Emergency Medical Scenarios, Exams of Nursing

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Paramedic FISDAP Final exam

questions and answers solution 2023

1. A 30 year old climber is experiencing sever shortness of breath after reaching an elevation of 12000feet. The PT is very anxious and has rales noted to all quadrants but is otherwise healthy. He is not accustomed to high altitudes. What should you do? - Administer oxygen while descending to a lower altitude.
2. A 26 year old female does not respond to verbal stimuli but moans in response to pain. A friend states the patient has ingested approx 150 amitriptyline tables. Vital Signs are BP 88/50 R16. You establish IV access and administer a fluid challenge. En route to the hospital her ECG shows a widening QRS. You should administer - Sodium Bicarbonate.
3. You PT experienced trauma yesterday and you are transferring her to a larger facility. She has been experiencing progressive hypoxia. You notice coarse crackles in all lung fields on ventilation. Vital signs are BP 90/50 and SPO2 90%. You should - Transport emergency and continue ventilation.
4. An alert 22 year old male was just disentangled from debris in a house collapse. He denies head or neck pain, but complains of server hip pain. Vital signs are BP 88/40. P120 R 16 you should administer. - sodium bicarbonate
5. Braxton Hicks contractions - occur in the second trimester and are false labor.
6. A 40 year old male crashed his motorcycle. He had a brief loss of consciousness, woke up and walked home. You find him 2 hours later at home unconscious. You should suspect. - epidural hematoma
7. A 47 year old male who was found unconscious on the side of the road respond only to painful stimulus. When you attempt to establish IV access he stiffens his arms and legs. He has minor abrasions all over his body. Vital signs are BO 178/122 P56 R irregular ETCO2 30. What should you do? - Assist ventilations at 12 breaths per minHg.
8. A 28 year old female has a sudden onset of tightness in her chest and server difficulty breathing. Her tongue face and neck appear swollen and she has red itchy hives on her torso. Her signs are BP 80/40 P 130. You should administer - Epinephrine 0.3mg
9. You are asked to set up a patient treatment area after a box labeled "radio active" was found unattended in a park. Which of the following would be the best location. - Building in the park

10.You are at a house fire with multiple patients. Which patient should be transported First to a burn center? - 52 year old with second degree burns to face and right hand 11.What is the most common cause of status epilepticus in adults. - Failure to take prescribed medications 12.A 58 year old male with history of renal failure complains of dizziness lethargy and difficulty breathing. He says he missed his last dialysis appointment. Vital signs are BP 160/90 P 100 R 28 with rales heard in the basses. SPO2 92% you should suspect. - Fluid Overload. 13.A 12 year old girl is seizing. Her mom tells you that her daughter has been feeling tired for days. Her skin is dry and she has been very thirsty. Vital signs are BP 118/80 P115 R26 you should suspect. - Diabetic ketoacidosis 14.A 42 year old female has fallen down a flight of stairs. She appears anxious her skin is cool and clammy her radial pulses are weak at 112 beats per min and she complains of abdominal pain in the left upper quadrant with radiation to the left scapula. You should suspect. - Torn or lacerated spleen. 15.Emergency medical responders are ventilating an apneic medical patient with a bag valve mask. You note abdominal distention and minimal chest rise. What should you do? - Reposition the head. 16.A 6 month old male was found lying face down in the crib. He is cyanotic and apneic. A weak brachial pulse is present. You are unable to see a chest rise with your second attempt at rescue breathing after repositioning the head. What should you do. - Start CPR 17.You have just been called to a dialysis clinic for a 58 year old male in cardiac arrest. The online physician may order you to administer which of the following medications. - Sodium Bicarbonate. 18.A 27 year old male has been assaulted with a pen in the supraclavicular area. He is anxious and pale and his vital signs are BP 80/42 P 128 R 32 and shallow. First responders have sealed the wound with a bandage. Assessment reveals lung sounds on the right and poor chest rise what should you do. - Burp dressing 19.A 50 pound child is unresponsive pulseless and apneic. The cardiac monitor displays ventricular fibrillations. CPR is in progress. The initial defibrillator should be at.

