FISDAP Paramedic Final Exam Questions with Complete Verified Solutions 2024(635 Questions, Exams of Nursing

Download FISDAP Paramedic Final Exam Questions with Complete Verified Solutions 2024(635 Questions and more Exams Nursing in PDF only on Docsity! FISDAP Paramedic Final Exam Questions with Complete Verified Solutions 2024(635 Questions and Answers) You have received an order for a dopamine drip. You carry 500cc bags of D5W. How much dopamine should you add to the bag to create a 1600mcg/1mL dilution? A. 800mg B. 1600mcg C. 1600mg D. 400mcg A. 800 mg 2. During the absolute refractory period, what happens to the cardiac cell? A. It is unable to be stimulated. B. The cell is vulnerable to partial stimulation. C. Potassium is being pumped out of the cell. D. Calcium has just rushed into the cell. A. It is unable to be stimulated. 3. A 29 year old female fell from an 18 foot roof. During your rapid trauma assessment, where are you most likely to find life-threatening injuries? A. Head, neck, extremities B. Head, chest, abdomen C. Abdomen, pelvis, arms D. Chest, pelvis, extremities B. Head, chest, abdomen 4. Unequal pupils are a result of pressure on which structure? A. Central medulla B. Trochlear membrane C. Vagus nerve D. Occulomotor nerve D. Occulomotor nerve 5. What is an abnormally high level of carbon dioxide in the blood called? A. Pneumonia B. Hypoxia C. Hypercapnia D. Emphysema C. Hypercapnia 6. What is oxygen deficiency in the body called? A. Hypercarbia B. Hyperoxia C. Hypoxia D. Hypoxemia C. Hypoxia 7. What is your initial priority at a trench collapse? A. Establishing medical command B. Maintaining control of the crowd C. Preventing a secondary collapse D. Protecting the patient's airway A. Establishing medical command 8. A 23 year old male complains of neck stiffness and flu symptoms for the past few days. He also describes a high fever with a severe headache, dizziness and blurred vision. What should you suspect? A. Hemorrhagic stroke B. Migraine C. Meningitis D. Influenza C. Meningitis 9. What causes an emphysema patient to have a pink appearance? A. Elevated PCO2 level B. Polycythemia C. Anemia D. Elevated PO2 level C. Ruptured diaphragm D. Flail chest C. Ruptured diaphragm 21. How does the blood flow through the heart? A. Right ventricle to right atrium to lungs to left ventricle to left atrium B. Right atrium to right ventricle to lungs to left atrium to left ventricle C. Left ventricle to left atrium to lungs to right ventricle to right atrium D. Left atrium to left ventricle to lungs to right atrium to right ventricle B. Right atrium to right ventricle to lungs to left atrium to left ventricle 22. As soon as an infant's head is delivered, what should you do? A. Determine the location of the umbilical cord. B. Rotate the shoulders to the anterolateral position. C. Examine the vulva and perineum for lacerations. D. Exert strong steady pressure on the fundus. A. Determine the location of the umbilical cord. 23. A patient has aphasia following a stroke, which lobe of the brain was affected? A. Temporal B. Occipital C. Parietal D. Frontal A. Temporal 24. What does the P wave represent with an ECG? A. Ventricular depolarization B. Atrial depolarization C. Ventricular repolarization D. Atrial repolarization B. Atrial depolarization 25. A lethargic 22 month old male presents with hoarseness and coughing. He has sternal retractions and his belly and chest move in opposite directions with each breath. He is breathing at a rate of 64. What should you suspect? A. Cardiopulmonary failure. B. Respiratory failure. C. Cardiopulmonary arrest. D. Respiratory distress. B. Respiratory failure. 26. A patient was ejected from an automobile and is apneic and pulseless. ECG reveals a regular rhythm with an R-R interval of 1.24 seconds and a QRS width of 110 milliseconds. You should consider A. transcutaneous pacing. B. atropine 0.5 mg IV. C. epinephrine 1 mg IV. D. adenosine 6 mg rapid IV. C. epinephrine 1 mg IV. 27. What organ is located in the upper right quadrant? A. Kidney B. Liver C. Pancreas D. Spleen B. Liver 28. A 24 year old male was stabbed in the thigh. Bright red blood spurts from the wound. What should you suspect that the patient severed? A. Vein B. Artery C. Ligament D. Tendon B. Artery 29. A 24 year old male was working underneath his car when it fell off of the jack. He was under the car approximately 20 minutes before being extricated. He has bluish discoloration of his skin above the nipple line. What should you suspect? A. Traumatic asphyxiation B. Pericardial tamponade C. Cushing's triad D. Pulmonary contusion A. Traumatic asphyxiation 30. A unrestrained 24 year old female driver hit an electrical pole and struck the steering wheel. She appears pale and complains of nausea and abdominal pain. What organ is LEAST likely to suffer an injury as a result of this impact? A. Spleen B. Diagphram C. Liver D. Stomach D. Stomach 31. What causes Down's syndrome? A. Brain trauma B. Extra chromosome C. Bacterial infection D. Psychological trauma B. Extra chromosome 32. Where would you insert the needle to decompress the chest? A. Below the 3rd rib midclavicular line B. Below the 4th rib midclavicular line C. Above the 4th rib midclavicular line D. Above the 3rd rib midclavicular line D. Above the 3rd rib midclavicular line 33. A 67 year old male complains of bloody stool with accompanying nausea and emesis. He states symptoms began 3 days ago. Vital signs BP 100/86, P 88, R 18. What should you do? A. IV fluid bolus B. Administer a diuretic C. Administer an antiemetic D. Apply oxygen A. IV fluid bolus 34. How much time do you have to successfully intubate a patient? A. 30 seconds. B. 15 seconds. C. 60 seconds. D. 45 seconds. A. 30 seconds. 35. What condition results when the alveoli collapse? A. Pneumothorax B. Pneumonia C. Effusion D. Atelectasis D. Atelectasis 36. Why should you administer IV fluid to a patient in hypovolemic shock? A. Increase the blood pressure B. Maintain adequate tissue perfusion C. Increase the body's oxygen carrying capacity D. Maintain the body's homeostatic state B. Maintain adequate tissue perfusion 37. What best defines shock? A. Deficiency of vascular tone due to hemorrhage. B. Inadequate cerebral blood flow. C. Administer sodium bicarbonate D. Administer nitroglycerin B. Begin manual ventilations 49. Which stage of delivery begins with complete cervical dilation and ends with delivery of the baby? A. Second B. Third C. Fourth D. First A. Second 50. A 7 year old boy is found supine at the base of 15 foot high jungle gym. His teacher is unsure if he fell from the equipment. Vital signs are BP 100/90, R 0, P 42, SaO2 93%. What should you do? A. Insert an oropharyngeal airway. B. Open his airway with a head tilt-chin lift maneuver. C. Open his airway with a jaw thrust maneuver. D. Start CPR. C. Open his airway with a jaw thrust maneuver. 51. What process involves a gas that travels from an area of higher concentration to lower concentration? A. Diffusion B. Osmosis C. Activated Transport D. Filtration A. Diffusion 52. A 12 year old male has suffered a blast injury. What phase would projectiles have caused injury to the patient? A. Primary B. Quaternary C. Tertiary D. Secondary D. Secondary 53. A 25 year old female began to experience shortness of breath, chest tightness, and coughing. She has difficulty speaking in full sentences. Vital signs are BP 116/64, P 96 and regular, RR 24 and labored, SpO2 93% on room air. You auscultate her lung sounds and hear high-pitched lung sounds on exhalation. What should you do? A. Assist with her prescribed nitroglycerin B. Administer albuterol via a nebulizer C. Administer abdominal thrusts D. Assist ventilations with a bag-valve mask B. Administer albuterol via a nebulizer 54. You have been assigned to triage at an MCI. Your patient is bleeding from a cut on his head, R 22, P 100 radially, and he keeps asking "What happened?". What priority should be assigned to this patient? A. Yellow B. Red C. Black D. Green A. Yellow 55. A 32 year old female seated at a restaurant has severe wheezing. She is flushed, appears anxious, and has a runny nose. She states that she is allergic to shellfish and peanuts. What should you suspect? A. Anaphylaxis B. Epiglottitis C. Asthma D. Aspiration A. Anaphylaxis 56. You arrive on scene to find a 14 year old male leaning forward in a chair. He appears anxious, is drooling and you hear high-pitched sounds when he inhales. His mother states he has a fever and has been complaining of a sore throat. What should you suspect? A. Anaphylaxis B. Asthma C. Croup D. Epiglottitis D. Epiglottitis 57. How should you ensure that your glucometer is functioning properly? A. Insert a test strip and ensure that the glucometer turns on. B. Measure your partner's blood glucose level and compare to normal. C. Measure your own blood glucose level and compare to your normal. D. Insert a test strip and acquire a drop of the glucometer control solution D. Insert a test strip and acquire a drop of the glucometer control solution 58. What is the biggest difference between cardiogenic shock and hemorrhagic shock? A. Pulmonary edema B. Hypotension C. Cardiac Arrest D. Cyanosis A. Pulmonary edema 59. When you apply an end-tidal CO2 monitor, what are the 3 main items you are measuring? A. Metabolism, perfusion, and ventilation B. Metabolism, perfusion, and respiration C. Metabolism, cardiac output, and ventilation D. Perfusion, ventilation, and oxygenation A. Metabolism, perfusion, and ventilation 60. What do you call progressively deeper, faster breathing alternating gradually with shallow, slower breathing? A. Kussmaul's respirations B. Cheyne-Stokes respirations C. Biot's respirations D. Agonal respirations B. Cheyne-Stokes respirations 61. What happens during phase 0 of the cardiac action potential? A. The sodium-potassium pump is initiated. B. Potassium moves rapidly into the cell. C. The slow calcium channels close. D. The fast sodium channels open. D. The fast sodium channels open. 62. A 26 year old female jumped from the second floor of her house. She states she was getting away from her abusive husband. What should you do? A. Obtain a set of vital signs. B. Check for bilateral ankle fractures. C. Determine if the scene is safe. D. Asses for compression injury to the spine. C. Determine if the scene is safe. 63. What structure has baroreceptors? A. Vena cava B. Ventricular wall C. Atrioventricular node D. Aortic arch D. Aortic arch 64. An alert, 78 year old female complains of dyspnea. She speaks in full sentences and answers all your questions. Vital signs are BP 150/70, P 110 and irregular, R 26 and labored. You note peripheral cyanosis. What should you do? A. Begin positive-pressure ventilation with a BVM. B. Sedate and intubate orotracheally. C. Apply a nasal cannula with high flow oxygen at 2 lpm. D. Apply high flow oxygen at 12-15 lpm. C. Visualizing the tube passing the vocal cords. D. End tidal CO2 confirmation. B. Auscultation of the epigastrium ? 