with a brain abscess would be most similar to which of the following?

1. Epilepsy
2. Neoplasm
3. Intracranial hemorrhage
4. Degenerative neurological disorder

2. Neoplasm

You are called to assess a pt who is taking a monoamine oxidase inhibitor and earlier in the day he consumed some cheese and red wine. Which of the following would you most likely expect to find during your pt assessment?

1. Depression
2. Tachycardia
3. Hypertension
4. Extrapyramidal symptoms

3. Hypertension

You are called to the scene of a 48yo male complaining of severe dyspnea. The pt has a hx of right sided MI. He has a rx inhaler that contains a beta agonist as well as steroids. His inhaler has provided no relief. Which of the following would you most likely expect to find with this pt as a result of his long-term steroid use?

1. The long term steroid use played no role in precipitating the MI
2. The pt may present with signs consistent with Cushing’s disease
3. The pt will demonstrate signs of dehydration and a decrease in available sugar
4. A more rapid, positive response to his beta 2 stared inhaler in cases of status asthmatics

1. The long term steroid use played no role in precipitating the MI

Along the jogging trail in town, a woman is found sitting on the trail holding her foot. EMS is called to evaluate the patient. The healthy 45-year-old female complains of burning and pain on the bottom of her foot. She has had this pain for about four weeks and it is worse in the morning. Today was she was walking, it became so bad she could not put weight on it. Her pain is most likely caused from:

1. Chronic sprain
2. Stress fx
3. Simple arthritis
4. Non-traumatic inflammation

4. Non-traumatic inflammation

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

1. Leukemia
2. Lymphoma
3. Hemophilia
4. Multiple myeloma

1. Leukemia

Hemorrhoids are commonly caused by which of the following?

1. Diabetes
2. Frequent diarrhea
3. Ingestion of caustic substance
4. Chronic portal hypertension

4. Chronic portal hypertension

A serious and common problem that will interfere with the provision of TCP is:

1. Battery failure
2. Causing an R on T phenomena
3. The presence of a runaway pacemaker
4. Failure to synchronize with the pt’s intrinsic rate

1. Battery failure

Pain associated with peritoneal irritation will typically be described by the pt as which of the following?

1. Visceral – dull, poorly localized pain
2. Somatic/parietal – dull, poorly localized pain
3. Visceral – sharp, easily localized pain
4. Somatic/parietal – sharp, easily localized pain

4. Somatic/parietal – sharp, easily localized pain

for which of the following pt would a 3 lead ECG analysis be the most useful?

1. Unresponsive trauma pt
2. Pt complaining of chest pain
3. Pt complaining of a racing heart
4. Unresponsive pt with rigor mortis

3. Pt complaining of a racing heart

You are dispatched to the scene of a 64yo female diabetic who is awake but unable to communicate. Your assessment reveals vitals all within normal limits and a weakness on the left side. Which of the following interventions is the most appropriate?

1. Administer 25G dextrose
2. Position the pt on her left side
3. Administer 80g of chewable ASA
4. Administer 4-6 lpm O2 using a NC

2. Position the pt on her left side

Which of the following interventions would be the most appropriate selection to increase the blood pressure of a 47yo hypotensive, bradycardia (HR-55) pt with ST elevation in Leads V1 and V2 and chest pain so as to receive nitro and/or morphine?

1. Atropine 2-10mcg/min
2. Fluid challenge 200-1000 ml
3. Dopamine drip 2-10mcg/kg/min
4. Epinephrine drip 2-10mcg/kg/min

3. Dopamine drip 2-10mcg/kg/min

Which of the following oxygen or ventilation therapy choices would be appropriate for a pt suffering from a TIA with an isolated complaint of dysphasia?

1. Advanced airway
2. Nasal cannula
3. Assisted ventilation
4. NRB

2. Nasal cannula

During which phase of the stress response does an individual begin to cope with the stress and possibly become desensitized to the stressors?

1. Alarm
2. Resistance
3. Exhaustion
4. Rest/recovery

2. Resistance

Which of the following would best be classified as an exposure for reporting purposes?

1. A pt spitting on your shirt
2. Getting poked with a sterile needle
3. Touching blood with your gloved hand
4. Treating a TB pt while wearing a surgical mask

4. Treating a TB pt while wearing a surgical mask

What is the correct volume of 10% dextrose to administer at 1G/kg for a 2wk old infant weighing 4kg?

1. 4cc
2. 8cc
3. 10cc
4. 40cc

4. 40cc

Which of the following would demonstrate the best method of showing respect and treating a pt with dignity?