• 50 joules.

32.A 19 year old male has suffered blunt trauma on his left chest. He complains of server dyspnea and pain over the affected area. Vital signs are BP 92/60 P 128 R 32. Breath sounds are very diminished over the left chest. You should - perform needle thoracostomy 33.A 44 year old patient has a persistent cough and occasional spits up bloody sputum

. He has been living in a a shelter for the past three weeks and he smells like alcohol you should. - Put on N95 mask and eye protection. 34.While treating a patient with suspected TB. What type of personal protective equipment is essential - HEPA respirator 35.A 2 year old male has been sick over the last 48 hours with a low grade fever runny nose and upper respiratory infection. He has a seal bark cough. The patient is using accessory muscles to breath and appears fatigued his upper airway has stridours sounds. His lung sounds appear clear. SPO2 92% how would you treat the patient. - Oxygen nebulized racemic epinephrine transport.

36. 78 year old male lying unresponsive in his bed vital signs are BP unobtainable. R 12 and normal depth radial pulse rate matches ECG below ECG bradycardia - Perform transcutaneous pacing. 37.A 48 year old patient is chocking on a hot dog. He is unresponsive apneic and has a strong pulse. Chest compression are infective at relieving the obstruction. You should. - use lagosopy and magill forceps to remove the object. 38.87 year male is complaining of dizziness. Physical exam revals pale cool and diaphoretic skin. Pulse matches ECG bradycardia. You should - administer atropine 39.A 14 year old patient was pulled form a indoor pool. She is pulseless and apneic. You should - perform CPR endotracheal intubation establish an IV and administer epinephrine 40.A trauma patient has lost approx 500ml of blood the amount of crystalloid solutions needed to replace this blood loss is - 1500 ml of saline ( 3 to 1 rule) 41.A 43 year old female has been stuck in the chest with a baseball bat. There is a large bruise over her sternum. She is obversely in pain an states her heart feels like it is beating funny Vital signs are BP 109/80 P 124 and irregular R 22 The ECG show sinus tachycardia with ST elevation and frequent PVC's. You should suspect - myocardial contusion 42.A 28 year female is speaking very quickly and stating that she is going see the president of the united states after she buys all her family members a new car. She has not slept in four days because she does not need sleep.

She usually takes lithium but

and believes that the

children plan to harm him. Which of the following statement is most helpful when treating the patient. - I understand that you are concerned. Can you tell me more about why you fell this way. 53.A 67 year old man has collapsed and is on the floor. He is pale clammy and moaning with vomit around his mouth. Vital signs are BP 180/30 P and weak R28 and shallow. Oropharynx is clear and lungs are clear bilaterally. His ECG shows ventricular tachycardia. That should you do? - Synchronized cardio100J 54.You arrive at the scene of a single vehicle crash. A woman walks up to a your ambulance with a cut on her forehead. You should - determine if she is the only victim 55.A 73 year old male has several fractured ribs on his right side with unequal chest wall movement. He has dyspnea and diminished breath sounds on the right. Vital signs are BP 124/76 P124 R 26 and shallow. His trachea is mid line and neck veins are flat. Most likely has - a flail chest segment 56.You have just converted a 318 lb cardiac arrest patient into a normal sinus rhythm. She is hypotensive and you have been ordered to start the an epinephrine drip at 3mcg/min using a 60 drip set. You have mixed a 4:1 concentration of epinephrine and should set the drip rate at - 45 drops/min (clock) 57.You are assisting with a deliver and the infants head has been deviled. You notice the umbilical cord is wrapped around the infants neck. You should - gently slip the cord over the infants head or clamp the cord in two places and cut between the clamps to release the cord. 58.A 50 year old male is complaining of a chronic cough. He has lost his appetite and has had hot flashes and periods of sweating during the night. He has noticed some red specks in his sputum when he coughs. You should suspect - Tuberculosis 59.A patient has surfaced rapidly from a deep dive and is now complaining of difficultly breathing and extreme muscle and joint pain. You should - Transport rapidly to the nearest hyperbaric chamber. 60.It is mid-December and a 13 month old child is awakened in the middle of the night with barking cough and inspiratory stridor. The child has been ill for a few days with chills and congestion. You should suspect - croup 61.An 80 year old male has just collapsed. Vital signs are BP 90/40 pulse matches ECG 3 degree block R 20 What should you do? - Apply transcutaneous pacing. 62.A patient involved in a motor vehicle crash has an obvious open femur

guarding his chest and he gasps "i cant breath". You should be MOST concerned by the