76. A 88 year old male is combative and angry. His wife states that he is normally pleasant and calm. What intervention would narrow your differential diagnosis? A. A response to oxygen therapy B. A blood glucose reading C. If he responds to forceful control D. Cincinnati stroke scale B. A blood glucose reading 77. What does preload refer to? A. The pressure in the filled ventricle at the end of systole. B. The pressure in the filled ventricle at the end of diastole. C. The pressure in the filled atria at the end of the systole. D. The pressure in the filled atria at the end of the diastole. B. The pressure in the filled ventricle at the end of diastole. 78. Which immunoglobulin is mainly responsible during inflammation? A. IgM B. IgE C. IgG D. IgA B. IgE 79. What percent of oxygen is delivered with a pocket mask on room air? A. 23 B. 92 C. 17 D. 10 C. 17 ? 80. A 57 year old male complains of chest pain, shortness of breath and nausea. A 12 lead ECG shows ST elevation in Ieads V2, V3 and V4. What should you administer? A. Dopamine and oxygen. B. Aspirin and oxygen. C. Epinephrine and nitroglycerin. D. Nitroglycerine and oxygen. B. Aspirin and oxygen. 81. Which of the following is an autosomal disorder of the exocrine glands which results in physiological changes in the respiratory, GI, integumentary, and muscoskeletal systems? A. Tuberculosis B. Sickle cell anemia C. Pneumonia D. Cystic fibrosis D. Cystic fibrosis 82. What structure prevents food or liquid from entering the trachea? A. Thyroid cartilage B. Uvula C. Larynx D. Epiglottis D. Epiglottis 83. What is diphenhydramine HCL? A. Beta agonist B. Antihistamine C. Sympathomimetic D. Diuretic B. Antihistamine 84. An 18 year old male was struck in the head by a large rock. When caring for this patient, what should you continually reassess? A. Level of consciousness. B. Locomotor function. C. Pulse motor sensory. D. Quality and degree of pain. A. Level of consciousness. 85. What is the onset of action for succinylcholine? A. 15-30 seconds B. 60-90 seconds C. 3-4 minutes D. 2-3 minutes B. 60-90 seconds 86. You arrive at a house and find the occupants unconscious with the stove on. You should suspect A. carbon monoxide poisoning. B. carbon dioxide poisoning. C. medication overdose. D. cyanide poisoning. A. carbon monoxide poisoning. 87. A 76 year old female is pulseless and apneic. The ECG monitor shows asystole. What should you do? A. Administer epinephrine B. Start chest compressions C. Attempt a precordial thump D. Perform immediate defibrillation B. Start chest compressions 88. Which of the following structures serves as a passageway for both the respiratory and digestive system? A. Trachea B. Pharynx C. Esophagus D. Cricoid cartilage B. Pharynx 89. What is a highly infectious disease that causes bronchiolitis? A. RSV B. Pneumonia C. Common cold D. Asthma A. RSV 90. A 39 year old male has an angulated deformity to the humerus. You cannot feel a distal pulse and the limb is blue. What should you do? A. Contact medical control for pain medication orders. B. Attempt to pull gentle traction and realign the bones. C. Splint with a sling and swathe, apply ice, and transport. D. Transport emergently to the closest hospital B. Attempt to pull gentle traction and realign the bones. 91. A 23 year old male complains of diffuse lower leg pain and tension after a car accident. Pedal pulses are absent bilaterally and you note slight cyanosis in his feet. Vital signs are BP 130/90, P 88, R 16. What should you suspect? A. Iliac arterial rupture B. Bilateral tibial fractures C. Compartment syndrome D. Lower leg embolism C. Compartment syndrome 92. What happens to hemoglobin as the blood pH decreases? A. Releases oxygen. 103. What occurs during compression of the inferior vena cava? A. Supine hypotensive syndrome B. Eclampsia C. Preeclampsia D. Pregnancy induced hypertension A. Supine hypotensive syndrome 104. What will stimulation of a B1 receptor in the heart do? A. Slow the heart with an increase contraction strength B. Speed up the heart rate and increase contraction strength C. Speed up the heart rate and decrease contraction strength D. Slow the heart with an decrease contraction strength B. Speed up the heart rate and increase contraction strength 105. What is abnormality of breathing rate, pattern, or effort called? A. Dysphonia B. Hypoxia C. Dyspnea D. Anoxia C. Dyspnea 106. What are you required to report directly to law enforcement? A. Presence of illegal drugs B. Trauma caused by alcohol use C. Suspected child abuse D. Suspected sexual assault D. Suspected sexual assault 107. What is the function of the ductus arteriosus? A. Provide a way for fetal wastes to leave material circulation. B. Allow blood to bypass the fetus's lungs before birth. C. Allow the neonate to take a breath following delivery. D. Decrease ambient pressure in the lungs before birth. B. Allow blood to bypass the fetus's lungs before birth. 108. You are dispatched to a residence for a 67 year old female complaining of chest pain. The patient is pale, diaphoretic and describes are pain as crushing. Vital signs are BP 120/80, Pulse 100, Respirations are 22 and oxygen saturation is 90 percent. Select the correct medications in order: A. Oxygen, Morphine, Digoxin B. Metoprolol, Nitroglycerine, Aspirin C. Nitroglycerine, Aspirin D. Oxygen, Aspirin, Nitroglycerine D. Oxygen, Aspirin, Nitroglycerine 109. What inherited metabolic disease of the lungs and digestive system manifests during childhood? A. Multiple sclerosis B. Cerebral palsy C. Cystic fibrosis D. Sickle cell disease C. Cystic fibrosis 110. Which stage of shock occurs when cardiac output and systolic blood pressures are maintained by increasing catecholamine production? A. Compensated shock B. Uncompensated shock C. Irreversible shock D. Diffuse shock A. Compensated shock 111. How many people does it take to provide Optimal BVM ventilation? A. 1 B. 4 C. 3 D. 2 C. 3 (Likely wrong, D. 2 is better IMO) 112. During the resuscitation of a 45 year old female you note a change in rhythm and the ECG now shows sinus bradycardia. What should you do? A. Assess for a pulse B. Administer atropine C. Obtain a blood pressure D. Begin transcutaneous pacing A. Assess for a pulse 113. A 23 year old alert and pregnant female complains of severe abdominal pain after an motor vehicle crash. You note her stomach is rigid and distended. There is no vaginal bleeding or discharge. Vital signs are BP 94/58, P 128, R 30 and shallow, SpO2 90%. What should you suspect? A. Uterine rupture B. Placenta previa C. Placenta abruptio D. Pre-term labor A. Uterine rupture 114. A motor vehicle collided with an electrical pole resulting in downed power lines. A large crowd has gathered around the accident. Whom should you call for support? A. Volunteer Fire Department and Rescue Squad B. Local Power Company and State Police C. Volunteer Fire Department and State Police D. Local Power Company and Volunteer Fire Department B. Local Power Company and State Police 115. What effect does reducing preload have in a patient with pulmonary edema? A. Decreased respiratory demand B. Decreased cardiac efficiency C. Increased afterload D. Improved cardiac efficiency D. Improved cardiac efficiency 116. Which of the following would properly represent a female who has been pregnant three times, given birth twice, and had one spontaneous abortion? A. P3, G2, AB1. B. P5, G2, AB1. C. G3, P2, AB1. D. G2, P2, AB1. C. G3, P2, AB1. 117. A 28 year old male has severe flank pain radiating to his back. He squirms around on the floor unable to find a comfortable position, rating his pain a 9/10. He has consumed no fluids over the past day. Vital signs are BP 200/80, P 100, R 18. What should you do? A. Administer morphine or hydromorphone. B. Apply oxygen by nonrebreather mask and transport. C. Establish IV access and administer a fluid bolus. D. Administer aspirin and nitroglycerin. A. Administer morphine or hydromorphone. 118. An 18 year old female with a suspected cervical spine injury has a significant amount of blood in her mouth. What should you do? A. Stabilize her head and suction her airway. B. Perform a jaw-thrust maneuver and attempt to ventilate her. C. Perform a jaw-thrust and finger sweep in order to remove blood from her mouth. D. Assess the her respiratory rate for no longer than 30 seconds. A. Stabilize her head and suction her airway. 119. A a family calls you to take their 20 year old son to the hospital for an involuntary psychiatric evaluation. They state that he is physically aggressive and refuses to take his antipsychotic drugs. He is quiet and refuses to communicate. What should you do? A. Ask the parents to help you restrain the patient. 130. An alert 17 year old male was struck in the abdomen with a large wrench. Vital signs are BP 90/78, P 120 R 22. He is cool, pale and diaphoretic. Palpation of the abdomen reveal bruising, pain, and rigidity to the right upper quadrant. To which organ should you suspect injury? A. Spleen B. Liver C. Right kidney D. Small intestine B. Liver 131. An intoxicated 45 year old homeless man was hit in the chest. He complains of pain with inspiration. Bilateral lung sounds are clear. Vital signs are BP 130/80, P 76, R 12, SpO2 94%. What should you suspect? A. Rib fractures B. Tension Pneumothorax C. Head injury D. Pericardial tamponade A. Rib fractures 132. What does oversecretion by the adrenal cortex cause? A. Cushing's disease B. Diabetes mellitus C. Myxedema D. Graves' disease A. Cushing's disease 133. What is the main site of drug metabolism? A. Liver B. Kidney C. Spleen D. Lungs A. Liver 134. Your 65 year old male patient presents with a fever and sharp, steady pain along the upper neck and shoulder that worsens when he takes a breath. Vital signs are BP 144/92, P 99 and regular, R 18 and regular, SpO2 of 95% on room air. What should you do? A. Administer nitroglycerin B. Obtain intravenous access C. Perform a 12-lead ECG D. Apply oxygen C. Perform a 12-lead ECG 135. A 23 year old pregnant female is pushing when you arrive. You find her bag of water broke and the fluid was green. Fetal heart tones are 80. What should you do? A. Encourage her to continue pushing. B. Start at least one large bore IV. C. Place her on her side and apply oxygen. D. Place her in knee-chest position and apply oxygen. C. Place her on her side and apply oxygen. 