1. Leaving a pt exposed who has multiple injuries
2. Listening to a pt as he provides his medical hx
3. Providing analgesics prior to immobilizing an injured extremity
4. Cleaning a pt who has had diarrhea prior to arrival at the hospital

4. Cleaning a pt who has had diarrhea prior to arrival at the hospital

Which drug is considered a Class 1a anti arrhythmic drug?

1. Lidocaine
2. Phenytoin
3. Procainamide
4. Tocanide

3. Procainamide

Your state regulatory agency has enacted a rule that EMS providers must attend a continuing education session regarding legal issues. Which of the following sources of law does this most likely fall under?

1. Administrative law
2. Common law
3. Constitutional law
4. Legislative law

1. Administrative law

You are called to treat a pt who is unresponsive, pulseless, and apneic. The pt has a valid DNR bracelet, yet his wife is asking you to provide treatment. What should you do?

1. Call the hospital for clarification before doing anything
2. Begin CPR and then immediately contact medial control
3. Follow the pt’s wishes and do not attempt resuscitation
4. Do CPR at the scene only and transport the pt to the hospital

2. Begin CPR and then immediately contact medial control

Which mechanism is responsible for potassium being able to enter the cardiac cells?

1. Osmosis
2. Diffusion
3. Active transport
4. Facilitated diffusion

3. Active transport

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

1. Insulin lispro (Humalog)
2. NPH (Humalin N)
3. Regular insulin (Humalin R)
4. INsulin Glargine (Lantus)

3. Regular insulin (Humalin R)

For regulation of the acid-base balance, which of the following has the fastest response?

1. Respiration
2. Renal function
3. Hepatic function
4. Bicarbonate buffer system

4. Bicarbonate buffer system

Which statement regarding the use of rocuronium is true?

1. Rocuronium has a more rapid onset than vecuronium
2. Rocuronium has the same mechanism of action os succinylcholine
3. Rocuronium is the leas cardiac stable neuromuscular blocking agent
4. Rocuronium has a significantly longer (up to 3 hours) duration than vecuronium

1. Rocuronium has a more rapid onset than vecuronium

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

1. Desired dose = ((volume on hand) x (volume to be administered))/(dosage on hand)
2. Desired dose = ((volume on hand) x (dosage on hand))/(volume to be administered)
3. Volume to be administered = ((dosage on hand) x (desired dose))/(volume on hand)
4. Volume to be administered = ((volume on hand) x (desired dose))/(dosage on hand)

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

Which of the following physiological components responds first to the site of a new open wound?

1. Eosinophils
2. Histamine
3. Fibrin
4. Hemoglobin

3. Fibrin

You were called to the scene of an unresponsive, adult diabetic. Upon administering glucose, the pt is now conscious, alert, and refusing any further treatment or transport. Your partner discontinues the IV, has the pt sign a refusal, and heads back to the ambulance. Which of the following premises did your partner use to decide that it was acceptable to clear the scene?

1. The pt was conscious and alert and refusing treatment
2. The pt was alert and aware of the possible consequences
3. The pt was adequately treated and needed no further care
4. Your partner’s action was wrong and the pt should have been transported

2. The pt was alert and aware of the possible consequences

You are assessing an unresponsive 32yo female who has a hx of asthma. She takes steroid daily to help prevent her asthma attacks and a bronchodilator for acute care of asthma. She is breathing deeply at 26x 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 pt?

1. Constricted pupils
2. An emaciated appearance
3. An elevated blood pressure
4. An elevated blood glucose level

4. An elevated blood glucose level

You are dispatched to the residence of a 42yo male observed sitting in a tripod posiiton. Which of the following would be the most critical sign regarding this pt?

1. Peripheral edema
2. Pulmonary edema
3. Elevated HR
4. Peripheral cyanosis

2. Pulmonary edema

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

1. Beta 2 stimulation
2. To suppress coughing
3. For drying of secretions
4. To increase expectoration

3. For drying of secretions

Which statement regarding the use of rocuronium is true?

1. Rocuronium has a more rapid onset than vecuronium
2. Rocuronium has the same mechanism of action os succinylcholine
3. Rocuronium is the leas cardiac stable neuromuscular blocking agent
4. Rocuronium has a significantly longer (up to 3 hours) duration than vecuronium

1. Rocuronium has a more rapid onset than vecuronium

Which of the following is appropriate regarding suctioning through an ET tube?

1. The suction catheter should go down to the carina
2. Suctioning should never last longer than 20 seconds
3. The pt must always be pre-oxygenated prior to suctioning
4. The larger the number of French units the smaller the diameter of the suction catheter

1. The suction catheter should go down to the carina

You have extended the neck and placed you index fingers on the angle of the jaw an moved it in an anterior fashion. Which of the following best describes the procedure performed?