• respiratory difficulty 63.A 37 year male is chocking and has become unconscious. Attempts to ventilate are unsuccessful. you should - perform chest compressions 64.An unconscious 78 year old male post cardiac arrest is being actively ventilated with a bag valve mask. Initial vitals are BP 98/40 P 82 and irregular. After several minutes reassessment of vital signs are etco2 22 BP 68/28 and irregular spo2 92 you should - decrease the rate of respirations 65.An 86 year old female presents with a rhythm in the ECG she is immobile due to server arthritis and has a history or atherosclerosis and hypertension. What should you suspect - Left ventricular hypertrophy LVH 66.A 37 year old suicidal male is bing violent. Police has pinned him in a prone position but he continues to struggle and fight. You should - sedate the patient and place him supine on the stretcher in soft restraints 67.The termination of pregnancy for maternal health reasons is called a - therapeutic abortion 68.While using the START system at a major incident you encounter a patient not breathing. After positioning the airway the patient breaths 16 a min. You should catagorize him as? - Immediate 69.You are transporting the victim of a major trauma which occurred yesterday to a larger facility. This patient has been experiencing progressive hypoxemia. You hear coarse crackles blatantly during auscultation of the lungs and the pulse oximetry reading is falling in spite of the patent being intubated. You should suspect - that acute respiratory distress syndrome has developed 70.A 19 year old female is 25 weeks pregnant. She has server headache blurred vision and edema she has not regularly seen a doctor during her pregnancy. What other symptom should you expect. - hypertension 71.Which of the following is a cause of multifocal atrial tachycardia - Electrolyte imbalance 72.After receiving Narcan. A patient is waking up quickly and pulling at the airway you have placed. Before removing it you should - prepare to begin suctioning 73.A 66 year old male complains of server dyspnea. His has breath sounds on the right and diminished on the left. He has a long history of cigarette smoking. Vital signs are

BP 80/30 P124 R 26 and shallow SPO2 88% on 4 lpm What should you suspect? - Emphysema exacerbation 74.A patient is complains of left calf pain. The left leg is cool to the touch and paler than the right leg. You should suspect - Arterial occlusion 75.After placing a combitube bilateral breath sounds are present and chest rise is equal. You notice quiet gurgling in the stomach with each ventilation. You should. - add air to the distal cuff 76.A seven month old is breathing at a rate of 60 per min. He has nasal flaring and intercostal retractions. You hear stridorous noises on inspiration. This is most likely caused by a - foreign body obstruction the upper airway 77.A 28 year old suffered a head injury. Vital signs a BP 140/120 P 55 R 30 and irregular. Which of the following signs would you expect to see in this patient. - Decerebrate posturing 78.During transportation you PT becomes very upset complaining about her medical expenses. How should you respond? - You seem angry is there any way hat i can help 79.Which of the following pharmacological agents are most likely to cause premature arterial contractions. - stimulants 80.You are dispatched to a house early on the morning for a family complaining of headaches and nausea. You should - evacuate the house. 81.A patient is threatening suicide because his wife left him. Which of the following statements or questions would be appropriate? - What method had you intended to use to kill yourself 82.A 44 year old male complains of extreme fatigue headache and fever with pain in this right upper quadrant and joints. He admits to a history of alcoholism and smoking two pack per day for the past 20 years his skin and sclera are yellow in color. You should suspect - hepatitis 83.A patient was just pulled from a burning building. You have started oxygen and initiated transport. While en route to the hospital you notice singed hairs around his face and a spot around his nose and mouth.. He is coughing up black sputum mixed with blood and shows signs of increasing hypoxia. Which developing condition is your biggest concern. - Laryngeal edema