136. A 16 year old boy tells you that he "caught" his 40 year old mother "holding a handful of sleeping pills." The son explains that she is depressed, and he is convinced that she meant to kill herself. She is extremely agitated and is refusing treatment. What should you do? A. Request law enforcement assistance to transport the patient. B. Contact social services to recommend they follow up on this family. C. Carefully document the woman's refusal and have her sign the form. D. Encourage the patient to see a mental health professional that day. A. Request law enforcement assistance to transport the patient. 137. A 56 year old female has an arm injury with arterial bleeding. The dressing becomes soaked with blood. What should you do? A. Wrap an elastic bandage around the blood soaked dressing. B. Apply additional dressing material with direct pressure. C. Remove and replace the dressing with a thicker dressing. D. Cover the existing dressing with an occlusive dressing. B. Apply additional dressing material with direct pressure. 138. A 32 year old female attempted to commit suicide by taking sleeping pills and cutting her wrists. She has dark red blood oozing from the wrist lacerations. Vital signs are BP 90/52, P 130 and weak, R 18. What type of bleeding should you suspect? A. Arterial B. Superficial C. Venous D. Capillary C. Venous 139. A 51 year old male with a history of COPD is having difficulty breathing. Vital signs are BP 136/74, R 22, P 100, SpO2 95%. What should you do? A. Apply high-flow oxygen by bag-valve mask. B. Withhold oxygen to avoid decreasing the hypoxic drive. C. Apply low-flow oxygen by nasal cannula. D. Administer oxygen by nonrebreather mask. D. Administer oxygen by nonrebreather mask. 140. What is the leading cause of cardiac arrest in pediatric populations? A. Infection B. Blunt force trauma C. Respiratory compromise D. Hypovolemic shock C. Respiratory compromise 141. A 55 year old female has difficulty breathing and is unable to lie supine. She has pedal edema and bilateral crackles are heard on auscultation. What should you suspect? A. Congestive heart failure B. Asthma exacerbation C. Chronic bronchitis D. Myocardial infarction A. Congestive heart failure 142. An alert, ambulatory, 26 year old female admits to laying her motorcycle down at 25 mph to avoid a crash. She has extreme pain to her left side where you note severe abrasions. She denies any neck or back pain. What should you do? A. Sterile dressings and treat her pain with ice. B. Oxygen and transport in a semi-sitting position of comfort. C. C-collar and immobilize her fully in the standing position. D. C-collar and transport her on his left side. C. C-collar and immobilize her fully in the standing position. 143. A 45 year old female has type I diabetes and a non-healing foot ulcer. You find that she lacks sensation in her foot. What should you suspect? A. Brown-Sequards B. Peripheral neuropathy C. Claudication D. Ranaud's syndrome B. Peripheral neuropathy 144. What environmental emergency is life-threatening? A. Chilblains B. Heat exhaustion C. Heat stroke D. Frostbite C. Heat stroke 145. Where is the blood found during hemoptysis? A. Stool B. Esophagus 157. A 20 year old male struck his head on a diving board and is unconscious and apneic. Vital signs are BP 88/70, P 80. He has a large amount of swelling and deformity in the cervical spine area. What should you suspect? A. Increased intracranial pressure B. Cervical spine injury C. Cerebral contusion D. Hypovolemic shock B. Cervical spine injury 158. A 55 year old male was pulled from a burning building. He has difficulty breathing and is coughing. High flow oxygen does not provide relief. You are hearing bilateral wheezing the upper lobes of his lungs. What should you do? A. Obtain a set of vital signs. B. Insert an oropharyngeal airway. C. Administer nebulized albuterol. D. Administer 0.3 mg epinephrine 1:1000 SQ. C. Administer nebulized albuterol. 159. A man is threatening to beat his wife to death. The police have checked for weapons and called you to evaluate him. While interviewing the patient, what should you do? A. Keep him between yourself and the exit. B. Quickly expedite transport. C. Enter his personal space. D. Keep large furniture between him and you. D. Keep large furniture between him and you. 160. What is a contraindication of a traction splint? A. Potential spinal injury B. Pelvic fracture C. Signs of hypoperfusion D. Swelling or deformity to the thigh B. Pelvic fracture 161. A patient with AIDS vomited blood during transport. How should you disinfect your ambulance? A. Soak the mattress pad for 20 minutes in disinfectant, then let the mattress stand for 6 hours before use. B. Using universal precautions, spray a bleach-based cleaning solution and carefully wipe down the stretcher. C. Replace the mattress and throw out the sheets. D. Place the ambulance out of service until a full OSHA cleaning can be completed. B. Using universal precautions, spray a bleach-based cleaning solution and carefully wipe down the stretcher. 162. You are dispatched for a 78 year old person fallen. They have no complaints and are alert and oriented. They state they are unsure if they lost consciousness at any point. The patient takes metoprolol and atorvastatin. Vital signs: BP 130/84, P 88, R 16, SpO2 = 95%. The patient wants to refuse care. You should first: A. acquire a 12 lead ECG B. counsel the patient to accept transport C. repeat the vital signs D. complete a fingerstick glucose A. acquire a 12 lead ECG 163. What is the most effective way to terminate ventricular fibrillation? A. Defibrillation B. Cardioversion C. Chest compressions D. Amiodarone A. Defibrillation 164. A 36 year old male and his 34 year old wife complain of severe headaches, confusion, and dizziness. He also complains of chest pain. Both are short of breath. What type of poisoning should you suspect? A. Organophosphate B. Carbon dioxide C. Carbon monoxide D. Ammonia C. Carbon monoxide 165. When the vascular container enlarges without proportional increase in the fluid volume, what type of shock should you suspect? A. Hypovolemic B. Decompensated C. Cardiogenic D. Distributive D. Distributive 166. You need to perform a needle cricothyrotomy for transtracheal jet ventilation on an adult patient. What is the smallest catheter that is recommended for use? A. 16ga. B. 12ga. C. 18ga. D. 14ga. A. 16ga. 167. A patient has been taking pain medication for several months. To maintain the desired effect, they must periodically increase his dose. What is this known as? A. Cumulative effect B. Tolerance C. Synergism D. Additive effect B. Tolerance 168. A 70 year old male with a history of CHF complains of severe dyspnea. During transport his SpO2 drops to 76% and he starts to cough up pink sputum. What should you do? A. Assist his ventilations B. Increase the flow of oxygen C. Administer 40mg of Lasix IVP D. Perform a 12 lead EKG A. Assist his ventilations 169. A 47 year old, 98 kg male has burns on 25% of his body. In the first 8 hours post-burn, what fluid treatment should he recieve? A. 9800 ml of normal saline (NS). B. 4900 ml of normal saline (NS). C. 4900 ml of lactated ringers (LR). D. 9800 ml of lactated ringers (LR). C. 4900 ml of lactated ringers (LR). 170. What is the correct dosage of ipratropium bromide during an asthma attack? A. 0.3-0.5 mg, subcutaneously B. 250 mg, by nebulizer C. 0.5 mg, by nebulizer D. 0.25 mg, subcutaneously C. 0.5 mg, by nebulizer 171. What structure contains the respiratory center of the brain? A. Cerebrum B. Cerebellum C. Pons D. Medulla D. Medulla C. Normal vital signs D. Rapid, bounding pulse A. Delayed capillary refill 183. On arrival of a motor vehicle crash, what degree of scene assessment needs to be completed? A. 90 degrees from the front of the car B. 180 degrees of the patient C. 360 degrees of the scene D. 220 degrees from side of approach C. 360 degrees of the scene 184. What is the pathophysiological reason behind severe joint and abdominal pain in a patient with Drepanocytosis? A. Inflammatory reaction from arthritis B. Vascular occlusion from abnormal shaped cells C. Severe infection involving his appendix D. Microvascular occlusion from nitrogen bubbles B. Vascular occlusion from abnormal shaped cells 185. What is the role of angiotensin II in the body? A. Inhibits the creation of aldosterone increasing blood pressure. B. Stimulates the creation of aldosterone increasing blood pressure. C. Stimulates the creation of aldosterone decreasing blood pressure. D. Inhibits the creation of aldosterone decreasing blood pressure. B. Stimulates the creation of aldosterone increasing blood pressure. 186. A 38 year female is in labor in her car. This is her fourth child, contractions last 30 seconds and occur every 1-2 minutes. What should you do? A. Tell her to bear down hard and to push. B. Call for air medical transport. C. Move her to the ambulance and prepare for delivery. D. Transport the patient to the hospital for treatment. C. Move her to the ambulance and prepare for delivery. 187. A 62 year old man is unresponsive 5 minutes into his dialysis treatment. He has snoring respirations. Pulses are weak and you are unable to obtain a blood pressure. ECG reveals a wide-complex idioventricular rhythm at a rate of 50. What should you do? A. Administer calcium chloride B. Check his blood glucose C. Start CPR D. Cardiovert at 360J A. Administer calcium chloride 188. An alert 18 year old female is trapped in her car after a single car crash. She complains of hip and left leg pain. When she is finally extricated from the car, her vital signs decrease. What stages of shock is she transitioning from? A. Decompensated to hypovolemic B. Compensated to decompensated C. Decompensated to compensated D. Neurogenic to hypovolemic B. Compensated to decompensated 189. What is the name of the tracheal ring that sits directly inferior to the larynx? A. Cuneiform cartilage B. Cricoid cartilage C. Thyroid cartilage D. Corniculate cartilage B. Cricoid cartilage 190. What condition is caused by twisting of the spermatic cord, resulting in a sudden onset of severe scrotal pain? A. Epididymitis B. Urinary calculi C. Priapism D. Testicular torsion D. Testicular torsion 191. At a mass gathering several hundred people suddenly began to experience severe salivation, lacrimation, urination, and vomiting. What should you do? A. Set up a command post and ensure scene safety. B. Alert the Center for Disease Control. C. Contact the Department of Homeland Security. D. Evacuate all of the patients from the premises. A. Set up a command post and ensure scene safety. 