1. Head-tilt chin-lift
2. Head-tilt jaw-thrust
3. Modified jaw thrust
4. Triple airway maneuver

3. Modified jaw thrust

An unresponsive adult pt is on 4lpm through a nasal cannula. She has a pulse ox reading of 100, end-tidal CO2 of 47, respirations of 10, and a pulse of 110. Which of the following represents the appropriate treatment?

1. Switch to BVM
2. Turn the NC up to 6lpm
3. Turn the NC down to 2lpm
4. Switch to a NRB at 12-15lpm

3. Turn the NC down to 2lpm

Which of the following patients would most likely require ventilatory assistance with a BVM?

1. A pt with varicella virus
2. A pt with MS
3. A pt with Kussmaul respirations
4. A pt with hyperventilation syndrome

4. A pt with hyperventilation syndrome

You are called to transfer a COPD pt who is on a venturi mask set at 28% FIO2. The pt is suffering from a situation which is causing a shift to the left of his oxygen-hemoglobin dissociation curve. Which of the following would best address this issue?

1. Switch the pt to a nasal cannula at 2lpm
2. Cool the pt to cause the curve to shift to the right
3. Increase the venturi mask setting to a higher percentage
4. Remove the oxygen and have the pt breathe room air.

4. Remove the oxygen and have the pt breathe room air

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

1. King airway
2. LMA
3. Oral tracheal intubation
4. Oropharyngeal airway

1. King airway

Rescuers have placed an OPA into your adult pt but selected a size larger than you would have preferred. You are now unable to ventilate the pt. Which of the following most likely occurred?

1. Longer OPA caused a bronchospasm
2. Longer OPA protruded into the glottic opening
3. Longer OPA pushed the tongue over the glottic opening
4. Longer OPA pushed the epiglottis over the glottic opening

4. Longer OPA pushed the epiglottis over the glottic opening

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

1. Decreased peak flow and decreased forced expiratory volume
2. Decreased peak flow and increased forced expiratory volume
3. Increased peak flow and decreased force expiratory volume
4. Increased peak flow and increased forced expiratory volume

1. Decreased peak flow and decreased forced expiratory volume

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

1. Diminished lung sounds
2. Decreasing BP
3. Decreasing pulse
4. Pink, frothy sputum

1. Diminished lung sounds

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

1. Hemoptysis
2. Unequal lung sounds
3. JVD
4. Unilateral hyperresonance

4. Unilateral hyperresonance

Which of the following adult patient’s would be considered to be breathing adequately?

1. Respiratory rate of 8 and a tidal volume of 500ml
2. Respiratory rate of 10 and a tidal volume of 600ml
3. Respiratory rate of 20 and a tidal volume of 500ml
4. Respiratory rate of 40 and a tidal volume of 150ml

2. Respiratory rate of 10 and a tidal volume of 600ml

You have been called to the scene of a pt with a serious medical emergency and the pt is now refusing treatment and transportation. Which of the following would be the most difficult to achieve in order for the refusal to be legitimate?

1. Consulting with online medical direction
2. Making certain that the pt is fully informed
3. Having the pt and a disinterested witness sign the refusal form
4. Enlisting the help of the family to convince the pt to accept care

2. Making certain that the pt is fully informed

Which of the following BEST describes the provider’s role in continuous quality improvement (CQI)

1. Do not make mistakes
2. Avoid documentation errors
3. Attempt to achieve benchmarks
4. Inform others when mistakes are made

3. Attempt to achieve benchmarks

You are called to the residence of an elderly patient who tripped on a throw rug, fell, and broke her lower let. Which of the following would be the most appropriate injury prevention strategy the EMS provider could perform?

1. Return after the call and remove trip hazards
2. Immediately remove all throw rugs from her home
3. Refer the case to an agency that specialized in making homes safe
4. Encourage the pt to consider moving to an assisted living center

3. Refer the case to an agency that specialized in making homes safe

Which of the following is the primary responsibility of the National Registry of EMTs?

1. To develop national registry of EMTs
2. To license EMS providers nationally or at the state level
3. To develop the scope of practice for EMS providers
4. To administer an exam to determine entry-level competence

4. To administer an exam to determine entry-level competence

Which of the following would be the appropriate target heart rate to improve cardiovascular endurance for a 30yo with a resting heart rate of 70?

1. 143
2. 154
3. 163
4. 174

2. 154

During which of the following age ranges should you expect hearing to reach maturity?

1. 0 to 12 months
2. 12 to 24 months
3. 24 to 36 months
4. 36 to 48 months

4. 36 to 48 months

The use of norepinephrine would be contraindicated for which of the described clinical conditions?

1. Septic shock
2. Cardiogenic shock
3. Hypovolemic shock
4. Resistant Wasserman’s hypotension

3. Hypovolemic shock

Select an environmental condition a rescuer will most commonly experience and need to overcome while working in an urban setting.