128 R 28 you should suspect - neurogenic shock or Hypovolemia do to bleeding from other injury's 96.You are working during inclement weather in a remote location. The nearest hospital is more than two hours away. Your patient just delivers a healthy baby boy but has inverted her uterus. What orders you expect from an online physician - Replace the inverted uterus with a gloved hand 97.A 67 year old female with a history of diabetes complainants of nausea and began vomiting an hour ago. She denies any pain her blood glucoses is 208 her skin is cool and pale vital signs are BP 146/88 R 24 P 126 and irregular. What should you suspect - Myocardial infarction 98.A 34 year old female crashed her motorcycle while wearing an open face helmet. She is unconsciousness her facial bones and soft tissue are missing from the nose to the upper part of her neck. You are having difficulty ventilating her and you can see bubbles coming from the center of a large mass of tissues when she exhales. You should - insert an ET at the site of the bubbles 99.A 14 year old female is crying and complain of knee pain after a soccer injury. The knee is deformed and obviously angulated. Distal pulses are intact. You should - apply ice split in position found and transport 100.A 53 year old man fell from a ladder. he has multiple abrasions and localized swelling on his head. You have oratorically intubated him. His ETOC2 is 30 his pupils are midpoint and reactive how many times per minute should you ventilate - 10 102.A patient involved in a fist fight. He complains of point tenderness in the right upper abdominal quadrant. You should suspect injury to the - liver 103.Successful intubation of a newborn is more successful by placing padding under the - shoulders 104.For the past 5 min you have been providing ventilations to an intubated patient and performing CPR it is becoming progressively more difficult to ventilate and the chest is moving less during inspiration. What should you suspect - tension pneumothorax 105.An elderly pt is complaining of dyspnea that woke her from sleep about an hour ago. She denies chest pain. Auscultation reveals wheezing and crackles in both lower lobes of her lungs. Vitals signs are 158/108 P 128 and irregular R 32 and slightly labored what should you administer - albuterol

106.A 59 year old pt is lethargic with shallow respiration he has a valid DNR order during transport his respiratory rate diminishes to 8 breaths a min you should - begin assisting with a bvm 107.a 89 year old nursing home pt is in respiratory distress. She is on 3 lpm of oxygen by nasal cannula. She has a history of COPD asthma and diabetic and you note wheezing in all lung fields. Vitals BP 146/84 P 114 R 24 you should - place her on 15 lpm or oxygen via nonrebreather mask 108.you are performing Orotracheal intubation with a mac blade. You can see the cords when you notice the top of the blade is in the vellicula you should - pass an ET through the cords 109.A confused 34 year old male is ambulatory ofter crashing his car. Airbags were deployed he complains of extreme wrist pain and double vision. You note deformity and superficial burns on his writs what should you do - cspine 110 A patient with server closed head injury vitals 180/112 P 48 R 8 and irregular immediate treatment should include - intubate and ventilate at 20 breaths per min 110 A 22 year old pregnant patient is experiencing a significant amount of painless bleeding shorty after sexual intercourse. The most likely cause is - placenta previa 111.An elderly patient has been ill for last few days and has been vomiting. He reports chest discomfort and is now pale and diaphoretic. Vitals BP 130/70 R24. ECG shows (afib RVR) You administer oxygen and now have an IV you should. - Fluid bolus 112.Signs and symptoms of hypoglycemia may mimic which of the following conditions

• CVA 113.A patient complains of server right upper quadrant pain. Right scapula pain and nausea after eating a cheeseburger you should suspect
• cholecystitis 114.Your patent is suffering from exacerbated emphysema which of the following medications is least likely to be a part of his standard therapy - nitrates 115.A 7 year old has a suspected broken arm and numerous bruises what finding would lead you to suspect that a mothers account of the injures may not be true. - You note purple yellow and green bruises ( indicates different stages of healing)