192. A 88 year old female has acute onset of diplopia, slurred speech, difficulty swallowing, and unilateral facial drooping. What should you suspect? A. Bacterial meningitis B. An ischemic stroke C. A subdural hematoma D. A postictal state B. An ischemic stroke 193. A 13 year old has been found unresponsive on her bedroom floor. She has shallow respirations at four-times-a-minute, unobtainable radial pulse, pinpoint pupils, and a slow carotid pulse. Her mother provides you with a prescription bottle labeled morphine. Assisted ventilations are started with a bag- valve mask and an IV has been established. What medication would benefit this patient the most? A. Lidocaine B. Atropine C. Naloxone D. Epinephrine C. Naloxone 194. Which of the following is the MOST common cause of airway obstruction? A. Trauma B. The tongue C. Laryngeal spasm D. Foreign bodies B. The tongue 195. What contains detailed information about all potentially hazardous substances found in a workplace? A. MSDS B. Placards C. NFPA labels D. UN number signs A. MSDS 196. What ion plays a major role in regulating the distribution of water in the body? A. Magnesium B. Calcium C. Sodium D. Potassium C. Sodium 197. After initial treatments of an arterial bleed in the left forearm are unsuccessful. What should you do? A. Apply pressure to the radial artery. B. Apply a tourniquet. C. Apply pressure to the subclavian artery. D. Lower the extremity. B. Apply a tourniquet. 198. What complication may occur as a result of incomplete delivery of the placenta? A. Uterine rupture B. Chronic urinary tract infections C. Disseminated intravascular coagulation D. Postpartum vaginal hemorrhage C. Disseminated intravascular coagulation 210. An 18 year old male presents with symptoms of hypoglycemia. What criteria must be met for him to receive oral glucose? A. He must be conscious, with a patent airway. B. He must have a history of type 1 diabetes. C. He must have a prescription for oral glucose. D. His blood glucose analysis must be between 70 and 95 mg/dL. A. He must be conscious, with a patent airway. 211. A 41 year old female is bleeding profusely from an extremity wound. Vital signs are BP 78/40, P 130 and weak, R 22. After stopping the bleeding, what should you do? A. Reassess her vital signs. B. Begin rapid IV fluid replacement. C. Place her in the shock position. D. Apply a tourniquet above the wound. B. Begin rapid IV fluid replacement. 212. A 73 year old female complains of shortness of breath. While treating her, she stops breathing. What should you do? A. Ventilate with a BVM. B. Check her pulse. C. Start CPR. D. Perform orotracheal intubation. B. Check her pulse. 213. What process is involved in the formation of a blood clot? A. Tissue plasminogen activator creates fibrin B. Thrombin converts fibrinogen into fibrin C. Hemoglobin is converted to platelets D. Prothrombin stimulates the release of troponin B. Thrombin converts fibrinogen into fibrin 214. What is the inherent rate for the AV node? A. 150-250/min B. 20-40/min C. 60-100/min D. 40-60/min D. 40-60/min 215. Which of the following medications can produce anticholinergic effects. A. Epinephrine. B. Atropine sulfate. C. Etomidate. D. Nitroglycerin. B. Atropine sulfate. 216. How quickly should you expect a clot to form from a venous laceration? A. 1 minute B. 7-10 minutes C. 11-14 minutes D. 4-6 minutes D. 4-6 minutes 217. While assessing a 32 year old pregnant female, you discover fetal heart tones at 98 bpm. What should you do? A. Obtain a secondary set of vital signs B. Start a dopamine drip C. Turn to her left side and apply oxygen D. Administer atropine C. Turn to her left side and apply oxygen 218. A 42 year old female complains of tinnitus, nausea and vomiting. Her husband meets you at the door and states that he returned home this morning finding his wife and two children lying on the floor with nausea and headaches. What type of poisoning should you suspect? A. Severe randon gas B. Carbon monoxide C. Toxic black mold D. Hydrogen sulfide B. Carbon monoxide 219. A 30 year old female has recently given birth at home. During transport she has a sudden onset of shortness of breath and chest pain. Vital signs are BP 96/60, P 130, R 30, SpO2 92%. What should you administer? A. High-flow oxygen and a fluid bolus. B. Low-flow oxygen and tocolytic. C. A bronchodilator and perform a detailed exam. D. Nitroglycerin and obtain a 12 lead ECG. A. High-flow oxygen and a fluid bolus. 220. A 45 year old female has been sexually assaulted with a blunt object. She complains of diffuse abdominal pain, and her vital signs are BP 100/60, P 120, R 26. What should you suspect? A. Internal hemorrhage B. Ectopic pregnancy C. Prolapsed uterus D. Uterine cramping A. Internal hemorrhage 221. How should you manage the airway of an unconscious 55 year old male with snoring respirations? A. Head-tilt/chin-lift maneuver B. Endotracheal intubation C. Modified jaw-thrust maneuver D. Sellick's maneuver A. Head-tilt/chin-lift maneuver 222. Lead aVR is often discounted. What is the significance of ST elevations in this lead? A. Old STEMI B. Proximal LMCA occlusion C. No significance D. Significant lateral MI B. Proximal LMCA occlusion 223. In which factor of clotting physiology are the clotting proteins, platelets, and red blood cells "washed out" of the vascular space through ongoing hemorrhage? A. Medication B. Hemodilution C. Hypothermia D. Acidosis B. Hemodilution 224. A patient vomits blood onto your uniform at the hospital. Your service has no more ambulances available. What should you do? A. Alert dispatch that you are out of service for the next 6 hours. B. Rinse your uniform out in the sink and notify dispatch of your location. C. Wash your uniform only if your patient had a communicable disease. D. Thoroughly clean yourself, the ambulance and don a pair of scrubs. D. Thoroughly clean yourself, the ambulance and don a pair of scrubs. 225. During transport a 32 year old pregnant female tells you the baby is coming. You look and see two feet at the vaginal canal. What should you do? A. Apply fundal pressure and prepare for a breech delivery. B. Direct your partner to pull over and come back to assist you. C. Tell her to pant and have your partner begin rapid transport. D. Apply oxygen and place her in a knee-chest position. D. Apply oxygen and place her in a knee-chest position. C. Schizophrenia D. Bi-polar disorder C. Schizophrenia 236. Which structure separates the upper airway from the lower airway? A. Hyoid bone B. Trachea C. Carina D. Vocal cords D. Vocal cords 237. What is the antidote for Verapamil overdose? A. Benadryl B. Calcium C. Glucagon D. Narcan B. Calcium 238. Which of the following is NOT a communicable disease? A. Cancer B. Hepatitis B C. Tuberculosis D. HIV/AIDS A. Cancer 239. A 20 year old female has burns on her chest, abdomen, and on the anterior side of her right arm. What percentage of body is burned? A. 18% B. 22.5% C. 40.5% D. 27% B. 22.5% 240. You find a patient in the tripod position. What should you suspect? A. A cardiac emergency B. Gastrointestinal distress C. Respiratory distress D. A transischemic attack C. Respiratory distress 241. After the birth of male child, you note he is blue all over, is not breathing, and has no pulse. What is his APGAR? A. 5 B. 8 C. 0 D. 2 C. 0 242. A 20 year old male struck his head while jumping into a swimming pool. He is unconscious and apneic. Vital signs are BP 88/70, P 80. There is a large amount of swelling and deformity in the cervical spine area. What should you do? A. Use the head tilt/chin lift to open his airway B. Administer oxygen via non-rebreather mask C. Secure him to a long spineboard D. Apply and inflate MAST C. Secure him to a long spineboard 243. How should you dispose of dressings and bandages that are saturated with blood? A. A cardboard box and sealed with tape B. In any normal garbage container C. In a red bag with a bio hazard seal D. At a hospital ED trash container C. In a red bag with a bio hazard seal 244. A 43 year old male complains of a stiff neck, persistent cough, and fever for the past week. He states he has been in and out of homeless shelters for the past 5 months. What should you do? A. Apply oxygen by non-rebreather mask. B. Put on eye protection and a surgical mask. C. Have the patient wear a HEPA mask. D. Use gloves, gown, and HEPA mask. D. Use gloves, gown, and HEPA mask. 245. What medical term describes wheals on the skin during an allergic reaction? A. Urticaria B. Angioedema C. Pruritus D. Myxedema A. Urticaria 246. What are the 5 variables needed to interpret cardiac rhythms? A. Rate, regularity, QRS width, P waves, and P-R interval B. Rate, irregularity, U wave, P waves, and P-R interval C. Rate, regularity, ST segment, QRS width, and T waves D. Rate, regularity, QRS width, ST segment, and P-R interval A. Rate, regularity, QRS width, P waves, and P-R interval 247. A 42 year old male complain of hives and itching on his lower right leg immediately after mowing the lawn. Vital signs are BP 146/84, P 92, R 16. What should you suspect? A. Anaphylaxis B. Allergic reaction C. Eczema D. Insecticide poisoning B. Allergic reaction 248. A 25 year old female is in labor and reports an urge to push. Suddenly her contractions weaken. You should suspect: A. uterine rupture B. false labor C. uterine inversion D. placenta previa A. uterine rupture 249. An 27 year old male suffered a partial amputation of his foot in a farming accident. Bleeding is controlled. He is alert and oriented but refuses treatment. He speaks directly with online medical control but still refuses treatment and transportation. What should you do? A. Call law enforcement for an assisted transport. B. Carefully obtain and document the patient's refusal. C. Assume implied consent and transport the patient. D. Call social services and report suspicions of neglect. B. Carefully obtain and document the patient's refusal. 250. An unresponsive 35 year old female has been stabbed in the abdomen. She flexes her arms when you establish an IV and mumbles incomprehensible words, but her eyes remain closed. Respirations are 8-10 times per minute. How should you protect her airway? A. Nasal airway B. Endotracheal tube C. Head tilt chin lift D. Oropharyngeal airway B. Endotracheal tube 251. What does S-T segment elevation greater than 0.1 mV in at least two contiguous leads indicate? A. Active ischemia B. Unstable angina C. A Mobitz II heart block D. A myocardial infarction D. A myocardial infarction C. Administer ondansetron D. Administer morphine B. Administer aspirin 263. What medication is an appropriate treatment for anaphylaxis? A. Nitroglycerin B. Epinephrine C. Naloxone D. Albuterol B. Epinephrine 264. The spread of an electrical impulse through the ventricles that normally measures 0.08-0.12 seconds in length is represented on an ECG as the A. QRS complex. B. T wave. C. P wave. D. Atrial complex. A. QRS complex. 