1. Being yelled at by angry family members
2. Working in settings of extreme temperatures
3. Moving pt that exceeds 500lbs.
4. Being exposed to hazardous materials

2. Working in settings of extreme temperatures

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

1. Chlorpromazine
2. Citalopram
3. Haloperidol
4. Ziprasidone

2. Citalopram

Which of the following pathophysiological causes of dehydration is also referred to as third space fluid loss?

1. Insensible such as in fever or hyperventilation
2. Gastrointestinal such as in vomiting or diarrhea
3. Plasma loss such as in burns or open wounds
4. Internal such as from peritonitis or bowel obstruction

4. Internal such as from peritonitis or bowel obstruction

Which of the following activities would be the best to perform daily in order to improve physical fitness?

1. Stretching
2. Upper body exercises
3. Lower body exercises
4. Cardiac exercise to target heart rate

1. Stretching

Which of the following would have the greatest impact on reducing illness and injury of EMS personnel?

1. Obtaining the necessary vaccinations
2. Attending injury prevention seminars
3. Performing a scene survey on all calls
4. Wearing gloves on all emergency calls

3. Performing a scene survey on all calls

Which of the following best describes what is meant by “citizen involvement in the EMS system”?

1. Training citizens on when and why to call EMS
2. Educating the public in basic life-support procedures
3. Providing those directly involved in EMS with a customer viewpoint
4. Obtaining financial support from the public to provide EMS services

3. Providing those directly involved in EMS with a customer viewpoint

Historically, which of the following had the greatest influence on how we practiced EMS?

1. Evidence-based practice
2. Medical control protocols
3. Laboratory-based research
4. Emergency department practice

4. Emergency department practice

After an EMS run, your partner suggests you write down vital signs differently than the ones obtained. What is the best reason to write the vital signs down accurately?

1. If the vitals are inaccurate, it puts the rest of the document in question
2. Criminal charges can be filed against the providers if the vitals are found to be false
3. Vital signs are a critical data set required for insurance billing
4. It will impact the treatment given by the emergency department

1. If the vitals are inaccurate, it puts the rest of the document in question

During a quality assurance review of EMS run forms, there is evidence that personnel failed to follow the standard of care properly. Which statement is true regarding the standard of care and this scenario?

1. The local protocol and standard of care are considered legal contracts with providers
2. Failure to follow the standard of care is a violation of the scope of practice
3. Standards of care are ethical standards set forth by other allied health professionals
4. Employees should use protocols to help identify local standards of care for their community

4. Employees should use protocols to help identify local standards of care for their community

Which of the following is the principle regulator of water retention and distribution?

1. Calcium
2. Potassium
3. Vasopressin
4. Hydrostatic pressure

3. Vasopressin

EMS providers are testifying in court during a civil case. Select the characteristic that will make the document legally legitimate.

1. Hand written text
2. Carbon copy type forms
3. A signature of the provider
4. Accurate times on the report

4. Accurate times on the report

Water will leave the capillaries and enter the interstitial space because of:

1. Filtration
2. Oncotic pressure
3. Osmotic pressure
4. Hydrostatic pressure

4. Hydrostatic pressure

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

1. Butorphanol
2. Fentanyl
3. Meperidine
4. Morphine

1. Butorphanol

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

1. Acetaminophen
2. Aspirin
3. Ketoralac
4. Nalbuphine

1. Acetaminophen

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

1. 2.5 mg SVB
2. 0.63mg SVN
3. 1 inhalation of 90mcg MDI
4. 1 inhalation of 0.63mcg MDI

2. 0.63mg SVN

Which of the following best reflects the reason to collect data on illnesses and injuries in your community regarding illness and injury prevention programs?

1. It will provide information as to where you should focus additional training
2. It is used by medical direction to assess the quality of pt care in the system
3. It will provide information you can present to related agencies for funding support
4. It is a necessary component of the pt care report in order to receive reimbursement

3. It will provide information you can present to related agencies for funding support

Where would you look in a research paper or abstract to determine if the findings were conclusive and dependable?

1. In the conclusion
2. In the raw data section
3. In the description of the study
4. In the reported confidence interval

4. In the reported confidence interval

Which of the following is true regarding advanced directives where a pt has chosen some interventions to be done but have other things withheld?

1. These choices are usually financially driven
2. The choices are most often medically sound
3. These are usually invalid in a pre-hospital setting
4. These differ from DNR orders as these patients have no terminal illness

3. These are usually invalid in a pre-hospital setting

Which of the following is the most uncommon reason for the varying degrees of DNR orders?

1. Fear of pain
2. Financial reasons
3. Religious reasons
4. Lack of understanding

2. Financial reasons

Medical control has ordered rescues to extubate a pt who is resisting ventilations through an ET tube. Which of the following complications should rescuers anticipate upon removal of the ETT?