117.Followng a cardioversion of a 72 year old female she coverts to the rhythm bellow ( 3 degree) you identity this as - third degree heart block 118.A 13 year old has been found unresponsive. Her mother proves you with a prescription bottle of Oxycontin. What should you give? - narcan 119 A man was involved in a lateral impact auto accident that deformed the vehicle. The patient could have sustained a? - traumatic aortic dissection 120 You are assisting with vaginal delivery. The infant head has been delivered and the mouth and nose suction. To deliver the anterior shoulder you should - gently guide the infants head downward 121.A 22 year old female 22 weeks pregnant is experiencing abdominal discomfort during evaluation you notice the umbilical cord is pressing the vaginal canal. How should the patient be positioned - supine with legs open

122. Which of the following situations constitutes abandonment? - A patient is unattended in the ambulance while loading a second patient 123.A patient is arching his back and rolling his eyes upward. He was recently prescribed compazine. How should you teat this patient? - 25 mg benadryl IVP 124.A 38 year old male has been sick for a few days he is now complaining of sharp mid chest pain vitals 118/69 pulse 124 and regular and R 24 and slight laberod temp 102. You should suspect? - pericarditis 125 46 year old male is alert oriented and complains of a headache. He has tremors in his hands he has been in the detox unit for 32 hours. Vitals signs are BP 210/100 P100 R 25. He has a history of alcoholism and seizures. He takes tegretol you should administer - 20mg diazepam 126.You are reliving a crew form a 24 hour shift before you compete the ambulance check you are dispatched to a cardiac arrest with CPR in progress. what should you do before leaving for the call? - ensure essential equipment is present and the ECG monitor is functional 127.A pregnant patient is experiencing contractions upon examination you notice that the infantst head is bulging from the premium and the patent has the urge to push what stage of labor is this? - two 128.you are dispatched to a playground for a patent with difficulty breathing. Upon arrival you find a five year old male who appears anxious with noted cyanosis and intercostal retraction BP 85/pb P112 R24 with swelling of the upper airway. You should suspect - anaphylaxis

129.A 28 year old female is 34 weeks pregnant and experiences sudden sharp tearing pain in her abdomen and developers a rigid abdomen what should you suspect - abruptio placenta 130.After a prehospital delivery the mother should be allowed to breastfeed her newborn because - breast feeding helps constrict the uterus and reduce bleeding 131.A two year old male has been ill for several days with a respirator tract infection. Yesterday he developed server headache high fever and extreme lethargy. You should suspect. - meningitis

132. When starting an external jugular IV the needle should point - toward the feet 133.while using the backwards upward right pressure BURP maneuver during an orotracheal intubation you patient begins to vomit. What should you do? - Stop the intubation attempt and suction 134.You have just assisted with the delivery of a 32 week old infant. She is apneic and has a pulse of 64. What should you do? - open the airway ventilate with a bag valve mask for 30 seconds and reassess 135.During a yearly heath screening a clinic discovered your patient has the heart rhythm shown below (bradycardia). She alert and oriented but scared because the clinic call for an ambulance Vital signs bp 114/50 R12 spo 99%. You should administer - atropine 136.A 18 year old male was 40 miles into a long distance bike race when he had a syncopal episode and fell off his bike. He responds to painful stimulation BP 60/40 P160 skin cool and diaphoretic. You should administer?

• lactated ringers 137 An 18 year old male suffered second degree burns to his entire head and neck anterior chest and both arms while removing a radiator cap from his overheated engine. Using the rule of nines what percentage of his body is burned? - 36% 138 You are unable to ventilate a trauma patient with extreme facial trauma using advanced airway maneuvers. You should - insert a 14 g needle in cricothyroid membrane 45 degree angle.

139. Which of the following is a prehospital medication given for compartment syndrome

• sodium bicarbonate 140.which of the following would be an indication for the use of needle cricothyrotomy?