265. What should you do when you suspect child abuse? A. Question the parent about the events leading to the injury. B. Remove the child from the abuser's care. C. Confirm your suspicions of abuse. D. Report your suspicions to the appropriate authorities. D. Report your suspicions to the appropriate authorities. 266. What type of pain allows an examiner to pinpoint the area of irritation? A. Somatic B. Visceral C. Referred D. Parietal A. Somatic 267. What class of medication causes the uterus to contract? A. Antipyretics B. Oxytocics C. Antihistamines D. Steriods B. Oxytocics 268. What is the innermost layer of the heart? A. Hypercardium B. Endocardium C. Myocardium D. Epicardium B. Endocardium 269. A 25 year old female is found lying in the shrubs on a college campus. Her clothing is torn and she is covered in dirt. She does not remember how she got there and cannot answer all of your questions. What should you do? A. Perform a detailed assessment B. Check her blood glucose C. Call for police assistance D. Notify her parents C. Call for police assistance 270. A 57 year old male complains of bleeding with defecation. He claims no significant medical history, has had no recent illness, and takes no medications. What should you suspect? A. Pancreatitis B. Viral gastroenteritis C. Ulcerative colitis D. Cholecystitis C. Ulcerative colitis 271. Where in the respiratory system does gas exchange occur? A. Alveoli B. Bronchioles C. Pharynx D. Larynx A. Alveoli 272. What is the study of the drug receptor interaction called? A. Pharmacology B. Physiology C. Pharmacodynamics D. Pharmacokinetics C. Pharmacodynamics 273. What are the primary ions involved in action potential synthesis and transmission? A. K+, Na+, Hg+++ B. Na+, K+, Ca++ C. Ca++, Na+ D. Ca++, H+ B. Na+, K+, Ca++ 274. An 80 year old male is confused and in his apartment on a hot summer day. Vital signs are BP 80/P, P 132 and regular, R 40 and shallow, skin is hot and dry. What should you suspect? A. Heatstroke B. Hypoglycemia C. Heat exhaustion D. Dementia A. Heatstroke 275. What will initial compensatory mechanisms do during hemorrhaging? A. Decrease respiratory rate and increase heart rate. B. Increase stroke volume and increase cardiac output. C. Increase cardiac output and reduce mean arterial pressure. D. Decrease peripheral vascular resistance and increase respiratory rate. B. Increase stroke volume and increase cardiac output. 276. What molecule are ketone bodies metabolized from? A. Carbohydrates B. Lipids C. Glycogen D. Proteins B. Lipids 277. What neural signal prevents the lungs from overinflating? A. Crutzfelts-Jacobs reflex B. Epstein-Barr reflex C. Frank-Starling reflex D. Hering-Breuer reflex D. Hering-Breuer reflex 278. A 72 year old female woke with dyspnea. Crackles are audible to her scapulae bilaterally. She is coughing frothy pink sputum. Vital signs are BP 158/98, P 128, R 8. What should you do to improve her minute volume? A. Administer nitroglycerin 0.4 mg sublingual B. Administer furosemide 1 mg/kg IV at 20 mg/min C. Intubate and ventilate with a BVM D. Provide oxygen by non-rebreather mask C. Intubate and ventilate with a BVM 279. A 55 year old female was in a motor vehicle crash. She starts vomiting while you attempt to nasotracheally intubate her. What should you do? A. Remove the tube and use an ET tube. B. Auscultate breath sounds over the lungs and epigastrium. A. Neuromuscular blocking agent 291. What is the first sign of decompensated shock? A. A decrease in blood pressure B. A decrease in body temperature C. A decrease in mental status D. A decrease in respiratory rate C. A decrease in mental status 292. You are completing your patient care report and cannot remember the correct spelling of a medical term. What should you do? A. Attempt the correct spelling. B. Use plain English instead. C. Cross out the sentence. D. Make up an abbreviation. B. Use plain English instead. 293. A 28 year old female is 30 weeks pregnant with twins. Her water has broken and she feels like she has to move her bowels. The nearest hospital is 40 miles away. A medical helicopter is responding but is 45 minutes from your location. What should you do? A. Load and go and deliver the babies en route B. Call for an additional ambulance C. Prepare for imminent delivery D. Administer brethine and wait for the helicopter C. Prepare for imminent delivery 294. A patient has been struck by lightning. You should be most concerned that the electrical current caused him to do which of the following? A. Become apneic B. Suffer circumferential burns C. Develop respiratory alkalosis D. Suffer brain damage A. Become apneic 295. Where should you perform a surgical airway? A. At the larynx superior to the hyoid bone. B. Superior to the thyroid cartilage. C. Caudally and at an angle to the cricoid cartilage. D. Midline through the cricothyroid membrane. D. Midline through the cricothyroid membrane. 296. What abdominal complaint is MOST concerning? A. Pain that is relieved by rocking or movement. B. A sudden, tearing pain. C. Pain that increase with eating. D. A dull, gradual-onset pain. B. A sudden, tearing pain. 297. A 73 year old female is her left side and responsive only to pain. You note a fruity odor on her breath. Her blood glucose is 431 mg/dL. Vital signs are BP 96/80, P 120, R 44. What should you administer? A. Furosemide B. Sodium bicarbonate C. Normal saline D. Diazepam C. Normal saline 298. Which cells within the islets of Langerhans produce the hormone insulin? A. Beta B. Delta C. Gamma D. Alpha A. Beta 299. A 46 year old male was struck in the eye with a racquet ball. He complains of eye pain, cheek pain and bleeding from one nostril. Upon exam his eye will move side to side but not up or down. What should you suspect? A. Le fort II Fracture B. Orbital blow-out fracture C. Le fort I Fracture D. Le fort III Fracture B. Orbital blow-out fracture 300. A 6 year old boy was struck by a car and thrown 30 feet. His skin is pale. He is unconscious and unresponsive to painful stimulus. Vital signs are BP 80/30, P 160, R 60 and shallow. Which of the following best describes his condition? A. Decompensated shock with respiratory distress B. Compensated shock with respiratory distress C. Decompensated shock with respiratory failure D. Compensated shock with respiratory failure C. Decompensated shock with respiratory failure 301. What classification is give to drugs that have accepted medical indications but a high abuse potential that may lead to physical or psychological dependence? A. Schedule II B. Schedule III C. Schedule IV D. Schedule V A. Schedule II 302. The end tidal CO2 detector is reading 0 mmHg after endotracheal intubation. Where does this indicate your tube has been placed? A. Left mainstem bronchus B. Esophagus C. Trachea D. Right mainstem bronchus B. Esophagus 303. A 50 year old male complains of light headedness and chest discomfort. Vital signs are BP 100/86, P 40, R 16. An ECG reveals a second degree type I AV block. What should you do? A. Start transcutaneous pacing B. Administer atropine C. Administer amiodarone D. Start a dopamine drip B. Administer atropine 304. Which of the following hormones affects the body's biological clock? A. Calcitonin B. Cortisol C. Melatonin D. Aldosterone C. Melatonin 305. Your successfully placed Endotracheal tube with a capnometry of 29 suddenly decreases to 4. What method would you use to determine the cause? A. LEMONS B. MOANS C. RODS D. DOPE D. DOPE 306. When communicating via the radio to your receiving hospital, it is common practice to use the "echo procedure." This procedure A. ensures that only the important facts have been communicated. B. confirms accurate reception and understanding. C. eliminates the use of words that are difficult to understand during the transmission.. D. conforms to HIPPA by protecting the patient's privacy. C. Increase the heart rate and decrease stroke volume. D. Decrease the heart rate and increase stroke volume. A. Decrease the heart rate and decrease stroke volume. 318. Firefighters pulled a 44 year old male from a burning house. His lips and nasal hairs are burnt. Vital signs are BP 160/90, P 98, R 32, SaO2 94%. What should you do? A. Insert a combitube B. Insert an oropharyngeal airway C. Endotracheally intubate D. Ventilate using a bag-valve-mask C. Endotracheally intubate 319. A patient with a history of sickle cell disease states he is in another crisis. You should A. administer a benzodiazepine hypnotic. B. assist the patient in taking his own pain medication. C. start a large bore IV and administer 20 mL/kg. D. administer high-flow oxygen and transport. D. administer high-flow oxygen and transport. 320. A 13 year old unconscious male and a 15 year old conscious female were in a motor vehicle collision. What should you do? A. Assess and treat only after a police officer gives you permission. B. Wait to treat both of the patients until you obtain parental consent. C. Wait to assess the 13 year old until a parent arrives. D. Treat the 13 year old under implied consent. D. Treat the 13 year old under implied consent. 321. After fertilization of an egg, where will embryo develop and mature? A. Cervix B. Fallopian tube C. Uterus D. Vagina C. Uterus 322. A 56 year old female is developing neurologic abnormalities during her hemodialysis. What should you suspect? A. Hypotension B. Acute myocardial infraction C. Hyperglycemia D. Accumulated blood urea D. Accumulated blood urea 323. What disease involves inflammation followed by demyelination of the brain and spinal cord nerve fibers? A. Alzheimer's disease B. Myasthenia gravis C. Muscular dystrophy D. Multiple sclerosis D. Multiple sclerosis 324. What is the medical term for decreased or a lack of urine production? A. Anuria B. Hematuria C. Polyuria D. Oliguria A. Anuria 325. What happens to hemoglobin when the blood is more acidic? A. Binds carbon dioxide B. Releases oxygen C. Binds oxygen D. Releases carbon dioxide B. Releases oxygen 326. How can persistent fetal circulation be triggered? A. Induced labor B. Hypothermia C. A hypovolemic state D. Alkalosis caused by maternal drug use B. Hypothermia 327. Which neurotransmitter is found in the post ganglionic synaptic terminals of the sympathetic nerves? A. Acetylcholine B. Serotonin C. Norepinephrine D. Gamma-aminobutyric acid C. Norepinephrine 328. A 76 year old nursing home patient needs weight based medication. The transfer papers say the patient weighs 154 lbs. How many kilograms does the patient weigh ? A. 308 B. 70 C. 80 D. 67 B. 70 329. What is a typical dose for Ativan for seizures? A. 200 mcg IV B. 2 g IV C. 2 gr IV D. 2-4 mg IV D. 2-4 mg IV 330. A 72 year old female overdosed on Norvasc (amlodipine) four hours ago. Vital signs are BP 70/50, P 40, R 20. What should you do? A. Dopamine drip B. Calcium chloride IV bolus C. Normal saline bolus D. Start transcutaneous pacing D. Start transcutaneous pacing 331. A 19 year old female gives birth to a baby boy. You note blue extremities and a pink trunk. His pulse is 108 and he cries weakly. He grimaces when you suction him, but other movement is limited. What is his APGAR score? A. 4 B. 8 C. 6 D. 2 C. 6 332. Why is the electrical impulse slightly delayed at the AV node? A. To allow the primary cardiac pacemaker to reset. B. To allow the bundle of His can depolarize fully. C. So the atria can empty into the ventricles. D. So the ventricles can contract completely. C. So the atria can empty into the ventricles. 