1. Laryngospasm
2. Petit mal seizure
3. Reflex bradycardia
4. Brochoconstriction

1. Laryngospasm

You are opening a partially-occluded airway with a jaw thrust technique. Which maneuver must be performed prior to displacing the jaw forward?

1. Tilting the head back slightly
2. Pacing your right hand under the neck
3. Holding the head and neck in neutral alignment
4. Placing your thumbs on either side of the mandible

1. Tilting the head back slightly

Which of the following measure carbon dioxide through the ventilatory cycle as a waveform?

1. Oximetry
2. Spironmeter
3. Capnometry
4. Capnography

4. Capnography

You are called to the scene of a pt who has received a burn to the upper airway secondary to smoke inhalation. Which of the following would provide for the highest protection of the airway?

1. CPAP
2. Intubation
3. King airway
4. LMA

2. Intubation

Your unconscious trauma pt has just vomited dark red blood. Select the best reason for suctioning this pt’s oral and nasal cavity after he has vomited.

1. To reduce the risk of aspiration pneumonia complications
2. To reduce intracranial pressure caused by vomiting
3. To measure, then quantify, volume of blood loss within the stomach
4. To reduce the chance the pt will vomit more blood later on

1. To reduce the risk of aspiration pneumonia complications

After performing basic maneuvers and chest compressions on an unresponsive and probably choking pt, you find you are unsuccessful at ventilating. Which of the following techniques will be most helpful now?

1. Deliver forceful ventilations
2. Deliver additional basic maneuvers
3. Perform a modified jaw thrust maneuver
4. Attempt a laryngoscopes removal with forceps

4. Attempt a laryngoscopes removal with forceps

Which statement is true regarding normal atmospheric air?

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

4. At sea level, atmospheric air pressure is approximately 760 mmHg

Which of the following is a common term used to describe a soft suction catheter?

1. Yankauer
2. Flexible
3. Oral
4. German

2. Flexible

The primary location of the body’s monitoring of CO2 concentrations occurs in receptors found in the:

1. Medulla
2. Aortic arch
3. Carotid arteries
4. Coronary arteries

1. Medulla

Which of the following best describes the proper placement and direction of an NPA?

1. Bevel toward the septum and insert at an angle parallel to the mouth
2. Bevel toward the septum and insert at an angle of 45 degrees cephalic
3. Bevel toward the floor of the nostril and insert at an angle slightly cephalic
4. Bevel toward the floor of the nostril and insert at an angle slightly caudally

2. Bevel toward the septum and insert at an angle of 45 degrees cephalic

When is the glottic opening the largest?

1. During pauses
2. When coughing
3. Upon inspiration
4. Upon exhalation

3. Upon inspiration

Which of the following would cause disruptions in perfusion, while diffusion would be normal?

1. Emphysema
2. Pulmonary edema
3. Inhalation injuries
4. Pulmonary embolism

4. Pulmonary embolism

Which of the following is correct regarding the technique for performing an open cricothyrotomy?

1. Insert a needle into the membrane caudally
2. Attach a large-bore IV needle to a 10cc syringe
3. Make a 1-2cm vertical incision over the membrane
4. Make a 1-2cm vertical incition through the membrane

3. Make a 1-2cm vertical incision over the membrane

In general, which of the following is the preferred method for gastric decompression when gastric distention is present and the pt is unresponsive?

1. Orogastric tube placement
2. Nasogatric tube placement
3. Esophageal tracheal tube placement
4. Placing the pt in the recovery position and pressing on the abdomen

2. Nasogatric tube placement

Which of the following is a common complication of a needle cricothyrotomy?

1. Thyroid gland damage
2. Cricoid cartilage damage
3. Laryngeal nerve damage
4. Barotrauma from over-inflation

4. Barotrauma from over-inflation

Which of the following is the appropriate measurement for an oropharyngeal airway?

1. From the corner of the mouth to the tragus
2. From the anterior portion of the teeth to the angle of the jaw
3. From the corner of the mouth to the posterior portion of the helix
4. From the anterior portion of the teeth to the posterior portion of the pinna

2. From the anterior portion of the teeth to the angle of the jaw

During the resuscitation of a traumatic cardiac arrest pt, the pt is being ventilated with a ATV. You are aware the the pt;s color has not improved at all during CPR and no carotid pulses are felt. Most likely there is no change in this pt because the ventilation is causing:

1. A pheumothorax
2. Further lung damage
3. Reduced blood return to the heart
4. An interference with the chest compressions

3. Reduced blood return to the heart

Which of the following describes agonal breathing?