141.A pale diaphoretic patient complains of chest pain at a level of 6 on 1- 20 BP 132/88 you see the following ECG (ST elevation) You have established oxygen and an IV you should give? - ASA and admin nitroglycerin 142.Identify this rhythm - paced rhythm 143 A 25 year old female was bitten by something while hiking 12 hours ago. She has slurred speech double vision and excessive salivation her boyfriend states she had a seizure about 20 min ago. You should: - thoroughly wash and immobilize the wound and start an IV 144.An obese 77 year old woman called EMS complaining of dyspnea cough with hemoptysis and diaphoresis. You note tachypnea tachycardia crackles and wheezing. She also has varicose veins. Find significance differences in BP between the right and left arms. You should suspect. - aortic aneurysm 145.A 76 year old patient is lying in soiled sheets with diarrhea and vomit. Both the stools and emesis look thick black and tarry similar to coffee grounds What should you suspect? - upper gastrointestinal bleeding 146.Your 3 lead ECG is shown below. You correctly identity the rhythm as? - 1st degree 147.A six year old female has suffered blunt trauma to her right upper quadrant. She responds to painful stimulation vitals signs 50/30 P132 R 32 she is in? - hypovolemic shock 148.You are first on scene of a crash. Where should you park your vehicle. - place the ambulance to block traffic 149.A 50 year old male at a mountain resort has begun to experiencing shortness of breath headache and dizziness. Lung sounds reveal inspiratory crackles. You should suspect - high altitude pulmonary edema 150.A seven year old is having difficulty breathing. He is lethargic with central cyanosis and poor muscle tone. Vitals Signs are P 70 and R 10. You should suspect? - Respiratory failure 151.An 84 year old male has extreme difficulty breathing apprehension cyanosis and diaphoresis. Assessment findings include elevated pulse and blood pressure and rales and rhonchi you should treat this patient for? - left ventricular failure 152.Online medical direction has ordered you to administer 13 mcgkf/min of dop to a patient who weighs 190lbs. Your concentration of dopamine is 1600 mc/mi you are going to administer this through a Micro-drip tubing. At how many drops per minute should you set the IV infusion - 42 gtts/min

153.You have just given a bolus of dextrose to an unconscious female patient with a blood glucose level of 30. The repeat blood glucose level is now 120. She is now alert and oriented and she refuses further treatment of transport. What should you do? - ask a neighbor to monitor the patient after you leave. 154.Ten workers were exposed to fluorine gas fumes but only two exhibit symptoms. One additional worker was exposed to hydro-fluoric acid on his skin. He is being decontaminated with water by the company's response team. Two ambulances are on scene. You should plan and prepare to? - order a full scale mass casualty response including eleven ambulances and additional fire and law enforcement agencies 155.A 54 year old male has fallen and is holding pressure on his abdomen with bloody kitchen rag. He has had abdominal surgery last week and his incision has ruptured and the abdominal contents are protruding. Vitals are BP 100/68 P 124 R 20 what should you do? - remove the rag apply a moist sterile dressing 156.You have just been stuck with a blood contaminated needle. You should you immediately deal with the exposure? - wash the affected area with soap and water 157.A container of hydro-flouric acid has spilled at a local metal plant. The hazmat team is responding and you are asked to stage at the front gate of the business where the company safety manger is waiting for you. What info would ou expect his manger to have - material safety data sheet MSDA 158.A 33lbs child is experiencing fever poor appetite purpura and vomiting. His cap refill is 3 seconds he is tachycardic you should administer - 300ml of crystalloid solution 159.Your crew is the first unit to arrive for a suspected radiation emergence after a box labeled recitative material was found unattended in a park. What three principals should you follow? - time distance and shielding 160.A 19 year old male has suffered a significant blunt trauma to his left anterior chest. He is in obvious respiratory distress vital signs are BP 80/p P 140 R 32 lung sounds are diminished and there is dullness to percussion over the left side of the chest. You should suspect - hemothorax 161.Side effects of oral contraceptives include - pulmonary embolism and stroke. 162.You are first on scene of a car crash. You partner stops the ambulance a safe distance from a single vehicle that crashed into a concrete barrier. Black smoke is coming from underneath the hood. The vehicles only occupant screams for assistance you should? - rapidly extricate the occupant without a cervical collar