333. What is inflammation of the membranes surrounding the brain called? A. Meningitis B. Encephalitis C. Aneurysm D. Hydrocephalis A. Meningitis 334. A 66 year old female has shortness of breath and diffuse back pain. Auscultation of lungs reveal crackles in the bases. Vital signs are BP 170/110 and P 112. What should you do administer? A. Furosemide A. Administer diphenhydramine. 345. You arrive on the scene of a three-car motor vehicle collision. Two of the cars have major damage and some debris is scattered in the roadway. What should you do? A. Immediately begin triage of the injured patients. B. Call your supervisor to provide incident command. C. Contact your dispatch and request more ambulances. D. Ensure your vehicle is parked out of oncoming traffic. D. Ensure your vehicle is parked out of oncoming traffic. 346. When should continuous positive airway pressure (CPAP) be discontinued? A. Patient develops hypotension B. Patient has crackling lung sounds C. Patient's symptoms are resolved D. Patient is wheezing A. Patient develops hypotension 347. The body will not tolerate an acute blood loss of greater than ________ of blood volume. A. 30% B. 10% C. 20% D. 40% D. 40% 348. A 40 year old female has chronic bronchitis and has a productive cough of white sputum. She also has JVD, peripheral edema, and hypercapnia. An ECG shows an increase P wave amplitude. What else should you suspect? A. Emphysema B. Asthma C. Picwickian Syndrome D. Cor Pulmonale D. Cor Pulmonale 349. A 29 year old male was an unrestrained driver of a car crash. Vital signs are BP 114/98, P 136 and weak, R 28 and shallow. He has jugular vein distension and breath sounds are equal bilaterally. Heart sounds are very distant. What should you suspect? A. Pericardial tamponade B. Hemothorax C. Tension pneumothorax D. Simple pneumothorax A. Pericardial tamponade 350. A 28 year old 32 week gestation patient complains of severe hand pain and deformity after slamming it in a car door. Vital signs are BP 110/70, P 80, R 14. In what position should you transport her? A. Left lateral B. Supine C. Prone D. Sim's position A. Left lateral 351. Which cranial nerves are involved in the cardinal positions of gaze? A. I, III, and IV B. VI, VII, and X C. III, IV, and VI D. I, III, and VI C. III, IV, and VI 352. A 45 year old male was submerged in a lake for 1-2 minutes. The outside temperature is 45 degrees. He is pulseless and apneic. What is your primary concern? A. Laryngeal spasm B. Asphyxia C. Pulmonary edema D. Hypothermia B. Asphyxia 353. For what medical condition is metformin prescribed? A. Type II diabetes mellitus B. Diabetic ketoacidosis C. Diabetes insipidus D. Type I diabetes melitus A. Type II diabetes mellitus 354. A 16 year old unconscious male was pulled from a swimming pool. What should you do? A. Assess for a carotid pulse B. Clear the his airway of aspirated water C. Stabilize his c-spine D. Ensure an open airway and assess breathing A. Assess for a carotid pulse 355. Which of the following causes unilateral paralysis of cranial nerve VII? A. Autonomic dysreflexia B. Bell's palsy C. Myoclonus D. Dystonia B. Bell's palsy 356. A 19 year old female with head trauma has hypertension, bradycardia, Cheynes-Stokes respirations and withdraws from pain. Which area of the brain is likely affected? A. Temporal lobe B. Medulla C. Cerebellum D. Hypothalamus B. Medulla 357. List all regions of human vertebral column. A. Intervertebral, coccyx, lumbar, thoracic. B. Cervical, thoracic, lumbar, sacral, coccygeal, coccyx. C. Cervical, thoracic, lumbar, sacral, coccygeal. D. Cervical, thoracic, lumbar, coccygeal, coccyx C. Cervical, thoracic, lumbar, sacral, coccygeal. 358. What is one of the best ways to minimize anxiety during a physical examination? A. Drive slowly to the hospital. B. Warm your hands and instruments prior to their use. C. Keep the patient's clothes on. D. Use a calm, professional demeanor. D. Use a calm, professional demeanor. 359. What effect does AIDS have on the body's immune system? A. It mutates into pneumonia. B. It changes the function of erythrocytes. C. It causes HIV to replicate and spread. D. It suppresses the T cell function. D. It suppresses the T cell function. 360. You are treating a hypotensive woman who weighs 212 lbs. You have been ordered to give her a Dopamine drip at 9 mcg/kg/min. Your ambulance service carries 250cc bags. How much dopamine would you mix in the bag to reach a dilution of 1600 mcg/mL? A. 200mg B. 800mg C. 1000mg D. 400mg D. 400mg 361. A 28 year old female is complaining of gradual-onset dyspnea after being released from the hospital. She was hospitalized for 1 day following thoracic trauma and a lung contusion. Lung sounds present with crackles in both bases. Vital signs are BP 130/80, P 110, R 32 shallow, SpO2: 88%. You should C. 25 373. Wolf Parkinson White syndrome originates from accessory pathways in what part of the heart? A. Purkinje fibers B. Bundle Branch C. Bundle of Kent D. Bundle of His C. Bundle of Kent 374. A 45 year old male has been injured in a house fire and has burnt nasal hairs. He also makes high- pitch noises with inspiration. How are these respirations defined? A. Wheezing B. Snoring C. Stridor D. Rhonchi C. Stridor 375. What is a high pitched noise heard during inspiration in a partial airway obstruction? A. Cough B. Dyspnea C. Stridor D. Dyphonia C. Stridor 376. What is the normal arterial pO2 level at sea level? A. 80-100 mmHg B. 60-80 mmHg C. 40-60 mmHg D. 100-120 mmHg A. 80-100 mmHg 377. Your patient has a small, sucking puncture wound on the right side of his chest. How should you dress the wound? A. Moist gauze. B. Roller gauze. C. An occlusive dressing. D. Butterfly bandages. C. An occlusive dressing. 378. Which of the following is the first sign of shock that usually appears in patients? A. Altered mental status B. Nausea and vomiting C. Changes in vital signs D. Pale, cool, and clammy skin A. Altered mental status 379. A patient has lost 800 mL of blood. Vital signs are BP 110/80, P 100, R 24. Which class of hemorrhagic shock are they experiencing? A. Class 2 B. Class 3 C. Class 1 D. Class 4 A. Class 2 380. What should you do to control post-delivery bleeding? A. Massage gently over her uterus. B. Squeeze her legs together. C. Place her in the recovery position. D. Place moist dressings in her uterus. A. Massage gently over her uterus. 381. What is the painless, progressive enlargement of tissue found mainly in the lymph nodes and spleen known as? A. Leukemia B. Polycythemia C. Hemolytic anemia D. Hodgkin's disease D. Hodgkin's disease 382. Why do you administer epinephrine to a patient in cardiac arrest? A. Increased rate of conduction. B. Increased blood flow to the heart and brain. C. Increased contractility of cardiac muscle. D. Increased bronchodilation. B. Increased blood flow to the heart and brain. 383. A 25 year old female has bruising and swelling to the left side of her throat. Subcutaneous emphysema and cyanosis are present. What should you suspect? A. Pneumothorax B. A ruptured esophagus C. Esophageal varices D. A tracheal tear D. A tracheal tear 384. What is the coarse sound of fluid movement heard on inspiration called? A. Rhonchi B. Snoring C. Crackles D. Gurgling A. Rhonchi 385. What is the process that causes a solute to move from a gradient of greater concentration to lower concentration called? A. Active transport B. Facilitated diffusion C. Osmosis D. Diffusion D. Diffusion 386. Which is an alkaloid blood pH? A. 7.45 B. 7.35 C. 7.30 D. 7.25 A. 7.45 387. Which anacronym is used to predict a difficult endotracheal intubation? A. LEMONS B. MOANS C. RODS D. SHORT A. LEMONS 388. Why do patient refusals require more documentation than the typical EMS call? A. A greater set of differential diagnoses needs to be noted as the patient was left untreated. B. There is greater potential for abandonment charges. C. There are additional witnesses that must be quoted. D. You need to note the interventions you would have performed had they given consent. B. There is greater potential for abandonment charges. 389. HIPAA legislation relates primarily to which medicolegal issue? A. Abandonment B. Consent C. Duty to act D. Confidentiality D. Confidentiality B. Place in position of comfort and apply oxygen by non-rebreather. C. Nasally intubate the patient and assist with his respirations using a BVM. D. Apply oxygen by non-rebreather and administer furosemide 40 mg IV. B. Place in position of comfort and apply oxygen by non-rebreather. 402. When assessing a supine patient involved in a motor vehicle collision, the patient complains of left should pain. This indicates: A. Grey Turner's sign B. Kehr's sign C. Murphy's sign D. Cullen's sign B. Kehr's sign 403. What will compromise your ability to develop rapport and trust with a patient? A. Using the patient's name as often as possible B. Speaking with a normal rate of speech C. Asking closed-ended questions D. Maintaining a calm appearance. C. Asking closed-ended questions 404. What are agonal respirations? A. Deep, rapid, and regular breaths. B. Shallow, slow, and irregular gasping breaths. C. Deep, very slow and irregular breaths. D. Shallow, rapid, and regular panting breaths. B. Shallow, slow, and irregular gasping breaths. 