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

2. Shallow and slow or infrequent breathing

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

1. Hyperthermia
2. Elevated blood sugar
3. Carbon dioxide retention
4. Low amplitude bradycardia

1. Hyperthermia

You are called to assess a 40yo male who had crushing chest pain while he was working out. After rest, the pain has diminished, but it is still present. The pt informs you he has a hx of angina and takes one nitro to have relief. Your 3-lead ECG shows sinus tachycardia of 110, ST elevation in Lead I, and ST depression in Leads II and III. After two nitro and O2 the ST segments are normal and the pt is pain free. Which of the following would be the most appropriate field impression and tx?

1. Stable angina; no intervention necessary
2. MI; O2, ASA, NTG, and transport
3. MI; O2, ASA, MS, and transport
4. Unstable angina, MI; O2, ASA, and transport

4. Unstable angina, MI; O2, ASA, and transport

Which of the following assessment findings would be most likely in a pt suffering from ruptured esophageal varices?

1. Decreased pulse rate
2. Coffee ground emesis
3. Right upper quadrant pain
4. A hx of portal hypertension

4. A hx of portal hypertension

Which of the following would be contraindicated in the pt with thyrotoxicosis?

1. Beta blockers
2. Glucocorticoids
3. Active rewarming
4. Fluid resuscitation

3. Active rewarming

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

1. 9%
2. 11%
3. 14%
4. 95%

1. 9%

A cluster headache would be classified as which of the following types of headache?

1. Tension
2. Organic
3. Migraine
4. Vascular

4. Vascular

Which of the following is the best definition of a behavioral emergency?

1. When a pt’s behavior deviates from society’s expectations or norms
2. When a pt poses a threat to the life or well-being of himself or others
3. When a pt’s behavior becomes so unusual that it alarms the pt or others
4. When a pt suffers from disorders such as anxiety, depression, and eating or personality disorders

1. When a pt’s behavior deviates from society’s expectations or norms

You are called to evaluate a 45yo female who is warm and dry. She has a hx of diabetes. She currently has frequent painful urination, foul smelling urine, fever, moan when you percuss the left flank area. her respiration are 26 and deep an her pulse is 120. Pt is most likely suffering from which o the following?

1. Renal calculi
2. Pyelonephritis
3. DKA
4. Lower urinary tract infection

2. Pyelonephritis

Which of the following is true regarding tuberculosis?

1. Incidence was at it’s lowest in the 8th century
2. A negative PPD skin test rules out active disease status
3. It is one of the most common preventable adult infectious diseases
4. It primarily affects the pleural lining of the lungs and the surrounding tissue

3. It is one of the most common preventable adult infectious diseases

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

1. 4th
2. 5th
3. 6th
4. 7th

4. 7th

Which of the following is the terminology for the cell from which other blood cells form?

1. Erythrocyte
2. Erythropoietin
3. Hematopoiesis
4. Pluripotent stem cell

4. Pluripotent stem cell

A pt with a recent diagnosis of a neoplasm within the brain is now experiencing paralysis on the left side of the face. Which of the following is occurring in this situation?

1. The tumor is impacting the afferent fibers of cranial nerve V
2. The tumor is impacting the efferent fibers of cranial nerve V
3. The tumor is impacting the afferent fibers of cranial nerve VII
4. The tumor is impacting the efferent fibers of cranial nerve VII

4. The tumor is impacting the efferent fibers of cranial nerve VII

You are dispatched to the residence of a 76yo female who is having a possible CVA. You arrive to find the pt alert and sitting in a chair with obvious left-sided paralysis and the inability to speak or swallow. She is breathing at 20x per minute, shallow, and her pulse ox is 94%. Which of the following would be an appropriate treatment for this pt?

1. Transport her on her left side and assist ventilations
2. Nasally intubate her and transport her in a supine position
3. Transport her on her right side and give 4lpm nasal cannula
4. Transport her sitting up and administer 12-15 lpm NRB

1. Transport her on her left side and assist ventilations

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

1. Referred pain
2. Visceral pain
3. Somatic pain
4. Inflammation

3. Somatic pain

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

1. Hypotension
2. Uremic frost
3. Foul smelling urine
4. Tall, peaked T waves

4. Tall, peaked T waves

Nitroglycerine accomplishes which of the following in the setting of congestive heart failure?