405. A 67 year old female is unconscious at the bottom of a flight of stairs. She responds to pain by stiffening her arms and legs but no external trauma is noted. Vital signs are BP 176/122, P 66, R 22 and irregular. What should you suspect? A. A lung injury B. Decompensated shock C. Hypovolemic shock D. A head injury D. A head injury 406. In asystole, what is the first medication you would administer? A. Lidocaine B. Sodium Bicarbonate C. Atropine D. Epinephrine D. Epinephrine 407. A 25 year old male attempted to commit suicide by taking 6 mg Lorazepam. What is your greatest concern? A. Circulatory alkalosis B. Agitated outbursts of anger C. Respiratory depression D. Hyperemesis C. Respiratory depression 408. Why are elderly trauma patients at risk for fluid overload and pulmonary edema as a result of intravenous therapy? A. Decreased chest wall compliance and movement B. Decreased baroreceptor sensitivity to pressure C. Decreased renal function and stroke volume D. Decreased chemoreceptor sensitivity C. Decreased renal function and stroke volume 409. What is the mechanism of action for amiodarone? A. Inhibits cardiac action potential in phase 0 B. Slows AV conduction transmittance C. Prolongs cardiac action potential in phase 3 D. Stabilizes all cardiac action potential membranes. C. Prolongs cardiac action potential in phase 3 410. Which of the following drugs is contraindicated in asthma patients? A. Digitalis B. Calcium Chloride C. Epinephrine D. Propranolol D. Propranolol 411. A 57 year old male with CHF has shortness of breath, coughing, and blood-tinged sputum. Vital signs are BP 140/88, P 86, R 28. What should you do? A. Aspirin, sublingual nitroglycerin, CPAP B. Morphine, aspirin, CPAP C. CPAP, morphine, intramuscular nitroglycerin D. Sublingual nitroglycerin, morphine, CPAP A. Aspirin, sublingual nitroglycerin, CPAP 412. What is status epilepticus? A. Two or more continuous seizures B. When the patient sees an aura prior to a seizure C. A seizure that occurs during a fever D. A seizure affecting one area of the body A. Two or more continuous seizures 413. A 60 year-old female presents with acute respiratory distress. She is conscious and confused with rapid respirations and clear, equal breath sounds. What should you do? A. Assist her respirations with a BVM. B. Provide oxygen via NRB mask. C. Use a nasal cannula at 2 L/min. D. Insert an oral airway adjunct. B. Provide oxygen via NRB mask. 414. Which complication of pregnancy can occur during the first trimester? A. Placenta previa B. Eclampsia C. Abortion D. Abruptio placenta C. Abortion 415. What blood type is the universal donor? A. A B. B C. O D. AB C. O 416. Which of the following receptors are responsible for monitoring changes in blood pressure? A. Reticular activating receptors B. Chemoreceptors C. Baroreceptors D. Carboxyhemoglobin receptors C. Baroreceptors 417. A 35 year old male has been electrocuted. What other life threat should you be prepared for? A. internal bleeding B. heat stroke C. cardiac arrest D. allergic reaction C. cardiac arrest 418. At the scene of a multiple vehicle accident, what should you do first? A. Treat the first patient you see B. Start triage 430. Which of the following behaviors may be considered abusive? A. Placing a child on "time-out" when they misbehave. B. Insisting a high school senior work a weekend job to earn money toward her college education. C. Placing a grandparent in nursing care when the burdens of extended care become unmanageable. D. Requiring a child to help out with chores around the house to earn their allowance. E. Withholding of asthma medication from a child who refuses to finish eating dinner. E. Withholding of asthma medication from a child who refuses to finish eating dinner. 431. When viewing a three channel cardiac monitor, leads I and II display artifact, and lead III shows a clear reading. Based on Einthoven's Triangle, you should A. monitor the patient by paddles. B. replace the right arm electrode. C. monitor only in lead III. D. discontinue cardiac monitoring. B. replace the right arm electrode. 432. Which structure in the kidney forms urine? A. Renal tube B. Renal medulla C. Nephron D. Renal cortex C. Nephron 433. A positive deflection on the ECG tracing paper indicates that the electrical impulse is A. traveling perpendicular to the lead. B. moving toward the negative electrode. C. non existent. D. moving toward the positive electrode. D. moving toward the positive electrode. 434. What condition results with the presence of an elevated intraocular pressure within the eye that can lead to vision loss? A. Strabismus B. Nystagmus C. Cataracts D. Glaucoma D. Glaucoma 435. What are written instructions expressing an individual's health care wishes in the event that they are incapacitated? A. Health care surrogates B. Medical practice directives C. Health care affidavits D. Advance directives D. Advance directives 436. A 25 year old male was found lying on the bottom of a pool. The lifeguard pulled him out and laid him beside the pool before calling EMS. He is unresponsive and not breathing. What should you do? A. Stabilize c-spine and assist his ventilations. B. Stabilize c-spine and intubate. C. Place the patient on his side and suction. D. Assist his ventilations with a BVM. A. Stabilize c-spine and assist his ventilations. 437. A 22 year old male hit a tree at a high speed and was thrown 20 feet. He has a rigid abdomen and you determine him to be in hypovolemic shock. Where is he most likely bleeding? A. Liver and kidney B. Spleen and pancreas C. Spleen and stomach D. Liver and spleen D. Liver and spleen 438. A 65 year old female complains of heart palpitations and dizziness after her dialysis. An ECG reveals peaked T waves and bigeminal PVCs. What should you suspect? A. Hyperkalemia B. Hypomagnesia C. Bundle branch block D. Hypercalcemia A. Hyperkalemia 439. Which of the following mechanisms of injury would likely result in coup-contrecoup trauma? A. A low-energy projectile. B. A front-impact motor vehicle collision. C. A fall from over 20 feet. D. Diving into shallow water. B. A front-impact motor vehicle collision. 440. A pregnant female has a grand mal seizure during active labor. What should you administer? A. Oxygen B. Valium C. Sodium bicarbonate D. Magnesium sulfate D. Magnesium sulfate 441. A 32 year old pregnant female complains of profuse vaginal bleeding. She denies any abdominal pain or discomfort. What should you suspect? A. Ruptured ovarian cyst B. Abruptio placenta C. Uterine rupture D. Placenta previa D. Placenta previa 442. When is it necessary to wear gloves, gown, mask, and protective eyewear? A. Assisting with a prehospital childbirth B. Oral suctioning on a tuberculosis patient C. Administering an IM injection to a MRSA patient D. Starting an IV on an AIDS patient A. Assisting with a prehospital childbirth 443. A 22 year old male complains of abdominal and joint pain following a dive. What should you suspect? A. Decompression sickness B. Pulmonary barotrauma C. Pneumomediastinum D. Tension pneumothorax A. Decompression sickness 444. A 34 year old female has a contusion above her left breast and left lateral torso after a motor vehicle collision. Vital signs are BP 102/64, P 96, R 18. During transport, her vital signs become BP 90/76, P 118, R 24. Breath sounds are absent on the left side. What should you do? A. Begin chest compressions B. Administer oxygen therapy C. Initiate IV therapy D. Decompress the chest D. Decompress the chest 445. An 18 year old female is found conscious and alert but trapped in her car after a single motor vehicle crash. The air bag deployed and she denies any head or neck pain, but she complains of hip and left leg pain. When your patient is finally extricated from the car, her vital signs begin to collapse. After starting a large bore IV of normal saline (NS), you should administer A. epinephrine. B. morphine sulfate. C. lidocaine. D. no other medication. D. no other medication. A. Supraventricular tachycardia with WPW 457. A 28 year old female has bilateral pelvic pain and yellow vaginal discharge. What should you suspect? A. Ruptured ovarian cyst B. Pelvic inflammatory disease C. Ectopic pregnancy D. An acute urinary tract infection B. Pelvic inflammatory disease 458. What buffer is used to maintain acid-base chemistry in the blood? A. Water B. Bicarbonate C. Chloride/sodium D. Sodium/potassium B. Bicarbonate 459. A 26 year old male scuba diver reports severe joint pain an hour after ascent. Vitals are: BP 110/68, P 60, R 14, and SpO2 100%. What should you do? A. Transport to a hyperbaric facility. B. Provide oxygen via a CPAP mask. C. Establish an IV to provide pain relief. D. Administer oxygen via an NRB. D. Administer oxygen via an NRB. 460. What specialized bands of tissue are inserted between myocardial cells that increase the rate of cellular conduction? A. Purkinje system B. Intercalated discs C. Atrial syncytium D. Internodal paths B. Intercalated discs 461. A 45 year old female with a 10 year cardiac history complains of severe dyspnea. She takes furosemide daily and has frothy sputum. Lung sounds reveal bilateral crackles. Vital signs are BP 90/70, P 56, R 32, SpO2 93%. What should you do? A. Begin rapid sequence intubation (RSI). B. Intubate and assist ventilations via bag-valve mask. C. Assist her respirations and administer nitroglycerin. D. Initiate CPAP and administer furosemide. C. Assist her respirations and administer nitroglycerin. 462. What is the generic name for Dilaudid? A. hydrochlorothiazide B. hydromorphone C. codeine D. hydrocodone B. hydromorphone 463. What is the responsibility of the Safety Officer? A. Collects hazard and risk data for documentation B. Supports operations C. Monitors the scene for potential hazards D. Alerts media regarding hazards to the community C. Monitors the scene for potential hazards 464. How is cardiac output calculated? A. Heart rate multiplied by stroke volume. B. Heart rate divided by stroke volume. C. Heart rate added to stroke volume. D. Stroke volume divided by heart rate. A. Heart rate multiplied by stroke volume. 