1. Causes coronary vasodilation
2. Increases preload
3. Decreases venous return
4. Promotes diuresis

3. Decreases venous return

Of those listed, your highest priority in the treatment of the pt with an eye problem is to:

1. Promote self care
2. Calm and reassure
3. Reduce strong lighting
4. Utilize standard precautions

4. Utilize standard precautions

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

1. P wave
2. PR interval
3. ST segment
4. T wave

4. T wave

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

1. Dispelling any fears the pt may have
2. Questioning what the delusional thoughts are
3. Determining if the pt is supposed to be taking medication
4. Questioning how many times the pt has been hospitalized

3. Determining if the pt is supposed to be taking medication

Dispatch is relaying information about a call to a large office building in the center of town. They first received one call about a woman with a headache and violent vomiting, Now they tell you they have received at least ten calls to this same address with victims having the same symptoms. What is the best information for you to relay back to dispatch regarding this call?Have dispatch tell:

1. Police to respond first
2. Callers to meet the ambulance outside
3. The FD to enter the scene first
4. A medical control physician to respond to the scene

3. The FD to enter the scene first

Pulmonary edema may develop during hypertensive emergency. This is because the high systemic pressure:

1. Increases pulmonic pressures
2. Causes a left ventricular failure
3. Forces fluid out of the lung’s parenchymal tissue
4. Forces blood out of the pulmonary capillaries into the alveoli

2. Causes a left ventricular failure

You are assessing a 65yo pt who has recurrent asthmatic attacks since the age of 12. Pt has hx of right sided MI with pedal edema. Which of the following would be an accurate description of how asthma precipitated the right sided MI?

1. The increase in pulmonary pressure made the right heart work harder than normal
2. The hypoxia caused by the recurrent asthma attacks made the right heart ischemic
3. The retention in CO2 the asthmatic experienced over the years caused and acidosis damaging the heart tissue
4. The repeated use of beta 2 agonists caused positive inotropic and chronotropic demands on the heart without sufficient oxygenation

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

Which of the following signs would you most likely expect to see as you assess a pt with a slow lower GI bleed?

1. Melena
2. Hematuria
3. Hematemesis
4. Hematochezia

1. Melena

A pt has CP, nausea, and general weakness. BP is 80/50, HR 58, you observe a first-degree heart block on your ECG, and your 12 lead indicates ST elevation in V1 and V2 with development of Q waves. Which of the following best describes the clinical significance of these findings?

1. The pt is likely to go into a complete heart block
2. The left CX is the probably location of the blockage
3. The pt should next progress into a second degree type 1
4. Atropine would be a safe drug to administer to increase the heart rate

1. The pt is likely to go into a complete heart block

You are called to treat a pt with a hx of Crohn’s disease who is unresponsive, tachycardic, pale, cool, clammy, and normotensive. The pt had diarrhea, vomiting, and abdominal pain. Which of the following is most likely to positively affect the unresponsiveness?

1. Fluid resuscitation
2. Oxygen administration
3. Dextrose administration
4. Antispasmodic administration

3. Dextrose administration

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

1. Too much insulin and not enough sugar
2. Too much antidiuretic hormone production
3. Too much sugar, causing hypovolemia secondary to osmotic diuresis
4. Too much sugar and not enough insulin, causing dehydration and ketoacidosis

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

Your 22yo male pt has been recently infected with Haemophilus influenza type B. This pt is at risk for which of the following illnesses?

1. Acute epiglottitis, pneumonia, and meningitis
2. Acute epiglottitis, pneumonia, and hemophilia B
3. Pneumonia, meningitis, and laryngotrachal bronchitis
4. Meningitis, hemophilia B, and laryngotracheal bronchitis

1. Acute epiglottitis, pneumonia, and meningitis

In most major crashes involving motor vehicles that have significant front end damage, the first objective after assuring the scene and pt are safe is:

1. Assuring the doors are not locked
2. Cutting the roof for primary access
3. Removing the windshield and glass first
4. Securing or chaining the bumpers in place to prevent injuries

1. Assuring the doors are not locked

You have a fire involving a vehicle built after 1970. Which of the following vehicle component, introduced after 1970, is most likely the cause of this fire?

1. Car battery
2. Catalyic converter
3. Electronic ignition system
4. Air-bag electrical system

2. Catalyic converter

Which of the following is the greatest common problem facing EMS systems regarding disaster management?

1. Financing
2. Scene stabilization
3. Communication issues
4. Insufficient number of hospital beds

3. Communication issues

When comparing G agents and VX agents, which agent is more toxic and by how much?

1. VX is 10-20 times more toxic than G
2. G is 10-20 times more toxic than VX
3. VX is 100-150 times more toxic than G
4. G is 100-150 times more toxic than VX

3. VX is 100-150 times more toxic than G

The National Disaster Medical System (NDMS) is:

1. A section of the US department of Health and Human Services and is responsible for managing the federal medical response to an emergency or disaster
2. A section of the US department of Health and Human Services and is responsible for managing the military response to civilian disaster situations
3. A section of the US department of Homeland Security and is responsible for managing state and local financial disaster resources
4. A section of the Federal Emergency Management Agency that is responsible for medical disaster oversight

1. A section of the US department of Health and Human Services and is responsible for managing the federal medical response to an emergency or disaster

Which of the following equipment would be viewed as necessary for an “off road” medical pack?

1. Defibrillator
2. Traction splint
3. Manual suction
4. Medication bag

3. Manual suction

On a hazmat scene one of the technicians is briefing everyone and mentions that toxidrome associated with a particular chemical. Your junior partner asks you to define the term “toxidrome”. What do you tell him?

1. Scale of measuring toxicity of a drug
2. Chemical weapon designed to be extremely toxic
3. Poisonous substance capable of causing injury or death
4. Collection of signs and symptoms that indicated a poisoning

4. Collection of signs and symptoms that indicated a poisoning

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

1. Triage
2. IC
3. Staging
4. Treatment section

2. IC

EMS is typically responsible for which of the following at a hazardous materials incident?

1. Establish a decontamination sector for the injured
2. Retrieve victims from the hot zone and provide decon
3. Contain the spill and prevent further damage to life and property
4. Use the placard system to identify the chemical

4. Use the placard system to identify the chemical

What is the risk of injury or illness to people at a scene where there is a substance that has a high threshold limit for all values? The substance also has a very high flash point, and a very low vapor density.

1. Very low and they could be moved to lower elevations
2. Very high and they should be moved to higher elevations
3. Very high explosive risk and they should be moved far away
4. Very low with he exception of ignition concerns from static electricity

1. Very low and they could be moved to lower elevations

A pt’s hands were exposed to a large amount of radiation in a short period of time about a week ago and he now has blisters on his hands. This pt is suffering from:

1. Radiation injury
2. Radiation illness
3. Radiation sickness
4. Radiation poisoning

1. Radiation injury

Which one of these is the most correct regarding an emergency landing zone?

1. 50×50 feet is needed for most landing zones
2. Use flashlights to signal the pilot at the landing zone
3. Rotary wing aircraft can usually land on a sloping terrain
4. Remember to remove your hat when approaching a rotary wing aircraft

4. Remember to remove your hat when approaching a rotary wing aircraft

Which of the following would be classified as a multiple casualty incident?

1. 10 injured people and only three ambulances available
2. Any time three or more people are injured at a given scene
3. Any time five or more people are injured at any given scene
4. Twenty injured people with at least 20 ambulances available

3. Any time five or more people are injured at any given scene

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

1. Past community responses and projected demographic changes
2. Local hospital peak loads and projected demographic changes
3. Projected demographic changes and reserve staffing capacity
4. Past community responses and local hospital peak loads

1. Past community responses and projected demographic changes

Which of the following would best prepare an emergency provider to be prepared for MCIs and disasters?

1. Being aware of local state scene authority law
2. Being familiar with the triage system utilized in his area
3. Being familiar with the incident command system in his area
4. Being able to perform skills in a rapid and efficient manner

3. Being familiar with the incident command system in his area

Three ambulances respond to a scene where it is determined that only four pt need transport. What is the best reason to implement the IC system

1. You will need to triage the pt
2. You may overlook one of the pt
3. It provides you an opportunity to practice
4. It is required by law any time you have multiple pts.

3. It provides you an opportunity to practice

You have arrived at a scene involving two vehicles and 12 injured pts. on a quiet street. Which of the following common systems should be initiated?

1. Triage IC
2. Unified IC
3. Singular IC
4. Multiple IC

3. Singular IC

You are using an IC system. What is the best organizational benefit for using standard operating guidelines?

1. Minimizes the effects of a disaster
2. Provides for additional federal and state funding
3. Prevents initial confusion and MCI
4. Allows everyone involved in the opportunity to be familiar with the system.

4. Allows everyone involved in the opportunity to be familiar with the system.

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

1. Reduce the use of the siren
2. Avoid talking with passengers
3. Use a GPS for navigation
4. Delegate other operational duties

4. Delegate other operational duties

You are deciding whether to use the fast break decontamination process of the eight step decon process. What factor affects your decision regarding the choice?

1. Injured rescuer
2. Size of the threat
3. Severity of the threat
4. Self rescued pts.

4. Self rescued pts.

Which is true regarding the administration of atropine in a nerve agent exposure?

1. Atropine removes the nerve agent from the enzyme
2. Atropine is effective even in small doses in nerve agent exposure
3. Atropine should only be given to patients experiencing moderate to severe symptoms
4. Atropine blocks the pt from experiencing fasciculation, weakness and respiratory arrest

3. Atropine should only be given to patients experiencing moderate to severe symptoms

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

1. They should be guided and protected
2. They should be utilized for help wherever possible
3. All should be considered suspects until cleared from suspicion
4. If they are able to walk they are usually capable of helping themselves

3. All should be considered suspects until cleared from suspicion

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