465. What condition is NOT commonly associated with sickle cell anemia? A. Excessive bleeding B. Renal disease C. Musculoskeletal pain D. Abdominal pain A. Excessive bleeding 466. What is a form of off line or indirect medical control signed by the medical director? A. Medical direction B. Advanced directive C. Protocol D. Standing order D. Standing order 467. You find a critically injured female in single vehicle automobile collision on a rural road. What additional resource should you mobilize? A. Local sheriff B. A second ambulance C. A rescue squad D. Air medical transport D. Air medical transport 468. An alert 65 year old male speaks in 2 word dyspnea. He has a 10 year cardiac history. Lung sounds reveal crackles in the bases with expiratory wheezing. Vital signs are BP 140/90, P 110, R 30. What should you do? A. Administer nitroglycerin B. Obtain IV access C. Acquire a 12 lead ECG D. Administer aspirin D. Administer aspirin 469. After several attempts at intubating a patient you are unsuccessful. What should you do? A. Insert an oral airway and ventilate using a bag-valve mask. B. Continue your attempts until you are too exhausted to continue. C. Provide high flow oxygen with a non-rebreather mask. D. Call medical control and request permission to stop the code. A. Insert an oral airway and ventilate using a bag-valve mask. 470. An 8 year old complains of severe lower leg pain. He was released from a local emergency room 8 hours ago following treatment for a closed tibia fracture. The whole lower leg is swollen, pale and has decreased sensation. What should you suspect? A. An acute arterial occlusion B. Compartment syndrome C. Ineffective immobilization D. An associated calf muscle strain B. Compartment syndrome 471. What is the most common cause of abdominal trauma? A. Gun shot wounds B. Multiple stab wounds C. Blunt trauma D. Motor vehicle crashes C. Blunt trauma 472. Which sound indicates an upper airway obstruction? A. Rales B. Wheezing C. Crackles D. Stridor E. Rhonchi D. Stridor 473. Where should you position your vehicle at a motor vehicle collision on the highway? A. 500 feet behind the patient's vehicle A. Cerebellum 485. A patient is trapped in a car with side to side rocking. What should you do? A. Extricate the patient B. Remove the steering wheel C. Stabilize the car D. Remove the roof C. Stabilize the car 486. A patient has excessive bleeding from the neck. What should you apply? A. A band-aid B. A tourniquet C. An occlusive dressing D. A pressure dressing D. A pressure dressing 487. A 59 year old female missed her weekly renal dialysis appointment. She is feeling weak and unable to care for herself. What should you suspect? A. Anemia B. Polyuria C. Fluid overload D. Hypokalemia C. Fluid overload 488. A 66 year old male complains of nausea and vomiting for the past day. He has been unable to eat any food as it causes his symptoms to worsen. He has pain that radiates from his stomach to his back. What should you suspect? A. Irritable bowel syndrome B. Gastroenteritis C. Actute MI D. Pancreatitis D. Pancreatitis 489. A 32 year old female is unconscious after being struck in the chest with a bat. Vital signs are BP 90/60, P 34, R 8. Her skin is cool, diaphoretic, and cyanotic. Breath sounds are absent and her trachea is deviated to the left. What should you suspect? A. Hemothorax B. Pneumothorax C. Flail chest D. Tension pneumothorax A. Hemothorax 490. It is 0300 and you respond to a person having a headache. There is no traffic on the road at this time. How should you respond? A. With lights and sirens. B. Expeditiously without lights and sirens. C. With lights only. D. Routine, without lights and sirens. A. With lights and sirens. 491. A 58 year old male complains of fever, nausea and blood tinged sputum for the past 3 weeks. He has bilateral rhonchi in all fields and says that it is difficult to catch his breath because he has been coughing so much. What should you do? A. Cover his face with a surgical mask B. Obtain a baseline set of vitals C. Administer a diuretic and apply oxygen D. Apply oxygen and start an IV A. Cover his face with a surgical mask 492. A 41 year old male has been injured in an explosion at a chemical laboratory. He has a ruptured tympanic membranes and sinus injuries. At what phase of the blast did the patient sustain the sinus injuries? A. Ultimate B. Primary C. Tertiary D. Secondary B. Primary 493. An alert 87 year old woman has peripheral cyanosis and complains of dyspnea. Vitals signs are BP 150/70, P 110, R 26. Suddenly she passes out on her sofa. What should you do? A. Insert a nasal airway and apply high flow oxygen. B. Check her airway for a FBAO. C. Position her airway using a modified jaw thrust maneuver. D. Use a head-tilt/chin-lift and assist her ventilations. D. Use a head-tilt/chin-lift and assist her ventilations. 494. What neurotransmitter is found in the synapse between the alpha or beta receptors and the postganglionic neuron? A. Norepinephrine B. Dopamine C. Adrenaline D. Acetylcholine A. Norepinephrine 495. A 38 year old male has been struck with a brick. His words are incomprehensible, and he has no eye opening or motor response. He has unequal pupils and has blood draining from his left ear. Vital signs are BP 178/110, P 58, R 8. What should you suspect? A. A narcotic overdose B. Subdural hematoma C. A basal skull fracture D. Hypovolemic shock C. A basal skull fracture 496. Which of the following patients should have the pneumatic anti-shock garment applied and inflated? A. 22 year old female gunshot wound to the flank, BP 84/44 B. 35 year old female blunt abdominal trauma, BP 180/90. C. 25 year old male head injury, apneic and tachycardia, BP 86/30 D. 16 year old male bilateral tibia and fibula fractures, BP 90/54 D. 16 year old male bilateral tibia and fibula fractures, BP 90/54 497. What mechanism does the body lose the majority of heat? A. Evaporation B. Conduction C. Convection D. Radiation D. Radiation 498. What is the expected breathing rate for a child under the age of eight? A. 10-20 breaths per min. B. 5-10 breaths per min. C. 20-40 breaths per min. D. 40-60 breaths per min. C. 20-40 breaths per min. 499. What level should EMS Professionals responding to high risk low incident rescues be trained? A. Operations B. Specialist C. Awareness D. Technical C. Awareness 500. What is an abnormal respiratory pattern characterized by deep, rapid breaths? A. Kussmaul's B. Cheyne-Stokes C. Ataxic (Biot's) D. Apneustic 512. You are treating a patient exhibiting signs and symptoms hypoglycemia. What hormones would you expect are being released in their body? A. Glucagon, epinephrine, cortisol B. Glucagon, ADH, oxytocin C. Cortisol, thyroxine, norepinephrine D. Insulin, epinephrine, ADH A. Glucagon, epinephrine, cortisol 513. What is the degree of skill and judgment that would be expected of a similarly trained, reasonable paramedic acting under similar circumstances is referred to as? A. Standard of care B. Professional standard C. Paramedic code D. Scope of practice A. Standard of care 514. What is the natural tendency of the body to maintain a steady and normal internal environment known as? A. Constant metabolism B. Positive feedback C. Homeostasis D. Osmosis C. Homeostasis 515. What blood type is known as the "universal recipient"? A. AB B. B C. A D. O A. AB 516. A 44 year old male complains of a headache. He states that there are too many people talking to him and asking him questions. He is agitated and confused. He states that "his friend," Martin is going to hurt you. You and your partner are alone. What should you do? A. Tell him to walk to the ambulance with you. B. Determine if he wants to hurt himself or you. C. Ask him why Martin is going to hurt you. D. Forcefully tell him to sit down on his hands. B. Determine if he wants to hurt himself or you. 517. A 34 year old male was involved in a car accident. He has significant facial trauma and is bleeding profusely from his mouth and nose. When performing your assessment, what findings are most indicative of neurological disorders? A. Changes in level of consciousness B. Tachycardia and hypotension C. Narrowing pulse pressure D. Head trauma A. Changes in level of consciousness 518. A carrier-mediated process that can move substances against a concentration gradient is defined as. A. Increased capillary permeability. B. Facilitated diffusion. C. Active transport. D. Diffusion. C. Active transport. 519. A 24 year old female was burned in a fire. She has third degree burns to her anterior chest, both her arms and hands, and burns to her face and head. What percentage of her body is burned? A. 27% B. 45% C. 18% D. 36% D. 36% 520. How should EMS units respond to violent situations to ensure safety? A. Remain away from the scene and have law enforcement bring the patient to you. B. Enter as quickly as possible because every patient needs prompt treatment. C. Enter the scene before law enforcement to avoid any potential confrontation. D. Remain away from the scene until law enforcement arrives and secures the scene. D. Remain away from the scene until law enforcement arrives and secures the scene 521. A 46 year old man is responsive to verbal stimuli after being stabbed. He has a bubbling wound to the left chest. His skin is cyanotic and diaphoretic. Vital signs are BP 108/76, P 120 and weak, R 10 and shallow. What should you suspect? A. Simple pneumothorax B. Tension pneumothorax C. Hemothorax D. Open pneumothorax D. Open pneumothorax 522. How should you alter your intubation technique for a 2 year old child? A. Do not hyperextend the neck as you visualize the vocal cords. B. Do not pre-oxygenate prior to beginning your intubation C. Insert the ET tube from the right side of the mouth. D. Insert the blade in the right side of the mouth instead of the left. A. Do not hyperextend the neck as you visualize the vocal cords. 523. What is the amount of blood ejected by the heart during one cardiac contraction known as? A. Stroke volume B. Cardiac cycle C. Ejection fraction D. Diastolic volume A. Stroke volume 524. A 22 year old female complained of a headache and collapsed suddenly. She has pinpoint pupils and withdraws from painful stimulus. She vomited once prior to your arrival. Vital signs are BP 190/126, P 60, R 36. What should you suspect? A. Hypoglycemia B. Grand mal seizure C. Hemorrhagic stroke D. Narcotic overdose C. Hemorrhagic stroke 525. An 11 year old male has been sick for two weeks and now has a distinct "whoop" sound after he coughs. What is the most likely cause? A. Bronchitis B. Meningitis C. Pertussis D. Tuberculosis C. Pertussis 526. A 24 year old male is lying supine and is unresponsive. You have opened his airway with a head- tilt/chin-lift maneuver and determined that he is apneic with a bradycardic pulse. You attempt to ventilate, but are unsuccessful. What should you do? A. Begin continuous chest compressions. B. Check for a carotid pulse. C. Reposition the airway and give 2 ventilations. D. Attempt to give 2 more forceful ventilations. C. Reposition the airway and give 2 ventilations. 527. Your ALS unit responds to a 55 year-old male complaining of chest pain and shortness of breath. Upon assessment, you find the patient has a rapid and regular narrow complex rhythm at a rate of 188 beats per minute. What is the correct treatment for this patient. A. Adenosine 6 mg IV Push B. Synchronized Cardioversion at 50-100 Joules